Asunto(s)
Adenocarcinoma/diagnóstico , Biomarcadores de Tumor/metabolismo , Células Epiteliales/metabolismo , Factores de Transcripción Paired Box/metabolismo , Próstata/patología , Neoplasias de la Próstata/diagnóstico , Vesículas Seminales/metabolismo , Adenocarcinoma/patología , Biopsia con Aguja , Diagnóstico Diferencial , Errores Diagnósticos/prevención & control , Células Epiteliales/patología , Estudios de Factibilidad , Humanos , Inmunohistoquímica , Masculino , Factor de Transcripción PAX8 , Neoplasias de la Próstata/patología , Vesículas Seminales/patologíaRESUMEN
El sarcoma epitelioide representa menos del 1% de los sarcomas de partes blandas, posee una elevada capacidad para invadir los linfáticos regionales y alta tasa de recurrencias. Las formas clásicas se localizan preferentemente en la porción distal de las extremidades y afectan sobre todo a varones jóvenes, mientras que las formas proximales, además de características histológicas diferentes, tienden a situarse en el tronco, la pelvis y la raíz de las extremidades. El desarrollo intraóseo de este sarcoma es excepcional. En este artículo describimos a un paciente de 47 años que consultó por dolor en la región sacroilíaca derecha imitando una sacroilitis. La tomografía computarizada pélvica objetivó una lesión osteolítica en la región posterosuperior del ilíaco derecho, de la que se obtuvieron muestras mediante biopsia percutánea. Los hallazgos histológicos fueron típicos de sarcoma epitelioide clásico. En nuestro conocimiento, este es el segundo caso descrito en la literatura en que esta neoplasia se desarrolla primariamente en el tejido óseo (AU)
Epithelioid sarcoma represents less than 1% of soft tissue sarcomas and has a high recurrence rate and strong ability to invade the regional lymphatic pathways. Classic epithelioid sarcoma has a predilection for young men and usually affects the distal extremities, while the proximal-type is characterized by different histological features and most commonly occurs in the proximal part of the extremities, trunk and pelvis. Intraosseous tumor development is rare. We describe a 47 year old patient with sacroiliac pain mimicking sacroiliitis. A computed tomography of the pelvis showed a destructive intraosseous lesion of the upper- right iliac. Percutaneous biopsy of the lesion was obtained and histological findings were typical of classic epithelioid sarcoma. To our knowledge, this is the second case of intraosseous epithelioid sarcoma described in the medical literature (AU)
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Sarcoma/complicaciones , Sarcoma/diagnóstico , Sarcoma/tratamiento farmacológico , Inmunohistoquímica , Sarcoma/cirugía , Metástasis de la Neoplasia/fisiopatología , Metástasis de la Neoplasia , Medronato de Tecnecio Tc 99m , Radiografía Torácica , Sarcoma/fisiopatología , Sarcoma , Ilion/patología , Ilion , Huesos/patología , Huesos , Articulación Sacroiliaca/patología , Articulación Sacroiliaca , Inmunohistoquímica/métodosRESUMEN
Epithelioid sarcoma represents less than 1% of soft tissue sarcomas and has a high recurrence rate and strong ability to invade the regional lymphatic pathways. Classic epithelioid sarcoma has a predilection for young men and usually affects the distal extremities, while the proximal-type is characterized by different histological features and most commonly occurs in the proximal part of the extremities, trunk and pelvis. Intraosseous tumor development is rare. We describe a 47 year old patient with sacroiliac pain mimicking sacroiliitis. A computed tomography of the pelvis showed a destructive intraosseous lesion of the upper- right iliac. Percutaneous biopsy of the lesion was obtained and histological findings were typical of classic epithelioid sarcoma. To our knowledge, this is the second case of intraosseous epithelioid sarcoma described in the medical literature.
Asunto(s)
Neoplasias Óseas/diagnóstico , Ilion , Sacroileítis/diagnóstico , Sarcoma/diagnóstico , Diagnóstico Diferencial , Humanos , Ilion/diagnóstico por imagen , Ilion/patología , Masculino , Persona de Mediana Edad , RadiografíaRESUMEN
Nephrogenic adenoma (NA) has been considered as a metaplastic process of the urothelium. It has been suggested that this lesion is of renal tubular cell origin or differentiation. Immunohistochemical studies of NA emphasize its staining with α-methylacyl-coenzyme A racemase (AMACR), and prostatic adenocarcinoma may be a possible differential diagnosis. This reactivity was recently discussed as an artifact due to endogenous biotin. Kidney-specific cadherin (Ksp-cad) is a marker of distal nephron. CD10 and KIT are also expressed in the kidney. We studied the immunohistochemical expression of AMACR, p63, Ksp-cad, CD10, and KIT in 9 cases of NA (forming a total of 12 lesions). Practically all of the lesions stained for AMACR with 2 different antibodies and 2 high-sensitivity (multimer or polymer based) biotin-free methods (83% and 100%). The staining was similar for both methods in 9 of these 12 lesions. All of the NAs were negative for p63 and KIT, except 1 case, with focal reactivity for KIT. CD10 was expressed very focally in 4 of the 12 lesions (33%). We observed weak staining for Ksp-cad in 6 lesions (50%) and 3 (25%) showed a moderate positivity in 15% to 50% of the cells. In conclusion, positivity of NA for AMACR is not an artifact, as we confirmed using 2 different methods. Besides, p63, a basal cell marker, is usually negative. Immunoreactivity for Ksp-cad seems to support the differentiation of NA to distal nephron cells, at least in some of the cases. Other markers expressed by the nephron, such as CD10 and KIT, are usually negative in NA.
