Document Detail

Leiomyosarcoma with prominent osteoclast-like giant cells. Analysis of eight cases closely mimicking the so-called giant cell variant of malignant fibrous histiocytoma.
MedLine Citation:
PMID:  8116793     Owner:  NLM     Status:  MEDLINE    
Eight cases of leiomyosarcoma with osteoclast-like giant cells, arising in deep soft tissue, and that mimicked closely the "giant cell variant of malignant fibrous histiocytoma (MFH)," have been studied morphologically and immunohistochemically. The age of the patients ranged from 7 to 88 years (mean, 66.2 years; median, 74 years); five were female patients. Three lesions arose in the lower limbs, two in the buttock, and one each in the shoulder, chest wall, and the floor of the mouth. Follow-up in one case revealed a local recurrence and in two cases systemic metastases. All cases showed, at least focally, interwoven spindle cell fascicles, with the cytologic features of smooth muscle cells, as well as strong positivity for alpha-smooth-muscle actin, muscle actin, and desmin. The morphologically benign osteoclast-like giant cells expressed CD68 but failed to stain with myogenic markers. The association of leiomyosarcoma with prominent osteoclast-like giant cells is not as uncommon as generally believed, being evident in 8.7% of the deep-seated nonvisceral leiomyosarcomas that we have studied. These results provide good evidence for myogenic differentiation in at least a subset of those tumors with morphologic features currently classified as the giant cell variant of MFH. Considering that at least some other reported cases of giant cell MFH appear to be a variant of extraskeletal osteosarcoma, we would suggest that lesions with this distinctive pattern should be more carefully classified according to their apparent line of differentiation.
T Mentzel; E Calonje; C D Fletcher
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of surgical pathology     Volume:  18     ISSN:  0147-5185     ISO Abbreviation:  Am. J. Surg. Pathol.     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-03-25     Completed Date:  1994-03-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7707904     Medline TA:  Am J Surg Pathol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  258-65     Citation Subset:  IM    
Department of Histopathology, St Thomas's Hospital, London, England.
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MeSH Terms
Aged, 80 and over
Antigens, CD / analysis
Antigens, Differentiation, Myelomonocytic / analysis
Diagnosis, Differential
Giant Cells / immunology,  pathology*
Histiocytoma, Benign Fibrous / pathology*
Leiomyosarcoma / diagnosis*,  immunology,  pathology
Middle Aged
Osteoclasts / pathology*
Soft Tissue Neoplasms / diagnosis,  immunology,  pathology
Reg. No./Substance:
0/Antigens, CD; 0/Antigens, Differentiation, Myelomonocytic; 0/CD68 antigen, human
Comment In:
Am J Surg Pathol. 1995 Apr;19(4):487-8   [PMID:  7694955 ]

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