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Imaging of giant cell tumour of the tendon sheath

Imaging del tumore gigantocellulare delle guaine tendine

  • Musculoskeletal Radiology/Radiologia Muscolo-Scheletrica
  • Published:
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Abstract

Giant cell tumours of the tendon sheath (GCTTS) and pigmented villonodular synovitis (PVNS) are part of a spectrum of benign proliferative lesions of synovial origin that may affect the joints, bursae and tendon sheaths. This review article describes the clinicopathological features and imaging findings in patients with GCTTS. GCTTS usually presents as a soft tissue mass with pressure erosion of the underlying bone. Magnetic resonance (MR) imaging of GCTTS typically shows low to intermediate signal on T1- and T2-weighted spin-echo sequences due to the presence of haemosiderin, which exerts a paramagnetic effect. On gradient-echo sequences, the paramagnetic effect of haemosiderin is further exaggerated, resulting in areas of very low signal due to the blooming artefact. Ultrasonography shows a soft mass related to the tendon sheath that is hypervascular on colour or power Doppler imaging.

Riassunto

Il tumore gigantocellulare delle guaine tendinee (GCTTS) e la sinovite villonodulare pigmentata (PVNS) fanno parte di uno spettro di lesioni proliferative benigne di origine sinoviale che possono interessare le articolazioni, le borse e le guaine tendinee. Questa review descrive le caratteristiche clinico-patologiche e di imaging in pazienti con GCTTS. Il GCTTS si presenta generalmente come una massa dei tessuti molli che determina una erosione da compressione dell’osso sottostante. L’imaging con risonanza magnetica (RM) del GCTTS tipicamente mostra un’intensità di segnale da bassa ad intermedia nelle immagini T1 e T2-pesate in sequenze SE, dovuta alla presenza di emosiderina che esercita un effetto paramagnetico. Nelle sequenze gradient echo l’effetto paramagnetico della emosiderina è ancora più evidente, determinando delle aree di ipointensità a causa di artefatti da “chemical shift”. L’ecografia documenta una massa dei tessuti molli che origina dalla guaina tendinea che è ipervascolarizzata all’esame color e power doppler.

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Correspondence to G. Guglielmi.

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Wan, J., Magarelli, N., Peh, W. et al. Imaging of giant cell tumour of the tendon sheath. Radiol med 115, 141–151 (2010). https://doi.org/10.1007/s11547-010-0515-2

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  • DOI: https://doi.org/10.1007/s11547-010-0515-2

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