Granular cell changes have also been observed in other neoplasm such as schwannoma, leiomyoma and leiomyosarcoma and the authors agree that correct morphological recognition together with the use of ancillary techniques (immunohistochemistry, IHC) are sufficient to make a correct diagnosis (smooth muscle actin, HHF35 actin, and desmin). The gene discussed is DES; the disease is leiomyosarcoma.