Touton-like giant cells in periapical granulomas

Two types of multinucleated giant cells were observed in periapical granulomas--the foreign body type and the Touton type. In the Touton type, the nuclei were near the center of the cell, surrounded by foamy cytoplasm. Both types of giant cells reacted positively to lysozyme, alpha 1-antitrypsin and alpha 1-antichymotrypsin, indicating their histiocytic origin.