Summary: | Aim: Granular cell tumors (GCTs) show neuroectodermal differentiation. Morphologically,
a wide variety of mesencymal tumors may have granular cell appearance. Nestin, which is an intermediate filament protein expressed in undifferentiated cells during
central nerves system development and its tumors. We aim to determine the diagnostic utility of Nestin in diagnosis of
GCTs. Methods: Nestin
immunohistochemistry applied to GCT cases and other mesenchymal tumors which
may have granular cytoplasm and the major differential diagnostic consideration
of GCT. A total of 21 GCT from different tissues (including 7 in the esophagus,
8 originating from skin tissues, 4 in the tongue, 2 in the vocal cord), 17 gastrointestinal stromal tumor in the gastrointestinal tract,
8 leiomyoma (5 in the esophagus and 3 originating from skin tissues), 4
schwannoma (1 in the esophagus and 3 originating from skin tissues), subcutaneous mesenchymal tumors ( including 7 neurofibroma, 5 fibroma, 15
dermatofibroma), 20 melanocytic nevi, 15 gastric xanthomas and 15 xanthalesma
of the skin were included the study. Results: Nestin positivity was detected in all GCTs. Additionally,
strong Nestin positivity
was seen in all gastrointestinal stromal tumors,
schwannoma and neurofibroma cases. However, Nestin was
negative in all leiomyoma, fibroma, dermatofibroma, melanocytic nevi, gastric
xanthoma and xanthalesma cases.
Conclusion: The study showed that
Nestin immunohistochemistry has limitation in distinction of GCT from tumors
arising from neural cell lineage such as gastrointestinal stromal tumor, schwannoma and neurofibroma; however, Nestin
as a neural marker provides an evidence to neural origin of GCT and could be useful
in distinction GCT from other mesenchymal tumors with granular cytoplasm such
as leiomyoma, dermatofibroma and melanocytic nevi.
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