Stromal Giant Cells / Mast Cells / Neutrophils / Multinucleate Plasma Cells

Stromal Giant Cells Feature:

Multinucleate or otherwise enlarged cells within the stroma not associated with particles of detritus

Mast Cells Feature:

Round or oval cells with granular blue cytoplasm and a single round or oval nucleus, imparting a “fried-egg” appearance

Neutrophils Feature:

Polymorphonuclear leukocytes within the tissue either around vessels, within granulation tissue, or within the interstitium or synovium.

Multinucleate Plasma Cell Feature:

Plasma cell with two or more nucleii

Magnification: 40x or scan at 10x and confirm at 20x

Grading:

Stromal Giant Cell

0: None (88%)
1: Present (12%)

Mast Cell

0: None (68%)
1: Present (32%)

Neutrophil

0: None (86%)
1: Granulation Tissue (0%)
2: Interstitial (14%)

Multinucleate Plasma Cell

0: None
1: Present

Stromal Giant Cell | Mast Cell | Neutrophil | Multinucleate Plasma Cell

Stromal Giant Cell: One large cell with a c-shaped group of 4 nuclei is apparent in this image of hypercellular stroma.

Mast Cell: Mast cells have a single oval nucleus placed centrally or peripherally within cytoplasm that has fine blue-staining granules. This image has at least 3 mast cells (2 in the center and 1 in upper left corner). Granular plasma cells may mimic mast cells.

Neutrophils: The neutrophils in this image are at the base of fibrin, but may be seen in the lining layer, and are not associated with necrosis. In granulation tissue, their presence may be indicative of infection.

Multinucleate Plasma Cell: Plasma cells that contain 2 nuclei are visible to the left and right of center in this sheet of plasma cells and have typical nuclear morphology. Large cells with 3 or more nuclei may also be seen in other cases.

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