RESUMO
PEComas represent a rare class of mesenchymal tumors, with different primary locations. There are less than 100 cases of uterine PEComas published in English literature until now and information considering imaging features of these PEComas is very limited, focusing on CT and MRI and not as much on ultrasounds (US). The authors present here a case of rapidly growing uterine PEComa, with local invasive potential and recurrence, and the review of literature on US characteristics of PEComas. Harboring a hyperechogeneous heterogeneous aspect with no clear separation from the adjacent uterus on the whole boundary, with an extremely rich central vascular network, with low impedance and a rapidly growing profile, this tumor does not show the classic US appearance of malignant PEComas, which are generally easily confused with leiomyomas. However, even if this pattern did not allow the authors to anticipate the histopathological result, it offered clear clues about its invasiveness potential.
Assuntos
Neoplasias de Células Epitelioides Perivasculares/diagnóstico por imagem , Ultrassonografia Doppler , Neoplasias Uterinas/diagnóstico por imagem , Adulto , Feminino , Humanos , Neoplasias de Células Epitelioides Perivasculares/irrigação sanguínea , Neoplasias de Células Epitelioides Perivasculares/patologia , Neoplasias Uterinas/irrigação sanguínea , Neoplasias Uterinas/patologiaAssuntos
Diagnóstico por Imagem/métodos , Neoplasias Hepáticas/diagnóstico , Neoplasias de Células Epitelioides Perivasculares/diagnóstico , Diagnóstico Diferencial , Humanos , Aumento da Imagem , Interpretação de Imagem Assistida por Computador , Achados Incidentais , Fígado/patologia , Neoplasias Hepáticas/irrigação sanguínea , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/terapia , Imagem Multimodal/métodos , Neoplasias de Células Epitelioides Perivasculares/irrigação sanguínea , Neoplasias de Células Epitelioides Perivasculares/patologia , Neoplasias de Células Epitelioides Perivasculares/terapia , Prognóstico , Sensibilidade e EspecificidadeRESUMO
We encountered a clear cell tumor of the lung (CCTL) that was located peripherally, adjacent to the visceral pleura. The tumor could be directly observed during surgery. We believe that this case report describing the surgical and related pathological findings is highly informative. A chest radiograph during routine examination of an asymptomatic 65-year-old woman being treated for hypertension and hyperlipidemia revealed a nodular shadow in the left lung field. Wedge resection was performed by video-assisted thoracic surgery. The in vivo color of the tumor was red, suddenly changing to white after the tumor was clamped. Pathology examination showed a uniform pattern consisting of large clear cells without cytologic atypia or increased mitotic activity. Immunohistochemistry revealed tumor cells positive for vimentin and melanocytic markers (HMB-45 and melan-A) and negative for epithelial membrane antigen and cytokeratin. With the absence of clinical findings in both kidneys, the tumor was diagnosed as a benign CCTL.