A slowly enlarging, non-painful benign neoplasm presenting as a submucosal mass with pseudoepitheliomatous hyperplasia of the overlying epithelium is most likely____________?
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Answer: C. Granular cell tumour
Explanation
Granular cell tumor is a benign submucosal neoplasm composed of large cells with granular cytoplasm. The expanding tumor mass induces pseudoepitheliomatous hyperplasia in the overlying stratified squamous epithelium. This reactive epithelial thickening can mimic squamous cell carcinoma microscopically if misinterpreted. Granular cell tumors most commonly arise on the dorsal surface of the human tongue. The granular appearance results from numerous autophagolysosomes accumulating within the cytoplasm. These slow-growing neoplasms are believed to originate from primitive Schwann cells of neural sheaths.
Surgical excision is curative, and recurrence is rare following complete tumor removal. Biopsy is essential because the clinical appearance resembles a simple fibroma or vascular lesion. Pathologists carefully examine the epithelial hyperplasia to rule out true malignancy in biopsies. Fibroma is a common reactive fibrous hyperplasia without granular cells or pseudoepitheliomatous changes. Rhabdomyoma is a rare benign striated muscle neoplasm lacking characteristic neural granular cells. Papilloma is a benign exophytic epithelial proliferation with a cauliflower-like surface projection.
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