Difference between revisions of "Giant cell tumour of bone"

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#redirect [[Bone_tumours#Giant_cell_tumour_of_bone]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Giant_cell_tumour_of_bone_-_high_mag.jpg
| Width      =
| Caption    = Giant cell tumour of bone. [[H&E stain]].
| Micro      = giant cells (usu. with >10 in the plane of section), mononuclear cells and small multinucleated cells with nuclei similar to those in the giant cells
| Subtypes  =
| LMDDx      = other [[giant cell lesions]]
| Stains    =
| IHC        = p63 +ve (patchy)
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[bone]], epiphysis usually
| Assdx      =
| Syndromes  =
| Clinicalhx = usu. young adults (20-45 years old)
| Signs      = +/-immobility
| Symptoms  = +/-pain
| Prevalence = uncommon ~ 5% of primary bone tumours
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    =
}}
'''Giant cell tumour of bone''' is an uncommon [[bone]] tumour.
 
==General==
Features:<ref name=Ref_WMSP648>{{Ref WMSP|648}}</ref>
*Approximately 5% of primary [[bone tumour]]s.
*Typical age: 20-45 years.
 
===Clinical===
*Location: growth plate of long bones.<ref name=pmid11501745>{{Cite journal  | last1 = Wülling | first1 = M. | last2 = Engels | first2 = C. | last3 = Jesse | first3 = N. | last4 = Werner | first4 = M. | last5 = Delling | first5 = G. | last6 = Kaiser | first6 = E. | title = The nature of giant cell tumor of bone. | journal = J Cancer Res Clin Oncol | volume = 127 | issue = 8 | pages = 467-74 | month = Aug | year = 2001 | doi =  | PMID = 11501745 }}</ref>
**May present with joint pain, immobility.
 
Note:
*Several types of [[giant cell lesions|giant cell tumours]] exist.
 
==Microscopic==
Features:<ref name=Ref_Klatt420>{{Ref Klatt|420}}</ref>
*Giant cells with a large number of nuclei (usu. >10 in the plane of section).
**Usu. have [[prominent nucleoli]].
*Mononuclear cells and small multinucleated cells with nuclei similar to those in the giant cells - '''key feature'''.
*+/-Hemosiderin deposition - not common.<ref name=pmid1939753>{{Cite journal  | last1 = Aoki | first1 = J. | last2 = Moriya | first2 = K. | last3 = Yamashita | first3 = K. | last4 = Fujioka | first4 = F. | last5 = Ishii | first5 = K. | last6 = Karakida | first6 = O. | last7 = Imai | first7 = S. | last8 = Sakai | first8 = F. | last9 = Imai | first9 = Y. | title = Giant cell tumors of bone containing large amounts of hemosiderin: MR-pathologic correlation. | journal = J Comput Assist Tomogr | volume = 15 | issue = 6 | pages = 1024-7 | month =  | year =  | doi =  | PMID = 1939753 }}</ref><ref name=pmid18554912>{{Cite journal  | last1 = Matsushige | first1 = T. | last2 = Nakaoka | first2 = M. | last3 = Yahara | first3 = K. | last4 = Kagawa | first4 = K. | last5 = Miura | first5 = H. | last6 = Ohnuma | first6 = H. | last7 = Kurisu | first7 = K. | title = Giant cell tumor of the temporal bone with intratumoral hemorrhage. | journal = J Clin Neurosci | volume = 15 | issue = 8 | pages = 923-7 | month = Aug | year = 2008 | doi = 10.1016/j.jocn.2007.03.013 | PMID = 18554912 }}</ref>
 
Notes:
*Giant cells typically present in abundance.
 
DDx:
*[[Giant cell lesions]].
**[[Aneurysmal bone cyst]] - typically has spindle cells around the giant cells.
 
===Images===
<gallery>
Image:Giant_cell_tumour_of_bone_-_low_mag.jpg | GCT of bone - low mag. (WC)
Image:Giant cell tumour of bone - intermed mag.jpg | GCT of bone - intermed. mag. (WC)
Image:Giant_cell_tumour_of_bone_-_high_mag.jpg | GCT of bone - high mag. (WC)
Image:Giant cell tumour of bone - very high mag.jpg | GCT of bone - very high mag. (WC)
</gallery>
 
==IHC==
*p63 +ve in scattered mononuclear cells.<ref name=pmid18311114>{{cite journal |author=Dickson BC, Li SQ, Wunder JS, ''et al.'' |title=Giant cell tumor of bone express p63 |journal=Mod. Pathol. |volume=21 |issue=4 |pages=369–75 |year=2008 |month=April |pmid=18311114 |doi=10.1038/modpathol.2008.29 |url=}}</ref>
**This seems to be contradicted by another paper.<ref name=pmid20012988>{{cite journal |author=Alberghini M, Kliskey K, Krenacs T, ''et al.'' |title=Morphological and immunophenotypic features of primary and metastatic giant cell tumour of bone |journal=Virchows Arch. |volume=456 |issue=1 |pages=97–103 |year=2010 |month=January |pmid=20012988 |doi=10.1007/s00428-009-0863-2 |url=}}</ref>
 
==See also==
*[[Bone]].
*[[Chondro-osseous tumours]].
*[[Giant cells]].
*[[Giant cell lesions]].
 
==References==
{{Reflist|2}}
 
[[Category:Diagnosis]]
[[Category:Chondro-osseous tumours]]

Latest revision as of 07:42, 1 October 2013

Giant cell tumour of bone
Diagnosis in short

Giant cell tumour of bone. H&E stain.
LM giant cells (usu. with >10 in the plane of section), mononuclear cells and small multinucleated cells with nuclei similar to those in the giant cells
LM DDx other giant cell lesions
IHC p63 +ve (patchy)
Site bone, epiphysis usually
Clinical history usu. young adults (20-45 years old)
Signs +/-immobility
Symptoms +/-pain
Prevalence uncommon ~ 5% of primary bone tumours

Giant cell tumour of bone is an uncommon bone tumour.

General

Features:[1]

  • Approximately 5% of primary bone tumours.
  • Typical age: 20-45 years.

Clinical

  • Location: growth plate of long bones.[2]
    • May present with joint pain, immobility.

Note:

Microscopic

Features:[3]

  • Giant cells with a large number of nuclei (usu. >10 in the plane of section).
  • Mononuclear cells and small multinucleated cells with nuclei similar to those in the giant cells - key feature.
  • +/-Hemosiderin deposition - not common.[4][5]

Notes:

  • Giant cells typically present in abundance.

DDx:

Images

  • GCT of bone - low mag. (WC)

  • GCT of bone - intermed. mag. (WC)

  • GCT of bone - high mag. (WC)

  • GCT of bone - very high mag. (WC)

IHC

  • p63 +ve in scattered mononuclear cells.[6]
    • This seems to be contradicted by another paper.[7]

See also

References

  1. ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 648. ISBN 978-0781765275.
  2. ↑ Wülling, M.; Engels, C.; Jesse, N.; Werner, M.; Delling, G.; Kaiser, E. (Aug 2001). "The nature of giant cell tumor of bone.". J Cancer Res Clin Oncol 127 (8): 467-74. PMID 11501745.
  3. ↑ Klatt, Edward C. (2006). Robbins and Cotran Atlas of Pathology (1st ed.). Saunders. pp. 420. ISBN 978-1416002741.
  4. ↑ Aoki, J.; Moriya, K.; Yamashita, K.; Fujioka, F.; Ishii, K.; Karakida, O.; Imai, S.; Sakai, F. et al. "Giant cell tumors of bone containing large amounts of hemosiderin: MR-pathologic correlation.". J Comput Assist Tomogr 15 (6): 1024-7. PMID 1939753.
  5. ↑ Matsushige, T.; Nakaoka, M.; Yahara, K.; Kagawa, K.; Miura, H.; Ohnuma, H.; Kurisu, K. (Aug 2008). "Giant cell tumor of the temporal bone with intratumoral hemorrhage.". J Clin Neurosci 15 (8): 923-7. doi:10.1016/j.jocn.2007.03.013. PMID 18554912.
  6. ↑ Dickson BC, Li SQ, Wunder JS, et al. (April 2008). "Giant cell tumor of bone express p63". Mod. Pathol. 21 (4): 369–75. doi:10.1038/modpathol.2008.29. PMID 18311114.
  7. ↑ Alberghini M, Kliskey K, Krenacs T, et al. (January 2010). "Morphological and immunophenotypic features of primary and metastatic giant cell tumour of bone". Virchows Arch. 456 (1): 97–103. doi:10.1007/s00428-009-0863-2. PMID 20012988.
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