Table 1.

Clinicopathologic characteristics of congenital granular cell epulis and its differential diagnosis

Lesion	Epidemiology	Predilection site	Histologic appearance	Immunohistochemistry
Congenital granular cell epulis	Newborn F > M	Alveolar ridge of the maxilla	Sheets of polygonal eosinophilic granular cells with overlying thin squamous epithelium	S-100 (−), vimentin (+)
Granular cell tumor [2]	30–60 years F > M	Tongue	Sheets of polygonal eosinophilic granular cells with overlying pseudoepitheliomatous hyperplasia of the squamous epithelium	S-100 (+), CD68 (+)
Rhabdomyoma [2]	Extracardiac - adults M > F	Extracardiac is rare (head and neck is the most common extracardiac site)	Fetal subtype—spectrum of myocyte differentiation Adult subtype—polygonal eosinophilic cells with granular cytoplasm and cross striations	Desmin (+), SMA (+)
Infantile myofibroma [2]	Newborn-6 years M > F	Tongue and buccal mucosa	Nodular proliferation with biphasic appearance: short fascicles of plump myofibroblasts in the periphery and central zones with hyperchromatic round-to-spindle cells and hemangiopericytoma-like vessels	Vimentin (+), SMA (+)
Melanotic neuroectodermal tumor of infancy [9]	5 months (median) F = M	Maxilla	Dual population of small neuroblastic cells and larger melanin-containing epithelial cells	Epithelial cells: CK (+), EMA (+), vimentin (+), HMB-45 (+) Small neuroblastic cells: synaptophysin (+), NSE (+)
Peripheral odontogenic fibroma [10]	Newborn-80 years F > M	Mandible	Cellular connective tissue with multiple small islands and strands of odontogenic epithelium	CK (+) in the epithelium

F female, M male, SMA smooth-muscle actin, CK cytokeratin, EMA epithelial membrane antigen, NSE neuron specific enolase