Which microscopic histologic findings characteristic of giant cell tumor of the tendon sheath?

Updated: Aug 06, 2019
  • Author: James R Verheyden, MD; Chief Editor: Harris Gellman, MD  more...
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Answer

Most giant cell tumors of the tendon sheath are moderately cellular and composed of sheets of rounded or polygonal cells that blend with hypocellular collagenized zones. Variable numbers of giant cells are present. Hemosiderin-containing xanthoma cells are common and often localized at the periphery of the lesion. (See the images below.)

Typical microscopic appearance of a giant cell tum Typical microscopic appearance of a giant cell tumor of the tendon sheath. Sheets of rounded or polygonal cells blend with hypocellular collagenized zones; variable numbers of giant cells are present.
Histologic findings of a giant cell tumor of the t Histologic findings of a giant cell tumor of the tendon sheath.
High-power photomicrograph of giant cell tumor of High-power photomicrograph of giant cell tumor of the tendon sheath shows occasional numerous mononuclear cells, scattered giant cells, and hemosiderin-containing xanthoma cells.
High-power photomicrograph depicts the histologic High-power photomicrograph depicts the histologic findings of a giant cell tumor of the tendon sheath.

In the localized form of the disease, a mature collagen capsule often surrounds the tumor. This capsule is continuous, with fibrous septa within the substance of the tumor that divide it into vague nodules. In the diffuse form, the tumor is not surrounded by this capsule and instead grows in expansive sheets.

Giant cells are also less common in the diffuse form. The histologic features of the localized and diffuse forms of giant cell tumor of the tendon sheath and those of the localized and diffuse forms of PVNS are essentially the same; therefore, these diseases form a histopathologic spectrum in which the tumors range from benign lesions to more locally aggressive lesions.


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