RESUMO
We describe the first case of primary thymic adenocarcinoma with signet ring cell features. The patient was a 39-year-old Filipino male who presented with a huge anterior mediastinal mass extending to the left supraclavicular fossa, which underwent an incisional biopsy. Extensive clinicoradiological work-up showed no evidence of any primary tumor in other organs, and radiological imaging confirmed a primary tumor location in the thymic area. He later developed bilateral pleural and pericardial effusions and eventually died of his tumor. The biopsy contained a neoplastic growth of solid nests made of cells with prominent signet ring features in sclerotic stroma. Immunohistochemically, the tumor cells were reactive for cytokeratin 7, carcinoembryonic antigen, and CD5 and negative for cytokeratin 20, TTF1, napsin A, α-fetoprotein, PAX-8, CD-117, CA19-9, CA-125, CDX2, p63, and CD99. No genetic alterations of ALK, RET, and ROS1 were found, nor was any ALK or ROS1 immunostaining detected, as known to occur in a fraction of primary pulmonary adenocarcinomas. Morphologically, this thymic tumor resembled signet ring cell adenocarcinomas of other locations, including, stomach, pancreas, and lung, but CD5 immunoreactivity strongly supported the clinical and radiological evidence of a primary thymic origin. In the English literature, only 58 cases of primary thymic adenocarcinoma are on record and this is the first report of a signet ring cell variant, which further broadens the morphological spectrum of thymic adenocarcinoma subtypes.
Assuntos
Carcinoma de Células em Anel de Sinete/patologia , Derrame Pericárdico/patologia , Derrame Pleural Maligno/patologia , Timo/patologia , Neoplasias do Timo/patologia , Adulto , Biópsia , Carcinoma de Células em Anel de Sinete/complicações , Carcinoma de Células em Anel de Sinete/diagnóstico , Evolução Fatal , Humanos , Masculino , Derrame Pericárdico/etiologia , Derrame Pleural Maligno/etiologia , Timo/diagnóstico por imagem , Neoplasias do Timo/complicações , Neoplasias do Timo/diagnóstico , Tomografia Computadorizada por Raios XAssuntos
Cordoma/diagnóstico , Cordoma/metabolismo , Metilação de DNA , Proteína SMARCB1/deficiência , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/patologia , Criança , Pré-Escolar , Cordoma/genética , Cordoma/patologia , Análise por Conglomerados , Variações do Número de Cópias de DNA , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Masculino , Prognóstico , Tumor Rabdoide/diagnóstico , Tumor Rabdoide/genética , Tumor Rabdoide/metabolismo , Tumor Rabdoide/patologia , Proteína SMARCB1/genética , Análise de Sobrevida , Teratoma/diagnóstico , Teratoma/genética , Teratoma/metabolismo , Teratoma/patologiaRESUMO
Here, we report an example of an atypical prolactin-producing pituitary adenoma showing clear morphologic and immunohistochemical evidence of neurocytic transformation. Its features support the concept that neoplastic neuroendocrine cells, in this case adenohypophyseal cells, are capable of neuronal differentiation and broaden the morphologic spectrum of such rare tumors. Our findings have implications with respect to the nosology of neuronal tumors of the adenohypophysis.
