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S-100 Immunohistochemical Positivity in Rhabdomyoma: An Underestimated Potential Diagnostic Pitfall in Routine Practice.

Authors
  • Palicelli, Andrea1
  • Ramponi, Antonio2
  • Valente, Guido3
  • Boldorini, Renzo2
  • Balbo Mussetto, Annalisa4
  • Zanelli, Magda1
  • 1 Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy. , (Italy)
  • 2 Pathology Unit, Department of Health Sciences, Università del Piemonte Orientale (UPO), 28100 Novara, Italy. , (Italy)
  • 3 Pathology Unit, Department of Translational Medicine, "Sant'Andrea" Hospital, Università del Piemonte Orientale (UPO), 13100 Vercelli, Italy. , (Italy)
  • 4 Radiology Department, Umberto I Mauriziano Hospital, 10128 Turin, Italy. , (Italy)
Type
Published Article
Journal
Diagnostics
Publisher
MDPI AG
Publication Date
Apr 02, 2022
Volume
12
Issue
4
Identifiers
DOI: 10.3390/diagnostics12040892
PMID: 35453940
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

A 66-year-old man presented with a 2.8 cm lesion of the left vocal cord. On contrast-enhanced computed tomography scans, the tumor extended to the supraglottis, subglottis, paraglottic space and anterior commissure, causing partial obstruction of the laryngeal lumen. At another hospital, a fragmented incisional biopsy was diagnosed as a granular cell tumor, as to the S-100 immunohistochemical positivity. After excision, the tumor revealed to be an adult-type laryngeal rhabdomyoma. The typical cytoplasmic rod-like inclusions and cross striations were more evident in the second specimen. We confirmed the unusual S-100 immunohistochemical positivity (variable intensity, >90% of tumor cells). Muscle markers were not performed on the previous biopsy, resulting positive in our specimen (Desmin: strong, diffuse expression; Smooth Muscle Actin: strong staining in 10% of tumor cells). Melan-A, CD68, GFAP, pan-cytokeratins, CEA, calretinin and neurofilaments resulted negative. To our brief, systematic literature review, S-100 positivity (usually variable, often weak or patchy/focal) was globally found in 19/34 (56%) adult-type rhabdomyomas of the head and neck region. Especially on fragmented biopsy material, the differential diagnoses of laryngeal rhabdomyomas may include granular cell tumors, oncocytic tumors of the salivary glands or of different origin, and paragangliomas.

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