GCTTS is a very common Benign tumor usually affecting the digits in females ( 2x more common) grossly it is a lobulated small (2-3 Cm.) yellowish mass.
Here in our case we can see :
- osteoclast like gaint cells with many bland looking nuclei.
- many mononuclear cells in the back ground.
- Not much inflammatory cells or hemosidren.
The differential here:
- pigmented villonodualr tenosynovitis – usually in large joints like knee with lots of hemosidren.
- other granulomatous lesions – many inflammatory cells.
- mononuclear cells stain with Desmin
- you may see necrosis , tumor thrombi on paraffin sections.
Neoplastic vs reactive nature is still one of the questions to be solved.
-Long slender tapering nuclei sometimes bend and form hooks and comma shapes.
– Fibrillari back ground.
– Watch out from degenerative changes which including pleomorphism.
– If you find verocay bodies you are lucky
This case is dedicated to our dear colleague and friend Ahmed AboSolb, leaving us soon. your case is solved from the very first day 🙂