Carcinoma of the breast with stromal multinucleated giant cells

Abstract

Three cases of invasive mammary carcinoma with stromal osteoclast-like giant cells are reported. All the specimens were grossly of reddish-brown colour. On microscopical examination two were invasive ductal carcinomas and the third was of mixed ductal and mucoid type. In the stroma all specimens showed numerous osteoclast-like giant cells, vascular proliferation, and accumulation of haemosiderin pigment. Supplementary immunohistochemical and electron microscopical investigations indicated that the giant cells originated from mononuclear stromal cells with only slight histiocytic properties. The giant cell formation was probably induced by the infiltrating carcinomatous tissue which is also believed to induce new blood vessel formation. However, there is no evidence of a direct relationship between these features.

Fine Needle Aspiration Cytology of Invasive Cribriform Carcinoma of the Breast with Osteoclastlike Giant Cells

“…As the giant cells are generally associated with areas of prominent angiogenesis, some suggest that the presence of osteoclastlike giant cells and stromal hypervascularity may be induced by some chemical substances secreted by the malignant cells. 3,4,6,10 These tumor-associated osteoclastlike giant cells are nonneoplastic and histiocytic in nature, as confirmed by immunohistochemistry, ultrastructural examination and molecular study using the microdissection technique. 24 In some of the reported cases, the giant cells are seen even within intralymphatic tumor emboli and distant metastatic foci.…”

“…3,4 Rarely are osteoclastlike giant cells seen in tubular, squamous, papillary, apocrine and mucinous carcinoma. [5][6][7][8] Because of the bland cytologic features, the associated invasive breast carcinoma may sometimes mimic benign proliferative diseases. The identification of osteoclastlike giant cells provides a useful clue to a malignant diagnosis.…”

Best Cases from the AFIP

“…Less than 100 cases of breast carcinoma with osteoclast-like giant cells have been reported (1). Most infiltrating breast carcinoma with osteoclast-like giant cells is invasive ductal carcinoma (1,4,5). Most infiltrating breast carcinoma with osteoclast-like giant cells is invasive ductal carcinoma (1,4,5).…”

Bilateral Infiltrating Lobular Carcinoma of the Breast with Osteoclast-Like Giant Cells

“…By immunohistochemistry, osteoclast‐like giant cells associated with carcinoma of the breast are reportedly negative for cytokeratins, carcinoembryonic antigen, epithelial membrane antigen, S‐100, factor VIII‐related antigen, and Ulex europaeus , and have been reported to be positive for leukocyte common antigen, acid phosphatase, nonspecific esterase, and CD 68, features that are consistent with histiocytic lineage (6,7,9,11,12,17,21). By electron microscopy these cells uniformly lack epithelial features such as desmosomes and intracytoplasmic lumina, exhibit abundant mitochondria, varying quantities of rough endoplasmic reticulum, and small vesicles, and usually contain short microvilli or irregular cytoplasmic processes (6,7,9–13,15, 20,21). Less commonly reported features include membrane‐bound, lysosomal‐like electron dense bodies within the cytoplasm (9,10,13,21) and free ribosomes (7,20,21).…”