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

Breast Carcinoma with Osteoclast-Like Giant Cells: Immunohistochemical and Ultrastructural Study of a Case and Review of the Literature

We describe an unusual case of infiltrating ductal carcinoma, not otherwise specified, containing numerous benign stromal osteoclast giant cells (OGCs). Macroscopically, the tumor appeared as a well-outlined dark brown mass and was initially interpreted as a benign lesion on the mammograms. OGCs were uniformly distributed in the tumor and were found in vascularized, hemorrhagic stroma often abutted on the nests of tumor cells. Electron microscopy supported a histiocytic origin of the OGCs, but immunohistochemistry failed to confirm the observation. The patient was alive and well 30 months following the operation. A review of the literature concerning breast carcinoma with OGCs is also presented.

Mammary carcinoma with osteoclast-like giant cells: A study of four cases and a review of literature

Mammary carcinoma with osteoclast-like giant cells (OGCs) is an extremely rare tumor. To the best of our knowledge, only 45 cases have been reported in the literature. Here we report four additional cases of this tumor. The fine-needle aspiration cytology was performed in all four cases, showing an abundance of giant cells and mononucleated stromal cells in intimate association with low- or medium-grade malignant epithelial clusters. Histologically, cribriform patterns predominated in three cases. In one case, OGCs were more pronounced in the vicinity of ductal carcinoma in situ accompanied by marked stromal angiogenesis. This study, as well as review of the literature, underlines the characteristic features of this rare histologic type of carcinoma.

Breast carcinoma with osteoclast-like giant cells: morphological and ultrastructural studies of a case with review of the literature

Primary carcinoma with osteoclast-like giant cells is a very rare tumour of the female breast. The clinical course, histological, immunohistochemical and ultrastructural features of 61 cases of invasive duct carcinoma with osteoclast-like multinucleated giant cells (OMGCs) are reviewed and a new case is presented. The median patient age of all patients included in the review was 42 years, the tumour was located in the upper outer quadrant and the mammographic and gross findings were of a well-defined tumour of dark-brown colour, resembling a metastatic melanoma. Follow-up data in the literature have shown that 86% of patients with these tumours are still alive after 5 years. Histologically, these tumours are invasive ductal carcinomas with OMGCs next to the neoplastic glands and within their lumen. Signs of recent and past haemorrhage are ubiquitously present in the highly vascularized stroma. Immunohistochemical and ultrastructural studies have claimed a benign histiocytic nature of the OMGCs; they may represent a special type of polykaryon, distinct from both osteoclasts and inflammatory giant cells.

Invasive mammary carcinoma with osteoclast-like giant cells diagnosed by fine-needle aspiration biopsy: Review of the cytologic literature and distinction from other mammary lesions containing giant cells

Invasive carcinoma with osteoclast-like giant cells is an unusual type of mammary adenocarcinoma with few cases reported in the cytology literature. We present the cytologic findings in a case of invasive cribriform carcinoma of the breast containing osteoclast-like giant cells diagnosed by fine-needle aspiration biopsy. The smears displayed three-dimensional cohesive cluster cells of uniform epithelial cells admixed with numerous multinucleated giant cells that morphologically resembled osteoclasts. Core biopsy confirmed the cytologic diagnosis. Immunohistochemical studies indicated that the multinucleated giant cells were of histocytic origin. Knowledge of the bland cytologic pattern and the admixture of giant cells seen in invasive cribriform carcinoma with osteoclast-like giant cells should avoid making a false negative diagnosis on aspiration biopsy.

Bilateral Infiltrating Lobular Carcinoma of the Breast with Osteoclast-Like Giant Cells

A case of bilateral infiltrating lobular carcinoma of the breast containing osteoclast-like giant cells is presented. Notable pathologic features include prominent tumor-associated angiogenesis and the presence of osteoclast-like giant cells in axillary lymph node metastases. Immunohistologic and ultrastructural examination support a nonepithelial, histiocytic origin for the giant cells, and results are similar to previous reports of osteoclast-like giant cells associated with breast carcinoma. This is the first report of bilateral pure infiltrating lobular carcinoma of the breast with osteoclast-like giant cells and the first case of pure lobular carcinoma with osteoclast-like giant cells present in lymph node metastases.

Sarcomatoid hepatocellular carcinoma with osteoclast-like giant cells: case report and immunohistochemical observations

Hepatocellular carcinoma (HCC) with osteoclast-like giant cells (OGC) developed in the cirrhotic liver of a 42-year-old male. Serum protein induced by vitamin K absence or antagonist II was elevated preoperatively. The patient died of the disease on the 28th postoperative day. Histologically, the tumor consisted of OGC and mononuclear cells (MC). The OGC were characterized by benign-appearing nuclei, whereas the MC had atypical nuclei with a considerable number of mitoses. A vaguely trabecular pattern was observed in the focal area of the tumor, but no evidence of overt HCC was found. Immunohistochemical analysis revealed that both OGC and MC were diffusely positive for histiocytic and mesenchymal markers. Some MC were focally positive for cytokeratins 7, 8 and 19, and for albumin. Our clinical, histological and immunohistochemical findings suggest that the MC were derived from hepatocytes, with some mesenchymal features, but the OGC were non-neoplastic and reactive histiocytes.

Aspiration cytodiagnosis of a rare carcinoma of breast with bizarre malignant giant cells

On a review of our experience with 14,526 fine-needle aspiration cytology (FNAC) studies of the breast which were done from January 1983 to July 1994, five cases of the rare breast carcinoma were diagnosed in which bizarre, pleomorphic malignant giant cells formed an integral part of the tumour. In all the five cases, immunocytochemical studies were done on aspirated samples. Based on our present findings, in FNAC samples and in keeping with the findings recently described by us in a case, it is stressed that the bizarre malignant giant cells in this type of breast carcinoma are indeed of an epithelial origin. The differential diagnoses of other breast conditions in which giant cells may be seen in FNAC samples is appropriately discussed.

Breast carcinoma with osteoclast-like giant cells

The cytological and histological findings of a case of breast carcinoma with osteoclast-like giant cells are presented. A fine needle aspiration specimen demonstrated the characteristic combination of malignant epithelium and reactive multinucleated cells and enabled identification of this rare variant of breast cancer. Immunocytochemical studies using the monoclonal antibody KP1[CD68] support a histiocytic origin for the osteoclast-like cells.

Osteoclast-like giant cell tumour of the urinary bladder

We report two cases of osteoclast-like giant cell tumour of urinary bladder associated with papillary transitional cell tumours. Both cases were morphologically identical to giant cell tumour of bone. The giant cells stained strongly for acid phosphatase which was resistant to tartrate digestion, a staining reaction typical of osteoclasts. In view of the ability of urinary bladder to induce metaplastic and neoplastic bone, we believe that these tumours may represent extraosseous giant cell tumours of bone.

Alveolar variant of infiltrating lobular carcinoma of the breast with stromal osteoclast-like giant cells

An alveolar variant of infiltrating lobular carcinoma of the breast in which a prominent feature was the presence of numerous osteoclast-like giant cells in a richly vascularized stroma is described. A similar stromal reaction has previously been reported in 46 breast carcinomas of various histologic types, but only once in a pure infiltrating lobular carcinoma. The fine needle aspiration cytological and histological appearances and the immunohistochemical and ultrastructural features of this tumor are reported. Our study confirms the histiocytic nature of the multinucleated giant cells and their similarity to normal osteoclasts.

The origin and nature of stromal osteoclast-like multinucleated giant cells in breast carcinoma: implications for tumour osteolysis and macrophage biology

The origin and nature of osteoclast-like multinucleated giant cells (OMGCs), in extraskeletal neoplasms, is uncertain. The ultrastructure, antigenic phenotype and function of OMGCsm in a breast carcinoma were studied in order to clarify the relationship between OMGCs, osteoclasts and other cells of the mononuclear phagocyte system (MPS). OMGCs resorbed cortical bone in a manner similar to osteoclasts. However, unlike osteoclasts, OMGCs did not possess a ruffled border or clear zone, and expressed HLA-DR and Fc receptors and CD14, CD16, CD18 and CD11 (p150,95) antigens. In addition, OMGCs failed to respond morphologically to calcitonin and were directly stimulated by parathyroid hormone (PTH) to increase bone resorption. These findings suggest that OMGCs are a specific type of macrophage polykaryon distinct from both osteoclasts and other types of inflammatory polykaryon. Occasional smaller (20-25 microns) macrophage-like cells were also associated with resorption pits. Bone resorption by OMGCs isolated from the breast indicates that a cell of the MPS can be transplanted to a new tissue location and perform a highly specialised function appropriate to an MPS cell of that tissue (i.e. the osteoclast). PTH stimulation of bone resorption by OMGCs suggests that PTH or a PTH-like protein, may be involved in the bone resorption and consequent hypercalcaemia associated with metastatic breast cancer.