BACKGROUND: @entity189 with @entity2527 -like giant cells are rare @entity788 that morphologically @entity2968 . Despite numerous publications based primarily on single case reports, the terminology, histogenesis, and biologic behavior of these @entity5 remain controversial. METHODS: The authors studied one periampullary and nine @entity788 of this type. Immunohistochemistry was performed on nine of the cases and clinical follow-up data was obtained in eight. RESULTS: The @entity5 were large (average 9 cm), partially or completely multicystic, and @entity548 . Histologically, they were composed predominantly of ovoid or spindle-shaped bland mononuclear cells and evenly spaced @entity2527 -like giant cells. However, three @entity5 had foci in which the nuclear pleomorphism of the mononuclear cells approached that observed in anaplastic spindle and @entity7468 . Other histologic features included phagocytosis of the mononuclear cells by the @entity2527 -like giant cells (in 7 of 10 cases), osteoid or bone formation (in 3 of 10 cases), and chondroid differentiation (in 1 of 10 cases). Four @entity5 had foci of conventional @entity420 and two arose in preexisting mucinous @entity788 . The mononuclear cells were positive for epithelial markers in six of nine @entity5 tested (cytokeratins @entity2278 , Cam 5.2, and/or epithelial membrane antigen). They were negative for the histiocytic markers ( @entity469 , lysozyme) in all nine cases tested. In contrast, the @entity2527 -like giant cells were positive for @entity469 in all nine cases, positive for lysozyme in four cases, and negative for cytokeratins ( @entity2278 , and Cam 5.2) in all nine cases. @entity876 stained the mononuclear @entity5 cells in three cases and @entity1758 stained the mononuclear @entity5 cells in four cases, but the @entity2527 -like giant cells did not stain with either antibody in all nine cases tested. Most of the @entity1 died of disease within 1 year of diagnosis; only 1 @entity1 was alive and disease free 14 years after surgical excision. CONCLUSIONS: The association of these @entity5 with conventional @entity420 or @entity14775 , the histologic features, and the immunohistochemical profile supports an epithelial phenotype for the mononuclear cells and a reactive histiocytic lineage for the nonneoplastic @entity2527 -like giant cells. These @entity5 , which are better classified as @entity189 , follow an @entity146 clinical course; most @entity1 die of disease within 1 year.

XXXX with osteoclast-like giant cells of the pancreas and periampullary region.

@entity1 :: ('9606', 'Species') :: ['patient', 'patients'] @entity788 :: ('MESH:D010190', 'Disease') :: ['pancreatic neoplasms', 'pancreatic and periampulary neoplasms', 'cystic neoplasms of the pancreas'] @entity2968 :: ('MESH:D018212', 'Disease') :: ['mimic giant cell tumor of bone'] @entity548 :: ('MESH:D006470', 'Disease') :: ['hemorrhagic'] @entity5 :: ('MESH:D009369', 'Disease') :: ['neoplasms', 'tumor', 'tumors'] @entity7468 :: ('MESH:D018286', 'Disease') :: ['giant cell carcinomas'] @entity2278 :: ('6521;6508', 'Gene') :: ['AE-1, AE-3'] @entity469 :: ('968', 'Gene') :: ['CD-68'] @entity146 :: ('MESH:D001523', 'Disease') :: ['aggressive'] @entity189 :: ('MESH:D002277', 'Disease') :: ['Undifferentiated carcinomas', 'undifferentiated carcinomas'] @entity876 :: ('7157', 'Gene') :: ['p53'] @entity14775 :: ('MESH:D018297', 'Disease') :: ['mucinous cystic neoplasms'] @entity2527 :: ('MESH:D001862', 'Disease') :: ['osteoclast'] @entity1758 :: ('57534', 'Gene') :: ['MIB-1'] @entity420 :: ('MESH:D000230', 'Disease') :: ['adenocarcinoma']
@entity189 :: (MESH:D002277,Disease) :: ['Undifferentiated carcinoma']
