Pleomorphic carcinoma with osteoclastic giant cells of the breast: Immunohistochemical differentiation between coexisting neoplastic and reactive giant cells
Version of Record online: 6 JAN 2009
© 2009 The Authors. Journal compilation © 2009 Japanese Society of Pathology
Volume 59, Issue 2, pages 91–97, February 2009
How to Cite
Kurokawa, K., Mouri, Y., Asano, A., Kamei, K., Iwata, Y., Isogai, M., Saga, S. and Ichihara, S. (2009), Pleomorphic carcinoma with osteoclastic giant cells of the breast: Immunohistochemical differentiation between coexisting neoplastic and reactive giant cells. Pathology International, 59: 91–97. doi: 10.1111/j.1440-1827.2008.02334.x
- Issue online: 6 JAN 2009
- Version of Record online: 6 JAN 2009
- Received 31 July 2008. Accepted for publication 24 September 2008.
- breast cancer;
- carcinoma with osteoclastic (osteoclast-like) giant cells;
- pleomorphic carcinoma
Herein is described a unique case of breast carcinoma with two different types of giant cells noted in both cytological and histological specimens. A 51-year-old Japanese woman noticed a hard mass in the upper outer quadrant of her left breast. Aspiration cytology exhibited numerous anaplastic giant cells; the cytological diagnosis was high-grade ductal carcinoma, although a few osteoclastic giant cells were also observed. A left simple mastectomy and sentinel lymph node biopsy were performed. Histologically, approximately 90% of the tumor was composed of giant cells; conventional invasive ductal carcinoma and ductal carcinoma in situ were found focally at the periphery of the tumor. The main part of the tumor contained both anaplastic, neoplastic giant cells and non-neoplastic, osteoclastic giant cells that were distinguishable from nuclear atypism. The presence of the two types of giant cells was also confirmed on immunohistochemistry using a histiocytic marker (CD68) and two epithelial markers (AE1/AE3 and CAM5.2). Based on the latest World Health Organization classification, the diagnosis was pleomorphic carcinoma with osteoclastic giant cells. To the authors' knowledge there has been no previous report on this subject except for a single case mentioned in Rosen's Breast Pathology.