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Immunophenotypic distinction between pigmented villonodular synovitis and haemosiderotic synovitis
  1. G Mahendra,
  2. K Kliskey,
  3. N A Athanasou
  1. Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK
  1. Correspondence to N A Athanasou, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Oxford OX 7LD, UK; nick.athanasou{at}noc.anglox.nhs.uk

Abstract

Aim: Haemosiderotic synovitis (HS) is caused by excessive bleeding into a joint. It occurs secondary to a variety of conditions and needs to be distinguished from pigmented villonodular synovitis (PVNS) for the purposes of treatment. The histopathological distinction between these conditions, particularly in biopsy specimens, can be problematic.

Methods: Immunophenotypic findings in 20 cases of PVNS and 20 cases of HS were analysed using monoclonal antibodies against proliferation (Ki-67), apoptosis (bcl2), macrophage (CD14, CD68, HLA-DR) and osteoclast (CD51) antigens.

Results: Macrophages in PVNS and HS expressed CD14 and HLA-DR. The giant cells in PVNS, but not those in HS, expressed CD51 and were negative for CD14 and HLA-DR, indicating that these cells had an osteoclast phenotype. Considerably more CD51-expressing mononuclear cells were noted in PVNS compared with HS. The Ki-67 proliferation index was higher in PVNS than in HS.

Conclusions: The findings indicate that there are immunophenotypic differences in giant cells between PVNS and HS, and that expression of CD51 and a high Ki-67 index effectively distinguishes between these two conditions.

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Footnotes

  • Funding This work was in part funded by a grant from the EU as part of the EuroBoNeT Network of Excellence. The authors would also like to acknowledge the support of the National Institute for Health Research Oxford Biomedical Research Unit.

  • Competing interests None.

  • Ethics approval Ethics approval was obtained from the Oxford Research Ethics Committee.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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