Breast – Malignant, Males, Children - Carcinoma with osteoclastic giant cells

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Breast-malignant, males, children

Carcinoma with osteoclastic giant cells

Author: Nat Pernick, M.D, PathologyOutlines.com, Inc.

Reviewer: Daniel Visscher, M.D., University of Michigan Hospitals, February 2009 (see Reviewers page)

Revised: 24 September 2009

Last major update: September 2009

Definition

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● Part of WHO classification

● Osteoclastic giant cells are present in stroma

● Presence of giant cells does not alter prognosis

Case reports

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● 51 year old woman with pleomorphic carcinoma and prominent osteoclastic giant cells (Pathol Int 2009;59:91)

● Cases with neuroendocrine carcinoma (Pathologica 2008;100:176)

● Ductal carcinoma with osteoclast-like giant cells (Radiographics 2002;22:691, Archives 1986;110:636)

Gross description

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● Often brown due to vascular stroma with hemosiderin

Microscopic description

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● Giant cells are associated with vascular stroma with extravasated red blood cells and hemosiderin, also chronic inflammatory cells and fibroblasts

● Giant cells have variable size and variable numbers of nuclei

● Similar histologic features in nodal metastases and recurrences

● Carcinoma component may be any type

Micro Images

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Whole mount Tubular growth, vascular Giant cells in stroma

stroma and hemorrhage and intraductal spaces

● Various images: #1; #2; #3; #4

Cytology description

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● Abundant giant cells and mononucleated stromal cells associated with carcinoma cells (Diagn Cytopathol 2005;33:246)

Positive stains

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● Osteoclastic giant cells: CD68; also acid phosphatase, lysosome, nonspecific esterase

Negative stains

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Osteoclastic giant cells: S100, actin, keratin, EMA, ER, PR, alkaline phosphatase

Electron Microscope

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● Osteoclasts are histiocytes

Additional References

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● Ann Pathol 1989;9:189, Hum Pathol 1990;21:1142, Stanford University

End of Breast – Malignant, Males, Children > Carcinoma with osteoclastic giant cells

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