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Tophaceous pseudogout in the knee joint is rare. We report an 82-year-old man who presented with a one-year history of pain and swelling of the right knee joint. Treatment with non-steroidal anti-inflammatory drugs and aspiration of the joint effusion had not been effective. The mass continued to enlarge, and the patient had difficulty walking. Radiographs and computed tomography showed meniscal calcification with an abnormal soft-tissue mass surrounded by calcification. After excision, massive calcified deposits were seen both inside and on the surface of the tophaceous pseudogout. The deposits showed birefringence under polarised light, suggestive of calcium pyrophosphate dihydrate crystals. At the 2-year follow-up, the patient could walk independently without knee pain or swelling, although his range of knee motion was slightly limited due to joint contracture that developed before surgery.
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http://dx.doi.org/10.1177/230949901001800127 | DOI Listing |
Am J Surg Pathol
April 2025
Anatomic Pathology, Robert J. Tomsich Department of Pathology and Laboratory Medicine, Diagnostics Institute, Cleveland Clinic, Cleveland, OH.
Although monosodium urate and calcium pyrophosphate dihydrate (CPPD) crystals have been documented together in synovial fluid, there are no descriptions regarding their simultaneous histologic presence within the same tophi. Furthermore, the incidence, significance, and clinicopathologic features of such patients have not been analyzed. We retrospectively reviewed consecutive cases of pathologic specimens over an ~4-year period with a confirmed histologic diagnosis of "gout" or "gouty tophi", focusing on concomitantly documented CPPD.
View Article and Find Full Text PDFMod Pathol
July 2025
Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan. Electronic address:
"Calcified chondroid mesenchymal neoplasm (CCMN)" is a recently proposed term for tumors with hypercellular chondroid histology and fusion genes. However, its impact on the present classification framework has not been extensively investigated. In this study, we analyzed 20 tumors with histology that would fit with that reported as "CCMN.
View Article and Find Full Text PDFRheum Dis Clin North Am
November 2024
Department of Medicine, Allergy/Immunology & Rheumatology Division, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 695, Rochester, NY 14642, USA. Electronic address:
Am J Surg Pathol
August 2024
Department of Pathology, Timone University Hospital, Marseille.
Recently, FN1 fusions to receptor tyrosine kinase genes have been identified in soft tissue tumors with calcified chondroid matrix named calcifying chondroid mesenchymal neoplasms (CCMNs). We collected 33 cases of CCMN from the French network for soft tissue and bone tumors. We performed whole-exome RNA sequencing, expression analysis, and genome-wide DNA methylation profiling in 33, 30, and 20 cases of CCMN compared with a control group of tumors, including noncalcified tenosynovial giant cell tumor (TGCT).
View Article and Find Full Text PDFOtol Neurotol
April 2024
Department of Otolaryngology-Head and Neck Surgery, San Antonio Uniformed Services Health Education Consortium, JBSA-Fort Sam Houston, Texas.
Objective: Tophaceous lesions of the middle ear from calcium pyrophosphate deposition disease (CPPD, or pseudogout) and gout are infrequently reported. Recognizing its characteristic findings will allow clinicians to accurately narrow the differential diagnosis of bony-appearing middle ear lesions and improve management.
Patients: Two consecutive cases of tophaceous middle ear lesions presenting to a tertiary care center between January 2021 and December 2021.