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Case Reports
. 2025 Mar;53(3):E51-E55.
doi: 10.1002/dc.25433. Epub 2024 Dec 17.

Metastatic Malignant Granular Cell Tumor in the Lymph Node: A Cytological Report With Immunocytochemical Analysis

Hiroyuki Okanishi  1 , Mitsuaki Ishida  1 , Naoto Kohno  1 , Hiroko Nakayama  1 , Kozue Ariga  1 , Shizuka Ono  1 , Chihiro Deguchi  1 , Reika Takeda  1 , Yoshitaka Kurisu  1 , Yoshinobu Hirose  1
Affiliations
Case Reports

Metastatic Malignant Granular Cell Tumor in the Lymph Node: A Cytological Report With Immunocytochemical Analysis

Hiroyuki Okanishi et al. Diagn Cytopathol. 2025 Mar.

Abstract

Granular cell tumors (GCTs) are relatively rare, whereas malignant GCTs are extremely rare. This brief report describes a cytological case of metastatic malignant GCT in the lymph node with immunocytochemical analysis. A 77 years old Japanese female with a history of surgical resection for malignant GCT in the back 8 years earlier presented with swelling of the right neck. Intraoperative touch smear of the biopsy specimen of the neck lymph node showed the presence of clusters of polygonal neoplastic cells as well as single neoplastic cells containing rich granular cytoplasm and eccentrically located large round to oval nuclei in a background of granular material. Immunocytochemical analysis demonstrated that these neoplastic cells showed positivity for S-100 protein and SOX10, and negativity for Melan-A and HMB45. According to these findings, a cytodiagnosis of metastatic malignant GCT was made with consideration of her history. Histopathological analysis confirmed a metastatic malignant GCT. The present study indicates that immunocytochemical staining for S-100 protein and SOX10 combined with cytomorphological features might be useful for the cytodiagnosis of malignant GCT.

Keywords: granular cell tumor; immunocytochemistry; lymph node metastasis; malignant granular cell tumor.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Cytological features and immunocytochemical findings of the touch smear of the cervical lymph node. (A) A cluster of polygonal neoplastic cells as well as single neoplastic cells in a background of granular material. (B) The neoplastic cells have eccentrically‐located large nuclei and rich granular cytoplasm. (C) Intranuclear inclusion is noted (arrow). (D) Spindle‐shaped neoplastic cells with rich granular cytoplasm (Papanicolaou stain, ×400 (A), ×1000 (B–D)). S‐100 protein (E) and SOX10 (F) are diffusely expressed in the neoplastic cells (×400).
FIGURE 2
FIGURE 2
Histopathological and immunohistochemical findings of the biopsied cervical lymph node. (A) Proliferation of the neoplastic cells having rich eosinophilic granular cytoplasm and large round to oval nuclei. (B) Spindle‐shaped neoplastic cells. (C) Intranuclear inclusion (arrow) (Hematoxylin and eosin, ×400 (A–C)). S‐100 protein (D) and SOX10 (E) are diffusely expressed (×400).
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