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Case 38 - Discussion

Surgical Pathology Case

   
EM EM
EM EM
EM EM
   
 

Immunohistochemical staining:

The tumor cells are positive for vimentin and focally positive for CD34, CD68, Factor XIIIa, and desmin. cytokeratin, S100, and SMA are negative.

 

Electron Microscopy:

Ultrastructurally, the tumor consists of spindle cells with irregular cellular borders. The tumor cells have moderate amounts of cytoplasm that is rich in rough endoplasmic reticulum (RER) and mitochondria. Some cells have dense bodies near the plasma membrane. The tumor cells have one large round, oval or irregular nucleus with one or two prominent nucleoli. Multinucleated or multilobe-nucleated cells are identified on some sections. No specific organelles, lysosomes or lipid droplets are present in the cytoplasm of tumor cells.
 

CYTOGENETICS REPORT:
Cytogenetic analysis revealed the presence of a near-diploid clone characterized by gain of chromosome Y, loss of chromosomes X, 2, 6, 7, 11 and 13, additional unknown material on 1p, 3p, 15q and 17q, a deletion of 2p, and several marker chromosomes. The cp symbol denoted that the karyotype presented is a composite, due to karyotypic heterogeneity, chromosome complexity and morphology within the tumor. Six cell were characterized by a normal male chromosome complement.
NOMENCLATURE:
44-46,Y,-X,+Y,add(1)(q12),-2,del(2)(p14),add(3)(p13),-6,-7,-11,-13,-13,add(15)(q22),
add(17)(q22),+mar1,+mar2,+mar3,+3-5mar[cp11]/46,XY[6]

 

Diagnosis: most consistent with malignant fibrous histiocytoma