Ueo Tetsuya, Kashima Kenji, Daa Tsutomu, Kashima Nobuyuki, Tsuji Koh-Ichi, Hisaoka Masanori, Yokoyama Shigeo
Department of Pathology, Faculty of Medicine, Oita University, Oita, Japan.
APMIS. 2004 Sep;112(9):624-8. doi: 10.1111/j.1600-0463.2004.apm1120911.x.
Tenosynovial chondromatosis has not been well recognized because of its rarity, but it is clinically important because of its high rate of recurrence. We report here a case of tenosynovial chondromatosis with deposits of crystalline material that appeared to be sodium urate (gouty tophi). A 37-year-old Japanese man was admitted because of a hard mass in his left third finger. He had undergone surgery at the same anatomical site four and seven years previously. The roentgenogram revealed a soft tissue mass in the flexor aspect of the proximal phalanx. At operation, the tumor was found to have arisen in the tendon sheath. Histopathological examination showed that the tumor was composed of well-defined, multiple, cartilaginous nodules that were surrounded by tenosynovial tissue. A few of the nodules were calcified. The chondrocytes had mild atypia, and were immunopositive for S-100 protein. A diagnosis of tenosynovial chondromatosis was made. The nodules also contained crystalline deposits, which bore a histological resemblance to gouty tophi. We were unable to define the exact nature of these deposits even by transmission electron microscopy and electron roentgenographic microanalysis. Crystalline deposits in chondromas of soft tissue have been reported but not in tenosynovial chondromatosis.
滑膜软骨瘤病因其罕见而未得到充分认识，但因其高复发率而在临床上具有重要意义。我们在此报告一例滑膜软骨瘤病，其晶体物质沉积似乎为尿酸钠（痛风石）。一名37岁的日本男性因左手第三指出现硬块而入院。他曾在4年前和7年前在同一解剖部位接受过手术。X线片显示近端指骨屈侧有一软组织肿块。手术中发现肿瘤起源于腱鞘。组织病理学检查显示，肿瘤由界限清楚的多个软骨结节组成，周围为滑膜组织。少数结节有钙化。软骨细胞有轻度异型性，S-100蛋白免疫阳性。诊断为滑膜软骨瘤病。结节中还含有晶体沉积物，在组织学上与痛风石相似。即使通过透射电子显微镜和电子X线显微分析，我们也无法确定这些沉积物的确切性质。软组织软骨瘤中的晶体沉积物已有报道，但滑膜软骨瘤病中尚未见报道。
