RESUMO
Angiomyofibroblastoma (AMF) is a rare benign mesenchymal tumor with tendency to arise in the lower genital tract of middleaged women, predominately in the vulva. A few cases of AMF in males have been reported involving the scrotum, perineum or spermatic cord. We report a new case of AMF arising in the right inguinal region of a 27-year-old man. The tumor was well-circumscribed, myxoid and measured 30 mm in maximum dimension. On microscopic examination, the tumor was composed of spindle cells without atypia and with less than one mitosis figure per 10 high-power fields. Multinucleated cells and mast cells were observed. The stroma was myxoid and edematous with abundant capillary-sized blood vessels. Immunohistochemical staining showed a strong immunoreactivity for desmin and smooth muscle actin. The tumor cells were negative for estrogen receptors and focally positive for progesterone receptors with a low proliferative index of Ki67 (< 5%). This unusual neoplasm should be distinguished from aggressive angiomyxoma and other myxoid malignant tumors.
Assuntos
Mixoma/diagnóstico , Neoplasias de Tecido Muscular/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Masculino , Mixoma/patologia , Neoplasias de Tecido Muscular/patologia , Neoplasias de Tecido Muscular/cirurgia , Cordão Espermático/patologiaRESUMO
IgG4-related diseases are a recently recognized systemic syndrome characterized by mass-forming lesions, in mainly exocrine tissue, that consist of lymphoplasmacytic infiltrates and sclerosis, which may mimic malignant neoplasm due to clinical and imaging features. We report an unusual case of a 62-year-old woman who presented with a left orbital mass, which histologically revealed to be an IgG4-sclerosing disease.
Assuntos
Imunoglobulina G/imunologia , Linfócitos/citologia , Neoplasias Orbitárias/patologia , Esclerose/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Orbitárias/diagnóstico , Neoplasias Orbitárias/imunologia , Esclerose/diagnóstico , Esclerose/imunologiaRESUMO
Papillary haemangiomas were recently defined as morphologically distinct and benign cutaneous haemangiomas showing a predominantly intravascular capillary proliferation within dilated thin-walled dermal blood vessels. We describe the case of a 45-year-old woman who presented with multiple eruptive red-bluish raised papules and nodules distributed over the skin of the chin that were related to a papillary haemangioma.
Assuntos
Capilares/patologia , Neoplasias Faciais/patologia , Hemangioma/patologia , Neoplasias Primárias Múltiplas , Antígenos CD34/análise , Biomarcadores Tumorais/análise , Biópsia , Capilares/química , Neoplasias Faciais/química , Feminino , Hemangioma/química , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Prognóstico , Fatores de TempoRESUMO
INTRODUCTION: We had for aim to study the factors influencing the rate of non satisfactory (NS) cervical node fine needle aspirations (CNFNA). MATERIALS AND METHODS: We prospectively included 272 CNFNA, performed over 2 years (2010-2012). NS results were studied according to the following criteria: age, size and location of the node, number of punctures performed, and the operating physician's experience. RESULTS: Fifty-six (20.6%) of the 272 CNFNA were NS because they were acellular or paucicellular. The rate of NS CNFNA was not correlated with the patient's age: 63.6% for small lymph nodes (≤1 cm: P=0.01). Submandibular and jugulodigastric locations were observed in 28% of NS CNFNA and in 5% of satisfactory ones (P=0.001). The rate of NS CNFNA was 67% if 1 or 2 punctures were performed; it decreased to 18% for 3 or more punctures (P=0.01). This rate was 77% for the first study semester, and 8% for the fourth semester (P=0.001). CNFNA has been repeated for 19 patients. The second CNFNA was contributive for 14 patients. Repeating the CNFNA increased its efficiency by 73.7% (14/19). DISCUSSION: The rate of NS CNFNA depends on the size and location of the lymph node, and the operating physician's experience. Repeating the CNFNA significantly improves its efficiency.
Assuntos
Linfonodos/patologia , Doenças Linfáticas/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia por Agulha Fina/instrumentação , Biópsia por Agulha Fina/métodos , Biópsia por Agulha Fina/estatística & dados numéricos , Criança , Pré-Escolar , Competência Clínica/estatística & dados numéricos , Humanos , Lactente , Doenças Linfáticas/epidemiologia , Doenças Linfáticas/patologia , Metástase Linfática/diagnóstico , Metástase Linfática/patologia , Pessoa de Meia-Idade , Pescoço , Agulhas , Valor Preditivo dos Testes , Biópsia de Linfonodo Sentinela/instrumentação , Biópsia de Linfonodo Sentinela/métodos , Biópsia de Linfonodo Sentinela/estatística & dados numéricos , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Tuberculose/patologia , Adulto JovemRESUMO
INTRODUCTION: Osteoclast-type giant cell tumors of the salivary gland are extremely rare; only 23 cases have been reported. Two presentations were observed: isolated tumor or tumor associated with a carcinomatous contingent. CASE REPORT: A 51-year-old female patient consulted for a painless left retro-angulo-mandibular swelling having appeared 2 years before. This was a 2 cm parotid mass without facial nerve palsy or cervical lymphadenopathy. The patient underwent a superficial parotidectomy to remove the nodule. The direct microscopic examination revealed an osteoclastic giant cell tumor without any carcinomatous contingent. At immunohistochemistry, mononuclear cells were diffusely and intensely stained by anti-pancytokeratin, while multinucleated cells were totally negative and CD68 positive. The patient was not given any complementary treatment. She was followed-up 23 months later and did not present any signs of recurrence or metastasis. DISCUSSION: The histogenesis and nosology of osteoclastic giant cell are currently unknown. Although this entity was not integrated into the latest WHO classification, most authors consider it as a variant of carcinoma. Published data on the epithelial or histiocytic nature of multinucleated cells is not consensual. Our case presentation supports the hypothesis of a histiocytic differentiation of giant cells and epithelial mononuclear cells.
Assuntos
Tumores de Células Gigantes/diagnóstico , Osteoclastos/patologia , Neoplasias Parotídeas/diagnóstico , Feminino , Tumores de Células Gigantes/patologia , Humanos , Pessoa de Meia-Idade , Neoplasias Parotídeas/patologiaAssuntos
Hidradenite Supurativa/complicações , Hiperpigmentação/complicações , Dermatopatias Genéticas/complicações , Dermatopatias Papuloescamosas/complicações , Adulto , Axila , Epitélio/patologia , Dermatoses Faciais/complicações , Dermatoses Faciais/genética , Dermatoses Faciais/patologia , Feminino , Genes Dominantes , Folículo Piloso/patologia , Humanos , Hiperpigmentação/genética , Hiperpigmentação/patologia , Pescoço , Dermatopatias Genéticas/genética , Dermatopatias Genéticas/patologia , Dermatopatias Papuloescamosas/genética , Dermatopatias Papuloescamosas/patologiaRESUMO
The lung, the liver, the bone tissue and the brain are the most frequent sites for renal cell carcinoma metastasis. Small bowel metastasis from renal cell carcinoma is rare, with only few cases published. We report the case of ileal metastasis from operated kidney cancer revealed by ileocolic intussusception and causing intestinal obstruction in a 32-year-old woman.
Assuntos
Carcinoma de Células Renais/cirurgia , Neoplasias do Íleo/cirurgia , Valva Ileocecal , Intussuscepção/cirurgia , Neoplasias Renais/cirurgia , Adulto , Carcinoma de Células Renais/secundário , Colectomia , Evolução Fatal , Feminino , Humanos , Neoplasias do Íleo/secundário , Intussuscepção/etiologia , Intussuscepção/patologia , Neoplasias Renais/patologia , NefrectomiaRESUMO
Fibroepithelioma of Pinkus is a rare cutaneous tumour. Its classification is controversial and is considered as a variant of either basal cell carcinoma or trichoblastoma. Its presentation as a multiple tumour is rare. We are reporting such a case occurring in a 55-year-old man presenting with multiple seborrheic keratosis-like lesions corresponding histologically to Pinkus tumours. The clinical diagnosis of Pinkus tumour represents a challenge. Histological examination is extremely useful in aiding in the diagnosis of difficult cases.
Assuntos
Neoplasias Fibroepiteliais/patologia , Neoplasias Cutâneas/patologia , Pele/patologia , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Pemphigus is a severe and life-threatening autoimmune bullous dermatosis. OBJECTIVE: We have analysed parameters that may influence prognosis of pemphigus (P). METHODS: It was a retrospective study (2002-2010), with pemphigus considered as severe if body surface involvement ≥ 30%. Disease control and relapse-free survival (Kaplan-Meier) were analysed and compared according to several parameters (P < 0.05). RESULTS: 47 cases of pemphigus were collected, mean age 51 years ± 16.8 (F/H = 3.27). There were 30 pemphigus profundus and 17 superficial pemphigus. The median remission period was of 9 months (1.2 months-5 years). The mean healing time was of 40 days (6 days-4 months), which did not depend on type of P, its severity or infectious complications, whereas it was shorter in aged patient (≥ 65 years) compared to non aged ones (P = 0.018). 36.2% of patients had relapsed. Relapses were significantly more frequently observed only in the presence of mucosal involvement at presentation (P = 0.015). The median overall 1st relapse-free survival was of 2.33 years. Only mucosal involvement at presentation was associated with a shorter median 1st relapse-free survival time (1.28 years vs. 3 years) (P = 0.0017). Mortality rate was of 10.6% (n = 5); in four patients the death was directly related to pemphigus and occurred rapidly after the onset of lesions. CONCLUSION: Our study illustrates the poor prognosis of pemphigus by a long duration to disease control, a high initial dose of oral steroid, a high rate of relapse and a short remission period. Only mucosal involvement at presentation was identified as a poor prognostic factor.
Assuntos
Pênfigo/tratamento farmacológico , Pênfigo/epidemiologia , Prednisona/uso terapêutico , Administração Oral , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Intervalos de Confiança , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Pênfigo/patologia , Prognóstico , Recidiva , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Taxa de Sobrevida , Resultado do Tratamento , Tunísia/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Malignant proliferating trichilemmal cyst is a rare tumour usually located on the scalp of elderly women. About 40 cases of malignant proliferating trichilemmal tumour have been documented. CASE REPORT: We report a case of a malignant proliferating trichilemmal cyst of the scalp in a 57-year-old woman. On the vertex she had a voluminous vegetated and multinodular tumour measuring 7 x 5 cm with spontaneous and abundant bleeding, and another lesion of the scalp corresponding to a trichilemmal cyst. Based on histopathological findings, the case was diagnosed as malignant proliferating trichilemmal cyst. CONCLUSION: Diagnostic, clinicoprognostic and histological features of this tumour are discussed. Treatment is not yet standardized given its rarity.
Assuntos
Carcinoma de Células Escamosas/patologia , Folículo Piloso/patologia , Couro Cabeludo/patologia , Neoplasias Cutâneas/patologia , Biópsia , Transformação Celular Neoplásica/patologia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: Ameloblastic fibro-odontoma (AFO) is a very rare mixed odontogenic tumor (2% of all odontogenic tumors). It is considered as a non-extensive non-aggressive tumor but recurrence and malignant transformation remain possible. We report a voluminous AFO in a child. CASE REPORT: A 7-year-old boy presented with a right mandibular and facial swelling. The panoramic radiograph and CT scan revealed a voluminous unilocular radiolucent lesion (10 cm) with an impacted tooth that involved the ramus area and the angle of the right mandible. Enucleation and curettage was performed with a good outcome. There was no recurrence at ten months. DISCUSSION: This case is exceptional because of the young patient's age, the large tumor diameter, and the good outcome after ten months. This tumor occurs more often in the posterior region of the mandible and is frequently seen in the first two decades of life. The diagnosis is made on radio-clinical data and may be confirmed by histology. A surgical treatment with complete tumor removal is recommended to prevent recurrence.
Assuntos
Neoplasias Mandibulares/diagnóstico , Odontoma/diagnóstico , Criança , Seguimentos , Humanos , Masculino , Dente Serotino/patologia , Radiografia Panorâmica , Tomografia Computadorizada por Raios X , Dente Impactado/diagnósticoRESUMO
The inflammatory myofibroblastic tumour has clinical, biological or histological features sometimes misleading with a septic condition. Presenting symptoms are variable and arising circumstances remain obscure. We report three cases occurring in a postpartum context. The first patient, a 28-year-old female, had left psoitis with a sepsis the first day postpartum in relation with an inflammatory myofibroblastic tumour of the meso-ovary. The second patient, a 40-year-old woman, had a hepatic inflammatory myofibroblastic tumour revealed by a ruptured sub-capsular haematoma of the liver in the forth day postpartum. The third patient, a 32-year-old woman, had a pulmonary inflammatory myofibroblastic tumour, diagnosed 5 months after a delivery and which recurred 10 years after surgical treatment. These cases illustrate the difficulty to diagnose inflammatory myofibroblastic tumour, particularly in postpartum.
Assuntos
Granuloma de Células Plasmáticas , Transtornos Puerperais , Adulto , Feminino , Granuloma de Células Plasmáticas/diagnóstico , Granuloma de Células Plasmáticas/etiologia , Humanos , Transtornos Puerperais/diagnóstico , Transtornos Puerperais/etiologiaAssuntos
Coristoma/diagnóstico , Pólipos/diagnóstico , Próstata , Doenças da Bexiga Urinária/diagnóstico , Biomarcadores Tumorais/análise , Coristoma/cirurgia , Cistoscopia , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos/química , Pólipos/cirurgia , Antígeno Prostático Específico/análise , Doenças Raras , Resultado do Tratamento , Ureteroscopia , Doenças da Bexiga Urinária/cirurgiaRESUMO
Disseminated histoplasmosis is a fungal infection caused by Histoplasma capsulatum. It often involves immunodeficient patients and can occur in two forms, i.e., the large- and small-celled variants. The purpose of this report is to describe a case of disseminated histoplasmosis with cutaneous and digestive involvement observed four years after kidney transplantation in a man from Senegal. The patient developed severe sepsis secondary to colonic perforation. Outcome was fatal due to delayed diagnosis and extent of disease.
Assuntos
Doenças do Ceco/etiologia , Histoplasmose/diagnóstico , Perfuração Intestinal/etiologia , Transplante de Rim , Humanos , Hospedeiro Imunocomprometido , Imunossupressores/uso terapêutico , MasculinoRESUMO
Rectal leiomyosarcoma is an uncommon malignancy. Herein, we describe the clinicopathological features and biological behaviour of these tumours, and provide a practical approach to differential diagnosis, particularly with gastrointestinal stromal tumours (GIST). We report two cases in elderly men. In the first, the lesion was 2 cm from the anal sphincter, while it was located in the rectal ampulla in the second case. Histologically, both tumours were characterized by pleiomorphic, large spindle cells, presenting numerous mitoses and marked nuclear atypia. Immunohistochemical analysis showed that tumour cells coexpressed both actin and desmin, whereas CD117 and S100 protein were negative. The final diagnosis was leiomyosarcoma. One of the patients died of pulmonary metastasis within six months. The second patient had bone metastasis, but was lost to follow up. This report underlines the potential diagnostic problems raised by rectal leiomyosarcoma and emphasizes the role of immunohistochemistry in achieving correct diagnosis, which has important clinical, therapeutic and prognostic consequences.
Assuntos
Neoplasias Ósseas/secundário , Leiomiossarcoma/secundário , Neoplasias Pulmonares/secundário , Neoplasias Retais/patologia , Actinas/metabolismo , Idoso , Biomarcadores Tumorais/metabolismo , Desmina/metabolismo , Diagnóstico Diferencial , Evolução Fatal , Tumores do Estroma Gastrointestinal/diagnóstico , Humanos , Imuno-Histoquímica , Leiomiossarcoma/metabolismo , Leiomiossarcoma/cirurgia , Masculino , Neoplasias Retais/metabolismo , Neoplasias Retais/cirurgiaRESUMO
UNLABELLED: Cutaneous tuberculosis accounts for 2% of all extrapulmonary tuberculosis and is one of the multiple clinical presentations of extrapulmonary tuberculosis. We report a case of cutaneous tuberculosis with unusual clinical and histological presentations. CASE REPORT: We report the case of a 29-year-old woman with plurifocal tuberculous lupus. Histological examination of cutaneous lesions revealed the presence of a granuloma with caseum necrosis. Chest X-ray showed a severe pulmonary tuberculosis lesion. The Mantoux test performed by intradermal injection was positive. Skin lesion PCR and sputum culture were negative. Both skin and pulmonary lesions responded to antituberculous treatment. COMMENTARY: Lupus vulgaris is commonly presents on the head and neck. The diagnosis may be difficult when lupus vulgaris occurs at unexpected sites or in unusual clinical presentations. Caseum necrosis observed in our patient was unusual.
Assuntos
Antituberculosos/uso terapêutico , Tuberculose Cutânea/diagnóstico , Adulto , Feminino , Granuloma/microbiologia , Granuloma/patologia , Humanos , Necrose , Pele/patologia , Testes Cutâneos , Tuberculose Cutânea/tratamento farmacológico , Tuberculose Cutânea/patologiaRESUMO
Plasmocytoid urothelial carcinoma is a rare subtype of tumour of the urinary bladder. Its clinical and histopathological features have not been well characterized. There are few reports of this type of tumour. We report a case of 65-year-old man who was operated in our department for bladder tumour. The pathological diagnosis was high-grade urothelial carcinoma with plasmocytoid component. The patient died shortly thereafter from liver and bone metastasis.