In early lesions, scalloped macrophages dominate the histology, but most well-developed lesions have a mixture of the above.14 Immunohistochemical studies show negative staining for S-100, CD1a, and Birbeck granules, and positive staining for the surface markers CD68 and factor XIIIa.15 Our patient had typical lesion involving typical sites and histopathology of skin lesions showed foamy histiocytes and occasional multinucleated giant cell
It features organisms that are visible on H&E within histiocytes and multinucleated giant cells
as well as within necrosis as faintly staining round yeasts with light gray cell walls surrounded by a clear space (Figure 1, A).
Foci of acute and granulomatous inflammation were appreciated (Figure 5) along with epithelioid histiocytes and multinucleated giant cells
Histological examination of omental and peritoneal biopsies disclosed the presence ofnoncaseating, nonnecrotic, sarcoid type granulomas containing multinucleated giant cells
(Figures 1 and 2).
As may occur in untreated rheumatoid arthritis patients, MTX treatment itself can induce the formation of nodules, an accumulation of multinucleated giant cells
derived from differentiated mononuclear cells.
a patient can be classified as having temporal arteritis if three of the following five criteria are met: (1) age of onset [greater than or equal to] 50 years: (2) localized headache of new onset or quality; (3) temporal artery abnormality such as tenderness or decreased pulsations unrelated to arteriosclerosis of cervical arteries: (4) ESR [greater than or equal to] 50 mm/h by the Westergren method; and (5) abnormal artery biopsy with predominance of mononuclear cells or granulomatous inflammation, usually with multinucleated giant cells
. The presence of three or more of these criteria yields a sensitivity of 93.5% and a specificity of 91.2%.
High risk features Size > 5 cm Infiltrative growth pattern High nuclear grade and cellularity Mitotic rate > 1/50 HPF Necrosis Vascular invasion Benign No high risk features Uncertain malignant potential 1 high risk feature including size [greater than or equal to] 5 cm, nuclear pleomorphism, or multinucleated giant cell
Malignant 2 or more high risk features
Microscopically, the classic histopathologic features of GCM are prominent myocyte necrosis associated with a multifocal or diffuse inflammatory cell infiltrate composed of abundant T lymphocytes, multinucleated giant cells
, plasma cells, easily identified eosinophils, and occasional neutrophils.
It is characterized by blood-filled spaces lined by fibrous septa containing osteoclast-like multinucleated giant cells
and delicate spicules of osteoid.
Histologic examination of biopsies taken from the abdominal wall adherent to the mass showed the presence of fungal hyphae that had large width, were pauciseptate, and were surrounded by eosinophils with multinucleated giant cells
, lymphocytes, and histiocytes.
There were also multinucleated giant cells
, neutrophils, and eosinophils, as well as proliferation of connective tissue with marked collagen deposition, characterizing the lesion as dermatitis, panniculitis, and granulomatous myositis.
The histologic feature is bizarre multinucleated giant cells
admixed with mononucleate tumor cells (Figures 3 and 4).