Tumor fibroso calcificante intestinal: reporte de caso / Intestinal calcifying fibrous tumor: case report

El tumor fibroso calcificante (TFC) es una inusual lesión benigna de origen mesenquimal que puede presentar características similares a otros tumores más comunes. El caso involucra a una mujer de 36 años con un tumor en el yeyuno proximal, inicialmente sospechoso de ser un tumor del estroma gastrointestinal (GIST). Se realiza una resección quirúrgica, revelando un nódulo bien delimitado en el borde antimesentérico con características microscópicas típicas de TFC. Las células tumorales presentaban positividad para CD34 y negatividad para demás marcadores, diferenciándolo de otras neoplasias. El TFC puede confundirse con tumores más comunes debido a su apariencia, pero un diagnóstico preciso respaldado por inmunohistoquímica es esencial. La extirpación quirúrgica completa suele ser curativa. (AU)

Calcifying fibrous tumor (CFT) is a rare benign lesion of mesenchymal origin that may present similar characteristics to other more common tumors. We present the case of a 36-year-old woman with a tumor in the proximal jejunum, initially suspected to be a gastrointestinal stromal tumor (GIST). Surgical resection was performed, revealing a well-demarcated nodule at the anti-mesenteric border with microscopic features typical of a calcifying fibrous tumor. The tumor cells were positive for CD34 and negative for other markers, differentiating it from other neoplasms. Calcifying fibrous tumors can be confused with more common tumors because of its appearance, but an accurate diagnosis supported by immunohistochemistry is essential. Complete surgical excision is usually curative. (AU)

[Intestinal calcifying fibrous tumor: case report]. / Tumor fibroso calcificante intestinal: reporte de caso.

Calcifying fibrous tumor (CFT) is a rare benign lesion of mesenchymal origin that may present similar characteristics to other more common tumors. We present the case of a 36-year-old woman with a tumor in the proximal jejunum, initially suspected to be a gastrointestinal stromal tumor (GIST). Surgical resection was performed, revealing a well-demarcated nodule at the anti-mesenteric border with microscopic features typical of a calcifying fibrous tumor. The tumor cells were positive for CD34 and negative for other markers, differentiating it from other neoplasms. Calcifying fibrous tumors can be confused with more common tumors because of its appearance, but an accurate diagnosis supported by immunohistochemistry is essential. Complete surgical excision is usually curative.

Cutaneous Angiomyolipoma-A Distinct Entity That Should Be Separated From Classic Angiomyolipoma: Complete Review of Existing Cases and Defining Fundamental Features.

Cutaneous angiomyolipoma is a rare mesenchymal tumor that is demographically, clinically, and immunohistochemically distinct from its renal and extrarenal counterparts. We present a case of cutaneous angiomyolipoma in the right retroauricular area of a 35-year-old male patient and provide a broad systematic review of the literature and the largest compilation of cutaneous angiomyolipomas reported to date. According to the findings presented in this review, we conclude that cutaneous angiomyolipoma should be completely separated from renal and extrarenal angiomyolipomas and therefore be considered a distinct entity in the classification of skin tumors.

Pure hibernoma of the breast: insights about its origins.

Hibernomas are rare benign tumors composed of cells reminiscent of brown adipose tissue. In the mammary gland, hibernomas are extraordinary rare, with only 4 cases reported previously. We report the fifth case in a 37-year-old woman who presented with a slowly growing mobile mass in her right breast. A 2.2 cm well-circumscribed lobulated mass was completely removed. The histopathologic analysis showed the full characteristics of the hibernoma. A review of the clinicopathologic features of hibernomas, its relation to brown adipose tissue in humans, and considerations about its histogenesis are made.

Adenoma oncocítico de tiroides (adenoma de células de Hürthle): revisión del espectro morfológico a propósito de cuatro casos / Thyroid oncocytic adenoma: a review of the morphological spectrum in four cases

El cambio oncocítico es un agrandamiento del citoplasma ocasionado por la acumulación de mitocondrias, que se presenta en una amplia variedad de condiciones reactivas y neoplásicas. En la glándula tiroides, dicho cambio es un fenómeno de metaplasia que ocurre en distintas situaciones que provocan estrés celular y en ocasiones da lugar a verdaderas neoplasias benignas y malignas, entre las que destaca el adenoma oncocítico. A propósito de cuatro casos estudiados en el Departamento de Patología del Hospital ABC con características citomorfológicas inusuales que representaron un reto diagnóstico, hacemos una revisión del espectro morfológico de estos tumores. Las características presentadas incluyeron necrosis isquémica masiva posterior a toma de biopsia por aspiración, tamaño mayor al esperado en un adenoma, coexistencia con una neoplasia maligna independiente y características histológicas similares a las observadas en carcinoma papilar. Es de gran importancia para el patólogo conocer estas características, para evitar errores diagnósticos que puedan implicar un inadecuado manejo terapéutico.

Oncocytic change involves a cytoplasmic enlargement due to mitochondrial accumulation observed in a wide variety of conditions and in multiple organs. It can be reactive or neoplastic. In the thyroid gland, this change is a metaplastic phenomenon that takes place under different circumstances that promote cellular stress, and could even produce a true neoplasm, both benign or malignant. The oncocytic adenoma, a malignant tumor will be described. We analyzed four cases studied at the surgical pathology department of the American British Cowdray Medical Center in Mexico City that displayed unusual cytomorphological features. They became a diagnostic challenge and in order to solve it we reviewed their morphological spectrum. Tumor characteristics in all cases included: massive ischemic necrosis short after a fine needle aspiration biopsy was performed, unexpected large size, coexistence with a malignant independent neoplasm and cytological features similar to those observed in papillary carcinomas. It is of utmost importance for the pathologist to acknowledge the existence of these features in order to avoid diagnostic mistakes that could lead to unsuccessful treatment.

Intra-abdominal follicular dendritic cell sarcoma with marked pleomorphic features and aberrant expression of neuroendocrine markers: report of a case with immunohistochemical analysis.

Follicular dendritic cell sarcoma (FDCS) is a very rare malignant tumor arising most frequently in lymph nodes with only few reports of extranodal locations. We report the case of a 35-year-old man with a large retroperitoneal mass. Histologically the tumor was composed of highly pleomorphic cells exhibiting some uncommon features such as an epithelioid appearance, cystic spaces, and multinucleated cells with morphologic features of emperipolesis. Immunohistochemically the neoplastic cells were immunoreactive for CD21, CD23 and CD35. A previously unreported expression of neuroendocrine markers (Synaptophisyn and Neuron-Specific-Enolase) was present. Ultrastructurally no neuroendocrine secretory granules were detected. FDCS can mimic a wide variety of other malignant tumors, and a correct diagnosis requires exclusion of other neoplasms and immunohistochemical confirmation.

[Serous micropapillary invasive carcinoma. Case report on both ovaries]. / Carcinoma seroso micropapilar invasor. Informe de un caso bilateral de ovario.

A subject that has been very controvertial in the last few years in the field of the surgical pathology has been the terminology and the concept of borderline serous tumor of ovary (TSL). Recently the term of micropapillary serous carcinoma was introduced (CSMP) to define a subtype of serous tumors that are characterized for a micropapillary grow pattern and that clinically associated with a more aggressive behavior than the classic TSL since they have an increased risk of invasion, recurrence and extraovarian tumor implantation. The majority of these cases are included within the serous bordering tumors of ovary, being the truly invasive tumors even more infrequent and with more aggressive clinical course. We reported the case of a 52 years old woman with bilateral invasive micropapillary serous carcinoma of ovary.

[Thyroid oncocytic adenoma. A review of the morphological spectrum in four cases]. / Adenoma oncocítico de tiroides (adenoma de células de Hürthle). Revisión del espectro morfológico a propósito de cuatro casos.

Oncocytic change involves a cytoplasmic enlargement due to mitochondrial accumulation observed in a wide variety of conditions and in multiple organs. It can be reactive or neoplastic. In the thyroid gland, this change is a metaplastic phenomenon that takes place under different circumstances that promote cellular stress, and could even produce a true neoplasm, both benign or malignant. The oncocytic adenoma, a malignant tumor will be described. We analyzed four cases studied at the surgical pathology department of the American British Cowdray Medical Center in Mexico City that displayed unusual cytomorphological features. They became a diagnostic challenge and in order to solve it we reviewed their morphological spectrum. Tumor characteristics in all cases included: massive ischemic necrosis short after a fine needle aspiration biopsy was performed, unexpected large size, coexistence with a malignant independent neoplasm and cytological features similar to those observed in papillary carcinomas. It is of utmost importance for the pathologist to acknowledge the existence of these features in order to avoid diagnostic mistakes that could lead to unsuccessful treatment.

[Expression of p53 and BCI-2 as prognostic markers and for anatomical location in gastrointestinal stromal tumors (GIST). Clinico-pathological and immunohistochemistry study of 19 cases]. / Expresión de p53 y Bcl-2 como marcadores pronósticos y de localización anatómica en tumores del estroma gastrointestinal. Estudio clínico-patológico e inmunohistoquímico de 19 casos.

OBJECTIVE: To correlate the expression of p53 and BCl-2 with the clinical outcome and anatomic location of the gastrointestinal stromal tumours (GIST). BACKGROUND DATA: The GIST are the most common nonepithelial neoplasm of the gastrointestinal tract. In spite of the existence of a wide range of predictive factors, their clinical outcome is unpredictable. There are several studies that correlate the expression of p53 and Bcl-2 with the clinical outcome and anatomic location of the GIST. METHODS: We obtained 19 cases from the archives of the Department of Pathology of the ABC Medical Center, in Mexico City. GIST were classified into risk groups according to the Fletcher et al. classification. We performed an immunohistochemestry panel including CD117, CD34, actin, desmin, P-S100, p53 and BCl-2 and correlated their expression to the risk group and anatomical site of the tumors. RESULTS: There was less expression of p53 in the gastric tumors (27%) than in small bowel tumors (100%). There was greater expression of p53 in the high-risk tumors than in the very low-risk ones, regardless of the anatomical site. Bcl-2 expression was more expressed in the small intestine tumors (100%) than in those located in the duodenum (50%) The high risk tumors showed slightly more expression of Bcl-2 than the low risk ones (89% vs. 100%), despite the anatomical location. CONCLUSIONS: Both, p53 and Bcl-2 are important markers to establish the anatomical site of GIST and are also helpful to predict the clinical behavior of these tumors.

Enfermedad de Kikuchi-Fujimoto (linfadenitis histiocítica necrosante): Estudio clinicopatológico e inmunohistoquímico de 14 casos y su diagnóstico diferencial con otras linfadenitis necrosantes reactivas y neoplásicas / Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenopathy) clinicopathologic and immunohistochemical study of 14 cases and its differential diagnosis with other reactive and neoplastic necrotizing lymphadenopathies

Kikuchi-Fujimoto disease also known as histiocytic necrotizing lymphadenopaty (HNL) is a rare entity, originally described in Japanese population, although currently it has been described all over the world. It is more frequent in young women and it is usually located in cervical lymph nodes. We report 14 cases of HNL in Mexican population, their clinicopathological and immunohistochemical study as well as a comparative study with other necrotizing lymphadenopaties due to B or T-cell lymphomas, tuberculosis, Epstein Barr virus infection, and non-specific necrosis. In our study we found that there was more expression of the immunomarkers CD68, MPO, CD123 and antikerat in OSCAR in the cases of HNL in contrast with the lesser or even null expression of the same markers in the necrotized lymph nodes of the comparative study group.

La enfermedad de Kikuchi-Fujimoto o linfadenitis histiocítica necrosante (LHN) es una entidad poco frecuente, inicialmente descrita en población japonesa. Sin embargo, actualmente se ha descrito alrededor de todo el mundo. Es más frecuente en mujeres jóvenes y su localización habitual es en ganglios linfáticos cervicales. Presentamos estudio clinicopatológico de 14 casos de LHN en pacientes mexicanos, y los comparamos con linfadenitis necrosantes secundarias a linfomas B y T, tuberculosis, virus de Epstein Barr y necrosis inespecífica. Encontramos mayor expresión de los anticuerpos CD68, MPO, CD 123 y antiqueratina OSCAR en los casos de LHN comparados con la expresión baja o nula de los mismos anticuerpos en las necrosis ganglionares del grupo comparativo.

[Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenopathy) clinicopathologic and immunohistochemical study of 14 cases and its differential diagnosis with other reactive and neoplastic necrotizing lymphadenopathies]. / Enfermedad de Kikuchi-Fujimoto (linfadenitis histiocítica necrosante). Estudio clinicopatológico e inmunohistoquímico de 14 casos y su diagnóstico diferencial con otras linfadenitis necrosantes reactivas y neoplásicas.

Kikuchi-Fujimoto disease also known as histiocytic necrotizing lymphadenopaty (HNL) is a rare entity, originally described in Japanese population, although currently it has been described all over the world. It is more frequent in young women and it is usually located in cervical lymph nodes. We report 14 cases of HNL in Mexican population, their clinicopathological and immunohistochemical study as well as a comparative study with other necrotizing lymphadenopaties due to B or T-cell lymphomas, tuberculosis, Epstein Barr virus infection, and non-specific necrosis. In our study we found that there was more expression of the immunomarkers CD68, MPO, CD123 and antikerat in OSCAR in the cases of HNL in contrast with the lesser or even null expression of the same markers in the necrotized lymph nodes of the comparative study group.