Giant cell tumour of bone

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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)

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

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.