1 research outputs found
Π Π΅Π΄ΠΊΠΈΠΉ ΡΠ»ΡΡΠ°ΠΉ Π»ΠΈΠΏΠΎΡΠΈΠ±ΡΠΎΠ°Π΄Π΅Π½ΠΎΠΌΡ ΡΠΈΠΌΡΡΠ°
Purpose of the study: differential diagnosis of tumors arising from the mediastinum, as well as the analysis of the biological potential of the tumor, taking into account the relatively low incidence of these tumors among the population.Material and Methods. Macroscopic and microscopic examinations of the surgical specimen were performed using routine H&E staining. Immunohistochemical staining of paraffin-embedded tissue sections was performed using a Roche Ventana BenchMark Ultra system. The results obtained were evaluated taking into account the available literature data published on this nosology.Description. We present a rare case of a benign neoplasm of the thymus, lipofibroadenoma (LFA), which was localized in the left pleural cavity and originated from the anterior mediastinum with partial compression of the lower lobe of the left lung in a 59-year-old man. The tumor was revealed during a routine medical examination. The patient underwent left-sided thoracotomy with complete excision of the tumor and anterior mediastinal lymph node dissection. Macroscopic examination reveled that the tumor was predominantly composed of adipose tissue with fibrous layers. Histological examination showed a tumor composed of mature adipocytes of various sizes, among which remnants of the thymus with Hassalβs bodies and small number of lymphocytes and calcifications were found. Areas of fibrous stroma predominated over narrow strands of anastomosing epithelial cells with clear nuclei. Epitheliocytes formed slit-like structures infiltrated with lymphocytes, resembling the structure of breast fibroadenoma. Immunohistochemical examination revealed that epithelial cells were positive for PanKeratin and CK19, lymphocytes were positive for CD3 and CD20, and thymic cells expressed TdT. In this case, the neoplasm was almost asymptomatic, in contrast to previously published observations, which described an association with erythrocyte aplasia.Conclusion. Considering the clinical, histological and immunohistochemical data, it was feasible to make a differential diagnosis of the neoplasm and determine the histological type of the tumor as lipofibroadenoma.Β Π¦Π΅Π»Ρ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ β Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½Π°Ρ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ° Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ, ΠΈΡΡ
ΠΎΠ΄ΡΡΠ΅Π³ΠΎ ΠΈΠ· ΡΡΠ΅Π΄ΠΎΡΡΠ΅Π½ΠΈΡ; ΡΡΠΎΡΠ½Π΅Π½ΠΈΠ΅ Π±ΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΏΠΎΡΠ΅Π½ΡΠΈΠ°Π»Π° ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ, ΠΏΡΠΈΠ½ΠΈΠΌΠ°Ρ Π²ΠΎ Π²Π½ΠΈΠΌΠ°Π½ΠΈΠ΅ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎ Π½ΠΈΠ·ΠΊΡΡ Π²ΡΡΡΠ΅ΡΠ°Π΅ΠΌΠΎΡΡΡ ΠΏΠΎΠ΄ΠΎΠ±Π½ΡΡ
Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠΉ.ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΎΠ°Π½Π°ΡΠΎΠΌΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠ³ΠΎ ΠΌΠ°ΡΠ΅ΡΠΈΠ°Π»Π° ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΌΠ°ΠΊΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈ ΠΌΠΈΠΊΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ Ρ ΡΡΡΠΈΠ½Π½ΠΎΠΉ ΠΎΠΊΡΠ°ΡΠΊΠΎΠΉ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΏΡΠ΅ΠΏΠ°ΡΠ°ΡΠΎΠ². ΠΠΌΠΌΡΠ½ΠΎΠ³ΠΈΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΎΠΊΡΠ°ΡΠΈΠ²Π°Π½ΠΈΠ΅ ΠΏΠ°ΡΠ°ΡΠΈΠ½ΠΎΠ²ΡΡ
ΡΡΠ΅Π·ΠΎΠ² ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π°Π²ΡΠΎΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΠΌΠΌΡΠ½ΠΎΠ³ΠΈΡΡΠΎΡΡΠ΅ΠΉΠ½Π΅ΡΠ° Roche Ventana BenchMark Ultra. ΠΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΎΡΠ΅Π½ΠΈΠ²Π°Π»ΠΈΡΡ Ρ ΡΡΠ΅ΡΠΎΠΌ Π΄ΠΎΡΡΡΠΏΠ½ΡΡ
Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΠ½ΡΡ
Π΄Π°Π½Π½ΡΡ
, ΠΊΠ°ΡΠ°ΡΡΠΈΡ
ΡΡ Π΄Π°Π½Π½ΠΎΠΉ Π½ΠΎΠ·ΠΎΠ»ΠΎΠ³ΠΈΠΈ.ΠΠΏΠΈΡΠ°Π½ΠΈΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠ»ΡΡΠ°Ρ. ΠΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ ΡΠ΅Π΄ΠΊΠΈΠΉ ΡΠ»ΡΡΠ°ΠΉ Π΄ΠΎΠ±ΡΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ Π²ΠΈΠ»ΠΎΡΠΊΠΎΠ²ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ Ρ 59-Π»Π΅ΡΠ½Π΅Π³ΠΎ ΠΌΡΠΆΡΠΈΠ½Ρ β Π»ΠΈΠΏΠΎΡΠΈΠ±ΡΠΎΠ°Π΄Π΅Π½ΠΎΠΌΡ (ΠΠ€Π), ΠΊΠΎΡΠΎΡΠ°Ρ Π»ΠΎΠΊΠ°Π»ΠΈΠ·ΠΎΠ²Π°Π»Π°ΡΡ Π² Π»Π΅Π²ΠΎΠΉ ΠΏΠ»Π΅Π²ΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΠΎΠ»ΠΎΡΡΠΈ ΠΈ ΠΈΡΡ
ΠΎΠ΄ΠΈΠ»Π° ΠΈΠ· ΠΏΠ΅ΡΠ΅Π΄Π½Π΅Π³ΠΎ ΡΡΠ΅Π΄ΠΎΡΡΠ΅Π½ΠΈΡ, Ρ ΡΠ°ΡΡΠΈΡΠ½ΠΎΠΉ ΠΊΠΎΠΌΠΏΡΠ΅ΡΡΠΈΠ΅ΠΉ Π½ΠΈΠΆΠ½Π΅ΠΉ Π΄ΠΎΠ»ΠΈ Π»Π΅Π²ΠΎΠ³ΠΎ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ. ΠΠΏΡΡ
ΠΎΠ»Ρ Π±ΡΠ»Π° ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½Π° Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ Π»ΡΡΠ΅Π²ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ ΠΏΡΠΈ ΠΏΠ»Π°Π½ΠΎΠ²ΠΎΠΉ Π΄ΠΈΡΠΏΠ°Π½ΡΠ΅ΡΠΈΠ·Π°ΡΠΈΠΈ. ΠΡΠΎΠΈΠ·Π²Π΅Π΄Π΅Π½Π° Π»Π΅Π²ΠΎΡΡΠΎΡΠΎΠ½Π½ΡΡ ΡΠΎΡΠ°ΠΊΠΎΡΠΎΠΌΠΈΡ Ρ ΠΏΠΎΠ»Π½ΡΠΌ ΠΈΡΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΠΈ ΠΏΠ΅ΡΠ΅Π΄Π½Π΅ΠΉ ΠΌΠ΅Π΄ΠΈΠ°ΡΡΠΈΠ½Π°Π»ΡΠ½ΠΎΠΉ Π»ΠΈΠΌΡΠΎΠ΄ΠΈΡΡΠ΅ΠΊΡΠΈΠ΅ΠΉ. ΠΡΠΈ ΠΌΠ°ΠΊΡΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ: ΠΎΠΏΡΡ
ΠΎΠ»Ρ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½Π° ΠΏΡΠ΅ΠΈΠΌΡΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎ ΠΆΠΈΡΠΎΠ²ΠΎΠΉ ΡΠΊΠ°Π½ΡΡ Ρ ΡΠΈΠ±ΡΠΎΠ·Π½ΡΠΌΠΈ ΠΏΡΠΎΡΠ»ΠΎΠΉΠΊΠ°ΠΌΠΈ. ΠΡΠΈ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ: Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»Π΅Π½ΠΎ Π·ΡΠ΅Π»ΡΠΌΠΈ Π°Π΄ΠΈΠΏΠΎΡΠΈΡΠ°ΠΌΠΈ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΡΠ°Π·ΠΌΠ΅ΡΠΎΠ², ΡΡΠ΅Π΄ΠΈ ΠΊΠΎΡΠΎΡΡΡ
ΠΎΠΏΡΠ΅Π΄Π΅Π»ΡΠ»ΠΈΡΡ ΠΎΡΡΠ°ΡΠΊΠΈ ΡΠΈΠΌΡΡΠ° Ρ ΡΠ΅Π»ΡΡΠ°ΠΌΠΈ ΠΠ°ΡΡΠ°Π»Ρ, Π½Π΅Π±ΠΎΠ»ΡΡΠΈΠΌ ΠΊΠΎΠ»ΠΈΡΠ΅ΡΡΠ²ΠΎΠΌ Π»ΠΈΠΌΡΠΎΡΠΈΡΠΎΠ², ΠΊΠ°Π»ΡΡΠΈΠ½Π°ΡΡ. Π£ΡΠ°ΡΡΠΊΠΈ ΡΠΈΠ±ΡΠΎΠ·Π½ΠΎΠΉ ΡΡΡΠΎΠΌΡ ΠΏΡΠ΅ΠΎΠ±Π»Π°Π΄Π°Π»ΠΈ Π½Π°Π΄ ΡΠ·ΠΊΠΈΠΌΠΈ ΡΡΠΆΠ°ΠΌΠΈ Π°Π½Π°ΡΡΠΎΠΌΠΎΠ·ΠΈΡΡΡΡΠΈΡ
ΠΌΠ΅ΠΆΠ΄Ρ ΡΠΎΠ±ΠΎΠΉ ΡΠΏΠΈΡΠ΅Π»ΠΈΠ°Π»ΡΠ½ΡΡ
ΠΊΠ»Π΅ΡΠΎΠΊ ΡΠΎ ΡΠ²Π΅ΡΠ»ΡΠΌΠΈ ΡΠ΄ΡΠ°ΠΌΠΈ. ΠΠ΅ΡΡΠ°ΠΌΠΈ ΡΠΏΠΈΡΠ΅Π»ΠΈΠΎΡΠΈΡΡ ΡΠΎΡΠΌΠΈΡΠΎΠ²Π°Π»ΠΈ ΠΈΠ½ΡΠΈΠ»ΡΡΡΠΈΡΠΎΠ²Π°Π½Π½ΡΠ΅ Π»ΠΈΠΌΡΠΎΡΠΈΡΠ°ΠΌΠΈ ΡΠ΅Π»Π΅Π²ΠΈΠ΄Π½ΡΠ΅ ΡΡΡΡΠΊΡΡΡΡ, Π½Π°ΠΏΠΎΠΌΠΈΠ½Π°ΡΡΠΈΠ΅ ΡΡΡΠΎΠ΅Π½ΠΈΠ΅ ΡΠΈΠ±ΡΠΎΠ°Π΄Π΅Π½ΠΎΠΌΡ ΠΌΠΎΠ»ΠΎΡΠ½ΠΎΠΉ ΠΆΠ΅Π»Π΅Π·Ρ. ΠΡΠΈ ΠΈΠΌΠΌΡΠ½ΠΎΠ³ΠΈΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΎΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ ΡΠΏΠΈΡΠ΅Π»ΠΈΠ°Π»ΡΠ½ΡΠ΅ ΠΊΠ»Π΅ΡΠΊΠΈ Π±ΡΠ»ΠΈ ΠΏΠΎΠ»ΠΎΠΆΠΈΡΠ΅Π»ΡΠ½Ρ Π½Π° PanKeratin ΠΈ CK19, Π° Π»ΠΈΠΌΡΠΎΡΠΈΡΡ β Π½Π° CD3 ΠΈ CD20, ΡΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΊΠ»Π΅ΡΠΊΠΈ ΡΠΊΡΠΏΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π»ΠΈ TdT. Π Π΄Π°Π½Π½ΠΎΠΌ ΡΠ»ΡΡΠ°Π΅ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΡΠΎΡΠ΅ΠΊΠ°Π»ΠΎ ΠΏΡΠ°ΠΊΡΠΈΡΠ΅ΡΠΊΠΈ Π±Π΅ΡΡΠΈΠΌΠΏΡΠΎΠΌΠ½ΠΎ, Π² ΠΎΡΠ»ΠΈΡΠΈΠ΅ ΠΎΡ ΡΠ°Π½Π΅Π΅ ΠΎΠΏΡΠ±Π»ΠΈΠΊΠΎΠ²Π°Π½Π½ΡΡ
Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΠΉ, Π³Π΄Π΅ ΠΎΠΏΠΈΡΠ°Π½Π° Π°ΡΡΠΎΡΠΈΠ°ΡΠΈΡ Ρ ΡΡΠΈΡΡΠΎΡΠΈΡΠ°ΡΠ½ΠΎΠΉ Π°ΠΏΠ»Π°Π·ΠΈΠ΅ΠΉ.ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π‘ ΡΡΠ΅ΡΠΎΠΌ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΡ
Π΄Π°Π½Π½ΡΡ
, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠΎΠ² Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈ ΠΈΠΌΠΌΡΠ½ΠΎΠ³ΠΈΡΡΠΎΡ
ΠΈΠΌΠΈΡΠ΅ΡΠΊΠΈΡ
ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΉ ΡΠ΄Π°Π»ΠΎΡΡ ΠΏΡΠΎΠ²Π΅ΡΡΠΈ Π΄ΠΈΡΡΠ΅ΡΠ΅Π½ΡΠΈΠ°Π»ΡΠ½ΡΡ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΡ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ ΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»ΠΈΡΡ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠΈΠΏ ΠΎΠΏΡΡ
ΠΎΠ»ΠΈ ΠΊΠ°ΠΊ ΠΠ€Π