Multinucleated Giant Cells in Fine-Needle Aspiration of Thyroid Nodules: Their Diagnostic Significance

Abstract

Multinucleated giant cells (MNGCs) are reported in many thyroid lesions. This study examines whether their quantity and quality can help in the differential diagnosis. All fine‐needle aspirations (FNAs) of the thyroid with a “significant” number of MNGCs were reviewed from 1995 –1998. There were 23 cases (<1% of thyroid FNAs): 8 papillary carcinomas (PC), 4 subacute thyroiditis (ST), 3 granulomas, 7 adenomatous goiters (AG), and one Hurthle‐cell adenoma (HA). MNGCs with dense cytoplasm were seen exclusively in PC, ST, and granulomas. They had angulated shapes. They were most numerous, largest, and with the highest number of nuclei in ST and granulomas. MNGCs with foamy cytoplasm were seen in AG and HA and 80% of the other cases (PC, ST, and granulomas). In PC, rare MNGCs had intranuclear inclusions and grooves. The accompanying cell population was characteristic of each disease. The quantity and quality of MNGCs in thyroid FNA may be helpful in narrowing the differential diagnosis. Diagn. Cytopathol. 1999;21:307–312. © 1999 Wiley‐Liss, Inc.

Multinucleated Giant Cells’ Incidence, Immune Markers, and Significance: A Study of 172 Cases of Papillary Thyroid Carcinoma

“…Multinucleated giant cells are present within cystic spaces. Characteristic features include dense eosinophilic cytoplasm, well-demarcated borders, and a profusion of randomly assorted nuclei ( a – b )MGCs needed to be located within cystic spaces.They must have glossy dense eosinophilic cytoplasm (either with or without hemosiderin or vacuoles) [6, 10]. …”

“…They must have glossy dense eosinophilic cytoplasm (either with or without hemosiderin or vacuoles) [6, 10]. …”

“…A third possibility is that the MGCs evolve as a non-specific immune response to the carcinoma itself, and act as phagocytes ingesting the malignant follicle cells. MGCs in the thyroid are not specific for PTC: they can be found in benign thyroid diseases such as Hashimoto’s, De Quervain’s, or palpation thyroiditis, as well as in other malignancies such as follicular and anaplastic carcinoma [1, 2, 6, 7]. The prognostic significance of MGCs in PTC is uncertain.…”

Fine needle aspiration of giant cell tumor involving thyroid gland: A case report of an unprecedented entity

“…When GCT involves the thyroid gland, attention should be paid to the differential diagnosis of PTLs with multinucleated giant cells. Differential diagnoses of giant cell lesions in thyroid gland include subacute thyroiditis, papillary carcinoma, anaplastic carcinomas and true granulomatous conditions such as fungal infections, tuberculosis, or sarcoidoses . The dual cell pattern and immunophenotyping of GCT are helpful for identification.…”

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

“…These multinucleated giant cells are non-neoplastic cells and have a histiocytic origin. 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].…”