• The Korean Journal of Cytopathology
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• v.19 no.1
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• pp.57-64
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• 2008

Giant cell tumor of the tendon sheath (GCTTS) is a slowly growing, benign soft tissue tumor. The tumors occur predominantly on the hands and feet. Although the clinical and histopathologic features are well-defined, only a few reports have described the cytologic appearance of this entity. A 26-year-old woman presented with a gradually developing circumscribed soft tissue mass near the proximal phalanx of her left little finger for one year. Imprint and fine needle aspiration (FNA) smears were obtained from the excisional biopsy specimen. The imprint smears were composed of predominantly singly dispersed bland mononuclear cells and several giant cells. The mononuclear cells were polygonal to round, and they showed a histiocyte-like appearance. Osteoclast-type multinucleated giant cells of various sizes were randomly scattered throughout the smears, and these cells contained 3 to 50 nuclei. Nuclear atypia and pleomorphism were absent in both the single and giant cells. Loose aggregates of hemosiderin-laden macrophages and binuclear stromal cells were also seen. The cytologic features of the FNA smears were similar with those of the imprint, Additionally, the FNA smears contained several clumps of densely collagenous stromal tissue that were seldom noted in previously reported cytologic material. The cytologic features were well-correlated with the concurrent histologic findings and the diagnosis of GCTTS was made. When the clinical and radiologic datas are integrated, the diagnosis of GCTTS can be strongly suggested, based on the pre-operative cytologic specimen.

• Journal of Microbiology and Biotechnology
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• v.11 no.5
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• pp.727-738
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• 2001

Macrophagal polykaryocytes (MPs) are terminally differentiated multinuclear macrophage cells responsible for remodeling and resorption of bone, foreign body, and tissue deposition in inflammation. MPs are encountered only in bone and cartilagenous tissues, in which they are referred to as osteoclasts, odontoclasts, in which they are referred to as osteoclasts, odontoclasts, and septoclasts. Depending on the disease, the MPs differentiate into many morphological variants that include foreign-body giant cells, Langhans-type cells, and Touton-type cells. Morphological heterogeneity of MPs could Touton-type cells. Morphological heterogeneity of MPs could reflect the giant cell formation from phenotypically different marophage precursors by the process of fusion. At present, many cytokines, adhesion/fusion molecules, and other factors of the microenvironment have been discovered that influence the multinucleation process. Many evidences suggest that conditions in giant cell fibrohistiocytomas, which facilitate MP formation, are similar to the inflammation site of granulomatosis. MPs in the giant cell tumors and granulomatosis foci are formed in response to the factors secreted by mesenchymal cells. It is proposed that one of the first steps in vertebrate evolution could be the organization of skeleton remodeling, in which osteoclasts play a major role. In this step, the same mechanism of regulations served as a basis for the development of both osteoclast and inflammatory forms of MPs.

• Imaging Science in Dentistry
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• v.40 no.3
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• pp.149-153
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• 2010

Brown tumor is usually diagnosed at the terminal stage of hyperparathyroidism. Diagnosis of this tumor is confirmed by endocrinologic investigations along with clinical and radiographic examination. Radiographical differential diagnosis of this tumor includes central giant cell granuloma, aneurysmal bone cyst, metastatic tumor, multiple myeloma, and Paget disease. This report presents a rare case of multiple brown tumors occurring at the maxilla and mandible, which was initially misdiagnosed as central giant cell granuloma. Plain radiographs demonstrated multiple well-defined multilocular radiolucency. CT images showed soft tissue mass with low attenuated lesions, perforation of the lingual cortical plate, and a heterogeneous mass at the right thyroid lobe. These findings were consistent with parathyroid adenoma. The patient had hypercalcemia, hypophosphatemia, and elevated alkaline phosphatase level. Surgical excision of the tumor was performed. No recurrence was observed during a 28-month follow-up.

• Journal of Chest Surgery
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• v.20 no.3
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• pp.582-587
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• 1987

Castleman`s disease, giant lymph node hyperplasia, is a rare benign disease. The lesion usually consists of a single node, unassociated with any abnormality of the adjacent lymph nodes or other organs. In the first accounts of giant lymph node hyperplasia of Castleman, the lesion was described as solitary and localized to the mediastinum, which is still the most frequent site of involvement. The disease occurs in all age groups and there is no particular sex preference. It is symptomless and is usually detected on chest films as an incidental finding. On a single involvement, it does not recur after excision, whether total or partial, and the main indication of operation is to rule out more serious tumors. Recently multicentric form appears to be a variant of classic giant lymph node hyperplasia and is associated with significant morbidity and mortality. Histologically, two distinct types have been reported; hyaline-vascular and plasma cell. The hyaline-vascular type of lesion is much more common than the plasma cell type. We report two cases of the hyaline-vascular type of Castleman`s disease.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.1
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• pp.61-66
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• 2009

The brown tumors develop in bone and it develop on various area which in clavicle, rib bone, cervical bone, iliac bone etc. The development on the maxillofacial region is rare, relatively more develop on the mandible. The brown tumor directly develop by the dysfunction of calcium metabolism according to hyperparathyroidism and differential diagnosis with other bone lesion should be difficult if it would diagnose by only radiographic features. The histological feature is that proliferation of spindle cells with extravasated blood and haphazardly arranged, variably sized, multinucleated giant cell is seen. The brown tumor is firm diagnosed by physical examination, because of these histological feature show similar with other giant cell lesions(giant cell granuloma, aneurysmal bone cyst, cherubism). The brown tumors have been described as resulting from an imbalance of osteoclastic and osteoblastic activity. It result in bone resorption and fibrous replacement of the bone. So these lesions represent the terminal stage of hyperparathyroidism-dependent bone pathology. Therefore, it is the extremely rare finding that brown tumor in the facial bone as the first manifestation of an hyperparathyroidism. We experience 1 case of brown tumor(50 years old female) that developed on Maxilla and mandible with no history of hyperparathyroidism. So we report this case with a literature review.

• The Journal of the Korean bone and joint tumor society
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• v.6 no.1
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• pp.30-34
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• 2000

Giant cell tumor of the small bones of the hands and feet is rare. Giant cell tumors in these locations develop at young age, are more commonly multifocal, and show the higher risk of recurrence than those at the end of the long bone. It should be differentiated from the other lesions of the hands, such as giant cell reparative granuloma, aneurysmal bone cyst and enchondroma. We experienced a case of giant cell tumor in the proximal phalanx of the left hand with swelling and pain. Curettage and bone graft were performed. Histologically large number of giant cells were distributed diffusely in the highly cellular stroma containing sheets of mononuclear cells. Secondary aneurysmal bone cyst and hemorrhage were associated.

• The Korean Journal of Cytopathology
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• v.1 no.1
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• pp.93-97
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• 1990

Two cases of giant cell tumor of bone diagnosed by fine needle aspiration cytology are described. Case 1 was a 28-year-old male who had pain sense for one year at the right distal thigh. His radiologic finding revealed a destructive cortical lesion with soft tissue extension at medial side of epiphysis of the distal femur. Case 2 was a 21-year-old female complaining pain at left distal forearm for eight months and showed a well-demarcated expansile osteolytic lesion with multiseptation, and cortical destruction at epiphysis and metaphysis of the left distal radius on the X-ray. Fine needle aspiration of each lesion was performed. The aspirate of the case 1 revealed moderate cellularity, which was composed of scattered giant cells of osteoclastic type and small round to oval monotonous stromal cells in large areas. Giant cells were evenly distributed in single or small groups and had irregular but abundant cytoplasms with 10 to 20 nuclei in the center. The nuclei showed ovoid shape, fine granular chromatin, and a small but conspicuous nucleolus. Stromal cells were dispersed in isolated pattern or sometimes aggregated in clusters and showed the same nuclei as those of giant cells and scanty cytoplasms. Comparing to case 1, case 2 had a more translucent abundant cytoplasm in the giant cells and more spindled stromal cells. All two cases revealed neither nuclear atypism nor increased abnormal mitoses In both giant and stromal cells, suggesting no evidence of malignancy. Thereafter the lesions were treated with excision and curettage, and histologically confirmed as giant cell tumors of the bone.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.146-149
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• 1999

The localized form of a giant cell tumor of tendon sheath rarely affected the large weight-bearing joints. Only four cases of localized giant cell tumor arising in the knee joint could be found in the literatures. Physical examination of the affected knee could show pain, swelling, locking, giving way and limitation of extension, but it was difficult to differentiate from meniscal tear or cruciate ligament tear. Two cases of localized giant cell tumor of tendon sheath were incidentally found in the knees during the reconstruction of the anterior cruciate ligaments. Both tumors arising from the anterior cruciate ligament were excised arthroscopically and were confirmed to be localized giant cell tumor of tendon sheath by microscopic examination. The clinical results were good after complete excision, so we reported these cases with a review of the literatures.

• Archives of Reconstructive Microsurgery
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• v.16 no.2
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• pp.100-107
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• 2007

Treatment of giant cell tumor of distal radius can be treated in several ways according to the aggressiveness of the tumor. But the management of giant cell tumor involving juxta-articular portion has always been a difficult problem. In some giant cell tumors with bony destruction, a wide segmental resection may be needed for preventing to recur. But a main problem is preserving of bony continuity in bony defect as well as preservation of joint function. We have attempted to overcome these problems by using a microvascular technique to transfer the fibula with peroneal vascular pedicle or anterior tibial vessel as living bone graft. From April 1984 to July 2005, we performed the reconstruction of wide bone defect after segmental resection of giant cell tumor in 14 cases, using Vascularized Fibular Graft, which occur at the distal radius. VFG with peroneal vascular pedicle was in 8 cases and anterior tibial vessel was 6 cases. Recipient artery was radial artery in all cases. Method of connection was end to end anastomosis in 11 cases, and end to side in 3 cases. An average follow-up was 6 years 6 months, average bone defect after wide segmental resection of lesion was 6.8 cm. All cases revealed good bony union in average 6.5 months, and we got the wide range of motion of wrist joint without recurrence and serious complications. Grafted bone was all alive. In functional analysis, there was good in 7 cases, fair in 4 cases and bad in 1 case. Pain was decreased in all cases but there was nearly normal joint in only 4 cases. Vascularized fibular graft around wrist joint provided good functional restoration without local recurrence.

• Journal of Chest Surgery
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• v.7 no.1
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• pp.61-66
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• 1974

Primary tumors of the chest wall are rare than those of other portions of the body. Soft tissue tumors of the chest wall, though these are benign or malignant, should not be paid special attentions about their management than other soft tissue tumors of the body. Thoracic skeletal tumors, however, have some problems in the treatment because of defect in chest wall leading to herniation of lung and paradoxical movement of thoracic cage. The authors experienced 10 case of primary chest wall tumors at the department of thoracic and cardiovascular surgery, the national medical center, during last 15 years. Five of 10 cases were soft tissue tumors, and they were 2 case of lipoma and each one case of myxosarcoma and leiomyosarcoma. Among 5 bone tumors there no cases of sternal tumor, and their histopathological diagnosis were each one of fibrous dysplasia, giant cell tumor, osteochondroma, Ewing`s sarcoma and osteogenic sarcoma. Wide excision, though it was palliative one in certain case, was performed in 9 cases and only diagnostic incisional biopsy in one case, There were no postoperative deaths during admission to the hospital and all cases were missed during short term follow up after discharge from the hospital.