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Tenosynovial giant cell tumour (pigmented villonodular synovitis-)-like changes in periprosthetic interface membranes

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Abstract

Tenosynovial giant cell tumour (TSGCT; synonym, pigmented villonodular synovitis (PVNS)) is a rare low-grade mesenchymal neoplasm of either intra-articular or extra-articular origin. The etiopathogenesis of TSGCT is still uncertain, but recent studies showed a translocation involving colony-stimulating factor 1 (CSF-1) gene in a subset of cases. Histological features mimicking TSGCT can sometimes be encountered in periprosthetic interface membranes. To investigate the frequency and morphologic spectrum of this phenomenon, we conducted a systematic analysis of 477 periprosthetic interface membranes and performed immunohistochemical analysis on a subset of lesions compared to genuine TSGCT. In 26 of 477 periprosthetic membrane samples (5 %), at least some TSGCT-like features were found and 18 cases (4 %) strongly resembled it. Wear particles were detected in 100 % of the TSGCT-like lesions but only in 63.3 % of the whole cohort of periprosthetic membranes (p value <0.001). Immunohistochemistry comparing true TSGCT and TSGCT-like membranes showed similar inflammatory infiltrates with slightly elevated CD3+/CD8+ T lymphocytes and a slightly higher proliferation index in TSGCT samples. In conclusion, TSGCT-like changes in periprosthetic membranes likely represent exuberant fibrohistiocytic inflammatory response induced by wear particles and should be distinguished from genuine (neoplastic) TSGCT. Although TSGCT and TSGCT-like periprosthetic membranes represent different entities, their comparable morphology might reflect analogous morphogenesis.

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Acknowledgments

We are grateful to Claudia Giedl (Immunohistochemistry Laboratory, Erlangen) and Ingrid Mons (Department of Experimental Tumour Pathology, Erlangen) for technical assistance.

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Authors and Affiliations

  1. Institute of Pathology, Friedrich-Alexander-University, 91054, Erlangen, Germany

    Stephan Söder & Abbas Agaimy

  2. Department of Orthopaedic Surgery, Friedrich-Alexander-University, 91054, Erlangen, Germany

    Stefan Sesselmann

  3. Institute of Pathology, Hospital of Coburg, 96450, Coburg, Germany

    Thomas Aigner

  4. Department of Orthopaedics, Hospital of Rummelsberg, 90592, Schwarzenbruck, Germany

    Stephan Oehler

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  1. Stephan Söder
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  2. Stefan Sesselmann
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Correspondence to Abbas Agaimy.

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Söder, S., Sesselmann, S., Aigner, T. et al. Tenosynovial giant cell tumour (pigmented villonodular synovitis-)-like changes in periprosthetic interface membranes. Virchows Arch 468, 231–238 (2016). https://doi.org/10.1007/s00428-015-1874-9

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  • DOI: https://doi.org/10.1007/s00428-015-1874-9

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