MEETING No. 21, JUNE 17th- 18th, ALBA, CUNEO

Case 1
Case 2
Case 3
Case 4
Case 5
Case 6
Case 7

Case 1

"MEDIASTINAL MASS IN A SMOKER"
M. GIUDICI - Biella Hospital
(pict. by dr. Faravelli)

Clinical history: a 62y.o. man with smoking history presents with fever and non-specific generic symptoms; the clinical and instrumental examinations show a large mediastinal mass which compress and infiltrates the trachea.
During surgery a frozen section examination of a lymph node is performed and is diagnostic for neoplasia.
Microscopic description: Lymph node and tracheobronchial biopsies show the same histological picture: a proliferation of large atypical cells ( pict. 1) - ( pict. 2) - ( pict. 3) with abundant eosinophilic cytoplasm and irregular, large nuclei with multiple nucleoli.
In the tumor there are necrotic areas with lymphocytes and neutrophils infiltrates ( pict. 4) - ( pict. 5).
The neoplastic cells are positive with immunohistochemical staining for Vimentin ( pict. 6), CD68-PGM1 ( pict. 7), Lysozime (+/-) ( pict. 8), CD14 ( pict. 9), Cytokeratin pool ( pict. 10), EMA (+/-) ( pict. 11), CD68-KP1, alfa-1 antitrypsin, HLA-DR, S100.
Negative results are obtained with antisera for Desmin, Pan-Actin, ESA, CEA, CD45, CD5, CD45RO, CD20, CD15 and CD30.

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7	pict. 8
pict. 9	pict. 10
pict. 11

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