The history, MRI, and histology suggest pigmented villonodular synovitis of the knee. However, the question asks what is the analogous histologic disease process of PVNS when located away from the synovial lining of joints, which is giant cell tumor of tendon sheath. Features that help make the diagnosis of PVNS in this case include the intra-articular location, signal uptake on MRI, and the diagnostic hemosiderin laden macrophages on histology. The reference by Abdul-Karim et al. describes the histologic similarities between giant cell tumor of tendon sheath and PVNS. Fibrous dysplasia would show a fibrous histiocytic background with the characteristic chinese letters. Hemangiomas show vascular structures on histology. There is no cellular atypia or high nuclear to cytoplasmic ratio as would be seen with synovial sarcoma and the characteristic giant cell tumor of bone would show the spindle cell background with associated multinucleated giant cells. In addition, none these lesions "change" names with anatomic location. In the reference by McCarthy et al, they discuss the differential diagnosis and treatment of synovial based lesions including PVNS. They argue that because PVNS is a difficult disease to cure, if a patient is relatively asymptomatic treat first with observation followed by synovectomy if pain continues.
Many men with Peyronie’s disease are anxious about the appearance of their penis, for obvious reasons. Some might feel worried about not being able to satisfy their partner or even fathering a child, due to difficulties having intercourse. The loss of intimacy and the relationship problems due to Peyronie’s disease can strongly affect one’s psychological well-being. [ 1,2 ] That is why it is important to be open about these feelings, however difficult it might be. Here are some tips/guidelines for talking to your partner about Peyronie’s disease.