Abstract
Giant cell tumour of bone (GCTB) is genetically characterised by an H3F3A mutation. GCTB is treated with curettage or resection, and denosumab may be administered. Herein, we retrospectively analysed a large cohort of GCTB and identified a previously uncharacterised distinct blue matrix. Among 127 archival GCTB cases positive for the H3F3A G34 mutation, a blue lacy matrix was observed in 10 cases (7.9%). Five patients were previously treated with denosumab. Although a focal observation, the matrix was multifocal or relatively conspicuous in a subset. It appeared as blue mottles or bands, in which a delicate meshwork of basophilic, focally calcified, lacy material intricately surrounded the H3.3 G34W-positive mononuclear cells. The matrix was associated with depletion of osteoclast-like giant cells and fascicular proliferation of spindle cells, regardless of the history of denosumab therapy. Recognising this unique matrix will help avoid confusion with other bone tumours with different clinical management.
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Data Availability
The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request and IRB approval.
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Acknowledgements
The authors thank Sachiko Miura for excellent technical assistance.
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This work was partly supported by JSPS KAKENHI (Grant Number JP21K06919, AY).
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AY designed the study. YT and AY performed histological analysis. SI and AK provided samples and data. YT and AY wrote the manuscript, which was approved by all authors.
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The study was approved by the institutional review board of the National Cancer Centre Hospital, Tokyo, Japan (#2014–089).
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Toda, Y., Ishihara, S., Kawai, A. et al. Blue lacy matrix in giant cell tumour of bone with or without denosumab therapy. Virchows Arch 483, 125–129 (2023). https://doi.org/10.1007/s00428-022-03468-4
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DOI: https://doi.org/10.1007/s00428-022-03468-4