Ameloblastoma with stromal multinucleated giant cells

We report a case of ameloblastoma which uniquely showed heavy-osteoclast-like giant cell accumulation and woven bone formation in the surrounding fibrous stroma. Immunohistochemistry showed that the giant cells were non-epithelial in origin and suggested that stromal factors (i.e. the presence or absence of mineralized bone) determines whether these cells express an osteoclastic antigenic phenotype.     

Carcinoma of the breast with stromal multinucleated giant cells

Three cases of invasive mammary carcinoma with stromal osteoclast-like giant cells are reported. All the specimens were grossly of reddish-brown colour. On microscopical examination two were invasive ductal carcinomas and the third was of mixed ductal and mucoid type. In the stroma all specimens showed numerous osteoclast-like giant cells, vascular proliferation, and accumulation of haemosiderin pigment. Supplementary immunohistochemical and electron microscopical investigations indicated that the giant cells originated from mononuclear stromal cells with only slight histiocytic properties. The giant cell formation was probably induced by the infiltrating carcinomatous tissue which is also believed to induce new blood vessel formation. However, there is no evidence of a direct relationship between these features.     

Fibroadenoma of the female breast with multinucleated giant cells

A fibroadenoma in the female breast is described, which contained multiple multinucleated giant cells within the stroma. The investigation indicated the giant cells to be of epithelial nature, caused by epithelial degeneration secondary to myoepithelial swelling of unknown cause. Their presence and morphology could cause anxiety about malignancy, but this was found groundless.     

Benign tumors of the breast with multinucleated stromal giant cells

The authors present six cases of benign tumors of the breast with numerous multinucleated stromal giant cells (MSGC). All six patients were women aged 37-70 years (mean 48 years), presenting clinically with a breast mass 1.0-3.8 cm in size (mean 1.9 cm; median 1.5 cm). By standard H&E examination, all cases showed the presence of numerous MSGC haphazardly dispersed within the tumor stroma. Three cases revealed MSGC merging into the surrounding adipose tissue simulating infiltrative growth. The MSGC appeared to have multiple nuclei (5 to 25) with fine chromatin and sporadic small nucleoli. Their cytoplasm was inconspicuous. The MSGC expressed vimentin only and to lesser extent CD34. These cells were negative for muscle markers, keratins, S-100 protein, vascular markers, CD68 and hormone receptors. Interestingly, the majority of MSGC and mononuclear stromal cells showed reactivity for p53 protein and Ki-67 proliferation antigen. All patients were treated by simple excision and remain free of recurrence (mean 70 months, median 48 months.). The reactivity of p53 in MSGC and mononuclear stromal cells may play a key role in linking these two cell types. Nonetheless, the presence of MSGC does not alter prognosis of otherwise typical benign lesions.     

Myxoid plexiform fibrohistiocytic tumor without multinucleated giant cells

Plexiform fibrohistiocytic tumour is a rare soft-tissue tumour of intermediate malignancy. It is more prevalent in children and in young adults. We report a case of this tumour presenting as a nontender swelling on the shoulder of an 8-year-old girl. Clinically, the mass was subcutaneous and measured 2 cm in greatest diameter. The histopathological examination revealed a mesenchymal dermic and subcutaneous tumour composed of confluent nodules. These nodules were made of aggregates of histiocyte-like cells and concentric fascicles of spindle cells. The stroma was myxo?d or collagenous. This case was particular by the lack of giant cells and the focally myxoid background. The epidemiologic, clinicopathologic features and outcome of this lesion are discussed and similar published cases are reviewed.     

Breast carcinoma with osteoclastic giant cells: case report and review of the literature

Breast carcinoma with osteoclastic giant cells (OGCs) are uncommon. Here, we report a 46-year-old woman with a painless lump in her left breast that has been proved clinically and radiographically. Microscopical examination showed OGCs accompanying invasive ductal carcinoma. Immunohistochemical assay revealed that OGCs derived from macrophages. Despite positive lymph node metastasis, the patient has been well without evidence of recurrence or metastasis one year after the operation. To date, the influence of OGCs on the prognosis of patients is still controversial. Our case may provide insights into further understanding beast carcinoma with OGCs.     

Breast carcinoma with stromal multinucleated giant cells--a light microscopic, histochemical and ultrastructural study

A rare form of infiltrating ductal carcinoma of the breast containing numerous benign stromal multinucleated giant cells (MNGC) is described. Giant cell tumours of the breast are usually the result of stromal metaplasia or fusion of malignant cells or occur as extraskeletal giant cell tumours. Benign multinucleated cells in breast carcinoma, however, are a very unusual phenomenon and have been said to arise from the fusion of mononuclear cells, in response to increased vascularity. The present investigation by light and electron microscopy, in part, supports an origin for the multinucleated giant cells from mononuclear cells, but immunohistochemistry surprisingly failed to confirm this observation. Also, the formation of the multinucleated giant cells did not show any direct relationship with tumour vascularity.     

Histiocytic sarcoma - a case with evenly distributed multinucleated giant cells

Histiocytic sarcoma is an uncommon neoplasm of mature histiocytes with a poor clinical outcome. We report a case of a true histiocytic sarcoma with prominent and evenly distributed multinucleated giant cells that mimics a giant cell tumor of soft tissue. The tumor was located between the appendix, right ovary, and the terminal ileum with severe adhesion. The liver and spleen were not enlarged. Grossly, the tumor appeared grayish white, solid, and soft. Microscopically, polygonal mononuclear tumor cells aggregated to form somewhat epithelioid nests, which occasionally showed coagulative necrosis. Prominent and evenly scattered giant cells were present in all sections. In addition, tumor cell infiltration was noted in regional lymph nodes. The tumor cells were positive for lysozyme, CD68, CD163, and negative for T- and B-cell lineage markers, follicular dendritic cell, megakaryocytic, epithelial, muscular, and melanocytic markers, CD1a and CD30. This case posed great difficulty in clinical and pathological diagnoses. Gross pictures, microscopic findings, and extensive immunostains are important for the differential diagnosis.     

Chondroid lipoma associated with osteoclast‐like multinucleated giant cells – a case report

Chondroid lipoma is a rare soft tissue neoplasm. We report case of chondroid lipoma associated with osteoclast‐like multinucleated giant cells. To the best of our knowledge, the presence of these giant cells has not been previously described in the English literature. The recognition of these cells is important and their occurrence in this rare neoplasm should not mislead the pathologist to misdiagnose this entity.     

Unusual abscesses associated with colon cancer: report of three cases

Three cases of colon cancer accompanied by unusual abscess formation are reported. Case I : A 77-year-old man was diagnosed with a paracolic abscess formation behind the cecum and a swollen appendix by computed tomography (CT) scan. Case II : An 85-year-old woman was diagnosed with an abscess formation of the right iliopsoas muscle, a swollen appendix, and a thickened right colon wall by CT scan. After antibiotic therapy failed, both patients underwent ileocecal resection urgently under suspicion of appendicitis, but cecal cancer around the entrance to the appendix caused secondary appendicitis in both cases. Case III : A 50-year-old woman was diagnosed with sigmoid colon cancer with an abscess formation in the pelvic cavity concomitant with ovarian tumor. A Hartmann procedure was performed, and a pathological examination revealed that a subserosal abscess behind the sigmoid colon cancer perforated the rectum with abscess formation. All cases were definitively diagnosed intraoperatively. The cancer recurred in cases I and III. We emphasize that precise surgical evaluation has an important role in the diagnosis of these complicated diseases. In addition, surgery affords the patient the best chance of recovery, and in these advanced cases radical treatment is recommended as early as possible.     

Breast carcinoma with osteoclastlike giant cells

Seven carcinomas of the breast with osteoclastlike giant cells were studied. Recurrences and lymph node metastases also contained osteoclastlike giant cells. Judging from ultrastructural and histochemical studies, the osteoclastlike giant cells are not epithelial, but are of mesenchymal origin. They may appear in a variety of different types of carcinoma.     

Breast carcinomas with immunocytochemical detection of aromatase in fine-needle aspirates: report of three cases

Three postmenopausal women with breast carcinoma underwent the fine-needle aspiration (FNA) preoperatively, and these specimens were stained by the antiaromatase antibody. We evaluated the identification of the aromatase immunoreactivity in breast carcinoma specimens obtained from both FNA and surgery. FNA specimens showed positive intracellular immunoreactivity of aromatase in these cases. The presence for aromatase in FNA specimens was identified with that in the surgical specimens. To our knowledge, the present cases are the first to report the aromatase staining of FNA specimens. The immunoreactivity of aromatase in FNA specimen may be useful to estimate the effectiveness of new aromatase inhibitors in patients with breast carcinoma. HUM PATHOL 32:348-351.     

Diagnostic relevance of multinucleated giant cells in papillary thyroid cancer. A cytological and histological study

Zusammenfassung Zytologisch untersucht wurden insgesamt 17 Manifestationen papillärer Schilddrüsenkarzinome (PC) und histologisch geprüft wurden insgesamt 58 PC sowie jeweils 50 follikuläre Adenome (FA) und follikuläre Karzinome (FC) auf das Vorkommen histologisch intrafollikulär gelegener mehrkerniger histiozytärer Riesenzellen (RZ). In Übereinstimmung mit Literaturbefunden fanden sich derartige RZ bei 70% der PC und nur in 8% bei FA und FC. Die RZ sind vermutlich Ausdruck einer histiozytären Fremdkörperreaktion gegen ein bei PC physikochemisch alteriertes Kolloid. Ihr Nachweis kann die zytologische oder histologische Diagnose eines PC erleichtern.

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