Differential diagnosis

This includes giant cell (reparative) granuloma, brown tumour of hyperparathy-roidism, fibrous histiocytoma and a pleomorphic carcinoma. Giant cell granuloma of the cricoid cartilage is exceptionally rare {2587}. The giant cells in this tumour are not evenly distributed, but rather concentrate around areas of recent and/or old haemorrhage. A giant cell granuloma also exhibits more stro-mal fibrosis. A brown tumour is identical histologically to the giant cell granuloma, but is associated with elevated serum calcium. A benign fibrous histiocytoma contains a more uniform storiform arrangement of fibroblasts and does not show a symmetrical distribution of giant cells. A malignant fibrous histiocytoma (giant cell type) exhibits significant nuclear pleomorphism and abnormal mitoses, none of which are seen in a giant cell tumour. A pleomorphic carcinoma will not only show abnormal mitoses and pleomorphism, but will also be positive for cytokeratin.

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