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Giant cell tumour of tendon sheath (view source)
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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== | |||
*Can be thought of as the small joint version of [[diffuse tenosynovial giant-cell tumour]] ([[AKA]] ''PVNS'').<ref name=Ref_DCHH341>{{Ref DCHH|341}}</ref> | |||
*Rarely recur. | |||
*Classically afflicts the hand.<ref name=Ref_WMSP612>{{Ref WMSP|612}}</ref> | |||
*Rarely malignant.<ref name=pmid19094761>{{Cite journal | last1 = Pan | first1 = YW. | last2 = Huang | first2 = XY. | last3 = You | first3 = JF. | last4 = Tian | first4 = GL. | last5 = Li | first5 = C. | title = [Malignant giant cell tumor of the tendon sheaths in the hand]. | journal = Zhonghua Wai Ke Za Zhi | volume = 46 | issue = 21 | pages = 1645-8 | month = Nov | year = 2008 | doi = | PMID = 19094761 }}</ref><ref name=pmid8230758>{{Cite journal | last1 = Shinjo | first1 = K. | last2 = Miyake | first2 = N. | last3 = Takahashi | first3 = Y. | title = Malignant giant cell tumor of the tendon sheath: an autopsy report and review of the literature. | journal = Jpn J Clin Oncol | volume = 23 | issue = 5 | pages = 317-24 | month = Oct | year = 1993 | doi = | PMID = 8230758 }}</ref> | |||
==Gross== | |||
Features:<ref name=Ref_WMSP612>{{Ref WMSP|612}}</ref> | |||
*Circumscribed mass - yellow-brown to tan. | |||
Note: | |||
*May be associated with bony erosions in larger lesions.<ref name=Ref_WMSP612>{{Ref WMSP|612}}</ref> | |||
Image: | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3122708/figure/Fig2/ GCT of tendon sheath (nih.gov)].<ref name=pmid22282671>{{Cite journal | last1 = Suresh | first1 = SS. | last2 = Zaki | first2 = H. | title = Giant cell tumor of tendon sheath: case series and review of literature. | journal = J Hand Microsurg | volume = 2 | issue = 2 | pages = 67-71 | month = Dec | year = 2010 | doi = 10.1007/s12593-010-0020-9 | PMID = 22282671 }}</ref> | |||
==Microscopic== | |||
Features:<ref name=Ref_DCHH341>{{Ref DCHH|341-2}}</ref> | |||
*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,<ref name=pmid8230758>{{Cite journal | last1 = Shinjo | first1 = K. | last2 = Miyake | first2 = N. | last3 = Takahashi | first3 = Y. | title = Malignant giant cell tumor of the tendon sheath: an autopsy report and review of the literature. | journal = Jpn J Clin Oncol | volume = 23 | issue = 5 | pages = 317-24 | month = Oct | year = 1993 | doi = | PMID = 8230758 }}</ref> abnormal mitoses, >10 mitoses/[[HPF]], tumour necrosis lack of maturation to superficial part (nuclei shrink, cytoplasm lipid-ified).<ref name=Ref_DCHH341>{{Ref DCHH|341-2}}</ref> | |||
DDx: | |||
*[[Giant cell lesions]]. | |||
===Images=== | |||
<gallery> | |||
Image:Giant_cell_tumor_of_tendon_sheath_histopathology%281%29.jpg | GCT of tendon sheath. (WC/KGH) | |||
</gallery> | |||
www: | |||
*[http://www.webpathology.com/image.asp?n=1&Case=484 GCT of tendon sheath - very low mag. (webpathology.com)] | |||
*[http://www.webpathology.com/image.asp?case=484&n=5 GCT of tendon sheath - low mag. (webpathology.com)]. | |||
*[http://www.webpathology.com/image.asp?n=4&Case=484 GCT of tendon sheath - high mag. (webpathology.com)]. | |||
==Sign out== | |||
<pre> | |||
LESION, RIGHT INDEX FINGER, EXCISION: | |||
- GIANT CELL TUMOUR OF THE TENDON SHEATH. | |||
</pre> | |||
===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== | |||
*[[Chondro-osseous tumours]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Chondro-osseous tumours]] | |||