Granular cell tumor

Granular cell tumor is a benign neural tumor that can occur anywhere in the larynx, but most commonly in the posterior half of the true vocal cord.  In this low magnification view of the lesion, there is a marked pseudoepitheliomatous hyperplasia.  The granular cells can be visualized inferior to the hyperplastic epithelium.

Higher magnification view of the pseudoepitheliomatous hyperplasia.

Higher magnification view of the granular cells, which are poorly circumscribed and spindle-shaped.  The cytoplasmic granularity is due to the presence of lysosomes.

Granular cell tumors are especially common in African Americans, and typically occur in the third decade of life. The lesion can occur both in the larynx and the trachea. It generally presents as a single lesion, but multiple lesions can also occur. Patients present with hoarseness and/or airway obstruction. Granular cell tumors are resistant to radiotherapy, and therefore surgical excision is the treatment of choice. About 2-8% of patients present with recurrences following surgical treatment.