Osteoklast benzeri dev hücreler içeren faringeal skuamöz hücreli karsinom: Olgu sunumu ve literatürün gözden geçirilmesi

Year 2009, Volume: 24 Issue: 2, 80 - 84, 01.03.2009

Nilüfer Onak Kandemir Sibel Bektaş Gamze Yurdakan Ebru Taş

Abstract

Benign osteoclast-like multinuclear giant cells are rarely found in tumors other than bone and soft tissue neoplasms, and they are even rarer in squamous cell carcinomas. We examined a nasopharyngeal tumor from a 52-year-old female who had undergone surgery one year earlier for hypopharyngeal squamous cell carcinoma. Histopathologically, in addition to tumor infiltration by atypical epithelial cells with squamoid differentiation, giant cells with 10-20 nuclei and a large amount of eosinophilic cytoplasm were seen infiltrating the tumor. The giant cells did not show atypia or mitosis. Immunohistochemically, the tumor cells stained for pan-keratin and epithelial membrane antigen, and the giant cells were positive for leukocyte common antigen, CD68, and Mac 387. This case was diagnosed as moderately differentiated squamous cell carcinoma with multinuclear giant cells. In this case, the giant cells infiltrating the tumor were benign and of monocytic/histiocytic origin. Studies including large case series are needed to obtain reliable information on the clinical and prognostic importance of this histological feature.

Keywords

-

Pharyngeal squamous cell carcinoma with osteoclast-like giant cells: A case report and review of the literature

Abstract

Benign osteoklast benzeri multinükleer dev hücrelerin, kemik ve yumuşak doku tümörleri dışındaki tümörlere eşlik etmesi nadir bir histopatolojik bulgudur. Skuamöz hücreli karsinomlarda ise çok daha nadiren saptanmaktadır. Bir yıl önce hipofarengeal skuamöz hücreli karsinom nedeniyle opere olan 52 yaşındaki kadın hastada, nazofarinkste saptanan tümöre biyopsi yapıldı. Histopatolojik olarak skuamoid diferansiasyon gösteren atipik epitelyal hücrelerin oluşturduğu tümöral infiltrasyonun yanı sıra tümör dokusunu infiltre eden, geniş eozinofilik sitoplazmalı ve ortalama 10-20 nükleus içeren dev hücreler dikkati çekti. Dev hücrelerde atipi ve mitoz izlenmedi. İmmünhistokimyasal olarak tümör hücrelerinde pankeratin ve EMA ile dev hücrelerde ise LCA, CD68 ve Mac 387 ile reaksiyon gözlendi. Olguya, multinükleer dev hücrelerin eşlik ettiği orta derecede diferansiye skuamöz hücreli karsinom tanısı verildi. Olgumuzda tümörü infiltre eden dev hücrelerin benign karakterde ve monositik/histiyositik kökenli olduğu saptandı. Geniş olgu serilerinde yapılacak çalışmalar, bu histolojik özelliğin klinik ve prognostik önemine yönelik güvenilir bilgiler sağlayacaktır.

Keywords

Nazofarenks, osteoklast benzeri dev hücre, skuamöz hücreli karsinom

References

• 1) Sakai Y, Kupelioglu AA, Yanagisawa A, Yamaguchi K, Hidaka E, Matsuya S, et al. Origin of giant cells in osteoclast-like giant cell tumors of the pancreas. Hum Pathol 2000;31(10):1223-9
• 2) Westra WH, Sturm P, Drillenburg P, Choti MA, Klimstra DS, Albores-Saavedra J, et al. K-ras oncogene mutations in osteoclast-like giant cell tumors of the pancreas and liver: genetic evidence to support origin from the duct epithelium. Am J Surg Pathol 1998;22(10):1247-54
• 3) Emanuel PO, Shim H, Phelps RG. Poorly differentiated squamous cell carcinoma with osteoclastic giantcell-like proliferation. J Cutan Pathol 2007;34(12):930-3
• 4) Krishnan C, Longacre TA. Ductal carcinoma in situ of the breast with osteoclast-like giant cells. Hum Pathol 2006;37(3):369-72
• 5) Cai N, Koizumi J, Vazquez M. Mammary carcinoma with osteoclast-like giant cells: a study of four cases and a review of literature. Diagn Cytopathol 2005;33(4):246-51
• 6) Akatsu T, Kameyama K, Kawachi S, Tanabe M, Aiura K, Wakabayashi G, et al. Gallbladder carcinoma with osteoclast-like giant cells. J Gastroenterol 2006;41(1):83-7
• 7) Willems S, Carneiro F, Geboes K. Gastric carcinoma with osteoclast-like giant cells and lymphoepithelioma-like carcinoma of the stomach: two of a kind? Histopathology 2005;47(3):331-3
• 8) Baydar D, Amin MB, Epstein JI. Osteoclast-rich undifferentiated carcinomas of the urinary tract. Mod Pathol 2006;19(2):161-71
• 9) Fadare O, McCalip B, Mariappan MR, Hileeto D, Parkash V. An endometrial stromal tumor with osteoclast-like giant cells. Ann Diagn Pathol 2005;9(3):160-5.