MRI characteristics of giant cell tumor of the tendon sheath / 实用放射学杂志

ABSTRACT

Objective To investigate the MRI characteristics and pathological features of giant cell tumor of the tendon sheath (GCTTS)to improve the diagnostic accuracy.Methods MRI features of 22 cases of GCTTS confirmed by postoperative pathology were reviewed retrospectively.MRI plain scans were performed in all patients,in which there were 16 cases with enhanced MRI scans.HE staining and immunohistochemical analysis were used to investigate the histopathological characteristics.Results All of lesions were unilateral,3 cases were located in the left ankle,2 cases in the right ankle,5 cases in the left hand,2 cases in the right hand,2 cases in the left knee joint,6 cases in the right knee joint,1 case in the left foot and 1 case in the right foot.There were 14 cases of local type giant cell tumor of the tendon sheath(L-GCTTS)and 8 cases of diffuse type giant cell tumor of the tendon sheath(D-GCTTS). Compared with normal skeletal muscle signals,lesions showed isointensity on T1WI and high-low mixed intensity on T2WI.No bone abnormality was found in 11 cases,adjacent bone absorption in 6 cases,and adjacent bone destruction in 5 cases.In 16 patients with contrast-enhanced MRI,significantly heterogeneous enhancement was showed in 11 cases,mild heterogeneous enhancement in 3 cases and no heterogeneous enhancement in 2 cases.Pathological results revealed that GCTTS parenchyma cells were mainly formed by multinucleated giant cells and mononuclear stromal cells,scattered with interstitial collagen fibers and different amounts of hemosiderin composition.Conclusion MRI has a significant advantage in detecting hemosiderin in GCTTS.Combination of the history with location, GCTTS may be diagnosed by pathological examination.