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Inability to validate an association between CD23 expression and site or grade of follicular lymphoma

tissue in various settings, with the foreign body type being the most common type of giant cell usually associated with foreign body or granulomatous inflammatory reactions. Fibroepithelial breast lesions and breast carcinomas associated with multinucleated stromal giant cells and osteoclast-like giant cells (OGCs) are also well documented. In situ breast carcinomas with multinucleated giant cells are extremely rare. Kirshnan and Longacre have reported a case of DCIS with OGCs without an invasive component in which giant cell formation was caused by peripheral monocyte recruitment and transformation into OGCs as a result of cytokine stimuli of tumour cells analogously to its invasive counterpart. In contrast, Coyne has described four cases of DCIS and lobular carcinoma in situ (LCIS) with multinucleated tumour giant cells, in which occurrence of giant cells was probably the result of aneuploidy or polyploidy of tumour cells analogous to those more easily found malignant multinucleated cells in invasive carcinomas with tumour giant cells. In the case presented here the formation of foreign body giant cells was part of a morphological spectrum of extensive fibrous obliteration of in situ carcinoma, also known as the ‘healing’ phenomenon referred to by Muir and Aitkenhead. The cause of extensive periductal fibrosis with occasional ‘healing’ of carcinomatous foci is not clear and probably represents the host response to the tumour or its products. The finding of foreign body giant cells with intracytoplasmic debris in ‘healed’ ducts and their propagation to non-fibrotic neoplastic ducts are probably a secondary inflammatory phenomenon. When the tissue core biopsy is performed on a small target of in situ carcinoma, only ‘healing’ areas with no carcinomatous cells may be found. In such cases, the pathologists aware of this phenomenon should consider the possibility that the areas of high-grade in situ carcinoma may still exist in the breast tissue around fibrous foci.