Multinucleated giant cells in various forms of giant cell containing lesions of the jaws express features of osteoclasts

Abstract

These results suggest that MGCs in the four types of giant cell-containing lesions of the jaws show characteristics of the osteoclast phenotype. The mononuclear stromal cells, which show TRAP positively, may be the precursors of the MGCs. RANKL, OPG, and RANK expressed in these lesions may play important roles in the formation of the MGCs. The similar characteristics and mechanisms in the differentiation of MGCs in these lesions also suggest that there might be a similar kind of pathogenesis involved in the formation of the MGCs in these lesions

So-called Hybrid Central Odontogenic Fibroma/Central Giant Cell Lesion of the Jaws. A Report on Seven Additional Cases, Including an Example in a Patient with Cherubism, and Hypotheses on the Pathogenesis

“…However, giant cell reaction appears to be very rare in these lesions and cystic changes suggestive of aneurysmal bone cyst have not been observed in reported hCOF/CGCL [9]. In CGCL there is evidence that receptor activator of nuclear factor-kappa b ligand (RANKL), its receptor (RANK), and osteoprotegerin (OPG),a decoy receptor for RANKL, play a crucial role in its pathogenesis [14]. Specifically, the spindle cell component recruits monocyte-macrophages precursors inducing them to differentiate towards osteoclast-type giant cells.…”

Peripheral and central giant cell lesions: etiology, origin of giant cells, diagnosis and treatment

“…number of multinucleated giant cells containing 4 to 20 nuclei (aggregated or not) dispersed in the fibrous stroma in a perivascular or adjacent position to areas of hemorrhage (Figures 3 and 4). Round macrophages, deposition of hemosiderin, extravasated erythrocytes, foci of osteoid material (bone trabeculae), dystrophic calcification and predominantly mononuclear inflammatory infiltrate, particularly surrounding the periphery of the lesion, are also found (2,6,8,14,19,22,25,28,36,37) . Although multinucleated giant cells are present in large quantity, they are not regarded as proliferative cells.…”

“…It is noteworthy that CGCL and brown tumor of hyperparathyroidism are histologically similar, especially in cases in which there is intense endogenous brownish pigmentation of hemosiderin. Therefore, it is essential to request additional tests such as serum calcium, phosphate, parathyroid hormone and alkaline phosphatase, whose values are normal in CGCL (6,19,24,25,32,37) .…”

Clinically aggressive central giant cell granulomas in two patients with neurofibromatosis 1

“…Although the MGCs seen in CGCG share some similarities with the osteoclast 26,27 , there are enough phenotypic differences to suggest that these may not be true osteoclasts 28 . It is generally accepted that these MGCs develop as a result of cell-cell fusion of mononuclear cells 29 .…”