Giant Cell Tumor Of Bone

This tumor occurs in the epiphyseal region of long bones in the skeletally mature, with 50% reported in the vicinity of the knee. The usual histologic appearance shows multinucleated giant cells uniformly distributed against the background of mononuclear cells, which are round

FIGURE 22 Plasmacytoma/multiple myeloma. Monomorphic population of plasma cells with occasional binucleation. The nuclear chromatin is irregularly distributed (hematoxylin and eosin, original magnification x 40).
FIGURE 23 Giant cell tumor of bone. Evenly distributed multinucleated giant cells and associated mononuclear cells. The nuclei of both the giant cells and mononuclear cells are similar (hematoxylin and eosin, original magnification x 40).

to oval in shape. There is cytologic similarity between the nuclei of the mononuclear cells and multinucleated giant cells (Fig. 23). Mitotic activity can be present and may be brisk in the mononuclear cells, but atypical forms are absent. Cartilage is not present unless there is a fracture. Osteoid formation can be identified in about half of the lesions in the vicinity of the advancing tumor edge. Secondary aneurysmal bone cyst change may complicate and, at times, obscure the giant cell tumor. Histologic grading of giant cell tumors has not been helpful in predicting the recurrence, local aggressiveness, or metastasis of these lesions (71,20).

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