1. Abstract
Pigmented Villonodular Synovitis (PVNS) is a rare
overgrowth of the synovium, the connective tissue that lines
our joints. Although PVNS has been diagnosed in case studies
with human patients, it has yet to be cited in cadaveric
studies. Studying diseases in cadavers provides a powerful
educational tool towards future healthcare providers and
scientists that study the relationship between structure and
function in the human body. We hypothesize that higher
resolution photographs of PVNS will be able to materialize the
images seen in MRI, CT, and other scans. Photos of the
synovial outgrowth on the knee were taken using a Reichert
dissecting microscope, as well as a Nikon D600 with a Nikon
Micro-NIKKOR 105mm Lens. Previous photos of a dissected
synovial joint had not been documented in a cadaveric
specimen beforehand, and the ones developed illustrated the
physical manifestations of PVNS as well as higher definition of
the characteristics of the disease: particularly its pigmented
nodules. Different photographs display the progression of the
disease in this particular joint with the development of
synovial pigmentation to nodule formation. By studying PVNS
in the cadaver, we can present the tumor in a new light for
those studying anatomy and physiology, as well as provide
excellent models for analyzing arthritic diseases.
Pigmented Villonodular Synovitis: A Cadaveric Dissection & Photographical Documentation
Scott Campit1, John Yassa1, Ryan Marder2, Gloria Nusse3
Department of Biology, San Francisco State University
San Francisco, CA
Photographic Exhibit of PVNS Conclusion
This cadaveric dissection of a PVNS patient has
provided a useful model for studying this rare disease as
well as other arthritic diseases. The dissections made on
the shoulders (Fig 3.) and knees (Fig. 1) provided us with
a composite view of how the tumor presents itself in
different stages of development. The left knee and
shoulder displayed mature development of PVNS,
exhibiting massive growth of nodules and pigmentation
(Fig. 1, 4 and 6), whereas the right shoulder simply
showed pigmentation without the formation of the
nodules that usually accompany the disease (Fig. 7). The
right knee displayed intermediate development of the
disease as it began to form nodules along with apparent
pigmentation (Fig. 2 and 5). Maturation of PVNS in this
cadaver appears to have started unilaterally from the left
side of the body and began to develop on the right side
of the body. While a previous diagnosis has implicated
arthritis of the knee, the evidence provided in this study
leads us to believe that this patient had PVNS.
Acknowledgements
The authors wish to thank the UCSF Willed Body
Program and the individuals who donate their bodies
and tissues for the advancement of education and
research. We would also like to thank the SFSU Biology
Department and the SFSU anatomy lab for their
contributions to this project.
References
Bouali, H., Deppert, E., Leventhal, L., Reeves, B., & Pope,
T. (2004). Pigmented Villonodular Synovitis: A Disease in
Evolution. Journal of Rheumatology
Goel, S., Sharma, M., Bairwa, S., & Kanwat, P. (2014).
Bilateral Knee Pigmented Villonodular Synovitis: An
Uncommon Case Report. Scholars Journal of Medical
Case Reports.
Figure 2. Anterior view of the right
knee
Figure 1. Anterolateral view of the
left knee
Figure 4. Anterior view of left knee
Figure 3. Anterolateral view of the
left shoulder joint (zoomed out)
Figure 5. Anterior view of right
knee
Figure 6. Left shoulder joint
(zoomed in)
Figure 7. Right shoulder joint
(zoomed in)
Introduction
Pigmented Villonodular Synovitis (PVNS) is a rare disease
resulting in overgrowth of synovium (Goel, Sharma et. al
2014), ultimately leading to various skeletal conditions. There
are two forms of PVNS – a diffuse type that is widespread and
involves the entire joint and the localized type that involves
only the tendons or only occurs in one area of the joint
(Bouali, Deppert, et. al 2004).
In this study, we examine a synovial outgrowth of the
knee and shoulder in one of the cadavers at San Francisco
State that is thought to have PVNS. The cadaver examined was
a 84 year old woman diagnosed with arthritis in her knees
which was caused by the PVNS. It was determined that PVNS
had caused the swelling in her left knee and had begun
metastasize to other regions of the body, as further dissection
revealed additional tumors in the shoulder and the hip joint
(not shown).