RESUMEN
Objetivo. Determinar el valor de la clasificación Gynecologic Imaging Reporting and Data System (GI-RADS) para discriminar las masas anexiales malignas de las benignas. Material y métodos. Estudio observacional retrospectivo de 87 pacientes operadas en nuestro hospital con un total de 98 masas anexiales. Se clasificaron mediante el sistema GI-RADS y se compararon con la histología definitiva. Resultados. GI-RADS 3: 75 casos. En todos los casos GI-RADS 3, el diagnóstico definitivo fue de benignidad. GI-RADS 4: 11 casos. En el 27,27% de los casos el diagnóstico definitivo fue de malignidad (un carcinoma y 2 tumores borderline), y en el 72,72% de los casos, de benignidad. GI-RADS 5: 12 casos. En el 91,66% de los casos el diagnóstico histológico informó de malignidad (10 carcinomas y un tumor borderline). Discusión. Nuestros resultados refuerzan la fiabilidad de la clasificación para catalogar correctamente las tumoraciones malignas en los grupos GI-RADS 4 y 5 (AU)
Objective. To assess the clinical usefulness of the Gynecologic Imaging Reporting and Data System (GI-RADS) classification to distinguish between benign and malignant adnexal masses. Material and methods. A retrospective study was conducted in 98 adnexal masses in 87 patients who underwent surgery in our hospital. The masses were classified according to GI-RADS and the results were compared with their definitive histologic diagnosis. Results. Seventy-five masses were classified as GI-RADS 3. All GI-RADS 3 masses had a definitive histologic diagnosis of benignity. Eleven masses were GI-RADS 4, of which 27.27% had a definitive histologic diagnosis of malignancy (one carcinoma and 2 borderline tumors) and 72.72% were diagnosed as benign. Twelve masses were GI-RADS 5, of which 91.66% had a definitive histologic diagnosis of malignancy (10 carcinomas and one borderline tumor). Discussion. Our results support the reliability of the GI-RADS classification to correctly identify malignant tumors in GI-RADS 4 and 5 (AU)
Asunto(s)
Humanos , Femenino , Neoplasias de Anexos y Apéndices de Piel/clasificación , Neoplasias de Anexos y Apéndices de Piel/cirugía , Neoplasias de Anexos y Apéndices de Piel/diagnóstico , Carcinoma de Apéndice Cutáneo/clasificación , Carcinoma de Apéndice Cutáneo/complicaciones , Sensibilidad y Especificidad , Neoplasias de Anexos y Apéndices de Piel/fisiopatología , Neoplasias de Anexos y Apéndices de Piel , Estudios Retrospectivos , Carcinoma Papilar/clasificación , Carcinoma Papilar , Cistoadenoma/clasificación , CistoadenomaRESUMEN
BACKGROUND: Adnexal skin tumors share many features in common and differentiate along one line. Their detailed morphological classification is difficult because of the variety of tissue elements and patterns seen. They may be clinically confused with other cutaneous tumors. The aim of this report is to review and classify all adnexal tumors seen in a pathology department over a 16-year period. METHOD: A 16-year retrospective analysis of all adnexal skin tumors seen in a large University Teaching Hospital in Nigeria from January 1991- December 2006. All tissue specimens were fixed in 10% formalin, processed in paraffin wax and stained with Haematoxylin and Eosin. Histology slides were retrieved, studied and lesions characterized. RESULTS: Fifty-two adnexal tumors were seen, accounting for 0.9% of all cutaneous tumors seen within the same period. The median age was 33 years (range: 4 days-70 years). Clinical presentations varied from discreet swellings and nodules to ulcerated masses. Five patients presented with recurrent lesions. Only two cases had a clinical diagnosis of adnexal tumor. Twenty-four (46%) of the lesions were distributed in the head and neck region. Duration of symptoms was 2 months to 15 years (median: 12 months). Tumours of the sweat gland were the commonest--41 (78.8%); they comprised predominantly eccrine acrospiroma (17), characterized histologically by solid nests of round to polygonal cells with clear to eosinophilic cytoplasm, forming tubules in areas. Tumours of sebaceous gland were 7 (13.5%); they comprised mainly Nevus sebaceous of Jadassohn (6), composed of immature sebaceous glands and pilar structures microscopically and a solitary sebaceous adenoma. Tumours of hair follicle were 4 (7.7%) and included trichoepithelioma, characterized microscopically by multiple horn cysts and epithelial tracts connecting abortive pilar structures and a trichofolliculoma. Forty-six lesions (88.5%) were benign and six (11.5%) malignant. CONCLUSION: Adnexal skin tumors have distinct histological patterns which differentiates them from other cutaneous tumors. They are commonly distributed in the head, neck and trunk. The commonest variants are those of eccrine sweat gland origin. Malignant adnexal tumors are uncommon in our setting.
Asunto(s)
Carcinoma de Apéndice Cutáneo/clasificación , Neoplasias de Anexos y Apéndices de Piel/clasificación , Adenocarcinoma Sebáceo/epidemiología , Adenocarcinoma Sebáceo/patología , Adenoma de las Glándulas Sudoríparas/epidemiología , Adenoma de las Glándulas Sudoríparas/patología , Adolescente , Adulto , Anciano , Carcinoma de Apéndice Cutáneo/epidemiología , Carcinoma de Apéndice Cutáneo/patología , Niño , Preescolar , Femenino , Folículo Piloso/patología , Neoplasias de Cabeza y Cuello/epidemiología , Neoplasias de Cabeza y Cuello/patología , Humanos , Recién Nacido , Masculino , Persona de Mediana Edad , Neoplasias de Anexos y Apéndices de Piel/epidemiología , Neoplasias de Anexos y Apéndices de Piel/patología , Nigeria/epidemiología , Estudios Retrospectivos , Neoplasias de las Glándulas Sebáceas/epidemiología , Neoplasias de las Glándulas Sebáceas/patología , Neoplasias de las Glándulas Sudoríparas/epidemiología , Neoplasias de las Glándulas Sudoríparas/patologíaRESUMEN
BACKGROUND: Chondroid syringoma, a tumor of the eccrine glands, was previously called mixed tumor of skin as it has both mesenchymal and epithelial elements. Malignancy in this tumor is extremely rare. Although there are a few reports describing the cytomorphologic features of chondroid syringoma, the cytologic findings of its malignant counterpart have not been described. CASE: A 40-year-old female presented with a recurrent swelling on the scalp of one year's duration. Fine needle aspiration yielded blood-mixed gelatinous material. May-Grünwald-Giemsastained smears showed epithelial cells arranged in cordlike structures and ill-formed glands against a myxomatous background. The epithelial cells had scanty cytoplasm and markedly pleomorphic nuclei with prominent nucleoli. A few cells in the stroma had a halo around them and a resemblance to cartilage cells. A preoperative diagnosis of malignant chondroid syringoma was made. The tumor was excised, and the cytologic diagnosis was confirmed on histopathology. CONCLUSION: Cytomorphologic features of a rare case of malignant chondroid syringoma are reported for the first time. The presence of malignant epithelial cells against a myxoid background with a few chondroid foci helped in making a correct preoperative diagnosis.
Asunto(s)
Adenoma Pleomórfico/diagnóstico , Adenoma Pleomórfico/patología , Carcinoma de Apéndice Cutáneo/diagnóstico , Carcinoma de Apéndice Cutáneo/patología , Cuero Cabelludo , Adulto , Biopsia con Aguja , Carcinoma de Apéndice Cutáneo/clasificación , Femenino , HumanosRESUMEN
We report two cases of microcystic adnexal carcinoma showing extensive sebaceous differentiation. Multiple cellular nests and strands within a moderately sclerotic stroma involving the full thickness of the dermis were observed. Clusters of basaloid cells with extensive sebaceous differentiation were present. Foci of sebaceous ductal differentiation were observed in the more superficial areas. Neither strikingly atypical cells nor mitotic figures were present. Perineural invasion was present in the deep areas of both tumors. Clinically, the lesions were solitary whitish-pink papules with a central dell on the faces of 2 men (aged 78 and 73 years old). We propose a relationship between these tumors and other cytologically bland but locally aggressive adnexal carcinomas. Sebaceous differentiation itself in a poorly circumscribed neoplasm does not indicate conventional extraocular sebaceous carcinoma. We propose a simple classification of locally aggressive adnexal carcinomas that takes into account the full range of adnexal differentiation that can occur in such lesions.