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Treatment of pigmented villonodular synovitis with yttrium-90: Changes in immunologic features, Tc-99m uptake measurements, and MR imaging of one case

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Summary

Pigmented villonodular synovitis (PVNS) is an uncommon proliferative disease of synovium. We report a 35-year-old male with diffuse form of PVNS of left knee, treated with intraarticular injection of 5 mCi of yttrium-90 (Y-90) silicate colloid consisting of two doses with a 3-month interval between them. During follow-up, the affected knee showed clinical improvement and was accompanied by a decrease of the levels of soluble interleukin-2 receptor in sera and synovial fluids (SF). When compared to osteoarthritis subjects, SF lymphocyte subsets of this case before Y-90 therapy showed a lower CD4: CD8 cell ratio and absence of suppressor inducer cells (CD4+2H4+). The Tc-99m pertechnetate knee uptake indexes correlated well with clinical improvement. Serial magnetic resonance imaging revealed significant change one year after Y-90 therapy. The findings of immunological assessment suggested that immunoregulatory dysfunction may be related to the pathogenesis of PVNS.

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Authors and Affiliations

  1. Department of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, No. 160, Section 3, Chung-Kang Road, Taichung, Taiwan

    D-Y. Chen, J-L. Lan & S-J. Chou

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  1. D-Y. Chen
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  2. J-L. Lan
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  3. S-J. Chou
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Chen, DY., Lan, JL. & Chou, SJ. Treatment of pigmented villonodular synovitis with yttrium-90: Changes in immunologic features, Tc-99m uptake measurements, and MR imaging of one case. Clin Rheumatol 11, 280–285 (1992). https://doi.org/10.1007/BF02207973

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