GIANT Cell tumour orthopaedics pathology.ppt

Giant cell tumour in orthopedic

2. HISTIOCYTES
•CELLS THAT FUNCTION AS
PHAGOCYTES
•RICH IN LYSOSOMES AND ACID
PHOSPHATASE

3. 5TYPES OF HISTIOCYTES
•HAEMOPOETIC HISTIOCYTES
•CONNECTIVE TISSUE HISTIOCYTES
•HISTIOCYTES OF RE ORGANS
•BONE RESORPTION HISTIOCYTES
•HISTIOCYTES OF CNS

4. WHEN MACROPHAGES
ENCOUNTER
INSOLUBLE MATERIAL
THEY COALESCE
TO FORM GIANT CELLS

5. DEVELOPBY ACCIDENT
WHEN TWO OR MORE
MACROPHAGES ATTEMPT
SIMULTANEOUSLY TO
ENGULF THE SAME
PARTICLE

6. IN HUMAN TISSUE
MITOTIC FIGURES ARE
NOT SEEN IN GIANT
CELLS

7. •
FOREIGN BODY GIANT CELL
CONTAINS NUMEROUS NUCLEI
NUCLEI UNIFORM SIZE&SHAPE
RESEMBLES NUCLEI OF
MACROPHAGES
NUCLEI
SCATTEREDTHROUGHOUT
CYTOPLASM
SEEN IN CHRONIC INFECTIOS
GRANULOMAS

9. LANGHANS GIANT CELLS
•In tuberculosis & sarcoidosis
•Nuclei resemble to macrophage&epithelioid
cells
•Nuclei arranged in the periphery as horse
shoe,ring or at two poles of the cells

11. TOUTON GIANT CELL
•Vacuolated cytoplasm due to lipid content
•Nuclei arranged around central eosinophilic
cytoplasm
•Seen in xanthomas

13. MISCELLANEOUS
•Aschoff cells in rheumatic nodules
•Reedsternberg cells in hodgkins disease
•Osteoclast
•Warthin finkeldey giant cells in measles
•Epithelial giant cells in herpes virus
infection

14. PATHOLOGICAL CONDITIONS
•BENIGN TUMOURS
•INFECTIONS
•HISTIOCYTOSES
•GIANT CELL NEOPLASMS

15. MULTINUCLEATED GIANT
CELLS
•OSTEOGENIC SARCOMA
•METASTATIC CARCINOMA
•MEGAKARYOCYTIC MYELOSIS
•METASTATIC MELANOMA

16. MULTINUCLEATED GIANT
CELLS
•RETICULUM CELL SARCOMA
•MALIGNANT FIBROUS
HISTIOCYTOSES
•HODGKINS DISEASE
•GIANT CELL SARCOMA

17. TUMOUR GIANT CELLS
•Numerous nulei
•Nucleoi hyperchromatic&varying in
size& shape
•Large cells
•Not derived from macrophages
•Formed from dividing nuclei of
neoplastic cells

18. BENIGN OSTEOCLAST
LIKE GIANT CELLS
•HISTOLOGICALLY IDENTICAL TO
OSTEOCLASTS
•NOT FOUND IN DIRECT APPOSITION
TO BONES

19. THEY MAY FORM LARGE
TUMOUR MASSES IN
•ASSOCIATION WITH EXCESSIVE
PARATHORMONE
•PAGETS DISEASE
•OSTEOCLASTOMA

20. ANAPLASTIC OSTEOCLAST
LIKE GIANT CELLS
•CELLS WITH INDIVIDUAL NUCLEI
•NUCLEI SHOW UNEQIVOCAL
ANAPLASIA
•OTHERWISE SIMILAR TO
OSTEOCLASTS
•SEEN IN GIANT CELL SARCOMA

21. BENIGN HISTIOCYTIC GIANT
CELL
•Resemble FB and langhans giant
cells
•Abundant foamy vacuolated
cytoplasm
•Seen in gauchers disease

22. ANAPLASTIC HISTIOCYTIC
GIANT CELL
•Multiple separate or multilobulated
nuclei
•Nuclei show features of anaplasia
•Seen in
• hodgkins disease
• malignant fibrous histiocytoma
• reticulum cell sarcoma

23. REED SRERNBERG CELLS
•Anaplastic histiocytic giant cells
•2-8 centrally placed nuclei
•Large pink nucleoli
•Spoke wheel chromatin
•Found in association with variable
quantities of benign chronic
inflammatory cells

24. Anaplastic giant cells of
nonhistiocytic nonosteoclastic
origin
•High grade anaplastic metastatic
carcinoma
•Melanomas
•Osteogenic sarcoma

25. HISTOLOGIC INTERPRETATION
•Number of nuclei
•Separate versusmultilobulated nuclei
•Central or peripheral placement
•Size of nuclei
•Absence or presence of anaplasia
•Cytoplasmic characterestics
•Sarrounding stroma