RESUMO
Urethral leiomyoma is a rare benign mesenchymal tumour arising from the smooth muscle of the urethra. It most often appears in females of reproductive age. Approximately 100 cases have been reported to date. The most usual presentation is urinary infection, hematuria or a mass. We report a case of a 42 year old woman who presented with sporadic hematuria, dysuria and dyspareunia. Histopathological studies confirmed urethral leiomyoma.
Assuntos
Leiomioma/patologia , Neoplasias Uretrais/patologia , Feminino , Humanos , Neoplasias Pélvicas/patologiaRESUMO
DOG1 is a highly-sensitive marker often included in the immunohistochemical panel for the diagnosis of gastrointestinal stromal tumors (GISTs). Recent research has shown that DOG1 may also be expressed by low-grade fibromyxoid sarcomas (LGFMSs); this may give rise to diagnostic error when the sarcoma is located in the abdominal cavity. This paper reports on immnohistochemical expression of DOG1 in 19 LGFMSs using two different monoclonal antibodies: K9 (Leica, Novocastra Laboratories, Newcastle upon Tyne, UK) and SP31 (Thermo Scientific, Freemont, USA). All LGFMSs displayed the standard histological pattern of alternating myxoid and fibrous areas, low cellularity and bland spindle-cell morphology. Positive staining for MUC4 was observed in 18/19 cases (94.7%), while there was rearrangement of the FUS gene in 14/19 (73.7%) cases and of the EWR1 gene in 2/19 (10.5%). The sarcoma staining negative for MUC4 displayed FUS gene rearrangement. Whole-section immunohistochemistry revealed positive staining for DOG1 in 8/19 cases (42.1%), though only with clone K9. Cytoplasmic as well as membrane staining was observed in all cases; staining was focal (10-30%) and of varying intensity (1+ to 2+). In conclusion, DOG1 clone K9 exhibited low sensitivity (42.1%) for the diagnosis of LGFMS, although higher than clone SP31. Since the two clones display similar sensitivity and specificity for GIST diagnosis, SP31 would appear to be more specific for this purpose, since no reaction was observed here with LGFMS, a GIST-mimicking lesion.
Assuntos
Anoctamina-1/metabolismo , Fibrossarcoma/metabolismo , Mixossarcoma/metabolismo , Proteínas de Neoplasias/metabolismo , Adulto , Idoso , Anticorpos Monoclonais , Biomarcadores Tumorais/metabolismo , Criança , Feminino , Fibrossarcoma/patologia , Rearranjo Gênico , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Mixossarcoma/patologia , Sensibilidade e Especificidade , Adulto JovemRESUMO
BACKGROUND: Gastrointestinal stromal tumours (GISTs) are the most common primary mesenchymal neoplasia in the gastrointestinal tract, although they represent only a small fraction of total gastrointestinal malignancies in adults (<2%). GISTs can be located at any level of the gastrointestinal tract; the stomach is the most common location (60-70%), in contrast to the rectum, which is most rare (4%). When a GIST invades into the adjacent prostate tissue, it can simulate prostate cancer. In this study, we report on a case comprising the unexpected collision between a rectal GIST tumour and a prostatic adenocarcinoma. FINDINGS: We describe the complexity of the clinical, endoscopic and radiological diagnosis, of the differential diagnosis based on tumour biopsy, and of the role of neoadjuvant therapy using imatinib prior to surgical treatment. CONCLUSIONS: Although isolated cases of coexisting GISTs and prostatic adenocarcinomas have previously been described, this is the first reported case in the medical literature of a collision tumour involving a rectal GIST and prostatic adenocarcinoma components. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1238437468776331.
Assuntos
Adenocarcinoma/patologia , Tumores do Estroma Gastrointestinal/patologia , Neoplasias Primárias Múltiplas/patologia , Próstata/patologia , Neoplasias da Próstata/patologia , Neoplasias Retais/patologia , Adenocarcinoma/química , Adenocarcinoma/terapia , Antineoplásicos/uso terapêutico , Benzamidas/uso terapêutico , Biomarcadores Tumorais/análise , Biópsia , Quimioterapia Adjuvante , Diagnóstico Diferencial , Tumores do Estroma Gastrointestinal/química , Tumores do Estroma Gastrointestinal/terapia , Humanos , Mesilato de Imatinib , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante , Invasividade Neoplásica , Neoplasias Primárias Múltiplas/química , Neoplasias Primárias Múltiplas/terapia , Piperazinas/uso terapêutico , Valor Preditivo dos Testes , Próstata/química , Próstata/cirurgia , Prostatectomia , Neoplasias da Próstata/química , Neoplasias da Próstata/terapia , Pirimidinas/uso terapêutico , Neoplasias Retais/química , Neoplasias Retais/terapia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
OBJECTIVE: To correlate the cytologic grade of breast carcinoma with the expression of E-cadherin/catenin system molecules and the presence of metastasis in regional lymph nodes. STUDY DESIGN: Aspirate smears were examined together with histologic sections from the corresponding neoplasms taken from 100 patients with invasive ductal carcinoma. In 50 cases, > or = 1 metastatic nodes were identified. Cytologic grading of the smears was performed using the Robinson method. Immunohistochemical expression of E-cadherin and of alpha-, beta- and gamma-catenin was studied. RESULTS: A statistically significant relationship was observed between E-cadherin/catenin expression and cytologic grade (p < 0.0005). This association was particularly relevant to the cell dissociation parameter (p < 0.0005). CONCLUSION: The cytological grade established in preoperative studies may provide relevant information on the aggressiveness of invasive ductal carcinoma and its tendency to produce regional metastasis. This finding could be particularly useful in cases of breast carcinoma in which neoadjuvant therapy is the method of choice.
Assuntos
Neoplasias da Mama/diagnóstico , Caderinas/biossíntese , Carcinoma Ductal de Mama/diagnóstico , Linfonodos/patologia , alfa Catenina/biossíntese , beta Catenina/biossíntese , gama Catenina/biossíntese , Biópsia por Agulha Fina/métodos , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Feminino , Humanos , Imuno-Histoquímica , Metástase Linfática , Invasividade Neoplásica , Sensibilidade e Especificidade , Coloração e RotulagemRESUMO
OBJECTIVE: To evaluate the importance of cytologic grading of breast carcinoma and its association with histologic grading and the existence of axillary lymph node metastasis. STUDY DESIGN: Aspirates and surgical samples from 100 patients with invasive ductal breast carcinoma not otherwise specified were studied. In 50 patients, > or = 1 metastatic nodes were identified. The cytologic grade was evaluated using the Robinson method and the histologic grade using the Elston modification of the Bloom-Richardson method. A study was undertaken to establish the association between histologic and cytologic grades and to compare the various parameters used to evaluate cytologic grade with the presence of axillary node metastasis. RESULTS: A statistically significant association was observed between cytologic and histologic grades (p < 0.0005) and between cytologic grade and presence of axillary metastasis (p < 0.0005). Similarly, cell dissociation (p < 0.0005), cell uniformity (p = 0.0010) and the appearance of nuclear margins (p < 0.0005) all displayed a positive correlation with regional metastasis. CONCLUSION: Cytologic grade may provide relevant information on the aggressiveness of invasive ductal breast carcinoma and could be a useful parameter to take into consideration when selecting neoadjuvant therapy.