Multinucleated Fibroblasts Research Articles

Giant Cell Fibroma Clinically Mimicking Malignancy: A Case Report

Giant Cell Fibroma (GCF) is a benign rare fibrous lesion that predominantly occurs on the mandibular gingiva. Clinically, it is presented as a sessile or pedunculated mass that frequently occurs in the third decade with a slight female predilection. The lesion is usually characterized by stellate and multinucleated fibroblasts located in the lamina propria near the overlying epithelium and radiographically treated as a benign lesion.
 A 20-year-old female was referred to the Oral and Maxillofacial Medicine Department of Semnan Dental School, with the chief complaint of tooth displacement and gingivitis. Clinical examination revealed maxillary protrusion, mouth breathing, localized gingivitis in the interdental areas of the papilla of the lateral and canine teeth; also alveolar bone with pus discharge in the right mandibular premolar area. Radiographically, the lesion leads to the bone resorption and linguistic movement of the teeth in the right side of Mandible. There were no root resorption and no bone expansion. Gentle scaling and root planning, biopsy, and second premolar extraction were performed. The presence of the giant fibroblasts in superficial connective tissue confirmed the diagnosis of Giant Cell Fibroma. At the follow-up session, tissue repair was accomplished, and the first premolar was immobile and was no longer loose.
 Nevertheless, further studies are required to investigate the precise nature of the mono or multinucleated cells, i.e., atypical fibroblasts that illustrate degenerative and functional changes. Moreover, a high index of suspicion and appropriate analytical examination is required for distinct lesions to achieve a proper diagnosis and suggest an appropriate treatment.

Multinucleate cell angiohistiocytoma: A clinicopathologic study of 62 cases and proposed diagnostic criteria.

Multinucleate cell angiohistiocytoma (MCAH) is an uncommon and likely underdiagnosed entity that is thought to be of vascular and fibrohistiocytic origin. We retrospectively reviewed all cases diagnosed as MCAH at the Yale Medicine Dermatopathology laboratory between 1 January 1990 and 1 September 2018. Sixty-two cases were retained. We performed immunohistochemistry on the ten most inflamed lesions found and assessed for a possible alteration within the Wnt/ß-catenin signaling pathway, involved in follicular induction in dermatofibroma. We subsequently established histologic diagnostic criteria to differentiate MCAH from its mimickers. MCAH affected both genders equally. The hands or fingers were affected in 51.6% of cases. We found the most specific histologic criteria to be: (a) presence of odd multinucleated fibroblasts, (b) presence of superficial parallel fibrosis, (c) presence and thickening of superficial papillary dermal vessels, and (d) absence of perifollicular fibrosis. As for immunoreactivity, we found positivity to CD138, CD163, and CD117 in the mononuclear inflammatory infiltrate. There was no histopathologic evidence of follicular induction, as can be seen in dermatofibromas, and no expression of nuclear beta-catenin as seen in dermatofibromas with follicular induction. This large case series establishes MCAH as a distinct clinical and histopathologic entity.

Desmoplastic Fibroblastoma in the Cavity Oral: Report of a Rare Case

Desmoplastic fibroblastoma (DF), a rare benign soft tissue neoplasm of fibroblasts and myofibroblasts, disseminates widely and can be intramuscular or subcutaneous. A few cases of DF in the oral cavity have been reported. We reported a case of DF in the inferior alveolar ridge of the mandible, in a 59-year-old woman, presenting as a nodular lesion, a healthy mucosa-colored tumor, pediculate, lobular surfaced, with 10 mm in its greater diameter. The lesion was surgically excised. The tissue was submitted for histopathologic examination, and stained sections showed spindle and stellate-shaped fibroblasts in a collagen-rich stroma, and binucleated and multinucleated fibroblasts with prominent nucleoli were observed. An immunohistochemical study showed overall diffuse positivity and focal spindle cells positivity for SMA and CD-99, and negativity for CD-34 and S-100. Histopathological findings associated with the immunohistochemical profile were consistent with DF. The patient was followed up for 1 year, and there was no recurrence.

Clinical Features and Histological Findings of 17 Patients with Chronic Actinic Dermatitis

ObjectivesThis study was designed to evaluate the clinical, histological and immunohistochemical findings and treatment of chronic actinic dermatitis in Korean patients. MethodsSeventeen Korean patients with chronic actinic dermatitis were enrolled for this study. The clinical and histological findings and the results of phototest were reviewed with medical records, clinical photographs and pathologic slides. We also reviewed the effectiveness of the treatments in all patients with chronic actinic dermatitis. ResultsIn all patients with chronic actinic dermatitis, pruritus was severe, and the patients present in the early stages with erythemas on the face, neck and the back of the hands. As the eruption progresses, it became lichenified and scaly plaques and papules developed. The face, upper extremity and neck were most commonly affected. The most common abnormal results of the phototests were decreased MED-UVB alone. In 8 patients with actinic reticuloid, histopathologic findings showed irregular acanthosis, parakeratosis, spongiosis, atypical hyperchromatic cells with cerebriform nuclei, epidermotropism, Pautrier-like microabscess, deep perivascular lymphocytic infiltrates, vertically-streaked collagen in the papillary dermis, stellate and multinucleated fibroblasts. Treatment includes topical tacrolimus and corticosteroid, oral corticosteroid, azathioprine and cyclosporine. ConclusionsOur study showed classic clinical and histological findings. The most common abnormal results of the phototests were decreased MED-UVB alone. Topical steroid, tacrolimus and systemic cyclosporine, azathioprine are effective in treating chronic actinic dermatitis.

Multinucleated giant cells from fibroblast cultures

Many multinucleated giant cells are well-known to form from macrophage origin. Those formed from other cell types are less described, but may be as prevalent in pathological tissue. Giant multinucleated cells derived from secondary and primary fibroblast sources in various cultures with similar characteristics to foreign body giant cells are reported. Secondary-transformed NIH 3T3 fibroblasts rapidly fuse within 24 h in contact co-cultures with RAW 264.7 immortalized macrophages, while 3T3 monocultures, non-contact (transwell) co-cultures, and macrophage-conditioned media-treated 3T3 monocultures all do not fuse. Primary-derived murine fibroblasts also form multinucleated cells, both in the presence or absence of co-cultured macrophages that increase during long-term culture (5–30 days). In contrast to 3T3 fusion, this primary cell phenomenon is not due to fibroblast fusion, but rather to nuclear division without cytokinesis. That these multinucleated fibroblasts can originate via different mechanisms may influence and distinguish their behaviors in conditions under which they may arise, including various in vitro culture assays, and in certain fibroblastic pathologies such as the foreign body response, fibrosis, cancer and aged tissue.

Pretibial Pruritic Papular Dermatitis

We describe the clinico-pathologic features of 44 patients with a peculiar pretibial pruritic papular dermatitis (PPPD). Clinically, PPPD consists of discrete, roundish, extremely pruritic papules with a smooth surface caused by the delicate and persistent rubbing of pretibial skin. Histologically, PPPD showed minimal compact orthokeratosis, flattening of the rete ridges, a superficial and mid-dermal perivascular and interstitial infiltrate of lymphocytes, histiocytes, eosinophils and multinucleated fibroblasts, and thickened collagen bundles in haphazard array in the superficial dermis. The clinical picture of PPPD closely resembled that of lichen simplex chronicus/circumscribed neurodermatitis or lichen amyloidosus. Histologically, the absence of uneven psoriasiform epidermal hyperplasia, marked compact orthokeratosis, hypergranulosis, and coarse bundles of collagen arranged in vertical streaks in the papillary dermis distinguished PPPD from lichen simplex chronicus, whereas the lack of amyloid deposits in the dermal papillae differentiated PPPD from lichen amyloidosus. We suggest that PPPD is an unusual morphologic expression of gentle and chronic rubbing of pretibial skin with distinctive histopathologic features.

The retrocuspid papilla and factor XIIIa: an epidemiologic and histomorphologic study.

The retrocuspid papilla (RCP) is a poorly recognized entity. In one part of our study, we found 10 cases of lesions clinically compatible with RCP in 1150 consecutively examined patients. In another part of the study, we found 15 cases of RCP in more than 2000 consecutive cases of oral mucosal hyperplasia submitted as surgical biopsies during 1989-92. The lesions were situated in the attached gingiva, lingual to the two mandibular canines, often bilaterally. They were covered by normal pink mucosa with a size and a height each of 2-3 mm. Histologically, the RCP was a broad-based, often downfolded hyperplasia, covered with a parakeratinized epithelium of normal thickness. The rete pegs were often elongated and blunt, frequently bent inward toward the center. The lamina propria was mostly composed of a loosely arranged, delicate, fibrous connective tissue. The lesions could be classified into two groups by the presence or absence of stellate and occasionally multinucleated fibroblasts. Immunohistochemical staining with an FXIIIa antibody disclosed a population of reactive spindle-shaped cells, mainly localized in the connective-tissue papillae. These cells may be of pathogenetic importance.

Ultrastructural Study of Multinucleated Fibroblasts and Osteoblasts in the Periodontal Ligament of Aged Rat

Ultrastructural Study of Multinucleated Fibroblasts and Osteoblasts in the Periodontal Ligament of Aged Rat

The Retrocuspid Papilla of the Mandibular Lingual Gingiva

The retrocuspid papilla (RCP) is a circumscribed nodule that lies lingual to the mandibular cuspid on the gingival tissue. RCP is observed more frequently in young children and seems to regress or disappear with age. Little information is available in the literature on this entity and there are contradictory reports regarding its histologic features. Histomorphologic analysis of 30 specimens diagnosed as RCP revealed that in most cases (80%) it is composed of loosely-arranged delicate fibrous connective tissue with stellate and multinucleated fibroblasts. Elongation of the rete ridges and/or increased vascularity are also present in a significant number of cases. Stellate and multinucleated fibroblasts are not unique to RCP and they have been described as prominent histologic features in other lesions of skin and mucous membrane. RCP is considered to be a "normal anatomical structure" or an "anatomic variation" of the gingiva. The clinical significance of RCP is that it may simulate pathological gingival conditions from which it must be differentiated.

Formation of multinucleated fibroblasts in the periodontal ligaments of old mice.

Multinucleated cells were observed to account for more than 17% of all cells in the periodontal ligament (PDL) of 20-month-old mice. The number of nuclei contained in sections of these cells ranged from 2 to 17, with over 50% of the multinucleated cells containing four or more nuclei within the plane of section. The multinucleated cells contained several cytoplasmic features resembling those previously described by the authors as characteristic of PDL fibroblasts. The multinucleated cells did not resemble osteoclasts or foreign body giant cells. It is suggested that fibroblasts develop a tendency to fuse and form multinucleated cells in the aged PDL. Similar cells were not observed in the PDL of young (5-week-old) mice or in the tail tendon at any age.

Fibrous lesions of the skin and mucous membranes which contain stellate and multinucleated cells

Various fibrous lesions of the skin and mucous membranes share the common histologic feature of stellate and multinucleated fibroblasts. These cells are conspicuous under the light microscope because they contain a well-developed, rough endoplasmic reticulum which, because of its high RNA content, stains basophilic. These characteristic cells are a nearly constant feature of the retrocuspid papilla. They are apparent in about half of the fibrous papules of the nose and abundant in about 1 per cent of irritation fibromas. These lesions most likely represent a non-specific proliferation of the lamina propria or papillary dermis to various stimuli.

The Production of Multinucleated Lymphocytes by Cytochalasin B. An Electron Microscopic Study

The cytochalasins are newly derived from moulds and are useful in studying nuclear division. Multinucleated fibroblasts were produced by CARTER [Nature 213: 261, 1967] and lymphocytes by us [Nature 216: 1134, 1967]. Lymphocytes with up to eight nuclei were seen. Progressive nuclear addition [1, 2, 3 etc.) was found instead of a doubling of the nuclei (1, 2, 4, etc.). The term ‘pseidomitosis’ was proposed for the process of synchronous mitosis, but which results in the division of only one nuclei.Our observations, using the light microscope shows the nuclei of binucleated cells to be similar in size and shape; however, in cells with more than two nuclei there is marked vaiation in size and shape of each nucleus. What might have appeared, in many instances, as separate nuclei are seen by electron microsopy to be lobes of a rather large and irregular nucleus. In other instances, small nuclear bridges connected what might appear as separate nuclei. Variation exists in nuclear size from rather large nuclei to very small micronuclei. Serial sectioning of cell nuclei verified the morphological variability seen in single sections. Spindle fibers and kinetochore attachment to the chromosomes revealed no unusual features. Electron microscopy showed synchronous division of nuclei. Golgi apparatus remained as a single large unit. There was a doubling of centrioles in binucleated cells. What appears as separate nuclei under the light microscope were connected by nuclear bridges. The finding suggests that as nuclei accumulate that the spindle bridge is unable to accurately divide the large numbers of chromosomes present.