Granular cell tumor of the breast
Updates to Case Attributes
GanularGranular cell tumours were originally describedby Abrikossoff in 1926 and are usually found in themouth or skin but 6% occur in the breast. Up to 10% are multiple.
Incidence Incidence < 1 in a1000 breast masses
Occurs. Occurs from 20 – 80 butaround 40 years of age most common with slight preponderance in premenopausalblack women.
Usually less than30mm in size, and are most frequently found in the upper innerquadrant (supraclavicular nerve territory) followed by the axillary tail.
They They are a neuroendocrine tumourof perineural or Schwann cell origin that typically express S100 and CD68(KP-1).
At mammography - range from a round well-circumscribed mass, toan indistinct or spiculated lesion. Microcalcifications are not usually afeature.
At ultrasound, presentas solid, poorly marginatedlesions with marked posterior shadowing or as more benign-appearing well-circumscribedsolid masses. Lesion often have a reflective halo or are partially hyper-reflectivewhich is due its infiltrative growth pattern.
-<p>Ganular cell tumours were originally described-by Abrikossoff in 1926 and are usually found in the-mouth or skin but 6% occur in the breast. Up to 10% are multiple.</p>-<p>Incidence < 1 in a-1000 breast masses</p>-<p>Occurs from 20 – 80 but-around 40 years of age most common with slight preponderance in premenopausal-black women</p>-<p>Usually less than-30mm in size, and are most frequently found in the upper inner-quadrant (supraclavicular nerve territory) followed by the axillary tail. </p>-<p>They are a neuroendocrine tumour-of perineural or Schwann cell origin that typically express S100 and CD68-(KP-1)</p>-<p>At mammography - range from a round well-circumscribed mass, to-an indistinct or spiculated lesion. Microcalcifications are not usually a-feature.</p>-<p>At ultrasound, present-as solid, poorly marginated-lesions with marked posterior shadowing or as more benign-appearing well-circumscribed-solid masses. Lesion often have a reflective halo or are partially hyper-reflective-which is due its infiltrative growth pattern.</p>- +<p><a title="Granular cell tumours of the breast" href="/articles/granular-cell-tumour-of-the-breast">Granular cell tumours</a> were originally described by Abrikossoff in 1926 and are usually found in the mouth or skin but 6% occur in the breast. Up to 10% are multiple. Incidence < 1 in a 1000 breast masses. Occurs from 20 – 80 but around 40 years of age most common with slight preponderance in premenopausal black women.</p><p>Usually less than 30mm in size, and are most frequently found in the upper inner quadrant (supraclavicular nerve territory) followed by the axillary tail. They are a neuroendocrine tumour of perineural or Schwann cell origin that typically express S100 and CD68 (KP-1).</p><p>At mammography - range from a round well-circumscribed mass, to an indistinct or spiculated lesion. Microcalcifications are not usually a feature.</p><p>At ultrasound, present as solid, poorly marginated lesions with marked posterior shadowing or as more benign-appearing well-circumscribed solid masses. Lesion often have a reflective halo or are partially hyper-reflective which is due its infiltrative growth pattern.</p>
References changed:
- 1. Scaranelo A, Bukhanov K, Crystal P, Mulligan A, O'Malley F. Granular Cell Tumour of the Breast: MRI Findings and Review of the Literature. BJR. 2007;80(960):970-4. <a href="https://doi.org/10.1259/bjr/95130566">doi:10.1259/bjr/95130566</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/17940129">Pubmed</a>
- Granular cell tumour of the breast: MRI findings and review of the literature. The British Journal of Radiology, 80 (2007), 970–974
Systems changed:
- Oncology
Updates to Study Attributes
Macroscopy
An irregular firm stellate lesionlesion with white cut surface measuring 20 x 15 x18 mm.
Microscopy
Solid nests of cells, cords and sheets of cells withwith abundant eosinophilic granular cytoplasm, prominent nucleoli and moderate cellular atypia.
Polygonal, spindle-like cells resting in a hyaline, fibrous stroma.
The cells have distinct borders, small centrally to eccentrically placed nuclei, inconspicuous nucleoli and abundant eosinophilic cytoplasm. B
The cytoplasm contains numerous fine granules as well as scattered larger eosinophilic granules.
There is no evidence of nuclear pleomorphism, multinucleated cells or mitosis.
Stains and Immunohistochemistry
- DPAS positive
- Nuclear and cytoplasmic positivity for S100.
- Cytoplasmic staining for CD68, due to their
lysososmallysosomal activity. - Negative for Cytokeratins, HMB45 and
MelanAMelan-A
Image Pathology ( update )
Image Pathology ( update )
Image Pathology ( update )
Updates to Study Attributes
Breast assessment MRI was performed to further characterize the mass.
Image MRI ( update )
Image 1 MRI ( update )
Updates to Study Attributes
Vascular irregular mass had ultrasound-guided 14G needle core biopsy performed.
Image Ultrasound ( update )
Image 1 Ultrasound ( update )
Updates to Study Attributes
Spiculated mass overlying the left pectoral muscle that is better seen on an extended lateral film.
BIRADS R4 (Tabar/ Nottingham 4A4A) appearance at mammography, ultrasound and MR.
Biopsy result is a benign granular cell tumour that expresses S100(P2).
Tumour was surgicalsurgically resected and the patient was reassured.
Image Mammography (MLO) ( update )
Image Mammography (MLO) ( update )
Image Mammography (CC) ( update )
Image Mammography (CC) ( update )
Image Mammography ( update )
Image Mammography ( update )
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