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Granular cell change in astrocytic tumors
J F Geddes1, M Thom, S F Robinson
1Department of Morbid Anatomy, London Hospital Medical College, England, UK.
The American Journal of Surgical Pathology
|January 1, 1996
Summary
Intracerebral granular cell neoplasms are rare astrocytomas. Recognizing this variant is crucial to avoid misdiagnosis of infarcts or carcinomas on small biopsies.
Area of Science:
- Neuropathology
- Neurosurgery
- Oncology
Background:
- Intracerebral granular cell neoplasms are uncommon.
- Granular cell change is a rare phenomenon in astrocytic neoplasms.
Purpose of the Study:
- To describe the clinicopathologic features of five hemispheric astrocytomas with granular cell change.
- To highlight the importance of recognizing this variant to prevent diagnostic confusion.
Main Methods:
- Histopathological examination of five hemispheric astrocytomas.
- Immunohistochemical staining for glial fibrillary acidic protein and epithelial membrane antigen.
- Periodic acid-Schiff (PAS) staining with and without diastase digestion.
- Ultrastructural analysis.
Main Results:
- All five tumors exhibited granular cell change, characterized by cells with granular eosinophilic cytoplasm.
- Four tumors showed transition from anaplastic astrocytoma and contained lipidized cells.
- Cytoplasmic granules were PAS-positive and diastase-resistant; focal glial fibrillary acidic protein expression was observed.
- Diffuse cytoplasmic epithelial membrane antigen positivity was noted, without true membrane staining.
- Ultrastructural analysis revealed membrane-bound autophagic vacuoles.
Conclusions:
- Granular cell change in astrocytomas is a degenerative phenomenon.
- Recognition of this rare histologic variant is essential to avoid misdiagnosis, particularly on small biopsy samples.
- Differential diagnoses include infarct, demyelinating disease, or secondary carcinoma.