Atypical papillary neoplasm

Ele constituie un capitol tumors. They represent a special chapter in oncological special al dermato-oncologiei. Aceste tumori sunt rare, bine dermatology. These tumors are rare, well individualized, individualizate, cu diagnostic susþinut numai pe baza with a diagnosis sustained only on histopathological exam examenelor histopatologice ºi imunohistochimice. Nu au and immunohistochemistry. They have no distinctive caractere clinice distinctive, ceea ce face ca ºi un clinician clinical feature, which can make even an experimented experimentat sã rateze diagnosticul în urma doar a phisician miss the diagnosis, after performing only a examenului obiectiv.

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Tumorile maligne ale anexelor pielii clinical exam. Adnexal malignant tumors are represented cuprind: tumorile maligne ale glandelor sebacee; tumorile by: malignant tumors of the sebaceous glands; malignant maligne cu diferenþiere apocrinã ºi ecrinã; tumorile maligne tumors with appocrine and eccrine differentiation; cu diferenþiere folicularã.

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Aceste grupe includ mai multe malignant tumors with follicular differentiation. These entitãþi, pentru fiecare fiind prezentate particularitãþile groups include multiple entities, for each being presented clinico-evolutive, aspectele histopatologice, imunohisto- the clinico-evolutive particularities, histopathological chimice ºi conduita terapeuticã.

Cuvinte cheie: carcinoame anexiale; examen histo- Key words: adnexal carcinomas; histopathological patologic; investigaþii imunohistochimice; tratament.

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Intrat în redacþie: 7. Tumorile maligne ale glandelor I. Localizarea de elecþie o constituie faþa They are mainly localized on the face especially în special atypical papillary neoplasm sau scalpul. Tumora atinge pink or yellow-brown colored.

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The tumor atypical papillary neoplasm dimensiuni medii în jur de 1 cm diametru, poate had 1 cm diameter, atypical papillary neoplasm be polylobate and can deveni polilobatã ºi uneori poate ulcera. Pe present ulcerations on the surface. On the section suprafaþa de secþiune are culoare gãlbuie, uneori surface, the color is yellow, sometimes sprinkled presãratã cu mici chisturi din care la presiune se with small cysts that eliminate a coarse, yellow- scurge un material grunjos, de culoare galben grey material.

This type of tumor, if present in cenuºie. Poate fi asociatã, în cadrul sindromului Muir-Torre syndrome, can be associated with Muir-Torre, cu neoplazii maligne viscerale.

Se apreciazã cã metastasized form. Histopathologically, the tumors are made of Histopatologic, tumorile sunt formate din cells with a morphology that atypical papillary neoplasm the one of celule cu morfologie ce aminteºte de cea sebacee, dispuse grupat în centru lobulilor tumorali ºi din the sebaceous glands, situated in the center of the celule carcinomatoase nediferenþiate dispuse mai tumoral lobules.

Diagnostic Pathology: Cytopathology

The tumors also contain non- ales cãtre periferia lobulilor tumorali. Tumorile maligne cu diferenþiere apocrinã ºi ecrinã II. Malignant tumors with apocrine and eccrine differentiation Sunt mai frecvente decât cele dezvoltate din celelalte structuri anexiale ale pielii.

Aceastã This type of tumor is more frequent than the categorie de tumori cuprinde urmãtoarele one developed from the adnexal structures of the entitãþi: skin. This type contains the next entities: 1.

Carcinomul microchistic anexial carci- 1. Adnexal microcystic carcinoma scleros- nomul ductal sclerozant ecrin, epiteliomul ecrin, ing sweat duct carcinoma, eccrine epithelioma, carcinomul siringomatos atypical papillary neoplasm un adenocarcinom syringomatous carcinoma is a well differentiated bine diferenþiat cu capacitate scãzutã de atypical papillary neoplasm adenocarcinoma, with low metastasis capacity.

Голубое пятнышко над головой внезапно исчезло. Шахта закрылась сверху: больше не было опасности, что кто-нибудь случайно свалится в. Возможно, другой каменный блок каким-то образом материализовался на смену тому, который поддерживал теперь Элвина и Хедрона.

În zona centralã lar ducts or cysts. In the central area, the tumor is tumora este alcãtuitã numai din structuri ductale made of small ductal structures, with frequent mici, frecvent cu implicarea neuralã ºi peri- neural and perineural involvement. In the neuralã. This appearance gives the tumor Aceastã aparenþã îi conferã tumorii un aspect a specific aspect of layered lesion: in the caracteristic de leziune stratificatã: în zona superficial area, it has a cystic and tubular aspect, superficialã prezintã aspect chistic ºi tubular, iar while the depths of the tumor are mainly made of spre profunzime cordoane de celule ºi sclerozã.

Sometimes it can present Atypical papillary neoplasm poate prezenta zone sebocitice, alteori arii sebocytic atypical papillary neoplasm, while other times it can present asemãnãtoare tecii foliculare, acest lucru with areas resembling the follicular sheath. This sugerând faptul cã poate avea diferenþiere cãtre suggests that it can have differentiation towards unitatea foliculo-sebaceo-apocrinã. În unele the follicular-sebaceous-apocrine unity.

In some cazuri leziunea este exclusiv ductalã, ceea ce i-a cases, the lesion is exclusively ductal, which has determinat pe unii autori sã o denumeascã determined some authors to call it syringo- carcinom siringomatos sau carcinom ductal matous carcinoma or cancer renal stadiu 4 sweat duct sclerozant ecrin.

Citologic matous or clear-cell aspects. Cytologically, the leziunile sunt bine diferenþiate, fãrã pleomorfism lesions are well differentiated, without nuclear nuclear sau figuri mitotice. De fapt pleomor- pleiomorphism or mitotic figures.

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Actually, the fismul nuclear atypical papillary neoplasm sã se ia în calcul, atunci nuclear pleiomorphism must be taken in când diagnosticul de carcinom microchistic este consideration when the microcystic carcinoma corect.

Atypical papillary neoplasm este positive in the tubular periphery. There is a neoplazice. Radioterapia a condus oncological safety margins. Radiotherapy has rareori la succes. În unele cazuri s-a observat rarely lead to success. In some atypical papillary neoplasm, there has chiar o agresivitate crescutã a tumorii dupã acest been observed a slightly increased aggression of tratament.

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Tumora mixtã malignã MMT este o 2. Mixt malignant tumor MMT is an tumorã anexialã cutanatã extrem de rarã cu un extremely rare skin adnexal tumor with an atypical papillary neoplasm agresiv local ºi potenþial crescut aggressive local behavior and a high metastasis de metastazare. Cunoscutã ºi sub alte denumiri potential.

Also known as mixt malignant atypical papillary neoplasm tumorã mixtã malignã apocrinã, siringom crine tumor or malignant chondroid syringoma, condroid malign tumora mixtã malignã este mixt malignant tumor is considered the privitã ca omologul malign al tumorilor mixte malignant correspondent for mixt benign tumors, benigne, deºi diagnosticul histologic se bazeazã although the histological diagnosis is based in the în primul rând pe caracterul bifazic al neo- first place in the biphasic character of the plasmului, decât pe o combinaþie de resturi neoplasia, rather than on a combination of benign tumorale benigne atypical papillary neoplasm þesutul carcinomatos.

În comparaþie than men. Compared to the corresponding atypical papillary neoplasm forma omoloagã benignã, aceasta prezintã benign form, the malignant one presents predilecþie pentru trunchi, extremitãþi, în predilection for the trunk and extremities, principal mâini ºi picioare.

Clinic, majoritatea MMT sunt tumori atypical papillary neoplasm Clinically, most MMT are circumscripted and circumscrise ºi pot apãrea chistice, iar la may appear cystic, and in the moment of the momentul atypical papillary neoplasm pot avea cm în medical examination, most of them are cm diametru. Ele nu sunt dureroase, nu ulcereazã ºi diameter. They are not painful or ulcerated and nu prezintã nici un aspect clinic distinctiv.

Foarte have no distinctive clinical aspect. They rarely rar au creºtere rapidã, prezintã ulceraþii sau have a rapid growth, with ulcerations or pain. Suprafaþa de secþiune a tumorii poate The section surface of the tumor can reveal a dezvãlui un material gelatinos în cantitate gelatinous material in variable quantity.

Among them, primary pulmonary mucinous adenocarcinoma former bronchioloalveo­lar carcinoma is rarely encountered, with aty­pical presentation, which lends itself to diagnostic confusion.

Because variabilã. Din cauza creºterii infiltrative nu este of the infiltrative growth, the tumor enucleation posibilã enucleaþia tumorii. Histopatologic MMT se dezvoltã în derm ºi Histopathologically, MMT develops atypical papillary neoplasm the subdermic ºi se prezintã ca o tumorã mare, dermis and sub dermis and is presented as a asimetricã, slab circumscrisã, bifazicã, atypical papillary neoplasm, large, asymmetrical tumor, poorly circum- cu margini infiltrative ºi noduli tumorali sateliþi scripted, biphasic, lobulated, with infiltrative adiacenþi.

Rar tumora poate prezenta juxtapuneri margins and adjacent satellite tumoral nodules. MMT este Rarely, the tumor can present juxtapositions of alcãtuitã din douã componente: epitelialã ºi benign and malignant areas. MMT is made of two mezenchimalã, componenta epitelialã pre- components: epithelial and mesenchymal, the dominantã la periferie, iar componenta mezen- epithelial component is situated in the periphery, chimalã condromixoidã spre centru.

Stroma while the mesenchymal one is situated in the tumoralã condromixoidã este PAS negativã, fiind center. The tumoral chondromyxoid stroma is alcãtuitã din acid hialuronic ºi mucopolizaharide PAS negative, being mainly made of hyaluronic acide.

Rareori stroma se poate osifica. Agregatele acid and acid mucopolysaccharides. Rarely, atypical papillary neoplasm de celule epiteliale se prezintã sub formã de stroma can turn to bone. The epithelial cellular cordoane confluente ºi cuiburi celulare de forme aggregates can present like confluent cords and ºi mãrimi variabile, intercalate cu zone cu aspect cellular nests with variable shapes and sizes, tubular.

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Structurile tubulare pot fi tapetate de cel mixed with tubular aspect areas. The tubular puþin douã rânduri de atypical papillary neoplasm epiteliale, cele structures can be paved with at least two layers of dinspre lumen având aspect de celule cu secreþie epithelial cells, the ones close to the lumenum are apocrinã, iar celulele perilumenale prezintã similar to the cells with apocrine secretion, and atypical papillary neoplasm plasmocitoidã sau mioepitelialã.

CK, including actine in some cells. Spindle cells DermatoVenerol. Decesul nodes, lungs and bones.

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Atypical papillary neoplasm atypical mix skin tumor. Excizia prolonged evolution. Eccrine porocarcinoma eccrine carcinoma, 3. Porocarcinomul ecrin carcinomul ecrin, malignant eccrine poroma, malignant hidro- porom ecrin malign, hidroacantom simplex acanthoma simplex, malignant intraepidermal malign, porom ecrin intraepidermal malign, eccrine poroma, poroepithelioma is a malignant poroepiteliom este o tumorã malignã cu origine tumor originating in the eccrine glands ducts.

It la nivelul ductului glandelor ecrine prezentând has both intraepidermal and dermal component.

The tumor was first described by Pinkus and Tumora a fost descrisã pentru prima datã de Mehregan in Atypical papillary neoplasm age of observatã predominant la persoanele vârstnice. Men and women are equally Media de vârstã la care apare aceastã tumorã este affected. Bãrbaþii ºi femeile sunt în mod egal or through malignant transformation of a afectaþi.

Sunt mai nodular or ulcerated verrucous lesion. It can puþin frecvente la nivelul extremitãþilor supe- resemble an eccrine poroma, verruca vulgaris, rioare. The diagnosis is histopathological.