Epithelioid morphology

  • 文章类型: Journal Article
    卵巢血管肉瘤(OA)是罕见的,英语文献中仅报道了零星病例。我们对PubMed上发表的病例进行了系统回顾,科学直接,和谷歌学者数据库,目的是描述报告的OA的临床病理特征。回顾了53篇报道60例患者的文章。在60名患者中,7例(11.6%)被诊断为继发性(转移性)卵巢血管肉瘤,53例(88.3%)被诊断为原发性卵巢血管肉瘤。卵巢血管肉瘤的平均年龄为38.3±17.8岁。卵巢血管肉瘤的平均肿瘤大小为11.9±6.1cm。在45/60(75%)中报告了腹胀。显微镜检查发现坏死28/60(46.7%),32/59(54.2%),44/60的有丝分裂图(73.3%),27/36(75%)的梭形细胞,上皮样细胞在20/36(55.5%),12/36(33.3%)患者的混合上皮样细胞和纺锤形细胞。在免疫组织化学上,CD31在41/41(100%)中呈阳性,CD34in38/39(97.4%),18/21(85.7%)患者中的因子VIII相关抗原。43/60(71.6%)患者存在转移。36/52(69.2%)进行了化疗和手术。卵巢血管肉瘤的中位随访时间为7个月(IQR1-IQR3:2-13.5个月)。有可用生存数据的50例患者中有24例(48%)存活,26/50(52%)死于疾病。生存分析(KM曲线)显示,组织病理学上存在坏死(对数秩检验;p=0.05)和不存在纺锤形细胞(对数秩检验;p=0.04)与较差的预后相关。而联合化疗和手术切除治疗与更好的生存率相关(P<0.001),因此,及时诊断和早期治疗联合化疗和手术切除可以延长OA的生存期。
    Ovarian angiosarcoma (OA) is rare, with only sporadic cases reported in English literature. We performed a systematic review of cases published in the PubMed, Science Direct, and Google Scholar databases with the aim of describing the reported clinicopathological features of OA. Fifty-three articles that reported 60 patients were reviewed. Of the 60 patients, 7 (11.6 %) were diagnosed with secondary (metastatic) ovarian angiosarcoma and 53 (88.3 %) were diagnosed with primary ovarian angiosarcoma. The mean age at presentation for ovarian angiosarcoma was 38.3±17.8 years. The average tumor size for ovarian angiosarcoma was 11.9±6.1 cm. Abdominal distention was reported in 45/60 (75 %). Microscopic examination revealed necrosis in 28/60 (46.7 %), pleomorphism in 32/59 (54.2 %), mitotic figures in 44/60 (73.3 %), spindle-shaped cells in 27/36 (75 %), epithelioid-shaped cells in 20/36 (55.5 %), and mixed epithelioid and spindle-shaped cells in 12/36 (33.3 %) patients. On immunohistochemistry CD 31 was positive in 41/41 (100 %), CD 34 in 38/39 (97.4 %), and Factor VIII related antigen in 18/21 (85.7 %) patients. Metastasis was present in 43/60 (71.6 %) patients. Chemotherapy and surgery was performed in 36/52 (69.2 %). The median follow-up time for ovarian angiosarcoma was 7 months (IQR1-IQR3:2-13.5 months). 24 (48 %) of the 50 patients with available survival data were alive and 26/50 (52 %) were dead of disease. Survival analyses (KM curves) revealed that the presence of necrosis (log-rank test; p = 0.05) and absence of spindle-shaped cells (log rank test; p = 0.04) on histopathology were associated with worse outcomes, while treatment with combined chemotherapy and surgical excision was associated with better survival (P < 0.001) therefore, prompt diagnosis and early treatment with combined chemotherapy and surgical excision can prolong survival in OA.
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  • 文章类型: Case Reports
    Kaposi sarcoma is an oligoclonal HHV-8-driven vascular proliferation that was first described by a Viennese dermatologist Dr Moritz Kaposi. The disease has been seen in different clinical-epidemiological settings with a wide morphologic spectrum. We report a 52-year-old Caucasian man with HIV/AIDS and Kaposi sarcoma who presented with dyspnea and pleural effusion. He reported numerous tender subcutaneous nodules developing over the past few months on his chest, back and abdomen. An excisional biopsy of one of the nodules was performed. Touch preps revealed malignant cells in clusters. Microscopically, the neoplasm appeared undifferentiated with an epithelioid morphology, and involved the dermis and subcutaneous fat. Despite the medical history, Kaposi sarcoma was not considered foremost in the differential diagnosis. The malignant cells were positive for vimentin and negative for S100 protein, keratin AE1/3, CK7, CK20, napsin A, TTF-1 and synaptophysin. Additional stains revealed positivity for HHV-8, CD31 and D2-40, supporting the diagnosis of Kaposi sarcoma. Kaposi sarcoma has been well described with many variants that may cause diagnostic difficulty. An epithelioid variant has not been reported and consequently, may cause misinterpretation of an otherwise well-known entity that may become life threatening if appropriate treatment is not initiated in a timely manner.
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