|
Case 1
“Esophageal Neoplasia”
Mirella Fortunato – Cuneo Hospital
(pictures by Dr. M. Fortunato)
Clinical history
61 y.o man, with ingravescent dysphagia for 3 weeks. Initially for solids subsequently for liquids with regurgitation. Rx to the esophagus: heteroplastic vegetant lesion to the esophagus.
Microscopical description
Malignant proliferation of fusocellular and pleomorphic cells (Pict. 1). Cells are positive with immunohistochemical staining for alpha-actin (Pict. 2), CD31 (Pict. 3), actin HHF35 (Pict. 4), protein S100 and negative for CKAE1/AE3 (Pict. 5), CK34betaE12.
Diagnosis (biopsy)
The patient underwent surgery for the removal of the neoplasia.
Macroscopical description
At roughly 2,5cm from the esophageal margin was present a polypoid lesion, vegetant, reddish-white, firm, 6cm in diameter, occluding the lumen (Pict. 6).
Microscopical description.
Polypoid lesion with a short, vascular bud (Pict. 7). The mucous membrane that covered the vascular bud showed areas of in situ squamous carcinoma (Pict. 8). Examination of different areas of the lesion, starting from the surface, showed fusocellular and pleomorphic cells (Pict. 9) and cells with epithelial differentiation (Pict. 10). With immunohistochemistry stains cells were strongly positive for CK34BE12 (Pict. 11) and showed weak positivity, both for epithelial and pleomorphic, fusiform cells for alpha-actin (Pict. 12), CD117, CK7,CK19,CKAE1/AE3,EMA, CEA.
Diagnosis
|
