RESUMO
Angiomyolipoma is the most common mesenchymal renal tumour, the clonal origin of which has recently been demonstrated. It is composed of varying amounts of blood vessels, smooth muscle and fat. In this report, we describe a renal angiomyolipoma, which is unusual owing to the presence of a lymphangioleiomyomatosis-like component, occurring in a 41-year-old woman suffering from sporadic lymphangioleiomyomatosis. The diagnosis was based on histopathological and immunohistochemical findings. The tumour consisted of an intimate admixture of two components: one was typical of a classical angiomyolipoma and the other was reminiscent of lymphangioleiomyomatosis. HMB45 positivity was found on 5% of the cells of the angiomyolipoma component. Ten percent of the nuclei of the lymphangioleiomyomatosis and angiomyolipoma components expressed oestrogen receptors and 5% progesterone receptors. This case illustrates a very unusual pattern of a renal angiomyolipoma containing a lymphangioleiomyomatosis-like component. The oestrogen and progesterone immunoreactivity suggests that angiomyolipoma could be hormonally dependent. Therefore, we have emphasised the morphological and immunohistochemical similarities between angiomyolipoma and lymphangioleiomyomatosis.
Assuntos
Angiomiolipoma/patologia , Neoplasias Renais/patologia , Linfangioleiomiomatose/patologia , Receptores de Estrogênio/análise , Receptores de Progesterona/análise , Adulto , Angiomiolipoma/química , Feminino , Humanos , Neoplasias Renais/química , Proteínas Repressoras/genética , Proteína 2 do Complexo Esclerose Tuberosa , Proteínas Supressoras de TumorRESUMO
We report the case of primary malignant melanoma of oesophagus in a 63-year-old man who presented with a 8-week history of dysphagia. Esophagoscopy demonstrated a polypoid mass expanding in the mid-oesophagus without causing obstruction. Based on histological and immunohistochemical studies, the diagnosis of primary esophageal malignant melanoma was made. Radical resection was not possible because of regional tumour extension at the time of diagnosis. The patient underwent percutaneous endoscopic gastrostomy. Death occurred 4 months later because of acute respiratory failure.
Assuntos
Neoplasias Esofágicas , Melanoma , Biópsia , Transtornos de Deglutição/etiologia , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/patologia , Esofagoscopia , Esôfago/patologia , Gastrostomia , Humanos , Imuno-Histoquímica , Masculino , Melanoma/diagnóstico , Melanoma/diagnóstico por imagem , Melanoma/patologia , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
Myoepithelioma of soft tissues is a rare and under-recognized tumor. We report a case of a myoepithelioma arising in the soft tissue of the wrist in a 37-year-old man. This 3cm, nodular, well circumscribed tumor consisted of a mixture of spindle and epithelioid cells in a fibrous or focally myxoid stroma. Nuclear atypia were mild and mitotic activity was 1 mitotic figure per 10 high-power fields. No tubular epithelial structure was found. The tumoral cells expressed cytokeratin (KL1) and S-100 protein. Smooth muscle actin and desmin were negative. The excision was complete. At 5 months, no recurrence was noted. Myoepithelioma of deep soft tissue has a predilection for extremity involvement. It has to be differentiated from extraskeletal myxoid chondrosarcoma, parachordoma and synovial sarcoma. Most of myoepitheliomas are benign. However, metastasis may occur in a minority of cases.
Assuntos
Mioepitelioma/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Actinas/análise , Adulto , Núcleo Celular/patologia , Desmina/análise , Células Epiteliais/patologia , Humanos , Queratinas/análise , Masculino , Mitose , Mioepitelioma/patologia , Mioepitelioma/cirurgia , Proteínas S100/análise , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/cirurgiaRESUMO
Lymph node ratio (LNR) (positive lymph nodes/sampled lymph nodes) is predictive of survival in colon cancer. The aim of the present study was to validate the LNR as a prognostic factor and to determine the optimum LNR cutoff for distinguishing between "good prognosis" and "poor prognosis" colon cancer patients. From January 2003 to December 2007, patients with TNM stage III colon cancer operated on with at least of 3 years of follow-up and not lost to follow-up were included in this retrospective study. The two primary endpoints were 3-year overall survival (OS) and disease-free survival (DFS) as a function of the LNR groups and the cutoff. One hundred seventy-eight patients were included. There was no correlation between the LNR group and 3-year OS (P=0.06) and a significant correlation between the LNR group and 3-year DFS (P=0.03). The optimal LNR cutoff of 10% was significantly correlated with 3-year OS (P=0.02) and DFS (P=0.02). The LNR was not an accurate prognostic factor when fewer than 12 lymph nodes were sampled. Clarification and simplification of the LNR classification are prerequisites for use of this system in randomized control trials. An LNR of 10% appears to be the optimal cutoff.