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Li M, Abe M, Nakano S, Tsuneki M. Deep Learning Approach to Classify Cutaneous Melanoma in a Whole Slide Image. Cancers (Basel) 2023; 15:cancers15061907. [PMID: 36980793 PMCID: PMC10047087 DOI: 10.3390/cancers15061907] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/02/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
Although the histopathological diagnosis of cutaneous melanocytic lesions is fairly accurate and reliable among experienced surgical pathologists, it is not perfect in every case (especially melanoma). Microscopic examination-clinicopathological correlation is the gold standard for the definitive diagnosis of melanoma. Pathologists may encounter diagnostic controversies when melanoma closely mimics Spitz's nevus or blue nevus, exhibits amelanotic histopathology, or is in situ. It would be beneficial if diagnosing cutaneous melanocytic lesions can be automated by using deep learning, particularly when assisting surgical pathologists with their workloads. In this preliminary study, we investigated the application of deep learning for classifying cutaneous melanoma in whole-slide images (WSIs). We trained models via weakly supervised learning using a dataset of 66 WSIs (33 melanomas and 33 non-melanomas). We evaluated the models on a test set of 90 WSIs (40 melanomas and 50 non-melanomas), achieving ROC-AUC at 0.821 for the WSI level and 0.936 for the tile level by the best model.
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Affiliation(s)
- Meng Li
- Medmain Research, Medmain Inc., Fukuoka 810-0042, Japan
| | - Makoto Abe
- Department of Pathology, Tochigi Cancer Center, 4-9-13 Yohnan, Utsunomiya 320-0834, Japan
| | - Shigeo Nakano
- Department of Surgical Pathology, Tokyo Shinagawa Hospital, 6-3-22 Higashi-Ooi, Shinagawa, Tokyo 140-8522, Japan
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2
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Ríos-Martín JJ, Pérez-Pérez M, Umbría-Jiménez S, Moreno-Ramírez D, Vallejo-Benítez A. An Unusual Case of Desmoplastic Melanoma With Monster Cells Imitating an Atypical Fibroxanthoma. Int J Surg Pathol 2021; 30:313-316. [PMID: 34541940 DOI: 10.1177/10668969211044758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Numerous cells with very large and irregular nuclei ("monster" cells) have not hitherto been reported in desmoplastic melanoma (DM). Their prognostic significance in melanomas is a matter of debate, although some authors have associated them with more aggressive tumor behavior. We report a mixed DM on the scalp of an 88-year-old woman imitating an atypical fibroxanthoma. Tumor cells stained positive for SOX10, S100, and cyclin D1; BRAF mutation status was negative, and fluorescence in situ hybridization analysis showed copy number gains in 11q13 (cyclin D1) and 6p25 (RREB1), and loss in 6q23 (MYB). Cyclin D1 amplification is associated with poor prognosis in melanoma.
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Affiliation(s)
- Juan J Ríos-Martín
- 16582Department of Pathology, University Hospital Virgen Macarena, Sevilla, Spain
| | - Manuel Pérez-Pérez
- 16582Department of Pathology, University Hospital Virgen Macarena, Sevilla, Spain
| | | | - David Moreno-Ramírez
- 16582Department of Dermatology, University Hospital Virgen Macarena, Sevilla, Spain
| | - Ana Vallejo-Benítez
- 16582Department of Pathology, University Hospital Virgen Macarena, Sevilla, Spain
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3
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Meierjohann S. Effect of stress-induced polyploidy on melanoma reprogramming and therapy resistance. Semin Cancer Biol 2021; 81:232-240. [PMID: 33610722 DOI: 10.1016/j.semcancer.2021.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/03/2021] [Accepted: 02/09/2021] [Indexed: 12/15/2022]
Abstract
Melanomas and their precursors, the melanocytes, are frequently exposed to UV due to their anatomic location, leading to DNA damage and reactive oxygen stress related harm. Such damage can result in multinucleation or polyploidy, in particularly in presence of mitotic or cell division failure. As a consequence, the cell encounters either of two fates: mitotic catastrophe, resulting in cell death, or survival and recovery, the latter occurring less frequently. However, when cells manage to recover in an polyploid state, they have often acquired new features, which allow them to tolerate and adapt to oncogene- or therapy induced stress. This review focuses on polyploidy inducers in melanoma and their effects on transcriptional reprogramming and phenotypic adaptation as well as the relevance of polyploid melanoma cells for therapy resistance.
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Affiliation(s)
- Svenja Meierjohann
- Institute of Pathology, University of Würzburg, Würzburg, Germany; Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Würzburg, Germany.
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Weng CH, Wu CS, Wu JC, Kung ML, Wu MH, Tai MH. Cisplatin-Induced Giant Cells Formation Is Involved in Chemoresistance of Melanoma Cells. Int J Mol Sci 2020; 21:ijms21217892. [PMID: 33114317 PMCID: PMC7660656 DOI: 10.3390/ijms21217892] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 01/03/2023] Open
Abstract
Melanoma is notoriously resistant to current cancer therapy. However, the chemoresistance mechanism of melanoma remains unclear. The present study unveiled that chemotherapy drug cisplatin induced the formation of giant cells, which exhibited enlargement in cell diameter and nucleus in mice and human melanoma cells. Giant cells were positive with melanoma maker S100 and cancer stem cell markers including ABCB5 and CD133 in vitro and in vivo. Moreover, giant cells retained the mitotic ability with expression of proliferation marker Ki-67 and exhibited multiple drug resistance to doxorubicin and actinomycin D. The mitochondria genesis/activities and cellular ATP level were significantly elevated in giant cells, implicating the demand for energy supply. Application of metabolic blockers such as sodium azide or 2-deoxy glucose abolished the cisplatin-induced giant cells formation and expression of cancer stemness markers. The present study unveils a novel chemoresistance mechanism of melanoma cells via size alteration and the anti-neoplastic strategy by targeting giant cells.
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Affiliation(s)
- Chien-Hui Weng
- Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan;
| | - Chieh-Shan Wu
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan;
- Department of Dermatology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Jian-Ching Wu
- Biobank and Tissue Bank, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan;
| | - Mei-Lang Kung
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan;
| | - Ming-Hsiu Wu
- Department of Nutrition and Health Science, Fooyin University, Kaohsiung 83102, Taiwan
- Correspondence: (M.-H.W.); (M.-H.T.)
| | - Ming-Hong Tai
- Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan;
- Institute of Biomedical Sciences, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
- Correspondence: (M.-H.W.); (M.-H.T.)
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5
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Cancer regeneration: Polyploid cells are the key drivers of tumor progression. Biochim Biophys Acta Rev Cancer 2020; 1874:188408. [PMID: 32827584 DOI: 10.1016/j.bbcan.2020.188408] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/16/2020] [Accepted: 07/23/2020] [Indexed: 12/15/2022]
Abstract
In spite of significant advancements of therapies for initial eradication of cancers, tumor relapse remains a major challenge. It is for a long time known that polyploid malignant cells are a main source of resistance against chemotherapy and irradiation. However, therapeutic approaches targeting these cells have not been appropriately pursued which could partly be due to the shortage of knowledge on the molecular biology of cell polyploidy. On the other hand, there is a rising trend to appreciate polyploid/ multinucleated cells as key players in tissue regeneration. In this review, we suggest an analogy between the functions of polyploid cells in normal and malignant tissues and discuss the idea that cell polyploidy is an evolutionary conserved source of tissue regeneration also exploited by cancers as a survival factor. In addition, polyploid cells are highlighted as a promising therapeutic target to overcome drug resistance and relapse.
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6
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White-Gilbertson S, Voelkel-Johnson C. Giants and monsters: Unexpected characters in the story of cancer recurrence. Adv Cancer Res 2020; 148:201-232. [PMID: 32723564 DOI: 10.1016/bs.acr.2020.03.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Polyploid giant cancer cells (PGCC) constitute a dangerous subpopulation of cancer cells and are a driving force in cancer recurrence. These unique cells arise from diploid tumor cells in response to stress encountered in the tumor microenvironment or during cancer therapy. PGCC are greatly dedifferentiated, acquire pluripotency, and are able to replicate through a form of asymmetric division called neosis, which results in new populations that are themselves able to differentiate into new cell types or to re-establish tumors. Progeny tend to be more genetically unstable than the founding population due to the dysregulation required to transition through a PGCC state. Therefore, cancers that escape stressors through this mechanism tend to re-emerge with a more aggressive phenotype that is therapy resistant. This review focuses on the clinical significance of PGCC, the need for standardized nomenclature and molecular markers, as well as possible avenues to develop therapies aimed at PGCC and the process of neosis. The biology underlying the development of PGCC including cell cycle checkpoint dysregulation, stress responses, dedifferentiation, stemness and epithelial-mesenchymal transition is discussed.
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Affiliation(s)
- Shai White-Gilbertson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, United States
| | - Christina Voelkel-Johnson
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, United States.
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Cota C, Saggini A, Lora V, Kutzner H, Rütten A, Sangüeza O, Requena L, Cerroni L. Uncommon Histopathological Variants of Malignant Melanoma: Part 1. Am J Dermatopathol 2019; 41:243-263. [PMID: 30024414 DOI: 10.1097/dad.0000000000001218] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Despite new horizons opened by recent advances in molecular pathology, histological evaluation still remains the diagnostic gold standard regarding cutaneous melanocytic neoplasms. Several histological variants of melanoma have been described, and their knowledge is crucial for accurate diagnosis and classification of cases with unusual clinicopathological features. Uncommon histological variants of melanoma have been described based on a broad constellation of features, including architectural pattern, stromal alterations, cytological attributes, and other morphological properties. This review is aimed at providing an extensive discussion of unusual but distinctive histopathological variants of melanoma.
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Affiliation(s)
- Carlo Cota
- Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
- San Gallicano Dermatological Institute, Rome, Italy
| | - Andrea Saggini
- Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
- Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Viviana Lora
- San Gallicano Dermatological Institute, Rome, Italy
| | - Heinz Kutzner
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
| | - Arno Rütten
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
| | - Omar Sangüeza
- Department of Pathology, Wake Forest School of Medicine, Winston Salem, NC
| | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Lorenzo Cerroni
- Research Unit Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria
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Srisuttiyakorn C, Bulloch K, Rodic N, Bosenberg M, Ariyan S, Narayan D, Gould Rothberg BE, Galan A. Intratumoral multinucleated giant cells are not a prognostic pathologic feature in cutaneous melanoma. J Cutan Pathol 2016; 43:821-9. [DOI: 10.1111/cup.12750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/30/2016] [Accepted: 05/30/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Chutika Srisuttiyakorn
- Department of Medicine, Division of DermatologyPhramongkutklao Hospital Bangkok Thailand
- Department of DermatologyYale School of Medicine New Haven CT USA
| | - Kaleigh Bulloch
- Department of Internal Medicine, Medical Oncology DivisionYale School of Medicine New Haven CT USA
| | - Nemanja Rodic
- Department of DermatologyYale School of Medicine New Haven CT USA
| | - Marcus Bosenberg
- Department of DermatologyYale School of Medicine New Haven CT USA
- Department of PathologyYale School of Medicine New Haven CT USA
| | - Stephen Ariyan
- Department of Surgery, Section of Plastic and Reconstructive SurgeryYale School of Medicine New Haven CT USA
| | - Deepak Narayan
- Department of Surgery, Section of Plastic and Reconstructive SurgeryYale School of Medicine New Haven CT USA
| | - Bonnie E. Gould Rothberg
- Department of Internal Medicine, Medical Oncology DivisionYale School of Medicine New Haven CT USA
- Department of PathologyYale School of Medicine New Haven CT USA
- Department of EpidemiologyYale School of Medicine New Haven CT USA
| | - Anjela Galan
- Department of DermatologyYale School of Medicine New Haven CT USA
- Department of PathologyYale School of Medicine New Haven CT USA
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Kim HY, Yoon JH, Cho EB, Park EJ, Kim KH, Kim KJ. A case of spitzoid melanoma. Ann Dermatol 2015; 27:206-9. [PMID: 25834363 PMCID: PMC4377413 DOI: 10.5021/ad.2015.27.2.206] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 09/11/2014] [Accepted: 10/11/2014] [Indexed: 11/28/2022] Open
Abstract
Spitzoid melanoma is a subtype of melanoma that, clinically and histologically, resembles a Spitz nevus. Clinically, spitzoid melanomas usually evolve from amelanotic nodular lesions, growing to 1 cm or more in diameter. They often remain clinically undiagnosed because of their wide variety of clinical appearances and a lack of pigmentation. Distinguishing a Spitz nevus from a spitzoid melanoma can be extremely difficult. Features that favor the diagnosis of a spitzoid melanoma are asymmetrical shape, diameter greater than 1 cm, a lesion with a deep invasive component, and a high degree of cytologic atypia. There have been only rare reports in the literature of the presence of giant cells in malignant melanoma, and the presence of these cells may result in its misdiagnosis as a histiocytic tumor. We present a case of spitzoid melanoma on the right ankle of a 22-year-old-woman.
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Affiliation(s)
- Heung Yeol Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Jong Hyun Yoon
- Department of Dermatology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Eun Byul Cho
- Department of Dermatology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Eun Ju Park
- Department of Dermatology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Kwang Ho Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Kwang Joong Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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10
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Romanucci M, Malatesta D, Berardi I, Pugliese G, Fusco D, Della Salda L. Cytological, histological and ultrastructural nuclear features of monster cells in a canine carotid body carcinoma. J Comp Pathol 2014; 151:57-62. [PMID: 24811273 DOI: 10.1016/j.jcpa.2014.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 01/14/2014] [Accepted: 03/04/2014] [Indexed: 11/25/2022]
Abstract
A 7-year-old female Shih-tzu dog was presented with severe dyspnoea. A large mass was palpated in the left cranial neck. Cytological examination of an aspirate sample revealed cells with marked anisokaryosis, giant elements and many bare nuclei. Scattered intact giant cells showed scant, granular cytoplasm and intranuclear inclusions. Histologically, neoplastic cells were subdivided into lobules by fine collagenous trabeculae. Numerous pleomorphic giant, or 'monster', cells were observed, showing a highly indented nuclear envelope, intranuclear cytoplasmic pseudoinclusions (ICPs) and 'ground-glass' nuclear appearance. Neoplastic emboli were present, but no distant metastases were detected grossly. Immunohistochemically, the neoplastic cells expressed synaptophysin and had variable expression of neuron-specific enolase and vimentin. The cells were negative for pan-cytokeratin, CAM 5.2, glial fibrillary acidic protein and S100. Nuclear abnormalities and cytoplasmic neurosecretory granules were noted ultrastructurally. These features were consistent with a diagnosis of carotid body carcinoma (chemodectoma). Monster cells with ICPs have not been documented previously in canine chemodectoma.
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Affiliation(s)
- M Romanucci
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - D Malatesta
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy
| | - I Berardi
- Veterinary Practitioner, Montesilvano, Pescara, Italy
| | - G Pugliese
- Veterinary Practitioner, Montesilvano, Pescara, Italy
| | - D Fusco
- Veterinary Practitioner, Montesilvano, Pescara, Italy
| | - L Della Salda
- Faculty of Veterinary Medicine, University of Teramo, Teramo, Italy.
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11
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Hawryluk EB, Baran JL, Gerami P, Sepehr A. 'Monster cell' melanoma with pulmonary metastasis and cyclin D1 amplification. J Cutan Pathol 2013; 40:61-5. [PMID: 23278726 DOI: 10.1111/cup.12024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 07/17/2012] [Accepted: 08/23/2012] [Indexed: 01/16/2023]
Abstract
Markedly pleomorphic epithelioid cells with high mitotic activity, giant cell formation, very large atypical nuclei, multiple nucleoli and abundant cytoplasm characterize 'monster' cells and may indicate aggressive tumor behavior. Very rare reports of melanomas comprised of 'monster cells' or cells with comparable histomorphological features, found in tissue samples from skin, lymph nodes, CNS, oral cavity and ileum have been published in the literature. This case is the first such description in the lung, and it is characterized with a battery of immunohistochemical stains; BRAF mutation status was negative, and fluorescence in situ hybridization analysis revealed increased copy number gains in 11q (cyclin D1), which is associated with poor prognosis in melanoma. The presence of monster cells in melanoma was associated with aggressive behavior in the reported patient.
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Affiliation(s)
- Elena B Hawryluk
- Department of Dermatology, Harvard Medical School, Boston, MA, USA
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12
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Bono F, Testi MA, Rosai J. Desmoplastic Small Cell Tumor With Bizarre Giant Nuclei. Int J Surg Pathol 2011; 19:843-6. [DOI: 10.1177/1066896911400738] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A case is reported of an intra-abdominal desmoplastic small cell tumor featuring giant bizarre nuclei, an event not previously recorded in this entity to the best of the authors’ knowledge. The diagnosis was confirmed by immunohistochemistry and molecular genetics. A list is provided of the many other conditions in which this morphologically spectacular but clinically inconsequential nuclear change has been recorded.
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Affiliation(s)
| | | | - Juan Rosai
- Centro Diagnostico Italiano, Milan, Italy
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13
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Defty CL, Segen J, Carter JJ, Ahmed I, Carr RA. Basaloid squamous cell carcinoma with 'monster' cells: a mimic of pleomorphic basal cell carcinoma. J Cutan Pathol 2010; 38:354-6. [PMID: 21039745 DOI: 10.1111/j.1600-0560.2010.01627.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Pleomorphic giant or 'monster' cells represent a well-recognized yet uncommon finding associated with basal cell carcinoma (BCC), usually of nodular type. We present a case of basaloid squamous cell carcinoma (basaloid SCC) with 'monster' cells that closely mimicked those described in pleomorphic nodular BCC. Clinically, the lesion presented as a fleshy, hyperkeratotic nodule in an 82-year-old woman. Histopathology revealed a basaloid lesion with lobulated borders and focal retraction artifact but a lack of prominent palisading or stromal mucin. There were areas of necrosis and small foci of keratinization. Striking bizarre monstrous pleomorphic nuclei were widely scattered throughout the lesion. Ber-EP4 immunohistochemistry proved to be negative and epithelial membrane antigen (EMA) expression was moderate to strong in 70% of the basaloid epithelium. Monster cells have not previously been highlighted in cutaneous SCC or in its uncommon cutaneous basaloid variant. The prognostic significance of monster cells is unknown but, given the relative paucity of keratinization in basaloid SCC, these lesions should probably be regarded as poorly differentiated. We have not previously encountered an SCC that so closely resembles nodular BCC with pleomorphic monster cells and believe that this is the first such report in the literature.
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Affiliation(s)
- Clare L Defty
- Department of Dermatology, University Hospitals of Coventry & Warwickshire NHS Trust, Clifford Bridge Road, Coventry, UK
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15
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Ossifying Dermatofibroma With Osteoclast-Like Giant Cells: Report of a Case and Literature Review. Am J Dermatopathol 2009; 31:379-83. [DOI: 10.1097/dad.0b013e3181966747] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Jozan S, Aziza J, Kamar N, Collin L, Courtade-Saïdi M. [Monster cells in a bronchoalveolar lavage fluid]. Ann Pathol 2008; 27:331-2. [PMID: 18185465 DOI: 10.1016/s0242-6498(07)73913-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Suzanne Jozan
- Service d'Anatomie Pathologique et d'Histologie-Cytologie, CHU Toulouse Rangueil, 1 avenue J. Poulhès TSA 50032, Toulouse Cedex 9
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