Abstract
We here report on the cytological, immunohistochemical and scanning electron microscopic findings in a case of osteoclastoid type giant cell carcinoma of the pancreas in a 71 y-o female. She was admitted because of obstructive jaundice in Oct. 1988, and diagnosed as having a tumor of the pancreatic head metastasizing to the gall-bladder and lymph nodes. The tumor of the pancreatic head, 5×5.5 cm in size, protruded into the duodenal lumen. Each tumor nodule including the metastatic foci was greyish or brownish-red with focal necrosis in the cut surface, and a clear margin.
In touch smear preparations of the main tumor, osteoclastoid type multinucleated giant cells and mononuclear cells were found. These tumor cells had nuclei with clear nucleoplasm and prominent nucleoli, and their cytoplasm was abundant. The tumor of the gall bladder showed the same findings as those observed in the tumor of the pancreatic head tumor.
Immunohistochemically, the multinucleated giant cells were positive for an antiserum to the α subunit of S-100 protein and also a monoclonal antibody, MB-1, in their cytoplasm. Scanning electron microscopic findings revealed nuclear excavation, some pits in the surface of the multinucleated giant cells, and extending irregular cytoplasmic processes. These multinucleated cells were intimately intermingled with mononuclear cells.
These are the touch smear findings of osteoclastoid type giant cell carcinoma in the pancreas, supported by the histopathological studies. Although this tumor, having a better prognosis than the ordinary giant cell type, is rare, these characteristic findings should be kept in mind in order to diagnose correctly tumors of the pancreaticoduodenal region.
