Assuntos
Angiomiolipoma/patologia , Angiomiolipoma/cirurgia , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Angiomiolipoma/diagnóstico por imagem , Biópsia por Agulha , Seguimentos , Humanos , Imuno-Histoquímica , Neoplasias Renais/diagnóstico por imagem , Leiomioma/diagnóstico por imagem , Leiomioma/patologia , Leiomioma/cirurgia , Masculino , Nefrectomia/métodos , Medição de Risco , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: The mediastinum is an uncommon site for liposarcoma, with <1 % of all tumors occurring in this site. CASE: A 40-year-old woman presented with superior vena caval syndrome. Radiologic investigations revealed the presence of a large soft tissue mass occupying the anterior and middle mediastinum. A computed tomography (CT)-guided fine needle aspiration cytology (FNAC) sample showed the presence of fibrillary myxoid material with arborizing blood vessels and atypical lipoblasts. A diagnosis of myxold liposarcoma was made, which was later confirmed on bistopathology. CONCLUSION: The mediastinum is a challenging area for FNAC, which is a useful tool for accurate diagnosis. Awareness of the presence of liposarcoma is important for its recognition.
Assuntos
Lipossarcoma Mixoide/patologia , Neoplasias do Mediastino/patologia , Adulto , Biópsia por Agulha Fina , Feminino , Humanos , Lipossarcoma Mixoide/diagnóstico por imagem , Neoplasias do Mediastino/diagnóstico por imagem , Síndrome da Veia Cava Superior/diagnóstico por imagem , Síndrome da Veia Cava Superior/patologia , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Angiomyolipoma is a rare benign neoplasm, commonly involving the kidney. Preoperative diagnosis on fine needle aspiration cytology can confirm the diagnosis, reducing the chances of unnecessary surgery. CASES: We studied cases of renal angiomyolipoma (AML) presenting within 1 year with palpable renal masses confirmed on ultrasound to be of renal origin. Fine needle aspiration cytology (FNAC) smears showed a few cohesive syncytial fragments with adipocytes, spindle cells and isolated single cells with foamy cytoplasm; a diagnosis of AML was made. The diagnosis was confirmed on histopathology, which showed mature adipose tissue, tortuous and thick-walled blood vessels lacking elastic tissue lamina and bundles of smooth muscles that seemed to emanate from the blood vessels. CONCLUSION: A preoperative diagnosis of renal AML is of great importance for correct management. In fact, when the lesion is small and asymptomatic, a conservative approach may be considered. Partial nephrectomy is possible with masses < 5 cm. Preoperative FNAC along with computed tomographic findings and immunocytochemical analysis of FNAC smears with HNB-45 can confirm the diagnosis of AML, thus preventing unindicated nephrectomy.
