Primary epithelioid angiosarcoma of the thyroid: an infrequent malignant thyroid tumor.

We present a case of epithelioid angiosarcoma of the thyroid, a rare and aggressive tumor, in a 74-year-old woman with a chronic euthyroid goiter. The tumor, which involved most of the glandular surface of the thyroid, showed an infiltrating histological pattern, with epithelioid cells displaying a tendency to form vascular lights. Immunohistochemical analysis (CD31 and factor VIII) confirmed the angiomatous nature of the neoplasm and enabled us to establish the differential diagnosis with other malignant processes that can also affect this anatomical area.

Prevalence of human papillomavirus genotypes in cytologic abnormalities from unvaccinated women living in north-western Spain.

Cervical cancer and its precursors low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) are associated with infection by human papillomavirus (HPV), in particular HPV 16 and 18. The distribution of the HPV genotype varies with the severity of cervical disease, age and the geographic location of the patients. We report the results of a population study carried out in a region of north-western (NW) Spain aimed at determining the prevalence of single and multiple infections by 35 types of HPV using low-density microarrays for 113 cases with negative for intraepithelial lesions or malignancies; 588 with atypical squamous cells of undetermined significance (ASCUS)/LSIL; 183 with HSIL; and seven cases of squamous cell carcinomas. Of the 891 patients analysed, 50.2% had single infections and 49.8% had multiple HPV infections. In women aged below 30 years, there was a predominance of multiple infections (p = 0.027). ASCUS/LSIL was associated with multiple and HSIL with single infections (p = 0.025). We observed significant increases in the percentage of infections due to a high-risk (HR) type of HPV when the severity of the cytological lesion increased (p = 0.001). No relationship was found between greater aggressiveness in the cytological diagnosis and a higher number of HPV types involved in multiple infections. The five most frequent genotypes were HPV 16 (26.3%), 53 (18.2%), 51 (17.3%), 6 (14.8%) and 66 (13.1%). The prevalence of HPV 16, 33 and 58 increased significantly from ACUS/LSIL to HSIL and the prevalence of HPV 51, 53 and 66 decreased. HPV 16 was the only genotype that showed a significant increase in prevalence when the severity of the cytological disease increased in single infections (p = 0.0001). The implementation of bivalent prophylactic vaccination could potentially lead to prevention in 32% of the population included in the study - in at least a quarter of patients with ACUS/LSIL (26.7%), and in half of HSIL (50.2%).

High-resolution genome-wide analysis of chromosomal alterations in elastofibroma.

Elastofibroma is a rare, benign fibrous proliferation that most commonly occur in periscapular soft tissues and is characterized by accumulated elastic fibers. Although the lesion is generally regarded as a reactive process, an unusual fibroblastic pseudotumor or as a fibroelastic tumor-like lesion, its etiology remains unknown. Cytogenetic studies in these lesions detected chromosomal instability and some recurrent clonal chromosomal changes, which raised the possibility that the lesion represents a neoplastic process. Here, we report the genomic alterations detected by array-based comparative genomic hybridization (aCGH) and by multiplex ligation-dependent probe amplification (MLPA) in two cases of elastofibroma. Both cases showed losses on 1p, 13q, 19p, and 22q by aCGH. In addition, deletion of CASR (3q21), GSTP1 (11q13), BRCA2 (13q12) and gains on APC (5q21) and PAH (12q23) were observed by MLPA in both samples. Genomic screening studies of this fibrous proliferation may lead to identify chromosomal regions containing genes involved in the development of elastofibromas.

Divergent ependymal tumor (ependymoblastoma/anaplastic ependymoma) of the posterior fossa: an uncommon case observed in a child.

We report a divergent ependymal tumor of the posterior fossa (ependymoblastoma/anaplastic ependymoma) observed in an 8-year-old boy. The tumor showed the histological pattern typical of an ependymoblastoma (tubular-papillary fetaloid architecture with stratification of the tumor cells) next to areas in which findings typical of an anaplastic ependymoma were detected. The immunohistochemical study confirmed our diagnostic suspicion, allowing us to establish a differential diagnosis with other entities such as medulloblastoma, medulloepithelioma, atypical rhabdoid/teratoid tumor, or metastases.

Cutaneous apocrine cystic adenolipoma.

Adenolipoma is a rare microscopic variant of cutaneous lipoma composed of large lobules of mature adipocytic tissue admixed with eccrine ducts and glands. We report a new case of cutaneous adenolipoma, and the first showing an apocrine cystic glandular component. This lesion may not be a specific entity, and could represent entrapment of epithelial structures within a lipoma.

Angiosarcoma epitelioide primario de tiroides. Ejemplo poco frecuente de neoplasia maligna tiroidea / Primary epithelioid angiosarcoma of the thyroid: an infrequent malignant thyroid tumor

Presentamos en nuestro trabajo un angiosarcoma epitelioide tiroideo, tumor raro y agresivo, observado en una paciente de 74 años, portadora de un bocio crónico eutiroideo. El tumor, que afectaba a la mayor parte de la superficie glandular del tiroides, mostró un patrón histológico infiltrante, con células epitelioides que tenían tendencia a formar luces vasculares. La inmunohistoquímica (CD31 y factor VIII) confirmaron el carácter angiomatoso de la neoplasia y permitieron establecer un diagnóstico diferencial con otros procesos malignos que pueden, igualmente, afectar a esta región anatómica (AU)

We present a case of epithelioid angiosarcoma of the thyroid, a rare and aggressive tumor, in a 74-year-old woman with a chronic euthyroid goiter. The tumor, which involved most of the glandular surface of the thyroid, showed an infiltrating histological pattern, with epithelioid cells displaying a tendency to form vascular lights. Immunohistochemical analysis (CD31 and factor VIII) confirmed the angiomatous nature of the neoplasm and enabled us to establish the differential diagnosis with other malignant processes that can also affect this anatomical area (AU)