Sun Li-Mei, Zhang Qing-Fu, Tang Na, Mi Xiao-Yi, Qiu Xue-Shan
Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University Shenyang 110001, China.
Int J Clin Exp Pathol. 2015 Aug 1;8(8):9718-22. eCollection 2015.
Giant cell rich osteosarcoma is a relatively unusual histological form of osteosarcoma, common lesion usually presenting in the long bones of the appendicular skeleton. The occurrence in the mandible is exceptional rare. Histologically, this tumor tends to be a highly anaplastic, pleomorphic tumor in which the tumor cells may be: plasmacytoid, fusiform, ovoid, small round cells, clear cells, mono-or multinucleated giant cells, or, spindle cells. Herein, we present a case with the sternum and first thoracic vertebra metastasis from primary giant cell rich osteosarcoma of the mandible in a 28 year-old Chinese female. The tumor was predominantly composed of abundant spindle cells with marked atypia and numerous osteoclast-like giant cells reminiscent of malignancy in giant cell tumor. The unusual histological appearance can pose a great diagnostic challenge. It may be easily misdiagnosed, especially if the specimen is limited or from fine-needle aspiration.
富含巨细胞的骨肉瘤是骨肉瘤一种相对不常见的组织学类型，常见病变通常出现在四肢骨骼的长骨中。发生在下颌骨极为罕见。组织学上，这种肿瘤往往是一种高度间变、多形性肿瘤，其中肿瘤细胞可能为：浆细胞样、梭形、卵圆形、小圆形细胞、透明细胞、单核或多核巨细胞，或梭形细胞。在此，我们报告一例28岁中国女性，其下颌骨原发性富含巨细胞的骨肉瘤转移至胸骨和第一胸椎。肿瘤主要由大量具有明显异型性的梭形细胞和众多类似破骨细胞的巨细胞组成，让人联想到骨巨细胞瘤中的恶性情况。这种不寻常的组织学表现可能带来巨大的诊断挑战。它可能很容易被误诊，尤其是在标本有限或来自细针穿刺的情况下。
