Mammary myofibroblastoma: a clinicopathological analysis of fifteen cases / 中华病理学杂志

Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of breast myofibroblastoma. Methods: The clinicopathological data and prognostic information of 15 patients with breast myofibroblastoma diagnosed at the Department of Pathology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China from 2014 to 2022 were collected. Their clinical characteristics, histological subtypes, immunophenotypes and molecular characteristics were analyzed. Results: There were 12 female and 3 male patients, ranging in age from 18 to 78 years, with a median and average age of 52 years. There were 6 cases in the left breast and 9 cases in the right breast, including 12 cases in outer upper quadrant, 2 cases in inner upper quadrant and 1 case in outer lower quadrant. Most of the cases showed a well-defined nodule grossly, including pushing growth under the microscope in 13 cases, being completely separated from the surrounding breast tissue in 1 case, and infiltrating growth in 1 case. Among them, 12 cases were classic subtype and composed of occasional spindle cells with varying intervals of collagen fiber bundles; eight cases had a small amount of fat; one case had focal cartilage differentiation; one case was epithelioid subtype, in which epithelioid tumor cells were scattered in single filing or small clusters; one case was schwannoma-like subtype, and the tumor cells were arranged in a significant palisade shape, resembling schwannoma, and one case was invasive leiomyoma-like subtype, in which the tumor cells had eosinophilic cytoplasm and were arranged in bundles, and infiltrating into the surrounding mammary lobules like leiomyoma. Immunohistochemical studies showed that the tumor cells expressed desmin (14/15) and CD34 (14/15), as well as ER (15/15) and PR (15/15). Three cases with histologic subtypes of epithelioid subtype, schwannoma-like subtype and infiltrating leiomyoma-like subtype showed RB1 negative immunohistochemistry. Then FISH was performed to detect RB1/13q14 gene deletion, and identified RB1 gene deletion in all three cases. Fifteen cases were followed up for 2-100 months, and no recurrence was noted. Conclusions: Myofibroblastoma is a rare benign mesenchymal tumor of the breast. In addition to the classic type, there are many histological variants, among which the epithelioid subtype is easily confused with invasive lobular carcinoma. The schwannoma-like subtype is similar to schwannoma, while the invasive subtype is easily misdiagnosed as fibromatosis-like or spindle cell metaplastic carcinoma. Therefore, it is important to recognize the various histological subtypes and clinicopathological features of the tumor for making correct pathological diagnosis and rational clinical treatment.

Tumor miofibroblástico de laringe: reporte de caso clínico y revisión de literatura / Miofibroflástico larynx tumor: case report and literature review

El tumor miofibroblástico inflamatorio de laringe es una patología rara dentro de los tumores de cabeza, cuello y de vía aérea, con una baja prevalencia, existiendo escasa literatura al respecto. Corresponde a un tumor benigno que generalmente se presenta como hallazgo incidental en relación a cuerdas vocales con mayor frecuencia, que puede ser de carácter asintomático o presentarse con clínica de obstrucción de vía aérea como estridor y disnea progresiva, además de disfonía. Puede afectar a pacientes de cualquier edad, siendo más frecuentes en adultos en edad media. El diagnóstico se hace a través de radiología y visualización directa mediante laringoscopía con la consiguiente obtención de muestra y estudio histopatológico. El tratamiento consta en la resección quirúrgica completa de la lesión, asociado o no a terapia esteroidal, sin embargo la curación completa no se logra en todos los casos producto de la naturaleza recidivante de la lesión.

The inflammatory myofibroblastic umor of the larynx is a rare condition in tumors of head, neck and airway, with a low prevalence, and scarce existing literature. It corresponds to a benign tumor that usually occurs as an incidental finding in relation to vocal cords more frequently, which can be asymptomatic or present with clinical character of airway obstruction, as progressive stridor and dyspnea, plus dysphonia. It can affect patients of any age are more common in adults in middle age. The diagnosis is made by radiology and direct laryngoscopy with visualization by obtaining sample and histology. Treatment consists of surgical removal of the entire lesion with or without steroid therapy, however complete healing is not achieved in all the cases product of the recurrent nature of the patology.

The Juscelino Kubitschek government and the Brazilian Malaria Control and Eradication Working Group: collaboration and conflicts in Brazilian and international health agenda, 1958-1961 / O governo JK e o Grupo de Trabalho de Controle e Erradicação da Malária no Brasil: encontros e desencontros nas agendas brasileira e internacional de saúde, 1958-1961

Malaria, a disease which was under control in the beginning of Juscelino Kubitschek government, became the most important endemic disease in 1958, when Brazil made a commitment with the World Health Organization to convert its control programs into eradication programs. For this purpose a Malaria Control and Eradication Group was set up under the leadership of the malaria specialist Mário Pinotti. Malaria would become an important bargaining chip in the context of the development policies of Kubitschek. This article focuses on path of the Malaria Control and Eradication Working Group in Brazil, in its varying relationships with the arguments and guidelines established at international level.

A malária, doença que estava controlada no início do governo de Juscelino Kubitschek, torna-se a mais importante endemia em 1958, quando o Brasil assumiu o compromisso com a Organização Mundial da Saúde de converter seus programas de controle em programas de erradicação. Para isso foi instalado um Grupo de Controle e Erradicação da Malária sob a direção do malariologista Mário Pinotti. A malária seria uma importante moeda de negociação no contexto da política de desenvolvimento de Kubitschek. Este artigo tem como foco a trajetória do Grupo de Trabalho de Controle e Erradicação da Malária no Brasil, em suas diferentes relações com as discussões e normativas travadas e estabelecidas em âmbito internacional.

Mammary-type myofibroblastoma of soft tissue.

A 40-year-old woman presented with a 1 year history of a painless, subcutaneous lump on the right buttock. Clinical examination showed an approximately 6 cm large subcutaneous mass covered by apparently normal-looking skin. No inguinal lymphadenopathy was found. The mass was excised with the clinical diagnosis of fibroma. Histologically, the lesion was consistent with mammary-type myofibroblastoma of soft tissue, a very rare, benign mesenchymal neoplasm with myofibroblastic differentiation. After surgical excision she was free of recurrence over a period of 8 months. This article also challenges the theory that suggests the origin of this tumor to be from the embryonic mammary tissue, adding another case of a site other than the milk lines.

Miofibroblastoma de la mama femenina: reporte de un caso / Miofibroblastoma of the female breast: a case report

El miofibroblastoma constituye una entidad benigna de la mama de presentación muy infrecuente, que afecta principalmente la mama masculina. Su principal característica histológica es su estirpe mesenquimal caracterizada por la proliferación de células fusiformes rodeadas de colágeno y que derivan de los fibroblastos. El tratamiento principal es la cirugía, con tendencia a la preservación de la glándula sobre todo en la mujer. Presentamos el caso de una paciente femenina de 64 años de edad, con un tumor solitario, de crecimiento progresivo durante 5 años, hasta que decide solicitar asistencia médica, planteándose el diagnóstico preoperatorio de una lesión de tipo mesenquimal; la cual posterior al tratamiento quirúrgico y mediante estudios inmunohistoquímicos se confirma la presencia de un miofibroblastoma clásico, siendo estos tumores infrecuentes en la práctica clínica diaria, debiendo ser considerados al momento de hacer diagnóstico diferencial.

The miofibroblastoma is a benign tumor of the breast of very infrequent presentation that mainly affects the male breast. The main histological characteristic is the mesenchymal ancestry characterized by the proliferation of plump and spindle cells surrounded by collagen and that derive from fibroblasts. The surgery is the main treatment with preservation of the breast in female patients. We presented a case of a female patient of 64 years old, which presents a solitary tumor with progressive growth by 5 years, until she decides to ask for medical aid, considering the preoperating diagnosis of an tumor of mesenchymal type; which subsequent to the surgical treatment and confirmed by immunohistochemistry the presence of miofibroblastoma of the breast, being this finding very unusual in the clinical practice, and to be considered at the time of making differential diagnosis.

Miofrioblastoma mamário em axila / Mammary myofibroblastoma in axila

Miofibroblastoma é um tumor benigno raro de mama, de origem mesenquimal. A localização em região axilar é ainda mais incomum. Tendo em vista a dificuldade em se estabelecer o diagnóstico diferencial baseado apenas nos achados clínicos e imaginológicos, a confirmação histopatológica é imprescindível no diagnóstico diferencial com tumor oculto de mama.

Myofibroblastoma is a rare and benign mesenchymal breast neoplasm. The axillary topography is further more uncommon. The histologic identification is important because the differencial diagnosis with malignant tumours of the breast. This report a case of mammary myofibroblastoma in axilla, wich was initially diagnosticated as an occult lobular carcinoma.

Tumores con rabdomioblastos y neuroblastos / Tumors with rhabdomyoblasts and neuroblasts

Se evalúa uma técnica de impregnación metálica, doble impregnación de Del Río Hortega, para evidenciar rabdomioblastos y neuroblastos, con recomendaciones sobre los tiempos de impregnación para obtener mejores resultados. Las imágenes obtenidas son muy demostrativas, tanto de los elementos embrionarios del mesénquima primitivo desde mioblasto, miotubo a célula acintada rabdomiobástica con estraciones transversales, hasta los elementos neopláticos de esta estripe. Y de los neuroblastos con sus prolongaciones. El material de estudio incluye un Tumor de Wilms renal con rabdomioblastos y neuroblastos, y un Neuroblastoma de cerebelo con componente rabdomioblástico. A estas lesiones se las considera desembrioplasias. Además se estudiaron 2 Rabdomiosarcomas embrionarios botrioides, uno de ellos de presentación inusual en una mujer menopáusica, 2 Tumores müllerianos mixtos de útero y trompa de Falopio, un Rabdomioma de faringe, y 3 embriones humanos de material de aborto entre 5 y 13 semanas. Destacamos la utilidad de la doble impregnación para estudiar rabdomioblastos y neuroblastos. En los Rabdomiosarcomas se pueden ver estructuras y elementos comparables con los de la etapa embrionaria: células raquetoides, acintadas, miotubos, rabdomioblastos. El Tumor de Wilms es un tumor disembrioplásico y está constituido por el blastema renal. En él hemos encontrado rabdomioblastos y neuroblastos. En el Neuroblastoma del cerebelo servamos rabdomioblastos con cierta organicidad (ectomeséquima). Y por último describimos un caso poco frecuente de Ragdomiosarcoma botrioide de cuello uterino en una mujer menopáusica.

Myofibroblastoma of breast--an appraisal of cytoskeletal phenotypes.

Myofibroblastoma of the breast is a recently described entity. Since its first description in 1987, less than 50 cases have been reported. We present the first (reported) myofibroblastoma to be detected as a non-palpable mass on a routine screening mammogram and emphasize the importance of not mis-diagnosing this rare cellular lesion as malignant on frozen section. Review of the literature demonstrates changes in the clinical presentation of myofibroblastomas. Once considered more common in men than in women, myofibroblastomas are now being reported with increasing frequency in women. The age at presentation is a decade earlier, and not surprizingly, the size of the earlier detected lesion is smaller. Recently four different cytoskeletal phenotypes (V, VA, VAD and VD) of myofibroblastomas have been described, depending upon the vimentin (V), actin (A), and desmin (D) immunoreactivity. Whereas vimentin reactivity is universal, actin and desmin immunoreactivity is variable, desmin being more frequently positive than actin. As more is known about the clinical behavior of myofibroblastomas, their rate of recurrence and malignant potential, if any, the relationship of the cytoskeletal content to prognosis may become clearer. Currently, complete immunohistochemical analysis and electron microscopic examination of this interesting breast lesion is recommended. List of abbreviations-Vimentin (V), actin (A), and desmin (D), vimentin and actin (VA), vimentin and desmin (VD), vimentin, actin and desmin (VAD).

Estadiamento de Enneking dos tumores músculo-esqueléticos / Enneking staging of musculoskeletal tumors

O autor apresenta a traduçäo e adaptaçäo para a língua portuguesa do estadiamento dos tumores do sistema músculo-esquelético proposto pelo Prof. Willian Enneking e utilizado mundialmente. O autor faz um resumo dos principais tópicos do estadiamento, explicando o texto através de esquemas adaptados das conferências do Prof. Enneking

Medullomyoblastoma. A case report.

A case of medullomyoblastoma was studied by light and electron microscopy and by immunohistochemistry. It showed glial and neuronal differentiation in the medulloblastoma areas and rhabdomyoblastic differentiation in the intervening areas.

Fibroma aponeurótico calcificante juvenil: relato de dois casos e revisäo da literatura / Juvenile aponeurotic calcifying fibroma: report of 2 cases and review of the literature

Descrevem-se dois casos de fibroma aponeurótico calcificante juvenil localizados na regiäo do punho de pacientes jovens do sexo masculino. Em um dos casos a lesäo apresentou três episódios de recorrência num período de 11 anos, estando tal paciente já há três anos livre de nova recorrência. Estes casos parecem ser os primeiros casos de fibroma aponeurótico calcificante juvenil descritos no Brasil

Tumor de Abrikossoff (Schwannoma de células granulosas): Estudio inmunohistoquímico de estirpe celular / Abrikossofff's tumor (granulomatoris cell schweinnoma): inmunohistochemical study of the cell line

Se presenta un caso de tumor de Abrikossoff de localización poco frecuente. Debido a las diferentes teorías acerca de su histogénesis, la lesión fue estudiada por medios inmunohistoquímicos aplicados al diagnóstico de estirpe celular. En base a los orígenes más probables se seleccionó mioglobina, vimentina y proteína S-100 como marcadores. La técnica desarrollada fue la inmunoperoxidasa indirecta (PAP-complex). Las células neoplásicas fueron negativas para mioglobina y vimentina, y positivas para proteína S-100. Consideramos que nuestro hallazgo está a favor de la teoría que dostiene que el tumor de Abrikossoff deriva de las células de Schwann

Tumor de células granulares (mioblastoma) da vulva: relato de três casos / Granular cell tumor (myoblastoma) of the vulva: report of cases

Os autores apresentam três casos de Tumores de Células Granulares (Mioblastoma de Células Granulares) da vulva, tratados mediante excisäo cirúrgica ampla. O estudo histológico revelou uma neoplasia constituída por células grandes com citoplasma granular. O problema da histogênese é discutido. A natureza do tumor bem como dos grânulos citoplasmáticos permanece obscura. Apesar de muitos investigadores terem tentado estabelecer a verdadeira identidade do tumor, a célula precursora (célula de Schwann, histiócito, fibroblasto) ainda näo pôde ser definitivamente identificada mesmo com a ajuda de procedimentos histoquímicos e da elétron-microscopia. Um dos tumores estudados nesta série exibiu uma intensa hiperplasia pseudo-epiteliomatosa do epitélio escamoso recobrindo a lesäo. Este achado se reveste de importância clínica devido ao fato de o mesmo poder ser confundido com um carcinoma epidermóide bem diferenciado