Difference between revisions of "Diffuse tenosynovial giant-cell tumour"

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| Synonyms  = pigmented villonodular synovitis (PVNS) - old term
| Synonyms  = pigmented villonodular synovitis (PVNS) - old term
| Micro      = nodules composed of cells with abundant cytoplasm & pale nuclei, multinucleated giant cells, hemosiderin-laden macrophages, foam cells
| Micro      = nodules composed of cells with abundant cytoplasm & pale nuclei, multinucleated giant cells, hemosiderin-laden macrophages, foam cells
| Subtypes  =
| Subtypes  = generalized, localized (articular, extra-articular)
| LMDDx      = [[giant cell lesions]], others
| LMDDx      = [[giant cell lesions]], others
| Stains    =
| Stains    =
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| Molecular  =
| Molecular  =
| IF        =
| IF        =
| Gross      = pigmented
| Gross      = pigmented, articular or extra-articular
| Grossing  =
| Grossing  =
| Site      = large [[joints]] - esp. knee or hip; occ. extra-articular
| Site      = large [[joints]] - esp. knee or hip; occ. extra-articular
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| Signs      =
| Signs      =
| Symptoms  =
| Symptoms  =
| Prevalence =  
| Prevalence = uncommon
| Bloodwork  =
| Bloodwork  =
| Rads      =
| Rads      =
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**Occasionally malignant.<ref name=pmid22827766>{{Cite journal  | last1 = Kondo | first1 = R. | last2 = Akiba | first2 = J. | last3 = Hiraoka | first3 = K. | last4 = Hisaoka | first4 = M. | last5 = Hashimoto | first5 = H. | last6 = Kage | first6 = M. | last7 = Yano | first7 = H. | title = Malignant diffuse-type tenosynovial giant cell tumor of the buttock. | journal = Pathol Int | volume = 62 | issue = 8 | pages = 559-64 | month = Aug | year = 2012 | doi = 10.1111/j.1440-1827.2012.02838.x | PMID = 22827766 }}</ref><ref name=pmid18301053>{{Cite journal  | last1 = Li | first1 = CF. | last2 = Wang | first2 = JW. | last3 = Huang | first3 = WW. | last4 = Hou | first4 = CC. | last5 = Chou | first5 = SC. | last6 = Eng | first6 = HL. | last7 = Lin | first7 = CN. | last8 = Yu | first8 = SC. | last9 = Huang | first9 = HY. | title = Malignant diffuse-type tenosynovial giant cell tumors: a series of 7 cases comparing with 24 benign lesions with review of the literature. | journal = Am J Surg Pathol | volume = 32 | issue = 4 | pages = 587-99 | month = Apr | year = 2008 | doi = 10.1097/PAS.0b013e318158428f | PMID = 18301053 }}</ref><ref name=pmid10757395>{{Cite journal  | last1 = Somerhausen | first1 = NS. | last2 = Fletcher | first2 = CD. | title = Diffuse-type giant cell tumor: clinicopathologic and immunohistochemical analysis of 50 cases with extraarticular disease. | journal = Am J Surg Pathol | volume = 24 | issue = 4 | pages = 479-92 | month = Apr | year = 2000 | doi =  | PMID = 10757395 }}</ref>
**Occasionally malignant.<ref name=pmid22827766>{{Cite journal  | last1 = Kondo | first1 = R. | last2 = Akiba | first2 = J. | last3 = Hiraoka | first3 = K. | last4 = Hisaoka | first4 = M. | last5 = Hashimoto | first5 = H. | last6 = Kage | first6 = M. | last7 = Yano | first7 = H. | title = Malignant diffuse-type tenosynovial giant cell tumor of the buttock. | journal = Pathol Int | volume = 62 | issue = 8 | pages = 559-64 | month = Aug | year = 2012 | doi = 10.1111/j.1440-1827.2012.02838.x | PMID = 22827766 }}</ref><ref name=pmid18301053>{{Cite journal  | last1 = Li | first1 = CF. | last2 = Wang | first2 = JW. | last3 = Huang | first3 = WW. | last4 = Hou | first4 = CC. | last5 = Chou | first5 = SC. | last6 = Eng | first6 = HL. | last7 = Lin | first7 = CN. | last8 = Yu | first8 = SC. | last9 = Huang | first9 = HY. | title = Malignant diffuse-type tenosynovial giant cell tumors: a series of 7 cases comparing with 24 benign lesions with review of the literature. | journal = Am J Surg Pathol | volume = 32 | issue = 4 | pages = 587-99 | month = Apr | year = 2008 | doi = 10.1097/PAS.0b013e318158428f | PMID = 18301053 }}</ref><ref name=pmid10757395>{{Cite journal  | last1 = Somerhausen | first1 = NS. | last2 = Fletcher | first2 = CD. | title = Diffuse-type giant cell tumor: clinicopathologic and immunohistochemical analysis of 50 cases with extraarticular disease. | journal = Am J Surg Pathol | volume = 24 | issue = 4 | pages = 479-92 | month = Apr | year = 2000 | doi =  | PMID = 10757395 }}</ref>
*''[[Giant cell tumour of the tendon sheath]]'' is considered to be the soft-tissue counterpart of PVNS.<ref>URL: [http://emedicine.medscape.com/article/1253223-overview http://emedicine.medscape.com/article/1253223-overview]. Accessed on: 6 January 2011.</ref>
*''[[Giant cell tumour of the tendon sheath]]'' is considered to be the soft-tissue counterpart of PVNS.<ref>URL: [http://emedicine.medscape.com/article/1253223-overview http://emedicine.medscape.com/article/1253223-overview]. Accessed on: 6 January 2011.</ref>
Subclassification:<ref name=pmid10725067>{{Cite journal  | last1 = Perka | first1 = C. | last2 = Labs | first2 = K. | last3 = Zippel | first3 = H. | last4 = Buttgereit | first4 = F. | title = Localized pigmented villonodular synovitis of the knee joint: neoplasm or reactive granuloma? A review of 18 cases. | journal = Rheumatology (Oxford) | volume = 39 | issue = 2 | pages = 172-8 | month = Feb | year = 2000 | doi =  | PMID = 10725067 }}
</ref>
*Generalized PVNS.
*Localized PVNS.<ref name=pmid12876042>{{Cite journal  | last1 = Huang | first1 = GS. | last2 = Lee | first2 = CH. | last3 = Chan | first3 = WP. | last4 = Chen | first4 = CY. | last5 = Yu | first5 = JS. | last6 = Resnick | first6 = D. | title = Localized nodular synovitis of the knee: MR imaging appearance and clinical correlates in 21 patients. | journal = AJR Am J Roentgenol | volume = 181 | issue = 2 | pages = 539-43 | month = Aug | year = 2003 | doi = 10.2214/ajr.181.2.1810539 | PMID = 12876042 }}</ref>
**Articular.
**Extra-articular.


==Gross==
==Gross==
*Typically knee or hip.<ref name=pmid10524485>{{Cite journal  | last1 = Frassica | first1 = FJ. | last2 = Bhimani | first2 = MA. | last3 = McCarthy | first3 = EF. | last4 = Wenz | first4 = J. | title = Pigmented villonodular synovitis of the hip and knee. | journal = Am Fam Physician | volume = 60 | issue = 5 | pages = 1404-10; discussion 1415 | month = Oct | year = 1999 | doi =  | PMID = 10524485 | URL = http://www.aafp.org/afp/1999/1001/p1404.html }}</ref>
*Typically knee or hip.<ref name=pmid10524485>{{Cite journal  | last1 = Frassica | first1 = FJ. | last2 = Bhimani | first2 = MA. | last3 = McCarthy | first3 = EF. | last4 = Wenz | first4 = J. | title = Pigmented villonodular synovitis of the hip and knee. | journal = Am Fam Physician | volume = 60 | issue = 5 | pages = 1404-10; discussion 1415 | month = Oct | year = 1999 | doi =  | PMID = 10524485 | URL = http://www.aafp.org/afp/1999/1001/p1404.html }}</ref>
*May be extra-articular.<ref name=pmid10757395/>
*May be extra-articular.<ref name=pmid10757395/>
Note:
*Localized form - classically fat pad inferior to patella.<ref name=pmid23798766/>


==Microscopic==
==Microscopic==
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*Degenerative changes ([[osteoarthritis]]).
*Degenerative changes ([[osteoarthritis]]).
*[[Rheumatic joint disease|Rheumatic disease]].
*[[Rheumatic joint disease|Rheumatic disease]].
*[[Localized nodular synovitis]] - histology very similar.<ref name=pmid12876042>{{Cite journal  | last1 = Huang | first1 = GS. | last2 = Lee | first2 = CH. | last3 = Chan | first3 = WP. | last4 = Chen | first4 = CY. | last5 = Yu | first5 = JS. | last6 = Resnick | first6 = D. | title = Localized nodular synovitis of the knee: MR imaging appearance and clinical correlates in 21 patients. | journal = AJR Am J Roentgenol | volume = 181 | issue = 2 | pages = 539-43 | month = Aug | year = 2003 | doi = 10.2214/ajr.181.2.1810539 | PMID = 12876042 }}</ref>


===Images===
===Images===
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*[http://path.upmc.edu/cases/case251/micro.html PVNS - several images (upmc.edu)].
*[http://path.upmc.edu/cases/case251/micro.html PVNS - several images (upmc.edu)].
*[http://www.webpathology.com/image.asp?case=357&n=2 PVNS (webpathology.com)].
*[http://www.webpathology.com/image.asp?case=357&n=2 PVNS (webpathology.com)].
 
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3687912/figure/F4/ Localized nodular synovitis (nih.gov)].<ref name=pmid23798766>{{Cite journal  | last1 = Park | first1 = JH. | last2 = Ro | first2 = KH. | last3 = Lee | first3 = DH. | title = Localized nodular synovitis of the infrapatellar fat pad. | journal = Indian J Orthop | volume = 47 | issue = 3 | pages = 313-6 | month = May | year = 2013 | doi = 10.4103/0019-5413.111514 | PMID = 23798766 }}</ref>
==Molecular==
==Molecular==
*Clonal - overexpresses CSF1.<ref name=pmid22849738>{{Cite journal  | last1 = Lucas | first1 = DR. | title = Tenosynovial giant cell tumor: case report and review. | journal = Arch Pathol Lab Med | volume = 136 | issue = 8 | pages = 901-6 | month = Aug | year = 2012 | doi = 10.5858/arpa.2012-0165-CR | PMID = 22849738 }}</ref>
*Clonal - overexpresses CSF1.<ref name=pmid22849738>{{Cite journal  | last1 = Lucas | first1 = DR. | title = Tenosynovial giant cell tumor: case report and review. | journal = Arch Pathol Lab Med | volume = 136 | issue = 8 | pages = 901-6 | month = Aug | year = 2012 | doi = 10.5858/arpa.2012-0165-CR | PMID = 22849738 }}</ref>
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