Giant cell tumour of tendon sheath

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Giant cell tumour of tendon sheath is a relatively common tumour of small joints. It is grouped with the chondro-osseous tumours. It is abbreviated GCT of tendon sheath.

General

Gross

Features:[2]

  • Circumscribed mass - yellow-brown to tan.

Note:

  • May be associated with bony erosions in larger lesions.[2]

Image:

Microscopic

Features:[1]

  • Foam cells.
    • Cells with moderate to abundant foamy-appearing cytoplasm.
  • Multinucleated giant cells - may be scarce.
  • +/-Tendon.
    • Dense connective tissue.
  • +/-Hemosiderin-laden macrophages.

Note:

  • Features of malignancy: nuclear pleomorphism,[4] abnormal mitoses, >10 mitoses/HPF, tumour necrosis lack of maturation to superficial part (nuclei shrink, cytoplasm lipid-ified).[1]

DDx:

Images

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LESION, RIGHT INDEX FINGER, EXCISION:
- GIANT CELL TUMOUR OF THE TENDON SHEATH.

Micro

The sections show histiocytes and rare multinucleated giant cells on a background of dense connective tissue compatible with tendon. No nuclear atypia is apparent. Rare mitotic activity is identified. No atypical mitoses are apparent.

Alternate

The sections show histiocytes and rare multinucleated giant cells on a background of dense connective tissue compatible with tendon. Hemosiderin-laden macrophages are present. No nuclear atypia is apparent. No mitotic activity is apparent.

See also

References

  1. 1.0 1.1 1.2 Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 341. ISBN 978-0470519035. Cite error: Invalid <ref> tag; name "Ref_DCHH341" defined multiple times with different content Cite error: Invalid <ref> tag; name "Ref_DCHH341" defined multiple times with different content
  2. 2.0 2.1 2.2 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 612. ISBN 978-0781765275.
  3. Pan, YW.; Huang, XY.; You, JF.; Tian, GL.; Li, C. (Nov 2008). "[Malignant giant cell tumor of the tendon sheaths in the hand].". Zhonghua Wai Ke Za Zhi 46 (21): 1645-8. PMID 19094761.
  4. 4.0 4.1 Shinjo, K.; Miyake, N.; Takahashi, Y. (Oct 1993). "Malignant giant cell tumor of the tendon sheath: an autopsy report and review of the literature.". Jpn J Clin Oncol 23 (5): 317-24. PMID 8230758.
  5. Suresh, SS.; Zaki, H. (Dec 2010). "Giant cell tumor of tendon sheath: case series and review of literature.". J Hand Microsurg 2 (2): 67-71. doi:10.1007/s12593-010-0020-9. PMID 22282671.