RESUMO
Fundamento: el tumor de células gigantes de la vaina tendinosa ocupa el segundo lugar en frecuencia dentro de las neoplasias de la mano. El diagnóstico es clínico y radiológico y se confirma por medios de estudios anatomopatológicos. Objetivo: describir la epidemiología, aspectos clínicos e histológicos del tumor de células gigantes de la vaina tendinosa. Métodos: se realizó un estudio observacional descriptivo para el reporte de seis casos de los archivos del Departamento de Anatomía Patológica de 2016 y 2018, para identificar los casos con diagnóstico tumor de células gigantes de la vaina tendinosa. Resultados: se diagnosticaron un total de seis casos de tumor de células gigantes de la vaina tendinosa, los cuales se correspondieron a igual número de casos para cada sexo, en su mayoría eran pacientes menores de 40 años y en todos los casos el sitio de presentación del tumor fue la mano, con predominio de la región palmar del dedo pulgar. Ninguno de los casos manifestó dolor. En el estudio morfológico microscópico se observaron, los elementos histológicos característicos del tumor de células gigantes de la vaina tendinosa. Conclusiones: los seis pacientes estudiados presentaron la clínica típica del tumor de células gigantes de vaina tendinosa, es decir, refirieron aumento de volumen que se corroboró con el examen físico al palpar una tumoración de tejido subcutáneo, no dolorosa, lisa, blanda y de bordes bien definidos. De igual manera en el estudio histopatológico, se corroboraron los elementos morfológicos característicos, por lo cual se puede establecer que hubo una correlación clínico-patológica del 100 %.
ABSTRACT Background: the giant cell tumor of the tendon sheath occupies the second place in frequency in the neoplasms of the hand. The diagnosis is clinical and radiological, confirmed by anatomic-pathological studies. Objective: to describe the epidemiology, clinical and histological aspects of the giant cell tumor of the tendon sheath. Methods: a descriptive observational study was carried out for the report of six cases from the files of the Department of Pathology from 2016 and 2018, to identify the cases with a diagnosis of giant cell tumor of the tendon sheath. Results: a total of six cases of giant cell tumor of the tendon sheath were diagnosed, corresponding 50% to each sex; the majority were under 40 years old; and in all cases the site of presentation of the tumor was the hand; with a predominance in the palm region of the thumb. None of the cases manifested pain. In the morphological study, the characteristic histological elements of the giant cell tumor of the tendon sheath were observed microscopically. Conclusions: the six patients studied presented the typical symptoms of the Giant cell tumor of the tendon sheath, referring to an increase in volume that was corroborated with the physical examination by palpating a mass of subcutaneous, non-painful, smooth, soft tissue with well-defined borders. In the same way, histopathologically, the characteristic morphological elements were corroborated, for which it can be established that there was a clinical-pathological correlation of 100%.
RESUMO
ABSTRACT: A 12-year-old female mixed-breed dog presented with lameness, pain, and an enlarged, non-ulcerated, nodular mass in the region proximal to the tarsal joint of the right pelvic limb. Surgical excision was performed, revealing a 6.5 cm mass adherent to the deep flexor tendon and adjacent tissues. The cut section had cysts filled with blackened clotted material, which exuded reddish serous fluid. Microscopically, the cysts were filled with red blood cells and were either denuded or covered by synoviocytes. In addition, the mass was characterized by marked fibrovascular connective tissue associated with siderophages and multinucleated giant cells. These findings were consistent with those of pigmented villonodular tenosynovitis, a rare condition affecting several animal species and humans.
RESUMO: Uma cadela de 12 anos, sem raça definida, apresentou claudicação, algia e aumento de volume não ulcerado, de aspecto nodular, na região proximal à articulação do tarso do membro pélvico direito. A excisão cirúrgica foi optada e revelou uma massa de 6,5 cm de diâmetro, aderida ao tendão flexor profundo e aos tecidos adjacentes. Ao corte, exsudava líquido seroso avermelhado e cistos preenchidos por material coagulado enegrecido foram observados. Microscopicamente, a massa apresentava formações císticas frequentemente preenchidas por hemácias, que encontravam-se ora revestidas por sinoviócitos, ora desnudas. Havia ainda acentuada quantidade de tecido fibrovascular associado a siderófagos e células gigantes multinucleadas. Esses achados foram consistentes com tenossinovite vilonodular pigmentada, uma rara condição que afeta diversas espécies de animais e humanos.
RESUMO
A 12-year-old female mixed-breed dog presented with lameness, pain, and an enlarged, non-ulcerated, nodular mass in the region proximal to the tarsal joint of the right pelvic limb. Surgical excision was performed, revealing a 6.5 cm mass adherent to the deep flexor tendon and adjacent tissues. The cut section had cysts filled with blackened clotted material, which exuded reddish serous fluid. Microscopically, the cysts were filled with red blood cells and were either denuded or covered by synoviocytes. In addition, the mass was characterized by marked fibrovascular connective tissue associated with siderophages and multinucleated giant cells. These findings were consistent with those of pigmented villonodular tenosynovitis, a rare condition affecting several animal species and humans.
Uma cadela de 12 anos, sem raça definida, apresentou claudicação, algia e aumento de volume não ulcerado, de aspecto nodular, na região proximal à articulação do tarso do membro pélvico direito. A excisão cirúrgica foi optada e revelou uma massa de 6,5 cm de diâmetro, aderida ao tendão flexor profundo e aos tecidos adjacentes. Ao corte, exsudava líquido seroso avermelhado e cistos preenchidos por material coagulado enegrecido foram observados. Microscopicamente, a massa apresentava formações císticas frequentemente preenchidas por hemácias, que encontravam-se ora revestidas por sinoviócitos, ora desnudas. Havia ainda acentuada quantidade de tecido fibrovascular associado a siderófagos e células gigantes multinucleadas. Esses achados foram consistentes com tenossinovite vilonodular pigmentada, uma rara condição que afeta diversas espécies de animais e humanos.
Assuntos
Feminino , Animais , Cães , Doenças do Cão/patologia , Neoplasias/patologia , Neoplasias/veterinária , Pelve , Tendões , Tenossinovite/cirurgia , Tenossinovite/veterináriaRESUMO
A 12-year-old female mixed-breed dog presented with lameness, pain, and an enlarged, non-ulcerated, nodular mass in the region proximal to the tarsal joint of the right pelvic limb. Surgical excision was performed, revealing a 6.5 cm mass adherent to the deep flexor tendon and adjacent tissues. The cut section had cysts filled with blackened clotted material, which exuded reddish serous fluid. Microscopically, the cysts were filled with red blood cells and were either denuded or covered by synoviocytes. In addition, the mass was characterized by marked fibrovascular connective tissue associated with siderophages and multinucleated giant cells. These findings were consistent with those of pigmented villonodular tenosynovitis, a rare condition affecting several animal species and humans.(AU)
Uma cadela de 12 anos, sem raça definida, apresentou claudicação, algia e aumento de volume não ulcerado, de aspecto nodular, na região proximal à articulação do tarso do membro pélvico direito. A excisão cirúrgica foi optada e revelou uma massa de 6,5 cm de diâmetro, aderida ao tendão flexor profundo e aos tecidos adjacentes. Ao corte, exsudava líquido seroso avermelhado e cistos preenchidos por material coagulado enegrecido foram observados. Microscopicamente, a massa apresentava formações císticas frequentemente preenchidas por hemácias, que encontravam-se ora revestidas por sinoviócitos, ora desnudas. Havia ainda acentuada quantidade de tecido fibrovascular associado a siderófagos e células gigantes multinucleadas. Esses achados foram consistentes com tenossinovite vilonodular pigmentada, uma rara condição que afeta diversas espécies de animais e humanos.(AU)
Assuntos
Animais , Feminino , Cães , Doenças do Cão/patologia , Tendões , Pelve , Tenossinovite/cirurgia , Tenossinovite/veterinária , Neoplasias/patologia , Neoplasias/veterináriaRESUMO
OBJETIVO: Mostrar los hallazgos imagenológicos en la resonancia magnética (RM) de la sinovitis vellonodular pigmentada (SVP) y el tumor de células gigantes de la vaina sinovial (TCGVS), dado que son entidades que representan un diverso grupo de alteraciones en la proliferación de la sinovial. MATERIALES Y MÉTODOS: Entre mayo de 2011 y junio de 2013, se estudiaron en nuestra institución 25 casos con diagnóstico histológico de proliferación de la sinovial. Se destacaron los distintos tipos de presentación en imágenes a través de una RM 1.5 Tesla. Los resultados fueron analizados y comparados con la literatura. RESULTADOS: La RM mostró características similares para esta patología en todos los pacientes. No obstante, se distinguieron 4 patrones principales de presentación, dependiendo de la morfología, la localización de la lesión y las características radiológicas diferenciales. Estos fueron: como dominante, el tumor de células gigantes de la vaina sinovial (n = 10), todos de localización extraarticular; la sinovitis vellonodular pigmentada de localización bursal (n = 2); la sinovitis vellonodular pigmentada de forma intraarticular focal (n = 5); y la sinovitis vellonodular pigmentada difusa (n = 8). CONCLUSIÓN: La sinovitis vellonodular pigmentada y el tumor de células gigantes de la vaina sinovial se consideran entidades similares desde el punto de vista anatomopatológico. La RM fue de gran utilidad para objetivar tanto las características radiológicas comunes como las diferenciales. Estas últimas, junto con la localización, nos permitieron clasificar 4 patrones de presentación. Su reconocimiento posibilita un adecuado seguimiento de la patología y un óptimo manejo terapéutico.
PURPOSE: To show the resonance magnetic imaging (MRI) findings of pigmented villonodular synovitis (PVNS) and giant cell tumor of the tendon sheath (PVNTS), entities with similar histology but differences in clinical and some radiological manifestations. MATERIALS AND METHODS: We studied 25 cases with histologically benign synovial proliferation in intra and extraarticular location of the extremities. It highlighted with a 1.5T MRI unit the different types of images presentation. The results were analyzed and compared with the literature. RESULTS: MRI displayed very specific imaging features in all patients. However, we were able to distinguish 4 main patterns of presentation depending on the morphology, location of the lesion and radiological differential. These were: as dominant presentation, pigmented villonodular synovitis localized form (n=10); pigmented villonodular synovitis bursal form (n=2); pigmented villonodular synovitis focal (n =5); and pigmented villonodular synovitis diffuse (n = 8). CONCLUSION: Both pigmented villonodular synovitis as well as giant cell tumor of the tendon sheath are considered similar from the point of view of the histological findings. MRI was useful to objectify both radiological features in common, such as the differential, which along with the location, allow us to classify patterns into 4 individual presentations. This recognition involves adequate radiological evaluation and is important for optimal management.
Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Sinovite Pigmentada Vilonodular , Espectroscopia de Ressonância Magnética , Sinoviócitos , Tumor de Células Gigantes de Bainha Tendinosa , Tumores de Células Gigantes , Dor , Imageamento por Ressonância Magnética , Pé , Mãos , JoelhoRESUMO
Objetivo: Mostrar los hallazgos imagenológicos en la resonancia magnética (RM) de la sinovitis vellonodular pigmentada (SVP) y el tumor de células gigantes de la vaina sinovial (TCGVS), dado que son entidades que representan un diverso grupo de alteraciones en la proliferación de la sinovial. Materiales y métodos: Entre mayo de 2011 y junio de 2013, se estudiaron en nuestra institución 25 casos con diagnóstico histológico de proliferación de la sinovial. Se destacaron los distintos tipos de presentación en imágenes a través de una RM 1.5 Tesla. Los resultados fueron analizados y comparados con la literatura. Resultados: La RM mostró características similares para esta patología en todos los pacientes. No obstante, se distinguieron 4 patrones principales de presentación, dependiendo de la morfología, la localización de la lesión y las características radiológicas diferenciales. Estos fueron: como dominante, el tumor de células gigantes de la vaina sinovial (n = 10), todos de localización extraarticular; la sinovitis vellonodular pigmentada de localización bursal (n = 2); la sinovitis vellonodular pigmentada de forma intraarticular focal (n = 5); y la sinovitis vellonodular pigmentada difusa (n = 8). Conclusión: La sinovitis vellonodular pigmentada y el tumor de células gigantes de la vaina sinovial se consideran entidades similares desde el punto de vista anatomopatológico. La RM fue de gran utilidad para objetivar tanto las características radiológicas comunes como las diferenciales. Estas últimas, junto con la localización, nos permitieron clasificar 4 patrones de presentación. Su reconocimiento posibilita un adecuado seguimiento de la patología y un óptimo manejo terapéutico.(AU)
Purpose: To show the resonance magnetic imaging (MRI) findings of pigmented villonodular synovitis (PVNS) and giant cell tumor of the tendon sheath (PVNTS), entities with similar histology but differences in clinical and some radiological manifestations. Materials and methods: We studied 25 cases with histologically benign synovial proliferation in intra and extraarticular location of the extremities. It highlighted with a 1.5T MRI unit the different types of images presentation. The results were analyzed and compared with the literature. Results: MRI displayed very specific imaging features in all patients. However, we were able to distinguish 4 main patterns of presentation depending on the morphology, location of the lesion and radiological differential. These were: as dominant presentation, pigmented villonodular synovitis localized form (n=10); pigmented villonodular synovitis bursal form (n=2); pigmented villonodular synovitis focal (n =5); and pigmented villonodular synovitis diffuse (n = 8). Conclusion: Both pigmented villonodular synovitis as well as giant cell tumor of the tendon sheath are considered similar from the point of view of the histological findings. MRI was useful to objectify both radiological features in common, such as the differential, which along with the location, allow us to classify patterns into 4 individual presentations. This recognition involves adequate radiological evaluation and is important for optimal management.(AU)