Asunto(s)
Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/tratamiento farmacológico , Enfermedad Relacionada con Inmunoglobulina G4/diagnóstico , Enfermedad Relacionada con Inmunoglobulina G4/tratamiento farmacológico , Inmunoglobulina G/inmunología , Lóbulo Temporal/diagnóstico por imagen , Adulto , Antiinflamatorios no Esteroideos/uso terapéutico , Antineoplásicos/uso terapéutico , Femenino , Humanos , Enfermedad Relacionada con Inmunoglobulina G4/diagnóstico por imagen , Imagen por Resonancia Magnética , Rituximab/uso terapéuticoRESUMEN
Primary cardiac angiosarcoma is a rare neoplasm and the epithelioid variant is exceedingly rare. We report a case of an epithelioid angiosarcoma that involved the right atrium and aorta of a 47-year-old male. The patient presented with atrial fibrillation and presyncopal spells. Following clinical evaluation, including computed tomography scan and trans-esophageal echocardiography, the neoplasm was surgically removed. It was a poorly differentiated malignant neoplasm composed of medium-sized epithelioid cells with a moderate amount of amphophilic cytoplasm. Immunohistochemical staining, including positive staining for CK22, AE1/AE3, melan-A, vimentin, and CD31, indicated the neoplasm was best categorized as an epithelioid angiosarcoma.
Asunto(s)
Células Epitelioides/patología , Neoplasias Cardíacas/patología , Hemangiosarcoma/patología , Aorta Abdominal/patología , Aorta Abdominal/cirugía , Fibrilación Atrial/etiología , Fibrilación Atrial/patología , Biomarcadores de Tumor/metabolismo , Terapia Combinada , Ecocardiografía Transesofágica , Células Epitelioides/metabolismo , Resultado Fatal , Atrios Cardíacos/patología , Atrios Cardíacos/cirugía , Neoplasias Cardíacas/complicaciones , Neoplasias Cardíacas/metabolismo , Neoplasias Cardíacas/terapia , Hemangiosarcoma/complicaciones , Hemangiosarcoma/metabolismo , Hemangiosarcoma/terapia , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The determination of tumor cell estrogen receptor (ER) expression status by immunohistochemical analysis has become standard practice, yet assay reproducibility has not been assessed adequately. By using a breast cancer tissue microarray, we examined interlaboratory variability in ER reporting. A 2-fold redundant tissue microarray block was created from 29 breast cancers. Unstained slides were distributed to 5 laboratories, and each laboratory immunostained and scored 1 slide for ER. Interlaboratory agreement ranged from moderate to high (overall kappa = 0.54 for 0-3+ grading; overall kappa = 0.84 for negative vs positive assessment of ER status). When 1 observer scored each of the 5 slides, interlaboratory agreement was slightly better (kappa = 0.63 for 0-3+ scoring; kappa = 0.96 for negative vs positive scoring). One laboratory, which had used an antibody and antigen retrieval method different from the others, demonstrated only fair concordance with the other 4 laboratories, but there was substantial intralaboratory interobserver agreement and excellent agreement with an outside observer reviewing the slide stained in that laboratory. The tissue microarray was an efficient and effective tool for identifying variability in ER reporting and should prove valuable in other external quality assurance programs.
