Published online Sep 16, 2023. doi: 10.12998/wjcc.v11.i26.6091
Peer-review started: June 25, 2023
First decision: July 18, 2023
Revised: August 16, 2023
Accepted: August 25, 2023
Article in press: August 25, 2023
Published online: September 16, 2023
Multinucleated giant cells (MGCs) in bladder carcinomas are poorly studied.
To describe the function, morphogenesis, and origin of mononuclear and MGCs in urothelial carcinoma (UC) of the bladder in Bulgarian and French patients.
Urothelial bladder carcinomas (n = 104) from 2016-2020 were analyzed retrospec
We confirm that MGCs in the mucosa in UC of the bladder were positive for both mesenchymal and myofibroblast markers (vimentin, smooth muscle actin, Desmin, and CD34) and the macrophage marker CD68. Furthermore, IHC studies revealed the following profile of these cells: Positive for p16; negative for epithelial (CK AE1/AE3 and GATA-3), vascular (CD31), neural (PS100 and C-KIT), cambial, blastic (CD34-blasts and C-KIT), and immune markers (IG G, immunoglobulin G4, and PD-L1); no proliferative activity, possess no specific immune function, and cannot be used to calculate the Combined Positive Score scale.
In conclusion, the giant stromal cells in non-tumor and tumor bladder can be used as a characteristic and relatively constant, although nonspecific, histological marker for chronic bladder damage, reflecting the chronic irritation or inflammation. Likewise, according to the morphological and IHC of the mono- and multinucleated giant cells in the bladder, they are most likely represent telocytes capable of adapting their morphology to the pathology of the organ.
Core Tip: Based on our results and data from the literature, we have developed and proposed an algorithm of histological, histochemical, and immunohistochemical (IHC) criteria, and also a generalized algorithm for the differential diagnosis of multinucleated giant cells (MGCs) in bladder urothelial carcinoma and benign or malignant lesions of other visceral organs. According to the data obtained by us in the morphological and IHC study, MGCS are modified telocytes. The reason for this modification is the chronic damage to the bladder mucosa (regardless of the etiological factor), which leads to the fusion of telocytes and their transformation into multinucleated cells. At the same time, they lose C-kit expression, penetrate phagocytic function, and begin to express p16, which is, as described in detail above, a sign of cellular aging.