Yozu Masato, Glengarry Joanna, Ahmed Syed Salahuddin
Department of Pathology, Lab Plus, Auckland City Hospital, Auckland, New Zealand.
J Pak Med Assoc. 2011 Sep;61(9):922-5.
Proliferation of osteoclast-like giant cells in a cutaneous squamous cell carcinoma is a rare phenomenon and so far only four cases have been reported. In previous reports, osteoclast-like giant cells were admixed with sarcomatoid component of squamous cell carcinoma and it is therefore debatable if the osteoclast-like giant cells represent a reactive phenomenon or a part of the malignant tumour. A case of cutaneous squamous cell carcinoma associated with osteoclast-like giant cells is reported. However, sarcomatous component of squamous cell carcinoma was not identified in this case. Morphologically, the osteloclast-like giant cells appeared to be benign. The localization of the squamous cell carcinoma and the osteoclastic-like giant cells were separate from one another. Immunohistochemically, squamous cell carcinoma was positive for high molecular weight cytokeratin, cytokeratin-5 and p63, whereas the osteloclast-like giant cells were positive for histiocyte marker CD68 and vimentin and negative for epithelial markers supporting a reactive nature of osteoclast-like giant cells to the cutaneous malignancy.
皮肤鳞状细胞癌中破骨细胞样巨细胞的增殖是一种罕见现象，迄今为止仅报道过4例。在以往的报道中，破骨细胞样巨细胞与鳞状细胞癌的肉瘤样成分混合存在，因此破骨细胞样巨细胞是一种反应性现象还是恶性肿瘤的一部分仍存在争议。本文报道1例伴有破骨细胞样巨细胞的皮肤鳞状细胞癌。然而，该病例中未发现鳞状细胞癌的肉瘤样成分。形态学上，破骨细胞样巨细胞似乎是良性的。鳞状细胞癌与破骨细胞样巨细胞的定位彼此分开。免疫组织化学检查显示，鳞状细胞癌对高分子量细胞角蛋白、细胞角蛋白-5和p63呈阳性，而破骨细胞样巨细胞对组织细胞标志物CD68和波形蛋白呈阳性，对上皮标志物呈阴性，支持破骨细胞样巨细胞对皮肤恶性肿瘤的反应性本质。
