ABSTRACT
O adenocarcinoma de células claras (CCA) primário de colo uterino em pacientes jovens é uma doença rara, de etiologia desconhecida e que no passado estava associada ao uso do dietilestilbestrol durante a gestação, quando sua comercialização era permitida. A queixa mais frequente do CCA é o sangramento vaginal irregular. Relatamos o caso de CCA de endocérvice em paciente jovem que engravidou naturalmente após o diagnóstico da neoplasia.(AU)
Primary cervical clear cell adenocarcinoma (CCA) in young patients is a rare disease of unknown etiology in the past associated with the use of diethylstilbestrol during pregnancy when its use was permitted. The most frequent complaint is irregular vaginal bleeding. We report the case of endocervous clear cell adenocarcinoma in a young patient who became naturally pregnant, even after the diagnosis of the neoplasia.(AU)
Subject(s)
Humans , Female , Pregnancy , Adult , Pregnancy Complications/physiopathology , Adenocarcinoma, Clear Cell , Pregnancy, High-RiskABSTRACT
RESUMEN La endometriosis corresponde a la presencia de glándulas endometriales o estroma en sitios distintos a la cavidad uterina. Afecta del 5 al 15% de las mujeres en edad reproductiva y se asocia a importante sintomatología. La teoría de la menstruación retrógrada propuesta por Sampson es la más aceptada para explicar su etiología. Varios estudios han asociado esta enfermedad a un riesgo aumentado de neoplasia, ésta entidad, denominada endometriosis asociada a malignidad, se localiza en sitios extra gonadales en un 20% de los casos, donde la pared abdominal no alcanza más de 30 casos reportados. Si bien no existe un tratamiento estándar, la mayoría de los autores han adaptado el protocolo de tratamiento para el cáncer de ovario asociado a endometriosis.
ABSTRACT Endometriosis corresponds to the presence of endometrial glands or stroma at sites other than the uterine cavity. It affects 5 to 15% of women of reproductive age and is associated with a significant symptomatology. The theory of retrograde menstruation proposed by Sampson is the most accepted to explain its etiology. Several studies have associated this disease with an increase in neoplasia, the entity, called endometriosis associated with malignancy, is located in extra gonadal sites in 20% of cases, where the abdominal wall does not reach more than 30 reported cases. Although there is no standard treatment, most authors have adapted the treatment for ovarian cancer associated with endometriosis.
Subject(s)
Humans , Pregnancy , Middle Aged , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/pathology , Adenocarcinoma, Clear Cell/diagnosis , Endometriosis/diagnosis , Endometriosis/epidemiology , Palliative Care , Sex Cord-Gonadal Stromal Tumors/pathology , Diagnosis, Differential , Drug TherapyABSTRACT
The aim of this report is to describe the first histopathological, immunohistochemical, and clinical characteristics of a feline glycogen-rich clear cell carcinoma (GRCCC). A Persian queen was admitted with mammary gland tumors and underwent radical unilateral mastectomy. Overall survival was considered 33 days and death was due to clinical evolution of the disease. Microscopic evaluation demonstrated epithelial cells arranged in a predominantly solid pattern, tumor cells presented an ample, granular, and foamy clear cytoplasm, and moderate cellular pleomorfism. The presence of cytoplasmatic glycogen was confirmed through diastase digestion followed by PAS staining. Histopathological and histochemical findings lead to the diagnosis of GRCCC with regional metastases.(AU)
O objetivo deste relato de caso é descrever as características clínicas, histopatológicas e imuno-histoquímicas do primeiro carcinoma mamário de células claras rico em glicogênio em felino. Uma gata persa foi atendida com tumores na glândula mamária e foi submetida à mastectomia radical unilateral. A sobrevida livre de doença foi considerada 33 dias, e o óbito foi devido à evolução da doença. A avaliação microscópica demonstrou células epiteliais arranjadas em um padrão predominantemente sólido, as células tumorais apresentaram um citoplasma claro, amplo, granular e espumoso e pleomorfismo celular moderado. A presença do glicogênio citoplasmático foi confirmada pela digestão pela diástase, seguida da coloração de PAS. Achados histopatológicos e histoquímicos levaram ao diagnóstico de carcinoma de células claras rico em glicogênio felino com metástase regional.(AU)
Subject(s)
Animals , Cats , Adenocarcinoma, Clear Cell/veterinary , Glycogen/analysis , Mammary Neoplasms, Animal/pathology , Amylases/analysisABSTRACT
El carcinoma renal con diferenciación sarcomatoide es una entidad rara con muy pocos casos reportados en la literatura. Se presenta un caso de un paciente masculino de 65 años que por historia de hematuria macroscópica, se le realizan estudios diagnósticos, reportándose masa renal izquierda, efectuándos ele nefrectomía radical cuyo resultado de patología fue un carcinoma de células claras. Tres meses después de la cirugía el paciente refiere dolor localizado en el mismo sitio anatómico por lo que se le realiza tomografía, reportándose masa a nivel del retroperitoneo, debido a este hallazgo se decide efectuar tumorectomía, en la que se reporta sarcoma fusocelular de alto grado. Los resultados patológicos no corresponden a dos entidades patológicas diferentes, sino al mismo origen tumoral, con progresión de la enfermedad.
Sarcomatoid diferentaton in renal cell carcinoma is a rare disease with very few cases reported in the literature. A 65 year old man with hematuria anda lef renal mass underwent radical nephrectomy. Pathology reported a clear renal cell carcinoma. Three months afer surgery, the patent presentedwith abdominal complaints and a CT scan of the abdomen revealing fndings consistent with a retroperitoneal mass. The patent underwent a secondsurgical resecton and pathology revealed a high grade spindle cell sarcoma. The two diferent pathology reports are not two diferent pathologies; sarcomatoid diferentaton in renal cell carcinoma represents a common pathway of de-diferentaton of renal tumors.
Subject(s)
Male , Carcinoma, Renal Cell/pathology , Hematuria/complications , Hematuria/physiopathology , Nephrectomy/adverse effects , Kidney Neoplasms/surgeryABSTRACT
El carcinoma de células claras es una neoplasia rara de bajo grado que se desarrolla casi exclusivamente en glándulas salivales menores humanas. El objetivo de esta comunicación es analizar las características estructurales, histoquímicas e inmunohistoquímicas (IHQ) de dos casos de carcinoma de células claras de parótida y realizar el diagnóstico diferencial con otros tumores salivales primarios y metastásicos que presentan células claras. Cortes de ambos tumores fueron procesados para H/E, tricrómicos de Masson y Dane, Azul de toluidina, Azul alciano, PAS y PAS/diastasa; marcaciones IHQ para citoqueratinas de bajo y alto peso molecular, ki67, HMB45, p63 y proteína S-100. El patrón estructural de estos tumores estaba determinado por nidos y cordones de células claras delimitados por un estroma no hialinizado. En un tumor se observó una neoplasia maligna a células claras con manifiesta anaplasia. La expresión de ki67 fue importante. El otro tumor estaba constituido por células claras monomorfas sin signos manifiestos de atipia y casi nula expresión de ki67. Con PAS se demostró la presencia de glucógeno y no se observó un desarrollo importante del estroma colágeno en ambas neoplasias. En ambos casos resultó francamente positiva la inmunomarcación para citoqueratinas de bajo y alto peso molecular. Por el contrario resultó negativa para HMB45 y p63. La proteína S-100 tuvo su expresión en células aisladas. Se concluye que los casos presentados son de localización poco común (parótida) según lo descripto en la bibliografía; corresponden a la variedad no hialinizante ya que no está presente un importante estroma colágeno hialinizado, y ambos tumores son primarios de glándulas salivales, de origen epitelial, no melanocítico ni hematopoyético (linfomas) como lo demuestran las marcaciones IHQ.
The clear cell carcinoma is a rare neoplam of low level grade that develops almost exclusively in human minor salivary glands. The objective of this present work is to analyze the structural, histochemical and inmunohistochemical (IHQ) characteristics of two cases of parotid clear cell carcinoma and make a differential diagnosis with other primary and metastatic salivary tumors that clear cells show. Serial cuts of both tumors were processed for H/E, Masson and Dane trichromes, Toluidine blue, Alcian blue, PAS and PAS/diastase; IHQ marking of both high-and low-molecular weight cytokeratins, ki67, HMB45, p63 and S-100 protein. The structural pattern of these tumors were determined by nests and cords of clear cells delimited by a stroma non hyaline. In a tumor a malign neoplasia was observed in clear cells with anaplasia. The ki67 expression was important. The other tumor was constitued of clear monomorph cells without manifestation signs of atypia and almost no ki67 expression. With PAS was confirmed the presence of glycogen and not observed an important development of the collagen stroma in both neoplasms. Both cases resulted very positive the immunostaining of both high and low molecular weight cytokeratins. It resulted negative for the HMB45 and p63. The protein S-100 has it´s expression in isolated cells. We conclude that: the presented cases are very uncommon localization (parotid) as described by the literature; it matches a non hyalinizing variety because a very important hyalinized collagen stroma is not present, both primary tumors of salivary glands, of epithelial origin, non melanocytic, renal or hematopoietic lymphomas which shows immunostaining IHQ.
Subject(s)
Humans , Male , Female , Middle Aged , Adenocarcinoma, Clear Cell/pathology , Parotid Neoplasms/pathology , Adenocarcinoma, Clear Cell/diagnosis , Diagnosis, Differential , Immunohistochemistry , Parotid Neoplasms/diagnosisABSTRACT
O carcinoma rico em glicogênio da mama é uma variante rara de carcinoma ductal infiltrativo. Clinicamente, não difere de outros tipos de carcinoma mamário. Relatamos um caso de paciente de 56 anos, com nódulo não-palpável de mama direita, cujo diagnóstico por biópsia foi de carcinoma de células claras da mama. Posteriormente, a paciente foi submetida a setorectomia com biópsia do linfonodo sentinela. Como apresentava receptores de estrógeno e progesterona positivos, optou-se por radioterapia e hormonoterapia como tratamento adjuvante. De história pregressa, há cinco anos, a paciente havia sido submetida a nefrectomia por carcinoma renal, diagnosticado à época como carcinoma de células claras, sugerindo que o tumor mamário atual fosse de natureza metastática, hipótese afastada por estudo imunoistoquímico. A revisão do tumor renal, no entanto, mostrou tratar-se de carcinoma de células cromófobas do rim, variante de prognóstico favorável e sem potencial metastático.
The glycogen-rich carcinoma of the breast is an uncommon type of ductal invasive carcinoma. Its clinical presentation does not differ from other types of invasive carcinoma of the breast. Herein, we report a case of a 56-year old woman presenting with a nonpalpable nodule in the right breast whose biopsy diagnosis was glicogen-rich clear-cell carcinoma. A lumpectomy was performed later on with sentinel lymph node biopsy. As it expressed estrogen and progesterone receptors, radiotherapy and hormoniotherapy were given as adjuvant treatment. Of interest, 5 years ago, the patient had been underwent a nephrectomy due to a renal carcinoma diagnosed as clear-cell carcinoma of the kidney raising the suspect that the breast tumor might be a metastase. This hypothesis, however, was eliminated by immunohistochemistry. Moreover, the review of the slides of the renal tumor showed a cromophobe-cell carcinoma, a variant associated with favorable prognosis and no metastatic potential.