RESUMO
Resumen Se presenta el caso clínico de una paciente del sexo femenino, de 30 años, con adenopatías supraclaviculares y axilares ipsilaterales, quien fue sometida a biopsia excisional con posterior estudio. El análisis histopatológico de la muestra de tejido resecado reveló una serie de características distintivas asociadas con la enfermedad de Castleman variante hialinovascular. La presentación de este caso no solo proporciona información detallada sobre la evolución clínica de la paciente, sino que también sirve como base para ilustrar los aspectos clave del diagnóstico histopatológico y las implicaciones inmunohistoquímicas en la enfermedad de Castleman. Además de hacer una revisión de tema respecto a esta patología poco común, en la cual los informes de casos son fundamentales para aumentar la comprensión de su variabilidad clínica y su abordaje diagnóstico, ilustrando los desafíos en el diagnóstico diferencial y como deben abordarse los mismos.
Abstract The clinical case of a 30-year-old female patient with supraclavicular and ipsilateral axillary lymphadenopathy who underwent excisional biopsy with subsequent study is presented. Histopathological analysis of the resected tissue sample revealed a series of distinctive features associated with hyalinevascular variant Castleman disease. The presentation of this case not only provides detailed information about the clinical evolution of the patient, but also serves as a basis to illustrate Key aspects of histopathological diagnosis and immunohistochemical implications in Castleman disease. In addition to making a review of the topic regarding this rare pathology in which case reports are essential to increase the understanding of its clinical variability and its diagnostic approach, illustrating the challenges in differential diagnosis and how they should be addressed.
RESUMO
The cotyledonoid dissecting leiomyoma of the uterus, or Stenberg tumor, is a rare variant of a smooth muscle benign tumor, classified in the group presenting an unusual growth pattern; clinically, it affects women in reproductive age. We report the case of a 43 year-old woman, who turned up at the Centro Estatal de Atencion Oncologica (State Cancer Care Center) in Morelia, Michoacan, presenting abnormal uterine bleeding and uterine fibroid of major elements. When performing a palpatory bimanual exam, a loose uterus of approximately 7 by 6 inches was identified; it ached when moving. The laboratory tests reported normal parametriums; the ultrasound showed, however, uterine fibroids of major elements. The uterus was enlarged due to a tumor of exophytic growth, which resembles placental cotyledons extended over the uterine surface, composed by smooth muscle nodules that dissected the uterine wall, and with infiltrative appearance in parametriums and the myometrial wall. Despite this microscopic aggressive appearance, a number of ultrastructuctural studies and immunohistochemical techniques proved its benign nature. This can help patients who want to preserve fertility avoid radical surgery.