Central giant cell granuloma of the jaws and giant cell tumor of long bones: an immunohistochemical comparative study

Maria Do Socorro Aragão,Roseana De Almeida Freitas,Lélia Batista De Souza,Leão Pereira Pinto,Cassiano Francisco Weege Nonaka,Marta Rabello Piva

doi:10.1590/s1678-77572007000400013

Abstract

This study investigated whether some components of the extracellular matrix and CD68 expression may drive the differences between the central giant cell granuloma (CGCG) of the jaws and giant cell tumor (GCT) of long bones, which present distinct evolution and clinical behavior. Eight cases of CGCG and 7 cases of GCT were selected and immunohistochemically analyzed to verify the pattern of expression of CD68, tenascin (Tn) and fibronectin (Fn). A large number of the mononuclear cells and multinucleated giant cells CD68+ was observed in both of the studied lesions, indicating histiocyte/ macrophage origin. Seven cases of CGCG of the jaws showed intense staining of Fn, with uniform distribution predominantly. In all 7 cases of GCT of long bones the Fn displayed intense expression, with distribution pattern varying from uniform to reticulate/fibrillar. Six cases of CGCG were intensively stained by Tn, presenting focal expression in half of specimens, and reticulate/ fibrillar pattern of expression in 4 cases. All cases of GCT of the long bones presented intense expression of Tn, uniform distribution, and reticulate/fibrillar pattern of expression in four cases. The immunoexpression of CD68 in mononuclear cells and multinucleated giant cells and staining patterns of Fn and Tn were similar in both entities. These findings indicate that these proteins could not be used to explain the differences between the CGCG of the jaws and GCT of the long bones.

Highlights

Central giant cell granuloma of the jaws and giant cell tumor of long bones are well-recognized entities revealing benign nature[16]
Morphologic studies performed in order to compare central giant cell granuloma (CGCG) and giant cell tumor (GCT) features have shown that most of jaw lesions may be distinguished from tumor of long bones on histological appearance, many jaw lesions display the histological profile of the tumor of long bones
CD68 CD68 positive cells were detected in many mononuclear cells and in the majority of multinucleated giant cells of the CGCG of the jaws (Figure 1) and GCT of long bones (Figure 2) evaluated

Summary

Introduction

Central giant cell granuloma of the jaws and giant cell tumor of long bones are well-recognized entities revealing benign nature[16]. Their clinical behavior[8,13,29], prognostic factors and the histogenesis have been subject of several studies. Morphologic studies performed in order to compare CGCG and GCT features have shown that most of jaw lesions may be distinguished from tumor of long bones on histological appearance, many jaw lesions display the histological profile of the tumor of long bones. Whitaker and Waldron[29] (1993) reported that CGCG of the jaws and GCT of long bones could represent the development of a single pathologic process that may be influenced by patient’s age, location and other unknown factors. The true GCT of the jaws is rare and local prognosis is considered worse in GCT than in CGCG8

Methods

Discussion

Conclusion