Difference between revisions of "Tenosynovium"
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*[[Tenosynovitis]]. | *[[Tenosynovitis]]. | ||
*Carpal tunnel syndrome. | *Carpal tunnel syndrome. | ||
==Tenosynovitis== | |||
:''Stenosing tenosynovitis'' directs here. | |||
===General=== | |||
*Uncommon pathology specimen. | |||
*May cause ''trigger finger''.<ref name=pmid23396894>{{Cite journal | last1 = Vuillemin | first1 = V. | last2 = Guerini | first2 = H. | last3 = Bard | first3 = H. | last4 = Morvan | first4 = G. | title = Stenosing tenosynovitis. | journal = J Ultrasound | volume = 15 | issue = 1 | pages = 20-8 | month = Feb | year = 2012 | doi = 10.1016/j.jus.2012.02.002 | PMID = 23396894 }}</ref> | |||
===Microscopic=== | |||
Features:<ref name=pmid20442645>{{Cite journal | last1 = Shon | first1 = W. | last2 = Folpe | first2 = AL. | title = Tenosynovitis with psammomatous calcification: a poorly recognized pseudotumor related to repetitive tendinous injury. | journal = Am J Surg Pathol | volume = 34 | issue = 6 | pages = 892-5 | month = Jun | year = 2010 | doi = 10.1097/PAS.0b013e3181d95a36 | PMID = 20442645 }}</ref> | |||
*Dense connective tissue (tendon). | |||
*Histiocytes. | |||
*+/-[[Psammoma bodies]]. | |||
DDx: | |||
*Calcific tendinitis. | |||
*[[Giant cell tumour of the tendon sheath]]. | |||
*[[Palmar fibromatosis]]. | |||
===IHC=== | |||
Features: | |||
*CD68 +ve. | |||
*Beta-catenin -ve. | |||
Note: | |||
*Immunostains are usually not required for the diagnosis. | |||
===Sign out=== | |||
<pre> | |||
Tenosynovium, Left Wrist, Excision: | |||
- Dense connective tissue (consistent with tendon) with degenerative | |||
changes and lymphohistiocytic infiltrate. | |||
- NEGATIVE for apparent giant cells and NEGATIVE for calcification. | |||
- NEGATIVE for malignancy. | |||
</pre> | |||
====Block letters==== | |||
<pre> | |||
TENOSYNOVIUM, LEFT MIDDLE FINGER, EXCISION: | |||
- DENSE CONNECTIVE TISSUE (CONSISTENT WITH TENDON) WITH LYMPHOHISTIOCYTIC INFILTRATE. | |||
- NEGATIVE FOR GIANT CELLS. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
====Micro==== | |||
The sections show dense connective tissue (tendon) containing a cluster of cells with | |||
indistinct cellular borders, abundant foamy grey cytoplasm, and round/oval | |||
pale-staining nuclei with small nucleoli (histiocytes). The cell cluster has a small | |||
number of interspersed lymphocytes, and the centre of the cell cluster has acellular | |||
hyaline material (degenerative tendon). | |||
No calcification is identified. No giant cells are seen. | |||
No nuclear atypia is apparent and no mitotic activity is appreciated. | |||
=====Alternate===== | |||
The sections show dense connective tissue (tendon) containing rare histiocytes and | |||
lymphocytes. No calcification is identified. No giant cells are seen. No nuclear atypia | |||
is apparent and no mitotic activity is appreciated. | |||
==Carpal tunnel syndrome== | ==Carpal tunnel syndrome== | ||
===General=== | ===General=== | ||
*Clinical diagnosis. | *[[Clinical diagnosis]]. | ||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref name=pmid10530852>{{Cite journal | last1 = Chell | first1 = J. | last2 = Stevens | first2 = A. | last3 = Davis | first3 = TR. | title = Work practices and histopathological changes in the tenosynovium and flexor retinaculum in carpal tunnel syndrome in women. | journal = J Bone Joint Surg Br | volume = 81 | issue = 5 | pages = 868-70 | month = Sep | year = 1999 | doi = | PMID = 10530852 }}</ref> | Features:<ref name=pmid10530852>{{Cite journal | last1 = Chell | first1 = J. | last2 = Stevens | first2 = A. | last3 = Davis | first3 = TR. | title = Work practices and histopathological changes in the tenosynovium and flexor retinaculum in carpal tunnel syndrome in women. | journal = J Bone Joint Surg Br | volume = 81 | issue = 5 | pages = 868-70 | month = Sep | year = 1999 | doi = | PMID = 10530852 }}</ref> | ||
*Tenosynovium with edema or fibrosis +/-myxoid degeneration | *Tenosynovium with edema or fibrosis +/-myxoid degeneration | ||
===Sign out=== | |||
<pre> | |||
Tenosynovium, Excision: | |||
- Benign fibroconnective tissue with focal myxoid changes without | |||
significant inflammation. | |||
- NEGATIVE for evidence of malignancy. | |||
</pre> | |||
==See also== | ==See also== | ||
Latest revision as of 13:33, 16 June 2016
Tenosynovium is a relatively common ditzel.
General
DDx:
- Tenosynovitis.
- Carpal tunnel syndrome.
Tenosynovitis
- Stenosing tenosynovitis directs here.
General
- Uncommon pathology specimen.
- May cause trigger finger.[1]
Microscopic
Features:[2]
- Dense connective tissue (tendon).
- Histiocytes.
- +/-Psammoma bodies.
DDx:
- Calcific tendinitis.
- Giant cell tumour of the tendon sheath.
- Palmar fibromatosis.
IHC
Features:
- CD68 +ve.
- Beta-catenin -ve.
Note:
- Immunostains are usually not required for the diagnosis.
Sign out
Tenosynovium, Left Wrist, Excision: - Dense connective tissue (consistent with tendon) with degenerative changes and lymphohistiocytic infiltrate. - NEGATIVE for apparent giant cells and NEGATIVE for calcification. - NEGATIVE for malignancy.
Block letters
TENOSYNOVIUM, LEFT MIDDLE FINGER, EXCISION: - DENSE CONNECTIVE TISSUE (CONSISTENT WITH TENDON) WITH LYMPHOHISTIOCYTIC INFILTRATE. - NEGATIVE FOR GIANT CELLS. - NEGATIVE FOR MALIGNANCY.
Micro
The sections show dense connective tissue (tendon) containing a cluster of cells with indistinct cellular borders, abundant foamy grey cytoplasm, and round/oval pale-staining nuclei with small nucleoli (histiocytes). The cell cluster has a small number of interspersed lymphocytes, and the centre of the cell cluster has acellular hyaline material (degenerative tendon).
No calcification is identified. No giant cells are seen.
No nuclear atypia is apparent and no mitotic activity is appreciated.
Alternate
The sections show dense connective tissue (tendon) containing rare histiocytes and lymphocytes. No calcification is identified. No giant cells are seen. No nuclear atypia is apparent and no mitotic activity is appreciated.
Carpal tunnel syndrome
General
Microscopic
Features:[3]
- Tenosynovium with edema or fibrosis +/-myxoid degeneration
Sign out
Tenosynovium, Excision: - Benign fibroconnective tissue with focal myxoid changes without significant inflammation. - NEGATIVE for evidence of malignancy.
See also
References
- ↑ Vuillemin, V.; Guerini, H.; Bard, H.; Morvan, G. (Feb 2012). "Stenosing tenosynovitis.". J Ultrasound 15 (1): 20-8. doi:10.1016/j.jus.2012.02.002. PMID 23396894.
- ↑ Shon, W.; Folpe, AL. (Jun 2010). "Tenosynovitis with psammomatous calcification: a poorly recognized pseudotumor related to repetitive tendinous injury.". Am J Surg Pathol 34 (6): 892-5. doi:10.1097/PAS.0b013e3181d95a36. PMID 20442645.
- ↑ Chell, J.; Stevens, A.; Davis, TR. (Sep 1999). "Work practices and histopathological changes in the tenosynovium and flexor retinaculum in carpal tunnel syndrome in women.". J Bone Joint Surg Br 81 (5): 868-70. PMID 10530852.