ABSTRACT
OBJECTIVE/METHOD: The aim of this study was to assess the importance of immunohistochemical markers in the diagnosis of pigmented conjunctival lesions. Due to the difficulty of making an exact clinical diagnosis, the suspicion of malignancy requires the removal of the lesion and performing a histopathology study in which immunohistochemical markers may help to determine the nature of the lesion. CASES REPORT/DISCUSSION: A case is presented of a 25 year-old woman with a pigmented lesion in the caruncle. It appeared recently and was growing fast with increasing pigmentation. Due to a suspicion of malignancy, the total lesion was removed. The microscopic study revealed cellular alterations which suggested malignancy. However, after carrying out immunohistochemical markers the diagnosis was conjunctival compound nevus.
Subject(s)
Conjunctival Neoplasms/diagnosis , Nevus, Pigmented/diagnosis , Antigens, CD/analysis , Antigens, Differentiation, Myelomonocytic/analysis , Biomarkers, Tumor , Conjunctival Neoplasms/chemistry , Conjunctival Neoplasms/pathology , Conjunctival Neoplasms/surgery , Diagnosis, Differential , Female , Humans , MART-1 Antigen/analysis , Melanoma/diagnosis , Melanoma-Specific Antigens/analysis , Nevus, Pigmented/chemistry , Nevus, Pigmented/pathology , Nevus, Pigmented/surgery , Young Adult , gp100 Melanoma AntigenABSTRACT
Objetivo/Método: Valorar la importancia de los marcadores inmunohistoquímicos para el diagnóstico de certeza de lesiones pigmentadas de la conjuntiva. Debido a la dificultad del diagnóstico clínico exacto, la sospecha de malignidad obliga a realizar una extirpación de la lesión y estudio anatomopatológico en el cual los marcadores inmunohistoquímicos ayudan a determinar la naturaleza de la lesión. Caso clínico/Discusión: Mujer de 25 años que presenta una lesión pigmentada en carúncula de aparición reciente y crecimiento rápido con aumento de la pigmentación. Se sospecha malignidad por lo que se realiza extirpación total de la lesión. El estudio microscópico muestra alteraciones celulares sugerentes de malignidad pero tras realizar marcadores inmunohistoquímicos el diagnóstico es nevus conjuntival compuesto(AU)
Objective/Method: The aim of this study was to assess the importance of immunohistochemical markers in the diagnosis of pigmented conjunctival lesions. Due to the difficulty of making an exact clinical diagnosis, the suspicion of malignancy requires the removal of the lesion and performing a histopathology study in which immunohistochemical markers may help to determine the nature of the lesion. Cases Report/Discussion: A case is presented of a 25 year-old woman with a pigmented lesion in the caruncle. It appeared recently and was growing fast with increasing pigmentation. Due to a suspicion of malignancy, the total lesion was removed. The microscopic study revealed cellular alterations which suggested malignancy. However, after carrying out immunohistochemical markers the diagnosis was conjunctival compound nevus(AU)
Subject(s)
Humans , Immunohistochemistry , Immunohistochemistry/classification , Immunohistochemistry/methods , Immunohistochemistry , Biomarkers, Tumor , Conjunctival Neoplasms/diagnosis , Conjunctival Neoplasms/microbiology , Conjunctival Neoplasms/pathology , Diagnostic Techniques, Ophthalmological , Biomarkers, Tumor/analysis , Nevus/diagnosis , PigmentationABSTRACT
Castleman's disease is an unknown etiology lymphoproliferative disorder rare in childhood (only 100 cases described in the literature, 7 of them in Spain). It usually appears in young adults, with no gender-related differences. There are two clinical forms of the disease: the localized variant, the more frequent type, usually presented as a solitary mass (generally in the mediastinum) and asymptomatic at the time of diagnosis, and the multicentric variant, less frequent and usually associated with systemic symptoms and a more aggressive clinical evolution. The diagnosis is confirmed based on the histopathological study. There are two histological variants: the hyaline-vascular type, which usually appears as a localised variant, and the plasma-cell type, which usually appears as multicentric variant and has a worse prognosis. While the best treatment for the localised variant is surgical resection, which is curative, for the multicentric variant many therapeutic strategies have been used without real success. In the present article we report a new case of this disease in a 3-year-old girl with the localised form, who remains asymptomatic after two years of follow-up, and a review of the available literature. This disease should be included in the differential diagnosis of the lymphoproliferative disorders.
Subject(s)
Castleman Disease , Castleman Disease/pathology , Castleman Disease/surgery , Child, Preschool , Female , HumansABSTRACT
La enfermedad de Castleman es un trastorno linfoproliferativo de etiología desconocida, de escasa frecuencia en Pediatría (sólo hay 100 casos descritos, 7 en España). Suele afectar a adultos jóvenes y se describen 2 formas clínicas: la forma localizada (que suele presentarse como una masa única y asintomática al diagnóstico) y la forma multicéntrica, (generalmente con afectación sistémica y un comportamiento más agresivo). El diagnóstico de confirmación es anatómico y patológico. Histológicamente hay 2 variantes: la forma hialina-vascular, que suele corresponder a las formas localizadas de la enfermedad, y la variante de células plasmáticas, que suele ser multicéntrica. La resección quirúrgica es curativa para las formas localizadas, mientras que se han ensayado una multitud de tratamientos sin éxito para las formas multicéntricas. A continuación se presenta el caso de una preescolar de 3 años con una forma localizada de la enfermedad que, tras 2 años de seguimiento, se mantiene asintomática. Asimismo, se realiza una revisión de la literatura médica disponible al respecto (AU)
Castleman´s disease is an unknown etiology lymphoproliferative disorder rare in childhood (only 100 cases described in the literature, 7 of them in Spain). It usually appears in young adults, with no gender-related differences. There are two clinical forms of the disease: the localized variant, the more frequent type, usually presented as a solitary mass (generally in the mediastinum) and asymptomatic at the time of diagnosis, and the multicentric variant, less frequent and usually associated with systemic symptoms and a more aggressive clinical evolution. The diagnosis is confirmed based on the histopathological study. There are two histological variants: the hyaline-vascular type, which usually appears as a localised variant, and the plasma-cell type, which usually appears as multicentric variant and has a worse prognosis. While the best treatment for the localised variant is surgical resection, which is curative, for the multicentric variant many therapeutic strategies have been used without real success. In the present article we report a new case of this disease in a 3-year-old girl with the localised form, who remains asymptomatic after two years of follow-up, and a review of the available literature. This disease should be included in the differential diagnosis of the lymphoproliferative disorders (AU)
