Teresa González Serrano

Cross-reactivity of EGFR mutation-specific immunohistochemistry assay in HER2-positive tumors.

The coexpression of HER2 and EGFR L858R in a solitary nodule removed from the lung, whose mutation was not confirmed by molecular techniques, made us think about the possible existence of a cross-reaction between HER2 and the EGFR L858R-specific antibody. Our study was designed to further analyze the existence of this cross-reaction and stress the need to exclude a metastatic breast cancer when dealing with EGFR L858R-positive cases. The series consists of 42 primary breast carcinomas, 22 HER2 positive for overexpression and amplification, and 20 negative for both. EGFR mutations were studied by immunohistochemistry and confirmed using real-time PCR when positive. Immunohistochemistry assay with EGFR L858R was positive in 19 (86%) of the HER2-positive breast carcinomas and negative in all HER2-negative carcinomas. The EGFR L858R antibody gives false-positive results in most of the breast carcinomas with HER2 overexpression/amplification. As a consequence, it is essential to confirm any EGFR L858R-positive cases by molecular methods or at least discard the presence of HER2 overexpression/amplification before rendering a diagnosis. It is also important to consider that HER2 has been described in other carcinomas such as urothelial, gastric or ovarian, as well as lung, although infrequently.

Carcinoide-adenocarcinoma mixto de apéndice cecal. Aspectos terminológicos a propósito de un caso

SUMMARY Background: Goblet cell carcinoids tumours accounts for less than 5% of primary tumors of the appendix. They are rare and distinctive tumours, composed of clusters of mucinous cells with a signet ring cell appearance that infiltrate the appendix circumferentially and express neuroendocrine markers. The term mixed carcinoid-adenocarcinoma has been proposed to designate carcinomas of the appendix that arise by progression from a pre-existing goblet-cell carcinoid. Methods: We have reviewed the histological features, clinical features and the medical literature. Representative sections were stained with hematoxylin-eosin, periodicacid-Schiff and alcian blue. Immunohistochemical stains were performed by using the streptavidin-biotin peroxidase method for cytokeratin 20, chromogranin A, synaptophysin and carcinoembryonic antigen. Results: The tumour showed carcinomatous growth pattern in greater than 50% of total volume. Immunohistochemical stains (cytokeratin 20, chromogranin A, synaptophysin and carcinoembryonic antigen), periodic-acid-Schiff and alcian blue were diffusely positive. Conclusions: Immunohistochemical stains were helpful to separate these tumors from mucinous adenocarcinoma, signet-ring cell carcinoma and carcinoid tumours.

Hemangioma epitelioide en localización profunda y extrafacial. A propósito de dos casos y revisión de la literatura

SUMMARY Background: Epithelioid hemangioma is an uncommon benign and idiopathic vasculoproliferative condition. Typically occurs in the skin and subcutaneous tissues of the head and neck region, especially the preauricular area, though it has been reported on the trunk and extremities. The main histologic features of epithelioid hemangioma are proliferation of large endothelial cells lining vascular spaces, and lymphocytic and eosinophilic infiltrate. The differential diagnoses include pyogenic granuloma, angiosarcoma, and Kimura’s disease. Methods: Two new cases of Epithelioid hemangioma were report. We have reviewed the histological features, clinical features, the medical literature and the different theories about its histogenesis. Results: We report two new cases arising in extremities and with variable inflammatory response. Conclusions: The main histological characteristic of epithelioid hemangioma is the endothelial appearance and not the inflammatory intensity.

Hemangioendotelioma retiforme: descripción de dos casos y revisión de la literatura

Resumen El hemangioendotelioma retiforme (HR) es una neoplasia vascular rara y con rasgos morfologicos distintivos que por su elevada tasa de recidivas locales y ocasionales metastasis fue descrita inicialmente como angiosarcoma de bajo grado de malignidad. En la literatura revisada hemos encontrado un total de 23 casos bien documentados. Describimos dos nuevos casos de HR y realizamos una revision de la literatura. Una paciente de 82 anos se presento con una placa indurada, mal definida y de crecimiento lento, situada en el dorso de la mano derecha; la segunda paciente tenia 31 anos y consulto por una lesion en la planta del pie. En el estudio histologico ambas lesiones presentaban las caracteristicas propias del HR con una proliferacion dermohipodermica infiltrativa de canales vasculares elongados, arborescentes de paredes finas, tapizados por celulas endoteliales con morfologia en tachuela y sin atipia ni figuras de mitosis. El diagnostico diferencial se establece fundamentalmente con el tumor de Dabska, el hemangioma en tachuela y el angiosarcoma convencional. La aportacion de nuevos casos de este infrecuente tumor vascular puede ayudar a definir con mayor precision el espectro clinico y morfologico del HR.

Tumor mülleriano mixto maligno del cérvix uterino. A propósito de un caso y revisión de la literatura

Resumen Introduccion Los tumores mullerianos mixtos malignos (TMMM) de cervix o tumores mesodermicos mixtos malignos son neoplasias infrecuentes con poco mas de 50 casos descritos en la literatura y probablemente constituyen Metodo Hemos revisado las caracteristicas histologicas, clinicas y la literatura medica. Secciones representativas han sido tenidas con hematoxilina-eosina. El estudio inmunohistoquimico se realizo con el metodo estreptavidina- biotina-peroxidasa para citoqueratina, antigeno carcinoembrionario, CD10, calretinina, vimentina, desmina y mioglobina. Resultado El tumor es bifasico compuesto de una mezcla de componente epitelial y mesenquimal homologo y heterologo. Las tinciones inmunohistoquimicas mostraron positividad para citoqueratina y antigeno carcinoembrionario y negatividad para CD10, calretinina y vimentina en el componente epitelial. El componente heterologo mostro positividad para desmina y mioglobina. Conclusion Aportamos un nuevo caso de tumor mulleriano mixto maligno originado en cervix uterino y revisamos la literatura.

Adenocarcinoma papilar seroso en colon sigmoide originado sobre endosalpingiosis quística. A propósito de un caso y revisión de la literatura

SUMMARY Background: Endosalpingiosis is defined as the presence of histologically benign glands lined by tubal-type epithelium and is commonly encountered in the visceral pelvic and abdominal peritoneum. Although rarely serous adenocarcinomas, similar to those occurring within the ovary, arise in the retroperitoneum, this is the second reported occurrence in association with a endosalpingiosis. Methods: We have reviewed the histological features, clinical features and the medical literature. Representative sections were stained with hematoxylin-eosin and inmunohistochemical stains were performed by using the streptavidinbiotin peroxidase method for cytokeratin 20, cytokeratin 7, calretinin, CA125, CA19.9 and estrogen receptor. Results: histologically serous papillary adenocarcinoma areas was composed of a complex papillary and glandular arrangement of cuboidal cells with moderate nuclear atypia. Areas of transition could be seen between the benign ciliated lining and the well differentiated serous adenocarcinoma. Immunohistochemically, the tumour cells were positive for cytokeratin 7, CA125 and estrogen receptor, but were negative for cytokeratin 20, calretinin and CA19.9. Conclusions: we report a new case of a serous papillary adenocarcinoma arising in the sigmoid colon within cystic endosalpingiosis.