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Castillo A, Perelló-Fabregat C, García-Gómez J, Sanz C, Valdivieso L, Jimeno M. Squamous cell carcinoma of uterine cervix with osteoclast‑like giant cells: A case report. Mol Clin Oncol 2024; 21:56. [PMID: 38978975 PMCID: PMC11228563 DOI: 10.3892/mco.2024.2754] [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: 11/06/2023] [Accepted: 04/30/2024] [Indexed: 07/10/2024] Open
Abstract
Squamous cell carcinoma (SCC) is a common tumor of the uterine cervix, usually related to human papillomavirus (HPV). While osteoclast-like giant cells (OGCs) have been reported to be associated with tumors at various locations, to the best of our knowledge, only six cases have been reported in the cervix to date. The present study describes the case of a 38-year-old woman with a medical history of ectopic pregnancy and vaginal childbirth, who presented with coitorrhagia. On physical examination, a mass of ~4 cm was found in the uterine cervix. A biopsy of this lesion revealed infiltrating SCC, leading to a radical hysterectomy 2 months later. The surgical specimen displayed an exophytic lesion with a maximum diameter of 3.5 cm confined to the uterine cervix, histologically consistent with an infiltrating non-keratinizing SCC. There was a prominent intra- and peritumoral chronic inflammatory reaction, and a high number of OGCs. Immunohistochemically, tumoral cells were positive for cytokeratin βE12, epithelial membrane antigen, p40, p63 and p16, and negative for CD68, vimentin and CD163. OGCs exhibited an inverted expression pattern, with positivity only for histiocytic markers. PCR for HPV detection revealed a HPV 34 genotype (probable high oncogenic risk). This profile suggests the non-neoplastic nature of OGCs, i.e. they should be considered as part of the immune response to the tumor. To the best of our knowledge, this case is the seventh instance of SCC with OGCs in the uterine cervix. Similar findings in other organs, such as the breast, pancreas or stomach, have been associated with a favorable prognosis. While two of the three reported cases with poor outcomes in the uterine cervix had an associated sarcomatoid component, the limited number of cases described to date in this location does not yet allow for an accurate prediction of behavior.
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Affiliation(s)
- Ana Castillo
- Department of Pathology, Germans Trias i Pujol University Hospital, 08916 Barcelona, Spain
- Department of Molecular and Translational Pathology, Germans Trias i Pujol Institute, 08916 Barcelona, Spain
| | | | - Javier García-Gómez
- Department of Pathology, Germans Trias i Pujol University Hospital, 08916 Barcelona, Spain
| | - Carolina Sanz
- Department of Pathology, Germans Trias i Pujol University Hospital, 08916 Barcelona, Spain
- Department of Molecular and Translational Pathology, Germans Trias i Pujol Institute, 08916 Barcelona, Spain
| | - Lorena Valdivieso
- Department of Pathology, Germans Trias i Pujol University Hospital, 08916 Barcelona, Spain
- Department of Molecular and Translational Pathology, Germans Trias i Pujol Institute, 08916 Barcelona, Spain
| | - Mireya Jimeno
- Department of Pathology, Germans Trias i Pujol University Hospital, 08916 Barcelona, Spain
- Department of Molecular and Translational Pathology, Germans Trias i Pujol Institute, 08916 Barcelona, Spain
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Koufopoulos NI, Boutas I, Pouliakis A, Samaras MG, Kotanidis C, Kontogeorgi A, Dimas DT, Ieronimaki AI, Leventakou D, Spathis A, Zanelli M, Palicelli A, Zizzo M, Goutas D, Pateras IS, Panayiotides IG. The "Forgotten" Subtypes of Breast Carcinoma: A Systematic Review of Selected Histological Variants Not Included or Not Recognized as Distinct Entities in the Current World Health Organization Classification of Breast Tumors. Int J Mol Sci 2024; 25:8382. [PMID: 39125951 PMCID: PMC11313581 DOI: 10.3390/ijms25158382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/26/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
Breast carcinoma is the most common cancer in women. Nineteen different subtypes of breast carcinomas are recognized in the current WHO classification of breast tumors. Except for these subtypes, there are a number of carcinomas with special morphologic and immunohistochemical features that are not included in the 5th WHO classification, while others are considered special morphologic patterns of invasive breast carcinoma of no special type. In this manuscript, we systematically review the literature on four different subtypes of invasive breast carcinoma, namely lymphoepithelioma-like breast carcinoma, breast carcinoma with osteoclast-like giant cells, signet-ring breast carcinoma, and metaplastic breast carcinoma with melanocytic differentiation. We describe their clinicopathological characteristics, focusing on the differential diagnosis, treatment, and prognosis.
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Affiliation(s)
- Nektarios I. Koufopoulos
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Ioannis Boutas
- Breast Unit, Rea Maternity Hospital, Palaio Faliro, 17564 Athens, Greece
| | - Abraham Pouliakis
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Menelaos G. Samaras
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Christakis Kotanidis
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Adamantia Kontogeorgi
- Third Department of Obstetrics and Gynecology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
| | - Dionysios T. Dimas
- Breast Unit, Athens Medical Center, Psychiko Clinic, 11525 Athens, Greece
| | - Argyro-Ioanna Ieronimaki
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Danai Leventakou
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Aris Spathis
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Magda Zanelli
- Pathology Unit, Azienda Unita Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Andrea Palicelli
- Pathology Unit, Azienda Unita Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Dimitrios Goutas
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Ioannis S. Pateras
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
| | - Ioannis G. Panayiotides
- Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece; (A.P.); (I.G.P.)
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Veekmans T, Weynand B, Floris G. Invasive Breast Cancer of No Special Type With Osteoclast-Like Giant Cells: A Cytological Clue Providing the Final Diagnosis for Histology. Cureus 2024; 16:e58518. [PMID: 38957813 PMCID: PMC11218474 DOI: 10.7759/cureus.58518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2024] [Indexed: 07/04/2024] Open
Abstract
Breast cancer associated with osteoclast-like giant cells (OGCs) refers to a morphological pattern of invasive breast carcinoma of non-special type. Their presence is sometimes subtle, but OGCs can be appreciated both histologically and immunohistochemically. The origin of OGCs as well as their implication for prognosis remain debated. We describe the case of a 65-year-old woman, wherein the presence of OGCs in the fine-needle aspiration cytology of a metastatic axillary lymph node suggested the final diagnosis on histology. The differential diagnosis is broad, and here we provide evidence for strict cytological-histological correlation when dealing with unusual breast lesions.
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Affiliation(s)
- Tristan Veekmans
- Department of Pathology, KU Leuven-University of Leuven, University Hospitals Leuven, Leuven, BEL
| | - Birgit Weynand
- Department of Pathology, KU Leuven-University of Leuven, University Hospitals Leuven, Leuven, BEL
| | - Giuseppe Floris
- Department of Pathology, KU Leuven-University of Leuven, University Hospitals Leuven, Leuven, BEL
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Wang YJ, Huang CP, Hong ZJ, Liao GS, Yu JC. Invasive breast carcinoma with osteoclast-like stromal giant cells: A case report. World J Clin Cases 2023; 11:1521-1527. [PMID: 36926394 PMCID: PMC10011994 DOI: 10.12998/wjcc.v11.i7.1521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/06/2022] [Accepted: 02/16/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Invasive breast carcinoma with osteoclast-like stromal giant cells (OGCs) is an extremely rare morphology of breast carcinomas. To the best of our knowledge, the most recent case report describing this rare pathology was published six years ago. The mechanism controlling the development of this unique histological formation is still unknown. Further, the prognosis of patients with OGC involvement is also controversial.
CASE SUMMARY We report the case of a 48-year-old woman, who presented to the outpatient department with a palpable, growing, painless mass in her left breast for about one year. Sonography and mammography revealed a 26.5 mm × 18.8 mm asymmetric, lobular mass with circumscribed margin and the Breast Imaging Reporting and Data System was category 4C. Sono-guided aspiration biopsy revealed invasive ductal carcinoma. The patient underwent breast conserving surgery and was diagnosed with invasive breast carcinoma with OGCs, grade II, with intermediate grade of ductal carcinoma in situ (ER: 80%, 3+, PR: 80%, 3+, HER-2: negative, Ki 67: 30%). Adjuvant chemotherapy and post-operation radiotherapy were initiated thereafter.
CONCLUSION As a rare morphology of breast cancer, breast carcinoma with OGC occurs most often in relatively young women, has less lymph node involvement, and its occurrence is not race-dependent.
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Affiliation(s)
- Yi-Jie Wang
- Department of Surgery, Tri Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Chien-Peng Huang
- Department of Pathology, Tri Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Zhi-Jie Hong
- Division of Traumatology, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Guo-Shiou Liao
- Division of General Surgery, Department of Surgery, Tri Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Jyh-Cherng Yu
- Division of General Surgery, Department of Surgery, Tri Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
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Sajjadi E, Gaudioso G, Terrasi A, Boggio F, Venetis K, Ivanova M, Bertolasi L, Lopez G, Runza L, Premoli A, Lorenzini D, Guerini-Rocco E, Ferrero S, Vaira V, Fusco N. Osteoclast-like stromal giant cells in breast cancer likely belong to the spectrum of immunosuppressive tumor-associated macrophages. Front Mol Biosci 2022; 9:894247. [PMID: 36090031 PMCID: PMC9462457 DOI: 10.3389/fmolb.2022.894247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/28/2022] [Indexed: 12/11/2022] Open
Abstract
Background: Breast cancer with osteoclast-like stromal giant cells (OSGC) is an exceedingly rare morphological pattern of invasive breast carcinoma. The tumor immune microenvironment (TIME) of these tumors is populated by OSGC, which resemble osteoclasts and show a histiocytic-like immunophenotype. Their role in breast cancer is unknown. The osteoclast maturation in the bone is regulated by the expression of cytokines that are also present in the TIME of tumors and in breast cancer tumor-associated macrophages (TAMs). TAMs-mediated anti-tumor immune pathways are regulated by miRNAs akin to osteoclast homeostasis. Here, we sought to characterize the different cellular compartments of breast cancers with OSGC and investigate the similarities of OSGC with tumor and TIME in terms of morphology, protein, and miRNA expression, specifically emphasizing on monocytic signatures. Methods and Results: Six breast cancers with OSGC were included. Tumor-infiltrating lymphocytes (TILs) and TAMs were separately quantified. The different cellular populations (i.e., normal epithelium, cancer cells, and OSGC) were isolated from tissue sections by laser-assisted microdissection. After RNA purification, 752 miRNAs were analyzed using a TaqMan Advanced miRNA Low-Density Array for all samples. Differentially expressed miRNAs were identified by computing the fold change (log2Ratio) using the Kolmogorov-Smirnov test and p values were corrected for multiple comparisons using the false discovery rate (FDR) approach. As a similarity analysis among samples, we used the Pearson test. The association between pairs of variables was investigated using Fisher exact test. Classical and non-classical monocyte miRNA signatures were finally applied. All OSGC displayed CD68 expression, TILs (range, 45–85%) and high TAMs (range, 35–75%). Regarding the global miRNAs profile, OSGC was more similar to cancer cells than to non-neoplastic ones. Shared deregulation of miR-143-3p, miR-195-5p, miR-181a-5p, and miR-181b-5p was observed between OSGC and cancer cells. The monocyte-associated miR-29a-3p and miR-21-3p were dysregulated in OSGCs compared with non-neoplastic or breast cancer tissues. Conclusion: Breast cancers with OSGC have an activated TIME. Shared epigenetic events occur during the ontogenesis of breast cancer cells and OSGC but the innumophenotype and miRNA profiles of the different cellular compartmens suggest that OSGC likely belong to the spectrum of M2 TAMs.
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Affiliation(s)
- Elham Sajjadi
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Gaudioso
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Terrasi
- Division of Molecular Biology, Biomedical Center, Faculty of Medicine, LMU Munich, Planegg-Martinsried, Munich, Germany
| | - Francesca Boggio
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Konstantinos Venetis
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Mariia Ivanova
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Letizia Bertolasi
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Lopez
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Letterio Runza
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Alice Premoli
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniele Lorenzini
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
| | - Elena Guerini-Rocco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Stefano Ferrero
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Valentina Vaira
- Division of Pathology, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Nicola Fusco
- Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- *Correspondence: Nicola Fusco,
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Angellotti G, Tomasicchio G, Montanaro AE, Telgrafo M, Matropasqua MG, Punzo C. Osteoclast-like stromal giant cells in invasive ductal breast cancer: A case series. Int J Surg Case Rep 2022; 97:107421. [PMID: 35863289 PMCID: PMC9403206 DOI: 10.1016/j.ijscr.2022.107421] [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: 06/09/2022] [Revised: 07/12/2022] [Accepted: 07/12/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Breast Cancer with osteoclast-like stromal giant cells (OLGCs) is a rare pattern of invasive non-special type ductal carcinoma. The OLGCs are specific type of macrophage and are likely distinct from true osteoclasts. The aim of this case series was to describe the characteristics of this invasive ductal carcinoma rare histotype. PRESENTATION OF CASES The authors present the cases of two young women that, during national screening, discovered with mammography X-ray a breast lump suspected for malignancy. The core needle biopsy confirmed the malignancy of both nodule and in one patient the histological analysis revealed pre-operative OLGCs. In both cases the sentinel lymph node biopsy was negative therefore a quadrantectomy without axillary lymphadenectomy was done. The definitive histopathological examination was positive for invasive ductal carcinoma with OLGCs and CD 68 marker positivity. After surgery, patients underwent adjuvant therapy and multidisciplinary follow-up. DISCUSSION The origin and mechanism for developing osteoclast-like giant cells is unknown. The OLGCs directly descend from the precursors of the monocyte-macrophage. The rarity of this entity often promotes a misleading diagnosis, with >50 % of erroneous diagnosis of benign lesion. The prognostic significance of OLGCs in breast cancer is controversial, however it doesn't seem to influence the axillary lymph nodes spread. The presence of preoperative OLGCs didn't modify our surgical and oncological approach. CONCLUSION Breast Cancer with OLGCs is a rare tumour that has a similar prognosis to other carcinomas of identical grade and stage in most cases. The rarity and characteristics of this neoplasm require personalized treatments, discussed by a multidisciplinary team.
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Affiliation(s)
- Giustina Angellotti
- DETO, Department of Emergency and Organ Transplantations, Breast Care Unit, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Giovanni Tomasicchio
- DETO, Department of Emergency and Organ Transplantations, Breast Care Unit, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy,Corresponding author at: Str. Cannaruto 1/3, Bari, Italy.
| | | | - Michele Telgrafo
- DETO, Department of Emergency and Organ Transplantations, Breast Care Unit, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Mauro Giuseppe Matropasqua
- DETO, Department of Emergency and Organ Transplantations, Breast Care Unit, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Clelia Punzo
- DETO, Department of Emergency and Organ Transplantations, Breast Care Unit, Aldo Moro University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy
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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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Breast carcinomas with osteoclast-like giant cells: a comprehensive clinico-pathological and molecular portrait and evidence of RANK-L expression. Mod Pathol 2022; 35:1624-1635. [PMID: 35697931 PMCID: PMC9596373 DOI: 10.1038/s41379-022-01112-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/08/2022] [Accepted: 05/12/2022] [Indexed: 11/28/2022]
Abstract
Breast carcinomas (BC) with osteoclast-like giant cells (OGC) are rare. Despite their distinct stromal features, their molecular characteristics remain unknown. Here, we report comprehensive clinico-pathological and molecular findings for 27 patients diagnosed with BC-OGC at Institut Curie between 2000 and 2021. Seventeen (63%) cases were invasive carcinomas of no special type (IC NST) with OGC (OGC-IC NST), four (15%) were mixed or multifocal cases with and without OGC (OGC-Mixed), and six (22%) were metaplastic carcinomas with OGC (OGC-MC). All OGC-IC NST and OGC-Mixed cases were ER+ HER2- tumors (most being luminal A based on transcriptomic subtyping, when available), while all OGC-MC were triple-negative. The median age at diagnosis was 46, 45 and 62 years for OGC-IC NST, OGC-Mixed and OGC-MC, respectively. Three patients developed distant metastases (one OGC-IC NST, two OGC-Mixed), one of whom died of metastatic disease (OGC-Mixed), and one other patient died of locally advanced disease (OGC-MC). Histopathological evaluation comparing 13 OGC-IC NST and 19 control IC NST without OGC confirmed that OGC-IC NST showed significantly higher density of vessels (by CD34 immunohistochemistry (IHC)), iron deposits (Perls stain), and CD68 and CD163-positive cell infiltrates. Genomic findings for nine OGC-IC NST and four OGC-MC were consistent with the underlying histologic subtype, including activating alterations of the PI3K/AKT/mTOR pathway in 7/13 cases. Using RNA-seq data, differential gene expression analysis between OGC-IC NST (n = 7) and control IC NST without OGC (n = 7) revealed significant overexpression of TNFSF11 (RANK-L), TNFRSF11A (RANK), CSF1 (M-CSF), CSF1R, and genes encoding osteoclastic enzymes (MMP9, ACP5, CTSK, CTSB) in OGC-IC NST, while OPG (osteoprotegerin) was underexpressed. We also confirmed for the first time RANK-L expression in BC with OGC by IHC (seen in 15 out of 16 cases, and only in 2 of 16 controls without OGC). These findings could offer a rationale for further investigating RANK-L as a therapeutic target in BC with OGC.
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Absence of multinucleated giant cell reaction as an indicator of tumor progression in oral tongue squamous cell carcinoma. Eur Arch Otorhinolaryngol 2021; 279:3123-3130. [PMID: 34689239 DOI: 10.1007/s00405-021-07139-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/13/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE The aim of this study was to evaluate the presence and distribution of multinucleated giant cell (MGC) reactions in 61 cases of OTSCC and to verify the association of this microscopic finding with clinicopathological parameters (gender, age, tumor size/extent, regional lymph node metastasis, distant metastasis, clinical stage, and histopathological grade of malignancy). METHODS Clinical data were collected from medical records and the histopathological grade of malignancy of OTSCCs was evaluated using the World Health Organization (WHO) grading system. The presence and distribution of MGC reaction in high power fields (HPFs) were evaluated in hematoxylin-eosin-stained histological sections. In all cases containing MGCs, immunohistochemical analysis for CD68 was performed in order to confirm the histiocytic nature of these cells. RESULTS Twenty-one (34.4%) cases had MGC reactions, with a higher frequency of the focal distribution pattern (57.1%). All MGCs were immunohistochemically positive for CD68. The absence of MGC reaction was significantly associated with regional lymph node metastasis (PR: 2.75; 95% CI 1.05-7.20; p = 0.027), advanced clinical stage (PR: 3.37; 95% CI 1.28-8.85; p = 0.006), and moderately/poorly differentiated tumors (PR: 3.36; 95% CI 1.51-7.48; p = 0.001). No significant associations were observed between the distribution of MGCs and clinicopathological parameters (p > 0.05). CONCLUSION Taken together, the results of this study suggest that the absence of MGC reaction may represent an indicator of tumor progression in OTSCCs.
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Irelli A, Sirufo MM, Quaglione GR, De Pietro F, Bassino EM, D’Ugo C, Ginaldi L, De Martinis M. Invasive Ductal Breast Cancer with Osteoclast-Like Giant Cells: A Case Report Based on the Gene Expression Profile for Changes in Management. J Pers Med 2021; 11:156. [PMID: 33672165 PMCID: PMC7927002 DOI: 10.3390/jpm11020156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 02/11/2021] [Accepted: 02/16/2021] [Indexed: 12/16/2022] Open
Abstract
We report the case of a 49-year-old woman diagnosed with a rare histotype of early breast cancer (BC), invasive ductal carcinoma with osteoclast-like giant cells (OGCs), from the perspective of gene profile analysis tests. The patient underwent a quadrantectomy of the right breast with removal of 2 cm neoplastic nodule and three ipsilateral sentinel lymph nodes. The Oncotype Dx gave a recurrence score (RS) of 23, and taking into account the patient's age, an RS of 23 corresponds to a chemotherapy benefit of 6.5%. After a multidisciplinary collegial discussion, and in consideration of the patient's age, the absence of comorbidity, the premenopausal state, the rare histotype and the Oncotype Dx report, the patient was offered adjuvant chemotherapy treatment followed by hormone therapy. This case may be an example of the utility of integrating gene expression profiling tests into clinical practice in the adjuvant treatment decision of a rare histotype BC. The Oncotype Dx test required to supplement the histological examination made us opt for the proposal of a combined treatment of adjuvant chemotherapy followed by adjuvant hormone therapy. It demonstrates the importance of considering molecular tests and, in particular, the Oncotype Dx, in estimating the risk of disease recovery at 10 years in order to identify patients who benefit from hormone therapy alone versus those who benefit from the addition of chemotherapy, all with a view toward patient-centered oncology. Here, we discuss the possible validity and limitations of the Oncotype Dx in a rare luminal A-like histotype with high infiltrate of stromal/inflammatory cells.
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Affiliation(s)
- Azzurra Irelli
- Medical Oncology Unit, Department of Oncology, AUSL 04 Teramo, 64100 Teramo, Italy;
| | - Maria Maddalena Sirufo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (E.M.B.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, 64100 Teramo, Italy
| | | | - Francesca De Pietro
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (E.M.B.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, 64100 Teramo, Italy
| | - Enrica Maria Bassino
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (E.M.B.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, 64100 Teramo, Italy
| | - Carlo D’Ugo
- Radiotherapy Unit, Department of Oncology, AUSL 04, 64100 Teramo, Italy;
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (E.M.B.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, 64100 Teramo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (F.D.P.); (E.M.B.); (L.G.)
- Allergy and Clinical Immunology Unit, Center for the diagnosis and treatment of Osteoporosis, AUSL 04 Teramo, 64100 Teramo, Italy
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11
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Jamiyan T, Kuroda H, Hayashi M, Abe A, Shimizu K, Imai Y. Ductal carcinoma in situ of the breast with osteoclast-like giant cells: A case report with immunohistochemical analysis. HUMAN PATHOLOGY: CASE REPORTS 2020. [DOI: 10.1016/j.ehpc.2020.200383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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12
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Tuzlali S, Yavuz E. Pathology of Breast Cancer. Breast Cancer 2019. [DOI: 10.1007/978-3-319-96947-3_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Ahmadi Moghaddam P, Singh R, Mahmoodi M, Mehrotra M, Benaim G, Luthra R, Paniz-Mondolfi A. Poorly differentiated osteoclast-like giant cell variant of cutaneous squamous cell carcinoma: Uncovering its mutational landscape through massive parallel sequencing. Pathol Res Pract 2018; 214:1898-1903. [PMID: 30146254 DOI: 10.1016/j.prp.2018.08.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 08/11/2018] [Accepted: 08/18/2018] [Indexed: 01/18/2023]
Affiliation(s)
- Parnian Ahmadi Moghaddam
- Department of Pathology, University of Massachusetts Memorial Medical Center, Worcester, MA, USA
| | - Rajesh Singh
- Molecular Diagnostics Laboratory, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mandana Mahmoodi
- Department of Dermatopathology, Miraca Life Sciences Research Institute & Tufts University School of Medicine, Boston, MA, USA
| | - Meenakshi Mehrotra
- Molecular Diagnostics Laboratory, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gustavo Benaim
- Laboratorio de Señalización Celular y Bioquímica de Parásitos, Instituto de Estudios Avanzados (IDEA), Caracas, Venezuela
| | - Rajyalakshmi Luthra
- Molecular Diagnostics Laboratory, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alberto Paniz-Mondolfi
- Laboratorio de Señalización Celular y Bioquímica de Parásitos, Instituto de Estudios Avanzados (IDEA), Caracas, Venezuela; Instituto de Investigaciones Biomédicas IDB, Cabudare, Venezuela; Dirección de Salud, Docencia e Investigación, Instituto Venezolano de los Seguros Sociales (IVSS), Venezuela.
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14
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Breast carcinoma with osteoclast-like giant cells: A cytological-pathological correlation with a literature review. Ann Diagn Pathol 2018; 33:1-5. [DOI: 10.1016/j.anndiagpath.2017.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 11/07/2017] [Indexed: 11/16/2022]
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15
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Fortuitous administration of denosumab in breast carcinoma with osteoclastic giant cells. Anticancer Drugs 2018; 29:466-470. [PMID: 29481473 DOI: 10.1097/cad.0000000000000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Breast carcinoma with osteoclastic giant cells (OGCs) is a rare entity characterized by an admixture of giant cells and malignant epithelial cells within an inflammatory and vascular stroma. Denosumab is a monoclonal antibody that targets the pathway for osteoclast formation and activation, indicated for the prevention of skeletal-related events in patients with bone metastases, as well as for the treatment of giant cell tumor of bone. We report a patient who presented with aggressive bone recurrence of breast cancer 12 years after her original diagnosis, showing a transformed histology that included multinucleated OGCs, and that was refractory to traditional therapy. Misdiagnosed with a tumor-to-tumor metastasis of breast cancer to a giant cell tumor of bone, she was treated with denosumab for her presumed primary bone disease and had a remarkable clinical and radiological response. To the best of our knowledge, this is the first report of breast cancer with OGCs occurring initially in a metastasis while absent in the original tumor and the first description of its successful treatment with denosumab. This case sheds light on the development of giant cells in the tumor microenvironment and suggests the potential use of denosumab in the management of cancers with giant cell elements.
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16
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Osteoclast-like giant cells in invasive breast cancer predominantly possess M2-macrophage phenotype. Pathol Res Pract 2017; 214:253-258. [PMID: 29129494 DOI: 10.1016/j.prp.2017.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 10/21/2017] [Accepted: 11/03/2017] [Indexed: 01/09/2023]
Abstract
Breast carcinoma with osteoclast-like giant cells (OGCs) is a rare tumor; however, their clinicopathological aspects remain unclear. We described the clinicopathological characteristics of 8 patients with breast carcinoma with OGCs. Immuno-phenotypes of the OGCs were comparatively examined with that of foreign body giant cells (FBGCs) in 4 cases of granulomatous reaction (GR) without cancerous elements. In most cancers, tumors displayed cribriform and tubular growth patterns. Three cases showed moderate to high nuclear grade, while all the other tumors had low nuclear grade. Six patients were estrogen receptor (ER) positive, while triple negative phenotype was identified in 2 patients. During the follow-up period, 1 patient had local recurrence of the tumor, and all the patients remained alive. All OGCs and FBGCs expressed CD68, a pan-macrophage marker. OGCs in all the breast cancers showed moderate to high expression of CD163 - a marker of M2-macrophage with pro-tumoral function - whereas its expression in FBGCs was low to moderate (p=0.04). CD86 - a marker of M1-macrophage with a tumoricidal activity - was positive in the OGCs of 3 breast cancers, and in the FBGCs of 3 GR cases (p=0.15). The expression of CD163 was significantly higher than that of CD86 in the OGCs of breast cancer (p<0.001), whereas they were comparable in the FBGCs of GR (p=0.79). In summary, we found that breast carcinoma with OGCs mostly exhibited cribriform and tubular growth pattern, ER positivity, and predominantly possessed the M2-macrophage phenotype. However, the clinical significance of OGCs in breast cancer needs to be elucidated in further studies involving a larger number of cases.
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17
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Santos HBDP, Miguel MCDC, Pinto LP, Gordón-Núñez MA, Alves PM, Nonaka CFW. Multinucleated giant cell reaction in lower lip squamous cell carcinoma: a clinical, morphological, and immunohistochemical study. J Oral Pathol Med 2017; 46:773-779. [DOI: 10.1111/jop.12565] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Leão Pereira Pinto
- Postgraduate Program in Oral Pathology; Federal University of Rio Grande do Norte; Natal RN Brazil
| | | | - Pollianna Muniz Alves
- Postgraduate Program in Dentistry; State University of Paraíba; Campina Grande PB Brazil
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18
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Invasive ductal carcinoma of the breast with osteoclast-like giant cells and clear cell features: a case report of a novel finding and review of the literature. World J Surg Oncol 2016; 14:227. [PMID: 27561329 PMCID: PMC5000466 DOI: 10.1186/s12957-016-0982-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 08/13/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Osteoclast-like giant cells (OLGCs) are a rare histologic finding within a tumor of the breast. Although there has been discussion as to the pathogenesis and prognosis related to this finding, our understanding of its significance remains inconclusive. Clear cells are another unique histologic finding in breast tumors and are typically associated with tumors arising in other organs such as renal cell carcinoma. CASE PRESENTATION This is a case report of a 64-year-old female who presented with one tumor identified as invasive ductal carcinoma with a combination of OLGCs and clear cell features. CONCLUSIONS To our knowledge, this combination of findings has not been previously described in the literature and therefore represents another morphologic manifestation of breast carcinoma. As patients are diagnosed earlier and live longer, a growing number of these rare variants may be recognized and provide opportunities to further our understanding of the associated molecular pathways which could contribute to the possibility of therapeutic intervention.
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19
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Ampuja M, Alarmo E, Owens P, Havunen R, Gorska A, Moses H, Kallioniemi A. The impact of bone morphogenetic protein 4 (BMP4) on breast cancer metastasis in a mouse xenograft model. Cancer Lett 2016; 375:238-244. [DOI: 10.1016/j.canlet.2016.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/03/2016] [Accepted: 03/03/2016] [Indexed: 02/06/2023]
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20
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Undifferentiated (anaplastic) carcinoma with osteoclast-like giant cells of the pancreas: a series of 5 cases with clinicopathologic correlation and cytomorphologic characterization. J Am Soc Cytopathol 2016; 5:321-330. [PMID: 31042543 DOI: 10.1016/j.jasc.2016.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 04/10/2016] [Accepted: 04/11/2016] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas (UCOGCP) is a rare neoplasm involving the pancreas. Although typically diagnosed initially via endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), cytomorphologic characterization of the neoplasm has been limited to individual cases in the literature. MATERIALS AND METHODS Five cases were identified in a retrospective review of our institution's records from 2006 to 2015. Cytomorphologic, immunophenotypic, and corresponding clinical features of the neoplasm are examined and described. RESULTS UCOGCP accounted for 0.9% of all new pancreatic neoplastic diagnoses, had a median greatest dimension of 4.3 cm, were variably located within the pancreas, and had variable features by radiologic imaging. Patients were of a median age of 78 years old at diagnosis, and had a median length of survival of 10 months. Smear-based cytomorphology and histomorphology from cell block preparations show atypical/pleomorphic mononuclear carcinomatous and bland osteoclast-like giant cellular populations. The immunophenotype of the mononuclear carcinomatous component was CD68, CD99, CK7 (variably), CKAE1/AE3 (variably), and, rarely, p40-positive. The osteoclast-like giant cells positively expressed CD68 and CD99. CONCLUSIONS Initial diagnosis of UCOGCP is frequently made via EUS-FNA of pancreas tumors, with cytomorphologic features on smears and hematoxylin and eosin stained slides prepared from cell block material being characteristic for the diagnosis. Although the cellular constituents have a consistent immunophenotype, the diagnosis can be based on the morphologic features alone. UCOGCP is an important diagnosis as it may have a distinct clinical course from undifferentiated carcinomas of the pancreas lacking osteoclast-like giant cells.
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21
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Saito R, Fujishima F, Nakamura Y, Hoshikawa Y, Tominaga J, Taniuchi S, Kasajima A, Watanabe M, Okada Y, Sasano H. A case of pulmonary adenocarcinoma harboring osteoclast-like giant cells: Its evaluation by immunohistochemical and genetic analyses. Pathol Int 2016; 66:224-9. [PMID: 26939759 DOI: 10.1111/pin.12395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 01/18/2016] [Accepted: 01/28/2016] [Indexed: 11/28/2022]
Abstract
Tumors harboring osteoclast-like giant cells (OGCs) at extraosseous site are extremely rare. These rare tumors have been detected most frequently in the pancreas and few pulmonary tumors harboring OGCs have been previously reported. In addition, the genetic profiles of these tumors have remained virtually unknown. Therefore, we report a case of pulmonary adenocarcinoma harboring OGCs in which k-ras mutation and immunohistochemical study of proteins associated with OGCs were examined. The case was a 70-year-old man, who demonstrated a pulmonary mass associated with unusual radiological features. Histopathologically, three different cell types, mucinous adenocarcinoma cell, OGC and mononuclear cell were detected. OGCs were immunohistochemically negative for epithelial markers and positive for histiocytic markers but mononuclear cells were immunopositive for epithelial markers. In addition, both mononuclear and adenocarcinoma cells had the same k-ras mutation profiles and mononuclear cells were immunohistochemically positive for macrophage colony-stimulating factor (M-CSF), one of the factors associated with OGC differentiation. Therefore, mononuclear cells were considered to be derived from neoplastic epithelium and OGCs could represent non-neoplastic cells. In addition, M-CSF locally produced could promote the differentiation of OGCs.
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Affiliation(s)
- Ryoko Saito
- Department of Pathology, Tohoku University School of Medicine, Miyagi, Japan
| | | | - Yasuhiro Nakamura
- Department of Pathology, Tohoku University School of Medicine, Miyagi, Japan
| | - Yasushi Hoshikawa
- Department of Thoracic Surgery, Tohoku University Hospital, Miyagi, Japan
| | - Junya Tominaga
- Department of Radiology, Tohoku University Hospital, Miyagi, Japan
| | - Shinji Taniuchi
- Department of Pathology, Tohoku University Hospital, Miyagi, Japan
| | - Atsuko Kasajima
- Department of Pathology, Tohoku University Hospital, Miyagi, Japan
| | - Mika Watanabe
- Department of Pathology, Tohoku University Hospital, Miyagi, Japan
| | - Yoshinori Okada
- Department of Thoracic Surgery, Tohoku University Hospital, Miyagi, Japan
| | - Hironobu Sasano
- Department of Pathology, Tohoku University School of Medicine, Miyagi, Japan.,Department of Pathology, Tohoku University Hospital, Miyagi, Japan
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A case of osteoclast-like giant cell-rich epithelioid glioblastoma with BRAF V600E mutation. Brain Tumor Pathol 2015; 33:57-62. [PMID: 26602910 DOI: 10.1007/s10014-015-0239-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/09/2015] [Indexed: 10/22/2022]
Abstract
Epithelioid glioblastomas (E-GBMs) are rare, highly aggressive tumors consisting of closely packed tumor cells with smooth, round cell borders and abundant eosinophilic cytoplasm. They tend to affect younger patients compared with conventional GBM. BRAF V600E mutation is characteristically found in approximately 50% of all E-GBMs, compared with a low frequency of this mutation in conventional GBM. Here, we report an unusual case of glioma involving the right frontal lobe, basal ganglia and thalamus in an HIV-positive 30-year-old man on antiretroviral therapy. The lesion was composed of abundant discohesive, monotonous epithelioid cells with extensive necrosis, spindle and polyhedral cells, low-grade oligoastrocytoma-like areas, sarcomatous components, and numerous osteoclast-like giant cells (OLGCs) intermingled with epithelioid tumor cells. As the epithelioid cells accounted for more than one-third of the tumor, a pathological diagnosis of E-GBM was made. BRAF V600E mutation was detected in both oligoastrocytoma-like and epithelioid cell components. Similar to previously reported findings on E-GBM associated with low-grade glioma, this case suggested that low-grade astrocytic glioma with BRAF V600E mutation progressed to E-GBM. OLGCs are rarely observed in gliomas, and this is the first case report of E-GBM associated with abundant OLGC infiltration.
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23
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Marchiò C, Pietribiasi F, Castiglione R, Fusco N, Sapino A. "Giants in a Microcosm": Multinucleated Giant Cells Populating an Invasive Micropapillary Carcinoma of the Breast. Int J Surg Pathol 2015; 23:654-5. [PMID: 26370736 PMCID: PMC4639821 DOI: 10.1177/1066896915605616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - Nicola Fusco
- Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
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24
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Tajima S, Koda K, Fukayama M. Primary leiomyosarcoma of the breast with prominent osteoclastic giant cells: A case expressing receptor activator of NF-κB ligand (RANKL). Pathol Int 2015. [PMID: 26150133 DOI: 10.1111/pin.12328] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 06/05/2015] [Indexed: 11/26/2022]
Abstract
Primary sarcomas of the breast are rare, accounting for less than 1% of all breast neoplasms. Leiomyosarcoma is one of the least common breast sarcoma subtypes, and less than 50 cases of primary breast leiomyosarcomas have been reported in the English literature. In other types of leiomyosarcoma, osteoclastic giant cells (OGCs) are occasionally admixed with tumor cells; however, this is rarely seen in primary breast leiomyosarcoma. We herein present the case of a 50-year-old woman with OGC-containing primary breast leiomyosarcoma whose tumor cells showed positive immunostaining for receptor activator of NF-κB ligand (RANKL). The presence of OGCs in tumors generally indicates tumor aggressiveness. This is true for leiomyosarcoma of the soft tissue and might be true for leiomyosarcoma of primary breast origin. Regarding RANKL expression, in giant cell tumor of bone (GCTB) in which OGCs expressing RANK were abundant, tumor cells are known for expressing RANKL. Therapy targeting RANKL decreases the number of tumor cells of GCTB. Our findings are clinically relevant as they indicate that RANKL expression should be investigated in various tumors containing OGCs. This might lead to the development of future molecule-targeted therapy.
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Affiliation(s)
- Shogo Tajima
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Koda
- Department of Pathology, Fujieda Municipal General Hospital, Shizuoka, Japan
| | - Masashi Fukayama
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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25
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Albawardi AS, Awwad AA, Almarzooqi SS. Mammary carcinoma with osteoclast-like giant cells: a case report. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:9038-9043. [PMID: 25674284 PMCID: PMC4313993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 12/01/2014] [Indexed: 06/04/2023]
Abstract
Mammary carcinoma with osteoclast-like giant cells is rare, and comprises less that 2% of breast carcinoma cases. Herein, we present a case of a 45-year-old woman who underwent breast lumpectomy and sentinel lymph node biopsy for a solitary well defined breast tumor. Histological examination revealed an invasive tumor composed of ducts, small nests and cribriform formations intermixed with a prominent osteoclast like giant cell component. The background stroma is hemorrhagic with conspicuous hemosiderin deposition. The paper will outline the clinico-pathologic characteristic features of this uncommon subtype as well as the current understanding on the pathogenesis of the osteoclast-like giant cells. The invasive carcinoma and the osteoclast-like giant cells staining patterns using immunohistochemical stains for estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, receptor activator of nuclear-kB, RANK ligand, and matrix metalloproteinase 1 are reported.
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Affiliation(s)
- Alia Saeed Albawardi
- Department of Pathology, College of Medicine & Health SciencesAl Ain, United Arab Emirates
- Tawam HospitalAl Ain, United Arab Emirates
| | | | - Saeeda Saleh Almarzooqi
- Department of Pathology, College of Medicine & Health SciencesAl Ain, United Arab Emirates
- Tawam HospitalAl Ain, United Arab Emirates
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26
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Beck AP, Brooks A, Zeiss CJ. Invasive ductular carcinoma in 2 rhesus macaques (Macaca mulatta). Comp Med 2014; 64:314-322. [PMID: 25296018 PMCID: PMC4170097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 11/24/2013] [Accepted: 01/01/2014] [Indexed: 06/03/2023]
Abstract
In the United States, breast cancer is the most common malignancy among women, with an estimated lifetime incidence of approximately 12% in American women. Invasive ductal carcinoma is the most common form of breast cancer in women, accounting for approximately 60% of all breast carcinomas. Prognostic markers are used to assess aggressiveness, invasiveness, and extent of spread of a neoplasm and thus may be correlated with patient survival. Immunohistochemistry is currently widely used for this purpose, with a variety of prognostication markers available. Classic markers for breast cancer in women include estrogen and progesterone receptor steroid hormone proteins and human epidermal growth factor receptor 2. Many additional markers have been used in diagnosis and prognostication, including p53, p63, and E-cadherin and cell proliferation markers such as Ki67. Despite an estimated lifetime incidence of approximately 6.1%, naturally occurring mammary neoplasms in nonhuman primates are uncommonly reported, with only sporadic references over the past 75 y. The majority of reported tumors occur in rhesus macaques, although this prevalence has been suggested to be a consequence of their high frequency of usage in biomedical research. Here we present 2 cases of mammary carcinoma in adult female intact rhesus macaques, with cytology, histopathology, and extensive immunohistochemical analysis. According to current classifications for human breast tumors, both tumors were classified as invasive ductal carcinoma. The prognostic value of immunohistochemical markers in human breast cancer and in reported cases in nonhuman primates is discussed.
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MESH Headings
- Animals
- Biomarkers, Tumor/analysis
- Biopsy/veterinary
- Carcinoma, Ductal, Breast/chemistry
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Ductal, Breast/veterinary
- Female
- Immunohistochemistry/veterinary
- Macaca mulatta
- Mammary Glands, Animal/chemistry
- Mammary Glands, Animal/pathology
- Mammary Glands, Animal/surgery
- Mammary Neoplasms, Animal/chemistry
- Mammary Neoplasms, Animal/pathology
- Mammary Neoplasms, Animal/surgery
- Mastectomy/veterinary
- Monkey Diseases/metabolism
- Monkey Diseases/pathology
- Monkey Diseases/surgery
- Predictive Value of Tests
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Affiliation(s)
- Amanda P Beck
- Section of Comparative Medicine, Yale University School of Medicine, New Haven, Connecticut, Scripps Florida, Jupiter, Florida, USA
| | - Amos Brooks
- Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Caroline J Zeiss
- Section of Comparative Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
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27
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Yu G, Lin C, Wang W, Han Y, Qu G, Zhang T. Squamous cell carcinoma of the uterine cervix associated with osteoclast-like giant cells: A case report and review of the literature. Oncol Lett 2014; 8:1595-1598. [PMID: 25202374 PMCID: PMC4156229 DOI: 10.3892/ol.2014.2384] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 07/01/2014] [Indexed: 11/25/2022] Open
Abstract
Squamous cell carcinoma is a common malignant tumor of the uterine cervix. The present study reports the case of squamous cell carcinoma of the uterine cervix with osteoclast-like giant cells (OGCs) in an 84-year-old female who had suffered from irregular vaginal bleeding for one month. Colposcopy was performed and a cauliflower-like mass was identified in the front lip of the uterine cervix. Biopsy was then performed, and the tumor was found to be composed of epithelial cell nests, ranging in size. The neoplastic cells exhibited unclear boundaries and eosinophilic cytoplasm. Additionally, the nuclei were atypical and mitosis was observed. Among the epithelial nests, there were numerous OGCs with abundant eosinophilic cytoplasm, as well as multinucleation with bland nuclei. By immunohistochemical staining, the epithelial cells were positive for cytokeratin, while negative for CD68 and vimentin. By contrast, the immunophenotype of the OGCs was the exact opposite. Based on the histological characters, a diagnosis of squamous cell carcinoma of the uterine cervix associated with OGCs was made. Considering the age of the patient, radiotherapy was administered. The patient succumbed to brain metastasis of the tumor after eight months of follow-up.
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Affiliation(s)
- Guohua Yu
- Department of Pathology, Shandong University School of Medicine, Jinan, Shandong 250012, P.R. China ; Department of Pathology, Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, Shangdong 264000, P.R. China
| | - Chunhua Lin
- Department of Surgery, Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, Shangdong 264000, P.R. China
| | - Wei Wang
- Department of Pathology, Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, Shangdong 264000, P.R. China
| | - Yekun Han
- Department of Pharmacology, Affiliated Hospital, Binzhou Medical College, Binzhou, Shandong 256603, P.R. China
| | - Guimei Qu
- Department of Pathology, Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, Shangdong 264000, P.R. China
| | - Tingguo Zhang
- Department of Pathology, Shandong University School of Medicine, Jinan, Shandong 250012, P.R. China
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Invasive breast carcinomas of no special type with osteoclast-like giant cells frequently have a luminal phenotype. Virchows Arch 2014; 464:681-8. [DOI: 10.1007/s00428-014-1573-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 03/17/2014] [Indexed: 10/25/2022]
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Niu Y, Liao X, Li X, Zhao L. Breast carcinoma with osteoclastic giant cells: case report and review of the literature. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2014; 7:1788-1791. [PMID: 24817980 PMCID: PMC4014264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 02/02/2014] [Indexed: 06/03/2023]
Abstract
Breast carcinoma with osteoclastic giant cells (OGCs) are uncommon. Here, we report a 46-year-old woman with a painless lump in her left breast that has been proved clinically and radiographically. Microscopical examination showed OGCs accompanying invasive ductal carcinoma. Immunohistochemical assay revealed that OGCs derived from macrophages. Despite positive lymph node metastasis, the patient has been well without evidence of recurrence or metastasis one year after the operation. To date, the influence of OGCs on the prognosis of patients is still controversial. Our case may provide insights into further understanding beast carcinoma with OGCs.
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Affiliation(s)
- Ya Niu
- Department of Pathology, School of Basic Medical Sciences, Southern Medical UniversityGuangzhou, China
| | - Xin Liao
- Department of Imaging Center, Nanfang Hospital, Southern Medical UniversityGuangzhou, China
| | - Xuenong Li
- Department of Pathology, School of Basic Medical Sciences, Southern Medical UniversityGuangzhou, China
| | - Liang Zhao
- Department of Pathology, School of Basic Medical Sciences, Southern Medical UniversityGuangzhou, China
- Department of Pathology, Nanfang Hospital, Southern Medical UniversityGuangzhou, China
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Lin CH, Hsu CW, Tsao TY, Chou J. Idiopathic granulomatous mastitis associated with risperidone-induced hyperprolactinemia. Diagn Pathol 2012; 7:2. [PMID: 22221904 PMCID: PMC3261802 DOI: 10.1186/1746-1596-7-2] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Accepted: 01/05/2012] [Indexed: 02/06/2023] Open
Abstract
Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease. The etiology and treatment options of IGM remain controversial. Previous case reports have suggested that hyperprolactinemia may be associated with IGM. In the present report, we describe the first case of IGM associated with risperidone-induced hyperprolactinemia.
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Affiliation(s)
- Chih-Hsun Lin
- Cheng Hsin General Hospital, Department of Anatomic Pathology, Taipei, Taiwan
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Richter G, Uleer C, Noesselt T. Multifocal invasive ductal breast cancer with osteoclast-like giant cells: a case report. J Med Case Rep 2011; 5:85. [PMID: 21352587 PMCID: PMC3056805 DOI: 10.1186/1752-1947-5-85] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Accepted: 02/27/2011] [Indexed: 11/19/2022] Open
Abstract
Introduction To the best of our knowledge, this is the first case report of a multifocal (trifocal) invasive carcinoma of the breast containing osteoclast-like giant cells. Case presentation A 64-year-old Caucasian woman presented for routine mammography screening with three radiodense lesions in the lower inner quadrant of the right breast, a primary breast cancer. Microscopic examination showed three foci of invasive ductal carcinoma with multinucleated osteoclast-like giant cells. Osteoclast-like giant cells in breast cancer are a rare phenomenon. They are described in less than two percent of all breast cancers and occur in association with invasive ductal cancer and invasive lobular cancer. In addition, osteoclast-like giant cells have been described in several sarcomas and metaplastic carcinomas of the breast. Conclusion To the best of our knowledge, this is the first report of a multifocal infiltrating ductal carcinoma of the breast containing osteoclast-like giant cells. This could be an indication for a possible early event in carcinogenesis associated with a biological event or secretion that indicates the differentiation and/or migration of stromal cells or macrophages.
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