20/04/2013 - Botucatu

DIAGNÓSTICOS

1- Caso Dra. Dora - Londrina - 27 y/o man. Bilateral renal tumor.Past history of neuroblastoma (B12/17716-1: Right Kidney; B12/177716-2: Left Kidney).

Diagnóstico: Renal cell carcinoma associated with neuroblastoma.

Referência: Meadows AT, et al. Second neoplasms in survivors of childhood cancer: findings from the Childhood Cancer Survivor Study cohort. J Clin Oncol 2009; 27(14):2356-62.

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2- Caso Lab. F. Costa (Dra. Iria) - 77 y/o Woman. A retroperitoneal tumor.

Diagnóstico: Adrenocortical carcinoma; Immunohistochemistry Studies (IHC): Inhibin-A negative, Melan-A positiv e. 

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3-  Caso Michal - M185334/09: 71 y/o woman. A 15x15x7 cm endometrial tumor.

Diagnóstico: Endometrioid Carcinomas of the Uterine Corpus With Sex Cord-like Formations and Hyalinization.

Referência: Murray SK, et al. Endometrioid Carcinomas of the Uterine Corpus With Sex Cord-like Formations, Hyalinization, and Other Unusual Morphologic Features. Am J Surg Pathol 2005; 29(2):157-66. 

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4- Caso Hospital Aliança - Masc. 61 anos. Passado recente de neoplasia de cólon. Fez ciclo de quimioterapia. Frequente contato com pássaros. Evoluiu com dispnéia, sendo diagnosticado infiltrado pulmonar a esclarecer bilateral, mais pronunciado a direita. Pneumonia de hipersenbilidade? Metástase? Doença granulomatosa?

Diagnóstico: Bronchiolitis, granulomatosis and bronchiolitis obliterans-organizing pneumonia. Note: These histological findings are in favor of chronic occult aspiration, even without see a hexogen material in the samples.  Obs: case seen in consultation by Dr. Jeffrey Myers, University of Michigan.

Referência: Barnes WT, et al. Diffuse Bronchiolar Disease Due to Chronic Occult Aspiration. Mayo Clin Proc 2006; 81(2):172-176. 

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5- Caso Salomão Zoppi - IH2013-132 - Paciente do sexo masculino, 63 anos. Tumor em pulmão.

Diagnóstico: Epithelial – myoepithelial carcinoma of the lung; IHC: CK7, CK14 and calponin positive. 

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6- Caso HBH - 18765/12 - Mulher, 36 anos, com massa no cérebro. Sarcoma?

Diagnóstico: Hemangiopericytoma of the central nervous system; IHC: Factor XIII, BLC-2, CD34, CD99 positive and EMA negative.

Referência: Gengler C, Guillou L. Solitary fibrous tumour and haemangiopericytoma: evolution of a concept. Histopathology 2006; 48(1):63-74. 

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7 - Caso Porto - Man, 39 year-old, type 2 diabetes and Schizophrenia. Tonsillitis treated with antibiotics 3 days before admission to the hospital, with respiratory distress syndrome refractory to mechanical ventilation and nitric oxide. Died after 15 days of hospitalization. Autopsy lung tissue.

Diagnóstico: Diffuse alveolar damage in an organizing phase, without an infection agent. Histological findings compatible with idiopathic acute interstitial pneumonia (Hamman-Rich Syndro me).

Referência: Avnon LS, et al. Acute interstitial pneumonia-Hamman-Rich syndrome: clinical characteristics and diagnostic and therapeutic considerations. Anesth Analg. 2009; 108(1):232-7. 

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8- Caso Fausto J. Rodriguez, M.D. - R13-185: A 52 year-old woman developed an episode of slurred speech 7 years prior. MRI showed a homogeneously enchancing dural massa based on the interhemispheric fissure. The patient was followed by serial imaging. The mass recently showed a dramatic increase in size (preoperative MRI: 7.1x5.8x3.1 cm, impression was meningioma). A ressection was performed.

 
Diagnóstico: Low gr ade B-cell lymphoma with extensive plasmacytic differentiation; IHC: CD20 positive B cells, CD138 positive plasma cells, IgG positive; IgA and IgM negative.

Referência: Venkatamaran G, et al. Marginal Zone Lymphomas Involving Meningeal Dura: Possible Link to IgG4-Related Diseases. Modern Pathology 2011; 24: 355-366. 

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9- Caso Marília - LB 9304/12 - L.B.N., masc., 66 anos, lesão no dorso.

 Diagnóstico: Spindle cell lipoma; IHC: Vimentin, Desmin (focal) and CD34 positive; S100 negative.

Referência: Enzinger FM, Harvey DA. Spindle cell lipoma. Cancer 1975; 36(5):1852-9. 
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10 -Caso FMB - UNESP - Masculino, 12 anos, tumor interdigital na mão esquerda, de crescimento lento, levemente doloroso.

 Diagnóstico: Calcifying aponeurotic fibroma; IHC: vimentin, CD99, CD 68 and S100 positive.  

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11- Caso Hospital Brigadeiro - Man, 14 y/o. Lesion in the left shoulder for 6 months.

 Diagnóstico: Cellular neurothekeoma; IHC: Vimentin, CD10, Neuron Specific Enolase, CD63 positive and synaptophysin, S100, CD34, Desmin, HMB45, negative.

Referência: Hornick JL, Fletcher CD. Cellular neurothekeoma: detailed characterization in a series of 133 cases. Am J Surg Pathol 2007; 31(3):329-40.