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Adenocarcinoma papilar de seio nasal em cão: abordagem histomorfológica, imunofenotípica e terapêutica / Papillary Adenocarcinoma of Nasal Sinus in a Dog: Approach Histomorphologic, Immunophenotypic, and Therapeutic

Campos, Liliane Cunha; Silva, Juliana de Oliveira; Souza, Cristina Maria de; Campos, Cecília Bonolo de; Gamba, Conrado de Oliveira; Damasceno, Karine Araújo; Horta, Rodrigo dos Santos; Lavalle, Gleidice Eunice; Cassali, Geovanni Dantas.
Acta sci. vet. (Impr.); 41(supl.1): Pub. 16, 2013. ilus
Artigo em Português | VETINDEX | ID: biblio-1372659

Resumo

Background: Sinus adenocarcinomas of papillary pattern are neoplasms rarely described in dogs and most cases are characterized by slow growth, local invasion and rare cases of metastasis. Their characteristics are presence of glandular structures that may have papillary pattern, tubulo-papillary, acinar and mixed pattern. Approximately 80% of primary nasal tumors are malignant and adenocarcinomas are the most frequently histology type. This paper reports a case of papillary adenocarcinoma of nasal sinus in the dog, emphasizing the use of histochemical and immunohistochemical techniques to aiding for appropriate therapy. Case: A 14-year-old male Poodle dog, presenting seropurulent nasal discharge, frequent sneezing and an enlargement in the nasal region, was submitted to surgical excision of a tumor. Macroscopically, was observed fragment coated with soft hairy skin and shear blackish color, and some fragments associated with more firm tissues like cartilage and bone tissue. Tumor specimens were collected, fixed in 10% neutral buffered formalin solution and embedded in paraffin. Afterwards, 4 µm histological sections were obtained and stained with HE. For immunohistochemical analysis a biotin-peroxidase system was used and secondary antibodies were identifi ed using Advance HRP. CKAE1/AE3, CK34ßE12, SMA, E-cadherin, Cox-2, Ki-67 and Her-2 expression were evaluated. For CK AE1AE3 antibody a qualitative method was used and neoplasia were classified as negative (-) or positive (+) and for CK34ßE12 was used semiquantitative evaluation and neoplasms were classified as negative (-), positive with focal staining (+) and positive with diffuse staining (++). The graduation for HER-2 expression was (+) for 4 (++++), were 4 (++++) was the most intensity membrane staining. For Cox-2 the system used was semiquantitative and the distribution was scored by estimating the percentage of tumor cells staining. Intensity was estimated on a scale from 0 (absent) to 12 (strong). The proliferative index was calculated by counting nuclei positive for Ki-67 (anti-MIB-1) in a total of 1000 neoplastic cells. Microscopically, was observed a proliferation of epithelial cells in papillary arrangement with delicate connective axis of support and areas of stromal invasion, and the tumor received the diagnosis of papillary adenocarcinoma of nasal sinus. Immunohistochemical analysis revealed strong staining for Cox-2 (score 12), CKAE1/AE3 positivity and CK34ßE12 (+ + +) and negative for Her-2 (+). Loss of E-cadherin expression was observed and SMA allowed the visualization of areas of basal membrane rupture. The rate of proliferation was evaluated by means of the expression of MIB-1 was high (16%). Chemotherapy was performed with carboplatin and gemcitabine. Discussion: Sinus carcinomas in general, despite their slow growth, are locally invasive and cause extensive destruction of adjacent tissues. In this case, the immunohistochemical analysis presented positive expression of CK AE1/AE3 and CK34ßE12, indicating epithelial histogenesis with basal phenotype. Strong intensity of COX-2 expression was observed, indicating a poor prognostic for the patient. The loss of expression of E-caderin, areas of invasive tumors and high rate of cell proliferation, demonstrated the aggressive character of papillary adenocarcinoma nasal sinus. Surgery with chemotherapy- associated was effective and tolerant treatment. Diagnosis was based on histopathological and immunohistochemical analysis. Correct characterization of this neoplasm associated with the appropriate therapy aided in prognosis and in the improvement of the animal's quality of life. The patient's overall survival has been evaluated since the surgical procedure up to this date and is over 18 months.
Biblioteca responsável: BR68.1