EVALUATION OF DEVELOPMENT AND GROWTH OF PERIPHERAL GIANT CELL GRANULOMA USING OSTEOCALCIN, CD68, CD34, AND KI-67 MARKERS

Peripheral giant cell granuloma of jaws is considered as a reactive lesion. This lesion is characterized by the presence of multiple multinucleated giant cells (MNGCs) in addition to mononuclear cells. The origin of the multinucleated giant cells is controversial.
Objective: Assessment of the expression of CD34, CD68 and osteocalcin in peripheral giant cell granulomas to clarify the origin of MNGCs and to determine Ki-67 positive cells which are responsible for the growth of the lesion.
Materials and Methods: In this study, nineteen cases of peripheral giant cell granuloma presented in Oral and Maxillofacial Surgery Department and were treated by surgical excision. Five sections were prepared from a paraffin-embedded specimen of each case and stained with Haematoxylin and Eosin (H&E), CD68, CD34, Ki-67, and osteocalcin.
Results: Ki-67, showed positive expression in mononuclear cells and few multinucleated giant cells.CD34 showed negative expression in mononuclear cells and multinucleated cells, while it showed positive results in endothelial cells of the blood vessels. CD 68 showed positive expression in multinucleated cells and few stromal cells. Osteocalcin (OC); bone formation marker showed positive expression in MNGCs and bone trabeculae.
Conclusions: These results suggest that multinucleated giant cells are osteoclastic in nature and may derive from monocyte/macrophage lineage and not the endothelial cells. Additionally, we underlined the importance of mononuclear cells in the growth of these lesions while multinucleated cells showed no role in their growth and their presence is considered reactive.