Invasive breast carcinoma - IARC

A
Fig. 2.129 Precursor T-cell lymphoblastic lymphoma of ovary. A High power magnification shows small to medium-sized cells with scant cytoplasm, round nuclei
and fine chromatin. B Immunohistochemical stain is positive for CD99.
B
Clinical features
Rarely, a patient presents with an ovarian
granulocytic sarcoma with or without
haematological evidence of acute
myeloid leukaemia {2099}. Cases of
acute lymphoblastic leukaemia, mostly in
children and teenagers, are known to
recur in the ovaries during haematological
remission.
Macroscopy
The ovarian tumours are usually large
and may be either unilateral or bilateral.
They are typically solid, soft, and white,
yellow or red-brown; occasionally, they
may be green, and such tumours have
been designated as a "chloroma" {2605}.
Histopathology
Granulocytic sarcomas have a predominantly
diffuse growth pattern, but sometimes
a cord-like or pseudoacinar
arrangement of the tumour cells is present
focally {2099]. They are usually composed
of cells with finely dispersed
nuclear chromatin and abundant cytoplasm
that may be deeply eosinophilic.
The identification of eosinophilic myelocytes
is helpful in establishing the diagnosis;
however, they are not always present.
Differential diagnosis
The most important differential diagnosis
is malignant lymphoma. Histochemical
stains for chloracetate esterase or
immunohistochemical stains for myeloproxidase,
CD68 and CD43 will establish
the diagnosis in almost all cases {2099}.
Plasmacytoma
Definition
A clonal proliferation of plasma cells that
is cytologically and immunophenotypically
identical to plasma cell myeloma
but manifests a localized growth pattern.
Histopathology
The tumour cells may be mature or
immature. The mature type has eccentric
nuclei with clumped chromatin, low
nuclear to cytoplasmic ratios, abundant
cytoplasm and a prominent perinuclear
hof. The immature form is pleomorphic
with frequent multinucleated cells.
Clinical findings
Ovarian plasmacytoma is a rare tumour
that may present clinically with a unilateral
adnexal mass. The 7 reported patients
were 12-63 years old {782}.
Macroscopy
The tumours were large, and the sectioned
surface was white, pale yellow or
grey.
Prognosis and predictive factors
One patient developed multiple myeloma
2 years after removal of the tumour.
192 Tumours of the ovary and peritoneum