Giant cells in phyllodes tumour of breast: a diagnostic dilemma

  • Kiran Agrawal Lady Hardinge Medical College, Delhi
  • Khushboo Dewan
  • Shailaja Shukla Professor Department of Pathology Lady Hardinge Medical College, Delhi
Keywords: Phyllodes tumor, Multinucleate giant cells, Ki-67 index


Phyllodes tumour (PT) accounts for 0.3-1% of all primary tumours of the breast. Classification of PT into benign, borderline and malignant types is important in determining the prognosis of the disease. Occurrence of multi-nucleate giant cells (MNGC) in PT is a rare occurrence.  Two types of MNGC have been described in mammary neoplasms, the multinucleate stromal giant cells (MNSGC) and the osteoclast-like giant cells (OLGC). Of thirteen cases of Phyllodes tumour (PT) with MNGC reported till date, eleven possessed pleomorphic, bizarre-appearing MNSGC and two had bland-looking OLGC. We present a case of borderline PT with multiple foci of both MNSGC and OLGC intermixed together in a hypervascular stromal background. To the best of our knowledge, such a case has not been reported earlier. The case also highlights the dilemma in grading of PT in the presence of many pleomorphic MNSGC. In these cases, Ki-67 proliferation index is important as it is not increased in the otherwise pleomorphic and bizarre-appearing MNSGC. It is also similar to the surrounding stromal cells, implying that MNSGC do not represent a more malignant population of cells. The case details along with a brief review of literature are presented.

Author Biographies

Kiran Agrawal, Lady Hardinge Medical College, Delhi
ProfessorDepartment of PathologyLady Hardinge Medical College, Delhi
Khushboo Dewan
Senior ResidentDepartment of PathologyLady Hardinge Medical College, Delhi 


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Case Report