Leiomioma de la uretra, localización inusual del tumor pélvico femenino más frecuente / An unusual location of urethral leiomyoma, the most common pelvic tumour in the female

El leiomioma de la uretra es un raro tumor de origen mesenquimal que deriva del músculo liso de la uretra. Suele aparecer en mujeres en edad fértil. Actualmente se han publicado poco más de 100 casos de este tumor. La mayoría de las mujeres presentan síntomas como hematuria, infección urinaria y otros con relación al efecto masa del tumor. Presentamos el caso de una mujer de 42 años que debuta con hematuria esporádica, disuria y dispareunia, confirmándose en el estudio histológico la presencia de un leiomioma de la uretra (AU)

Urethral leiomyoma is a rare benign mesenchymal tumour arising from the smooth muscle of the urethra. It most often appears in females of reproductive age. Approximately 100 cases have been reported to date. The most usual presentation is urinary infection, hematuria or a mass. We report a case of a 42 year old woman who presented with sporadic hematuria, dysuria and dyspareunia. Histopathological studies confirmed urethral leiomyoma (AU)

[An unusual location of urethral leiomyoma, the most common pelvic tumour in the female]. / Leiomioma de la uretra, localización inusual del tumor pélvico femenino más frecuente.

Urethral leiomyoma is a rare benign mesenchymal tumour arising from the smooth muscle of the urethra. It most often appears in females of reproductive age. Approximately 100 cases have been reported to date. The most usual presentation is urinary infection, hematuria or a mass. We report a case of a 42 year old woman who presented with sporadic hematuria, dysuria and dyspareunia. Histopathological studies confirmed urethral leiomyoma.

Expression of dog1 in low-grade fibromyxoid sarcoma: A study of 19 cases and review of the literature.

DOG1 is a highly-sensitive marker often included in the immunohistochemical panel for the diagnosis of gastrointestinal stromal tumors (GISTs). Recent research has shown that DOG1 may also be expressed by low-grade fibromyxoid sarcomas (LGFMSs); this may give rise to diagnostic error when the sarcoma is located in the abdominal cavity. This paper reports on immnohistochemical expression of DOG1 in 19 LGFMSs using two different monoclonal antibodies: K9 (Leica, Novocastra Laboratories, Newcastle upon Tyne, UK) and SP31 (Thermo Scientific, Freemont, USA). All LGFMSs displayed the standard histological pattern of alternating myxoid and fibrous areas, low cellularity and bland spindle-cell morphology. Positive staining for MUC4 was observed in 18/19 cases (94.7%), while there was rearrangement of the FUS gene in 14/19 (73.7%) cases and of the EWR1 gene in 2/19 (10.5%). The sarcoma staining negative for MUC4 displayed FUS gene rearrangement. Whole-section immunohistochemistry revealed positive staining for DOG1 in 8/19 cases (42.1%), though only with clone K9. Cytoplasmic as well as membrane staining was observed in all cases; staining was focal (10-30%) and of varying intensity (1+ to 2+). In conclusion, DOG1 clone K9 exhibited low sensitivity (42.1%) for the diagnosis of LGFMS, although higher than clone SP31. Since the two clones display similar sensitivity and specificity for GIST diagnosis, SP31 would appear to be more specific for this purpose, since no reaction was observed here with LGFMS, a GIST-mimicking lesion.

Carcinoma de próstata con componente de células pequeñas. Diagnóstico inicial en metástasis ganglionar con patrón de carcinoma neuroendocrino de células grandes. Descripción de un caso / Initial diagnosis of small cell carcinoma of prostate in a nodal metastasis of large cell neuroendocrine carcinoma. A case report

El carcinoma de próstata es el tumor maligno más prevalente en el varón. La glándula prostática normal está constituida por 3 tipos celulares: el luminal o secretor, el basal y el neuroendocrino. Las células neuroendocrinas se distribuyen en toda la extensión de la glándula prostática, con mayor frecuencia en los conductos que en el tejido acinar. La diferenciación neuroendocrina es un hallazgo frecuente en los carcinomas prostáticos, en su mayoría de modo focal, y en los casos en que la diferenciación es extensa, se asocia con refractariedad a la terapia hormonal o enfermedad agresiva. Describimos un caso de un carcinoma de próstata poco diferenciado de células pequeñas con diferenciación neuroendocrina con componente minoritario de adenocarcinoma convencional, resaltando el hallazgo del tumor primario mediante el diagnóstico de una metástasis ganglionar de carcinoma neuroendocrino de células grandes (AU)

Prostate carcinoma is the most common malignant tumour in men. The normal prostate gland is composed of three cell types: luminal, basal and neuroendocrine. Neuro-endocrine cells are found throughout the prostate gland, although are more frequent in ducts than in the acinar tissue. Neuroendocrine differentiation is often seen in prostatic carcinomas, usually focally, but, when differentiation is extensive, it is associated with failed hormonal therapy or aggressive disease. We describe a case of a poorly differentiated small cell prostate carcinoma with neuroendocrine differentiation that had a small component of conventional adenocarcinoma. Thus, a nodal metastasis of large cell neuroendocrine carcinoma led to the diagnosis of the primary tumour (AU)

Collision tumour involving a rectal gastrointestinal stromal tumour with invasion of the prostate and a prostatic adenocarcinoma.

BACKGROUND: Gastrointestinal stromal tumours (GISTs) are the most common primary mesenchymal neoplasia in the gastrointestinal tract, although they represent only a small fraction of total gastrointestinal malignancies in adults (<2%). GISTs can be located at any level of the gastrointestinal tract; the stomach is the most common location (60-70%), in contrast to the rectum, which is most rare (4%). When a GIST invades into the adjacent prostate tissue, it can simulate prostate cancer. In this study, we report on a case comprising the unexpected collision between a rectal GIST tumour and a prostatic adenocarcinoma. FINDINGS: We describe the complexity of the clinical, endoscopic and radiological diagnosis, of the differential diagnosis based on tumour biopsy, and of the role of neoadjuvant therapy using imatinib prior to surgical treatment. CONCLUSIONS: Although isolated cases of coexisting GISTs and prostatic adenocarcinomas have previously been described, this is the first reported case in the medical literature of a collision tumour involving a rectal GIST and prostatic adenocarcinoma components. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1238437468776331.

Robinson cytologic grading in invasive ductal carcinoma of the breast: correlation with E-cadherin and alpha-, beta- and gamma-catenin expression and regional lymph node metastasis.

OBJECTIVE: To correlate the cytologic grade of breast carcinoma with the expression of E-cadherin/catenin system molecules and the presence of metastasis in regional lymph nodes. STUDY DESIGN: Aspirate smears were examined together with histologic sections from the corresponding neoplasms taken from 100 patients with invasive ductal carcinoma. In 50 cases, > or = 1 metastatic nodes were identified. Cytologic grading of the smears was performed using the Robinson method. Immunohistochemical expression of E-cadherin and of alpha-, beta- and gamma-catenin was studied. RESULTS: A statistically significant relationship was observed between E-cadherin/catenin expression and cytologic grade (p < 0.0005). This association was particularly relevant to the cell dissociation parameter (p < 0.0005). CONCLUSION: The cytological grade established in preoperative studies may provide relevant information on the aggressiveness of invasive ductal carcinoma and its tendency to produce regional metastasis. This finding could be particularly useful in cases of breast carcinoma in which neoadjuvant therapy is the method of choice.

Robinson cytologic grading of invasive ductal breast carcinoma: correlation with histologic grading and regional lymph node metastasis.

OBJECTIVE: To evaluate the importance of cytologic grading of breast carcinoma and its association with histologic grading and the existence of axillary lymph node metastasis. STUDY DESIGN: Aspirates and surgical samples from 100 patients with invasive ductal breast carcinoma not otherwise specified were studied. In 50 patients, > or = 1 metastatic nodes were identified. The cytologic grade was evaluated using the Robinson method and the histologic grade using the Elston modification of the Bloom-Richardson method. A study was undertaken to establish the association between histologic and cytologic grades and to compare the various parameters used to evaluate cytologic grade with the presence of axillary node metastasis. RESULTS: A statistically significant association was observed between cytologic and histologic grades (p < 0.0005) and between cytologic grade and presence of axillary metastasis (p < 0.0005). Similarly, cell dissociation (p < 0.0005), cell uniformity (p = 0.0010) and the appearance of nuclear margins (p < 0.0005) all displayed a positive correlation with regional metastasis. CONCLUSION: Cytologic grade may provide relevant information on the aggressiveness of invasive ductal breast carcinoma and could be a useful parameter to take into consideration when selecting neoadjuvant therapy.

Adenoma tubular con diferenciación e inmunofenotipo anexial divergente (hidradenoma túbulo-papilar) / Tubular adenoma with adnexal divergent differentiation and immunophenotype (tubulopapillary hidradenoma)

Hidradenoma túbulo-papilar (HPT) es el término propuestopara designar tumores ductales dérmicos con diferenciacióndivergente ecrina y apocrina, englobando unespectro de lesiones que incluye adenoma tubular apocrino(ATA) y adenoma ecrino papilar (AEP).Presentamos un caso de HPT localizado en la pierna deuna mujer de 81 años de edad. El perfil inmunohistoquímicodemostró la coexistencia de inmunofenotipos secretoresapocrino y ecrino

Tubulopapillary hidradenoma (TPH) is a term describingdermal ductal tumors with both eccrine and apocrinedifferentiation, encompassing a spectrum of lesions includingtubular apocrine adenoma and papillary eccrine adenoma.We report a case of a TPH in a 81-years-old womanlocated on the leg. The immunohistochemical profile revealedthe coexistence of eccrine and apocrine secretory immunophenotypes

Dermatofibroma con empalizadas. Una variante histológica singular / Palisading dermatofibroma: an unusual histologic variant

Se presenta un caso de esta infrecuente variedad de dermatofibromaen un varón de 38 años cuya principal característicaes la disposición en empalizada de los núcleos. Histopatológicamente,la lesión estaba caracterizada por áreasde empalizada nuclear con formación de cuerpos de tipoVerocay, junto a áreas clásicas de dermatofibroma tipofibroso. Esta neoplasia debería ser diferenciada de otrostumores benignos y malignos cutáneos con patrón en empalizada.Patólogos y clínicos deberían conocer la existenciade este tipo de dermatofibroma, que no comporta peor pronósticoni tratamiento adicional

We report a new case of an unusual variant of dermatofibromaof a 38-year-old man in which nuclear palisading isa prominent feature. Histopathologically, the lesions werecharacterized by areas of nuclear palisading with formationof Verocay-like bodies in addition to the more typical featuresof the «fibrous» variant of dermatofibroma. This neoplasmshould be differentiated from benign and malignantskin tumors with a palisading pattern. Pathologists and cliniciansshould know of the existence of this type of dermatofibromaand should avoid overdiagnosis and overtreatment

Tumor carcinoide atípico de laringe: descripción de un caso / Laryngeal atypical carcinoid tumor: description of a case

El tumor carcinoide atípico de laringe es una neoplasia muy poco frecuente. Presentamos el caso de un varón de 67 años de edad con un tumor carcinoide atípico de laringe y metástasis en un ganglio linfático cervical. Se describen los hallazgos histológicos convencionales de esta neoplasia, enfatizando la necesidad del estudio inmunohistoquímico para su diagnóstico diferencial con el paraganglioma laríngeo. Es crucial el diagnóstico correcto, porque el tratamiento y el pronóstico son diferentes para ambas entidades ya que, como ocurrió en el presente caso, el diagnóstico en la pieza laríngea indicó un vaciamiento ganglionar cervical funcional homolateral en el que se identificó una metástasis de esta neoplasia (AU)