Perineurióm podobný angiofibrómu. Kazuistika

English version

Autoři: Michal Zámečník ¹; Petr Mukenšnabl ²; Alena Chlumská ^2,3
Působiště autorů: Medicyt s. r. o., Laboratory of Surgical Pathology, Trenčín, Slovak Republic ¹; Šikl`s Department of Pathology, Medical Faculty Hospital, Charles University, Pilsen, Czech Republic ²; Laboratory of Surgical Pathology, Pilsen, Czech Republic ³
Vyšlo v časopise: Čes.-slov. Patol., 49, 2013, No. 2, p. 86-88
Kategorie: Původní práce

Souhrn

Prezentujeme prípad perineuriómu s neobvykle bohatou vaskularizáciou, ktorá spôsobila podobnosť s angiofibrómom. Šlo o dermálny/subkutánny tumor ľavého ramena u 58-ročného muža. Tumor mal rozmery 2,5 x 2 x 2 cm. Histologicky bol tvorený blandnými fibroblastoidnými bunkami usporiadanými zväčša nepravidelne, len s ojedinelým špirálovitým radením okolo ciev. Malé množstvo buniek malo bipolárne tenké výbežky. Cievy predstavovali druhú prominentnú zložku lézie. Imunohistochemicky bola zistená expresia perineurálnych markerov (EMA, klaudín-1 a CD34) v perivaskulárnych bunkách a v malej časti buniek vzdialených od ciev. Tumor bol ďalej difúzne pozitívny na CD10. Náš nález ukazuje, že diagnózu perineuriómu je potrebné zvažovať aj pri bohato vaskularizovaných léziach s „angiofibroma-like“ morfológiou. Demonštrovaný prípad perineuriómu sa veľmi podobal na recentne popísaný angiofibróm mäkkých tkanív (u ktorého bola často pozorovaná aj expresia EMA).

Kľúčové slová:
perineurióm – angiofibróm – mäkké tkanivá – EMA – klaudín-1

Zdroje

1. Lazarus SS, Trombetta LD. Ultrastructural identification of a benign perineurial cell tumor. Cancer 1978; 41(5): 1823-1829.

2. Pina-Oviedo S, Ortiz-Hidalgo C. The normal and neoplastic perineurium: a review. Adv Anat Pathol 2008; 15(3):147-164.

3. Weiss SW, Goldblum JR. Enzinger and Weiss’s soft tissue tumors (4th ed.), Mosby Inc.: St. Louis, USA; 2001: 1173-1178.

4. Marino-Enriquez A, Fletcher CD. Angiofibroma of soft tissue: clinicopathologic characterization of a distinctive benign fibrovascular neoplasm in a series of 37 cases. Am J Surg Pathol 2012; 36(4): 500-508.

5. Schoolmeester JK, Sukov WR, Aubry MC, Folpe AL. Angiofibroma of soft tissue: core needle biopsy diagnosis, with cytogenetic confirmation. Am J Surg Pathol 2012; 36(9): 1421-1423.

6. Theaker JM, Gillett MB, Fleming KA, Gatter KC. Epithelial membrane antigen expression by meningiomas, and the perineurium of peripheral nerve. Arch Pathol Lab Med 1987; 111(5): 409.

7. Folpe AL, Billings SD, McKenney JK, Walsh SV, Nusrat A, Weiss SW. Expression of claudin-1, a recently described tight junction-associated protein, distinguishes soft tissue perineurioma from potential mimics. Am J Surg Pathol 2002; 26(12): 1620-1626.

8. Pai RK, Mojtahed A, Rouse RV, et al. Histologic and molecular analyses of colonic perineurial-like proliferations in serrated polyps: perineurial-like stromal proliferations are seen in sessile serrated adenomas. Am J Surg Pathol 2011; 35(9): 1373-1380.

9. Agaimy A, Stoehr R, Vieth M, Hartmann A. Benign serrated colorectal fibroblastic polyps/intramucosal perineuriomas are true mixed epithelial-stromal polyps (hybrid hyperplastic polyp/mucosal perineurioma) with frequent BRAF mutations. Am J Surg Pathol 2010; 34(11): 1663-1671.

10. Bunge MB, Wood PM, Tynan LB, Bates ML, Sanes JR. Perineurium originates from fibroblasts: demonstration in vitro with a retroviral marker Science 1989; 243(4888): 229–231.

11. Deniz K, āoban G, Okten T. Anti-CD10 (56C6) expression in soft tissue sarcomas. Pathol Res Pract 2012; 208(5): 281-285.

12. Cabibi D, Zerilli M, Caradonna G, Schillaci L, Belmonte B, Rodolico V. Diagnostic and prognostic value of CD10 in peripheral nerve sheath tumors. Anticancer Res 2009; 29(8): 3149-3155.

13. Nucci MR, Granter SR, Fletcher CD. Cellular angiofibroma: a benign neoplasm distinct from angiomyofibroblastoma and spindle cell lipoma. Am J Surg Pathol 1997; 21(6): 636-644.

14. Iwasa Y, Fletcher CD. Cellular angiofibroma: clinicopathologic and immunohistochemical analysis of 51 cases. Am J Surg Pathol 2004; 28(11): 1426-1435.

15. Fletcher CD, Tsang WY, Fisher C, Lee KC, Chan JK. Angiomyofibroblastoma of the vulva. A benign neoplasm distinct from aggressive angiomyxoma. Am J Surg Pathol 1992; 16(4): 373-382.

16. Allen PW, Dymock RB, MacCormac LB. Superficial angiomyxomas with and without epithelial components. Report of 30 tumors in 28 patients. Am J Surg Pathol 1988; 12(7): 519-530.

17. Garijo MF, Val-Bernal JF. Extravulvar subcutaneous cellular angiofibroma. J Cutan Pathol 1998; 25(6): 327-332.

18. Magro G, Greco P, Alaggio R, Gangemi P, Ninfo V. Polypoid angiomyofibroblastoma-like tumor of the oral cavity: a hitherto unreported soft tissue tumor mimicking embryonal rhabdomyosarcoma. Pathol Res Pract 2008; 204(11): 837-843.