Sabato 27 ottobre 2012 - Pacini Editore

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Fig. 4. HER-2/neu, score 3+, Cdi (40x).
Fig. 5. C-erbB2 gene amplification.
Results. There was no statistical significance for HR expression
(Figg. 1-2) in two subsets (pT1ab VS pT1c, χ 2 p:0.897). A high
proliferative activity (Fig. 3) was detected in 75.7% and 24.3%
respectively for pT1c and pT1a-b (τ-test, p:0.002). HER2/Neu
was positive (IHC, FISH, Figg. 4-5) in 22/187 (11.8%) cases
of pT1c and in 9/105 (8.5%) cases of pT1a-b; the proliferative
activity index was high in both HER2/Neu + subset (τ-test,
p:0.985). Follow up data (mean FU: 56.3 months; range 9-108
months) were available in 22/31 patients HER2/Neu + (8
pT1a-b, 14 pT1c). Two relapses (9.1%) 4 were observed: the
first (pT1b, G3, high Ki-67 treated only with radio-therapy),
recurred both locally and on visceral sites; the second patient
(pT1c, G2, high Ki-67 treated only with hormonal therapy)
showed a triple negative biological features on a re-biopsy performed
on liver metastases.
Conclusion. We observed that different Ki-67 expression 5 , in
two subset (pT1a-b vs pT1c), is associated with tumor size and
this difference is lost in HER2/Neu positive cases regardless of
tumor size (τ-test, p:0.985). We concluded that HER2/neu overexpression/amplification,
could represent a significant marker
of high risk of relapse and could be a prognostic and predictive
factor also in pT1N0M0 breast cancer 6 .
references
1 Neville AM, et al. J Clin Oncol;10:696-705.
2 Sánchez-Muñoz A et al. Breast Journal;17:32-8.
3 Wolff AC, et al. Arch Pathol Lab Med 2007;131:18-43.
4 Joensuu H, et al. Clin Cancer Res 2003;9:923-30.
5 Colleoni M, et al. Annals of Oncology;15:1633-9.
6 Curigliano G, et al. J Clin Oncol 2009;27:5693-9.
CONGRESSO aNNualE di aNatOmia patOlOGiCa SiapEC – iap • fiRENzE, 25-27 OttOBRE 2012
OSSO E PArTI MOLLI
Angiomyomatous hamartoma of the left inguinocrural
area: a case report
M.P. Brisigotti1 , F. Sarocchi1 , P. Calamaro1 , M. Bruzzone1 ,
F. Spagnolo3 , F. Cafiero4 , M. Trapasso3 , L. Moresco4 , B. Spina2 1 University of Genoa, Histhopathology, DISC, Azienda Ospedaliera e
Universitaria San Martino-IRCCS-IST, Genoa; 2 National Institute of
Cancer Research (IST), Pathology Unit, Azienda Ospedaliera e Universitaria
San Martino-IRCCS-IST, Genoa; 3 National Institute of Cancer Research
(IST), Plastic Surgery Unit, Azienda Ospedaliera ed Universitaria
San Martino-IRCCS-IST, Genoa; 4 National Institute of Cancer Research
(IST), Surgical Oncology Unit, Azienda Ospedaliera ed Universitaria San
Martino-IRCCS-IST, Genoa
Introduction. Angiomyomatous hamartoma (AMH) of the
lymph node is a benign vascular disorder and has been described
as a primary vascular tumor characterized by the replacement of
lymph node tissue by blood vessels, smooth muscle and fibrous
tissue in a sclerotic lymphatic stroma. These tumors of unknown
etiology, first described by Chan et al in 1992, are rare disease
and they usually involve inguinal and femoral lymph nodes.
Materials and methods. The patient is a 29 year old woman with
left inguino crural poli-adenopathy and a single painfull mass,
deep in the layers above the femoral nerve and vessels, developed
over the last three months. Color Doppler Ultrasound and MRI
revealed a solid mass measuring 2,5 cm with low vascular supply
and regular margins. A pre-operative lymphoscintigraphy showed
abnormalities in the lymph node flow in the inguino-crural and
pelvic lymph nodes. The mass was clinically diagnosed as a
schwannoma. Since the tumor gradually enlarged, wide excision
of the mass was performed.
Results. The gross specimen was composed of fibro-adipose tissue
measuring 8 x 4 x 2 cm in the contest of which there was a
nodular single mass measuring 2 cm that, on cut section had a firm,
gray-white appearance (Fig. 1). The specimen was extensively
sampled for histologic examination. Microscopically on routine
hematoxylin and eosin stains the nodular mass was a lymph node
with a peripheral rim of normal lymphoid tissue, with few residual
follicles, which was almost completely replaced by a proliferation
of numerous thick-walled muscular blood vessels (Fig. 2). This
proliferation was associated with haphazardly arranged bundles of
smooth muscle cells within a sclerotic stroma. There were also few
compressed lobules of benign adipocytes. None of the constituent
cells displayed cytologic atypia. Mitoses and necrosis were absent.
On immunohistochemical stains there was a strong reactivity for
smooth muscle actin (SMA) (Fig. 3) and desmin (Fig. 4) in the
spindle shaped cells dispersed throughout the fibrous tissue confirming
the muscular origine of these elements.
Morphological and immunohistochemical results lead to a diagnosis
of an angiomyomatous hamartoma.
Fig. 1.