ABSTRACT
En este trabajo presentamos el caso de una proliferación linfoide atípica constituida por una población de linfocitos T-CD30+, que ocupa los vasos de un granuloma piogénico (hemangioma capilar lobular). Esta población linfoide T (CD4) presenta atipia y alto índice proliferativo, por lo que resulta necesario descartar un linfoma intravascular. Se ha descrito recientemente una proliferación de estas características que puede ser malinterpretada como un linfoma intravascular debido a la atipia y al alto índice mitótico. Los pacientes tienen buen pronóstico y no presentan signos de linfoma. El reordenamiento T resultó nulo, y la paciente continúa asintomática hasta el presente. Nuestro objetivo es presentar esta nueva entidad de carácter reactivo que simula un linfoma, y resaltar la importancia de su reconocimiento en el diagnóstico diferencial de un linfoma intravascular cutáneo (AU)
We report a case of atypical intravascular CD30+ T-cell proliferation in a patient with pyogenic granuloma (Lobular Capillary Hemangioma). The T (CD4) cell population showed cell atypia and a high proliferation index, thus it was necessary to discard an intravascular lymphoma. Cutaneous intravascular lymphoma commonly represents a diffuse large B-cell lymphoma with predominantly intravascular growth, although it could be also represented by intravascular T cell lymphomas. Recently a CD30+ T-cell proliferation was described that could mimic an intravascular T cell lymphoma. In our case TCR rearrangement was null and the patient remained healthy. We report a new case of this benign reactive process and discuss the importance of its differential diagnosis (AU)
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Granuloma, Pyogenic/blood , Granuloma, Pyogenic/diagnosis , Granuloma, Pyogenic/pathology , Ki-1 Antigen/analysis , T-Lymphocytes/pathology , Cell Proliferation , Hyperplasia/pathology , Immunohistochemistry/methods , Antigens, CD20/analysis , Lymphoma, T-Cell, Cutaneous/diagnosis , Lymphoma, T-Cell, Cutaneous/pathologyABSTRACT
OBJECTIVES: To investigate the immunohistochemical expression of vascular endothelial growth factor (VEGF) and to determine its possible association with tumor differentiation status, optic nerve and/or choroidal invasion, anterior chamber invasion, vitreous seeding, and basophilic staining of the vascular walls. METHODS: A retrospective study was performed to identify the expression of VEGF in 47 of 129 consecutive patients with retinoblastoma treated at the Ocular Pathology Laboratory of the Anatomy and Pathology Institute of the Central University of Venezuela in Caracas from January 1, 2000, through December 31, 2007. RESULTS: A positive correlation between VEGF staining intensity and time of progression and mitotic and apoptotic indexes was observed. However, no correlation was found between VEGF expression and other prognostic factors in this malignant neoplasm, including tumor stage as assessed by the Grabowski and Abramson classification. CONCLUSIONS: Although the isolated characterization of VEGF in retinoblastoma is not grounds for this protein to be considered a prognostic factor, its association with mitotic and apoptotic indexes suggests it may play a role in the progression of this disease. Thus, therapeutic targeting of VEGF in retinoblastoma may be an effective strategy to reduce tumor progression.
Subject(s)
Neovascularization, Pathologic/metabolism , Retinal Neoplasms/blood supply , Retinoblastoma/blood supply , Vascular Endothelial Growth Factor A/metabolism , Apoptosis , Cell Differentiation , Child, Preschool , Disease Progression , Female , Humans , Immunoenzyme Techniques , Male , Mitotic Index , Neoplasm Invasiveness , Neoplasm Staging , Neovascularization, Pathologic/pathology , Retinal Neoplasms/pathology , Retinoblastoma/pathology , Retrospective StudiesABSTRACT
PURPOSE: To describe the histopathologic characteristics of all retinoblastoma biopsy specimens received at one institution. METHODS: All retinoblastoma biopsy specimens received between January 2000 and December 2005 were evaluated and a total of 109 eyes from 101 patients were studied. RESULTS: There were 9 (8.3%) well differentiated, 25 (23.0%) moderately differentiated, and 66 (60.5%) poorly differentiated retinoblastomas. The most common growth pattern was mixed, comprising 81 (74.4%) cases. Vitreous seeding, invasion of the anterior chamber, and invasion of the optic nerve beyond the lamina cribrosa, was present in 79 (72.5%), 24 (22.0%), and 44 (40.4%) eyes, respectively. The tumor was confined to the retina in only 26 (23.9%) cases, whereas 16 (14.8%) had minimal choroidal invasion, 45 (41.3%) had massive choroidal involvement, 10 (9.2%) had scleral invasion, and 11 (10.1%) had extraocular extension. CONCLUSION: In this study, the percentage of patients with choroidal and optic nerve invasion, reflecting a poor prognosis, was much higher than in previously reported North American series. However, similar findings have been described in other developing countries, where late diagnosis is common. This study emphasized the need for early diagnosis and treatment.
Subject(s)
Retinal Neoplasms/pathology , Retinoblastoma/pathology , Biopsy , Child , Child, Preschool , Developing Countries , Diagnosis, Differential , Female , Humans , Incidence , Infant , Male , Neoplasm Invasiveness , Neoplasm Staging , Retinal Neoplasms/epidemiology , Retinoblastoma/epidemiology , Retrospective Studies , Venezuela/epidemiologyABSTRACT
La calcinosis cutis comprende cuatro formas de presentación: calcinosis cutis metastásica, calcinosis distrófica, calcinosis idiopática y nódulos calcificados subepidérmicos. La calcinosis cutis metastásica se desarrolla como resultado de hipercalcemia o hiperfosfatemia. En la calcinosis cutis distrófica, el calcio se deposita sobre un tejido previamente dañado. La calcinosis cutis idiopática es similar a la calcificación distrófica, pero se presenta sin evidencia de enfermedad subyacente. Los nódulos calcificados subepidérmicos, también conocidos como cálculos cutáneos se observan como lesiones pequeñas, elevadas y únicas. Se ven en niños o adultos jóvenes. El aspecto puede ser verrugoso o en casos tiene apariencia suave. La localización más común es en la cara. Se presentan cinco casos con diagnóstico de nódulos calcificados subepidérmicos, localizados en el párpado, diagnosticados en la Sección de Patología Ocular del Instituto Anatomopatológico "Dr. J. A. ODaly"
Cutis calcinosis has four clinical presentations: metastatic calcinosis cutis, dystrophic calcinosis, idiopathic calcinosis and sub epidermal calcified nodules. Metastatic cutis calcinosis occurs as a result of hypercalcaemia or hyperphosphatemia. In dystrophic calcinosis cutis, calcium is deposited over a previously damaged tissue. Similar to dystrophic calcinosis, idiopathic calcinosis cutis is presented without any subjacent illness. Sub epidermal calcified nodules, also known as a cutaneous calculus are tiny, unique and elevated lesions. It is appear in children or young adults. The clinical aspect may be since soft lesions to verrugous appearance. The most common site to be seen is on the face. We present five eyelid sub epidermal calcified nodules diagnosed in Ocular Pathology Section at The Instituto Anatomopatologico "Dr. Jose A. ODaly"
