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Případ 8. Alena Skálová LF UK v Plzni Bioptická laboratoř, s.r.o. Letný bioptický seminar SD IAP, Senec 2010. Rychle rostoucí exulcerovaný nádor nosní dutiny s progresí do paranasálních dutin a destrukcí kosti 64-letá pacientka. Případ 8. MIB1. CALP. CK14. CK7. p63. S-100 protein.

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Případ 8

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Ppad 8

Alena Sklov

LF UK v Plzni

Bioptick laborato, s.r.o

Letn bioptick seminar SD IAP, Senec 2010


  • Rychle rostouc exulcerovan ndor nosn dutiny s progres do paranaslnch dutin a destrukc kosti

  • 64-let pacientka


Ppad 8


MIB1


CALP


CK14


CK7


p63


S-100 protein


EMA


EGFR


Ppad 8 Imunoprofil

  • Vechny buky pozitivn

    • AE1-AE3, p63, EGFR,S-100 protein

  • Asi 30% bunk m myoepiteliln diferenciaci

    • CK14+,calponin+, ASMA+

  • Slab a fokln pozitivn

    • EMA, c-kit, CK7

  • Negativn

    • CD34,HER2/neu, CD99, WT1, CK20, CDX2,CD56, synaptofyzin, chromogranin, NSE


Diagnza ppad 8

High grade membranozn basocelulrn adenokarcinom nosn dutiny


  • Neprokazujeme mutaci genu CYLD

    • Detekce mutac genu CYLD byla provedena pomoc metody PCR s pmm sekvenovnm

  • Neprokazujeme mutaci genu c-kit

    • Detekce mutac exon 9,11,13 a 17 genu c-kit byla provedena pomoc PCR s primery amplifikujcmi vybran exony a exon-intronov spoje a pmho sekvenovn


Membranozn basocelulrn adenokarcinom

  • Eosinofiln hyalinizovan materil ztlutlch BM

  • Tubuly, dilatovan cystick lumina, kribriformn, solidn struktury

  • CK14+, CK8, 18, 19+, S-100 protein+,c-kit fokln +

WHO 2005


Membranzn basocelulrn karcinom parotis


Diferenciln diagnza

  • Mebranozn BCA

  • Adenoidn cystick karcinom solidn (basaloidn) varianta

  • Basaloid squamous cell carcinoma

  • HG nerohovjc dladicov karcinom

  • Sinonasln nediferencovan karcinom (SNUC)

  • HG adenokarcinom (ITAC)

  • HG neuroendokrinn adenokarcinom

  • Olfaktorick neuroblastom

  • NUT karcinom


Mebranozn basocelulrn adenom parotis


Membranozn adenom submandibulrn lzy


Membranozn adenom submandibulrn lzy


Adenoidn cystick karcinom


Solidn varianta adenoidn cystickho karcinomu


Diferenciln dg.basaloidnch ndor


Dal diferenciln dg.

  • HG karcinom NOS

  • Sinonasln nediferencovan karcinom (SNUC)

  • HG adenokarcinom (ITAC)

  • HG neuroendokrinn adenokarcinom

  • Olfaktorick neuroblastom

  • NUT karcinom


HG adenokarcinom nosn sliznice NOS


SNUC nosn dutiny

synaptofyzin


Neuroendokrinn HG karcinom nosn dutiny CK+/chromogranin+


Olfaktorick neuroblastom


Olfaktorick neuroblastom


NUT karcinom nosn dutiny


NUT Midline carcinoma

  • Stelow et al. AJSP 2008:32:828-834

  • Nov popsan vzcn HG agresivn basaloidn karcinom u mladch lid

  • ve stedn e- nosn a paranasln sliznice, plce, mediastinum,larynx,parotis

  • Translokace t(15;19)(q14;p13.1)-fuzn gen BRD4-NUT (nuclear protein in testis)

  • BRD4-NUT fuzn protein


HG membranzn

basocelulrn karcinom

nosn sliznice a

paranaslnch sinus

Senec 2010


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