Giant cell lesions

  • Are lesions in which multinucleated giant cells constitute a hallmark, making their characterization by microscopy alone very unreliable and thus needing further investigations for their differential diagnosis. These lesions should not be confused with other lesions that may contain giant cells, such as TB. The latter lesions are usually easy to diagnose as they show some other pathognomonic features.

List of giant cell lesions

  1. Peripheral giant cell granuloma
  2. Central giant cell granuloma
  3. Giant cell tumor of bone (osteoclastoma)
  4. Giant cell fibroma
  5. Aneurysmal bone cyst
  6. Familial fibrous dysplasia (cherubism)
  7. Brown nodes of hyperparathyroidism

Other lesions which may contain giant cells

In this group of lesions, multinucleated giant cells may be seen scattered in the microscopic fields, but they do not constitute a hallmark of the lesion. Some of these giant cells have a characteristic morphology that aids in the diagnostic process.
  1. Infections:
    • TB granulomas
    • Syphilitic granulomas
    • Actinomycosis
    • Periapical granulomas
  2. Foreign body granulomas
  3. Tumors:
    • Benign osteoblastoma
    • Benign chondroblastoma
    • Benign cementoblastoma (true cementoma)
    • Benign fibrous histiocytoma
    • Malignant fibrous histiocytoma
    • Verruciform xanthoma (contains Touton giant cells)
    • Intradermal nevi (contain Touton-like giant cells)
  4. Developmental conditions:
    • Facial fibrous dysplasia
    • Cheilitis granulomatosa
  5. Conditions of obscure nature:
    • Sarcoidosis
    • Paget’s disease of bone

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