22/06/2013 - São Paulo - Elizabeth Montgomery

DIAGNÓSTICOS

Diagnoses

1.   NKM Lab. – Man, 62 y/o. Chronic sinusitis with necro-infectious involvement, of the orbital region, ethmoidal and sphenoidal sinus. Resection of left orbit.

Diagnosis: Extranodal NK-T cell -Lymphoma  (nasal type).

  1.      IHC panel: positive for CD3, CD65, CD30, Ki-67 - 90%, EBV, T1A1, CD8 (focal), CD2, CD56.

   Bibliografia:

  1.  WHO Classification of tumors of Haematopoietic and Lymphoid tissues.
  2. . Takhashi E. et al. Nodal T/NK-cell lymphoma of nasal type: a clinicopathological study of six cases. Histopathology 2008,52: 585-96
  3. . Ki-67 expression is predictive of prognosis in patients with stage I/II extranodal NK/T-cell lymphoma, nasal type. Annals of oncology 18:1382-1387, 2007
  4. . EBV Viral Load in Tumor Tissue Is an Important Prognostic Indicator for Nasal NK/T-Cell Lymphoma. Am J Clin pathol 2007; 128:579-84.

 

  1.    Suster case- 60 y-o woman is seen for shortness of breath. A single spiculated nodule 6 cm. in diameter is seen in her right upper lobe of lung. She has no previous history of malignancy.

Diagnosis: Pulmonary adenocarcinoma, with enteric differentiation (as described in 1991).

  1.      IHC panel: positive for Ck20, CDX2, Vilin (focal),  Ck7 (focal); negatve for TTF1, Napsin-A.

Referências: 1. Primary pulmonary adenocarcinoma with enteric differentiation resembling metastatic colorectal carcinoma: a report of the second case negative for cytokeratin 7. Hatanaka K. et al. T. Pathol Res Pract. 2011; 15;207(3):188-91. 2. Pulmonary adenocarcinomas with enteric differentiation: histologic and immunohistochemical characteristics compared with metastatic colorectal cancers and usual pulmonary adenocarcinomas. Inamura K. et al. Am J Surg Pathol. 2005; 29(5):660-5. 3. Primary pulmonary adenocarcinoma with enteric differentiation. Tsao MS, Fraser RS. Cancer. 1991; 68(8):1754-7.

 

  1.    Salomão & Zoppi Lab. AP13-9271. Woman, 41 y/o. Hysterectomy. Uterus weighing 126 g and measuring 10.8 x 6.7x 4.1 cm. Multiple myometrial nodules measuring up to 1.1 cm in diameter. There is a redish area covering all the external third of the myometrial wall, up to the cervix region. This area is permeated by channels measuring between 0.7 up to 1.0 cm in thickness.
  2. :  Uterine diffuse cavernous hemangioma associated with pregnancy (myometrial diffuse hemangioma).

Patogênese (Uterine hemangioma. A rare pathologic entity. Chou WY ET al. Arch Pathol. Lab. Med. 136: May, 2012.

  •          origem provável das células: céls mesodérmicas embrionárias pluripotentes
  •          Congênito

  - associado a doenças hereditárias  (Síndrome de Klippel-Trenaunay, Telangiectasia hemorrágica hereditária, Síndrome de Maffucci, Síndrome de Kasabach-Merritt

  •          Adquirido

  - alterações físicas e hormonais *

  - maioria dos casos relatados

  1.    EPM/Hosp. Brigadeiro case: Man, 60 y/o. Tumoral mass in the right kidney (16,5 x 12 x 9.5 cm)

Diagnosis: Renal cell clear carcinoma with extensive sarcomatous component (90%).

  1.      IHC panel: positive for AE1AE3, vimentin, CD10, CD34, CD31, factor VIII. 

                   Referências:

                                  1. Reiter M, Schwope R, Clarkson A. Sarcomatoid renal cell carcinoma: A case report and literature review. Radiology Case. 2012; 6:11-16

                                  2. Akhtar K. et al. Sarcomatoid Renal Cell Carcinoma Saudi J Kidney Dis Transplant 2011; 22: 120-122

                                  3. Shuch B. et al. Sarcomatoid Renal Cell Carcinoma: A Comprehensive Review of the Biology and Current Treatment Strategies . http://theoncologist.alphamedpress.org/

 

  1.    Belo Horizonte case: A 38 y/o woman. Tumor in the right ovary

Diagnosis: Adnexial tumor of probable Wolffian origin (FATWO).

  1.      IHC panel: positive for estrogen receptor, calretenin. CAM 5.2, AE1-AE3,CK7, inhibin alpha.

   

  1.    UNESP Case: A 23 y/o man with a pelvic tumor adhered to the terminal ileum and right ureter.

Diagnosis: Small round cell desmoplastic tumor.

  1.      IHC panel: positive for Desmin, CK, CD99, vimentin.
  2.  

1. Chang F. Desmoplastic Small Round Cell Tumors Cytologic, Histologic, and Immunohistochemical Features. Arch Pathol Lab Med. 2006;130:728–32.

2. Dufresne A. et al. Desmoplastic Small Round Cell Tumor: Current Management and Recent Findings. Sarcoma. 2012, 5 pages.

3. Jordan AH & Anderson PM. The diagnosis and management of desmoplastic small round cell tumor: a review. Current Opinion in Oncology. 2011; 23:385–9.

4. Koniari K. et al. Intraabdominal desmoplastic small round cell tumor: Report of a case and literature reviewInt J Surg Case Rep. 2011; 2(8): 293–6.

 

  1.    Case- Salvador, Hospital Aliança: Man, 66 y/o. Retroperitoneal tumor detected in routine exam. It was submitted to frozen section and imprints were prepared.

Diagnosis: Lipofibrosarcoma of low grade , myxoid variant, (myxofibrosarcoma).

IHC panel: positive for CD34., fascin, CD68.