Journal of Pathology and Translational Medicine

Case Reports

Osteoclast-like Giant Cell Tumor of the Parotid Gland Accompanied with Carcinoma ex Pleomorphic Adenoma.: Mi Jung Kwon, Eun Sook Nam, Seong Jin Cho, Hyung Sik Shin, Ji Hyun Kwon, Young Soo Rho; Korean J Pathol. 2011;45:S84-S88.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S84

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The origin of osteoclast-like giant cell tumor (OGCT) of the salivary gland has been debated because the prototypic cells of osteoclast-like cells and mononuclear stromal cells are largely unexplained in this gland. Bone marrow-derived CD14+ and CD45+ monocyte-derived multipotential cells (CD14+/CD45+ MOMC) may be one of the possible origins of OGCTs of salivary glands, which have never been explored in salivary OGCTs. We present a case of OGCT accompanied with carcinoma ex pleomorphic adenoma in the parotid gland of a 67-year-old Korean female. The tumor presented as a rapidly growing cervical mass comprising a central area of carcinoma ex pleomorphic adenoma and a peripheral circumferential area of OGCT. The immunohistochemical staining pattern was phenotypically consistent with bone marrow-derived CD14+/CD45+ MOMC. This case is the first report of a salivary OGCT in Korea.

Citations

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Giant cell tumour of the parotid gland: a rare, unusual entity
Erna Ahsan, Kranthi Kumar Jandrasupalli, Prashant Durgapal, Divya Yadav
BMJ Case Reports.2025; 18(4): e261751. CrossRef
Tumeur à cellules géantes de type ostéoclastique de la parotide
S. Rammeh, I. Hergli, M.K. M’farrej, N. Znaidi, S. Nechi, R. Zermani
Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale.2014; 115(3): 185. CrossRef

Aspiration Cytology of the Osteoclastic Variant of Anaplastic Thyroid Carcinoma: with Special Emphasis on the Undifferentiated Mononuclear Cells.: Kang Min Han, Dong Hoon Kim, Wonae Lee; Korean J Pathol. 2010;44(6):682-686.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.6.682

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Abstract PDF

Anaplastic thyroid carcinoma (ATC) is an uncommon aggressive malignant tumor, and the osteoclastic variant of ATC is extremely rare. We report here on the fine needle aspiration cytology of the osteoclastic variant of ATC in an 83-year-old woman. The smear was composed of many oval to slightly elongated undifferentiated mononuclear cells admixed with multinucleated osteoclast-like giant cells. The mononuclear tumor cells revealed inconspicuous nuclear pleomorphism and the nuclei were characterized by vesicular chromatin and an indented or lobulated nuclear membrane with conspicuous nuclear grooves. A few epithelial clusters suggestive of a papillary carcinoma component were also observed. Making the proper cytological diagnosis of the osteoclastic variant of ATC is helpful to determine the proper treatment modality for these patients.

Citations

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Anaplastic carcinoma of thyroid with giant cells –Cytodiagnosis of category VI high grade thyroid tumor
Dhiraj B Nikumbh
IP Archives of Cytology and Histopathology Research.2024; 9(4): 176. CrossRef
A case of osteoclastic variant of anaplastic thyroid carcinoma: Diagnostic and prognostic marker studies by cytology
Surekha Bantumilli, Lee‐Ching Zhu, Muthukumar Sakthivel, Leslie Dodd
Diagnostic Cytopathology.2022;[Epub] CrossRef
Cytodiagnosis of anaplastic thyroid carcinoma with osteoclast-like giant cells − A case report with a review of the literature
Padmanaban Krishnan Govindaraman, Selvaraj Balakumar, Anthuvan Jeyarani Lawrence
Thyroid Research and Practice.2021; 18(1): 40. CrossRef
Role of cytology in differentiating anaplastic thyroid carcinoma with osteoclast like giant cells from giant cell variant of medullary thyroid carcinoma
GP S Gahlot, Tathagata Chatterjee, Rohit Tewari, Vijendra Singh, Ankur Ahuja, Kanwaljeet Singh, Beenu Singh
Journal of Marine Medical Society.2020; 22(2): 255. CrossRef
Osteoclastic variant of anaplastic thyroid carcinoma
Divya Shelly, Divya Gupta, Shashank Mishra, Reena Bharadwaj
Journal of Cancer Research and Therapeutics.2019; 15(3): 704. CrossRef

Fine Needle Aspiration Cytology of Invasive Ductal Carcinoma with Osteoclast-like Giant cells: A Case Report .: Eun Ha Jung, Hye Rim Park, Jin Hee Sohn; J Pathol Transl Med. 1998;9(2):221-226.

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Abstract PDF: Malignant tumors of the breast with stromal multinucleated giant cells are rare entity of uncertain clinical significance. There have been few reports on the fine needle aspiration cytologic(FNAC) findings about these rare tumors. We report a FNAC case of invasive mammary carcinoma with osteoclast-like giant cells not only for its rare occurrence but in particular for its distinctive cytologic picture on aspirated material. The patient was a 40-year-old woman who presented with a right breast mass for one month. Mammography showed a well-demarcated rounded mass density without calcification. The aspirates of FNAC were highly cellular and two main cell types were seen; malignant epithelial cells and osteoclast-like multinucleated giant cells. The carcinoma cells occurred singly or arranged in loose clusters with ill-defined cytoplasm, oval nuclei, coarse chromatin and small but distinct nucleoli. The multinucleated giant cells showed variable number of nuclei with prominent nucleoli and abundant dense oxyphilic cytoplasm. The immunocytochemical studies suggested that osteoclast-like giant cells were not of epithelial origin, but rather of histiocytic origin.

Fine Needle Aspiration Cytology of Osteoclast-like Giant Cell Tumor of the Liver: A Case Report .: Chan Sik Park, Ji Eun Kim, Mee Soo Chang; J Pathol Transl Med. 1999;10(1):79-84.

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Abstract PDF: Osteoclast-like giant cell tumor of the liver is an extremely rare malignancy with poor prognosis. To our knowledge, 5 cases have been reported in English literatures, but there was no report about fine needle aspiration cytologic(FNAC) features. We experienced a case of osteoclast-like giant cell tumor of the liver obtained by computed tomography(CT)-guided FNAC and needle biopsy. The cytologic findings mimicked giant cell tumor of the bone. A large hepatic mass of the left lobe with abdominal wall invasion was found by CT in a 46-year-old female complaining of epigastric pain. The FNAC showed moderately cellular smears consisting of osteoclast-like giant cells and mononuclear cells, which were individually scattered or intermingled in clusters. The osteoclast-like giant cells had abundant cytoplasms and multiple small round nuclei with fine chromatin and distinct nucleoli. The mononuclear cells had moderate amount of cytoplasm and relatively bland-looking oval nuclei with single small nucleoli. All of the cytologic features recapitulated the histologic findings of bland-looking osteoclast-like multinucleated giant cells evenly dispersed throughout the background of mononuclear cell. The immunohistochemical study showed positive reaction for CD68 and vimentin, but negative for cytokeratin in both osteoclast-like giant cells and mononuclear cells.

Infiltrating Ductal Carcinoma of the Breast with Stromal Osteoclast-Like Multinucleated Giant Cell: A case report.: So Ya Paik, Sang Yeop Yi, Jai Hyang Go, Dong Hwan Shin; Korean J Pathol. 1996;30(1):61-64.

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Abstract PDF: Malignant tumors of the breast which contain stromal osteoclast-like, multinucleated giant cells are a rare entity of yet unknown clinical significance. These benign multinucleated giant cells are known to occur mostly in areas of prominent angiogenesis and in close association with tumor cells. Supplementary immunohistochemical and electronmicroscopic examinations indicate that the multinucleated giant cells are of histiocytic origin. We report on a case of infiltrating ductal carcinoma with stromal osteoclast-like multinucleated giant cells occurring in the right breast of a 37 year-old woman. Grossly, the tumor was characterized by a well-circumscribed dark brown, solid firm mass. Microscopically, multinucleated giant cells were found in the stroma intermingled with malignant tumor cells. The stroma showed only a small amount of mononuclear cell infiltration and a moderate degree of vascular proliferation. Immunohistochemical stains revealed the tumor cells to be positive for carcinoembryonic antigen, epithelial membrane antigen and cytokeratin while the multinucleated giant cells were positive for vimentin, CD68 and negative for all other stains tested. Ultrastructurally the multinucleated giant cells differed from tumor cells by having abundant cytoplasmic organelles such as rough endoplasmic reticulum, lysosomes, ribosomes, and vesicles but lacking desmosomes or other types of intercellular junctions. Other characteristic features of multinucleated giant cells included, indented nuclei and prominent cytoplasmic process.

Fine Needle Aspiration Cytology of Anaplastic Carcinoma of the Thyroid with Osteoclast-like Giant Cells : A Case Report.: Leeso Maeng, Jehoon Lee, Kyoung Mee Kim, Anhi Lee, Chang Suk Kang; J Pathol Transl Med. 2003;14(1):32-35.

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Abstract PDF: Multinucleated giant cells of osteoclast-like appearance can be seen in a type of anaplastic carcinoma of thyroid and only a few case reports for fine needle aspiration cytologic findings are found in the literatures. Recently, we experienced a case of anaplastic carcinoma of thyroid with many osteoclast-like giant cells in a 72-year-old woman. The cytologic features and immunohistochemical results are described with special emphasis on differential diagnosis.

Original Article

Fine Needle Aspiration Cytology of Anaplastic Carcinoma with Osteoclastlike Giant Cells of the Thyroid.: Ji Shin Lee, Hyang Mi Ko, Min Cheol Lee, Chang Soo Park, Sang Woo Juhng; J Pathol Transl Med. 1994;5(2):172-175.

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Abstract PDF: Anaplastic carcinoma of the thyroid is one of the most malignant tumors and survival for longer than three years after diagnosis is exceptional. Multinucleated giant cells of osteoclastlike appearances are seen in some of the anaplastic carcinoma, but only three cases in which the diagnosis was made by fine needle aspiration(FNA) cytology are reported in the international literature. We experienced a case of anaplastic carcinoma with osteoclastlike giant cells in a 66-yr-old female, diagnosed by FNA cytology. The smears revealed two cell populations; multinucleated giant cells and large polygonal or spindle shaped malignant cells. The FNA cytodiagnosis of anaplastic thyroid carcinoma containing osteoclastilke giant cells was substantiated by subsequent biopsy.

Case Report

Invasine Ductal Carcinoma with Osteoclast-Like Giant Cell in a Young Woman.: Hyun Jeong Kang, Jee Yeon Kim, Kyung Un Choi, Hee Suk Kwak, Mee Young Sol; J Pathol Transl Med. 2007;18(1):69-73.

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Abstract PDF: Mammary carcinoma with osteoclast-like giant cells is an unusual neoplasm characterized by giant cells, mononuclear stromal cells, and hemorrhage accompanying a low grade carcinoma. We present the cytological findings in a case of invasive ductal carcinoma with osteoclast-like giant cells that was initially confused with a fibroadenoma, due to its well-demarcated and soft mass and the young age of the patient. A 28-year-old female presented with a 4.5 cm, well demarcated, soft and nontender mass in the right breast. Fine needle aspiration cytology (FNAC) showed a combination of low grade malignant epithelial cell clusters and osteoclast-like giant cells. The atypical epithelial cells were present in cohesive sheets and clusters. Osteoclast-like giant cells and bland-looking mononuclear cells were scattered. An histological examination revealed the presence of an invasive ductal carcinoma with osteoclast-like giant cells. We report here the cytological findings of this rare carcinoma in a very young woman. The minimal atypia of the epithelial cells and its soft consistency may lead to a false negative diagnosis in a young woman. The recognition that osteoclastlike giant cells are rarely present in a low grade carcinoma, but not in benign lesion, can assist the physician in making a correct diagnosis.

Original Article

Fine Needle Aspiration Cytology of Osteoclastic Giant Cell Tumor of the Pancreas.: Sun Hee Sung, Woon Sup Han; J Pathol Transl Med. 1998;9(1):89-94.

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Abstract PDF: A case of fine needle aspiration cytology of an osteoclastic giant cell tumor of pancreas, which is an uncommon variant of ductal adenocarcinoma, is described. Aspirated tumor cells were characterized by three populations: (1) bland osteoclast like giant cells with multiple small, round nuclei with distinct nucleoli, and abundant cytoplasm, (2) individually scattered or loosely clustered medium sized mononuclear tumor cells, having fine chromatin, smooth nuclear membrane, often prominent nucleoli, and high N/C ratio, (3) bland or atypical spindle shaped cells. Osteoid like lacy material was also seen on cell block section. The immunohistochemical studies using paraffin embedded cell block section showed positivities for vimentin and lysozyme in both giant and mononuclear tumor cells. However, they were negative for cytokeratin, epithelial membrane antigen, S-100 protein, carcinoembryonic antigen, and p53.

Case Report

Undifferentiated Gallbladder Carcinoma with Osteoclast-like Giant Cells: A Case Report.: Yun Kyung Kang; Korean J Pathol. 2007;41(2):127-131.

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Abstract PDF: Undifferentiated carcinoma with osteoclast-like giant cells (OGCs) is the least common type of gallbladder carcinoma. Here, the author presents a case of undifferentiated gallbladder carcinoma with OGCs in an 81-year-old male patient. Grossly, the tumor was a 10x7 cm sized, polypoid, lumen-filling mass with extensive hemorrhage and necrosis. Microscopically, the tumor was composed of pleomorphic ovoid to spindle cells admixed with numerous OGCs. There was a minute focus of mucosal dysplasia and carcinoma in situ. Immunohistochemically, the mononuclear cells were positive for cytokeratin, p53 and Ki-67, while the OGCs were negative for these markers but positive for CD68. These findings support an epithelial origin for the ovoid to spindle cells and the nonneoplastic reactive histiocytic lineage of the OGCs.

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