Papillary Thyroid Carcinoma: Differential Diagnosis and Prognostic Values of Its Different Variants: Review of the Literature

Papillary thyroid carcinoma is the most common thyroid malignancy, and has an excellent prognosis, even with cervical lymph node metastasis; however, histological variants are considered relevant, which may be associated with familial adenomatous polyposis and tumor aggressiveness. Histological features, such as vascular and/or lymphatic invasion, angiogenesis, multifocality, high cellular proliferation rate, neoplastic cell dissemination, and the histological varieties, are indicative of poor prognosis, together with associated clinical factors: age, sex, and tumor size

A Histopathological and Immunohistochemical analysis of ameloblastic fibrodentinoma

Ameloblastic fibrodentinoma (AFD) is considered a mixed odontogenic tumor that is characterized by conserved epithelial and ectomesenchymal neoplastic components. AFD is composed of long narrow cords and islands of odontogenic epithelium; the epithelial strands lie in a myxoid cell-rich ectomesenchymal tissue with stellate-shaped fibroblasts that exhibit long slender cytoplasmic extensions that resemble dental papilla. The lesions show the presence of dysplastic dentin. Although AFD is a rare entity and its very existence is not completely accepted, based on the extent of histodifferentiation, it is considered to represent a stage between ameloblastic fibroma and ameloblastic fibroodontoma.This study aimed to provide a histopathological and immunohistochemical characterization of this infrequent tumor. A large panel of antibodies including amelogenin, Ck 19, calretinin, syndecan-1, E-cadherin, MSH2, histone H3, and Ki-67 was used to illustrate the nature of the tumor

Immunolocalization of VEGF-A and orosomucoid-1 in odontogenic myxoma

OBJECTIVE:The aim of the present study was to determine and establish the immunohistochemical distribution of VEGF-A and ORM-1 protein in odontogenic myxomas to suggest a possible function in the biological behavior of odontogenic myxomas.MATERIALS AND METHODS:A total of 33 odontogenic myxoma cases and three tooth germs were included. Immunohistochemistry was performed to localize VEGF-A and ORM-1 proteins in tumor cells, endothelial cells and extracellular matrix in the odontogenic myxomas. The intratumoral microvessel density (MVD) was determined with CD34 and Factor VIII antibodies.RESULTS:Immunopositivity was strong in the endothelial cells, which compose various vessels, and in the randomly oriented stellate, spindle-shaped and round tumoral cells with long cytoplasmic processes. More than half of the extracellular matrix lacked expression of VEGF-A. ORM-1 expression was strong in both endothelial cells and tumor cells, and the myxoid extracellular matrix was positive, with moderate or strong immunoexpression in all cases. An important finding of this study was the statistically significant positive correlation between the expression of ORM-1 and VEGF-A in tumor cells (p=0.02).CONCLUSIONS:The results of this study suggest that the expression of VEGF-A and ORM-1 may be associated with two mechanisms (angiogenesis and tumor structural viscosity) that may influence tumor growth in odontogenic myxomaOBJECTIVE:The aim of the present study was to determine and establish the immunohistochemical distribution of VEGF-A and ORM-1 protein in odontogenic myxomas to suggest a possible function in the biological behavior of odontogenic myxomas.MATERIALS AND METHODS:A total of 33 odontogenic myxoma cases and three tooth germs were included. Immunohistochemistry was performed to localize VEGF-A and ORM-1 proteins in tumor cells, endothelial cells and extracellular matrix in the odontogenic myxomas. The intratumoral microvessel density (MVD) was determined with CD34 and Factor VIII antibodies.RESULTS:Immunopositivity was strong in the endothelial cells, which compose various vessels, and in the randomly oriented stellate, spindle-shaped and round tumoral cells with long cytoplasmic processes. More than half of the extracellular matrix lacked expression of VEGF-A. ORM-1 expression was strong in both endothelial cells and tumor cells, and the myxoid extracellular matrix was positive, with moderate or strong immunoexpression in all cases. An important finding of this study was the statistically significant positive correlation between the expression of ORM-1 and VEGF-A in tumor cells (p=0.02).CONCLUSIONS:The results of this study suggest that the expression of VEGF-A and ORM-1 may be associated with two mechanisms (angiogenesis and tumor structural viscosity) that may influence tumor growth in odontogenic myxomaOBJECTIVE:The aim of the present study was to determine and establish the immunohistochemical distribution of VEGF-A and ORM-1 protein in odontogenic myxomas to suggest a possible function in the biological behavior of odontogenic myxomas.MATERIALS AND METHODS:A total of 33 odontogenic myxoma cases and three tooth germs were included. Immunohistochemistry was performed to localize VEGF-A and ORM-1 proteins in tumor cells, endothelial cells and extracellular matrix in the odontogenic myxomas. The intratumoral microvessel density (MVD) was determined with CD34 and Factor VIII antibodies.RESULTS:Immunopositivity was strong in the endothelial cells, which compose various vessels, and in the randomly oriented stellate, spindle-shaped and round tumoral cells with long cytoplasmic processes. More than half of the extracellular matrix lacked expression of VEGF-A. ORM-1 expression was strong in both endothelial cells and tumor cells, and the myxoid extracellular matrix was positive, with moderate or strong immunoexpression in all cases. An important finding of this study was the statistically significant positive correlation between the expression of ORM-1 and VEGF-A in tumor cells (p=0.02).CONCLUSIONS:The results of this study suggest that the expression of VEGF-A and ORM-1 may be associated with two mechanisms (angiogenesis and tumor structural viscosity) that may influence tumor growth in odontogenic myxomaOBJECTIVE:The aim of the present study was to determine and establish the immunohistochemical distribution of VEGF-A and ORM-1 protein in odontogenic myxomas to suggest a possible function in the biological behavior of odontogenic myxomas.MATERIALS AND METHODS:A total of 33 odontogenic myxoma cases and three tooth germs were included. Immunohistochemistry was performed to localize VEGF-A and ORM-1 proteins in tumor cells, endothelial cells and extracellular matrix in the odontogenic myxomas. The intratumoral microvessel density (MVD) was determined with CD34 and Factor VIII antibodies.RESULTS:Immunopositivity was strong in the endothelial cells, which compose various vessels, and in the randomly oriented stellate, spindle-shaped and round tumoral cells with long cytoplasmic processes. More than half of the extracellular matrix lacked expression of VEGF-A. ORM-1 expression was strong in both endothelial cells and tumor cells, and the myxoid extracellular matrix was positive, with moderate or strong immunoexpression in all cases. An important finding of this study was the statistically significant positive correlation between the expression of ORM-1 and VEGF-A in tumor cells (p=0.02).CONCLUSIONS:The results of this study suggest that the expression of VEGF-A and ORM-1 may be associated with two mechanisms (angiogenesis and tumor structural viscosity) that may influence tumor growth in odontogenic myxom

A Histopathological and Immunohistochemical Analysis of Ameloblastic Fibrodentinoma

Ameloblastic fibrodentinoma (AFD) is considered a mixed odontogenic tumor that is characterized by conserved epithelial and ectomesenchymal neoplastic components. AFD is composed of long narrow cords and islands of odontogenic epithelium; the epithelial strands lie in a myxoid cell-rich ectomesenchymal tissue with stellate-shaped fibroblasts that exhibit long slender cytoplasmic extensions that resemble dental papilla. The lesions show the presence of dysplastic dentin. Although AFD is a rare entity and its very existence is not completely accepted, based on the extent of histodifferentiation, it is considered to represent a stage between ameloblastic fibroma and ameloblastic fibroodontoma. This study aimed to provide a histopathological and immunohistochemical characterization of this infrequent tumor. A large panel of antibodies including amelogenin, Ck 19, calretinin, syndecan-1, E-cadherin, MSH2, histone H3, and Ki-67 was used to illustrate the nature of the tumor

Variante oncocítica del carcinoma mucoepidermoide

El carcinoma mucoepidermoide es el más común de todos los tumores malignos de glándulas salivales, constituye el 30 % de ellos. Aproximadamente la mitad de los casos (53 %) ocurre en las glándulas salivales mayores. El 45 % predomina en glándula parótida, el 7 % en la submandibular y el 1 % en la glándula sublingual. Este tumor se presenta con más frecuencia en el sexo femenino (3:2) y en la quinta década de la vida. Múltiples variantes, con diferentes rangos de diferenciación han sido descritas, se incluyen: la oncocítica, esclerosante, uniquística, sebácea, de células claras, células globosas de alto grado, células fusocelular y psamomatosa. El carcinoma mucoepidermoide variante oncocítica es un subtipo raro que puede mostrar prominentes cambios oncocíticos. Se reporta un caso de carcinoma mucoepidermoide variante oncocítica de alto grado histológico. El índice de Ki 67 fue del 5 %, el tumor fue negativo para C-erb2 y presentó inmunorreactividad para E-caderina y Syndecan-1

Leucemia de células dendríticas. A propósito de un caso

La leucemia de células dendríticas es una patología hematológica maligna rara, altamente agresiva, derivada de precursores de células dendríticas plasmocitoides. Se manifiesta con lesiones cutáneas e infiltración a médula ósea. Se presenta el caso clínico de un paciente masculino de 63 años de edad, quien presentó deterioro neurológico en contexto de uremia y leucocitosis con sospecha de leucemia aguda. Para la confirmación del diagnóstico requirió marcadores inmunológicos por citometría de flujo. Se identificó fenotipo compatible con leucemia/linfoma blástico de célula dendrítica plasmocitoide. Se inició un régimen de quimioterapia esquema 7+3, basado en citarabina 338 mg + 500 ml de NaCl 0,9 % en infusión intravenosa continua de 24 horas e Idarrubicina 20 mg + 250 ml de NaCl 0,9 % pasar IV en 2 horas. Recibió terapia de sustitución renal por 5 sesiones. El paciente pasó a estado crítico pese a tratamiento oncohematológico, presentó fallo multiorgánico y paro cardíaco. Se realizó reanimación cardiopulmonar avanzada de alta calidad, sin obtener retorno de la circulación espontánea y se declaró su fallecimiento. Se concluyó que esta neoplasia oncohematológica permite pocas expectativas de vida y los protocolos terapéuticos que mejoren la sobrevida son escasos. Palabras clave: Leucemia aguda, células dendríticas plasmocitoides, quimioterapia, cáncer, citometría de flujo

Tumores vasculares de mama. Presentación de cinco casos de angiosarcoma

Se realiza un estudio en el período comprendido desde 1974 hasta 2008  con un total de 18 pacientes, 17 del sexo femenino y uno del masculino, de los cuales 3 mujeres y el hombre se clasifican como hemangiomas subcutáneos y  cavernosos. Los tumores mamarios de catorce mujeres fueron diagnosticados como angiosarcomas de diversos. Se utiliza un muestreo para identificar las lesiones benignas de las malignas de bajo grado. Se utiliza por métodos de inmunohistoquímica algunos antígenos de proliferación celular como el Ki 67 que facilitan la valoración en relación a su agresividad y comportamiento biológico

Características clínico-patológicas y de neuroimagen de las metástasis encefálicas

OBJECTIVE: To determine the clinical-pathologic and neuroimaging characteristics of brain metastases.METHODS: It was done a retrospective longitudinal descriptive study from 1.01.2012 to 1.01.2014 according to clinical, anatomopathologic and neuroimaging variables from clinical histories of patients from Luis Diaz Soto Hospital and National Institute of Oncology and Radiobiology. The distributions of frequencies were analyzed to describe the qualitative variables and for quantitative variables with medium and range. The Fisher exact test was utilized with a confidence interval of 95 %.RESULTS: 32 patients and 70 lesions were identified. The age average was 53.9 years. The most frequent localizations were lung (44 %), breast (22 %), colorectal (10 %) and prostate (6 %). Single lesions were predominant in 60 % of cases. Oligo-metastasis was more frequent in breast, colorectal and prostate (p=0.007). Average volume of metastasis was 8 cm3 (0.1-46 cm3). 88 % were solid lesions and 76 % were lesions with low surrounding edema. Mainly lesions were below de 5 cm3 originated in lung and breast (p=0.004), but local cerebral edema was more frequent in relation with this primary sites (p=0.000).CONCLUSIONS: It was found a strong association between the primary organ and these variables: form of presentation, sex, number of lesions, volume and surrounding edema.OBJETIVO: Determinar las características clínico-patológicas y de neuroimagen de los pacientes con metástasis encefálica.MÉTODOS: Se realizó un estudio descriptivo correlacional retrospectivo desde el 1.01.2012 al 1.01.2014 de las variables clínicas, anatomopatológicas y de neuroimagen. Se revisaron las historias clínicas de los pacientes atendidos en consulta de neurocirugía del Hospital Dr. Luis Díaz Soto y del Instituto Nacional de Oncología y Radiobiología. Se analizaron las distribuciones de frecuencias para describir las variables cualitativas y para las cuantitativas la mediana y el rango. Para correlacionar variables cualitativas se utilizó el test exacto de Fisher con un intervalo de confianza del 95 %.RESULTADOS: Se identificaron 32 pacientes con metástasis encefálica y 70 lesiones. El promedio de edad fue de 53,9 años. Las localizaciones más frecuentes de la neoplasia primaria fueron: pulmón (44 %), mama (22 %), colorrectal (10 %) y próstata (6 %). Predominaron las lesiones únicas en un 60 % de los casos. La presentación con una sola metástasis fue más frecuente en las localizaciones en mamas, colorrectal y próstata (p=0,007). El volumen promedio de las metástasis fue de 8 cm3 (0,1-46 cm3). El 88 % fueron lesiones sólidas. El 76 % presento escaso edema cerebral asociado. Predominaron las lesiones con menos de 5 cm3 originadas en pulmón y mamas (p=0,004), y el edema local fue más frecuente en relación con estos sitios primarios (p=0,000).CONCLUSIONES: Se encontró una fuerte asociación del sitio primario con: la forma de presentación, el sexo, el número de lesiones, el volumen y el edema asociado

Características clínico-patológicas y de neuroimagen de las metástasis encefálicas

OBJECTIVE: To determine the clinical-pathologic and neuroimaging characteristics of brain metastases.METHODS: It was done a retrospective longitudinal descriptive study from 1.01.2012 to 1.01.2014 according to clinical, anatomopathologic and neuroimaging variables from clinical histories of patients from Luis Diaz Soto Hospital and National Institute of Oncology and Radiobiology. The distributions of frequencies were analyzed to describe the qualitative variables and for quantitative variables with medium and range. The Fisher exact test was utilized with a confidence interval of 95 %.RESULTS: 32 patients and 70 lesions were identified. The age average was 53.9 years. The most frequent localizations were lung (44 %), breast (22 %), colorectal (10 %) and prostate (6 %). Single lesions were predominant in 60 % of cases. Oligo-metastasis was more frequent in breast, colorectal and prostate (p=0.007). Average volume of metastasis was 8 cm3 (0.1-46 cm3). 88 % were solid lesions and 76 % were lesions with low surrounding edema. Mainly lesions were below de 5 cm3 originated in lung and breast (p=0.004), but local cerebral edema was more frequent in relation with this primary sites (p=0.000).CONCLUSIONS: It was found a strong association between the primary organ and these variables: form of presentation, sex, number of lesions, volume and surrounding edema.OBJETIVO: Determinar las características clínico-patológicas y de neuroimagen de los pacientes con metástasis encefálica.MÉTODOS: Se realizó un estudio descriptivo correlacional retrospectivo desde el 1.01.2012 al 1.01.2014 de las variables clínicas, anatomopatológicas y de neuroimagen. Se revisaron las historias clínicas de los pacientes atendidos en consulta de neurocirugía del Hospital Dr. Luis Díaz Soto y del Instituto Nacional de Oncología y Radiobiología. Se analizaron las distribuciones de frecuencias para describir las variables cualitativas y para las cuantitativas la mediana y el rango. Para correlacionar variables cualitativas se utilizó el test exacto de Fisher con un intervalo de confianza del 95 %.RESULTADOS: Se identificaron 32 pacientes con metástasis encefálica y 70 lesiones. El promedio de edad fue de 53,9 años. Las localizaciones más frecuentes de la neoplasia primaria fueron: pulmón (44 %), mama (22 %), colorrectal (10 %) y próstata (6 %). Predominaron las lesiones únicas en un 60 % de los casos. La presentación con una sola metástasis fue más frecuente en las localizaciones en mamas, colorrectal y próstata (p=0,007). El volumen promedio de las metástasis fue de 8 cm3 (0,1-46 cm3). El 88 % fueron lesiones sólidas. El 76 % presento escaso edema cerebral asociado. Predominaron las lesiones con menos de 5 cm3 originadas en pulmón y mamas (p=0,004), y el edema local fue más frecuente en relación con estos sitios primarios (p=0,000).CONCLUSIONES: Se encontró una fuerte asociación del sitio primario con: la forma de presentación, el sexo, el número de lesiones, el volumen y el edema asociado