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Four cases of giant cell reparative granuloma (GCRG) of small bones were analysed in order to determine the pathogenesis of the lesion and the nature of the component mononuclear and multinucleated cells. In cell cultures, giant cells formed a non-proliferating homogeneous population which expressed features characteristic of the osteoclast phenotype, including leucocyte common antigen, CD68, vitronectin receptor, and tartrate-resistant acid phosphatase. The giant cells were capable of lacunar resorption and their activity was inhibited by calcitonin. In addition to numerous macrophage-like cells, some of which expressed osteoclast phenotypic characteristics, there were also mononuclear stromal cells which proliferated in culture and were alkaline phosphatase-positive; these cells expressed receptor activator of NF-kappaB ligand (RANKL) and were capable of supporting human osteoclast formation from circulating precursors in vitro. These findings suggest that the osteoclast-like giant cells in GCRG of small bones are formed from monocyte/macrophage-like osteoclast precursors which differentiate into osteoclasts under the influence of mononuclear osteoblast-like stromal cells.

Original publication

DOI

10.1002/path.1184

Type

Journal article

Journal

The Journal of pathology

Publication Date

09/2002

Volume

198

Pages

30 - 36

Addresses

Nuffield Department of Orthopaedic Surgery, University of Oxford, Nuffield Orthopaedic Centre, Oxford OX3 7LD, UK.

Keywords

Hallux, Hand, Macrophages, Osteoclasts, Stromal Cells, Giant Cells, Humans, Bone Diseases, Granuloma, Giant Cell, Calcitonin, Cell Culture Techniques, Immunophenotyping, Cell Communication, Cell Differentiation, Adult, Middle Aged