Department of Pathology, Istanbul Education and Research Hospital, Istanbul, Turkey.
Diagn Pathol. 2009 Dec 31;4:48. doi: 10.1186/1746-1596-4-48.
Giant cell tumor, excluding its prototype in bone, is usually a benign but local aggressive neoplasm originating from tendon sheath or soft tissue. Malignant behavior is uncommon. Visceral organ involvement including urinary bladder is rare. Giant cell tumors in visceral organs usually accompany epithelial tumors and the clinical behavior of giant cell tumor in urinary bladder is similar to its bone counterpart. Here, we report two cases of giant cell tumor located in urinary bladder in comparison with nine reported cases in the English literature. Concurrent noninvasive urothelial carcinoma was also described in all these previous reports and only one patient with follow-up died of disease. One of the two cases we present had no concurrent urothelial tumor at the time of diagnosis but had a history of a low grade noninvasive urothelial carcinoma with three recurrences. The histology of these two cases was similar to the giant cell tumor of bone and composed of oval to spindle mononuclear cells with evenly spaced osteoclast-like giant cells. Immunohistochemically, the giant cells showed staining with osteoclastic markers including CD68, TRAP, and LCA. Immunohistochemical expression of vimentin, CD68, LCA, and smooth muscle actin in mononuclear cells supported a mesenchymal origin with histiocytic lineage. The histologic and immunohistochemical properties in our cases as well as their clinical courses were consistent with a giant cell tumor. Consequently, tumors in urinary bladder showing features of giant cell tumor of bone may also be considered and termed "giant cell tumor".
除了骨巨细胞瘤外，巨细胞瘤通常是一种良性但局部侵袭性的肿瘤，起源于腱鞘或软组织。恶性行为并不常见。内脏器官受累，包括膀胱，很少见。内脏器官中的巨细胞瘤通常伴有上皮性肿瘤，膀胱中的巨细胞瘤的临床行为与骨巨细胞瘤相似。在此，我们报告了 2 例位于膀胱的巨细胞瘤，并与以前在英文文献中报道的 9 例进行了比较。所有这些先前的报告中都描述了同时存在的非浸润性尿路上皮癌，只有 1 例有随访的患者死于疾病。我们报告的 2 例中，有 1 例在诊断时没有同时存在的尿路上皮肿瘤，但有低级别非浸润性尿路上皮癌病史，有 3 次复发。这两例的组织学与骨巨细胞瘤相似，由卵圆形至梭形单核细胞组成，均匀间隔分布破骨细胞样巨细胞。免疫组织化学染色显示，巨细胞表达破骨细胞标志物，包括 CD68、TRAP 和 LCA。单核细胞中波形蛋白、CD68、LCA 和平滑肌肌动蛋白的免疫组织化学表达支持其来源于间充质，具有组织细胞谱系。我们病例的组织学和免疫组织化学特征及其临床过程与巨细胞瘤一致。因此，表现为骨巨细胞瘤特征的膀胱肿瘤也可以被考虑并命名为“巨细胞瘤”。
