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Poorly differentiated adenocarcinoma on gastroesophageal junction (a) with multinucleated giant cells (b), (c), which are negative to keratins AE1AE3 (d). Coincidental GIST (e), (f) positive to CD117/c-kit antigen (g). (a) H-E ×40, (b) H-E ×100, (c) H-E ×400, (d) IHC ×400, (e) H-E ×20, (f) H-E ×400, and (g) IHC ×400.
Source publication
Reactive multinucleated osteoclast-like giant cells (OGCs) have been described in a variety of neoplasms but rarely in gastric carcinomas. Reported herein is a case of an 81-year-old Caucasian male presented with upper abdominal pain and dysphagia. Esophagogastroscopy revealed an ulcerative mass and a specimen of subtotal gastrectomy and lower esop...
Citations
Breast carcinoma with osteoclast-like giant cells (OGCs) is extremely rare. OGCs are found mostly in invasive breast carcinoma and ductal carcinoma in situ is extremely rare. We report a case of ductal carcinoma in situ with osteoclast-like giant cells of the breast (DCIS OGCs) in a 38-year-old female. Histologically, on a low-power view, the DCIS OGCs exhibited a solid pattern with thick fibrovascular stroma. On a high-power view, the tumor cells showed indistinct and eosinophilic cytoplasm, and round to oval nuclei with prominent nucleoli. Most OGCs were identified within the space formed by tumor cells and consisted of multiple nuclei with abundant eosinophilic cytoplasm. Immunohistochemically, p63 and α-smooth muscle actin were positive in a myoepithelial layer around the in situ component. The OGCs stained positive for CD68, vascular endothelial growth factor and tumor necrosis factor-α, but were negative for cytokeratin AE1/AE3, CD163, and transforming growth factor-β. We could not find vessel proliferation around the OGC and this may be different from OGCs in invasive breast cancer. Our IHC results suggest that OGCs are anti-tumoral M1-like macrophages and that they express antitumor effects on cytokines in DCIS OGCs. Previous and current data suggest the existence of both antitumor and protumor OGCs in breast carcinoma, whereby the phenotype is possibly influenced by tumor invasiveness.
Extraskeletal carcinomas with osteoclast-like giant cells (OGC) constitute a rare type of malignant tumors, usually located in the pancreas, gall bladder, breast and kidney. Histologically they are characterized by the presence of mul-tinucleated giant cells that resemble osteoclasts mixed with poorly differentiated adenocarcinoma cells. This paper reports a case of primary gastric adenocarcinoma with osteoclast-like giant cells in a 75-year-old woman who suffered from epigastric pain, nausea, vomiting and weight loss. Histological examination of the tissue obtained during initial surgery (subtotal palliative Billroth II resection) revealed poorly differentiated adenocarcinoma with an infiltrate of osteoclast-like giant cells and no EBV immunostaining (non-lymphoepithelioma-like carcinoma, stage pT4aN3a). The tumor progressed rapidly with extensive perigastric involvement, infiltration of the paraaortic lymph nodes and the head of the pancreas. Poor general condition (WHO 3) prevented postoperative chemotherapy. The patient died 5 months after surgery due to rapid relapse. There is still a lack of knowledge to determine the prognosis for patients with OGC carcinomas. In this study, we report a case of gastric adenocarcinoma with OGC and review the previously published literature clinical and pathologic data on this rare neoplasm. NOWOTWORY J Oncol 2018; 68, 2: 95-98
Objective:
Amyloidomas are tumor-like deposits of amyloid. Amyloidoma of the gastrointestinal tract is rare. To the best of our knowledge, this is the first instance of diagnosis of an amyloidoma in the gastrointestinal tract by fine needle aspiration (FNA).
Study design:
We report a case of a 64-year-old male with a history of ulcerative colitis and primary sclerosing cholangitis who was incidentally found to have a mass in the stomach wall.
Results:
Initially thought to be gastrointestinal stromal tumor, FNA demonstrated the lesion to be amyloidoma with a prominent giant cell reaction. This was further confirmed by mass spectrometry. This is the only case report of diagnosis of a gastric amyloidoma by FNA.
Conclusion:
The presence of a florid giant cell reaction in the absence of ulceration or an inflammatory or neoplastic lesion should alert the pathologist to the possibility of an amyloidoma. This is the only case report of diagnosis of a gastric amyloidoma by FNA.
