Kab mob raum: Glomus qog ntawm lub raum

Hu rau: Audrey Hu Whatsapp / hp: 0086 13880143964 Email:audrey.hu@wecistanche.com

Primary glomus qog ntawm lub raum

KR Aarthiprabha, Saloni Naresh Shah, Maya Menona, S. Annapurneswarib

Abstract:Thawjglomusqog nqaij hlavntawmraumtsawg tsawg nrog tsuas yog 33 kis tau tshaj tawm hauv cov ntaub ntawv. Peb nthuav qhia ib tus poj niam muaj hnub nyoog 59- xyoo uas mob plab thiab dyspepsia nrog kev kuaj mob ib ntus ntawm lub raum cell carcinoma ntawm daim duab. Pathological kev kuaj pom ib tug mesenchymal pericytic qog nrog morphology thiab immunohistochemistry tau zoo tshaj plaws nrog malignant glomus qog. Peb ntseeg tias qhov no yog thawj rooj plaub ntawmglomus qogntawmraumnyob rau hauv cov ntaub ntawv Indian. Peb tshaj tawm cov ntaub ntawv no muab nws qhov tsis tshua muaj thiab ntxiv rau cov ntaub ntawv luam tawm uas twb muaj lawm.

cistanche kho mob raum

Taw qhia

Glomus qogyog mesenchymal neoplasms cais raws li pericytic (perivascular) qog los ntawm lub koom haum ntiaj teb kev noj qab haus huv (WHO). Lawv tsim tsawg dua 2 feem pua ​​​​ntawm tag nrho cov nqaij mos mos, uas ib lub hlis twg tshwm sim los ntawm cov kab mob visceral. (Lamba li al., 2011) Lawv tshwm sim los ntawm neuro myoarterial glomus lub cev nyob rau hauv lub cutis thiab cov ntaub so ntswg superficial thiab tam sim no ua mob subungual nodules. (Li et al., 2017).Glomus qogtau piav qhia nyob rau hauv cov kab mob visceral xws li ntsws, siab, plab hnyuv, pob txha, poj niam qhov chaw mos, mediastinum, thiab cov kab mob genitourinary, txawm tias lawv tsis pom tseeb ntawm cov chaw no. (Lamba et al, 2011; Chen et al, 2017; Al-Ahmadie li al, 2007) Renalglomus qogtsis tshua muaj nrog tsuas yog 33 tus neeg uas tau tshaj tawm txog hnub no thoob ntiaj teb. (Dee et al.,2018) Cov neeg mob no tuaj yeem tshwm sim nrog kub siab, mob flank, microscopic hematuria, zoo li lwm yam qog nqaij hlav hauv lub raum thiab tsis tuaj yeem paub qhov txawv ntawm lub raum cell carcinoma radiologically. Yog li, kev ntsuam xyuas pathological yog sine qua tsis rau kev kuaj mob tseeb. Peb nthuav qhia thawj rooj plaub ntawm Glomus qog ntawmraumlos ntawm Is Nrias teb nrog kev tshuaj xyuas cov ntaub ntawv thiab cov ncauj lus kom ntxaws txog kev kuaj mob sib txawv.

cistanche kho mob raum

Case report

Ib tug poj niam muaj hnub nyoog 59- xyoo tau hais lus tsis txaus siab ntawm qhov tsis meej pem thiab mob plab rau peb lub tsev kho mob. Nws yog tus paub txog ntshav siab nrog keeb kwm ntawm sab laug radical nephrectomy, ua rau lwm qhov 14 xyoo dhau los. Tus neeg mob tsis muaj ntaub ntawv ntawm nws lub tsev kho mob yav dhau los. Hauv kev kuaj mob plab, ib qho kev sib tw loj uas ntsuas 6 × 6 cm tau muab sau rau hauv kab midclavicular 6 cm hauv qab ntawm txoj cai costal margin. Kev yees duab tau nthuav tawm ib qho exophytic loj ntawm tus ncej sab xisraum. Ib feem nephrectomy tau ua nrog kev kuaj mob ib ntus ntawm lub raum cell carcinoma. Nyob rau hauv tag nrho cov kev ntsuam xyuas, daj ntseg dawb, lobulated, mos mus rau ruaj, hemorrhagic loj nrog txawv ciam teb thiab ib tug nyias capsule ntsuas 7.5 × 7.5 × 6 cm. Ib lub tes tsho ntawm lub raum parenchyma ib txwm muaj nyob rau ntawm qhov chaw phais. Kev kuaj mob histopathological tau qhia txog cov khoom epithelioid neoplasm nrog cov hlwb uas muaj cov kab mob sib kis thiab hauv cov qauv perivascular nrog ntau cov hlab ntsha sib txawv ntawm ntau qhov sib txawv [Daim duab. 1 AW-C]. Cov hlwb muaj nruab nrab eosinophilic cytoplasm, puag ncig rau ovoid nucleus, thiab me me nucleoli [Fig. 1D thiab E]. Kev tawg ntawm ntau lub hlwb pleomorphic nrog cov nucleus loj thiab eosinophilic nucleoli [Daim duab. 1F thiab G] thiab thaj tsam ntawm necrosis [Daim duab. 1H] kuj muaj. Txog li 5 mitoses tau pom ib 50 HPF [Fig. 1D-F]. Capsular infiltration tau tshwm sim nrog ob peb lub tubules nkag ntawm qhov periphery ntawm qhov txhab [Fig. 1 Ib]. Immunohistochemistry tau pom tias muaj qhov ua tau zoo rau vimmentin, cov leeg nqaij du (SMA), h-caldesmon, thiab CD34 hauv cov hlwb epithelioid thiab tsis zoo rau pan-cytokeratin, desmin, HMB45, S-100 thiab CD117 [Fig. 2]. Cov morphology thiab immunohistochemistry tau zoo ib yam nrog cov qog malignant glomus ntawm lub cev.raum. Tus neeg mob tau ua zoo ob xyoos tom qab kev phais mob tsis muaj pov thawj ntawm kev rov ua dua lossis metastasis.

cistanche tuaj yeem tiv thaiv qog thiab mob qog noj ntshav

Kev sib tham

Glomus qogntawmraumtsis tshua muaj tshwm sim nrog 27 benignglomus qog,,3 casglomus qogntawm qhov tsis meej malignant muaj peev xwm (GT-UMP) thiab 3 malignantglomus qoguas tau tshaj tawm rau hnub tim.(Lamba et al.,2011;Li et al.,2017;Chen et al,2017;Al-Ahmadie et al.,2007; Dee et al.,2018; Sirohi et al.,2017 ; Folpe et al. 2001; Gill and Van Vliet, 2010) Cov neeg mob muaj hnub nyoog li ntawm 17 txog 81 xyoo nrog me ntsis txiv neej preponderance. Feem ntau ntawm cov noqog nqaij hlavtau exophytic thiab polar, nrog rau qee zaus qog tshwm sim los ntawm ureteropelvic hlws ris. Cov no tau zoo-circumscribed nrog cov cheeb tsam ntawm hemorrhage thiab necrosis thiab ranges ntawm 1 mus rau 16 cm loj. Raws li cov yam ntxwv ntawm histological, cov variants tuaj yeem raug xaiv ua glomus qog, glomangiomas, lossis gloman giomyomas. Hauv xyoo 2001, Folpe thiab cov npoj yaig tau tawm tswv yim txog cov txheej txheem histological rau malignantglomus qog of the soft tissue: large size(>2cm) thiab qhov chaw sib sib zog nqus (lossis) atypical mitotic cov duab (lossis) cim atypia nrog 5 lossis ntau dua mitoses rau qhov chaw siab zog. (Folpe et al., 2001)Nyob rau hauv no hais txog, peb cov ntaub ntawv ua tiav cov txheej txheem rau malignancy. Txawm li cas los xij, nyob rau xyoo tom ntej qee tus kws sau ntawv ntseeg tias cov qauv no yuav tsis siv rau lub raumglomus qog, raws li feem ntau ntawm cov ntaub ntawv nyob rau hauv cov ntaub ntawv yog loj-loj thiab nyob rau hauv tob qhov chaw tab sis muaj ib tug benign kho mob chav kawm. (Li li al., 2017; Sirohi li al., 2017) Malignant transformation yog pom nyob rau hauv 5 feem pua ​​​​ntawm cov neeg mob nrog loj loj ntawm cov qog, nuclear pleomorphism, muaj necrosis, nce / atypical mitoses, thiab lymphovascular ntxeem tau ua tus kwv yees. ntawm lub peev xwm metastatic. (Li et al., 2017)

Fig 1.Lub raum qog npaj nyob rau hauv ib tug perivascular qauv nrog ib tug nyob ib sab lub raum parenchyma (A, B, C) muaj cov epithelioid hlwb nrog pleomorphism thiab tawg pleb mitotic cov duab (D rau G), foci ntawm necrosis, thiab focal capsular infiltration (Haematoxylin & Eosin stain).

Fig 2.Immunohistochemistry stain qhia qhov zoo rau Vimentin, SMA, h- Caldesmon, thiab CD34, thiab tsis zoo rau Pan CK, c-KIT, desmin, thiab S-100.

Immunohistochemically,glomus qogyog qhov zoo rau vimentin, cov leeg nqaij du (SMA), thiab pericellular hom IV collagen. (Li et al. 2017; Chen et al, 2017) 19 feem pua ​​​​ntawm CD34 qhov zoo.glomus qogRaws li piv rau cov benign counterpart.(Gill and Van Vliet, 2010) Mesenchymal hlav xws li epithelioid angiomyolipoma, epithelioid leiomyoma, hemangiopericytoma, juxtaglomerular cell hlav (JGCT), epithelioid solitary fibrous cell (SFTcin), paraganglioma, thiab carcinogens. carcinoma warrant exclusion ua ntej tuaj txog ntawm qhov kev kuaj mob zaum kawg. Epithelioid variant ntawm angiomyolipoma teej tug mus rau pawg PEComa yog ib tug benign neoplasm tsim los ntawm ib tug triad ntawm tuab-walled cov hlab ntsha, proliferating smooth nqaij hlwb thiab adipocytic hlwb nyob rau hauv sib txawv pro-feem ntau nrog rau ib tug predominant pejxeem ntawm polygonal hlwb nrog ntom eosinophilic loj cytoplasm, vesicular nucleus, thiab cov nucleoli tseem ceeb uas nthuav qhia HMB45 thiab Melan A. Leiomyomas yog tsim los ntawm cov leeg nqaij pob nrog desmin zoo, tsis muaj cov qauv perivascular classic ntawm glomus qog. (Dee li al., 2018) SFT feem ntau zoo ncig nrog kev loj hlob ntawm bland spindle hlwb nyob rau hauv patternless nyob rau hauv ib tug hyalinized stroma tsis muaj mitotic cov duab, necrosis, los yog cystic hloov. Cov hlwb muaj qhov zoo rau STAT6 thiab Bcl2 thiab tsis zoo rau cov leeg nqaij zoo li pom. (Al-Ahmadie li al, 2007) Paraganglioma yog tsim los ntawm uni-form monomorphic hlwb txheej txheem nyob rau hauv ib tug nested los yog zellballen qauv sur-rounded los ntawm spindled sustentacular hlwb thiab cov hlab ntsha, qhov twg cov hlwb yog zoo rau synaptophysin thiab chromogranin thiab cov sustentacular hlwb qhia. S100. Carcinoids qhia trabaculae ntawm puag ncig thiab monomorphic hlwb nrog stippled nuclear chromatin thiab qhia cov cim neuroendocrine zoo li synaptophysin thiab chromogranin. (Dee li al, 2018) Juxtaglomerular cell hlav (JGCT) yog tsim los ntawm monomorphic nested round cells nrog rau cov tubules ib txwm muaj thiab rhomboid zoo li siv lead ua ntawm electron microscopy. Cov hlwb neoplastic zoo rau renin, vimentin, thiab CD34 thiab tsis zoo rau cov cim myoid. Ob leeg benign thiab malignantglomus qogqhia MIR143-NOTCH gene fusion. Gene fusions uas muaj MIR143 hauv band 5q32 thiab NOTCH2 hauv lp13 (malignant glomus qog) lossis NOTCH1 hauv 9q34 (cov qog qog nqaij hlav zoo) pom hauv 50 feem pua ​​​​ntawm cov neeg mob. (Sirohi thiab al., 2017)

cistanche ntxiv txhim kho kev tiv thaiv

Xaus

Thawjglomus qogntawm lub raum txawm tsis tshua muaj, feem ntau yog benign nrog tsuas yog peb tus mob malignant nyob rau hauv cov ntaub ntawv. Thawj kis tau nthuav tawm nrog ntau yam osseous metastases ntxiv rau qhov malignant morphology ntawm lub raum qog. Txawm hais tias thawj kab tshuaj kho mob thiab hluav taws xob, tus neeg mob tuag rau lub hlis tom qab kuaj mob. (Lamba li al.,2011) Qhov thib ob kis tau tus kab mob metastatic nrog kev koom tes hauv ntau lub cev 7 xyoo tom qab kuaj pom thawj zaug ntawm lub raum glomus qog. Qhov thib peb yog ib qho kab mob glomus qog ntawm lub cevraumnrog cov yam ntxwv zoo ib yam nrog malignancy.(Chen et al.,2017) Peb cov ntaub ntawv yog ib qho chaw hauv cheeb tsamraumqognrog perinephric infiltration, loj loj (7.5cms) nrog cellular pleomorphism thiab nce mitoses, kwv yees nws aggressive cwj pwm yog li nyiam malignancy. Kev kuaj mob pathological yog qhov tseem ceeb heev thiab tseem yog qhov tseem ceeb rau kev tuaj txog ntawm qhov kev kuaj mob tseeb. Ua tiav kev txiav tawm ntawm cov qog los ntawm ib nrab lossis radical nephrectomy yog qhov kev kho mob uas nyiam tshaj plaws.(Chen li al.,2017) Muab keeb kwm ntawm sab laug radical nephrectomy thiab qhov chaw exophytic ntawm txoj cai no.raumqog, kev phais nephron-sparing nrog cov npoo txaus tau ua hauv peb tus neeg mob. Prognosis, recurrence rate, thiab metastatic peev xwm ntawmglomus qogLub raum tseem tsis tau txiav txim siab vim qhov dearth ntawm cov neoplasms.

Tus neeg mob daim ntawv tso cai

Tus neeg mob qhov kev pom zoo tau txais ua ntej kev phais.

Tshaj tawm ntawm Kev Sib Tw Kev Txaus Siab

Sawv cev ntawm txhua tus kws sau ntawv, tus sau sau tau hais tias tsis muaj kev cuam tshuam ntawm kev txaus siab.

Daim ntawv qhia txog credit authorship contribution statement

KRAarthiprabha: Conceptualization, Methodology, Data curation, Sau-original draft. Saloni Naresh Shah: Conceptualization, Methodology, Supervision, Data curation, Sau-original draft, Sau-ing-review & editing, Project Administration.Maya Menon: Sau- tshuaj xyuas & kho. S. Annapurneswari: Sau- tshuaj xyuas & kho.

Kev lees paub

Nil

Cov khoom siv ntxiv

Cov ntaub ntawv ntxiv uas cuam tshuam nrog tsab xov xwm no tuaj yeem pom, hauv online version, ntawm doi: 10.1016/j.cpccr.2021.100102.

cistanche txhim kho kev tiv thaiv

Cov ntaub ntawv

Al-Ahmadie, HA, Yilmaz, A., Olgac, S. Reuter, VE2007.Glomus qogntawmraum: ib daim ntawv qhia txog 3 rooj plaub uas muaj lub raum parenchyma thiab tshuaj xyuas cov ntaub ntawv. Am. J Surg, Pathol 31.585-591.

Chen, Y.A., Li, H.N., Wang, R.C. Hung, S.-W., Chiu, K.-Y., 2017.Malignantglomus qogntawmraum; ib daim ntawv ceeb toom thiab tshuaj xyuas cov ntaub ntawv. Clin, Genitourin. Cancer 15, 151-153.

Dee, E, Login.A. Toth, T, Naznean, A., Borda, A., 2018.Glomus qogntawmraum: case report. Acta Med. Marisiensis 64 126-129.

Folpe, AL, Fanburg-Smith, JC, Miettinen, M, Weiss, SW, 2001.Atypical thiab malignantglomus qog: tsom xam ntawm 52 rooj plaub, nrog rau lub tswv yim rau reclassification ntawmglomus qog. Am. J. Surg. Pathol. 25, 1-12 ib.

Gill, J., Van Vliet, C., 2010. Infiltratingglomus qogntawm uncertain malignant tej zaum tshwm sim nyob rau hauv lubraum. Hum. Pathol. 41, 145-149, ib.

Lamba, G., Rafivath, SM, Kaur, H, Khan S., Singh. P, Hamilton, AM, et al..2011. Mob phemglomus qogntawmraum: thawj qhov xwm txheej thiab tshuaj xyuas cov ntaub ntawv. Hum. Pathol. 42, 1200-1203.

Li, R., Petros, FG, Davis, CJ., Ward, JF, 2017.Characterization ofglomus qogntawmraum. Clin. Genitourin. Cancer 8 (16), 253-256.

Sirohi, D., Smith, SC Epstein, JI, Balzer, BL, Simko, JP, Balitzer, D., thiab al, 2017.Pericyticqog nqaij hlavntawmraum- kev soj ntsuam ntawm clinicopathologic ntawm 17 tus neeg mob. Hum. Pathol. 64, {3}}.