Syntopy and pathomorphology of the volar ganglions

Abstract

The aim of our work was to study the syntopy and pathomorphology of excised volar ganglia. The study design involved two groups: an experimental group and a control group. The experimental group consisted of 20 patients with volar ganglion of the wrist joint who underwent treatment at the Microsurgery Research Institute clinic from October 2022 to January 2023. All patients underwent open excision of the volar ganglion under the control of 3× optical magnification. During the operation, the syntopy of the ganglion was studied in all patients, and a sample of the wrist joint capsule was taken for morphological examination, where the ganglion pedicle and the ganglion itself were attached. Anatomical material (7 specimens) served as a control a similar area of the wrist joint capsule taken from patients without wrist pathology, obtained from the pathological anatomy office. To determine the syntopy of the ganglion pedicle, intraoperative radiographic examination of the wrist joint was performed. The ganglion and the excised capsule segment were fixed in 10% neutral buffered formalin, then subjected to histological examination with hematoxylin and eosin staining. The pathomorphological picture of the excised joint capsule segment, adjacent to the ganglion pedicle, showed that the visually unchanged joint capsule consisted of coarse fibrous connective tissue with hyalinosis and areas of focal myxomatosis, with an increased number of fibrocytes and fibroblasts, as well as a small number of mononuclear elements.

The assessment of the pathomorphology of the volar ganglion itself showed that it was similar to the capsule, represented by coarse fibrous connective tissue with areas of hyalinosis. The epithelial lining was absent. Numerous areas of myxomatosis with uneven mononuclear infiltration and foci with a large number of fibroblastic and histiocytoid elements were present. The capsule and the volar ganglion itself had identical histological structures.