RESUMO
Mesothelioma in situ has been proposed as a precursor to malignant mesothelioma arising in the pleura or peritoneum. We report a case of malignant peritoneal mesothelioma which progressed from mesothelioma in situ over a 10-mo period in a 24-yr-old woman with stage IV endometriosis. Initial surgery showed deeply infiltrative endometriosis with progestin effect. Postoperatively the patient had intractable pelvic pain and vaginal discharge. Imaging studies were negative. Repeat laparoscopy 10 mo later revealed vesicular lesions on the omentum and pinpoint white lesions studding the small bowel, appendix, and pelvic peritoneum. A diagnosis of epithelioid mesothelioma was established on biopsy of the omentum and confirmed by immunohistochemistry showing complete loss of BRCA1-associated protein-1 (BAP1) nuclear staining. Retrospectively, BAP1 loss was identified in the cytologically bland, single-layer surface mesothelium of the prior resection specimen, consistent with mesothelioma in situ . The patient underwent genetic testing and was found to have a pathogenic germline mutation in BAP1 .
Assuntos
Endometriose , Neoplasias Pulmonares , Mesotelioma Maligno , Mesotelioma , Neoplasias Peritoneais , Biomarcadores Tumorais/genética , Endometriose/complicações , Endometriose/genética , Endometriose/cirurgia , Feminino , Células Germinativas/patologia , Mutação em Linhagem Germinativa , Humanos , Neoplasias Pulmonares/diagnóstico , Mesotelioma/complicações , Mesotelioma/diagnóstico , Mesotelioma/genética , Neoplasias Peritoneais/genética , Neoplasias Peritoneais/patologia , Estudos Retrospectivos , Proteínas Supressoras de Tumor/genética , Ubiquitina Tiolesterase/genéticaRESUMO
Biceps tendon rupture is generally a clinical and radiographic diagnosis, and only rarely presents to the cytopathologist for fine needle aspiration biopsy. We present a case of ruptured biceps tendon associated with a cystic mass of the upper arm that was diagnosed using fine needle aspiration biopsy, and confirmed with subsequent MRI scan. We describe the clinical presentation, cytomorphology, and immunohistochemical profile of the marked chronic inflammatory infiltrate within the synovial fluid. We also provide a discussion of the differential diagnosis for a cystic mass associated with the biceps tendon on cytology.
Assuntos
Cistos/diagnóstico , Cistos/patologia , Músculos/patologia , Ruptura/diagnóstico , Ruptura/patologia , Idoso de 80 Anos ou mais , Biópsia por Agulha Fina , Feminino , Humanos , Linfócitos/patologia , Macrófagos/patologia , Imageamento por Ressonância Magnética , TendõesRESUMO
PURPOSE OF REVIEW: There is a clinical need for biomarkers that can improve diagnostic accuracy and risk stratification of esophageal lesions. Here we review the current literature and highlight the most important, recent advancements in biomarkers as a supplement to histopathology for management of patients with Barrett's esophagus. RECENT FINDINGS: A prospective cohort study in Northern Ireland shows that a small panel of biomarkers (low-grade dysplasia, abnormal DNA ploidy and Aspergillus oryzae lectin) can identify patients at high risk for developing high-grade dysplasia or cancer. Recent research in molecular imaging shows promise for molecular probes in endoscopy, using fluorescently labeled peptides or lectins to identify dysplastic areas of Barrett's epithelium. Based on the current literature, p53 immunostaining is starting to be adopted by some centers as an adjunct to histopathology diagnosis for dysplasia. SUMMARY: The evidence base for the use of biomarkers is increasing and it appears that panels may have superior diagnostic and predictive power over single, candidate biomarkers. Prior to clinical implementation, biomarkers must overcome significant barriers including the need for large-scale prospective validation trials, and the limited ability of clinical laboratories to process and analyze complex biomarker assays.