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Tenosynovial giant cell tumors: evidence for a desmin-positive dendritic cell subpopulation.

Abstract
Diffuse tenosynovial giant cell tumor (DGCT) could present as a large intra-articular mass (pigmented villonodular synovitis, or PVNS) or as an extraarticular mass, which might be confused with a sarcoma, particularly when growth is destructive and giant cells are few. Prompted by a DGCT in which a subpopulation of cells was desmin positive and in which an erroneous diagnosis of myosarcoma was made, we analyzed the frequency of desmin, myogenin, MyoD1, and muscle-specific actin immunoreactivity in 45 well-characterized GCTs. We also analyzed a subset of these cases with antibodies to smooth muscle actin, as well as macrophage, follicular dendritic cell, extrafollicular dendritic cell, and dermal dendrocyte-associated antigens. Sections from 45 cases of formalin-fixed GCTs (22 DGCTs, 13 cases of PVNS, and 10 localized GCTs) were immunostained for desmin, myogenin, MyoD1, and muscle-specific actin. The eight cases that showed the largest number of desmin-positive cells were immunostained for smooth muscle actin, CD45, CD68, CD21, CD35, cytokeratin 8, and Factor XIIIa. Desmin-positive cells were seen in 20 (43%) of 45 cases: 10 (43%) of 22 DGCTs, 5 (38%) of 13 cases of PVNS, and 5 (50%) of 10 localized GCTs. In contrast, none were positive for any of the other muscle-associated proteins. In almost all of the cases, the desmin-positive cells were large and dendriform, with long processes that interdigitated between adjacent round cells. Desmin immunoreactivity was found in almost 50% of all GCTs, in the absence of positivity for other muscle markers. Desmin immunoreactivity in GCT seemed to be confined to a variably sized subpopulation of large dendritic cells whose exact identity remains uncertain.
AuthorsA L Folpe, S W Weiss, C D Fletcher, A M Gown
JournalModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc (Mod Pathol) Vol. 11 Issue 10 Pg. 939-44 (Oct 1998) ISSN: 0893-3952 [Print] United States
PMID9796719 (Publication Type: Journal Article)
Chemical References
  • Actins
  • Antibodies, Monoclonal
  • Antigens, CD
  • Desmin
  • MYOG protein, human
  • MyoD Protein
  • MyoD1 myogenic differentiation protein
  • Myogenin
  • Keratins
Topics
  • Actins (metabolism)
  • Antibodies, Monoclonal
  • Antigens, CD (metabolism)
  • Dendritic Cells (metabolism, pathology)
  • Desmin (metabolism)
  • Humans
  • Immunoenzyme Techniques
  • Keratins (metabolism)
  • MyoD Protein (metabolism)
  • Myogenin (metabolism)
  • Synovitis, Pigmented Villonodular (metabolism, pathology)

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