PMC4600547_01
(a) Ultrasound images of a granular cell tumor of the breast showing a solitary mass without vascularity. (b) Gross pathologic images of the resected granular cell breast tumor.
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On ultrasound examination, a solitary, solid 3 x 2.1 x 2.2-centimeter mass was noted at the 10 o'clock position, with no vascularity on Doppler exam, (Figure 1(a)) and interpreted as most consistent with a fibroadenoma. Gross pathologic exam of the 3.5 cm specimen revealed a round 2.1-centimeter, demarcated, distinct, homogenously yellow mass (Figure 1(b)).
(a) Margin of tumor, cords and files of tumor cells in compressed collagenous stroma, with normal ducts, minimal inflammatory reaction (H&E). (b) Center of the tumor; granularity of the abundant eosinophilic cytoplasm is apparent (H&E). (c) Low power architecture of tumor, with swirling cords; peripherally entrapped normal duct (middle of picture); compressed, minimally infiltrative strands on the right, along with normal breast lobules Immunostain for S100. (d) Center of the tumor, positive for S100 immunohistochemical stain. (e) Margin of the tumor (Immunostain for S100); short infiltrative tumor strands (right lower quadrant of image) in compressed stroma (right upper quadrant), entrapping normal ducts (left lower corner) by the tumor margin (left upper quadrant). (f) Diffuse immunohistochemical staining of the tumor with CD68.
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Immunohistochemical staining for CD68 and S100 was diffusely positive (Figure 2) but negative for cytokeratin, consistent with a GCT. The tumor borders were pushing and compressing the stroma at low power, with short peripheral extensions and limited peripheral encasement of occasional normal ducts and lobules at high power (Figure 2(e)).