Gastric Carcinoma With Osteoclast-like Giant Cells:Report of Four Cases

Abstract

Four cases of gastric carcinoma are described that are associated with an osteoclast-like giant cell (OGC) stromal component. The patients were all middle-aged men (range 53-63 years). Microscopically, the tumors were characterized by a bland cytologic appearance, and an either solid or cribriform pattern. Osteoclast-like giant cells were found adjacent to, or intimately intermixed with, the neoplastic cells in the primary gastric masses and in the lymph nodal metastases and were often associated with lymphocytes, histiocytes, and desmoplastic stroma. By immunohistochemistry, mononuclear cells and OGCs showed diffuse positivity for alpha-1-antichymotrypsin, alpha-1-antitrypsin, and CD68. Neoplastic cells that were positive for keratin and CEA, also showed reactivity for vimentin and the latent membrane protein of Epstein-Barr virus in one case. At follow-up, three patients had died at 13, 15, and 24 months after diagnosis, and one is still alive, without evidence of disease, after 120 months. This report describes a novel variant of gastric carcinoma with distinctive and histologic features.

Gastric carcinoma with osteoclast-like giant cells: a case report and review of the literature

“…The OGCs found in our patient had none of these characteristics. Similar to the reported cases of gastric carcinoma with OGCs (Baschinsky et al, 1999;Stracca-Pansa et al, 1995;Willems et al, 2005), the tumor invaded beyond the muscular layers in this case. There were 13 metastatic lymph nodes, and one of them was 3.5 cm in diameter.…”

“…60 μm 60 μm 60 μm 60 μm gastric carcinoma with OGCs (Baschinsky et al, 1999;Stracca-Pansa et al, 1995;Willems et al, 2005), one case was immunohistochemical positive for LMP of the EBV (EBV-LMP) (Stracca-Pansa et al, 1995), while another case showed intense nuclear positivity for EBV measured by in situ hybridization (Willems et al, 2005). However, in this case, the immunohistochemical staining for EBV-LMP and in situ hybridization for EBV were non-reactive.…”

“…So far, only six cases of gastric carcinoma with OGCs have been reported in the literature (Baschinsky et al, 1999;Stracca-Pansa et al, 1995;Willems et al, 2005). All these cases were poorly differentiated adenocarcinoma characterized by the presence of OGCs sprinkled among the tumor cells (Baschinsky et al, 1999;Stracca-Pansa et al, 1995;Willems et al, 2005). Gastric carcinomas with OGCs should be distinguished from giant cell carcinomas, which have the following distinctive features.…”

“…However, the clinical importance of this phenomenon remains unclear, owing to the rarity of such cases. So far, only six cases of gastric carcinoma with OGCs have been reported (Baschinsky et al, 1999;Stracca-Pansa et al, 1995;Willems et al, 2005). Although the significance of OGCs still remains unclear, these authors believed that gastric carcinoma with OGCs may represent a distinct pathological entity (Baschinsky et al, 1999;Stracca-Pansa et al, 1995;Willems et al, 2005).…”

Variants of Gastric Carcinoma: Morphologic and Theranostic Importance

“…Immunohistochemical staining for lysozyme, human defensin-5, and CDX2 is usually positive [204,205]. and (3) gastric carcinoma with osteoclast-like giant cells; these variants contains a minor component of giant cells that contain 3 to 20 nuclei and are positive for CD68 and vimentin [206]. These findings suggest that giant cells are of monocytic/ histiocytic origin and probably represent a host response to the tumor [207].…”