Difference between revisions of "Tenosynovium"
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Tenosynovium, Left Wrist, Excision: | Tenosynovium, Left Wrist, Excision: | ||
- Dense connective tissue (consistent with tendon) with degenerative | - Dense connective tissue (consistent with tendon) with degenerative | ||
changes and lymphohistiocytic infiltrate | changes and lymphohistiocytic infiltrate. | ||
- NEGATIVE for apparent giant cells and NEGATIVE for calcification. | - NEGATIVE for apparent giant cells and NEGATIVE for calcification. | ||
- NEGATIVE | - NEGATIVE for malignancy. | ||
</pre> | </pre> | ||
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.
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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
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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.