Neoplasia: granular cell tumour: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Neoplasia: granular cell tumour

Sample item

A 35-year-old woman has a painless firm nodule on the tongue. The overlying epithelium shows pseudoepitheliomatous hyperplasia, and the nodule contains sheets of large polygonal cells with abundant eosinophilic granular cytoplasm that are S-100 positive. What is the cell of origin?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Schwann cell

Granular cell tumour is now accepted as a Schwann cell tumour, shown by S-100 positivity and its location along nerves. The granules are lysosomes. Overlying pseudoepitheliomatous hyperplasia can be mistaken for squamous cell carcinoma on a superficial biopsy.

Option by option

  • A. Skeletal muscle cell

    The tumour was once thought to be myogenic, but this has been disproved.

  • B. Melanocyte

    Melanocytic tumours are S-100 positive but contain melanin and often HMB-45 positivity, unlike this tumour.

  • C. Schwann cell (correct)

    Correct. S-100 positivity points to a neural-crest Schwann cell origin.

  • D. Histiocyte

    This is not a histiocytic proliferation; the S-100 positive cells are of neural lineage.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Schwann cell. Granular cell tumour is now accepted as a Schwann cell tumour, shown by S-100 positivity and its location along nerves.

Why is "Skeletal muscle cell" not the answer?

The tumour was once thought to be myogenic, but this has been disproved.

Why is "Melanocyte" not the answer?

Melanocytic tumours are S-100 positive but contain melanin and often HMB-45 positivity, unlike this tumour.

Why is "Histiocyte" not the answer?

This is not a histiocytic proliferation; the S-100 positive cells are of neural lineage.

What concept does this question test?

It tests Neoplasia: granular cell tumour in Pathology. The granules are lysosomes. Overlying pseudoepitheliomatous hyperplasia can be mistaken for squamous cell carcinoma on a superficial biopsy.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neoplasia: granular cell tumour?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.