354 / 366
Conclusion:
Small biopsies or cytology study can cause diagnostic prob-
lems in terms of differential diagnosis. We believe these giant cell are part
of a host response to the primary tumour, nowadays the biological
significace of this reaction is unknow.
E-PS-15-009
Clinical case of adenosquamous lung carcinoma with EGFR
mutation
M. Byakhova*, L. Gurevich, L. Kogoniya, N. Korsakova
*MONIKI, Moscow, Russia
Objective:
A 57-year
–
old woman, non-smoked, was admitted to clinic
because of abnormal chest X-ray finding.
Method:
The patient was performed surgery. By immunohisto-
chemical method (IGH) two components were revealed in one
lung tumour.
Results:
1) squamous cells cancer (SCC) which expressed cytokeratins
(CK) 5/6 and didn
’
t express p63 and TTF-1, napsin A. 2) adenocarcinoma
and lymph nodes metastasis (3), creeping lapidary type, which cells
expressed TTF-1, napsin A and didn
’
t express CK5/6 and p63. Deletion
was detected in 19 exon of gene EGFR in both components of the tumour.
A month after the operation the patient complained on head subcutaneous
metastasis - well-differentiated keratinizing SCC with the presence of
horny pearls. IGH was carried out to identify mutations in the gene
EGFR. Currently the patient receives treatment by Gefitinib.
Conclusion:
Presented observation is of particular interest of that both
components of the primary tumour and metastasis have EGFR gene mu-
tation in the same deletion of 19 exon. Thus, these data indicate that we
have described two-component tumour occurred, probably from poorly
differentiated common precursor, which gave rise to two different popu-
lations of malignant cells.
E-PS-16-001
Epidermal cyst of the sole
A. Kilitci*, O. Memis
*Ahi Evran University Hospital, Dept. of Pathology, Kirsehir, Turkey
Objective:
Epidermal cyst (EC) arises mostly from the infundibu-
lar portion of the hair follicles.They appear every site of the
body,especially on the face,scalp,neck and trunk.They originate
rarely in areas without hair,such as the sole and palm.The ECs
on the palms and soles are easily confused with warts or
calluses.Obstruction of hair follicles and implantation of epidermal
fragments into the dermis from a penetrating or blunt injury have
been considered as causes of common ECs.
Method:
A 31 year-old healthy woman presented with complaints of
swelling on her right sole and pain during walking.The patient sustained
sharp-pointed glass injury 2 years earlier.A soft tissue
mass,firm,round,movable,1.8 cm in diameter and overlying the first
web was detected by palpation on the plantar side of the right
foot.Surgical excision was performed.
Re s u l t s :
A wh i t e c y s t i c wa l l w i t h wh i t e e xud a t e wa s
extirpated.Histopathological analysis revealed a stratified squamous epi-
thelium structure similar to that of the skin and a clear granular
layer.There were no signs of recurrence.
Conclusion:
Although,the sole is an area without hair,EC should be in the
list of differential diagnosis for plantar lesion of the foot.For proper
treatment,careful dissection is a must to avoid the recurrence and the risk
of damage to the underlying neurovascular structures.
E-PS-16-002
Inguinoscrotal angiomyofibroblastoma-like tumour: A case report
B. Noveska Petrovska*, L. Asani-Veliu, V. Stojkovski, M. Bogdanovska-
Todorovska, S. Kocmanovska-Petreska, V. Janevski, S. Kostadinovska-
Kunovska, L. Spasevska, V. Janevska, G. Petrushevska, B. Ilievski
*GH, Pathology, Skopje, F.Y. Republic of Macedonia
Objective:
Angiomyofibroblastoma-like(AMF-like) tumour is
derivated from perivascular stem cells and has capacity of lipoid
and myofibroblastic differentiation. This entity in male genitalia is
exceedingly rare. Here we present a case of 49-years-old male
patient who underwent left-sided inguinal hernia repair 3 years
prior to admittance.
Method:
The patient was admitted with pain and swelling in the lower
left abdominal region, clinically suspicious for relapsing inguinal hernia.
After medial laparotomy, tumourous formation together with the left testis
was extirpated from inguinoscrotal region. A gross examination revelled
solid relatively well demarcated pink-tan tumour measuring
9,5x6x5,5 cm, including the vas deferens from the spermatic cord, with-
out involvement of testis and epididymis. Standard procedure for histol-
ogy and immunohistochemistry was made.
Results:
Microscopically the tumour was composed of spindle-
shaped cells and small vessels proliferating in edematous and
focally fibroblastic stroma admixed with mature adipocytes. The
tumour was positive for SMA, Vimentin and CD34, with focal
Desmin expression, low proliferation index Ki-67(<1 %) and neg-
ative for S-100, HMB45 and PR. Pathological diagnosis for
AMF-like tumour was made.
Conclusion:
AMF-like tumours are rare and potentially recurrent mesen-
chymal neoplasms with lack of information regarding its characteristics.
Therefore long-term follow-up is necessary and essential for appropriate
patient care.
E-PS-16-003
Epithelioid inflammatory myofibroblastic sarcoma: A case report
D. Gigliano*, D. Montezuma, N. Coimbra, R. Castro, J. Vieira, A.
Ferreira, M. Afonso
*IPO - Porto, Pathology, Portugal
Objective:
Inflammatory myofibroblastic tumour (IMT) is a mes-
enchymal neoplasm of intermediate biological potential. We aim
to report a case of Epithelioid inflammatory myofibroblastic sar-
coma (EIMS), a rare variant of IMT with predilection for male
patients, distinctive morphological, immunohistochemical and ge-
netic features and malignant behavior.
Method:
Six month-old boy, with abdominal swelling, performed an
ultrasound that showed a 11x9cm well-defined hepatic mass, suggesting
hepatoblastoma. CT-scan displayed a large intra-abdominal neoplasm
(10x11x8cm) without infiltration of adjacent organs. A biopsy was per-
formed and a diagnosis of IMT was rendered. He underwent surgical
excision of the mass and multiple peritoneal implants.
Results:
Microscopically, the neoplasm was composed of spindle/round
cells with vesicular nuclei, prominent nucleoli and scanty cytoplasm,
admixed with polymorphic inflammatory infiltrate. Immunoexpression
for desmin and ALK (cytoplasmic, with perinuclear accentuation) was
observed. FISH showed rearrangement of ALK; karyotype demonstrated
an inversion of chromosome 2, involving ALK e RANBP2 genes. A final
diagnosis of EIMS was made. The patient underwent chemotherapy
(Euro-Ewing protocol). Three years after diagnosis he is alive without
evidence of disease.
Conclusion:
EIMS is a rare and highly aggressive variant of IMT.
Pathologists must be aware of its distinctive features because an accurate
diagnosis is vital for the correct management of these patients.
E-PS-16 Soft Tissue and Bone Pathology
Virchows Arch
(
2017
)
471
(
Suppl 1
):
S1
–
S352
S340