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| ==Giant cell tumour of tendon sheath== | | ==Giant cell tumour of tendon sheath== |
| *Abbreviated ''GCT of tendon sheath''. | | *Abbreviated ''GCT of tendon sheath''. |
| ===General===
| | {{Main|Giant cell tumour of tendon sheath}} |
| *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>
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| *Rarely recur.
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| *Classically afflicts the hand.<ref name=Ref_WMSP612>{{Ref WMSP|612}}</ref>
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| *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>
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| ===Gross===
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| Features:<ref name=Ref_WMSP612>{{Ref WMSP|612}}</ref>
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| *Circumscribed mass - yellow-brown to tan.
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| Note:
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| *May be associated with bony erosions in larger lesions.<ref name=Ref_WMSP612>{{Ref WMSP|612}}</ref>
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| Image:
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| *[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>
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| ===Microscopic===
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| Features:<ref name=Ref_DCHH341>{{Ref DCHH|341-2}}</ref>
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| *Foam cells.
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| **Cells with moderate to abundant foamy-appearing cytoplasm.
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| *Multinucleated giant cells - may be scarce.
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| *+/-Tendon.
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| **Dense connective tissue.
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| *+/-Hemosiderin-laden macrophages.
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| Note:
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| *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>
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| DDx:
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| *[[Giant cell lesions]].
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| ====Images====
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| <gallery>
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| Image:Giant_cell_tumor_of_tendon_sheath_histopathology%281%29.jpg | GCT of tendon sheath. (WC/KGH)
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| </gallery>
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| www:
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| *[http://www.webpathology.com/image.asp?n=1&Case=484 GCT of tendon sheath - very low mag. (webpathology.com)]
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| *[http://www.webpathology.com/image.asp?case=484&n=5 GCT of tendon sheath - low mag. (webpathology.com)].
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| *[http://www.webpathology.com/image.asp?n=4&Case=484 GCT of tendon sheath - high mag. (webpathology.com)].
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| ===Sign out===
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| <pre>
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| LESION, RIGHT INDEX FINGER, EXCISION:
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| - GIANT CELL TUMOUR OF THE TENDON SHEATH.
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| </pre>
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| ====Micro====
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| 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.
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| =====Alternate=====
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| The sections show histiocytes and rare multinucleated giant cells on a background of dense
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| connective tissue compatible with tendon. Hemosiderin-laden macrophages are present. No
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| nuclear atypia is apparent. No mitotic activity is apparent.
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| ==Adamantinoma== | | ==Adamantinoma== |