Tenosynovial giant cell tumors: evidence for a desmin-positive dendritic cell subpopulation.
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.
Folpe
A L
AL
University of Washington, Seattle, USA.
Weiss
S W
SW
Fletcher
C D
CD
Gown
A M
AM
D000199:Actins / Q000378:metabolism; D000911:Antibodies, Monoclonal; D015703:Antigens, CD / Q000378:metabolism; D003713:Dendritic Cells / Q000378:metabolism / Q000473:pathology*; D003893:Desmin / Q000378:metabolism*; D006801:Humans; D007124:Immunoenzyme Techniques; D007633:Keratins / Q000378:metabolism; D017570:MyoD Protein / Q000378:metabolism; D018008:Myogenin / Q000378:metabolism; D013586:Synovitis, Pigmented Villonodular / Q000378:metabolism / Q000473:pathology*
D000199:Actins; D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D003893:Desmin; C503799:MYOG protein, human; D017570:MyoD Protein; C057363:MyoD1 myogenic differentiation protein; D018008:Myogenin; D007633:Keratins