RESUMO

Gastrointestinal stromal tumors (GISTs) constitute the largest category of primary nonepithelial neoplasms of the stomach and small bowel. They represent about 1-2% from all neoplasms of the digestive tract. They occur most commonly in the stomach and small bowel, but small series of comparable tumors have also been reported in all the other parts of the tubular gastrointestinal tract, including esophagus, colon, rectum and anus. They can also involve omentum, mesentery, uterus, retroperitoneum, mesocolon and soft tissues. Originally recognized in 1960 by Martin et. al. as a distinctive type of stromal neoplasm of the bowel, they were subsequently reported by Stout, who introduced the term leiomyoblastoma. Because of difficulties in accurately predicting the biologic behavior of these tumors, the term "smooth muscle tumor of uncertain malignant potential" (SMTUMP) has been introduced for borderline tumors. In 1983, Mazur and Clark coined the term gastrointestinal stromal tumor and suggested that these neoplasms might arise from the myenteric nervous system. Some studies have reported evidence of neuronal cell differentiation in a proportion of GISTs and the term "gastrointestinal autonomic nerve tumor (GANT) has been introduced. Kindblom et al are providing cogent arguments to suggest that GISTs show differentiation toward interstitial Cajal cells (pacemaker cells of the gastrointestinal tract). Inmunohistochemically the GISTs often reveal inmunoreactivity for vimentin. CD34 and CD 117. The aim of this paper is to perform and analysis of the historic evolution and conceptual of the GISTs.

Assuntos

RESUMO

Los tumores estromales gastrointestinales (Gastrointestinal Stroma Tumors ¹ GITs) constituyen la categoría más amplia de neoplasias no epiteliales primarias del tracto gastrointestinal y representan aproximadamente el 1-2 % de todas las neoplasias del tubo digestivo. Ocurren más frecuentemente en estomago e intestinos delgado, pero también pueden estar presentes en otros sitios del tracto gastrointestinal tubular, incluyendo esófago, colón, recto y ano. Además han sido encontrados en sitios tales como retroperineo, útero. Omento, mesocolon y tejidos blandos. Originalmente reconocidos en 1960 por Martín como una entidad clínico-patológica y un tipo distintivo de neoplasia estromal gástrica, los GITs fueron posteriormente publicados por Scout, quien introdujo el termino letomioblastoma. Debido a la dificultas en predecir con seguridad el comportamiento biológico de estos tumores, el termino ¶tumor de músculo liso de potencial maligno incierto÷ fue introducido para los tumores borderline. En 1983 Mazur y Clark acuñaron el termino ¶tumor estromal gastrointestinal÷ y sugirieron que estas lesiones podrían originarse del sistema nerviosos mientérico. Algunos estudios reportaron evidencias de una diferenciación neural en algunos GITs y fue introducido el término ¶tumor autonómico gastrointestinal÷ (GANT). En 1998 Kindblom y col. Establecieron un nuevo candidato en la línea de diferenciación de los GITs y sugirieron que estas neoplasias muestran una diferenciación inmunofenotípica hacia células intersticiales de Cajal (células marcapasos dl tracto gastrointestinal). Inmunohistoquimicamente los GITs revelan frecuentemente inmunoreactividad para vicentina (VIM) CD34 Y c-kit (CD 117). El objetivo del presente trabajo es realizar un análisis de la evolución histórica y conceptual de los GITs.(AU)

Assuntos

RESUMO

Los tumores estromales gastrointestinales (Gastrointestinal Stroma Tumors – GITs) constituyen la categoría más amplia de neoplasias no epiteliales primarias del tracto gastrointestinal y representan aproximadamente el 1-2 % de todas las neoplasias del tubo digestivo. Ocurren más frecuentemente en estomago e intestinos delgado, pero también pueden estar presentes en otros sitios del tracto gastrointestinal tubular, incluyendo esófago, colón, recto y ano. Además han sido encontrados en sitios tales como retroperineo, útero. Omento, mesocolon y tejidos blandos. Originalmente reconocidos en 1960 por Martín como una entidad clínico-patológica y un tipo distintivo de neoplasia estromal gástrica, los GITs fueron posteriormente publicados por Scout, quien introdujo el termino letomioblastoma. Debido a la dificultas en predecir con seguridad el comportamiento biológico de estos tumores, el termino “tumor de músculo liso de potencial maligno incierto” fue introducido para los tumores borderline. En 1983 Mazur y Clark acuñaron el termino “tumor estromal gastrointestinal” y sugirieron que estas lesiones podrían originarse del sistema nerviosos mientérico. Algunos estudios reportaron evidencias de una diferenciación neural en algunos GITs y fue introducido el término “tumor autonómico gastrointestinal” (GANT). En 1998 Kindblom y col. Establecieron un nuevo candidato en la línea de diferenciación de los GITs y sugirieron que estas neoplasias muestran una diferenciación inmunofenotípica hacia células intersticiales de Cajal (células marcapasos dl tracto gastrointestinal). Inmunohistoquimicamente los GITs revelan frecuentemente inmunoreactividad para vicentina (VIM) CD34 Y c-kit (CD 117). El objetivo del presente trabajo es realizar un análisis de la evolución histórica y conceptual de los GITs.

Assuntos

RESUMO

Brown tumor (BT) is an uncommon condition that represents the terminal stage of the cystic osteitis fibrosa and have been increasingly reported in hyperparathyroidism secondary to renal failure, due to the increase of survival in patient with hemodialysis. The fine needle aspiration diagnosis is of great importance in the recognition of the BT, although it can be difficult to distinguish it of lesions as the aneurysmal bone cyst and giant-cell tumor. We describe the case of 20-year-old female with chronic renal failure undergoing hemodialysis during six years. Both x-rays and computer tomography revealed a tumor in head of right humerus and lytic images in scapula of the same side, clavicles and ribs. The patient was subjected to a fine needle aspiration biopsy of the tumor of humerus head and the sample was processed with the habitual technique of inclusion in paraffin and stained with hematoxilina and eosina. Histological preparations showed several multinucleate giant cells and spindly or fibrillary cells, feature that was pointed out as compatible, in a context of secondary hyperparathyroidism to chronic renal failure, with a BT. We consider that the radiological and tomographyc finds, besides the history of chronic renal failure with a long history of hemodialysis, were enough to link, with great approach, the histopathology with the diagnosis of BT.

Assuntos

RESUMO

Brown tumor (BT) is an uncommon condition that represents the terminal stage of the cystic osteitis fibrosa and have been increasingly reported in hyperparathyroidism secondary to renal failure, due to the increase of survival in patient with hemodialysis. The fine needle aspiration diagnosis is of great importance in the recognition of the BT, although it can be difficult to distinguish it of lesions as the aneurysmal bone cyst and giant-cell tumor. We describe the case of 20-year-old female with chronic renal failure undergoing hemodialysis during six years. Both x-rays and computer tomography revealed a tumor in head of right humerus and lytic images in scapula of the same side, clavicles and ribs. The patient was subjected to a fine needle aspiration biopsy of the tumor of humerus head and the sample was processed with the habitual technique of inclusion in paraffin and stained with hematoxilina and eosina. Histological preparations showed several multinucleate giant cells and spindly or fibrillary cells, feature that was pointed out as compatible, in a context of secondary hyperparathyroidism to chronic renal failure, with a BT. We consider that the radiological and tomographyc finds, besides the history of chronic renal failure with a long history of hemodialysis, were enough to link, with great approach, the histopathology with the diagnosis of BT.

RESUMO

INTRODUCTION: Trying to increase the specificity and demonstrated sensibility of thyroid fine needle aspiration (TFNA) in the diagnosis of the thyroid nodule, and to improve the cytomorphologic diagnosis, we used the approach of realization of thin prep (TP), adapting the technique to the methods within our possibilities. MATERIALS AND METHODS: The sample corresponded to a prospective study of 200 cases of material of thyroid nodules, obtained by means of ultrasonography guide fine needle aspiration, over a 30 month period. The study was carried out by means of conventional smear (CS) and TP, cytologic preparations were stained with hematoxilin-eosine (H-E), Papanicolaou (PAP) and Tint 15. The analysis of these same samples was carried out according to sex, age, characteristics of the nodules and cytomorphologic features. RESULTS: The samples were satisfactory in 184 cases (92%) and unsatisfactory in 16 cases (8%). The prevalence in samples corresponded to the female sex (88.5%). The pre-emptive diagnoses corresponded to: Multinodular Goiter: 41 (22.29%)--Hashimoto's thyroiditis: 4 (2.17%)--Follicular lesions I: 86(46.74%), II: 34 (18.47%), III: 6 (3.26%)--Hürthle cell neoplasm: 4 (2.17%)--Papillary carcinoma: 9 (4.90%). The patient study was carried out according to the modified algorithm proposed by Gharib in 1997 and the Department of Cytology of the Karolinska Hospital of Stockholm (Sweden). The cytological diagnosis was compared to the final histological results. CONCLUSIONS: The present work has demonstrated that even with the available methods, we have been able to carry out TP that were acceptable for its evaluation and with the same limitations of those obtained by CS, with respect to preparations dried in direct air and in the cases of non-conclusive diagnoses. We obtained a sensibility of 94.44% and a specificity of 98.79%.

Assuntos

RESUMO

INTRODUCTION: Trying to increase the specificity and demonstrated sensibility of thyroid fine needle aspiration (TFNA) in the diagnosis of the thyroid nodule, and to improve the cytomorphologic diagnosis, we used the approach of realization of thin prep (TP), adapting the technique to the methods within our possibilities. MATERIALS AND METHODS: The sample corresponded to a prospective study of 200 cases of material of thyroid nodules, obtained by means of ultrasonography guide fine needle aspiration, over a 30 month period. The study was carried out by means of conventional smear (CS) and TP, cytologic preparations were stained with hematoxilin-eosine (H-E), Papanicolaou (PAP) and Tint 15. The analysis of these same samples was carried out according to sex, age, characteristics of the nodules and cytomorphologic features. RESULTS: The samples were satisfactory in 184 cases (92 per cent) and unsatisfactory in 16 cases (8 per cent). The prevalence in samples corresponded to the female sex (88.5 per cent). The pre-emptive diagnoses corresponded to: Multinodular Goiter: 41 (22.29 per cent)--Hashimoto's thyroiditis: 4 (2.17 per cent)--Follicular lesions I: 86(46.74 per cent), II: 34 (18.47 per cent), III: 6 (3.26 per cent)--Hurthle cell neoplasm: 4 (2.17 per cent)--Papillary carcinoma: 9 (4.90 per cent). The patient study was carried out according to the modified algorithm proposed by Gharib in 1997 and the Department of Cytology of the Karolinska Hospital of Stockholm (Sweden). The cytological diagnosis was compared to the final histological results. CONCLUSIONS: The present work has demonstrated that even with the available methods, we have been able to carry out TP that were acceptable for its evaluation and with the same limitations of those obtained by CS, with respect to preparations dried in direct air and in the cases of non-conclusive diagnoses. We obtained a sensibility of 94.44 per cent and a specificity of 98.79 per cent.

Assuntos

RESUMO

INTRODUCTION: Trying to increase the specificity and demonstrated sensibility of thyroid fine needle aspiration (TFNA) in the diagnosis of the thyroid nodule, and to improve the cytomorphologic diagnosis, we used the approach of realization of thin prep (TP), adapting the technique to the methods within our possibilities. MATERIALS AND METHODS: The sample corresponded to a prospective study of 200 cases of material of thyroid nodules, obtained by means of ultrasonography guide fine needle aspiration, over a 30 month period. The study was carried out by means of conventional smear (CS) and TP, cytologic preparations were stained with hematoxilin-eosine (H-E), Papanicolaou (PAP) and Tint 15. The analysis of these same samples was carried out according to sex, age, characteristics of the nodules and cytomorphologic features. RESULTS: The samples were satisfactory in 184 cases (92 per cent) and unsatisfactory in 16 cases (8 per cent). The prevalence in samples corresponded to the female sex (88.5 per cent). The pre-emptive diagnoses corresponded to: Multinodular Goiter: 41 (22.29 per cent)--Hashimotos thyroiditis: 4 (2.17 per cent)--Follicular lesions I: 86(46.74 per cent), II: 34 (18.47 per cent), III: 6 (3.26 per cent)--Hurthle cell neoplasm: 4 (2.17 per cent)--Papillary carcinoma: 9 (4.90 per cent). The patient study was carried out according to the modified algorithm proposed by Gharib in 1997 and the Department of Cytology of the Karolinska Hospital of Stockholm (Sweden). The cytological diagnosis was compared to the final histological results. CONCLUSIONS: The present work has demonstrated that even with the available methods, we have been able to carry out TP that were acceptable for its evaluation and with the same limitations of those obtained by CS, with respect to preparations dried in direct air and in the cases of non-conclusive diagnoses. We obtained a sensibility of 94.44 per cent and a specificity of 98.79 per cent. (AU)

Assuntos

RESUMO

INTRODUCTION: Trying to increase the specificity and demonstrated sensibility of thyroid fine needle aspiration (TFNA) in the diagnosis of the thyroid nodule, and to improve the cytomorphologic diagnosis, we used the approach of realization of thin prep (TP), adapting the technique to the methods within our possibilities. MATERIALS AND METHODS: The sample corresponded to a prospective study of 200 cases of material of thyroid nodules, obtained by means of ultrasonography guide fine needle aspiration, over a 30 month period. The study was carried out by means of conventional smear (CS) and TP, cytologic preparations were stained with hematoxilin-eosine (H-E), Papanicolaou (PAP) and Tint 15. The analysis of these same samples was carried out according to sex, age, characteristics of the nodules and cytomorphologic features. RESULTS: The samples were satisfactory in 184 cases (92

) and unsatisfactory in 16 cases (8

). The prevalence in samples corresponded to the female sex (88.5

). The pre-emptive diagnoses corresponded to: Multinodular Goiter: 41 (22.29

)--Hashimotos thyroiditis: 4 (2.17

)--Follicular lesions I: 86(46.74

), II: 34 (18.47

), III: 6 (3.26

)--H³rthle cell neoplasm: 4 (2.17

)--Papillary carcinoma: 9 (4.90

). The patient study was carried out according to the modified algorithm proposed by Gharib in 1997 and the Department of Cytology of the Karolinska Hospital of Stockholm (Sweden). The cytological diagnosis was compared to the final histological results. CONCLUSIONS: The present work has demonstrated that even with the available methods, we have been able to carry out TP that were acceptable for its evaluation and with the same limitations of those obtained by CS, with respect to preparations dried in direct air and in the cases of non-conclusive diagnoses. We obtained a sensibility of 94.44

and a specificity of 98.79

.

RESUMO

The occurrence of ectopic decidua has been observed most often in the ovaries, uterus, and cervix. A peritoneal localization is less frequent and usually an asymptomatic incidental finding. Ectopic decidua was investigated in biopsies taken during cesarean sections, elective tubal ligations, appendectomy and in tubal pregnancies. Histologic studies have been carried out of fragments from the epiploon, appendiceal serosa, tubal serosa, retroperitoneal lymph nodes and various abdominal organs. Our purpose is to report a case of peritoneal deciduosis in a 46-year-old woman, asymptomatic, discovered during cesarean section and mimicking metastatic nodules (incidental finding). The histopathological diagnosis was done based on specimen studied with the common technique of paraffin embedding and hematoxilin--eosin staining. We believe that this decidual transformation of the peritoneum arises from a progesterone-induced metaplasia of the coelomic stroma, being often a totally reversible phenomenon.

Assuntos