Mitosis Figures Research Articles

Endoscopic semiotics and pathological characteristics of primary malignant esophageal melanoma: a case report

Primary malignant melanoma of the esophagus is defined as a tumor, the frequency of which is 0.1-0.2% of all malignant lesions of the esophagus. This type of neoplasia is difficult to diagnose and is characterized by rapid progression, high recurrence rate and metastasis. Despite the diagnostic capabilities of X-ray examination methods, which make it possible to identify a tumor and determine its localization, the correct diagnosis can only be established by endoscopic examination of the upper digestive tract with biopsy and subsequent pathological and immunohistochemical studies. A 78 year-old male patient was admitted to the Herzen Moscow State Medical Institute with suspected esophageal cancer. It is known from the anamnesis, that the patient for 6 months notes a dysphagia, pain in the chest area. Based on the data of our expert endoscopic examination, we suspected primary esophageal melanoma with a mixed growth - exophytic and flat-type. According to the results of pathological examination of the biopsies, pigment epithelial-cell melanoma of the esophagus with high mitotic index (up to 3 mitosis figures per 1 sq.mm) with infiltrative growth type. This clinical case demonstrates the importance of a detailed endoscopic examination and performing a targeted biopsy, followed by expert pathological examination in the differential diagnosis of esophageal diseases characterized by pigmentation of mucosa.

Особливості клінічного перебігу анапластичної крупноклітинної лімфоми в дітей. Клінічний випадок

Anaplastic large cell lymphoma (ALCL) is a rare type of T-cell non-Hodgkin lymphoma with a characteristic primary localized, mainly extra-bone marrow tumor growth of lymphoid tissue, the clinical picture of which includes lesions of peripheral lymph nodes and extranodal organs, such as bones, skin, lungs, liver, muscles which tissues and bone marrow. Purpose - to acquaint practicing doctors with the features of clinical manifestations, differential diagnosis and course of ALCL in children. Features of the clinical course of ALCL in a child are described. The main diagnostic value of the anamnesis, clinical picture, laboratory, instrumental, immunohistochemical and microscopic research methods, in particular trepan biopsy of this tumor, is highlighted. Microscopic examination of the tissue trepanbioptate show that in half of the cells of the bone marrow, its normal structure is revealed, hematopoietic bone marrow is present with the preservation of all sprouts, with a slightly increased number of megakaryocytes. Half of the cells are filled with solid layers of sharply atypical lymphocyte-like cells with a moderate amount of eosinophilic cytoplasm, the nuclei of tumor cells are large, vesicular, with the formation of 1-2 basophilic nuclei. In the tumor cells there are figures of mitosis, including atypical ones. Single hematopoietic cells of various germs are found between these cells. The conducted immunohistochemical study of tumor cells show that they are positive for common leukocyte antigen (CD4), negative for common cytokeratins, S-100, myogenin, MuoD1, which indicates their hematopoietic origin. Upon further examination, the tumor cells were positive for CD 30, negative for CD3, CD20, CD 43, CD 68, CD11c, tdt, myeloperoxidase, CD 1a. Staining for CD246 reveals a granular cytoplasmic reaction in tumor cells. The histological pattern and immunophenotype of tumor cells correspond to ALCL. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

Ocular Metastasis from Breast Carcinoma: A Case Report

Background: Eye metastases are a rare event in cancer, patients with breast cancer being the most common primary site (28.5%–58.8%). Patients with ocular metastatic disease can present with a variable clinical picture. Most often presents as a cutaneous or subcutaneous nodule simulating a chalazion but with rapid growth and possible superficial ulceration. The definitive diagnosis is based on the anatomopathological analysis of the lesion. The treatment remains palliative and the prognosis remains poor. Objectives: To further define the histopathologic features of breast carcinoma conducive to orbital metastasis. Methods: We report a case of ocular metastasis in a 46-year-old woman presenting with right eye pain. She had been treated for ductal carcinoma breast cancer with lymph node and bone metastases 5 years ago; a mastectomy with lymph node dissection was performed. The patient consults us for unilateral eyelid swellings evolving for 4 months. On examination, we find well-limited rounded tissue formation in the right upper eyelid ulcerated in places. Oculomotricity was preserved and the rest of the examination was unremarkable. A biopsy of the lesion was carried. Results & Conclusions: Microscopic examination revealed a fibrofatty tissue seat of a tumoral proliferation made of spans and cords, of carcinomatous cells with moderate atypia showing some mitosis figures. The stroma is fibrous. Immunohistochemical studies showed positive immunoreactivity to pancytokeratin, estrogen receptor, progesterone receptor and HER-2, the results were in favor of a metastatic breast carcinoma. In summary, In the case of a metastatic orbital tumor, breast cancer should be considered as a possible source, especially in elderly women. Integrating the clinical information with histopathological findings is warranted.

Solitary fibrous tumor: Two cases report with a focus on the differential diagnosis

Solitary fibrous tumor (SFT) is a neoplasm of fibroblastic/myofibroblastic origin with intermediate biological behavior. We report here two cases of SFT affecting an unusual anatomical site in 58-year-old and 40-year-old female patients and discuss the differential diagnosis of this lesion. In case 01, the lesion showed the clinical appearance of an asymptomatic “blister” with normal color, rubbery consistency, measuring 0.3 cm, and affected the lower lip; while in case 02, a symptomatic red nodular lesion with a soft consistency and measuring 0.5 cm affected the floor of the mouth. Excisional biopsies were performed. Microscopically, two well-delimited benign neoplasms were observed, exhibiting the proliferation of ovoid to spindle-shaped mesenchymal cells, vascular spaces with staghorn arrangement, and the absence of mitosis figures. Immunohistochemistry was performed in case 01 to assist in the diagnosis. Weak and diffuse immunostaining was observed for α-SMA and intense and diffuse immunopositivity for Bcl-2 and CD34. Based on histopathological and immunohistochemical features, a diagnosis of SFT was rendered in both cases. The low occurrence and nonspecific clinical features of oral SFT may make its clinical diagnosis difficult. Also, morphological and immunohistochemical are essential for differential diagnosis with other mesenchymal neoplasms.

Antitumor Effect of Açaí (Euterpe oleracea Mart.) Seed Extract in LNCaP Cells and in the Solid Ehrlich Carcinoma Model.

Euterpe oleracea (açaí) fruit has approximately 15% pulp, which is partly edible and commercialized, and 85% seeds. Although açaí seeds are rich in catechins-polyphenolic compounds with antioxidant, anti-inflammatory, and antitumor effects-almost 935,000 tons/year of seeds are discarded as industrial waste. This work evaluated the antitumor properties of E. oleracea in vitro and in vivo in a solid Ehrlich tumor in mice. The seed extract presented 86.26 ± 0.189 mg of catechin/g of extract. The palm and pulp extracts did not exhibit in vitro antitumor activity, while the fruit and seed extracts showed cytotoxic effects on the LNCaP prostate cancer cell line, inducing mitochondrial and nuclear alterations. Oral treatments were performed daily at 100, 200, and 400 mg/kg of E. oleracea seed extract. The tumor development and histology were evaluated, along with immunological and toxicological parameters. Treatment at 400 mg/kg reduced the tumor size, nuclear pleomorphism, and mitosis figures, increasing tumor necrosis. Treated groups showed cellularity of lymphoid organs comparable to the untreated group, suggesting less infiltration in the lymph node and spleen and preservation of the bone marrow. The highest doses reduced IL-6 and induced IFN-γ, suggesting antitumor and immunomodulatory effects. Thus, açaí seeds can be an important source of compounds with antitumor and immunoprotective properties.

Non jaagsiekte retrovirus associated adenosquamous lung carcinoma in a goat

An 11-year-old pet goat presented a clinical history of acute respiratory distress with ultrasound diagnosis of wide lung injury. The animal was euthanized due to welfare reasons. At necropsy, it was found pleural effusion and adhesion on the right cranioventral thoracic region. The right cranial and middle lung lobes were firm and light gray with a neocavity containing purulent exudate. From the middle lobe, there was a nodular proliferation occupying alveolar spaces, densely cellular and composed by cuboid-columnar epithelial cells arranged in papillae and acini (60%), as well as polygonal cells arranged in nests with squamous differentiation (40%). Marked pleomorphism, anisocytosis and anisocariosis were also noted. A total of 39 mitosis figures for ten fields at 400x magnification were counted. Lung samples were negative for jaagsiekte retrovirus (JSRV) by PCR. Immunostaining for TTF1 and P53 occurred in zones of adenomatous and squamous differentiation, respectively. In MIB-1, 14% (82/594) of immunolabeled cells were observed in the squamous component. In conclusion, the histopathological and immunohistochemical characteristics confirmed the diagnosis of a pulmonary adenosquamous carcinoma, without JSRV involvement, in goat species.

Carcinoma metaplásico de mama con diferenciación liposarcomatosa pleomórfica: reporte de un caso

Metaplastic breast carcinoma is a heterogeneous group of invasive carcinomas that can manifest a wide morphological spectrum, which generates difficulties in its diagnóstico. We present the case of a 27-year-old young adult, with no pathological history, who consulted for a large mass in the right breast of 12 months of evolution. Macroscopically, a yellowish lobulated tumor with areas of necrosis was observed. Microscopically, it presented two histological patterns: the first composed of epithelioid cells with atypical nuclei, pleomorphic and with figures of mitosis. The second by pleomorphic lipoblasts immersed in a sarcomatous background. The second case reported in the literature of a metaplastic carcinoma with pleomorphic liposarcomatous differentiation is presented, emphasizing the macroscopic, histological, immunohistochemical approach and its differential diagnoses.

Primary alveolar soft tissue sarcoma of the central nervous system. Case report

Background: Alveolar soft part sarcoma (ASPS) is a rare, slow-growing soft tissue tumor with uncertain etiology; it is considered among the least common sarcomas, representing 0.2-1% of these cases in large studies. These tumors usually appear during childhood or young patients, with predominance in females. Case description: We introduce the case of ASPS in a 62-year-old man, who presented with 7 months of progressive headache and diplopia. The brain MRI showed an infiltrative lesion in the anterior fossa that extended to the right orbital roof. The possibility of metastasis was ruled out. The patient underwent resection of the tumor with posteriorly good visual and neurologic recovery. Histologic characterization demonstrated homogeneous eosinophilic cells with a solid, vascularized pattern, cells with large and binucleated nucleoli, and vessels with endothelial and myoepithelial hyperplasia; numerous apoptotic bodies and mitosis figures were also present, but no necrosis. On immunohistochemistry, cells exhibited positive CD56, NSE in membrane form, and slight myogenin; vessels were strongly positive for myogenin, myoglobin, CD34, CD31, factor VIII, vimentin, and nestin as well as for HBM45, CD20, GFAP, and S-100; cytokeratin showed fine extracellular and intracellular filaments; GATA and TTF1 were negative. Some clear cells were observed to be positive for CD68. The piece was diagnosed as a non-meningeal alveolar sarcoma of the soft tissue with solid pattern. Discussion and Conclusion: This case corresponds to the second tumor of this kind presented at our institution, the first one reported, and perhaps, one of the oldest patients to develop it worldwide.

Primary alveolar soft tissue sarcoma of the central nervous system. Case report

Background: Alveolar soft part sarcoma (ASPS) is a rare, slow-growing soft tissue tumor with uncertain etiology; it is considered among the least common sarcomas, representing 0.2-1% of these cases in large studies. These tumors usually appear during childhood or young patients, with predominance in females. Case description: We introduce the case of ASPS in a 62-year-old man, who presented with 7 months of progressive headache and diplopia. The brain MRI showed an infiltrative lesion in the anterior fossa that extended to the right orbital roof. The possibility of metastasis was ruled out. The patient underwent resection of the tumor with posteriorly good visual and neurologic recovery. Histologic characterization demonstrated homogeneous eosinophilic cells with a solid, vascularized pattern, cells with large and binucleated nucleoli, and vessels with endothelial and myoepithelial hyperplasia; numerous apoptotic bodies and mitosis figures were also present, but no necrosis. On immunohistochemistry, cells exhibited positive CD56, NSE in membrane form, and slight myogenin; vessels were strongly positive for myogenin, myoglobin, CD34, CD31, factor VIII, vimentin, and nestin as well as for HBM45, CD20, GFAP, and S-100; cytokeratin showed fine extracellular and intracellular filaments; GATA and TTF1 were negative. Some clear cells were observed to be positive for CD68. The piece was diagnosed as a non-meningeal alveolar sarcoma of the soft tissue with solid pattern. Discussion and Conclusion: This case corresponds to the second tumor of this kind presented at our institution, the first one reported, and perhaps, one of the oldest patients to develop it worldwide.

Simultaneous stimulation of growth of malignant tumors with epithelioid and sarcomatous nature in experiment.

e23517 Background: The relevance of studying multiple primary malignant tumors (MPMTs) is determined by poor understanding of their pathogenesis. Our purpose was to create an experimental model of synchronous MPMTs with the stimulation of malignant growth of tumors with different histostructure. Methods: The study included 20 male BALB/c Nude mice. The main group included mice with simultaneous subcutaneous inoculation of tumors: murine B16/F10 melanoma (0.5 ml of suspension diluted 1:20 in saline solution) below the left scapula and rat sarcoma 45 (0.5 million tumor cells in 0.5 ml of saline solution) below the right scapula. Control groups included males with melanoma or sarcoma inoculated at the same dosage and volume as in the main group. Results: In the model of synchronous MPMTs, tumors appeared faster than in controls: melanoma–by 3 times, sarcoma–by 2 times; their volume was larger: melanoma–by 2.2 times, sarcoma–by 3.2 times. Melanoma metastasized, in addition to typical sites (the lungs, spleen, liver), into sarcoma 45 to the side adjacent to the chest, under the tumor node. The survival of mice with MPMTs was lower. The morphological structure of melanoma metastasis into sarcoma 45 was represented by large lamellar-rounded epithelium-like cells of melanosarcoma type with transparent cytoplasm and nuclei with a high frequency of pathological mitosis figures. Bundles of elongated spindle-shaped melanocytes with processes of the cytoplasm were determined in some melanoma areas, as well as alveolar and concentric structures. Conclusions: Synchronous subcutaneous inoculation of murine B16/F10 melanoma and rat sarcoma 45 to male BALB/c Nude mice increases their malignant potential due to an exchange of “structural information"; as a result, sarcoma acquires impulses of proliferative activity of melanoma, which, in turn, adapts and “mimics” a tumor into which it is going to metastasize.

Rabdomiossarcoma botrióide na vesícula urinária de um American Pitbull Terrier

O rabdomiossarcoma botrióide é uma variante do rabdomiossarcoma embrionário e tem origem nas células musculares estriadas, ou precursores destas células, por isso podem se iniciar em partes do corpo com ausência de músculo estriado, como o trato urogenital. Geralmente, os cães acometidos são jovens até dois anos e as massas neoplásicas têm aspecto de cacho de uva. O objetivo do presente relato foi descrever um caso de rabdomiossarcoma botrióide em um cão, American Pittbull Terrier, de 16 meses que apresentou uma massa no interior da vesícula urinária, posteriormente diagnosticada através de exame histopatológico e imunoistoquímico. A massa era multilobulada, firme, rósea a vermelha com áreas multifocais de necrose e estava aderida na mucosa da região mais cranial da vesícula urinária emitindo ramificações disseminadas em direção ao trígono vesical. Microscopicamente, a neoplasia é constituída por duas populações celulares entremeadas a uma matriz mixóide, uma composta por células pequenas e redondas, com citoplasma escasso e núcleo basofílico hipercorado e a outra por células alongadas, com citoplasma eosinofílico e núcleo paracentral, ambas as populações celulares possuíam pleomorfismo moderado e 2 figuras de mitose por campo (400 x). Densidade celular aumentada foi observada abaixo do epitélio vesical. A combinação de exames complementares foi conclusiva para o diagnóstico da neoplasia.

Extramedullary Plasmacytoma of the Third Eyelid in a Cat

Background: Extramedullary plasmacytoma is a neoplasm originating from plasmacytes with benign behavior, although it can present malignant characteristics such as local invasion and metastases in some cases. Primary extramedullary plasmacytoma in the third eyelid is rare in humans and animals and has not yet been described in cats. Thus, the goal of the present study is to describe the cytological and histopathological findings of an extramedullary plasmacytoma in a cat's third eyelid.Case: A 5-year-old female feline patient with a history of ocular alteration for approximately 30 days was referred to the ophthalmology service. Upon ophthalmic examination of the left eye, an increase in volume with tissue proliferation was identified in the third eyelid's conjunctiva. A collection of material for cytopathological examination was performed. Numerous plasmocytes and atypical lymphocytes with anisocytosis and anisokaryosis were observed, with a possible neoplastic injury being suggested and referred to the patient for surgical removal of the third eyelid. In the histopathological analysis, it was possible to observe several plasma cells and vascular neoformation along the entire conjunctive margin below the epithelium. The glands, serous and mucous, present in the fragment, revealed areas of intervening plasmacytic infiltrate and a large area close to the hyaline cartilage containing intense plasmacytic inflammatory infiltrate with rare neutrophils and macrophages. There was also a structural breakdown of glandular components and lymphocyte cells with mitosis figures and discrete cellular pleomorphism.Discussion: Plasmacytoma is a rare neoplasm in both dogs and cats. The anatomical regions most frequently affected are the digits, lips, and pinna. Concerning the 3rd eyelid tumor involvement, numerous types of neoplasms have been reported in dogs in the veterinary literature, including transmissible venereal tumor, squamous cell carcinoma, and melanocytoma melanoma, lymphoma, plasmacytoma, hemangioma, hemangiosarcoma, mastocytoma, and myoepithelioma. In cats, the third eyelid is the third site most affected by primary tumors. Adult and elderly animals are the most affected; however, an extramedullary plasmacytoma (PEM) has been reported in an eight-month-old male cat's skeletal muscle. Plasmacytoma aspirates, like other round cells, tend to be highly cellular, the cell morphology has a plasmacytoid aspect, resembling mature cells, the cytoplasm is intensely basophilic, and the round nucleus with an eccentric disposition has thin chromatin and indistinct nucleolus. Binucleate and multinucleate cells are common, and the absence of lymphoglandular corpuscles helps differentiate extramedullary plasmacytoma from lymphomas. Histologically, PEM is similar in dogs, humans, and felines, and variations in mature and immature plasma cells can be seen. The diagnosis of extramedullary plasmacytoma is fundamentally histological, and immunohistochemical analysis can also be performed. Surgical excision with safety margins is the primary type of treatment for neoplasms in the 3rd eyelid, being considered an effective method, as seen in this report, during the patient's follow-up for 13 months, no recurrence or metastasis of the neoplasm was seen. When signs of malignant neoplasms are found, it is recommended to evaluate the indication for chemotherapy before surgery and monitor the case after treatment due to recurrence risk.

Hiperplasia linfoide folicular oral: clinicopatológico de uma série de casos

ABSTRACT Follicular lymphoid hyperplasia (FLH) is a reactive lymphoid proliferation that can simulates lymphomas, both clinically and histologically. The aim of the present study was to investigate the clinical, morphological and immunohistochemical characteristics of a series of FLH cases of the oral cavity, and discuss important diagnostic aspects and differential diagnosis concerning follicular lymphomas. A retrospective analysis of the records of a database comprising 38 years revealed nine cases diagnosed as FLH of the oral cavity. Patient age ranged from 8 to 44 years. Most lesions were located in the buccal mucosa and the presence of a painless nodule was the most common clinical finding. Histopathological analysis revealed the proliferation of lymphoid cells arranged in a follicular pattern, presenting primary and secondary follicles with a germinal center and mantle zone, with evidence of macrophages containing apoptotic bodies in their interior, as well as evidence of typical mitosis figures. Interfollicular region, lymphocytes, macrophages and epimioepithelial islands were observed. Immunohistochemical analysis revealed positivity of the lymphoid follicles for CD20, CD68, CD3 and B-cell lymphoma 2 (Bcl-2). The clinical presentation of FLH and histopathological evidence of lymphatic follicles presenting indistinct germinal centers with poorly defined mantle zone may represent a problem due to theresemblance to follicular lymphoma.

Cutaneous Squamous Cell Carcinoma with Mucinous Metaplasia in Dogs

Background: Squamous cell carcinoma (SCC) is one of the most common malignant skin tumors in domestic animals. Histologically, they are characterized by a proliferation of neoplastic keratinocytes with varied keratin production. Some SCCs have peculiar histological characteristics that permit them to be classified into uncommon to rare histological subtypes, reported in animals and humans. However, according to the authors' knowledge, the mucin-producing subtype described in humans has not yet been reported in animals. In this study, we report the occurrence of two mucin-producing SCCs in dogs, a histological presentation similar to that seen in cutaneous SCCs with mucinous metaplasia in humans.Cases: Two dogs, a 5-year-old Yorkshire female and a 17-year-old Dachshund male, had a skin nodule near the tail and on the right eyelid. The nodules varied from 1 to 5 cm in diameter, were firm and covered with skin and hair. The cut surface was firm and white. Histological findings were compatible with squamous cell carcinoma, characterized by a neoplastic proliferation of keratinocytes originating in the epidermis and infiltrating the dermis. The keratinocytes were arranged in islands and occasional anastomosed cords, supported by a fibrous stroma. The formation of pearls varied from moderate to sparse. The nuclear and cellular pleomorphism was accentuated in case two and moderate in case one. Mitosis figures ranged from two to five in a high magnification field. Within the neoplasm, there were large vacuolated neoplastic cells with slightly fibrillar intracytoplasmic basophilic content. This content has been rarely observed in an extracellular medium. The presence of mucin was confirmed by positive Alcian Blue (AA) staining. In immunohistochemistry (IHC), tumor cells showed strong immunostaining for pancitokeratin, and in areas with marked mucin deposition, immunostaining was predominantly moderate to weak. No tumor cells were immunostained for CD34 and Blc-2 antibodies. Compared to AA and Harris' hematoxylin, it was possible to demonstrate the presence of mucin in the cytoplasm of neoplastic keratinocytes using IHC. No vascular or lymphatic invasion by neoplastic cells was observed. The average cell proliferation index assessed by counting the nucleolar argyrophilic organizing regions (AgNOR) was 3.4 in case 1 and 4.5 in case 2.Discussion: Although the SCC routinely does not present a diagnostic challenge in veterinary practice, the histological presentation of the reported cases does not fit the current classification available in veterinary medicine. The histological presentation observed in these two dogs is similar to that described for cutaneous SCCs with mucinous metaplasia in humans, and so far not described in animals. The observation of intracytoplasmic mucin in humans is an essential finding for the diagnosis of SCC with mucin metaplasia. In the present cases, we observed a slightly basophilic amorphous substance in the cytoplasm of proliferated neoplastic keratinocytes, which stained strongly in blue when applied the Alcian Blue (AA) histochemical technique. This observation became more evident when using IHC counterstained with AA and Harris hematoxylin. In the histological analysis, the absence of an adenoid growth pattern or glandular formation amid neoplastic proliferation ruled out the possibility of a mucinous adenocarcinoma or a mucoepidermoid carcinoma. In addition, we could rule out a follicular neoplasia, including keratinizing infundibular acanthoma due to the absence of a central pore and the absence of immunostaining for CD34 and Bcl-2. These immunohistochemical findings, together with histological findings, reinforce the diagnosis of SCC with mucinous metaplasia in our dogs.

Oral mucosa changes associated with chronic oral and inhalation exposure to 2,4-dichlorophenoxiacetic acid (2,4-D) in Wistar rats.

The respiratory tract and the oral mucosa are the first areas contaminated by pesticides. The herbicide dichlorophenoxyacetic acid (2,4-D) is a widely used pesticide across the world for both crops and gardens. The aim of this study was to evaluate oral mucosal damage after an experimental simulation of chronic oral and inhalational environmental exposure to 2,4-D formulation. Eighty male Wistar rats were exposed to three distinct concentrations of 2,4-D formulation (low-187.17mg/m3; medium-313.31mg/m3; and high-467.93mg/m3). Oral exposure (through contaminated feed) or inhalation exposure lasted 6months. Rat tongues were collected for cyto- and histopathology. There was a difference between exposure groups in the intensity of tissue congestion. Most rats exposed to 2,4-D presented mucosal inflammation at both cytology and histology (P<0.05). Hyperkeratosis only occurred in rats exposed orally at the high concentration. There was an increase in the number of nucleoli-organizing regions in the dorsal epithelium as the 2,4-D concentration increased (P<0.001). The inhalation route was more associated with increased mitosis figures and nucleoli-organizing region count (P<0.05). Chronic oral and inhalation exposure to high concentrations of 2,4-D formulation caused an increase in the proliferation rate and thickness of the tongue epithelium and stimulated the inflammatory response in the tissue.

EXTENSIVE ADENOID CYSTIC CARCINOMA IN THE MAXILLA: A CASE REPORT

A 65-year-old white male patient attended a surgical service because of a maladaptation of upper denture. Clinical examination showed white and erythematous lesions in the vestibular alveolar ridge and hard palate, respectively, with a slight volume increase. Tomographic examination showed expansive lesion associated with the destruction of the left hard palate and maxillary sinus. Incisional biopsy was performed in both lesions, and the specimens were referred for anatomopathologic examination with clinical suspicion of epidermoid carcinoma. Histopathologic examination revealed malignant glandular neoplasm characterized by proliferation of sheets and nests of hyperchromatic cells with scarce cytoplasm forming double layer ductile structures containing intraluminal eosinophilic material and solid areas with central necrosis and discrete mitosis figures. The diagnosis of adenoid cystic carcinoma was established. The patient underwent left maxillectomy, and histologic examination of the surgical specimen confirmed the previous diagnosis and pT4 to pNX staging. The patient is undergoing radiotherapy treatment.

ADENOSQUAMOUS CARCINOMA OF THE ORAL CAVIT: CASE REPORT

A 54-year-old male patient, presented a verrucous and vegetative surface lesion, erythroleukoplastic, in marginal gum region extending from the 13-tooth region to the 17 tooth, irregular contour, approximately 4 cm, and asymptomatic. The patient denied a habit of smoking and alcoholism or any other type of harmful habit. Incisional biopsy was done and the material forwarded for analysis. Histopathological examination revealed island of neoplastic cells, arranged in blocks. Cells showed hexagonal morphology and eosinophilic cytoplasm in the superficial portion of the tumor and in the deeper portion shows cells with intermediate appearance, clear, and/or squamous. Atypical mitosis figures and presence of moderate inflammatory infiltrate were visualized in connective tissue stroma. The diagnosis was adenosquamous carcinoma. The patient was referred to the oncology service of the Hospital de Câncer de Pernambuco (HCP), and died 90 days after treatment initiation. A 54-year-old male patient, presented a verrucous and vegetative surface lesion, erythroleukoplastic, in marginal gum region extending from the 13-tooth region to the 17 tooth, irregular contour, approximately 4 cm, and asymptomatic. The patient denied a habit of smoking and alcoholism or any other type of harmful habit. Incisional biopsy was done and the material forwarded for analysis. Histopathological examination revealed island of neoplastic cells, arranged in blocks. Cells showed hexagonal morphology and eosinophilic cytoplasm in the superficial portion of the tumor and in the deeper portion shows cells with intermediate appearance, clear, and/or squamous. Atypical mitosis figures and presence of moderate inflammatory infiltrate were visualized in connective tissue stroma. The diagnosis was adenosquamous carcinoma. The patient was referred to the oncology service of the Hospital de Câncer de Pernambuco (HCP), and died 90 days after treatment initiation.

Clinical case of breast tumor relapse in domestic cat

Domestic shorthair 10-year-old cat, not sterilized, not vaccinated, feeding from the table. We went to the clinic with breast cancer. General and special research methods were performed: blood analysis, x-ray examination of the lungs and abdominal ultrasound. Based on anamnesis and clinical examination, the diagnosis was made: a malignant breast tumor. The operation was performed. The operating material is sent for histological examination. Chemotherapy was prescribed. After the fi rst chemotherapy and monitoring of the animal's condition, it was necessary to perform a second unilateral mastoectomy of the remaining mammary glands, but the animal's owners refused to perform the operation. Chemotherapy was performed twice. Re-applied, after a year and a half with a sharp deterioration in the General condition and the appearance of a new tumor on the non-removed mammary glands. The owners refused the necessary treatment and decided to euthanize the cat. At the autopsy, breast neoplasms are presented as tubercles of various sizes. There are pronounced signs of inflammation, ulceration and necrosis foci. In the chest cavity, the lungs are enlarged, there were single and multiple formations of white and brown color, round shape of different diameters, dense consistency. There is a large number of metastases in the liver parenchyma. The organ is enlarged in size, dark brown in color, irregularly colored, with an uneven (bumpy) surface. In General, there are many dense nodes of a round-oval shape of white color, of various diameters. Histological examination of the tumor revealed foci of necrosis, atypical glandular complexes with frequently occurring mitosis figures. This structure indicates a low-grade breast adenocarcinoma. In the lungs, there is an expansion of the alveoli and bronchioles, thinning and rupture of the interalveolar partitions. There is a complex of tumor cells. In the liver, there is a lack of structural units of the liver, hepatocytes disperse chaotically, liver triads do not have a clear localization, atrophy and necrosis are expressed. Metastases in the liver, various forms. In a cat, a breast tumor interpreted as an adenocarcinoma had different biological behavior. At the initial diagnosis-adenocarcinoma of medium differentiation, and a year and a half later-low-grade adenocarcinoma.

Hemophagocytic Histiocytic Sarcoma in Dog

Background: Histiocytic sarcoma can present in a localized or disseminated form, being a malignant neoplasm derived from interstitial dendritic cells. Another form of the disease is called hemophagocytic histiocystic sarcoma (HHS), which originates from macrophages located in the splenic red pulp and bone marrow. HHS is a rare neoplasm with unknown etiology and rapid development. It mainly affects middle-aged to elderly animals. It primarily affects the spleen and bone marrow, with occurence of metastases in other organs. Some canine breeds are considered more predisposed to this neoplasia, among them the Rottweiler. The aim of this study was to report a case of HHS in a Rottweiler dog.Case: An 8-year-old Rottweiler suffering from hyporexia and progressive weight loss for a month was attended at the Veterinary Hospital of State University of Maringá. On physical examination, he only presented mild discomfort on abdominal palpation. Blood count was performed, which revealed mild thrombocytopenia (145,000/µL, reference value for the species 150,000-500,000/µL). The Polymerase Chain Reaction (PCR) exam was requested for babesiosis and ehrlichiosis, due to a history of ectoparasites. The animal was released with the prescription of Doxycycline at a dose of 10 mg/kg orally for 28 days. After 5 days, the condition worsened and the animal returned with emesis, apathy and hyporexia, being hospitalized. Abdominal ultrasound, blood count, urinalysis, serum urea and creatinine tests were requested. Among the hematological changes, thrombocytopenia (116,000/µL) and the appearing of regenerative anemia and atypical round cells with ample and slightly basophilic cytoplasm in the smear, similar to histiocytes, stood out. On ultrasound examination, splenomegaly was observed with hypoechogenic areas. Ultrasound-guided fine-needle aspiration cytology (FNAC) of the spleen was performed, which revealed the presence of abundant cellularity consisting of round cells arranged individually and in small groups, with variable nucleus / cytoplasm ratio, slightly basophilic cytoplasm and, sometimes, vacuolized. Eccentric nucleus with chromatin ranging from loose to dense, with evident and often multiple nucleus. In addition, a large number of multinucleated giant cells, mitosis figures (sometimes atypical) and intense anisocytosis and anisocariosis were observed. Furthermore, it was possible to observe erythrophagocytic activity, alterations compatible with histiocytic sarcoma (HS). After 10 days of the first visit, the animal died. At necropsy, samples from altered areas of the spleen, lungs and lymph nodes were collected and sent for histopathological and immunohistochemical examination, in which the diagnosis of hemophagic histiocytic sarcoma was confirmed, in addition to lungs and lymph node metastasis.Discussion: The prognosis of HHS is the worst among histiocytic disorders, as it is associated with coagulopathies and severe anemia due to erythrophagocytic activity, as occurred in the case presented, with a maximum survival time between one to two months. The described animal died ten days after showing the first clinical signs. The immunohistochemistry technique using HLA-DR, CD18, CD163, and CD11d markers was essential to confirm the cell line. Positivity for CD11d marker was found, which allowed to classify the neoplasm as hemophagocytic HS. This report exposes the importance of cytological examination for screening and histopathological and immunohistochemical tests to confirm the diagnosis of this extremely aggressive neoplasm.

Hemangiosarcoma in a Cat’s Tongue

Background: Hemangiosarcoma is a primary malignant neoplasm of vascular endothelial cells, common in dogs and uncommon in cats. It is characterized by being aggressive and presenting high metastatic behavior. It corresponds to 0.5% to 2% of all feline neoplasms, with more reports in shorthaired cats aged between 8 and 12.2 years old, with no predisposition for sex or breed. Among the diagnostic methods, histopathological and immunohistochemical exams stand out because they are more accurate, since the result of fine-needle aspiration biopsy is usually hidden by blood contamination. This report aims to describe a case of a hemangiosarcoma in a cat's tongue.Case: A 9-year-old, female, shorthair cat with a history of weight loss, lethargy, chewing difficulty with the evolution of three months and two-day oral bleeding was attended. Physical examination revealed blood in the oral cavity, enlargement, and darkening of the tongue surface, normalized oral and ocular mucous membranes, estimated dehydration of 7%, a rectal temperature of 38,8°C, and pulmonary and cardiac auscultation without changes. The cat was hospitalized, and euthanasia was elected. Cytological and histopathological exams of the tongue were requested, which revealed a neoplastic proliferation of endothelial cells expanding and replacing the muscular layer of the tongue, forming primitive vascular structures filled with a large number of red blood cells and supported by a delicate fibrovascular stroma. There were moderate anisocytosis and anisocariosis and rare figures of mitosis. Immunohistochemical examination showed the expression of von Willebrand factor, smooth muscle vimentin, and actin in the cytoplasm of neoplastic cells, and negative staining for pancitokeratin.Discussion: According to the results of cytological, histopathological and immunohistochemical examinations, the cat was diagnosed with tongue hemangiosarcoma. The involvement of the tongue in cases of feline hemangiosarcoma is not commonly reported, as the oral cavity is an uncommon site of neoplasm in cats and hemangiossarcoma neoplasm is considered rare in this species. The cytological examination of the patient's tongue was useful to suggest the diagnosis of sarcoma due to a large number of neoplastic cells present in the sample, and later, because it is more specific, the histopathological examination was performed to find out the origin of the tissue. The definitive diagnosis of hemangiosarcoma could be confirmed by the alterations found in the histopathological and immunohistochemical exams. The appearance of erythrocytes within tumor vascular channels, the rapid mass development, moderate anisocytosis, anisocariosis, and irregularity of vascular channels, along with the expression of smooth muscle action, excluded the differential diagnosis of hemangioma and lymphangiosarcoma. Due to the ability of the hemangiosarcoma to be a primary or metastatic tumor and the performance of the necropsy examination was not authorized, we could not determinate the primary origin of the tumor. However, we suggest in the present study that the neoplasm is primary of the tongue because there are no skin lesions or alterations in other organs, besides the tongue is not a common site of metastasis. In conclusion, hemangiosarcoma should be included as a differential diagnosis in cases of tongue neoplasia, although uncommon in felines, and that histopathological and immunohistochemical examinations are indispensable to define an accurate diagnosis.