Vaginálny myofibroblastóm so žliazkami exprimujúcimi mamárne a prostatické antigeny

Popísaný je prípad vaginálneho myofibroblastómu, ktorý obsahoval žliazky pozitívne imunohistochemicky na mamárne a prostatické markery. Jednalo sa o tumor zistený u70-ročnej pacientky v proximálnej tretine vagíny. Morfológia a imunofenotyp lézie boli typické pre cervikovaginálny myofibroblastóm. Periférna subepitelová zóna tumoru obsahovala niekoľko skupín žliazok, u ktorých bola predpokladaná pri prvom vyšetrení diagnóza vaginálnej adenózy alebo prostatických žliazok. Imunohistochémia ukázala prekvapujúcu pozitivitu týchto žliazok na prostatické i mamárne markery súčasne (prostatický špecifický antigén, prostatická kyslá fosfatáza, mamaglobín, GCDFP-15). Myoepitel žliazok exprimoval hladkosvalový aktín, p63 a CD10. Nález ukazuje, že pri vyšetrení glandulárnych lézií dolného genitálneho traktu ženy môže simultánne vyšetrenie na prostatické a mamárne antigény byť prínosom pre diagnózu i pre ďalšie poznanie mamárnej a prostatickej diferenciácie v tejto lokalizácii.

Kľúčové slová:
myofibroblastóm – vagína – mamárna žľaza – prostata – imunohistochémia

Autoři: M. Zámečník ¹; T. Sedláček ¹; I. Wallenfels ²; A. Chlumská ^3,4
Působiště autorů: Medicyt s. r. o., Laboratory Trenčín, Slovak Republic ¹; Department of Gynecology and Obstetrics, Faculty Hospital, Trenčín, Slovak Republic ²; Šikl`s Department of Pathology, Faculty Hospital, Charles University, Pilsen, Czech Republic ³; Laboratory of Surgical Pathology, Pilsen, Czech Republic ⁴
Vyšlo v časopise: Čes.-slov. Patol., 48, 2012, No. 1, p. 40-43
Kategorie: Původní práce

Souhrn

Kľúčové slová:
myofibroblastóm – vagína – mamárna žľaza – prostata – imunohistochémia

Zdroje

1. Laskin WB, Fetsch JF, Tavassoli FA. Superficial cervicovaginal myofibroblastoma: fourteen cases of a distinctive mesenchymal tumor arising from the specialized subepithelial stroma of the lower female genital tract. Hum Pathol 2001; 32: 715–725.

2. Ganesan R, McCluggage WG, Hirschowitz L, Millere K, Rollason TP. Superficial myofibroblastoma of the lower female genital tract: report of a series including tumours with a vulval location. Histopathology 2005; 46: 137–143.

3. McCluggage WG. A review and update of morphologically bland vulvovaginal mesenchymal lesions. Int J Gynecol Pathol 2005; 24: 26–38.

4. Kazakov DV, Spagnolo DV, Kacerovská D, Michal M. Lesions of anogenital mammary-like glands: an update. Adv Anat Pathol 2011; 18: 1–28.

5. van der Putte SC. Anogenital “sweat” glands. Histology and pathology of a gland that may mimic mammary glands. Am J Dermatopathol 1991; 13: 557–567.

6. van der Putte SC. Mammary-like glands of the vulva and their disorders. Int J Gynecol Pathol 1994; 13: 150–160.

7. McCluggage WG, Young RH. Tubulo-squamous polyp: a report of ten cases of a distinctive hitherto uncharacterized vaginal polyp. Am J Surg Pathol 2007; 31: 1013–1019.

8. Dundr P, Povýšil C, Mára M, Kuzel D. Tubulo-squamous polyp of the vagina. Cesk Patol 2008; 44: 45–47.

9. McCluggage WG, Ganesan R, Hirschowitz L, Miller K, Rollason TP. Ectopic prostatic tissue in the uterine cervix and vagina: report of a series with a detailed immunohistochemical analysis. Am J Surg Pathol 2006; 30: 209–215.

10. Kazakov DV, Stewart CJ, Kacerovská D, et al. Prostatic-type tissue in the lower female genital tract: a morphologic spectrum, including vaginal tubulosquamous polyp, adenomyomatous hyperplasia of paraurethral Skene glands (female prostate), and ectopic lesion in the vulva. Am J Surg Pathol 2010; 34: 950–955.

11. Larraza-Hernandez O, Molberg KH, Lindberg G, Albores-Saavedra J. Ectopic prostatic tissue in the uterine cervix. Int J Gynecol Pathol 1997; 16: 291–293.

12. Zaviacic M. The adult human female prostata homologue and the male prostate gland: a comparative enzyme-histochemical study. Acta Histochem 1985; 77: 19–31.

13. Watson MA, Fleming TP. Mammaglobin, a mammary-specific member of the uteroglobin gene family, is overexpressed in human breast cancer. Cancer Res 1996; 56: 860–865.

14. Fernandez-Flores A. Mammaglobin immunostaining in the differential diagnosis between cutaneous apocrine carcinoma and cutaneous metastasis from breast carcinoma. Cesk Patol 2009; 45: 108–112.

15. Mazoujian G, Pinkus GS, Davis S, Haagensen DE Jr. Immunohistochemistry of a gross cystic disease fluid protein (GCDFP-15) of the breast. A marker of apocrine epithelium and breast carcinomas with apocrine features. Am J Pathol 1983; 110: 105–112.

16. Howarth DJ, Aronson IB, Diamandis EP. Immunohistochemical localization of prostate-specific antigen in benign and malignant breast tissues. Br J Cancer 1997; 75: 1646–1651.

17. Seki K, Miyakoshi S, Lee GH, et al. Prostatic acid phosphatase is a possible tumor marker for intravascular large B-cell lymphoma. Am J Surg Pathol 2004; 28(10): 1384–1388.

18. Young RH, Clement PB. Sclerosing adenosis of the prostate. Arch Pathol Lab Med 1987; 111: 363–366.

19. Jones EC, Clement PB, Young RH. Sclerosing adenosis of the prostate gland. A clinicopathological and immunohistochemical study of 11 cases. Am J Surg Pathol 1991; 15: 1171–1180.

20. McMenamin ME, Fletcher CD. Mammary-type myofibroblastoma of soft tissue: a tumor closely related to spindle cell lipoma. Am J Surg Pathol 2001; 25: 1022–1029.