Sarcoma de Ewing/Pnet primário pré-sacral: relato de caso / Ewing Sarcoma/Pnet pre-sacral: case report

O sarcoma de Ewing é um tipo de tumor ósseo, de comportamento agressivo, que acomete principalmente indivíduos abaixo dos 30 anos e com predomínio no sexo masculino. A família de tumores de Ewing compreende um espectro de neoplasias de células neuroectodérmicas primitivas as quais são células embrionárias que migram da crista neural. Neste relato apresenta-se paciente do sexo masculino, 19 anos, admitido na emergência com quadro de lombalgia, fraqueza de membros inferiores, dificuldade de urinar e fratura de fêmur direito há um ano. Solicitada ressonância magnética da pelve e coluna lombosacra que evidenciaram lesão expansiva pré-sacral e lesões extramedulares e intradurais. Paciente submetido a exame anatomopatológico que evidenciou sarcoma de Ewing/Tumor Neuroectodérmico Primitivo. Realizado tratamento cirúrgico para descompressão medular e posterior radioterapia e quimioterapia...

Ewing’s sarcoma is a type of bone tumor that has aggressive behavior, which mainly affects individuals below 30 years and predominantly in males. The family of tumors includes Ewing a spectrum of neuroectodermal of primitive cells tumors which are embryonic cells migrating from the neural crest. In this report we present a male patient, 19 years, admitted to the emergency room with back pain, weakness of the lower limbs, difficulty urinating and right femur fracture a year ago. Requested magnetic resonance imaging of the pelvis and lumbosacral spine showed a presacral mass lesion and extramedullary and intradurallesions. Patient has been subjected to the pathological examination that showed Ewing’s sarcoma / primitive neuroectodermal tumor. Surgery for spinal decompression and subsequent radiotherapy and chemotherapy have been conducted...

Morphological characterization of the false vocal cords as larynx-associated lymphoid tissue.

The lymphoid follicles (LF) found in the false vocal cords (FVC) protect the upper air tracts, similar to the lymphoid tissue associated to the respiratory mucosas. However, studies that characterize the phenotype of cells like larynx-associated lymphoid tissue (LALT) are lacking. We analyzed the FVC of autopsied adults according to morphometric and immunohistochemical criteria and defined their possible role as LALT. We analyzed 249 FVC. Primary antibodies, CD68+ macrophages, CD20+, CD3+, and FDC+ were used for the evaluation of inflammatory cell phenotypes. In 40.6% of the cases, there was an inflammatory reaction. In 42.2% of the cases, LF were identified in the submucosa. In 17.3% of the cases, neither LF nor mononuclear cells were identified in the FVC, and these patients were from an older age group (p=0.013). A significant increase in the number of all LF cell phenotypes was observed in patients with pulmonary inflammation; the difference in both T- and B-lymphocytes was statistically significant (p=0.010). The morphological findings of LF suggest a probable participation of the FVC in the protection of the larynx and lungs, and similarity to LALT.

Histopathologic changes in human true vocal folds: a postmortem study.

Several articles describe the gross pathology alterations of the true vocal cords (TVC), but the histopathology descriptions in adults are rare in the literature and are normally associated with neoplasia. The aim of this study is to identify the TVC morphological lesions in adult autopsies. This was a cross-sectional study of 266 adults' larynxes consecutively autopsied from 1993 to 2003. Histochemical and immunohistochemical methods were used for morphological analysis. Considering the morphological analysis, 97 TVC (36.5%) were considered normal. The following lesions were found in the TVC: thickening of the basal membrane of the TVC in 81 patients (30.5%), inflammatory reaction in 66 patients (24.8%), hemorrhage in 19 patients (7.1%), and ulceration in 3 patients (1.1%). Our study demonstrated that the TVC microscopic lesions are frequent, present different morphological patterns, and showed different causes from what had been described until nowadays by the literature. Despite this difference in the morphological pattern, we were able to identify a common lesion pathway for ethiological different diseases.