Cytopathology of Soft Tissue and Bone Lesions Containing Giant Cells

  • Walid E. Khalbuss
  • Anil V. Parwani
Part of the Essentials in Cytopathology book series (EICP, volume 9)


There are varieties of soft tissue and bone lesions that are ­characterized by a prominence of multinucleated giant cells. The giant cells can be reactive or tumorous. The presence of bland-appearing giant cell nuclei does not indicate benign lesions, since certain high-grade malignancies such as giant-rich osteosarcoma and osteoclast-like giant cell pleomorphic carcinoma may contain reactive osteoclastic giant cells that appear cytologically bland.1,2 However, the presence of giant cells with significant nuclear atypia only seen in malignant conditions. The differential diagnoses of soft tissue and bone with prominence giant cells include 1–-3 benign lesions, low-grade malignant tumors, and high-grade malignant tumors (see Table 4.1). The benign conditions include giant cell tumor of tendon sheath, giant-cell reparative granuloma, fat necrosis, pigmented villonodular synovitis, and brown tumor of hyperparathyroidism. The low-grade malignant tumors include giant cell tumor of bone, soft tissue giant cell tumor of low malignant potential, and myxoid low-grade malignant fibrous histiocytoma (MFH). The high-grade malignant tumors include chondroblastoma, anaplastic MFH, giant cell-rich osteosarcoma, pleomorphic high-grade sarcoma (rhabdomyosarcoma, liposarcoma, and leiomyosarcoma), giant cell carcinoma, malignant melanoma, and anaplastic large cell lymphoma (see Table 4.1).


Giant Cell Anaplastic Lymphoma Kinase Malignant Fibrous Histiocytoma Giant Cell Tumor Anaplastic Large Cell Lymphoma 
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Copyright information

© Springer US 2011

Authors and Affiliations

  • Walid E. Khalbuss
    • 1
  • Anil V. Parwani
    • 1
  1. 1.Shadyside HospitalUniversity of Pittsburgh Medical CenterPittsburghUSA

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