Giant cell tumour of tendon sheath
| Giant cell tumour of tendon sheath | |
|---|---|
| Diagnosis in short | |
 GCT of tendon sheath. H&E stain. | |
|
| |
| LM | foam cells, multinucleated giant cells (may be scarce), +/-tendon, +/-hemosiderin-laden macrophages |
| LM DDx | giant cell lesions |
| Gross | circumscribed mass - yellow-brown to tan |
| Site | hand - classic site |
|
| |
| Prognosis | good (benign), can be malignant (rare) |
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.
Fibroma of tendon sheath (abbreviated FTS) redirect to this article.
General
- Can be thought of as the small joint version of diffuse tenosynovial giant-cell tumour (AKA PVNS).[1]
- Rarely recur.
- Classically afflicts the hand.[2]
- Rarely malignant.[3][4]
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:
- Giant cell lesions.
- Plexiform fibrohistiocytoma.[citation needed]
- Fibroma of tendon sheath (FTS) - if one believes it is a separate entity.[6]
- IHC suggests FTS and GCT of tendon sheath are one entity.[7]
Images
GCT of tendon sheath - intermed. mag. (WC)
GCT of tendon sheath - high mag. (WC)
GCT of tendon sheath - very high mag. (WC)
GCT of tendon sheath. (WC/KGH)
.jpg)
www:
- GCT of tendon sheath - very low mag. (webpathology.com)
- GCT of tendon sheath - low mag. (webpathology.com).
- GCT of tendon sheath - high mag. (webpathology.com).
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Submitted as "Giant Cell Tumour Right Long Finger", Excision: - Giant cell tumour of tendon sheath.
Block letters
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 histiocyte-like cells 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
- ↑ 1.0 1.1 1.2 Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 341-2. ISBN 978-0470519035.
- ↑ 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.
- ↑ 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.
- ↑ 4.0 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.
- ↑ 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.
- ↑ Heckert, R.; Bear, J.; Summers, T.; Frew, M.; Gwinn, D.; McKay, P. (Dec 2012). "Fibroma of the tendon sheath - a rare hand tumor.". Pol Przegl Chir 84 (12): 651-6. doi:10.2478/v10035-012-0107-z. PMID 23399633.
- ↑ Maluf, HM.; DeYoung, BR.; Swanson, PE.; Wick, MR. (Feb 1995). "Fibroma and giant cell tumor of tendon sheath: a comparative histological and immunohistological study.". Mod Pathol 8 (2): 155-9. PMID 7777476.