파골세포양 거대세포형 미분화 암종은 췌장암의 1%만을 차지하는 흔치 않은 암종으로 알려져 있다. 저자들은 39세 남자에게서 진단된, 수술 및 항암치료를 시행한 1예를 소개하고자 한다.

췌장의 파골세포양 거대세포 미분화 암종은 그 발생 빈도는 드물지만 높은 악성도를 가지는 외분비 췌장암이다. 췌장 의 파골세포양 거대세포 미분화 암종은, 복부 전산화단층촬 영에서 괴사와 출혈을 동반한 낭성 및 고형 종괴의 소견을 보이며, 다른 췌장의 낭성 종양과 감별이 필요하다. 현재까 지 명확하게 정립된 치료법은 없으며, 조기 진단 및 종양의 완전 절제만이 생존률 향상을 가져온다고 보고되고 있다. 본 증례는 58세 남성 환자에서 발생한 췌장의 파골세포양 거대 세포 미분화 암종이 수술 및 항암치료에도 불구하고 연조직 전이로 진행하여 사망한 1예로 문헌고찰과 함께 보고한다.

Multinucleated giant cells appear in a variety forms in different types of oral lesion. However, their nature is still not well understood. Thus, to address this issue, the immunohistochemical characteristics of inflammatory giant cells (Langhans’ giant cells in lesions of tuberculosis and foreign body giant cells in odontogenic keratocysts and squamous cell carcinomas) and tumor giant cells in central giant cell granulomas were compared with those of osteoclasts, the normal giant cell, using a panel of macrophage and osteoclast marker antibodies, such as calcitonin receptor (CT-R), c-Src, Cathepsin K (Cath-K), CD14, RANK, and c-fms. The foreign body giant cells around cholesterol clefts in inflamed odontogenic keratocysts revealed more macrophage-like characteristics than the foreign body giant cells resorbing keratin pearls in squamous cell carcinomas. As such, both cases of foreign body giant cell exhibited immunoreactivity for the macrophage markers, such as CD14, RANK, and c-fms, yet only the latter case exhibited immunoreactivity for the osteoclast markers, such as CT-R and c-Src. Moreover, both cases of foreign body giant cells were positive for TRAP activity, yet negative for Cathepsin K activity. In contrast, the other inflammatory giant cells, Langhans’ giant cells, exhibited immunoreactivity for both the macrophage and osteoclast markers, yet were negative for TRAP activity. Meanwhile, the giant cells in the central giant cell granulomas reacted positively to both the macrophage and osteoclast markers, and were also positive for TRAP activity. Accordingly, these findings suggest that the immunoprofiles of giant cells in oral lesions vary according to the nature of the lesion, despite shared osteoclast and macrophage characteristics. Furthermore, the giant cells in tumorous lesions closely associated with bony destruction revealed more osteoclastic characteristics and their enzyme components were different according to the nature of the lesion