Giant cells

Giant cell from a bronchial wash. Pap stain.

Giant cells are "big" cells with multiple nuclei. They come in different flavours, which are suggestive of causality.

This article deals with the classic types of giant cells. A more general differential diagnosis of giant cells is in giant cell lesions.

Giant cell types

List:

• Touton giant cell.
• Osteoclast-like giant cell.
• Foreign body type giant cell.

Table

Type	Histology	DDx	Other	Image
Touton giant cell	Nuclei form a ring around the cell periphery with eosinophilic cytoplasm centrally and foamy cytoplasm at the periphery.	Juvenile xanthogranuloma, xanthoma, Erdheim-Chester disease, fat necrosis, dermatofibroma	High lipid content lesions, Named after Karl Touton	JXG (WC)
Epithelioid type	scattered nuclei	drug reaction, neoplasm, foreign body, infection, idiopathic, autoimmune, allergic	granulomatous inflammation	Granuloma (WC)
Langhans giant cell	peripheral semi-circular eccentric nuclei	tuberculosis, sarcoidosis.	not to be confused with Langerhans cells, Named after Theodor Langhans	LGC (WC)
Osteoclast-like giant cells	multiple bland central nuclei, ruffled cell membrane.	osteoclasts, others	AKA osteoclast-type giant cells

See also

• Basics.
• Giant cell lesions - includes a DDx of lesions with giant cells.
• Histiocytoses.