Cai Guoping, Ramdall Risha, Garcia Roberto, Levine Pascale
Department of Pathology, New York University School of Medicine, New York, New York 10016, USA.
Diagn Cytopathol. 2007 Jun;35(6):358-62. doi: 10.1002/dc.20641.
Giant cell tumor is a benign but locally aggressive tumor that primarily affects the epiphyses of long bones of young adults. Pulmonary metastases in giant cell tumor are rare (about 1-9%). Here, we report a case of metastatic pulmonary giant cell tumor in a patient who had a previous history of giant cell tumor of the distal femur with multiple recurrences. The diagnosis of pulmonary metastasis was achieved by cytologic evaluation with concurrent immunohistochemical studies in material obtained by fine-needle aspiration biopsy. The aspirate smears contained clustered and dispersed mononuclear and osteoclast-like giant cells that had bland nuclei with inconspicuous nucleoli. All multinucleated cells showed immunoreactivity to KP-1 antibody, a histiocytic marker (not lineage specific) and only a subset of mononuclear cells (30%) stained with this marker. Twenty percent of the mononuclear cells also displayed increased Ki-67 and p53 protein expression. The pulmonary metastasis was similar morphologically and immunophenotypically to the recurrent giant cell tumor of the bone.
骨巨细胞瘤是一种良性但具有局部侵袭性的肿瘤，主要累及年轻成年人长骨的骨骺。骨巨细胞瘤发生肺转移的情况罕见（约1 - 9%）。在此，我们报告一例发生肺转移的骨巨细胞瘤病例，该患者既往有股骨远端骨巨细胞瘤病史且多次复发。通过对细针穿刺活检获取的材料进行细胞学评估并同时进行免疫组织化学研究，得以确诊肺转移。抽吸涂片可见成簇和散在的单核细胞及破骨细胞样巨细胞，其细胞核形态温和，核仁不明显。所有多核细胞对KP - 1抗体呈免疫反应性，KP - 1是一种组织细胞标志物（非谱系特异性），仅有一部分单核细胞（30%）被该标志物染色。20%的单核细胞还显示Ki - 67和p53蛋白表达增加。肺转移灶在形态学和免疫表型上与复发性骨巨细胞瘤相似。
