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Difference between revisions of "Tenosynovium"
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'''Tenosynovium''' is a relatively common [[ditzel]]. | |||
=General= | |||
DDx: | |||
*[[Tenosynovitis]]. | |||
*Carpal tunnel syndrome. | |||
==Tenosynovitis== | |||
:''Stenosing tenosynovitis'' directs here. | |||
===General=== | |||
*Uncommon pathology specimen. | |||
*May cause ''trigger finger''.<ref name=pmid23396894>{{Cite journal | last1 = Vuillemin | first1 = V. | last2 = Guerini | first2 = H. | last3 = Bard | first3 = H. | last4 = Morvan | first4 = G. | title = Stenosing tenosynovitis. | journal = J Ultrasound | volume = 15 | issue = 1 | pages = 20-8 | month = Feb | year = 2012 | doi = 10.1016/j.jus.2012.02.002 | PMID = 23396894 }}</ref> | |||
===Microscopic=== | |||
Features:<ref name=pmid20442645>{{Cite journal | last1 = Shon | first1 = W. | last2 = Folpe | first2 = AL. | title = Tenosynovitis with psammomatous calcification: a poorly recognized pseudotumor related to repetitive tendinous injury. | journal = Am J Surg Pathol | volume = 34 | issue = 6 | pages = 892-5 | month = Jun | year = 2010 | doi = 10.1097/PAS.0b013e3181d95a36 | PMID = 20442645 }}</ref> | |||
*Dense connective tissue (tendon). | |||
*Histiocytes. | |||
*+/-[[Psammoma bodies]]. | |||
DDx: | |||
*Calcific tendinitis. | |||
*[[Giant cell tumour of the tendon sheath]]. | |||
*[[Palmar fibromatosis]]. | |||
===IHC=== | |||
Features: | |||
*CD68 +ve. | |||
*Beta-catenin -ve. | |||
Note: | |||
*Immunostains are usually not required for the diagnosis. | |||
===Sign out=== | |||
<pre> | |||
Tenosynovium, Left Wrist, Excision: | |||
- Dense connective tissue (consistent with tendon) with degenerative | |||
changes and lymphohistiocytic infiltrate. | |||
- NEGATIVE for apparent giant cells and NEGATIVE for calcification. | |||
- NEGATIVE for malignancy. | |||
</pre> | |||
====Block letters==== | |||
<pre> | |||
TENOSYNOVIUM, LEFT MIDDLE FINGER, EXCISION: | |||
- DENSE CONNECTIVE TISSUE (CONSISTENT WITH TENDON) WITH LYMPHOHISTIOCYTIC INFILTRATE. | |||
- NEGATIVE FOR GIANT CELLS. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
====Micro==== | |||
The sections show dense connective tissue (tendon) containing a cluster of cells with | |||
indistinct cellular borders, abundant foamy grey cytoplasm, and round/oval | |||
pale-staining nuclei with small nucleoli (histiocytes). The cell cluster has a small | |||
number of interspersed lymphocytes, and the centre of the cell cluster has acellular | |||
hyaline material (degenerative tendon). | |||
No calcification is identified. No giant cells are seen. | |||
No nuclear atypia is apparent and no mitotic activity is appreciated. | |||
=====Alternate===== | |||
The sections show dense connective tissue (tendon) containing rare histiocytes and | |||
lymphocytes. No calcification is identified. No giant cells are seen. No nuclear atypia | |||
is apparent and no mitotic activity is appreciated. | |||
==Carpal tunnel syndrome== | |||
===General=== | |||
*[[Clinical diagnosis]]. | |||
===Microscopic=== | |||
Features:<ref name=pmid10530852>{{Cite journal | last1 = Chell | first1 = J. | last2 = Stevens | first2 = A. | last3 = Davis | first3 = TR. | title = Work practices and histopathological changes in the tenosynovium and flexor retinaculum in carpal tunnel syndrome in women. | journal = J Bone Joint Surg Br | volume = 81 | issue = 5 | pages = 868-70 | month = Sep | year = 1999 | doi = | PMID = 10530852 }}</ref> | |||
*Tenosynovium with edema or fibrosis +/-myxoid degeneration | |||
===Sign out=== | |||
<pre> | |||
Tenosynovium, Excision: | |||
- Benign fibroconnective tissue with focal myxoid changes without | |||
significant inflammation. | |||
- NEGATIVE for evidence of malignancy. | |||
</pre> | |||
==See also== | |||
*[[Ditzels]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Ditzels]] | |||