Giant cells

GIANT CELLS

1. Langhan’s giant cell –

   • Nuclei are arranged either around the periphery in the form of horse shoe or ring or clustered at the two poles of giant cells

   • They are seen in granulomatous conditions like TB, Syphilis, sarcoidosis, leprosy (mainly TT) type, Leishmaniasis, crohn’s disease      

2. Foreign body giant cells  –

   • Numerous nuclei are randomly scattered throughout the cytoplasm, often aggregating towards the center of cell

   • They are seen in response to various endogenous and exogenous foreign bodies  

3. Tumor giant cell –

   • Larger cells having numerous nuclei which are hyperchromatic and pleomorphic

   • They are formed from dividing nuclei of neoplastic cells

   • They are seen in Anaplastic carcinoma and high grade sarcomas   

4. Touton giant cells –

   • Also called as xanthelasmatic giant cells

   • They small sized cells with a full ring of nuclei with eosinophilic cytoplasm centrally and foamy cytoplasm at periphery

   • They are seen in lesions with high lipid content, xanthoma, Xanthogranuloma, fat necrosis, dermatofibroma           

5. Osteoclast like giant cell –

   • They have ruffled cell membrane with multiple bland central nuclei

   • They are seen in giant cell rich tumors of bone and soft tissue (like giant cell tumor) and in various high grade carcinomas (like pancreatic undifferentiated carcinoma)         

6. Floret cell –

   • They have scanty cytoplasm and wreath of hyperchromatic peripheral nuclei

   • They are seen in pleomorphic lipoma, neurofibroma, giant cell angiofibroma rarely in liposarcoma   

7. Warthin Finkeledey giant cell –

   • They have high N:C ratio crowded & irregular nuclei

   • They have desmosomes, cilia and thin filaments with dense bodies

   • They are seen in measles       

8. Tzanck giant cells –

   • They have bizarre & atypical nucleus which shows peripheral marign of chromatin & a ground glass appearance

   • These nuclei are crowded together leading to molding of the nuclei shape

   • They are seen in herpes simplex, varicella & herpes zoster, cytomegalovirus

9. Starburst giant cell  –

   • They are multinucleated melanocytes with a stellate appearance due to its prominent dendritic process

   • They are seen in lentigo maligina from photo damaged skin 

10. Reed stern berg tumor or Dorothy reed tumor giant cell  –

    • They are usually binucleated or bilobated so that the two halves appear as mirror images with prominent eosinophilic inclusion like nucleoli resembling “owls eye”

    • There may be multiple nuclei also

    • They are seem in hodgkins disease   

11. Balloon cells –

    • Nuclei are small, round, finely granular or vaculoated often with few small melanin granules

    • They are seen in Balloon cell nevus, balloon cell melanoma       

12. Aschoff giant cells–

    • Cytoplasm is more basophilic & contain upto 4 nulcei

    • They are found in aschoff bodies surrounding centers of fibrinoid necrosis

    • They are associated with rheumatic heart disease

13. Multinucleated epidermal giant cell –

    • They have more than three clumped nuclei

    • They are formed by epidermal cells in response to various types of inflammation

    • They are seen in chronic eczema, lichen amyloidosis, dermatitis herpetiformis, erythema multiforme, pustular psoriasis, lichen planus, lupus erythematosus         

14. Physiologic giant cells:

    1. Osteoclast

    2. Odontoclast

    3. Megakaryocyte

    4. Syncytiotrophoblast

    5. Skeletal muscle fibres

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