RESUMO
PURPOSE: The progression of synovial chondromatosis to chondrosarcoma is very rare. Distinction between these two entities may be difficult on histology alone, and should be based on clinical, radiographic and microscopic evidence. Immunohistochemical markers that would facilitate differentiation between synovial chondromatosis and chondrosarcoma are currently being investigated. PATIENTS: We describe the cases of two patients who presented with synovial chondromatosis and progression to synovial chondrosarcoma during periods of 7 and 11 years. Several biopsies and resected specimens demonstrated synovial chondromatosis before a diagnosis of chondrosarcoma was made. METHOD: We have examined five markers (Bcl2, Ki67, p27, p16, and p53) in all specimens from these cases, as well as known cases of chondromatosis and chondrosarcoma for control purposes. RESULTS: We found increased expression of Bcl2 in benign chondromatosis compared to synovial or central chondrosarcomas. DISCUSSION: Distinction between chondromatosis and its progression to low grade chondrosarcoma is difficult at histological level, and must involve incorporation of clinical and radiographical data. Although preliminary, our study suggests that reduced or absent expression of Bcl2 is associated withmalignant transformation of chondromatosis.
RESUMO
The present report describes the first reported case of microscopic pulmonary tumour embolism (MPTE) from thymic carcinoma. The carcinoma was discovered during an autopsy in a 55-year-old man who had undergone surgery for a pilonidal sinus two weeks before presentation. Pulmonary thromboembolism was suspected. This case was unusual because MPTE has never before been associated with thymic carcinoma, MPTE was the first clinical indication of an occult malignancy, and the clinical presentation was that of sudden onset of dyspnea associated with acute cor pulmonale. The cause of death was determined to be hypoxia secondary to extrinsic compression of the right pulmonary artery and extensive tumour emboli in the small arteries, arterioles and venules of the pulmonary parenchyma. A review of the clinical presentation and diagnosis of MPTE is included.
