Journal of Pathology and Translational Medicine

Case Study

A Solitary Fibrous Tumor with Giant Cells in the Lacrimal Gland: A Case Study: Da Hye Son, Su Hyun Yoo, Ho-Seok Sa, Kyung-Ja Cho; Korean J Pathol. 2013;47(2):158-162. Published online April 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.2.158

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Orbital solitary fibrous tumor (SFT) has recently been proposed as the encompassing terminology for hemangiopericytoma, giant cell angiofibroma (GCAF), and fibrous histiocytoma of the orbit. The lacrimal gland is a very rare location for both SFT and GCAF. A 39-year-old man presented with a painless left upper eyelid mass. An orbital computed tomography scan identified a 1.1 cm-sized well-defined nodule located in the left lacrimal gland. He underwent a mass excision. Histopathologic examination showed a proliferation of relatively uniform spindle cells with a patternless or focally storiform pattern. Dilated vessels were prominent, but angiectoid spaces lined with giant cells were absent. Floret-type giant cells were mostly scattered in the periphery. The tumor was immunoreactive for CD34 and CD99, but negative for smooth muscle actin and S-100 protein. This is the first Korean case of SFT of the lacrimal gland with overlapping features of GCAF, suggesting a close relationship between the two entities.

Citations

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A review of solitary fibrous tumours of the orbit and ocular adnexa
Cornelius René, Paolo Scollo, Dominic O’Donovan
Eye.2023; 37(5): 858. CrossRef
A giant orbital solitary fibrous tumor treated by surgical excision: a case report and literature review
Qi Zhou, Yuting Liu, Fang Wang, Yang Cao, Hongbin Lv, Xibo Zhang
Diagnostic Pathology.2023;[Epub] CrossRef
Giant cell-rich solitary fibrous tumour of the lacrimal gland with prominent angiomatoid cystic changes and an underlying NAB2ex3-STAT6ex18 fusion
Khaled A Alsaadi, Manar Alwohaib, Karen Pinto, Rola H Ali
BMJ Case Reports.2022; 15(2): e247141. CrossRef
Cystic appearance - a new feature of solid fibrous tumours in the lacrimal gland: a case report with literature review
Ancuta-Augustina Gheorghisan-Galateanu, Dana Cristina Terzea, Iulia Burcea, Roxana Dusceac, Cristina Capatina, Catalina Poiana
Diagnostic Pathology.2019;[Epub] CrossRef
Solitary Fibrous Tumor in the Lacrimal Gland Fossa: A Case Report
Jacqueline Mupas-Uy, Yoshiyuki Kitaguchi, Yasuhiro Takahashi, Emiko Takahashi, Hirohiko Kakizaki
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Ocular adnexal (orbital) solitary fibrous tumor: nuclear STAT6 expression and literature review
Aleksandra Petrovic, Aurélie Obéric, Alexandre Moulin, Mehrad Hamedani
Graefe's Archive for Clinical and Experimental Ophthalmology.2015; 253(9): 1609. CrossRef
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Revista Española de Patología.2014; 47(4): 223. CrossRef

Case Report

Cytologic Features of Giant Cell Ependymoma: A Case Report and Review of the Literature: Myoung Ju Koh, Sun Och Yoon, Hyae Min Jeon, Hyeon Joo Jeong, Soon Won Hong, Se Hoon Kim; Korean J Pathol. 2012;46(5):507-513. Published online October 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.5.507

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Abstract PDF

Here, we present a case of anaplastic giant cell ependymoma (GCE) occurring in a 15-year-old woman. Squash smear slides for intraoperative frozen section diagnosis revealed oval to round cell clusters with a papillary structure in a fibrillary background. This was occasionally accompanied by the presence of bizarre pleomorphic giant cells with hyperchromatic nuclei and prominent intranuclear inclusions. These intranuclear inclusions were a key clue to diagnosis of ependymoma. Histologic analysis revealed features of a high-grade tumor with perivascular pseudorosettes and bizarre pleomorphic giant cells, which established the diagnosis of GCE. We performed a review of literatures about the cytologic features of GCE, including our case, thus proposing that intraoperative frozen diagnosis of GCE would be established by squash smear preparations featuring the mitosis and necrosis, as well as the high cellularity, and the presence of giant cells showing hyperchromatic nuclei with eosinophilic cytoplasm and intranuclear inclusions/pseudoinclusions.

Citations

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Neuropathology.2024;[Epub] CrossRef
Report of a case of giant cell ependymoma with unusual clinical and pathological presentation
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Diagnostic Pathology.2017;[Epub] CrossRef
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World Neurosurgery.2017; 108: 997.e9. CrossRef

Original Article

Fine Needle Aspiration Cytology of Anaplastic Carcinoma with Osteoclastlike Giant Cells of the Thyroid.: Ji Shin Lee, Hyang Mi Ko, Min Cheol Lee, Chang Soo Park, Sang Woo Juhng; Korean J Cytopathol. 1994;5(2):172-175.

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Abstract PDF: Anaplastic carcinoma of the thyroid is one of the most malignant tumors and survival for longer than three years after diagnosis is exceptional. Multinucleated giant cells of osteoclastlike appearances are seen in some of the anaplastic carcinoma, but only three cases in which the diagnosis was made by fine needle aspiration(FNA) cytology are reported in the international literature. We experienced a case of anaplastic carcinoma with osteoclastlike giant cells in a 66-yr-old female, diagnosed by FNA cytology. The smears revealed two cell populations; multinucleated giant cells and large polygonal or spindle shaped malignant cells. The FNA cytodiagnosis of anaplastic thyroid carcinoma containing osteoclastilke giant cells was substantiated by subsequent biopsy.

Case Reports

Fine Needle Aspiration Cytology of Invasive Ductal Carcinoma with Osteoclast-like Giant cells: A Case Report .: Eun Ha Jung, Hye Rim Park, Jin Hee Sohn; Korean J Cytopathol. 1998;9(2):221-226.

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Abstract PDF: Malignant tumors of the breast with stromal multinucleated giant cells are rare entity of uncertain clinical significance. There have been few reports on the fine needle aspiration cytologic(FNAC) findings about these rare tumors. We report a FNAC case of invasive mammary carcinoma with osteoclast-like giant cells not only for its rare occurrence but in particular for its distinctive cytologic picture on aspirated material. The patient was a 40-year-old woman who presented with a right breast mass for one month. Mammography showed a well-demarcated rounded mass density without calcification. The aspirates of FNAC were highly cellular and two main cell types were seen; malignant epithelial cells and osteoclast-like multinucleated giant cells. The carcinoma cells occurred singly or arranged in loose clusters with ill-defined cytoplasm, oval nuclei, coarse chromatin and small but distinct nucleoli. The multinucleated giant cells showed variable number of nuclei with prominent nucleoli and abundant dense oxyphilic cytoplasm. The immunocytochemical studies suggested that osteoclast-like giant cells were not of epithelial origin, but rather of histiocytic origin.

Fine Needle Aspiration Cytology of Anaplastic Carcinoma of the Thyroid with Osteoclast-like Giant Cells : A Case Report.: Leeso Maeng, Jehoon Lee, Kyoung Mee Kim, Anhi Lee, Chang Suk Kang; Korean J Cytopathol. 2003;14(1):32-35.

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Abstract PDF: Multinucleated giant cells of osteoclast-like appearance can be seen in a type of anaplastic carcinoma of thyroid and only a few case reports for fine needle aspiration cytologic findings are found in the literatures. Recently, we experienced a case of anaplastic carcinoma of thyroid with many osteoclast-like giant cells in a 72-year-old woman. The cytologic features and immunohistochemical results are described with special emphasis on differential diagnosis.

Undifferentiated Gallbladder Carcinoma with Osteoclast-like Giant Cells: A Case Report.: Yun Kyung Kang; Korean J Pathol. 2007;41(2):127-131.

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Abstract PDF: Undifferentiated carcinoma with osteoclast-like giant cells (OGCs) is the least common type of gallbladder carcinoma. Here, the author presents a case of undifferentiated gallbladder carcinoma with OGCs in an 81-year-old male patient. Grossly, the tumor was a 10x7 cm sized, polypoid, lumen-filling mass with extensive hemorrhage and necrosis. Microscopically, the tumor was composed of pleomorphic ovoid to spindle cells admixed with numerous OGCs. There was a minute focus of mucosal dysplasia and carcinoma in situ. Immunohistochemically, the mononuclear cells were positive for cytokeratin, p53 and Ki-67, while the OGCs were negative for these markers but positive for CD68. These findings support an epithelial origin for the ovoid to spindle cells and the nonneoplastic reactive histiocytic lineage of the OGCs.

Dedifferentiated Chondrosarcoma with Giant Cell-rich Sarcomatous Component Resembling Giant Cell Tumor: A Case Report.: Pil Gyu Hwang, Jae Kyung Won, Min A Kim, Han Soo Kim, Sang Hoon Lee, Chong Jai Kim; Korean J Pathol. 2004;38(5):345-349.

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Abstract PDF: Dedifferentiated chondrosarcoma is an uncommon bone tumor, defined as a tumor in which two components -a low-grade chondrosarcoma and a high-grade non-cartilaginous sarcoma-coexist with abrupt interface. We report a rare case of giant-cell rich dedifferentiated chondrosarcoma occurred in the right distal femur shaft of a 60 year-old female. The plain X-ray film showed an irregular radiolucent mass. The T2-weighted MRI revealed a heterogeneous high signal intensity. It was an irregular mass composed of bluish-white, translucent chondroid elements and yellowish solid components with extraosseous invasion. Microscopically, a low-grade chondrosarcoma and a giant-cell rich spindle cell sarcoma with areas resembling giant cell tumor were recognized with abrupt transition. Immunohistochemical staining revealed a S100 protein positivity in chondroid cells and a few spindle cells. CD68 was strongly positive in giant cells. Vimentin was positive in both components and smooth muscle actin was positive in some spindle cells. There was no cytokeratin, desmin and myogenin immunopositivity. It is important to be aware of this rare variant of dedifferentiated chondrosarcoma to avoid the misdiagnosis of more common bone tumors including giant cell tumors.

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