Elsevier

Human Pathology

Volume 28, Issue 7, July 1997, Pages 815-819
Human Pathology

Original contribution
Giant cell tumor of tendon sheath is a polyclonal cellular proliferation

https://doi.org/10.1016/S0046-8177(97)90155-6Get rights and content

Abstract

Giant cell tumor of tendon sheath (GCTTS) is a common soft tissue tumor. Immunophenotypical evidence suggests it is of synovial cell origin. There is controversy regarding the underlying nature of this lesion, specifically whether it is a neoplastic or nonneoplastic (ie, reactive or hyperplastic) process. Karyotypic abnormalities have been identified in GCTTS and interpreted as evidence of neoplasia, although the finding of similar karyotypic abnormalities in unequivocally nonneoplastic proliferations raises questions about using such findings to define a neoplasm. In an attempt to resolve this uncertainty, a polymerase chain reaction (PCR)-based assay for methylation of the X-linked human androgen receptor gene (HUMARA) was used to assess whether GCTTS is a clonal or polyclonal proliferation. DNA was isolated from formalin-fixed, paraffin-embedded tissue blocks from eight cases of digital GCTTS in female subjects; two cases of hepatocellular carcinoma (HCC) were used as clonal controls. Seven of eight cases of GCTTS were informative, and each showed a polyclonal proliferation, whereas both cases of HCC were clonal. Our results indicate that GCTTS is a nonneoplastic proliferation, if one accepts that a population of cells forming a tumorous mass must show clonality to be classified as a neoplasm. Our results emphasize that simple karyotypic abnormalities do not define a neoplasm. It remains to be determined whether GCTTS is a reactive or hyperplastic process.

References (23)

  • JA Fletcher et al.

    Trisomy 5 and trisomy 7 are nonrandom aberrations in pigmented villonodular synovitis: Confirmation of trisomy 7 in uncultured cells

    Genes Chromosomes Cancer

    (1992)
  • Cited by (76)

    • RNAscope CSF1 chromogenic in situ hybridization: a potentially useful tool in the differential diagnosis of tenosynovial giant cell tumors

      2021, Human Pathology
      Citation Excerpt :

      Tenosynovial giant cell tumors (TGCT), initially described by Jaffe in 1941 [1], are relatively common tumors that typically arise in association with the synovium of tendon sheaths, joints, or bursae [2]. Thought for decades to represent a non-neoplastic and most likely reactive process [3], cytogenetic studies in the 1990s demonstrated recurrent cytogenetic aberrations typically involving chromosome 1p, suggesting instead neoplastic etiology [4–7]. This hypothesis was elegantly confirmed in 2006 by West et al, who demonstrated fusions of the CSF1 (colony stimulating factor-1) gene at 1p13 with the COL6A3 (collagen type VI alpha 3) gene at 2q35 in roughly one-third of cases [8].

    • Radiation therapy for infiltrative giant cell tumor of the tendon sheath

      2012, Journal of Hand Surgery
      Citation Excerpt :

      She had 2 previous excisions at another center; she was referred for radiation therapy but refused treatment. Complete surgical excision of GCTTS remains the treatment of choice.26 Multiple recurrences and excisions increase morbidity and may rarely lead to amputation.3,8,27–29

    • Tumors of Synovial Tissue

      2010, Bone and Soft Tissue Pathology
    View all citing articles on Scopus
    View full text