Features of histological structure and differential diagnostics of the diffuse-type giant cell tumor and its malignant form.

Authors

  • E. A. Dyadyk P.L.Shupik National Medical Academy of Post-Graduate Education, Kyiv, Ukraine
  • A. V. Hryhorovska Institute of Traumatology and Orthopedics, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine

DOI:

https://doi.org/10.26641/1997-9665.2016.3.144-149

Keywords:

diffuse-type giant cell tumor, differential histologic diagnostics, criterions of malignancy

Abstract

Background. Tenosynovial giant cell tumor of diffuse type is one of the most widespread tumor of joints, causing destruction of the soft tissues and bone articular surfaces. Objective. The purpose of the study was to formulate approaches to histological differential diagnostics between diffuse-type giant cell tumor and its malignant forms. Methods. Tissues of 40 biopsies and resected foci of the affected joints and tendon sheaths from patients with diagnosis Tenosynovial giant cell tumor of diffuse type or malignant giant cell tumor. Results. Important diagnostic signs of malignancy are cellular atypia, such as changed histological architectonics, high mitotic activity, the areas of necrosis, prevalence of the increased cellularity with spindling forms and hyperchromic nuclei in mononuclear component. Our experience of histologic diagnostics confirms that diffuse-type giant cell tumor without obvious evidences of malignancy usually possesses 2-4 significant diagnostic signs for its differentiation with the malignant form of the given tumor. Conclusion: Practice of histologic differential diagnostics reveals considerable difficulties of interpretation of histologic features of diffuse-type giant cell tumor. Thus, further research and specification of criteria for its differential diagnostics are relevant.

References

  1. Fletcher C, Bridge JA, Hogendoorn PCW, Mertens F, editors. WHO Classification of Tumours of Soft Tissue and Bone. Lyon: International Agency for Research on Cancer; 2013. de St Aubain Somerhausen N, van de Rijn M. Tenosynovial giant cell tumour, diffuse type. p. 102-103.
  2. Murphey MD, Rhee JH, Lewis RB, Fanburg-Smith JC, Flemming DJ, Walker EA. Pigmented villonodular synovitis: radiologic-pathologic correlation. Radiographics. 2008 Sep-Oct;28(5):1493-518. doi: 10.1148/rg.285085134.
  3. Folpe AL, Weiss SW, Fletcher CD, Gown AM. Tenosynovial giant cell tumors: evidence for a desmin-positive dendritic cell subpopulation. Mod Pathol. 1998 Oct;11(10):939-44.
  4. Huang HY, West RB, Tzeng CC, van de Rijn M, Wang JW, Chou SC, Huang WW, Eng HL, Lin CN, Yu SC, Wu JM, Lu CC, Li CF. Immunohistochemical and biogenetic features of diffuse-type tenosynovial giant cell tumors: the potential roles of cyclin A, P53, and deletion of 15q in sarcomatous transformation. Clin Cancer Res. 2008 Oct 1;14(19):6023-32. doi: 10.1158/1078-0432.CCR-08-0252.
  5. Nielsen AL, Kiaer T. Malignant giant cell tumor of synovium and locally destructive pigmented villonodular synovitis: ultrastructural and immunohistochemical study and review of the literature. Hum. Pathol. 1989;20(8);765-71.
  6. O'Connell JX, Wehrli BM, Nielsen GP, Rosenberg AE. Giant cell tumors of soft tissue: a clinicopathologic study of 18 benign and malignant tumors. Am J Surg Pathol. 2000 Mar;24(3):386-95.
  7. Dorwart RH, Genant HK, Johnston WH, Morris JM. Pigmented villonodular synovitis of synovial joints: clinical, pathologic, and radiologic fea-tures. AJR Am J Roentgenol. 1984 Oct;143(4):877-85.
  8. Jalgaonkar A, Dhinsa B, Cottam H, Mani G. Giant cell tumours of tendon sheath of hand: causes and strategies to prevent recurrence. Hand Surg. 2011;16(2):149-54.
  9. Abdul-Karim FW, el-Naggar AK, Joyce MJ, Makley JT, Carter JR. Diffuse and localized tenosynovial giant cell tumor and pigmented villonodular synovitis: a clinicopathologic and flow cytometric DNA analysis. Hum Pathol 1992 Jul;23(7):729-35.
  10. Layfield LJ, Meloni-Ehrig A, Liu K, Shepard R, Harrelson JM. Malignant giant cell tumor of synovium (malignant pigmented villonodular synovitis). Arch Pathol Lab Med. 2000 Nov;124(11):1636-41.
  11. Folpe AL, Morris RJ, Weiss SW. Soft tissue giant cell tumor of low malignant potential: a proposal for the reclassification of malignant giant cell tumor of soft parts. Mod Pathol. 1999 Sep;12(9):894-902.
  12. Ushijima M, Hashimoto H, Tsuneyoshi M, Enjoji M, Miyamoto Y, Okue A. Malignant giant cell tumor of tendon sheath. Report of a case. Acta Pathol Jpn. 1985 May;35(3):699-709.
  13. Enzinger FM, Weiss ShW. Soft tissue tumors. 2nd ed. St Louis: Mosby Company; 1988. p. 645-55.
  14. Ichikawa K.,Tanino R. Soft tissue giant cell tumor of low malignant potential. Tokai J Exp Clin Med. 2004 Sep;29(3):91-5.
  15. Bertoni F, Unni KK, Beabout JW, Sim FH. Malignant giant cell tumor of the tendon sheaths and joints (malignant pigmented villonodular synovitis). Am J Surg Pathol. 1997 Feb;21(2):153-63.
  16. Kalil LK, Unni KK. Malignancy in pigmented villonodular synovitis. Skeletal Radiol. 1998;27;392-5.
  17. Li CF, Wang JW, Huang WW, Hou CC, Chou SC, Eng HL, Lin CN, Yu SC, Huang HY. Malignant diffuse-type tenosynovial giant cell tumors: a series of 7 cases comparing with 24 benign lesions with review of the literature. Am J Surg Pathol. 2008 Apr;32(4):587-99. doi: 10.1097/PAS.0b013e318158428f.
  18. Shinjo K, Miyake N, Takahashi Y. Malignant giant cell tumor of the tendon sheath: an autopsy report and review of the literature. Jpn J Clin Oncol. 1993 Oct;23(5):317-24.

How to Cite

Dyadyk, E. A., & Hryhorovska, A. V. (2016). Features of histological structure and differential diagnostics of the diffuse-type giant cell tumor and its malignant form. Морфологія / Morphologia / Morfologìâ, 10(3), 144–149. https://doi.org/10.26641/1997-9665.2016.3.144-149

Issue

Section

Статті