Undifferentiated Carcinoma with Osteoclast-like Giant Cells of the Pancreas
Definition
- Undifferentiated carcinoma of the pancreas with scattered cytologically bland osteoclast-like giant cells
Alternate/Historical Names
- Giant cell carcinoma, epulis-osteoid type
- Giant cell tumor of the pancreas
- Osteoclast-like giant cell tumor
- Osteoclastoid type of giant cell tumor
- Osteoclastoma of the pancreas
Diagnostic Criteria
- Scattered large multinucleated giant cells
- Numerous to innumerable nuclei
- Nuclei uniform, bland and small
- No mitotic figures in giant cells
- May show phagocytosis
- Numerous to innumerable nuclei
- Background cells contain a cytologically malignant population
- May be round to spindled
- Cytologically pleomorphic
- May be poorly cohesive
- A benign mononuclear histiocytic component may also be seen
- May have focal osteoid or chondroid stroma
- May be associated with usual ductal adenocarcinoma or mucinous cystic neoplasm
Supplemental Studies
- Giant cells
- CD68 positive
- CD163 negative
- Keratin and EMA negative
- Negative for proliferation markers
- Background cells
- Cytologically malignant population
- Variably positive for epithelial markers and proliferation markers
- Cytologically bland population
- CD68 and CD163 positive
- Cytologically malignant population
- Associated carcinoma
- Keratin positive
Clinical
- Poor prognosis
Classification / Lists
Pancreatic Carcinomas
- Acinar cell carcinoma
- Adenosquamous carcinoma
- Colloid carcinoma
- Ductal adenocarcinoma
- Neuroendocrine carcinoma, poorly differentiated
- Well differentiated neuroendocrine (islet cell) tumors
- Hepatoid carcinoma
- Medullary carcinoma
- Micropapillary carcinoma
- Pancreatoblastoma
- Serous cystadenocarcinoma
- Signet ring cell carcinoma
- Undifferentiated carcinoma
- Undifferentiated carcinoma with osteoclast-like giant cells
Bibliography
- Bosman FT, Carneiro F, Hruban RH, Thiese ND (Eds). WHO Classifiication of Tumors of the Digestive System, IARC, Lyon 2010.
- Solcia E, Capella C, Kloppel G . Tumors of the Pancreas, Atlas of Tumor Pathology, AFIP Third Series, Fascicle 20, 1997.
- Molberg KH, Heffess C, Delgado R, Albores-Saavedra J. Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas and periampullary region. Cancer. 1998 Apr 1;82(7):1279-87.
- Dhall D, Klimstra DS. The cellular composition of osteoclastlike giant cell-containing tumors of the pancreatobiliary tree. Am J Surg Pathol. 2008 Feb;32(2):335-7.
- Bergmann F, Esposito I, Michalski CW, Herpel E, Friess H, Schirmacher P. Early undifferentiated pancreatic carcinoma with osteoclastlike giant cells: direct evidence for ductal evolution. Am J Surg Pathol. 2007 Dec;31(12):1919-25.
Author / Update
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Original posting/updates: 1/5/08, 3/27/08, 1/5/12
