Okoro T, Isaac S, Ashford R U, Kershaw C J
Department of Orthopaedics, University Hospitals Leicester NHS Trust, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
Foot (Edinb). 2009 Sep;19(3):186-8. doi: 10.1016/j.foot.2009.01.006. Epub 2009 Feb 24.
Pigmented villonodular synovitis (PVNS) is a locally aggressive synovial proliferative disorder of unknown aetiology affecting the linings of joints, tendon sheaths, and bursae. A 22-year-old female patient presented with a 3-year history of an increasingly painful swelling on the dorsum of her right foot. Examination revealed a 4 cm x 2 cm swelling that was fluctuant, tender on palpation, unattached to overlying skin and partially mobile. A firm, pedunculated intra-articular lesion from the talonavicular joint was removed at surgery. Histology revealed a nodular lesion of stromal cells and numerous giant cells with villous architecture as well as abundant haemosiderin deposition with foamy macrophages (in keeping with PVNS). The patient is currently under review by the orthopaedic oncology team. Talonavicular joint PVNS is rare. MRI scanning is the optimum investigation. Complete excision is necessary to minimise high risk of recurrence.
色素沉着绒毛结节性滑膜炎（PVNS）是一种病因不明的局部侵袭性滑膜增生性疾病，可累及关节、腱鞘和滑囊的内衬。一名22岁女性患者，右足背出现逐渐加重的疼痛性肿胀已有3年病史。检查发现一个4厘米×2厘米的肿胀，有波动感，触诊时有压痛，与上方皮肤不相连且可部分活动。手术切除了距舟关节处一个坚实的、有蒂的关节内病变。组织学检查显示为一个由基质细胞和大量巨细胞组成的结节性病变，具有绒毛状结构，以及大量含铁血黄素沉积和泡沫状巨噬细胞（符合PVNS）。该患者目前正在接受骨肿瘤学团队的复查。距舟关节PVNS较为罕见。MRI扫描是最佳的检查方法。为将高复发风险降至最低，必须进行完整切除。
