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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
KNOW THIS FIELD Table of Contents   
Year : 2007  |  Volume : 11  |  Issue : 2  |  Page : 51
 

Know this field


1 Department of Oral Pathology, SRM Dental College and Hospital, Chennai, India
2 Department of Oral and Maxillofacial Pathology, Meenakshi Ammal Dental College and Hospital, Chennai, India

Correspondence Address:
K Rajkumar
Department of Oral Pathology, SRM Dental College and Hospital, Chennai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-029X.37380

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How to cite this article:
Rajkumar K, Saraswathi T R, Sriram G, Sivapathasundharam B, Einstein A. Know this field. J Oral Maxillofac Pathol 2007;11:51

How to cite this URL:
Rajkumar K, Saraswathi T R, Sriram G, Sivapathasundharam B, Einstein A. Know this field. J Oral Maxillofac Pathol [serial online] 2007 [cited 2019 Aug 23];11:51. Available from: http://www.jomfp.in/text.asp?2007/11/2/51/37380



   Case Details Top


A 8-year-old child presented with a rapidly growing mass in the left angle of the mandible. Radiographs showed a multilocular lesion occupying the ramus, with expansion and erosion of the buccal and lingual cortical plates and lower border of the mandible.


   Histopathology Top


  1. Highly cellular stroma with areas of osteoid and plenty of giant cells [Figure - 1]
  2. Round to spindle shaped bland appearing mononuclear cells making up the cellular stroma [Figure - 2]
  3. Multinucleated giant cells of varying sizes; the nuclei bear resemblance to the nuclei of stromal cells [Figure - 3]
  4. Less cellular areas with osteoid-like material [Figure - 4],[Figure - 5]
  5. Immature bone formation [Figure - 6]
  6. Areas of osteoid undergoing chondroblastic differentation (malignant cartilage) [Figure - 7]
  7. Vascular invasion of the giant cells [Figure - 8]
  8. Mitotic figures in the stromal cells [Figure - 9]



   Impression Top


Giant cell tumours, Giant cells occur in many bone lesions, but in giant cell tumour they are an integral part of the neoplasm and are distributed evenly throughout the lesion. The giant cells are often large and are of uniform size and shape with their nuclei resembling those of the mononuclear cells. Stromal cells (mononuclear cells) are densely packed with fibrous stroma around them. Osteoid may be formed but is not characteristic and is very sparse. Bone formation may occasionally be seen in the periphery of the tumour mass.

Fibrohistiocytic tumours (Benign and Malignant Fibrohistiocytoma)

Mononuclear cells arranged in varying density is common in fibrohistiocytic tumours with variable amount of giant cells. The giant cells are usually pleomorphic in size and shape. The stromal cells exhibit high degree of mitotic activity especially in malignant variety. But osteoid, cartilage and bone formation does not occur.

Osteosarcoma

Generally in osteosarcoma, the stromal cells with an inditinct cytoplasmic borders exhibit high degree of pleomorphism and mitotic activity. The cytoplasm of these cells appear to merge with the surrounding osteoid-like material (tumout osteoid). Cartilage can be seen in varying amounts. Giant cells when present are very sparse.

Giant cell rich Osteosarcoma

Giant cells are present in numerous numbers and are increased in areas of high cellularity. They are highly pleomorphic in size and shape. The mononuclear cells have a darker, angular nuclei. Osteoid is found throughout the lesion with certain areas exhibiting differntiation to a cartilage-like material (malignant cartilage). Mitotic figures are present in low numbers.


   Final Diagnosis Top


Giant cell (osteoclast) rich Osteosarcoma


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5], [Figure - 6], [Figure - 7], [Figure - 8], [Figure - 9]



 

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Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow
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