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Pathology Cartoon of the Day -

Three Faces of Multinucleated Giant Cells in Pathology

"Cartoon: Giant and the Pathologist "

Dr Sampurna Roy MD


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A wide range of multinucleated giant cells have been described in pathology.

In this fun post I have used cartoons and histopathology images to explain the three main types of multinucleated giant cells.

(1) Langhans Giant Cells

(2) Touton Giant Cells

(3) Foreign Body Giant Cells





Giant cells are formed by fusion of macrophages.


1) Langhans Giant Cells:





In Langhans giant cell the nuclei are disposed to the periphery of the cell in the form of a horse shoe. These are conspicuous in lesions of Tuberculosis.




They are also formed in response to certain other organisms. Example: Fungal infections, leprosy, leishmanisis and syphilis can also lead to Langhans giant cell formation.


2) Touton Giant Cells



Touton giant cells are another type of multinucleated giant cells derived from macrophages and contain lipid.




In Touton giant cells the nuclei are arranged in a wreath like pattern. Its peripheral cytoplasm has a foamy or vacuolated appearance due to lipid and nuclei surrounds central area of eosinophilic cytoplasm.




Touton giant cells are found in xanthoma, xanthogranuloma and fat necrosis.


3) Foreign- Body Giant Cells




Foreign-body giant cells are frequently seen around exogenous foreign material like catgut, silk, talc, silica and plastic sponges.

They are also present around endogenous debris as sequestra, keratin, cholesterol crystals and uric acid crystals (in gout).




In foreign-body giant cells the nuclei are scattered haphazardly throughout the cytoplasm and some are present centrally and in close clusters. 




It is evident that monocytes can be regarded as undifferentiated cells that are released from the bone marrow, circulate in the blood stream and subsequently invade areas of damage and inflammation.

Here they differentiate into macrophages tend to aggregate to form follicles, and cells differentiate into epithelioid cells and "Giant Cells".



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Dr  Sampurna Roy  MD

Consultant Histopathologist (Kolkata - India)








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