I read the article by Sarode and colleagues entitled "Cellular cannibalism in giant cells of central giant cell granuloma of jaw bones and giant cell tumors of long bones" 1 in the Journal of Investigative and Clinical Dentistry and was interested in cellular cannibalism, and thought of its potential useful applications, particularly association to lichen planus malignancy. Cellular cannibalism (CC) is referred to as a phenomenon, in which a large tumoral cell engulfs a smaller tumoral cell in its cytoplasm. 2 This creates an unusual appearance of a complete cell with a semilunar nucleus that has swallowed a smaller cell with a round-to-oval nucleus. 3 This phenomenon is different from phagocytosis, because cannibalism cells exclusively digest viable cells. 2 Internalized cells are viable when swallowed, but this process results in their death. They are eventually degraded, 2 and show an apoptotic appearance with lost nucleus and increased cytoplasmic density. 1 CC has been described as a morphologic pattern of malignancy, 4 and it has been reported in many malignant tumors, especially aggressive malignancies. 3,4 It also has a significant correlation with anaplasia, invasiveness, and malignant metastatic potential, and can promote tumor progression. 4 Lichen planus (LP) is an immune-mediated, chronic inflammatory disorder affecting the skin and/or mucus membranes, and has variable clinical manifestations. LP is considered a premalignant LETTER TO THE EDITOR internalized cells impair the cytokinesis of cells that swallowed them and promote tumor growth by this mechanism and the development of aneuploidy 4 c) Carcinogenesis can occur in acidic microenvironments. The acidity of the microenvironment of the lesion plays an important role in the formation of CC, because these cells are particularly resistant to low pH and can tolerate such toxic environments and survive unfavorable conditions 1,3 d) Aside from the swallowing of tumoral cells by CC, 2 recent reports indicate swallowing of other cells, such as immune cells, as well.Thus, the lesion can use CC as an escape mechanism from the immune system. 2,3 With this process, cells with chromosomal instability can be protected from eradication This hypothesis requires further study, which could facilitate the screening and early detection of patients at risk. The presence of CC, especially the increasing number of such cells in LP, might be a potential cause of alarm to launch accurate assessment and continue follow up of LP patients by clinicians.
ORCID
Massoumeh Zargaran