mapetrsn
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Woman, age 24, reports a painful knee joint. X-ray reveals a bone lesion at the distal end of the femur. Examination of a fine needle aspiration of the joint reveals giant cells which resemble osteoclasts and a mononuclear infiltration. Name the tumor.
Of the two cell types present, which is neoplastic and which is reactive?
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| Ouli Maty
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Giant cell tumor and the giant cells that resemble osteoclast are the neoplastic cells.The mononuclear infiltrat is an attempt to clear or limit the disease. It is reactive.
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| mapetrsn
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Right tumor, wrong cell. It does seem like it SHOULD be the giant cells, I thought so as well. Actually it is the mononuclear cells which are neoplastic. The giant cells are derived from the fusion of the monocytes. When this tumor goes malignant, it is the monocytes which become anaplastic.
Cf. Baby Robbins, 7th ed., p. 769
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| Ouli Maty
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It was too easy to be all true.
The description you gave was exactly the same as the microscopic definition of giant cell tumor and the epidemiology and clinic also matched so well.
Thank you very much, I didn't have access to the intimal mechanism of the tumor when I was studying it. So I tough since the mononuclear cells are the precursor of the tissue macrophages they've got to be the reactional mechanism.
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