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Satturwar S, Parwani AV, Thomas R, Bastacky S, Dhir R, Quiroga-Garza GM. The osteoclast-type giant cell rich carcinoma of urinary bladder: A case series. Pathol Res Pract 2022; 239:154164. [DOI: 10.1016/j.prp.2022.154164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/28/2022] [Accepted: 10/06/2022] [Indexed: 10/31/2022]
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2
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Undifferentiated Carcinoma with Osteoclast-Like Giant Cells of the Common Bile Duct: A Case Report of a Rare Entity at an Unusual Location. Diagnostics (Basel) 2022; 12:diagnostics12071517. [PMID: 35885423 PMCID: PMC9324465 DOI: 10.3390/diagnostics12071517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/18/2022] [Accepted: 06/20/2022] [Indexed: 11/17/2022] Open
Abstract
Undifferentiated carcinoma with osteoclast-like giant cells (UCOGC) is a rare variant of carcinoma with unique radiological and pathological features. This unusual carcinoma has been reported in a variety of organs and pancreas is the most frequently involved anatomical site. UCOGC of pancreas attains a relatively indolent clinical behavior and should be distinguished from ordinary pancreatobiliary adenocarcinoma. This paper presents the first case of UCOGC involving the entire segment of common bile duct (CBD) and common hepatic duct (CHD) without extending to the pancreatic tissue. Getting familiar with its clinical, radiological and pathological characters can help establish accurate diagnosis despite the occurrence of an unusual location.
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Niwa A, Tomita H, Watanabe N, Kiriyama S, Hara A, Tanaka T. Case Report: A Case of Gallbladder Carcinosarcoma With Osteoclast-like Multinucleated Giant Cells that Was Associated With RANK-RANKL Signaling. Pathol Oncol Res 2022; 28:1610134. [PMID: 35401056 PMCID: PMC8983827 DOI: 10.3389/pore.2022.1610134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 02/21/2022] [Indexed: 11/23/2022]
Abstract
Introduction: Gallbladder carcinosarcoma with osteoclast-like multinucleated giant cells is known to be most uncommon form of gallbladder cancer. Owing to its rarity, the pathogenesis of gallbladder carcinosarcoma with osteoclast-like multinucleated giant cells is largely unknown. Case Presentation: We present a case of carcinosarcoma with osteoclast-like multinucleated giant cells in the gallbladder. A 57-year-old woman visited our hospital due to jaundice. An examination revealed calculous cholecystitis and gallbladder carcinoma. After cholecystectomy, macroscopic examination disclosed one whitish mass and another distinct brown and pendulous mass in the body of the gallbladder. A pathological examination revealed that each mass had a different histological type: adenosquamous carcinoma and carcinosarcoma with osteoclast-like multinucleated giant cells. Immunohistochemistry revealed that these osteoclast-like multinucleated giant cells are CD68(+), CD163(−), and MIB-1(−). In addition, the osteoclast-like multinucleated giant cells showed the strong expression of RANK and sarcoma cells around the osteoclast-like multinucleated giant cells, were positive for RANKL. Furthermore, RUNX2 was positive for some sarcoma cells. The result indicated that osteoclastic and osteoblast-like differentiation occurred in our case. Conclusion: To our knowledge, this is the first case to show the interaction of RANK-RANKL signaling in gallbladder carcinosarcoma with osteoclast-like multinucleated giant cells.
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Affiliation(s)
- Ayumi Niwa
- Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroyuki Tomita
- Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Naoki Watanabe
- Department of Diagnostic Pathology (DDP), Research Center of Diagnostic Pathology (RC-DiP), Gifu Municipal Hospital, Gifu, Japan
| | | | - Akira Hara
- Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Takuji Tanaka
- Department of Diagnostic Pathology (DDP), Research Center of Diagnostic Pathology (RC-DiP), Gifu Municipal Hospital, Gifu, Japan
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Smith JL, Jacovides CL, Tucker CM, Jiang W, Prestipino AJ, Yeo CJ. Sequencing of an Undifferentiated Carcinoma with Osteoclast-Like Giant Cells of the Pancreas: A Case Report. J Pancreat Cancer 2021; 7:71-73. [PMID: 34901698 PMCID: PMC8655799 DOI: 10.1089/pancan.2021.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Undifferentiated carcinoma with osteoclast-like giant cells/osteoclast-like giant cell reaction (UC-OGC) is a rare form of pancreatic cancer historically associated with a poor prognosis. Molecular tumor profiling provides new information about tumor origins and a more nuanced understanding of the potential efficacy of different chemotherapeutic agents. Presentation: A 69-year-old man presented with a 13-cm periampullary pancreatic mass. Biopsy of a neighboring lymph node was consistent with adenocarcinoma. After neoadjuvant chemoradiation, the patient underwent resection and the tumor was consistent with UC-OGC. Next-generation sequencing was performed with genomic and proteomic analyses analyzed by a molecular tumor board review. These analyses revealed genetic alterations similar to those seen in pancreatic ductal adenocarcinoma, as well as potential therapeutic targets for the patient's subsequent therapy. Conclusions: Understanding a tumor's genetic changes allows for better understanding of its biology and may improve treatment efficacy. We believe that future study in tumor profiling will improve our understanding of rare cancers such as UC-OGC and also pave the way for the use of novel therapies to specifically target mutations in a broad range of more common tumors.
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Affiliation(s)
- Jessica L Smith
- Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Christina L Jacovides
- Division of Trauma, Surgical Critical Care and Emergency Surgery, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, USA
| | - Catherine M Tucker
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Wei Jiang
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Anthony J Prestipino
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Charles J Yeo
- Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
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Behzatoglu K. Osteoclasts in Tumor Biology: Metastasis and Epithelial-Mesenchymal-Myeloid Transition. Pathol Oncol Res 2021; 27:609472. [PMID: 34257573 PMCID: PMC8262221 DOI: 10.3389/pore.2021.609472] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 02/24/2021] [Indexed: 11/30/2022]
Abstract
Osteoclast is a specialized cell that originates from monocytic lineage, communicates closely with osteoblasts under physiological conditions, participates in bone modeling and re-modeling, contributes to calcium homeostasis and osteoimmunity. In pathological conditions, it is involved in many tumors such as giant cell bone tumor (osteoclastoma), aneurysmal bone cyst, osteosarcoma, and metastatic cancers, and it usually causes local spread and progression of the tumor, working against the host. Since osteoclasts play an active role in primary bone tumors and bone metastases, the use of anti-osteoclastic agents significantly reduces the mortality and morbidity rates of patients by preventing the progression and local spread of tumors. Osteoclasts also accompany undifferentiated carcinomas of many organs, especially pancreas, thyroid, bladder and ovary. Undifferentiated carcinomas rich in osteoclasts have osteoclastoma-like histology. In these organs, osteoclastoma-like histology may accompany epithelial carcinomas, and de novo, benign and borderline tumors. Mature and immature myeloid cells, including osteoclasts, play an active role in the tumor progression in primary and metastatic tumor microenvironment, in epithelial-mesenchymal transition (EMT), mesenchymal-epithelial-transition (MET), and cancer stem cell formation. Additionally, they are the most suitable candidates for cancer cells in cell fusion due to their evolutionary fusion capabilities. Myeloid features and markers (CD163, CD33, CD68 etc.) can be seen in metastatic cancer cells. Consequently, they provide metastatic cancer cells with motility, margination, transmigration, chemotaxis, phagocytosis, angiogenesis, matrix degradation, and resistance to chemotherapy. For these reasons, we think that the concept of Epithelial-Mesencyhmal-Myeloid-Transition (EMMT) will be more accurate than EMT for cancer cells with myeloid properties.
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Mori D, Hiraki M, Yamaji K, Miyoshi A, Koga Y, Yamamoto T, Masuda M, Kitahara K. Non-invasive undifferentiated carcinoma with osteoclast-like giant cells of the common bile duct. Pathol Int 2021; 71:161-163. [PMID: 33470502 DOI: 10.1111/pin.13035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 09/28/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Daisuke Mori
- Department of Pathology, SAGA-KEN Medical Centre, Saga, Japan
| | | | - Koutaro Yamaji
- Department of Surgery, SAGA-KEN Medical Centre, Saga, Japan
| | | | - Yutaka Koga
- Department of Anatomic Pathology Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Takeo Yamamoto
- Department of Anatomic Pathology Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Masanori Masuda
- Department of Pathology, SAGA-KEN Medical Centre, Saga, Japan
| | - Kenji Kitahara
- Department of Surgery, SAGA-KEN Medical Centre, Saga, Japan
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Vahedi A, Azimpouran M, Ghavidel A, Karbasi M, Farhadi M. Synchronous gallbladder squamous cell carcinoma and adenocarcinoma, both as primary tumors in one patient. Int J Surg Case Rep 2018; 45:1-3. [PMID: 29549846 PMCID: PMC6000719 DOI: 10.1016/j.ijscr.2018.02.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 02/20/2018] [Accepted: 02/26/2018] [Indexed: 01/21/2023] Open
Abstract
We report a male patient with synchronous gallbladder carcinomas. This rare condition should be considered in the differential diagnosis of cholecystitis. The precise diagnosis of synchronous gallbladder carcinomas by surgeons can lead to proper management and choosing the best surgical strategy. It was very interesting that different type of carcinomas affect the gallbladder simultaneously. Although synchronous gallbladder carcinomas are very rare, presentation can mimic cholecystitis.
Introduction Synchronous primary carcinomas of gallbladder are extremely rare. In this paper, we report a case of double primary carcinomas in gallbladder Case report A 65 year old male was admitted to the hospital for surgical removal of gallbladder, which was diagnosed as cholecystitis in ultrasonography. Macroscopic examination disclosed a single whitish mass in gallbladder neck and another distinct mass in the fundus as wall thickening. Pathologic findings revealed squamous cell carcinoma of the neck and adenocarcinoma in the fundus. Discussion This study represents an example of misdiagnosis. Being cautious is mandatory in order to manage the patient properly. Conclusion Synchronous primary carcinomas of gallbladder are rare. However this diagnosis should be taken into account in patients with cholecystitis features in order to seeking for the best surgical approach.
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Affiliation(s)
- Amir Vahedi
- Department of General Pathology, Tabriz University of Medical Science, Tabriz, Iran.
| | - Mahzad Azimpouran
- Department of General Pathology, Tabriz University of Medical Science, Tabriz, Iran.
| | - Ali Ghavidel
- Liver and Gastrointestinal Diseases Research Centre, Tabriz University of Medical Sciences, Imam Reza Hospital, East Azerbaijan, Iran.
| | - Mahsa Karbasi
- Department of Radiology, Tabriz University of Medical Science, Tabriz, Iran.
| | - Mehrdad Farhadi
- Liver and Gastrointestinal Diseases Research Centre, Tabriz University of Medical Sciences, Imam Reza Hospital, East Azerbaijan, Iran.
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Jiménez-Heffernan JA, Adrados M, Muñoz-Hernández P, Fernández-Rico P, Ballesteros-García AI, Fraga J. Cytologic Features of Malignant Melanoma with Osteoclast-Like Giant Cells. Acta Cytol 2018; 62:151-154. [PMID: 29332062 DOI: 10.1159/000486027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 12/04/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Malignant melanoma showing numerous osteoclast-like giant cells (OGCs) is an uncommon morphologic phenomenon, rarely mentioned in the cytologic literature. The few reported cases seem to have an aggressive clinical behavior. Although most findings support monocyte/macrophage differentiation, the exact nature of OGCs is not clear. CASE A 57-year-old woman presented with an inguinal lymphadenopathy. Sixteen years before, cutaneous malignant melanoma of the lower limb had been excised. Needle aspiration revealed abundant neoplastic single cells as well as numerous multinucleated OGCs. Occasional neoplastic giant cells were also present. Nuclei of OGCs were monomorphic with oval morphology and were smaller than those of melanoma cells. The immunophenotype of OGCs (S100-, HMB45-, Melan-A-, SOX10-, Ki67-, CD163-, BRAF-, CD68+, MiTF+, p16+) was the expected for reactive OGCs of monocyte/macrophage origin. The tumor has shown an aggressive behavior with further metastases to the axillary lymph nodes and oral cavity. CONCLUSION Numerous OGCs are a rare and relevant finding in malignant melanoma. Their presence should not induce confusion with other tumors rich in osteoclastic cells. Since a relevant number of OGCs in melanoma may mean a more aggressive behavior, and patients may benefit from specific treatments, their presence should be mentioned in the pathologic report.
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Giant Cell Tumor of the Uterus: A Report of 3 Cases With a Spectrum of Morphologic Features. Int J Gynecol Pathol 2017; 34:340-50. [PMID: 25851705 DOI: 10.1097/pgp.0000000000000164] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Giant cell tumors, a well-recognized neoplasm of bone, can rarely be found in the uterus. Such tumors are characterized by a dual population of mononuclear and osteoclast-like giant cells that lack epithelial and specific mesenchymal differentiation. In this study, the clinicopathologic features of 3 giant cell tumors of the uterus were reviewed. Immunohistochemistry for CD68, CD163, h-caldesmon, desmin, SMA, AE1/AE3, CD10, ER, PR, cyclin D1, CD1a, CD34, CD30, S100, myogenin/myoglobin, and Ki-67 was performed in all tumors, along with ultrastructural analysis in one. The patients were 47, 57, and 59 yr and the tumors measured 2.5, 7.5, and 16.0 cm. One neoplasm was confined to the endometrium, whereas the other 2 were myometrial. All 3 tumors showed a nodular growth comprised of mononuclear and osteoclast-like giant cells. The endometrial-confined tumor consisted of histologically benign mononuclear cells, whereas the others exhibited marked atypia. Mitotic activity was up to 5/10 HPF in the benign tumor and up to 22/10 HPF in the malignant. No cytologic atypia or mitoses were observed in the giant cells. CD68 and CD10 were strongly and diffusely expressed in both components of 3 and 2 neoplasms, respectively. Cyclin D1 was focal in the mononuclear cells and focal to diffuse in the giant cells. CD163 was diffuse in the mononuclear cells, but absent to focal in the giant cells. Ultrastructural analysis lacked diagnostic features of epithelial or specific mesenchymal differentiation. Both malignant tumors demonstrated an aggressive behavior. In summary, although rare, giant cell tumor of the uterus should be included in the differential diagnosis of benign or malignant tumors containing osteoclast-like giant cells.
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Beaufrère A, Larousserie F, Dokmak S, Pasmant E, Selves J, Cazals-Hatem D. Primary giant cell tumor of the common bile duct: No mutation H3F3A found. Pathol Int 2017; 67:225-227. [PMID: 28105671 DOI: 10.1111/pin.12510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Safi Dokmak
- Department of HPB Surgery and Liver Transplantation surgery, Beaujon Hospital, Clichy, 92110, France
| | - Eric Pasmant
- Department of Molecular genetics, Cochin hospital, Paris, 75014, France
| | - Janick Selves
- Department of Pathology, Cancer Institute, Toulouse, 31110, France
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Muraki T, Reid MD, Basturk O, Jang KT, Bedolla G, Bagci P, Mittal P, Memis B, Katabi N, Bandyopadhyay S, Sarmiento JM, Krasinskas A, Klimstra DS, Adsay V. Undifferentiated Carcinoma With Osteoclastic Giant Cells of the Pancreas: Clinicopathologic Analysis of 38 Cases Highlights a More Protracted Clinical Course Than Currently Appreciated. Am J Surg Pathol 2016; 40:1203-16. [PMID: 27508975 PMCID: PMC4987218 DOI: 10.1097/pas.0000000000000689] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Undifferentiated carcinomas with osteoclastic giant cells of the pancreas (OGC) are rare tumors. The current impression in the literature is that they are highly aggressive tumors similar in prognosis to ductal adenocarcinomas. In this study, the clinicopathologic characteristics of 38 resected OGCs were investigated and contrasted with 725 resected pancreatic ductal adenocarcinomas without osteoclastic cells (PDCs). The frequency among systematically reviewed pancreatic cancers was 1.4%. OGCs showed a slight female predominance (62.9%, vs. 51.4% in PDCs). The mean age was 57.9 years (vs. 65.0). The mean size of invasive cancer was 5.3 cm (vs. 3.2). They were characterized by nodular, pushing-border growth, and 8 arose in tumoral intraepithelial neoplasms (4 in mucinous cystic neoplasms, 4 in intraductal papillary mucinous neoplasms type lesions), and 23 (61%) also showed prominent intraductal/intracystic growth. Twenty-nine (76%) had an invasive ductal/tubular adenocarcinoma component. Osteoid was seen in 12. Despite their larger size, perineural invasion and nodal metastasis were uncommon (31.6% and 22.6%, vs. 85.5% and 64.0%, respectively). Immunohistochemistry performed on 24 cases revealed that osteoclastic cells expressed the histiocytic marker CD68, and background spindle cells and pleomorphic/giant carcinoma cells often showed p53 and often lacked cytokeratin. Survival of OGCs was significantly better than that of PDCs (5 yr, 59.1% vs. 15.7%, respectively, P=0.0009). In conclusion, pancreatic OGCs present with larger tumor size and in slightly younger patients than PDC, 21% arise in mucinous cystic neoplasms/intraductal papillary mucinous neoplasms, and 61% show intraductal/intracystic polypoid growth. OGCs have a significantly better prognosis than is currently believed in the literature.
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Affiliation(s)
- Takashi Muraki
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, GA, USA
| | - Michelle D. Reid
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, GA, USA
| | - Olca Basturk
- Department of Pathology, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Kee-Taek Jang
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gabriela Bedolla
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, GA, USA
| | - Pelin Bagci
- Department of Pathology, Marmara University, Istanbul, Turkey
| | - Pardeep Mittal
- Department of Radiology, Emory University School of Medicine, GA, USA
| | - Bahar Memis
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, GA, USA
| | - Nora Katabi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, NY, USA
| | | | | | - Alyssa Krasinskas
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, GA, USA
| | - David S. Klimstra
- Department of Pathology, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Volkan Adsay
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, GA, USA
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Ardakani NM, Lum D, Ng L, Kumarasinghe MP. Giant cell tumour of the gallbladder can mimic undifferentiated/anaplastic carcinoma clinically and pathologically. Pathology 2015; 47:698-702. [PMID: 26517636 DOI: 10.1097/pat.0000000000000341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Nima Mesbah Ardakani
- 1PathWest Laboratory Medicine, QEII Medical Centre, Perth 2Western Diagnostic Pathology, Perth 3School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia
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Tamura H, Doi R, Adachi S. Polypoid extrahepatic bile duct carcinoma morphologically indistinguishable from benign giant cell tumor. Pathol Int 2015; 66:114-7. [DOI: 10.1111/pin.12340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Hiromi Tamura
- Department of Pathology; City Hospital of Toyonaka; Toyonaka Japan
| | - Reiko Doi
- Department of Pathology; City Hospital of Toyonaka; Toyonaka Japan
| | - Shiro Adachi
- Department of Pathology; City Hospital of Toyonaka; Toyonaka Japan
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Wang DD, Zheng YM, Teng LH, Sun YN, Gao W, Wang LM, Wang YH, Li F, Lu DH. Benign giant-cell tumor of the common bile duct: A case report. World J Gastroenterol 2014; 20:15448-15453. [PMID: 25386094 PMCID: PMC4223279 DOI: 10.3748/wjg.v20.i41.15448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Revised: 05/07/2014] [Accepted: 08/28/2014] [Indexed: 02/06/2023] Open
Abstract
Primary giant-cell tumors rarely arise in the common bile duct. We herein report a case of primary giant-cell tumor of the common bile duct. The patient was an 81-year-old male who was diagnosed with a well-defined 1.2-cm mass projecting into the lumen of the middle common bile duct. Excision of the gallbladder and extrahepatic bile duct and a Roux-en-Y cholangiojejunostomy were performed. Histologically, the tumor had no association with carcinomas of epithelial origin and was similar to giant-cell tumors of the bone. The tumor consisted of a mixture of mononuclear and multinucleated osteoclast-like giant cells. The mononuclear cells showed no atypical features, and their nuclei were similar to those of the multinucleated giant cells. CD68 was expressed on the mononuclear and multinucleated osteoclast-like giant cells, whereas CD163 immunoreactivity was restricted to the mononuclear cells. Six months after the operation, the patient was still alive and had no recurrence. The interest of this case lies in the rarity of this entity, the difficulty of preoperative diagnosis, and this tumor’s possible confusion with other malignant tumors.
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15
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Soft tissue giant cell tumor of low malignant potential with 3 localizations: report of a case. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:e135-8. [DOI: 10.1016/j.oooo.2014.03.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 03/10/2014] [Accepted: 03/17/2014] [Indexed: 01/04/2023]
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Kolokotronis T, Glanemann M, Wagner M, Bohle RM, Grünhage F. Giant cell tumor of the distal common bile duct: report of a rare, benign entity that may mimic malignant biliary obstruction. Int J Colorectal Dis 2014; 29:413-4. [PMID: 24287577 DOI: 10.1007/s00384-013-1798-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/18/2013] [Indexed: 02/04/2023]
Affiliation(s)
- Theodoros Kolokotronis
- Department of General, Visceral, Vascular and Pediatric Surgery, University of Saarland Medical School, Homburg Campus, 66421, Homburg, Saar, Germany,
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Terada T. Spindle Cell Carcinoma of the Common Bile Duct: Case Report with Immunohistochemical Analysis. Case Rep Gastroenterol 2010; 4:374-380. [PMID: 21060703 PMCID: PMC2975002 DOI: 10.1159/000320674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The author reports a very rare case of spindle cell carcinoma of the common bile duct with an emphasis on immunohistochemical features. A 65-year-old man was admitted to our hospital because of jaundice. Imaging modalities revealed a tumor of the common bile duct, and bile cytology demonstrated malignant cells. A pancreatico-duodenectomy was performed. Grossly, an elevated tumor (15 × 10 × 3 mm) was present in the middle portion of the common bile duct. Microscopically, the tumor consisted of well-differentiated adenocarcinoma (20% in area) and spindle cell carcinoma (80% in area). There were gradual transitions between the two. The tumor cells invaded into the serosa. Immunohistochemically, the spindle cell carcinoma element was positive for four types of pancytokeratins, cytokeratin 7 (CK7), CK8, CK18, CK19, CK20, epithelial membrane antigen, vimentin, p53 protein, Ki-67 (labeling = 52%), and CEA. It was negative for high-molecular-weight CK, CK5/6, CK14, p63, neuron-specific enolase chromogranin, synaptophysin, CD56, CA19-9, CD34, desmin, S100 protein, myoglobin, a-smooth muscle antigen, CD34, CD68 and KIT. The adenocarcinoma element showed similar immunoreactivity except for negative vimentin, and positive CA19-9. The present case is the first report of spindle cell carcinoma of the common bile duct demonstrating an extensive immunohistochemistry. The spindle cell carcinoma in the present case may be derived from sarcomatous transformation of the adenocarcinoma element. CK20 newly emerges in the development of spindle cell carcinoma of the common bile duct.
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Affiliation(s)
- Tadashi Terada
- Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan
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18
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Osteoclast-rich undifferentiated carcinoma of the urinary bladder: is it really an entity? Adv Anat Pathol 2010; 17:288; author reply 288-9. [PMID: 20574176 DOI: 10.1097/pap.0b013e3181e4e348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Griglione NM, Klapproth JMA, Keilin SA. Giant cell tumor of the common bile duct. Clin Gastroenterol Hepatol 2010; 8:A30. [PMID: 19765676 DOI: 10.1016/j.cgh.2009.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2009] [Revised: 09/02/2009] [Accepted: 09/06/2009] [Indexed: 02/07/2023]
Affiliation(s)
- Nicole M Griglione
- Department of Internal Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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20
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Itami H, Ohbayashi C, Sakai Y, Kajimoto K, Sakuma T. Pleural malignant mesothelioma with osteoclast-like giant cells. Pathol Int 2010; 60:217-21. [DOI: 10.1111/j.1440-1827.2009.02497.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Behzatoğlu K, Durak H, Canberk S, Aydin O, Huq GE, Oznur M, Ozyalvaçli G, Yildiz P. Giant cell tumor-like lesion of the urinary bladder: a report of two cases and literature review; giant cell tumor or undifferentiated carcinoma? Diagn Pathol 2009; 4:48. [PMID: 20043822 PMCID: PMC2811699 DOI: 10.1186/1746-1596-4-48] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 12/31/2009] [Indexed: 11/13/2022] Open
Abstract
Summary Giant cell tumor, excluding its prototype in bone, is usually a benign but local aggressive neoplasm originating from tendon sheath or soft tissue. Malignant behavior is uncommon. Visceral organ involvement including urinary bladder is rare. Giant cell tumors in visceral organs usually accompany epithelial tumors and the clinical behavior of giant cell tumor in urinary bladder is similar to its bone counterpart. Here, we report two cases of giant cell tumor located in urinary bladder in comparison with nine reported cases in the English literature. Concurrent noninvasive urothelial carcinoma was also described in all these previous reports and only one patient with follow-up died of disease. One of the two cases we present had no concurrent urothelial tumor at the time of diagnosis but had a history of a low grade noninvasive urothelial carcinoma with three recurrences. The histology of these two cases was similar to the giant cell tumor of bone and composed of oval to spindle mononuclear cells with evenly spaced osteoclast-like giant cells. Immunohistochemically, the giant cells showed staining with osteoclastic markers including CD68, TRAP, and LCA. Immunohistochemical expression of vimentin, CD68, LCA, and smooth muscle actin in mononuclear cells supported a mesenchymal origin with histiocytic lineage. The histologic and immunohistochemical properties in our cases as well as their clinical courses were consistent with a giant cell tumor. Consequently, tumors in urinary bladder showing features of giant cell tumor of bone may also be considered and termed "giant cell tumor".
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Affiliation(s)
- Kemal Behzatoğlu
- Department of Pathology, Istanbul Education and Research Hospital, Istanbul, Turkey.
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Manouras A, Genetzakis M, Lagoudianakis EE, Markogiannakis H, Papadima A, Agrogiannis G, Gakiopoulou H, Kekis P, Filis K, Patsouris E. Undifferentiated giant cell type carcinoma of the gallbladder with sarcomatoid dedifferentiation: a case report and review of the literature. J Med Case Rep 2009; 3:6496. [PMID: 19830109 PMCID: PMC2726484 DOI: 10.1186/1752-1947-3-6496] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2007] [Accepted: 01/22/2009] [Indexed: 12/24/2022] Open
Abstract
Introduction Undifferentiated gallbladder carcinoma is a rare entity. Among unusual types of undifferentiated gallbladder carcinoma, giant cell type carcinoma is infrequent and, moreover, very few cases of such neoplasms with osteoclast-like giant cells have been documented. We report a case of undifferentiated gallbladder carcinoma presenting an unusual immunophenotype that was shown to be of giant cell type with sarcomatoid dedifferentiation infiltrated by osteoclast-like multinucleated cells. Case presentation An 84-year-old Greek man presented with right upper quadrant pain, high fever, rigors, anorexia and weight loss during the past month. Clinical examination revealed tenderness in the right upper abdominal quadrant and a palpable gallbladder. Blood tests showed elevated white blood-cell count and transaminases. Abdominal ultrasound and computed tomography demonstrated a markedly distended gallbladder, measuring 16 cm x 8 cm, with oedema and pericholecystic fluid, consistent with gallbladder empyema. After an open cholecystectomy and an uneventful recovery, the patient was discharged on the 4th postoperative day. On cut surface, a 2cm solid mass was identified, obstructing the lumen in the neck of the gallbladder. Histopathology and immunohistochemistry offered the diagnosis of an undifferentiated, giant cell type carcinoma of the gallbladder with sarcomatoid dedifferentiation infiltrated with osteoclast-like giant cells. Conclusions Undifferentiated, giant cell type carcinoma of the gallbladder with sarcomatoid dedifferentiation infiltrated with osteoclast-like giant cells is a very infrequent neoplasm. Controversy exists over its nature, as related knowledge remains incomplete. Thorough histopathological and immunohistochemical evaluation is imperative for diagnosis. Due to their rarity, the biological behaviour and prognosis of these tumours remain unclear.
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The cellular composition of osteoclastlike giant cell-containing tumors of the pancreatobiliary tree. Am J Surg Pathol 2008; 32:335-7; author response 337. [PMID: 18223338 DOI: 10.1097/pas.0b013e3180342793] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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In Response. Am J Surg Pathol 2008. [DOI: 10.1097/pas.0b013e3181354263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yamamoto S, Tsuda H, Sakano T, Aikoh S, Tamai S, Matsubara O. Esophageal pleomorphic giant cell carcinoma combined with small cell carcinoma. Pathol Int 2007; 57:523-8. [PMID: 17610478 DOI: 10.1111/j.1440-1827.2007.02135.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Herein is presented the case of an esophageal pleomorphic giant cell carcinoma combined with small cell carcinoma (SCC). The patient, a 77-year-old man, initially presented with dysphagia and hoarseness, and endoscopy indicated a large esophageal tumor. Despite chemoradiation therapy, the patient died from widespread local extension of the tumor and distant metastases approximately 8 months after onset of the symptoms. Histologically, the primary tumor was composed of pleomorphic tumor components, SCC components, and a tiny focus of squamous cell carcinoma. The pleomorphic tumor cells, consisting of solid sheets of poorly cohesive epithelioid cells and numerous multinucleated giant cells with abundant eosinophilic cytoplasm, were immunohistochemically positive for vimentin and desmin, with scattered positivity for epithelial membrane antigen (EMA) and neuron-specific enolase (NSE), but negative for myoglobin. These findings were histopathologically compatible with pleomorphic giant cell carcinoma occurring at other sites such as the lung. SCC cells, morphologically similar to their pulmonary counterpart, were positive for EMA and some neuroendocrine markers such as chromogranin A and NSE, and occasionally positive for vimentin and desmin. Esophageal pleomorphic giant cell carcinoma can occur in close association with SCC, and should be included in the differential diagnosis of esophageal tumors showing pleomorphism.
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Affiliation(s)
- Sohei Yamamoto
- Department of Basic Pathology, National Defense Medical College, Tokorozawa, Japan
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Nakanishi Y, Ito T, Kubota K, Takeda H, Yonemori A, Kawakami H, Zen Y, Kondo S. Spindle Cell-Type Undifferentiated Carcinoma of the Common Bile Duct of the Hepatic Hilus: Report of a Case. Surg Today 2007; 37:708-12. [PMID: 17643221 DOI: 10.1007/s00595-007-3463-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2006] [Accepted: 01/03/2007] [Indexed: 12/01/2022]
Abstract
Spindle cell-type undifferentiated carcinoma arising from the extrahepatic bile duct is extremely rare. We herein report a case of this type of carcinoma in the common bile duct of the hepatic hilus. A 59-year-old man was admitted to our hospital complaining of jaundice. The laboratory data revealed an elevation of the serum carbohydrate antigen 19-9 level. Cholangiography revealed a complete obliteration of the left hepatic bile duct and stenosis of the bile duct from the superior to the right hepatic bile duct. Computed tomography showed the tumor to measure 15 x 12 mm in the hepatic hilus, with the obliteration of the right to main trunk of the portal vein and a swollen lymph node in the hepato-duodenum ligament. Arteriography revealed a kink of the right hepatic artery; therefore an encasement of the right hepatic artery was suspected. We preoperatively diagnosed hilus bile duct carcinoma and scheduled a right trisection hepatectomy. Intraoperative frozen sections taken from the tumor and tissues around the hepatic arteries showed spindle and inflammatory cells; therefore an inflammatory pseudotumor was diagnosed intraoperatively. As the right hepatic bile duct was occluded, a right lobe hepatectomy was performed. However, a permanent section revealed both spindle cells and poorly differentiated tubular adenocarcinoma cells positive for CAM5.2, AE1/AE3, and vimentin. On the basis of these findings, the tumor was finally diagnosed to be spindle cell-type undifferentiated carcinoma. Unfortunately, the patient died of pulmonary infarction 11 days after the operation.
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Affiliation(s)
- Yoshitsugu Nakanishi
- Department of Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Kita-Ku, Sapporo 060-8638, Japan
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Abstract
PURPOSE OF REVIEW Recent papers on disorders of the liver and biliary tract which clarify their pathogenesis and attendant morphologic changes are highlighted. RECENT FINDINGS The concept of 'bystander hepatitis' was cited in studies showing hepatic infiltration of CD8-positive T cells in the setting of extrahepatic infections such as influenza virus and severe acute respiratory syndrome. Diabetic liver lesions include glycogenic hepatopathy (in which poor diabetic control leads to swollen, glycogen-filled hepatocytes without fat, steatohepatitis or fibrosis) and diabetic hepatosclerosis in which there is diffuse perisinusoidal fibrosis (type IV collagen) without zonal predilection. Ground-glass hepatocellular inclusions (positive with periodic acid-Schiff stain for glycogen) were reported in three separate series of patients who were hepatitis B virus-negative, often transplant recipients, immunosuppressed and on multiple medications. A Banff consensus paper expertly compared and contrasted the histologic features which characterize the various causes of late liver allograft dysfunction. SUMMARY Informative papers emerged this past year concerning collateral damage to the liver in extrahepatic infections, diabetic lesions and causes of liver dysfunction after transplantation, among other topics.
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Affiliation(s)
- Jay H Lefkowitch
- Department of Pathology, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.
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