title: A case of pulmonary adenocarcinoma harboring osteoclast-like giant cells: Its evaluation by immunohistochemical and genetic analyses.
abstract: Tumors harboring osteoclast-like giant cells (OGCs) at extraosseous site are extremely rare. These rare tumors have been detected most frequently in the pancreas and few pulmonary tumors harboring OGCs have been previously reported. In addition, the genetic profiles of these tumors have remained virtually unknown. Therefore, we report a case of pulmonary adenocarcinoma harboring OGCs in which k-ras mutation and immunohistochemical study of proteins associated with OGCs were examined. The case was a 70-year-old man, who demonstrated a pulmonary mass associated with unusual radiological features. Histopathologically, three different cell types, mucinous adenocarcinoma cell, OGC and mononuclear cell were detected. OGCs were immunohistochemically negative for epithelial markers and positive for histiocytic markers but mononuclear cells were immunopositive for epithelial markers. In addition, both mononuclear and adenocarcinoma cells had the same k-ras mutation profiles and mononuclear cells were immunohistochemically positive for macrophage colony-stimulating factor (M-CSF), one of the factors associated with OGC differentiation. Therefore, mononuclear cells were considered to be derived from neoplastic epithelium and OGCs could represent non-neoplastic cells. In addition, M-CSF locally produced could promote the differentiation of OGCs.
authors.affiliation: Department of Pathology, Tohoku University School of Medicine, Miyagi, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Saito
authors.affiliation: Department of Pathology, Tohoku University Hospital, Miyagi, Japan.
authors.forename: Fumiyoshi
authors.initials: F
authors.lastname: Fujishima
authors.affiliation: Department of Pathology, Tohoku University School of Medicine, Miyagi, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Thoracic Surgery, Tohoku University Hospital, Miyagi, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Hoshikawa
authors.affiliation: Department of Radiology, Tohoku University Hospital, Miyagi, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Tominaga
authors.affiliation: Department of Pathology, Tohoku University Hospital, Miyagi, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Taniuchi
authors.affiliation: Department of Pathology, Tohoku University Hospital, Miyagi, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Kasajima
authors.affiliation: Department of Pathology, Tohoku University Hospital, Miyagi, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Thoracic Surgery, Tohoku University Hospital, Miyagi, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Okada
authors.affiliation: Department of Pathology, Tohoku University School of Medicine, Miyagi, Japan.|Department of Pathology, Tohoku University Hospital, Miyagi, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sasano
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000235:genetics / Q000378:metabolism; D000077192:Adenocarcinoma of Lung; D002288:Adenocarcinoma, Mucinous / Q000000981:diagnostic imaging* / Q000235:genetics / Q000378:metabolism; D000368:Aged; D004848:Epithelium / Q000473:pathology; D005820:Genetic Testing; D015726:Giant Cells / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics / Q000378:metabolism; D016173:Macrophage Colony-Stimulating Factor / Q000235:genetics* / Q000378:metabolism; D008297:Male; D009154:Mutation; D010010:Osteoclasts / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000235:genetics / Q000378:metabolism; D012907:Smoking; D014057:Tomography, X-Ray Computed; D059016:Tumor Microenvironment; D018631:ras Proteins / Q000235:genetics* / Q000378:metabolism
chemical_list: D016173:Macrophage Colony-Stimulating Factor; D018631:ras Proteins
keywords: M-CSF; Osteoclast-like giant cell; k-ras mutation