ABSTRACT
Las metástasis cutáneas aparecen en el 0,6-10,4% de los pacientes con tumores malignos y representan hasta el 2% de los tumores cutáneos. En algunos casos representan la primera manifestación de una neoplasia no conocida. Además pueden poner de manifiesto la progresión metastásica del tumor primario. Las metástasis de localización acral son particularmente raras. En la mayoría de los casos aparecen secundariamente a afectación ósea. Aunque la clínica es variable, generalmente se confunden con un proceso infeccioso o inflamatorio, retrasándose el diagnóstico. Cuando se localizan en los dedos de la mano la causa más frecuente es el carcinoma de pulmón, mientras que las localizadas en los dedos de los pies suelen deberse a tumores del tracto genitourinario. El estudio dermatopatológico en estos casos es fundamental para establecer el diagnóstico y orientar hacia el origen del tumor primario. Presentamos 2 casos clínicos de metástasis digital acral. El primero de ellos representa el primer caso de la literatura de metástasis acral de mioepitelioma maligno (carcinoma mioepitelial) de mama y el otro una metástasis acral como manifestación inicial de carcinoma de pulmón
Cutaneous metastases appear in 0.6% to 10.4% of malignant tumors and account for 2% of all cutaneous tumors. Metastasis to the skin may arise from progression of a known primary tumor or provide the first sign of an unsuspected one. Acral metastases are particularly unusual. Most derive from bone tumors. Clinical signs vary and the lesions generally resemble infection or inflammation, leading to diagnostic delays. When metástasis involves the fingers, the primary tumor is usually lung carcinoma. In contrast, toe involvement usually derives from a tumor in the genitourinary tract. A pathologic diagnosis in these cases is necessary and will suggest the location of the primary tumor. We report 2 cases of metástasis to the fingers. One is the first report of acral metástasis of a myoepithelial carcinoma of the breast. The other concerns acral metástasis as the first sign of lung carcinoma
Subject(s)
Humans , Male , Female , Aged , Skin Neoplasms/diagnosis , Lung Neoplasms/secondary , Neoplasm Metastasis/pathology , Fingers/pathology , Skin Neoplasms/pathology , Myoepithelioma/pathology , Immunohistochemistry , Amputation, Surgical , Diagnosis, DifferentialABSTRACT
Cutaneous metastases appear in 0.6% to 10.4% of malignant tumors and account for 2% of all cutaneous tumors. Metastasis to the skin may arise from progression of a known primary tumor or provide the first sign of an unsuspected one. Acral metastases are particularly unusual. Most derive from bone tumors. Clinical signs vary and the lesions generally resemble infection or inflammation, leading to diagnostic delays. When metástasis involves the fingers, the primary tumor is usually lung carcinoma. In contrast, toe involvement usually derives from a tumor in the genitourinary tract. A pathologic diagnosis in these cases is necessary and will suggest the location of the primary tumor. We report 2 cases of metástasis to the fingers. One is the first report of acral metástasis of a myoepithelial carcinoma of the breast. The other concerns acral metástasis as the first sign of lung carcinoma.
Subject(s)
Carcinoma, Squamous Cell/secondary , Fingers/pathology , Myoepithelioma/secondary , Skin Neoplasms/secondary , Aged , Breast Neoplasms/pathology , Fatal Outcome , Female , Humans , Lung Neoplasms/pathology , Male , Neoplasm Recurrence, LocalABSTRACT
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Subject(s)
Humans , Male , Aged, 80 and over , Mycosis Fungoides/complications , Mycosis Fungoides/diagnosis , Mycosis Fungoides/therapy , Immunophenotyping/instrumentation , Immunophenotyping/methods , Immunophenotyping , Cytotoxins/adverse effects , Cytotoxins/analysis , Immunohistochemistry/instrumentation , Immunohistochemistry/methods , Immunohistochemistry , Leukemia, B-Cell , Leukemia, T-Cell , Lymphoma, B-Cell , Lymphoma, T-CellSubject(s)
Atrial Appendage , Cardiac Surgical Procedures , Fibrosarcoma , Heart Neoplasms , Adult , Atrial Appendage/diagnostic imaging , Atrial Appendage/pathology , Cardiac Surgical Procedures/adverse effects , Cardiac Surgical Procedures/methods , Echocardiography/methods , Fatal Outcome , Female , Fibrosarcoma/diagnostic imaging , Fibrosarcoma/pathology , Fibrosarcoma/physiopathology , Heart Neoplasms/diagnostic imaging , Heart Neoplasms/pathology , Heart Neoplasms/physiopathology , Humans , Neoplasm Invasiveness , Tumor BurdenSubject(s)
Antigens, CD/analysis , Antigens, Neoplasm/analysis , Biomarkers, Tumor/analysis , Immunophenotyping , Mycosis Fungoides/pathology , Skin Neoplasms/pathology , T-Lymphocyte Subsets/pathology , Aged, 80 and over , CD8 Antigens/analysis , Diagnosis, Differential , Disease Progression , Fatal Outcome , Genes, T-Cell Receptor gamma , Humans , Ki-1 Antigen/analysis , Lymphoproliferative Disorders/diagnosis , Male , Mycosis Fungoides/diagnosis , Skin Neoplasms/diagnosis , Skin Ulcer/etiology , T-Lymphocyte Subsets/chemistryABSTRACT
Interstitial granulomatous dermatitis and arthritis (IGDA) is an uncommon clinicopathological condition that may occur in association with a number of systemic disorders. We present a novel case of IGDA in association with oesophageal squamous cell carcinoma (SCC). A 67-year-old man with a 3-month history of arthritis presented with several erythematous indurated plaques on his lateral trunk and arms. An oesophagogastroduodenoscopy showed an irregular mass 20 mm in size in the proximal third of the oesophagus, and on histopathological examination of a biopsy, the mass was identified as a poorly differentiated SCC. Histopathological examination of a skin biopsy found features consistent with interstitial granulomatous dermatitis. The combination of clinicopathological correlation and laboratory findings led to the diagnosis of IGDA. This association has not been previously described, to our knowledge.
Subject(s)
Arthritis/etiology , Carcinoma, Squamous Cell/complications , Dermatitis/etiology , Esophageal Neoplasms/complications , Granuloma/etiology , Aged , Humans , Male , Paraneoplastic Syndromes/pathologyABSTRACT
El cambio apocrino del epitelio mamario es una alteraciónfrecuente habitualmente conocida como metaplasia apocrina. Aunque comúnmente se observa en el epitelio de revestimiento de quistes mamarios, existen otras lesiones, histológicamente más complejas, desde las hiperplasias de diverso grado, la adenosis esclerosante, al carcinoma in situ o invasor, también con citología apocrina. Su particular morfología se acompaña, además, de un perfil de marcadores inmunohistoquímicos distinto al de las lesiones ductales comunes similares: se caracterizan por la expresión de GCDFP, pero, además por la negatividad para receptores de estrógenos, progesterona y bcl-2, y positividad para receptores de andrógenos. El significado biológico de las lesiones apocrinas benignas, en cuanto a riesgo de carcinoma posterior, es controvertido, al igual que su posible carácter preneoplásico
Apocrine change of breast epithelium is a frequent lesion usually known as apocrine metaplasia. It is commonly observed on the lining epithelium of breast cysts, but there are also another histologycally more complex lesions, from hyperplasias or sclerosing adenosis to in situ or infiltrating carcinoma, with apocrine cytology. Besides its special morphology, apocrine metaplasia shows a distinctive immunohistochemical profile, different from similar usual ductal lesions: positivity for GCDFP and androgens receptors and negativity for oestrogen and progesterone receptors and for bcl-2. The risk of subsequent carcinoma in patients with benign apocrine lesions and its possible precancerous condition are controversial subjects