bromochloroacetic-acid and Granuloma--Giant-Cell

Topics: Adolescent; Female; Granuloma, Giant Cell; Humans; Immunohistochemistry; Keratins; Mandible; Mandibular Diseases; Mandibular Neoplasms; Odontogenic Tumors

Central odontogenic fibroma (COF) is characterized by poor to cellular fibroblastic proliferation and a variable odontogenic epithelial (OE) component. Central giant cell lesions (CGCL) are osteolytic fibroblastic proliferations characterized by osteoclast-like multinucleated giant cells (MGC). Rare examples of hybrid COF/CGCL have been described. Two pathogenetic theories prevail based on clinicopathologic characteristics. One regards the CGCL component as reactive to the COF, while the other regards the CGCL as inductive of a COF-like proliferation. The possibility of colliding tumors seems unlikely.. Seven patients with hCOF/CGCL, among them one with cherubism, were studied. Immunohistochemistry for cytokeratin 19 was applied to better appreciate the epithelial component.. Six patients were males and one female and their age ranged from 15 to 73 years old. All lesions occurred in the premolars and molars of the mandible and presented as radiolucencies with primarily well-delineated borders. All patients underwent surgical excision and recurrences have not been reported to this date in 6 out of 7 patients (mean follow-up 60.6+/-36.25 months). The COF component predominated in 3 cases and the CGCL component in 3. Zones of collagen fibers featuring a whorling pattern and containing multiple nests of OE were present. In four cases there were hyalinized deposits in OE, while some foci of MGC contained few OE.. Gender predilection in our series is in contrast with previously published reports. However, when all previously reported cases are reviewed there is still female predilection. The predominant site, as previously reported, is the tooth-bearing areas of the posterior mandible. This is the first report of hCOF/CGCL in cherubism. The pathogenesis of hCOF/CGCG remains obscure and molecular interactions would be of interest to be investigated.

Topics: Adolescent; Adult; Aged; Cherubism; Female; Fibroma; Granuloma, Giant Cell; Humans; Jaw Neoplasms; Keratins; Male; Middle Aged; Odontogenic Tumors; Young Adult

Topics: Female; Giant Cells, Foreign-Body; Granuloma, Giant Cell; Humans; Keratins; Middle Aged; Nails, Ingrown; Postoperative Complications

An odontogenic keratocyst (OKC) and a giant cell granuloma (GCG) in the jaws are well-known entities, which have been reviewed extensively. However, there is no report in the literature of the simultaneous occurrence of these two lesions. A case of OKC in the mandible displaying foci of a GCG-like lesion is described. It is unclear whether the two lesions were just coincidental or were actually related to each other.

Topics: Child; Granuloma, Giant Cell; Humans; Keratins; Male; Mandibular Diseases; Odontogenic Cysts

In view of the different terminology for salivary gland tumours with giant cells, eleven cases were analysed by histopathology and immunocytochemistry. Four cases (three pleomorphic adenomas, one carcinosarcoma in a pleomorphic adenoma) were classified as having a foreign-body giant cell reaction, and five cases (two mucoepidermoid carcinomas, one acinic cell carcinoma, two carcinomas in pleomorphic adenomas) as having a sarcomatoid osteoclast-like giant cell reaction. In two further cases a giant cell tumour and a giant cell granuloma were associated with carcinomas in pleomorphic adenomas. All giant cells showed characteristic expression of CD68 as a typical marker for histiocytes and macrophages with their origin in mononuclear haematopoetic stem cells. There was no evidence for an epithelial origin of the giant cells because all those examined had a negative reaction to cytokeratin. Foreign-body cells were characterized by cytoplasmic vacuoles and irregularly dispersed nuclei. They showed a focally circumscribed reaction mostly outside the connective tissue pseudocapsule of the tumours. The sarcomatoid osteoclast-like giant cell reactions in carcinomas were distinctly intermingled with the carcinomatous patterns. In contrast, the associated osteoclast-like giant cell tumour was distinctly separate from the salivary gland tumour tissue and was composed of numerous larger osteoclast-like giant cells with a greater number of nuclei (more than 20); these giant cells were uniformly distributed throughout the tumour tissue. The giant cell granuloma was also separate from the carcinoma and was composed of nests of smaller, more irregularly distributed giant cells.

Topics: Adenoma, Pleomorphic; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Biomarkers; Carcinoma; Carcinoma, Acinar Cell; Carcinoma, Mucoepidermoid; Carcinosarcoma; Cell Lineage; Cell Nucleus; Connective Tissue; Epithelial Cells; Foreign-Body Reaction; Giant Cell Tumors; Giant Cells; Giant Cells, Foreign-Body; Granuloma, Giant Cell; Hematopoietic Stem Cells; Histiocytes; Humans; Immunohistochemistry; Keratins; Macrophages; Neoplasms, Multiple Primary; Osteoclasts; Salivary Gland Neoplasms; Sarcoma; Vacuoles

Granulomatous interstitial nephritis is a rare condition whose pathogenesis is poorly understood. Of 203 renal biopsies performed between 1974 to 1994 in which interstitial nephritis was the predominant change, granulomata occurred in 12. The authors reviewed the records of these patients and performed immunopathologic and immunohistochemical studies in their biopsies to characterize the phenotype of infiltrating cells. The authors used markers for T cells, B cells, and macrophages, and determined whether they were activated through assessment of upregulation of HLA-DR molecules. Additionally, the authors attempted to delineate whether or not tubules contributed to giant cell formation through assessment of intermediate filament for keratins and macrophage markers in epithelioid cells. Drug (aspirin, gentamycin, or combination of drugs), infection (Echerichia coli or various organisms), and sarcoidosis accounted for granulomatous inflammation in three patients each, Wegener's granulomatosis and oxalosis resulting from intestinal bypass in one patient each, and in one patient the possible cause could not be determined. Except for biopsies of granulomatous inflammation resulting from infection, in which neutrophils predominated, in all other biopsies, T cells and macrophages made up most of the inflammatory cell infiltrate. HLA-DR was upregulated in mononuclear cells infiltrating the interstitium and was expressed in proximal tubular cells and endothelial cells in all but biopsies of patients with sarcoidosis. In no instance was there evidence that tubules contributed epithelial cells to giant cell formation. These findings are consistent with the notion that granulomatous interstitial nephritis is a cell-mediated form of tissue injury in which T cell-macrophage seem to play a major role.

Topics: Adult; Aged; Female; Granuloma; Granuloma, Giant Cell; HLA-DR Antigens; Humans; Immunophenotyping; Keratins; Lymphocyte Activation; Male; Middle Aged; Nephritis, Interstitial