Histiocitoma fibroso maligno: estudio hisotpatologico e inmunohistoquímico / Malignant Fibrous Histiocytoma: Histopathological and Immunohistochemical Study

El histiocitoma fibroso maligno (MFH) es el tumor de tejido blando más común en adultos. Generalmente se considera que surge de las células mesenquimales primitivas que muestran diferenciación histiocítica y fibroblástica parcial. Las observaciones inmunohistoquímicas sugieren que la expresión de marcadores del músculo liso en el llamado MFH es el resultado de la diferenciación miofibroblástica. El presente estudio tiene como objetivo correlacionarse entre el subtipo histipatológico y los parámetros clínicos, calificar los casos de MFH dependiendo de los criterios histopatológicos para la clasificación, y examinar los casos inmunohistoquímicamente para la diferenciación miofibroblástica utilizando marcadores musculares lisos en casos de MFH como una ayuda para un diagnóstico preciso para un diagnóstico preciso. . Este estudio incluye 26 muestras de tejidos blandos diagnosticados como MFH recolectados de laboratorios histopatológicos privados y gubernamentales en Basrah durante el período de enero de 2000 a octubre de 2005. 4 casos adicionales (un leiomioma, dos fibromas y un fibrosarcoma se tomaron como control positivo y negativo. Los casos de MFH (77%) estaban en el grupo de edad de 45 a 60 años. La edad media fue de 53.5 años con una relación hombre / mujer de 1.3: 1. Diecinueve casos (73%) se ubicaron en las extremidades principalmente en las extremidades inferiores. Diecisiete años. Los casos (65.4%) fueron primarios. Veintidós (84.8%) eran de subtipo pleomórfico, dos eran mixoides y 2 eran inflamatorios. Todos los casos recurrentes se consideraban como el Grado III, de los diecisiete casos principales eran de grado III, por lo que veinte y veinte Tres casos (88.5%) fueron de grado III, los 3 casos restantes fueron de grado II. No se registró tumor de grado I. La mayoría de los casos de subtipo pleomórficos (95.5%) fueron de grado III. Ambos casos de subtipo mixoide fueron de grado Ii. Desmin expr Se encontró la en 3 casos (11.5%), ninguno para la actina del músculo liso o la proteína S-100. No hubo correlación entre la expresión de desmin y el sitio tumoral, subtipo o grado, así como, con la edad y el sexo de los pacientes. Se encontró una fuerte asociación entre la expresión de desmin y los tumores recurrentes del 33,3%

Malignant fibrous histiocytoma (MFH) is the most common soft tissue tumor in adult. It is generally regarded as arising from primitive mesenchymal cells that show partial histiocytic and fibroblastic differentiation. Immunohistochemical observations suggest that the expression of smooth muscle markers in the so called MFH is a result of myofibroblastic differentiation. The present study is aimed to correlate between histipathological subtype and clinical parameters, to grade the MFH cases depending on the histopathological criteria for grading, and to examine the cases immunohistochemically for myofibroblastic differentiation using smooth muscle markers in cases of MFH as an aid for accurate diagnosis. This study including 26 soft tissue specimens diagnosed as MFH collected from private and governmental histopathological laboratories in Basrah during the period from January 2000 to October 2005. Additional 4 cases (one leiomyoma, two fibromas and one fibrosarcoma were taken as control positive and negative. Twenty cases of MFH (77%) were in the age group 45-60 years. The mean age was 53.5 year with male to female ratio of 1.3: 1. Nineteen cases (73%) were located in the extremities mainly the lower limbs. Seventeen cases (65.4%) were primary. Twenty two (84.8%) were of pleomorphic subtype, two were myxoid and 2 were inflammatory. All the recurrent cases were regarded as grade III, from the seventeen primary cases fourteen were of grade III, so twenty three cases (88.5%) were of grade III, the remaining 3 cases were of grade II. No grade I tumor was recorded. The majority of pleomorphic subtype cases (95.5%) were of grade III. Both cases of myxoid subtype were of grade II. Desmin expression was found in only 3 cases (11.5%), none for smooth muscle actin or S-100 protein. There was no correlation between desmin expression and tumor site, subtype or grade, as well as, with age and sex of the patients. A strong association between desmin expression and recurrent tumors 33.3% was found.

Comparison of the Diagnostic Accuracy of FNAC and Biopsy in the Diagnosis of a Palpable Breast Lump

Background: Mammary gland carcinoma is the most common malignant tumor. Annually worldwide more than1,000,000 cases of breast carcinoma occur, which is the leading cause of carcinoma death in women. The most relevant and important method to diagnose breast cancer is Fine Needle Aspiration Cytology (FNAC). The use of core needle biopsy (CNB) has been increasing because of various limitations. Advantages of core needle biopsy over FNAC is, that core needle biopsy provide sufficient tissue for definitive histological diagnosis, differentiate between invasive cancer and carcinoma. The purpose of this study was to determine if there is a difference in diagnostic accuracy in using CNB and FNAC in patients with palpable breast lumps undergoing breast surgery. Methods: This was cross sectional type of study conducted in the Department of General Surgery at Muzaffarnagar Medical College, Muzaffarnagar. The study was carried out from July 2016 to March 2018. The study population was recruited from the patients presenting with suspicious palpable breast lump clinically and/or radiologically, attending at General Surgery Outpatient Department (OPD), Muzaffarnagar Medical College, Muzaffarnagar. Hundred (100) patients suffering from breast lumps were included in this study. Results: Total 58 patients (58% of total patients with breast lump) were found with malignancy having C5 category of FNAC. All of them confirmed malignancy after the surgery. FNAC showed malignancy in 58% cases of breast lump. There was no false positive case in FNAC findings. Rest of 42 patients showed non-malignant breast lumps which showed C2, C3 and C4 category of FNAC. Findings after excision biopsy showed that there were 26 patients (26%) were false negative. Conclusion: Findings of the present study suggest that FNAC is almost equally effective technique for the diagnosis of malignancy in patients suffering carcinoma of mammies. FNAC is considered as an economical, less complicated, rapid and reliable method for the pathological diagnosis of breast carcinoma in a developing country like India. Malignant tumour can be exactly diagnosed by FNAC as it is highly sensitive for malignancy. CNB should be put after FNAC If initial FNAC fails to determine the type of tumour, CNB can be a useful second line method of pathological diagnosis in order to minimize the chance of missed diagnosis of breast cancer. Excision biopsy should be considered as last option for pathological diagnosis.