Browsing by Subject "Paraganglioma"

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    A clinicopathologic study of paragangliomas of the urinary bladder: can the clinical behavior of the tumor be predicted?
    (Universidad de Murcia. Departamento de Biología Celular e Histología, 2016) Guo, Shuangping; Fan, Chaoliang; Rohr, Joseph; Fan, Linni; Wang, Yingmei; Li, Mingyang; Li, Xia; Guo, Ying; Yan, Qingguo; Wang, Lu; Wang, Zhe
    Paraganglioma of the urinary bladder is rare but even more unusual as no singular histologic feature is consistently characteristic of malignancy. Additionally, paragangliomas can manifest in hypertensive crisis for clinicians resecting the tumors in unusual locations without proper histologic diagnosis. Herein we report nine cases of paraganglioma of the urinary bladder with immunohistologic study and follow-up information, including one rare malignant case with liver metastasis. Comparison of the immunohistologic features reveal that the malignant case shows the common features suggested by both the Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) and Grading of Adrenal Pheochromocytoma and Extraadrenal Paraganglioma (GAPP) system. The predominant histopathologic features of malignant cases were large irregular nests with focal spindle tumor cells and a diffusely infiltrative growth pattern between smooth muscle of the urinary bladder wall with multiple necrotic areas and a high proliferative index. Eight cases without metastasis showed the classic zellballen of benign paragangliomas without irregular nests and welldemarcated nodules either in the submucosa or between smooth muscle bundles with no diffuse infiltration. We discuss the histopathologic and immunohistochemical features detecting malignant behavior, and comprehensively review the previously published cases of malignant paraganglioma of the urinary bladder. In summary, we assess some clinicopathologic features which might help to predict which neoplasms are more likely to behave in a clinically aggressive manner to avoid adverse outcomes in this rare tumor’s resection.
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    A comparative immunohistochemical study of phaeochromocytornas and paragangliornas
    (Murcia : F. Hernández, 1993) Fraga, M.; Garcia-Caballero, Tomas; Antúnez, J.; Couce, Marta; Beiras, Andres; Forteza, J.
    There is no definite morphological distinction between phaeochromocytomas and paragangliomas. We, therefore, attempted to determine the universality and differential utility of a panel of tumour markers for diagnosis in formalin-fixed, paraffinembedded specimens. Antibodies to neuron-specific enolase (NSE), chromogranin, synaptophysin, Leu-7, neurofilaments, cytokeratins, carcinoembryonic antigen (CEA), melanoma antigen HMB-45, S-100 protein and glial fibrillary acid protein (GFAP), were used on 11 phaeochromocytomas and 8 paragangliomas. NSE reactivity was detected in 10 phaeochromocytomas and in all paragangliomas. Chromogranin reactivity was found in all but two cases (one phaeochromocytoma and one paraganglioma). Synaptophysin reactivity was present in 10 phaeochromocytomas and in the 8 paragangliomas. Ten phaeochromocytomas stained for Leu-7, but none of the paragangliomas did. S- 100-positive cells (sustentacular or type 11 cells) were found in 8 phaeochromocytomas and 7 paragangliomas. GFAP stained sustentacular cells of only one paraganglioma. Only in 5 phaeochromocytomas was there a focal reaction by neurofilaments. Cytokeratins, CEA and HMB-45 were never detected. We conclude that NSE, chromogranin, synaptophysin and S-100 protein are useful markers of both types of tumour, whereas GFAP staining is limited to a small number of these neoplasms. Leu-7 reactivity seems to favour diagnosis of phaeochromocytoma rather than paraganglioma, but further studies with larger series are needed to confirm this. Unlike previous reports, we did not find cytokeratin or HMB-45 im~nunostainingin any case.