FIGURE 2:
- First histopathologic exam with diagnostic of “Suggestive of
Paraganglioma” showing, a mass consisting of strands of rounded
cells, with eosinophilic cytoplasm, oval nuclei and some areas of
hemorrhage and necrosis.
- CD68 positive marker showing macrophage activity and some interpose
multinucleated giant cells, in the first biopsy.
- H3.3G34W negative marker showing no activity for GCTB 4 years ago.
FIGURE 3: New histopathological features of the surgical
specimen 4 years after. This tumor was characterized by proliferation of
vascular spaces and fibroblastic cells with discrete collagen fibers and
areas of hemorrhage surrounded by a large number of multinucleated giant
cells, some with disorganized nuclei (A, B, C and D -
asterisk ), others similar to Touton giant cells (E - arrow ),
and different areas with osteoid material (arrow ). A large
proliferation of xanthomatous-looking cells was also observed
(F ), positive for periodic acid–Schiff staining (PAS, x200).