Pancreatic Pathology Online
Pathology of Osteoclast - like Giant Cell Tumour of the Pancreas
carcinoma with osteoclast-like giant cells is a rare neoplasm of
The association of these tumors with conventional adenocarcinoma or mucinous cystic neoplasms, the histologic features, and the immunohistochemical profile supports an epithelial phenotype for the mononuclear cells and a reactive histiocytic lineage for the nonneoplastic osteoclast-like giant cells.
This very rare neoplasm resembles giant cell tumor of bone.
An epithelial origin is now established and this tumor has been recently considered as a variant of ductal adenocarcinoma of the pancreas in the last WHO histological classification.
The diagnosis requires both morphology and immunohistochemistry.
These tumours are characterized by a dual population of mononuclear pleomorphic spindle and polygonal cells and osteoclast-like multinucleated giant cells with high mitotic activity.
Glandular structures and epithelial nests may be present.
Electron microscopy and immunohistochemical results:
(i) Positive immunostaining for cytokeratin of the mononuclear pleomorphic cells favours an epithelial origin.
(ii) Positive vimentin in the spindle cell with negative keratin staining suggest a mesenchymal origin.
(iii) Osteoclast-like cells stain for vimentin and leukocyte common antigen (CD45).
Overall view favour "a primary epithelial phenotype".
Prognosis: These neoplasms, which are better classified as undifferentiated carcinomas, follow an aggressive clinical course and most patients die of disease within 1 year.
A male case of an undifferentiated carcinoma with osteoclast-like giant cells originating in an indeterminate mucin-producing cystic neoplasm of the pancreas. A case report and review of the literature.
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