Pigmented villonodular synovitis pvns is a rare locally aggressive tumor. Necessity of adjuvant postoperative radiotherapy for diffuse. Definition of synovitis, pigmented villonodular in the dictionary. Pvns is an uncommon benign but locally aggressive disease, which mostly affects the large, synoviumlined. Mar 23, 20 pigmented villonodular synovitis pvns is a disease of the joints characterized by inflammations and overgrowth of joint lining. Pigmented villonodular synovitis pvns is a benign lesion that usually occurs in tendon sheaths, in burses or in the large joints synovia of the extremities. Pigmented villonodular synovitis of the thoracic spine. Magnetic resonance is the suitable imaging study for the diagnosis, as it provides useful information to establish the appropriate treatment. Villonodular synovitis is an intracapsular joint disorder characterized by nodular synovial hyperplasia, which is thought to represent a response to trauma. Pigmented villonodular synovitis pvns of the hip is a monoarticular proliferative process involving the synovial membrane. The tumors tend to involve a large area of the synovium often more than 5 cm. An executive in an it firm, presented with locking of knee, after getting up in morning. Pigmented villonodular synovitts, tenosynovitis, bursitis. Unusually, a tendon, bursa, or another joint can be involved.
It affects in decreasing order of frequency the knee, hip, ankle, and shoulder, while elbows are rarely involved. Pigmented villonodular synovitis pvns is a benign, of unknown etiology, proliferate. Chromosomal analysis suggests that it is a true neoplasm and not an inflammatory process. Pigmented villonodular synovitis radiology reference article. Pigmented villonodular synovitis pvns, first coined by jaffe et al. Methods electronic medical records emr of four chinese institutes were queried for patients with histologically proven pvns between january 2005 and february 2014. Both pigmented villonodular synovitis as well as giant cell tumor of the tendon sheath are considered similar from the point of view of the histological. Pigmented villonodular synovitis pvns is a benign synovial proliferation associated with hemosiderin deposits, which originates in joints, bursa or tendon sheaths. To illustrate the mri features of pigmented villonodular synovitis pvns, with special focus on the diffuse intraarticular form. Pigmented villonodular synovitis is a rare proliferative condition of the synovium. Although it can be painful, pvns usually does not spread.
Pvns is characterized by hyperplasia of the synovium or tendon sheath, with notable proliferation of stromal cells, large quantities of intra and extracellular hemosiderin and. Pigmented villonodular synovitis of knee radiology case. Pigmented villonodular synovitis pvns is a rare benign proliferative condition affecting synovial membranes of joints, bursae or tendons resulting from possibly neoplastic synovial proliferation with villous and nodular projections and hemoside. Pigmented villonodular synovitis pvns is a rare, benign, idiopathic proliferative disorder of the synovium that results in villous and or nodular formations that have been reported to manifest within joints, tendon sheaths, and bursae. Background pigmented villonodular synovitis pvns belongs to a family of uncommon benign neoplastic diseases of uncertain etiology that. Pigmented villonodular synovitis is a rare disease, but it involves the knee in 80% of the cases. To show the resonance magnetic imaging mri findings of pigmented villonodular synovitis pvns and giant cell tumor of the tendon sheath pvnts, entities with similar histology but differences in clinical and some radiological manifestations. Pigmented villonodular synovitis is a benign proliferative synovial disorder of unknown origin that may affect the joints, bursae, or tendon sheaths, most frequently the knee. Pvns affects people in their third or fourth decades of life. When suspected, magnetic resonance imaging is performed, and the diagnosis confirmed with a biopsy in which synovial inflammatory tissue with hemosiderin deposits is observed. Pigmented villonodular synovitis pvns is a rare benign proliferative condition affecting synovial membranes of joints, bursae or tendons resulting from possibly neoplastic synovial proliferation with villous and nodular projections and hemosiderin deposition.
J pigmented villonodular synovitis, bursitis, and tenosynovitis. It is characterized by a noncancerous mass or tumor. The purpose of this study is to define the spectrum and frequency of mri characteristics for pvns using conventional spin echo in two cases before and after intravenous administration of. In 1941, jaffe described it as a group of synovial, tenosynovial, and bursal lesions. Any joint can be affected, although the tumor is most commonly found in the knee or hip joint. For thisreason wedo notbelieve that thiscomplication ofpigmented villonodular synovitis issorare asappears from thefewcases published. Background pigmented villonodular synovitis pvns belongs to a family of uncommon benign neoplastic diseases of uncertain etiology that involve the synovium of the joint diffusely. Pigmented villonodular synovitis pvns, also known as intraarticular giantcell tumor of the. Pigmented villonodular synovitis diagnostic delay due to coexistence with ankylosing spondylitis.
Familiarity with the disease may ensure an earlier diagnosis and consequently early onset of therapy, which may prevent serious damage. Experimentally, villonodular synovitis has been reproduced in dogs by repeated intraarticular injections of whole blood. Pigmented villonodular synovitis pvns is a benign proliferative histiocytic disorder of the synovium. Extended pigmented villonodular synovitis of the hand. Recurrences have not been reported in diffuse pigmented villonodular synovitis of the shoulder after total synovectomy. It is characterized by the onset of unilateral pain and swelling of a joint, typically the knee 80%. Surgical outcomes of 26 patients with pigmented villonodular synovitis p vns of the knee at a mean followup of 4 years. The intra articular disease may be localized or diffuse. Dec 19, 2008 pigmented villonodular synovitis pvns is a benign proliferative histiocytic disorder of the synovium. Radiological features of pigmented villonodular synovitis and. Pigmented villonodular synovitis is an uncommon disease that remains a diagnostic challenge. If the hip is involved early destruction of the joint is common due to the tight structure of the.
The knee is the joint most commonly affected 80% of cases, and less frequently it can affect the shoulder, ankle and elbow. Jaffe was the first to describe pigmented villonodular synovitis pvns as a chronic proliferative disease that occurs in the joint, tendon and bursa synovium. Pigmented villonodular synovitis is a rare, benign, but potentially locally aggressive disease that should be considered in younger patients who present with monoarticular joint symptoms and pathology. The purpose of this study is to define the spectrum and frequency of mri characteristics for pvns using conventional spin echo in two cases before and after intravenous. Pigmented villonodular synovitis of the temporomandibular joint computed tomography and magnetic resonance findings. Pigmented villonodular synovitis of the temporomandibular. Case report unusual cases of pigmented villonodular synovitis after. The importance of excising virtually all of the synovium, however, should be.
Pigmented villonodular synovitis genetic and rare diseases nih. Pigmented villonodular synovitis pvns is a rare, benign, but potentially locally aggressive and recurrent condition characterized by synovial. Although the condition can present in any joint, the knee is the most commonly affected site. Villonodular synovitis is a type of synovial swelling types include. Information and translations of synovitis, pigmented villonodular in the most comprehensive dictionary definitions resource on the web. Pigmented villonodular synovitis pvns is a rare benign but aggressive disease of the synovium. Pigmented villonodular synovitis diagnostic delay due to. Both pigmented villonodular synovitis as well as giant cell tumor of the tendon sheath are considered. Radiological features of pigmented villonodular synovitis and giant. Mr imaging is routinely used for diagnosis and followup in patients with pigmented villonodular synovitis. Histologie findings in the case presented and in those reported by levine and cannon3 did not differ from descriptions of pigmented villonodular synovitis affecting other joints.
The case reported here isofspecial interest because oftheseverity oftheinvasion of thelower end oftheradius and because ofthesizeofthelesion. Pvns is a rare neoplasticlike pathological entity of unknown etiology affecting the synovium of the joint, tendon or bursa. Treatment of diffuse pigmented villonodular synovitis of. Apr 04, 2016 pigmented villonodular synovitis pvns is a disease in which the tissue lining the joints and tendons in the body synovium grows abnormally. Though they have very different names, they have the same histology, and stain positive for cd68, ham56, and vimentin. Pigmented villonodular synovitis can be focal or diffuse, the latter being the type with the worst prognosis. Possibility of pigmented villonodular synovitis pvns is considered. Pigmented villonodular synovitis pvns is described as a benign tumor of the synovium. There is a localized and a diffuse form of the disorder with the localized or nodular version amenable to. Neither the site of these lesions nor the young agegroupsinwhichtheyoccuris helpfulindifferentiating them from pvns. Pdf objectives several cases of bilateral diffuse pigmented villonodular synovitis pvns or tenosynovial giant cell tumor have been described in the. Pigmented villonodular synovitis pvns is a disease in which the tissue lining the joints and tendons in the body synovium grows abnormally.
We present the case of a 33yearold woman with a mass arising from her right hip joint that was examined using a multimodal radiological approach. Although the finger is one of the commonest sites for pvns, the lesion. Pigmented villonodular synovitis, am fam physician 1999. The final diagnosis of pvns is established on the ba sis of histological examination of synovial tissue 6. Pigmented villonodular synovitis pvns is a joint problem that usually affects the hip or knee. Pigmented villonodular synovitis pvns represents an uncommon benign neoplastic process that may involve the synovium of the joint diffusely or focally pvns or that may occur extraarticularly in a bursa pigmented villonodular bursitis pvnb or tendon sheath pigmented villonodular tenosynovitis pvnts. Pigmented villonodular synovitis pvns is a condition that causes the synoviumthe thin layer of tissue that lines the joints and tendonsto thicken and overgrow.
Response to imatinib in villonodular pigmented synovitis. Two cases 01 pigmented villonodular synovitis are reported. Low dose radiotherapy and staged surgical resection for. Pigmented villonodular synovitis pvns is a synovial proliferation disorder that remains a diagnostic difficulty because of its nonspecific presentation and subtle. Despite being a benign condition, pigmented villonodular synovitis is often aggressive, with. This lesion can be found in one in each 2500 arthroscopies. Their data were collected including gender, age at diagnosis, clinical presentation, affected site, symptom duration, comorbidities.
Pigmented villonodular synovitis pvns is a rare, benign, inflammatory, proliferative disorder of synovium. Pigmented villonodular synovitis of the hip and knee. This is an openaccess article distributed under the terms of the creative commons attribution license, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Treatment of diffuse pigmented villonodular synovitis of the. Pigmented villonodular synovitis occurs most commonly in the third and fourth decades of life. Mar 23, 2015 pigmented villonodular synovitis pvns, first coined by jaffe et al. Pigmented villonodular synovitis genetic and rare diseases. The mass or tumor that results from this overgrowth is not cancerous and does not spread metastasize to other areas of the body.
Pigmented villonodular synovitis radiology reference. Pigmented villonodular synovitis pvns is a disease of the joints characterized by inflammations and overgrowth of joint lining. Pigmented villonodular synovitis is a rare disease, with an incidence of 1. Localized and diffuse forms of synovial involvement were reported. A collection of disease information resources and questions answered by our genetic and rare diseases information specialists for pigmented villonodular. A discussion of the synovial and bursal equivalents of the tenosynovial lesion commonly denoted as xanthoma, xanthogranuloma, giant cell tumor or myeloplaxoma of the tendon sheath, with some consideration of the tendon sheath lesion itself. Presenting complaints commonly involve one joint, most often the knee or hip. The condition generally affects a persons knee or hip area, but can also be seen in other parts of the body as well, such as ankle, elbow, shoulder, hand or foot. Pigmented villonodular synovitis pvns is a relatively rare, benign proliferation lesion of the synovium of large joints. Pigmented villonodular synovitis pvns is a type of benign noncancerous tumor that arises from the soft connective tissue of joints. Pigmented villonodular synovitis of the knee joint. Arthroscopic treatment of pigmented villonodular synovitis. Pigmented villonodular synovitis pvns is a benign proliferation of the synovial membrane of joints, bursae and tendon sheaths, with hemosiderin deposits. Villonodular synovitis definition of villonodular synovitis.
However, in view of lack of trauma related history, and intact ligaments acl, menisci, pcl, pvns merits primary consideration. Case report pigmented villonodular synovitis combined with. Sinovitis pigmentada vilonodular pvns e uma lesao do tecido sinovial e raramente e encontrada na coluna vertebral. Introduction pigmented villonodular synovitis p vns is a condition of the synovial membrane that is characterized by the presence of inflammation and hemosiderin deposition in the synovium. Pigmented villonodular synovitis is a benign disease of the synovial membrane of joints, tendon sheaths, or bursae, which nevertheless can cause marked local destruction. Surgical outcomes of 26 patients with pigmented villonodular. Acause oferroneousdiagnosis ofpigmentedvillonodular synovitis macrophagetype cells whichformthe maincellular component ofthe pvnslesion. It is characterized by synovial hyperplasia and pigment deposition hemosiderin inside the joints, tendon sheaths and bursae. Pvns is most commonly monoarticular 70% knee joint but occasionally it can be oligoarticular. Dki olgu sunumu olgu sunumu nevzat selim gokay department of orthopaedics and traumatology, nam. Differential diagnosis include cyclops lesion, intraarticular chronic hematoma.
Pvns is characterized in most cases by a specific t1. Pigmented villonodular synovitis pvns boston childrens. Dr saxena specializes in sports medicine and surgery of the foot and ankle. The hip is less frequently affected than the knee, and hence is less discussed in. Pigmented villonodular synovitis pvns is a rare disease that can affect any joint, bursa or tendon sheath. Villonodular synovitis an overview sciencedirect topics. A chronic inflammation as well as a neoplastic process have been.
Rare neoplasticlike villonodular hyperplasia of synovium and tendon sheaths in young adults composed of mononuclear cells and multinuclear giant cells with hemosiderin deposition bonetumor. Pigmented villonodular synovitis pvns of the knee is a benign but locally aggressive disease of synovial proliferation that occurs in localized nodular and diffuse villous growth patterns. He has no previous history of trauma, or any sports related injury he doesnt play any sport in fact. Pathology outlines pigmented villonodular synovitis pvns. When you have pvns, the lining of a joint becomes swollen and grows. Pigmented villonodular synovitis pvns is a rare benign proliferative condition affecting synovial membranes of joints, bursae or tendons resulting from possibly. The final diagnosis of pvns is established on the ba. This is an epidemiological trial in order to determine the frequency of pigmented villonodular synovitis in a series of 1,150 arthroscopic procedures of the knee, for diagnosis and treatment for either traumatic or. It has been suggested that giantcell tumor of the tendon sheath be merged into this article. It can also occur in the shoulder, ankle, elbow, hand or foot. Diffuse pigmented villonodular synovitis in knee joint.
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