Analysis of imaging characteristics of undifferentiated carcinoma with pancreatic osteoclast-like giant cell / 中华消化杂志

Objective:To investigate the imaging characteristics of computed tomography (CT) and magnetic resonance imaging (MRI) of undifferentiated carcinoma with pancreatic osteoclast-like giant cell (UPC-OGC).Methods:From April 2015 to November 2019, at Zhongshan Hospital, Fudan University, 11 pathologically confirmed UPC-OGC patients who received upper abdominal CT or MRI before surgery and with complete clinical and pathological data were retrospectively included. The imaging characteristics of CT and MRI were analyzed, which included lesion location, number, shape, size, boundary, plain scan and enhancement features, adjacent tissue invasion and metastasis. Independent sample t test was used for statistical analysis. Results:The tumor lesions of 11 patients with UPC-OGC were all single, and the maximum diameter of lesion was (4.84±2.96) cm (ranged from 2.00 to 12.80 cm). The lesions of 7 patients with UPC-OGC were located in the head of pancreas, 2 located in the body of pancreas, 1 located in the tail of pancreas and 1 located in the junction of body and tail of pancreas. The lesion shapes of 3 patients with UPC-OGC were round, and the lesion shapes of 8 patients were oval with lobulation. The lesion boundaries of 8 patients with UPC-OGC were clear and the lesion boundaries of 3 patients were unclear. Seven patients with UPC-OGC were examined by plain and enhanced CT scan. Plain CT scan showed that the density of solid area of the tumor was similar to that of normal pancreatic parenchyma ((37.14±6.10) HU vs. (43.14±4.55) HU), and the difference was not significant ( t=-2.85, P=0.097). Contrast-enhanced CT scan in arterial phase showed that the degree of enhancement in solid area of the tumor was weaker than that of normal pancreatic parenchyma ((67.29±12.79) HU vs. (90.43±9.81) HU), and the difference was statistical significant ( t=-4.10, P=0.004), while contrast-enhanced CT scan showed that in venous phase the solid area of the tumor continued to strengthen and the degree of enhancement was similar to that of normal pancreatic parenchyma ((84.71±15.30) HU vs. (79.57±10.73) HU), and the difference was not significant ( t=0.38, P=0.535). Both CT and MRI enhanced scans showed uneven enhancement of the lesions, the degree of enhancement of solid component in arterial phase was slightly weaker than that of normal pancreatic parenchyma and the marginal and internal separation were progressively enhanced, and the degree of enhancement in the venous phase and balanced phase was slightly higher than that of the normal pancreatic parenchyma or similar to that of the normal pancreas. Conclusions:The imaging of CT and MRI of UPC-OGC have certain characteristics, which are helpful for the diagnosis and identification of the disease.

Imaging features of undifferentiated pancreatic carcinoma with osteoclast-like giant cells / 中华胰腺病杂志

Objective:To investigate the imaging features of undifferentiated pancreatic carcinoma (UCOGCP) with osteoclast-like giant cells.Methods:CT and MRI data of 4 pathologically diagnosed UCOGCP patients admitted in the First Affiliated Hospital of Naval Medical University from December 2014 to January 2019 were retrospectively analyzed. The tumor location, major length, shape, border, density or signal, capsule, calcification, hemorrhage, cystic degeneration, degree of enhancement, as well as the presence or absence of pancreatic duct dilatation, pancreatic parenchymal atrophy, peripheral vascular invasion, lymph node and organ metastasis were recorded.Results:Of 4 UCOGCP patients, 1 case had the mass located in head of pancreas, 2 cases in body of pancreas , and 1 in tail of pancreas. The length of tumor ranged from 3.3 cm to 13.0 cm, and the average was 8.8 cm.3 cases were round-like, and 1 was irregular; 2 tumors were well defined with capsules, 2 with unclear border. 4 cases showed solid-cystic masses, 3 of which had cystic separation. 4 cases showed heterogeneous low density on unenhanced CT, and 1 case had spotted calcification. The solid component of the mass was mild enhanced on enhanced CT, and partial solid component of the mass showed obvious enhancement in 2 cases. 2 cases showed mixed low signal on T 1WI, 1 of which had small patchy high signal indicating hemorrhage. 2 cases showed mixed high signal on T 2WI, and high signal on DWI. 2 cases had major pancreatic duct dilation. 1 case had pancreatic parenchyma atrophy. 1 case had descending duodenum invasion. 3 cases had peripheral vascular invasion, including portal vein, splenic artery, and splenic vein. 1 case had tumor thrombosis in the portal vein and splenic vein. 1 case was associated with pancreatogenous portal hypertension. Conclusions:The imaging features of UCOGCP showed a large solid-cystic mass with hemorrhage and calcification. The solid component of the mass was mild enhanced and the partially solid component was obviously enhanced. The combination of its imaging characteristics and clinical data can improve the accuracy of diagnosis.

Pathological features of undifferentiated pancreatic carcinoma with osteoclast-like giant cells / 中华胰腺病杂志

Objective To investigate the clinicopathological features of undifferentiated pancreatic carcinoma with osteoclast-like giant cells (UOC).Methods Clinical and pathological data of 6 patients with UOC admitted in Navy Medical University affiliated Changhai Hospital from April 2011 to December 2017 were retrospectively analyzed.The expressions of Cam5.2,EMA,CD68,vimentin,lysozyme,E-cad,C-erbB-2,p53,MUC1,MLH1,MSH2,MSH6,Osteoponin and Ki-67 were detected by immunohistochemistry,and Kras gene mutations was measured by fluorescence quantitative PCR method.Results There were two main types of UOC cells.One type was oval or spindle mononuclear tumor cells,and the other was osteoclast-like giant cells scattered among mononuclear cells.Immunohistochemical staining results showed that the epithelial markers like CAM5.2,EMA,E-cad,MLH1,MSH2,MSH6 and Ki-67 of the components of ductal adenocarcinoma in 6 UOC patients were all positively expressed,and the mesenchymal markers like vimentin,CD68,lysozyme and tumor-related markers like Her-2,p53 and MUC1 were all negatively expressed.Vimentin,CD68,lysozyme and Osteoponin were positively expressed in osteoclast-like giant cells,but epithelial markers like Cam5.2,EMA,E-cad,MLH1,MSH2 and MSH6 were negatively expressed.6 UOC patients all had K-ras codon 12 mutation,and the mutant type was GGT ＞ TGT,GGT ＞ GTT,GGT ＞ GCT,and no codon 13 mutation was observed.Conclusions Osteoclast-like giant cells may be reactive multinucleated giant cells rather than neoplastic components.

Sarcomatoid cholangiocarcinoma with osteoclast-like giant cells associated with hepatolithiasis: A case report

No abstract available.

A Case of Undifferentiated Carcinoma with Osteoclast-Like Giant Cells in the Pancreas / 대한내과학회지

Undifferentiated carcinomas with osteoclast-like giant cells are rare pancreatic and periampullary neoplasms that mimic giant cell tumors of bone morphologically. Recently, we experienced an osteoclast-like giant cell tumor arising in the tail of the pancreas. A 76-year-old male was admitted with epigastric discomfort and indigestion. Abdominal computed tomography (CT) and abdominal magnetic resonance imaging (MRI) showed a 3x3-cm mass containing necrotic and hemorrhagic areas in the tail of the pancreas. A distal pancreatectomy and splenectomy were performed. Histological examination showed tumor cell components consisting of mononuclear pleomorphic cells admixed with osteoclastic giant cells. The final diagnosis was undifferentiated carcinoma with osteoclast-like giant cells with ductal adenocarcinoma in the pancreas.

Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells / 대한외과학회지

Undifferentiated carcinoma with osteoclast-like giant cells is a rare neoplasm of the exocrine pancreas. Some similar cases have been reported, but the histogenesis of these tumors varies and is controversial. We report here on a case of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells. A 77-year old woman presented with abdominal pain and anorexia. Abdominal computed tomography and magnetic resonance imaging showed an approximately 10 x 5 cm highly attenuated mass arising from the tail of the pancreas and invading the spleen and adjacent bowel loop. The initial impression was a malignant endocrine tumor or solid-pseudopapillary tumor of the pancreas. The patient underwent a distal pancreatectomy with splenectomy and left hemicolectomy. The histopathology and immunohistochemistry helped make the diagnosis that of an undifferentiated carcinoma with osteoclast-like giant cells of the pancreas.

Undiffentiated Carcinoma with Osteoclast-like Giant Cells of the Pancreas / 대한소화기학회지

Undifferentiated carcinoma with osteoclast-like giant cells is a rare neoplasm of exocrine pancreas. Till recently, some cases have been reported, however histogenesis of the tumors are controversial and their characteristic findings have not been described yet. Thirty five-year-old men and 75-year-old men were presented with upper abdominal pain and a palpable mass. On computed tomography, one case showed a well enhancing solid tumor with low density and the other was showed a mainly cystic tumor with peripheral enhancement in the body and tail of the pancreas. One case accompanied multiple metastatic liver masses with subhepatic lymph node enlargement. Tumor staining was seen on angiography. Biopsy and pancreatectomy were performed. Pathological findings revealed tumors composed of neoplastic spindle shaped or pleomorphic large cells with scattered non-neoplastic osteoclast-like giant cells. In one case, there were small foci of adenocarcinoma components in the periphery of the tumor. On immunohistochemical stain, neoplastic cells showed focal positivity for epithelial membrane antigen and vimentin. Tumors were diagnosed as undifferented carcinoma with osteoclast-like giant cells. We report these rare cases with a review of literature.

A Case of Primary Leiomyosarcoma with Prominent Osteoclast-like Giant Cell of Lung with Cardiac Invasion / 결핵및호흡기질환

The incidence of a pulmonary leiomyosarcoma as a primary lung tumor is quite rare. We report a case of primary leiomyosarcoma with a cardiac invasion in a 76 year old man. He was admitted due to left anterior chest wall pain for one month. Chest computed tomography showed a 9x8x10cm sized , large round mass in the left upper and lower lobes, and an amorphous low density lesion within the left atrium. Chest magnetic resonance imaging showed a large round mass in the left upper and lower lobes with growth into the left atrium. A diagnosis of leiomyosarcoma with prominent osteoclast-like giant cells was made based on the microscopic and immunohistochemical findings of a permanent specimen by explothoracotomy. The pathologic features of the tumor showed round mononuclear hyperchromatic cells and multinucleated giant cells that resembled osteoclasts. The immunohistochemical staining showed that the giant cells are positive for CD68 but negative for the muscle markers while the round cells were positive for the muscle marker. The patient refused further treatment and died after two months.

Fine Needle Aspiration Cytology of Anaplastic Carcinoma of the Thyroid with Osteoclast-like Giant Cells : A Case Report / 대한세포병리학회지

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.

Fine Needle Aspiration Cytology of Invasive Ductal Carcinoma with Osteoclast-like Giant cells: A Case Report / 대한세포병리학회지

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.