Synovial Tumors
A 32-year-old woman presents with chronic left knee swelling and intermittent pain for 2 years. Aspiration yields bloody/brown fluid. MRI shows diffuse synovial thickening with low signal on both T1 and T2-weighted images (blooming artifact on gradient echo sequences). Histology reveals giant cells, hemosiderin-laden macrophages, and villonodular proliferation. Regarding pigmented villonodular synovitis (PVNS):
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PVNS (now termed tenosynovial giant cell tumor - TGCT) is a benign but locally aggressive proliferat...
The pathogenesis involves a translocation t(1;2) leading to CSF1 (colony-stimulating factor 1) overe...
PVNS is a malignant tumor; it never recurs after excision; the pathogenesis is unknown with no genet...
MRI is diagnostic showing characteristic low signal on both T1 and T2-weighted images (due to hemosi...
Treatment is surgical: arthroscopic or open synovectomy for diffuse disease (high recurrence rate 20...
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