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Int J Clin Exp Pathol 2012;5(4):374-376

Case Report
Giant cell tumor of the tendon sheath composed largely of epithelioid histiocyctes

Tadashi Terada

Departments of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan.

Received December 2, 2011; accepted February 21, 2012; Epub April 16, 2012; Published May 30, 2012

Abstract: Giant cell tumor of the tendon sheath (GCTTS) is a relatively uncommon lesion. GCTTS composed largely epithelioid histiocytes are
very rare. In the literature, the author could not find such cases. A 73-year-old man presented with a mass of right thumb, and resection of the
mass was performed. Grossly, the mass was encapsulated and yellowish, and measured 1.5 x 2 x 2 cm. Microscopically, the mass was
composed of cellular and hypocellular zones. The former was composed of spindle cells and osteoclast-like giant cells, while the latter of
epithelioid clear histiocytes. The area of the former was 20%, and the latter 80%. Pigment was seen in the former elements. Mitotic figures
were seen in 3/per 30 high power fields (HPFs) in the former element and 2/per 30 HPFs in the latter element. Histochemically, the pigment
was hemosiderin positive with Prussian blue staining. Immunohistochemically, both the elements were negative for cytokeratin (CK) CE1/3,
CK CAM5.2, CEA, HMB45, alpha-smooth muscle antigen, p53, CD10, TTF-1, and CDX2. Both the elements were positive for CD68 and Ki-67
(cellular element 30% and hypocellular element 20%). The histiocytes of the hypocelular element and osteoclast-like giant cell of the cellular
element were positive for CD45. S100-protein positive Langerhans cells and CD45-positive lymphocytes were scattered. The pathological
diagnosis was GCTTS. In the author’s experience, GCTTS composed largely epithelioid histiocytes are very rare. In the literature, the author
could not find such cases. Thus, the author reports herein this case.
(IJCEP1112002).

Keywords: Giant cell tumor, tendon, sheath, epithelioid, histiocytes


Address all correspondence to:
Dr. Tadashi Terada
Department of Pathology, Shizuoka City Shimizu Hospital
Miyakami 1231 Shimizu-Ku, Shizuoka 424-8636, Japan.
Tel: 81-54-336-1111; Fax: 81-54-336-1315
E-mail: piyo0111jp@yahoo.co.jp