YOU BE THE PATHOLOGIST!
What are these (*) large cells, considered to be one of the main inflammatory cells at the tissue-device interface? (Scale bar: 25 µm)
ANSWER
These are multinucleated giant cells!
Multinucleated giant cells are the dominant responders to biomaterial implantation. Other inflammatory cells can also be observed (lymphocytes, macrophages, plasma cells). The evaluation of cell type and severity of the inflammation are critical in assessment of local tolerance by medical device pathologists.
They are derived from « frustrated » macrophages which are unable to degrade a foreign body and so fuse to increase their phagocytosis ability. They are expected when foreign material is implanted, but some materials elicit an even greater multinucleated giant cell response than others. For example, sutures, such as are present in the field shown, are known to elicit a powerful inflammatory response.
H&ES, Original magnification: x40, scale bar: 25 μm.
*: Multinucleated giant cell
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