Blastoma adrenal en adulto / Adrenal blastoma in an adult

El blastoma adrenal es una neoplasia excepcional de la que hay una única publicación en un niño de 21 meses. Se presenta un caso similar desarrollado en un varón de 68 años. Se revisan los criterios anatomopatológicos e inmunohistoquímicos y el diagnóstico diferencial. En conclusión, el blastoma adrenal no es un tumor exclusivo de los niños (AU)

The behaviour of liposarcoma in tissue culture. A specific growth pattern.

There have been few studies of liposarcoma in tissue culture. We report a study of 27 cases of liposarcoma including examples of all subtypes in tissue culture. All the cases showed a uniform growth pattern of glass adherence by polygonal cells with short processes distributed in a random fashion. The cytoplasm of these cells became progressively loaded with glycogen followed by lipid droplets. These lipid droplets tended to fuse progressively to form a single or dominant vacuole. At the same time, the cells tended to adopt a rounded shape. This pattern of growth, which was seen in all subtypes of liposarcoma with minimal variation, is different from that shown by other soft tissue tumours and is similar to the growth of embryonal fat in tissue culture.

In vitro differentiation of myxoid liposarcomas maintained in organ culture system.

Liposarcoma falls into the differential diagnosis of myxoid malignant mesenchymal tumors. On the other hand, its relation with white or brown fat is controversial. Two cases of liposarcoma have been studied by organ culture, a method which provides cell and tissue redifferentiation in vitro. Both cases developed successively cytoplasmic glycogen granules and lipid droplets as well as a single lipidic vacuole in the late phase of cultivation as a marker of fat differentiation. Our results support the possibility of identifying myxoid liposarcomas as well as their origin from white fat tissue.

Hemangiopericytoma in a male breast. Report of a case with cytologic, histologic and immunochemical studies.

A hemangiopericytoma in a male breast was studied by fine needle aspiration (FNA) biopsy. The FNA smears contained tissue clumps showing knob-like formations of atypical cells, spindle-shaped cells and fragments of capillaries lined by normal endothelial cells. Immunocytochemical study showed a positive reaction for vimentin, but a negative reaction for desmin and keratin. Staining for Factor VIII was positive only in the capillaries and endothelial cells. The cytodiagnosis was "mesenchymal tumor." Histopathologic study of the mastectomy specimen made the final diagnosis of hemangiopericytoma. While FNA cytology and immunocytochemistry cannot make a definitive diagnosis of this rare vascular tumor, they can be decisive in planning the surgical treatment, as in the present case.

Cerebellar hemangioblastoma and subependymoma: a case report of an unprecedented association.

We report the case of a 71-year-old man who suffered from both a cerebellar hemangioblastoma and a subependymoma (glomerate subependymal astrocytoma) of the base of the fourth ventricle. His symptoms included episodes of loss of consciousness, cerebellar ataxia, and postural vertigo. The clinical diagnosis presented considerable difficulties. The simultaneous occurrence of both tumors in one patient has not been reported previously. After reviewing the literature, we conclude that this unusual association was a result of chance rather than common oncogenic factors.

Pulmonary plasma cell granuloma--an electron microscopic and tissue culture study.

A case of pulmonary plasma cell granuloma studied by electron microscopy and tissue culture is reported. Ultrastructurally, it showed a polymorphic composition in which a variety of inflammatory cells, collagen fibres and capillary vessels were identified. In vitro there was an initial emigration of inflammatory cells, followed by a predominance of fibroblasts and histiocytes. This pattern of growth is similar to that obtained from explants of granulation tissue and gives support to the previously suggested view that these lesions are inflammatory pseudotumours.

Intrapulmonary mesotheliomas: their identification by tissue culture.

Two cases of primary intrapulmonary spindle-celled sarcomas unrelated to the pleura have been studied by electron microscopy, tissue culture and histochemistry. Ultrastructurally both tumors showed some desmosomial unions. The first case showed cytoplasmic filaments, nuclear inclusions, prominent rough endoplasmic reticulum and abundant collagen in the interstitium. The second tumor showed scanty organelles and a paucity of interstitial connective tissue fibers. In spite of their spindle morphology both tumors showed a similar pattern in vitro, growing as an epithelial plaque in the same way as previously described mesotheliomas and related tumors, such as synovial sarcomas. Histochemistry of the tumor mass allowed the identification of most of the cavities which were engulfed alveoli and bronchioli. Both neoplasm were classified as intrapulmonary mesotheliomas. Their relationship to other pulmonary lesions is discussed.

Distinctive growth patterns between cerebral and cerebellar astrocytomas--a tissue culture study.

Astrocytomas have been alternatively considered as a single entity with topographical variabilities or as two different tumours--cerebral astrocytomas and mid line-cerebellar, astrocytomas. Twenty-two astrocytomas, 13 of the cerebral hemispheres, six cerebellar, two brain stem and one of spinal cord, have been studied by short-term tissue cultures. Two distinctive growth patterns have been found. Cerebral astrocytomas grew in the first week as radially arranged bipolar cells and subsequently by multipolar astrocytes in a reticular pattern. On the other hand, astrocytomas of the cerebellum, brain stem and spinal cord showed radial growth of long bipolar cells which persisted during the first 2-3 weeks. Only in the fourth week did a reticular pattern develop, but most of the cells remained bipolar. After the fourth week, a small number of multipolar astrocytes appeared and in two cases Rosenthal fibres were found. It is thus suggested that astrocytomas may be subdivided into two entities, those of the cerebral hemispheres and others in the cerebellum, optic nerve, brain stem and spinal cord which can be grouped as midline astrocytomas.

Sclerosing haemangioma of the lung. A histochemical, electron microscopical, tissue culture and time-lapse cinematographic study.

A case of pulmonary sclerosing haemangioma was studied by electron microscopy, tissue culture, time-lapse cinematography and enzyme histochemistry. The cells bordering the spaces and forming solid sheets showed abundant surface microvilli, desmosomes and osmiophilic inclusions some of which had a lamellar structure. No Weibel-Palade bodies were found. The cells showed a negative reaction to ATP-ase and stained focally for alkaline phosphatase. Normal cells inside the tumour showed positive reactions for both enzymes. In tissue culture, both conventional studies and time-lapse cinematography showed a rather characteristic behaviour unrelated to that previously described in other neoplasms or in cultures of normal lung. The findings contradict the view that pulmonary sclerosing haemangiomas are proliferations of immature respiratory epithelial cells.

Malignant cerebellar gliomas. Report of 4 cases with special reference to tissue culture study.

The rare malignant cerebellar gliomas have been considered as an unusual form of brain glioblastomas. However, different forms have been described which can be divided into three groups: (a) cerebellar astrocytomas with malignant features; (b) undifferentiated tumors mimicking the cerebral glioblastomas; (c) malignant glioblastomatous recurrences of primary benign cerebellar astrocytomas. The present series is composed of four cases studied with silver impregnation or with tissue culture and time-lapse cinematography. It appears from this study that the cerebellar glioblastomas bear no relationship to the cerebral glioblastoma. Silver impregnation shows many astrocytes taking part in the tumor cell population and the behavior in vitro is similar to that of the common benign astrocytomas from which they seem to be derived. Thus, a sequence can be established: benign cerebellar astrocytoma, malignant cerebellar astrocytoma, cerebellar glioblastoma.

Monophasic mesenchymal synovial sarcoma: its identification by tissue culture.

Tissue cultures from a series of spindle cell soft tissue sarcomas allowed th identification of five cases in which the neoplastic cells grew as polygonal elements, forming plaques in the same way as epithelial tumors. The similarity of this behavior in vitro to that of normal pleura and synovium, and to monophasic malignant pleural mesothelioma, allowed these tumors to be classified as monophasic synovial sarcomas. None of the five tumors showed specific light-optical features, being composed of fusiform cells with a tendency to form slits in two cases. No true epithelial differentiation was found. The topographic distribution and the response to therapy of the neoplasms were also similar to that found in the usual biphasic tumors.

The astrocytic nature of glioblastoma demonstrated by tissue culture.

Forty-eight cerebral astrocytomas and glioblastomas were studied by tissue culture for two purposes: (a) the establishment of a definite growth pattern of cerebral astrocytomas and (b) the comparison of this growth pattern and that of glioblastomas. According to the grade of malignancy the series was divided into four groups: low-, middle-, and high-grade astrocytomas and undifferentiated glioblastomas. All the astrocytomas showed the same growth pattern with two successive phases. First, bipolar cells in radial arrangement emigrated from the explant, whereas in the last weeks, multipolar astrocytic-like cells in reticular arrangement predominated. The more malignant the cases, the more prolonged the bipolar phase, with retardation of the development of multipolar cells. Glioblastomas showed the same behavior with maximal persistence of the bipolar phase. On this basis, we believe that (a) cerebral astrocytomas have a characteristic behavior in vitro and (b) the glioblastoma is an astrocytic tumor showing maximal dedifferentiation.

The fibroblastic nature of dermatofibrosarcoma protuberans. A tissue culture and ultrastructural study.

Dermatofibrosarcoma protuberans has been considered to be of fibrohistiocytic or fibroblastic origin. The purpose of this paper is to identify the original cell strain from which this neoplasm derives, using tissue culture and electron microscopic methods. Thirteen cases of DFSP characterised by clinical, topographical, histological and behavioral criteria were explanted. The emigrating cells were bipolar with two opposed processed and showed a radial arrangement in respect to the explants. After the second week the distal processes tended to curve back towards the cell body forming flame-like structures. This cell morphology and cellular orientation persisted during the whole life of the culture. Electron microscopy was performed in three cases; the newly grown cells maintained an electron microscopic picture similar to that found in the original tumors. This pattern of behaviour is characteristic of fibroblastic tumors and has been found in explants of normal fibroblasts, of fibromatosis and of fibrosarcomas used as controls. On this basis, we believe that DFSP is a fibrosarcoma of the skin of low grade malignancy.