Multinucleate Giant Cells in Papillary Thyroid Carcinoma:A Morphologic and Immunohistochemical Study

Abstract

Multinucleate giant cells (MGCs) occur in a variety of inflammatory, hyperplastic, and neoplastic thyroid disorders. They also have been recognized as a feature of papillary thyroid carcinoma (PTC), particularly in fine-needle aspiration biopsies (FNAB). However, the origin of the MGCs and their comparative frequencies in histologic and cytologic preparations have not been established. Therefore, histologic sections from 76 cases of PTC were examined and immunohistochemical analyses for epithelial and histiocytic markers were performed. Giant cells were identified in histologic sections of 35 cases (46%) of PTC. In cytologic preparations, MGCs were identified in 12 of 22 cases (55%).Multinucleate giant cells (MGCs) occur in a variety of inflammatory, hyperplastic, and neoplastic conditions of the thyroid gland, including Hashimoto's disease, multinodular goiter, follicular adenoma, and subacute thyroiditis. ' These cells have also been recognized as a distinctive feature of papillary thyroid carcinoma (PTC) in fine-needle aspiration biopsies (FNAB).2 However, the frequency of MGCs in routine histopathologic material and their origin (epithelial versus histiocytic) have not been established. Therefore, the goals of this investigation were to determine the frequency of MGCs in routine histologic sections and cytologic preparations of PTC and to determine their origin using immunohistochemical markers of epithelial and histiocytic differentiation. 3,4 The patients included 54 females and 22 males with a mean age of 44.52 years (range 16-87 years). Hematoxylin-and-eosin-stained sections were reviewed from all cases independently by both authors. An average number of four slides were examined per case (range 2-6 slides), and the presence or absence of MGCs was recorded. All sections were examined at medium power (X100) to determine whether MGCs were present. In those cases with MGCs, the sections were examined at high power (X400), and the numbers of MGCs were counted in at least 50 high power fields in areas of highest MGC density. MATERIALS AND METHODS SeventyThe presence of MGCs was assessed in 22 additional fine-needle biopsies of PTC. The cytologic preparations were examined at medium power (X100), and MGCs were recorded as being present or absent.In 10 cases of PTC containing MGCs, additional sections were stained for a variety of markers of epithelial and histiocytic differentiation. Antibodies against the following antigens were used: thyroglobulin and lysozyme (Dako Labs, Carpinteria, CA, dilution 1:750); a-1-antichymotrypsin (Dako Labs, Indianapolis, IN, dilution 1:800); KP1/CD68 (Dako Labs, dilution 1:50); AEI/ AEIII keratins (Boehringer-Mannheim, Indianapolis, IN, dilution 1:100). Immunohistochemical stains were performed on 5jt thick paraffin sections of formalin-fixed tissue. The sections were deparaffinized in xylene and hydrated in graded alcohols. They were then incubated in 765

Nonconventional papillary thyroid carcinomas with pleomorphic tumor giant cells: a diagnostic pitfall with anaplastic carcinoma

“…They have been described in a variety of inflammatory, hyperplastic or neoplastic thyroid diseases, including Hashimoto's disease, multinodular goiter, follicular adenoma, granulomatous thyroiditis and palpation thyroiditis [4,9,[39][40][41][42]. In the last WHO classification of thyroid tumors, these cells have been described as a histologic feature of the follicular variant of papillary carcinoma [1,39,42]. Even in anaplastic thyroid carcinoma, so-called osteoclastic-like giant cells are observed [1][2][3].…”

Fine‐needle aspiration biopsy of primary osteosarcoma of the thyroid: Report of a case and review of the literature

“…Significant numbers of multinucleated giant cells, including osteoclast-like giant cells, may be seen in variants of common thyroid epithelial tumors such as papillary carcinoma, anaplastic carcinoma, insular carcinoma, and medullary carcinoma. [35][36][37][38][39][40][41] Carcinosarcomas of the thyroid are also very rare tumors with an equally aggressive clinical course, with few patients surviving past 6 months despite aggressive therapy. 9 Histologic and immunohistochemical examination reveal malignant epithelial and mesenchymal components.…”

Papillary Thyroid Carcinoma: An Easy Fine Needle Aspiration Biopsy Diagnosis?

“…Since the early 1970s, when pioneer works on thyroid cytopathology formulated the first diagnostic criteria, papillary thyroid carcinoma (PTC) fine needle aspiration biopsy (FNAB) diagnosis [1,2] has made great progress [3,4,5,6,7,8,9,10,11,12,13], and has been extended significantly in relation to the newly described PTC variants [14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33]. Furthermore, its predictive potency and limits have been tested [34,35,36,37,38,39,40,41,42,43,44].…”