Image taken from Clinical Guide to Oral Diseases.
A 42-year-old woman presented for an evaluation of a lump on the right lateral margin of her tongue that has been present over the last year.
The swelling was initially small but got slowly bigger reaching its present size of 1.5 × 1.0 cm. As for her medical record, previous trauma, local thermal or chemical irritation were not linked with the lesion development, while any past family history was not contributory.
A well-circumscribed swelling of approximately 1.5 cm, in the lateral right margin of the tongue, opposite the first molar was found. The lesion was pinkish pale white in color, firm, adherent to the underlying structures, with a rough surface but covered with normal lingual papillae (Figure 24.5). Any case of regional lymphadenopathy was absent while no other similar lesions were found in her skin or other mucosae.
What is this lesion: Granular cell tumor.
Granular cell tumor is the correct answer. This tumor can appear everywhere in the body, but has a high predilection in the tongue (>70%) and especially of women rather than men. This lesion is presented as an asymptomatic, solitary, nodule on the anterior and sometimes on lateral margins of the tongue having a yellowish or pinkish color. This tumor is usually benign, of neural origin and from a histological point of view, it is composed of large polygonal, plump cells with eosinophilic granular cytoplasm within a fibrovascular corium where the overlying epithelium shows a pseudoepithelial hyperplasia.
The granular cell tumors are now accepted to have a neural origin as these lesions are close to peripheral nerve fibers, demonstrate ultrastructural myelin figures and have a positive reaction to S100 proteins, neuron specific enolase and myelin proteins.