Floret-like multinucleated giant cells in neurofibroma
© Shaktawat and Golka; licensee BioMed Central Ltd. 2007
Received: 07 August 2007
Accepted: 08 December 2007
Published: 08 December 2007
This short report discusses a case of neurofibroma containing floret-like multinucleated giant cells. This being the second such case in the literature. Floret-like multinucleated giant cells have been reported in gynaecomastia and neurofibroma in neurofibromatosis type 1. These cells have been reported in uncommon soft tissue tumours including pleomorphic lipoma, giant cell collagenoma, giant cell fibroblastoma and giant cell angiofibroma. We recommend these cells to be interpreted carefully keeping in mind the rare malignant change in neurofibromas. Immunohistochemistry would help in defining the nature of such cells.
The presence of FMGCs in sporadic neurofibroma, a rare finding, adds to the growing list of soft tissue tumours with FMGCs, which include pleomorphic lipoma, giant cell collagenoma and giant cell fibroblastoma [3–5]. FMGCs have also been described in giant-cell-rich variant of solitary fibrous tumour also known as giant cell angiofibroma [6, 7]. Many of these uncommon neoplasms may represent histologic spectrum of CD 34-positive dendritic interstitial cell neoplasms .
FMGCs have been described in gynaecomastia [8–10] and neurofibroma in NF1. We suggest that more studies are needed to understand the diagnostic utility of FMGCs in NF 1, whether it's an uncommon finding or typical for NF 1.
Benign nerve sheath tumours of soft tissue can adopt unusual morphologic appearances that may cause diagnostic difficulties, such as multinucleation, bizarre nuclei, intranuclear vacuoles, and other degenerative changes . The presence of FMGCs should be interpreted with care, keeping in mind the presence of malignant transformation of neurofibromas in NF1. Ancillary studies like immunohistochemistry would help to define the nature of these cells. The absence of cytological features like pleomorphism and mitosis with increase in proliferation markers (MIB1) would help in ruling out malignancy and avoid misinterpretation of FMGCs in neurofibromas.
The FMGCs in our case were mesenchymal or fibroblastic in origin and this case may represent a histologic variant of neurofibroma or is part of the spectrum of the CD 34-positive dendritic interstitial cell tumours. Further studies are needed to clarify the nature of this entity.
To Department of Cellular Pathology at Blackpool Victoria Hospital, where this case was received and where the study was conducted.
- Magro G, Scavo S, Ruggieri M: Floretlike multinucleated giant cells in a neurofibroma from a patient with NF1: an unusual finding for such a tumour. Virchows Arch. 2002, 441: 525-526. 10.1007/s00428-002-0669-y.View ArticlePubMedGoogle Scholar
- Khalifa MA, Montgomery EA, Ismail N, Azumi N: What are the CD 34+ cells in benign peripheral nerve sheath tumours? Double immunostaining study of CD 34 and S-100 protein. Am J Clin Pathol. 2000, 114: 123-126. 10.1309/C7N9-J2AU-5TB9-5FRL.View ArticlePubMedGoogle Scholar
- Azzopardi JG, Iocco J, Salm R: Pleomorphic lipoma: a tumour simulating liposarcoma. Histopathology. 1983, 7: 511-523. 10.1111/j.1365-2559.1983.tb02264.x.View ArticlePubMedGoogle Scholar
- Rudolph P, Schubert C, Harms D, Parwaresch R: Giant cell collagenoma: a benign dermal tumour with distinctive multinucleate cells. Am J Surg Pathol. 1998, 22: 557-563. 10.1097/00000478-199805000-00006.View ArticlePubMedGoogle Scholar
- Fletcher CD: Giant cell fibroblastoma of soft tissue: a clinicopathological and immunohistochemical study. Histopathology. 1988, 13: 499-508.View ArticlePubMedGoogle Scholar
- Dei Tos AP, Seregard S, Calonje E, Chan JK, Fletcher CD: Giant cell angiofibroma. A distinctive orbital tumour in adults. Am J Surg Pathol. 1995, 19: 1286-1293.View ArticlePubMedGoogle Scholar
- Mikami Y, Shimizu M, Hirokawa M, Manabe T: Extraorbital giant cell angiofibromas. Mod Pathol. 1997, 10: 1082-1087.PubMedGoogle Scholar
- Campbell AP: Multinucleated stromal giant cells in adolescent gynaecomastia. J Clin Pathol. 1992, 45: 443-444. 10.1136/jcp.45.5.443.PubMed CentralView ArticlePubMedGoogle Scholar
- Damani S, Eusebi V: Gynaecomastia in type-1 neurofibromatosis with features of pseudoangiomatous stromal hyperplasia with giant cells. Report of two cases. Virchows Arch. 2001, 438: 513-516. 10.1007/s004280100399.View ArticleGoogle Scholar
- Lipper S, Wilson CF, Copeland KC: Pseudogynaecomastia due to neurofibromatosis – light microscopic and ultrastructural study. Hum Pathol. 1981, 12: 755-759. 10.1016/S0046-8177(81)80180-3.View ArticlePubMedGoogle Scholar
- Plaza JA, Wakely PE, Suster S: Lipoblastic nerve sheath tumours: report of a distinctive variant of neural soft tissue neoplasm with adipocytic differentiation. Am J Surg Pathol. 2006, 30: 337-344.View ArticlePubMedGoogle Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.