A lesion on the DORSUM of the tongue is MOST specifically identified as which of the following on biopsy?

Correct answer: C. Granular cell tumor (large cells with eosinophilic granular cytoplasm, S-100 positive)

• A. Hemangioma on the tongue is vascular — not granular cells.
• B. Neurofibroma has spindle cells in a myxoid stroma — not the same histology.
• C. Correct. GRANULAR CELL TUMOR (GCT) is a specific benign lesion most commonly found on the DORSUM OF THE TONGUE. Histologically: large cells with abundant pink granular cytoplasm (secondary lysosomes), S-100 positive (neural origin — Schwann cells). Can cause pseudoepitheliomatous hyperplasia of the overlying epithelium that may be mistaken for SCC. Treatment: excision.
• D. Fibroma is dense collagen — not granular cells.