muramidase and Granuloma--Giant-Cell

To study the nature of multinucleated and mononuclear cells from peripheral giant cell granuloma (PGCG).. Formalin-fixed, paraffin-embedded sections of 40 cases of PGCG were immunohistochemically stained for vimentin, alpha I-antichymotrypsin, CD68, S-100 protein, lysozyme, leucocyte common antigen (LCA), factor VIII-related antigen and muscle cell actin. Six cases of PGCG were also studied by transmission electron microscopy.. Vimentin, alpha I-antichymotrypsin and CD68 were expressed in both the mononuclear and multinucleated giant cells. Dendritic mononuclear cells, positive for S-100 protein, were noted in 67.5% of the lesions, whereas lysozyme and leucocyte common antigen were detected in occasional mononuclear cells. Ultrastructural examination showed mononuclear cells with signs of phagocytosis and sometimes interdigitations with similar cells. Others presented non-specific characteristics and the third type exhibited cytoplasmic processes and occasional Birbeck granules. Some multinucleated giant cells showed oval nuclei, abundant mitochondria and granular endoplasmic reticulum whereas others presented with irregular nuclei and a great number of cytoplasmic vacuoles.. Immunohistochemical and ultrastructural results suggest that PGCGs of the jaws are composed mainly of cells of the mononuclear phagocyte system and that Langerhans cells are present in two thirds of the lesions.

Topics: Actins; alpha 1-Antichymotrypsin; Antibodies, Monoclonal; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Giant Cells; Gingival Diseases; Granuloma, Giant Cell; Humans; Immunoenzyme Techniques; Langerhans Cells; Leukocyte Common Antigens; Microscopy, Electron; Muramidase; Phagocytes; Retrospective Studies; S100 Proteins; Vimentin; von Willebrand Factor

Topics: Abdomen; Aged; Diabetes Complications; Elastic Tissue; Granuloma, Giant Cell; Histiocytes; Humans; Immunoenzyme Techniques; Male; Muramidase; Skin Diseases; Thorax

A spectrum of giant cell lesions was evaluated for muramidase, alpha-1 antitrypsin, alpha-1 antichymotrypsin, and S-100 protein immunoreactivity using an avidin-biotin-complex immunoperoxidase method. Peripheral giant cell granuloma, central giant cell granuloma, giant cell tumor, osteitis fibrosa cystica, cherubism, and giant cell tumor of tendon sheath showed similar patterns of reactivity. Granulomatous inflammatory lesions stained more intensely for muramidase than did noninflammatory lesions. Alpha-1-antichymotrypsin was a slightly better marker of giant cell lesions than was alpha-1-antitrypsin. Positive S-100 protein staining in half the lesions was thought to be due to the presence of Langerhans cells. The results supported the belief that giant cell lesions of bone and tendon sheath are differentiated toward cells of the mononuclear-phagocyte system and that multinucleated giant cells are derived from macrophages.

Topics: alpha 1-Antichymotrypsin; alpha 1-Antitrypsin; Cherubism; Giant Cell Tumors; Granuloma, Giant Cell; Histocytochemistry; Humans; Immunoenzyme Techniques; Macrophages; Muramidase; Osteitis Fibrosa Cystica; S100 Proteins; Tendons

Giant cell myocarditis (GCM) as a distinct disease entity has been questioned. The superficial morphologic resemblance to cardiac sarcoidosis and incomplete histopathologic assessment of extracardiac organ systems in reported cases has suggested that GCM represents a predominant cardiac manifestation of generalized sarcoidosis. The morphologic and immunocytochemical features at autopsy of this rare disorder were seen in a 15-year-old boy. All other organs were free of granulomatous inflammation. Transition from normal myocardial fibers to giant cells was observed, without a limiting plasma membrane between the two different aspects of the fiber. Immunocytochemistry for cytoplasmic muramidase (CM) showed CM in neutrophils and tissue macrophages. Cytoplasmic muramidase was distinctly absent from the characteristic giant cells. The classification of GCM as a disease separate from generalized sarcoidosis may be justified.

Topics: Adolescent; Diagnosis, Differential; Granuloma, Giant Cell; Humans; Immunoenzyme Techniques; Male; Microscopy, Electron; Muramidase; Myocarditis; Myocardium; Sarcoidosis