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Gastrointestinal stromal tumors (GIST) are relatively rare lesions of mesenchymal origin, being more frequent in the stomach and small intestine. These are clinically asymptomatic lesions, and in advanced stages may present with nausea, vomiting, bleeding, abdominal pain, a palpable mass, and even intestinal obstruction. The only effective treatment consists of a complete tumor resection. We report two cases of GIST located in the distal rectum and evaluated with three-dimensional anorectal ultrasonography, a procedure of great value in identifying the size of the lesion, its involvement toward nearby structures and lymph node invasion. Resumo: Os tumores estromais do trato gastrointestinal (GIST) são lesões relativamente raras de origem mesenquimal, sendo mais frequentes no estômago e intestino delgado. Clinicamente, são lesões assintomáticas e em estados avançados podem cursar com náusea, vômito, sangramento, dor abdominal, massa palpável e até obstrução intestinal. O único tratamento efetivo é a ressecção completa do tumor. Relatamos dois casos de GIST localizados no reto distal e avaliados com ultra-sonografia anorretal tridimensional, que se apresenta de grande valia na identificação do tamanho da lesão, acometimento de estruturas vizinhas e invasão linfonodal. Keywords: Gastrointestinal stromal tumor, CD 34, CD 117, Palavras-chave: Tumor estromal gastrointestinal, CD 34, CD 117

Introduction: Psoriasis is a chronic inflammatory skin disease characterized by epidermal hyperproliferation, abnormal differentiation and inflammatory infiltration in the dermis. The dermal microvascular expansion associated with abnormal orientation and dilatation of capillaries in the biopsies of the psoriatic skin suggest that the disease is dependent on angiogenesis. Aim: To analyze and compare the immunohistochemical expression of angiogenic factors - Vascular Endothelial Growth Factor (VEGF), von Willebrand Factor (vWF) and CD 34 in skin biopsies of psoriasis cases with control skin samples; and to correlate the expression of angiogenic factors with Psoriasis Area and Severity Clinical Index (PASI SCORE). Materials and Methods: This was a prospective case control study conducted over a period of 15 months. Thirty-two psoriasis cases and thirty control skin samples were included in the study. Skin biopsy specimen was taken from clinically diagnosed psoriasis cases who did not receive any treatment. The diagnosis of psoriasis vulgaris was confirmed after microscopic examination. Immunohistochemical expression for VEGF, vWF and CD 34 was studied. Results: VEGF expression in epidermis was significantly higher in cases when compared to control skin (p

Neoplastic lesions of the fallopian tube are rarely seen by surgical pathologists. Haemangioma of the fallopian tube is an extremely rare benign neoplasm. A 30-year-old lady with polymenorrhea and dysmenorrhea underwent hysterectomy and bilateral salpingo-oophorectomy. Her left fallopian tube showed a 2mm sized solid nodule in the wall. Histopathological examination revealed a well-defined vascular lesion in the left fallopian tube, consistent with capillary haemangioma. The vascular endothelium was highlighted by CD34 immunostaining. Our literature review has identified 10 cases of cavernous haemangioma of the fallopian tube. To the best of our knowledge, we report the first ever case of capillary haemangioma of the fallopian tube. This is also the smallest detected haemangioma in the fallopian tube.

Background: Chronic liver disease is characterized by inflammation and fibrosis. As a consequence angiogenesis leading to new vasculature may have prognostic value in disease progression. Interfering with angiogenesis may be a potential target to avoid progression of liver disease. Hence we planned to evaluate the CD34 and vascular endothelial growth factor (VEGF), the markers for angiogenesis in chronic liver disease.Method: Liver biopsies from 79 patients of chronic liver disease and 21 cases of HCC (M: F = 4:1, age range 22 to 80) were stained for routine HE, CD 34 and VEGF immunostaining (Dako Corp & Santa Cruz respectively). Etiologies of chronic liver disease were alcoholic liver disease, HBV, HCV infection, NAFLD, autoimmune liver disease, and cryptogenic liver disease. Thirty biopsies from normal liver obtained at autopsy were taken as controls. Expressions of CD 34 and VEGF were compared with the stage of fibrosis. Results: Out of 79 patients, angiogenesis was seen in 45.5% cases of chronic liver disease. None of the case with normal liver histology was CD 34 or VEGF positive. No significant correlation of angiogenesis was found between any etiologies of chronic liver disease. CD 34 was positive in 18/21 (85.7%) cases of hepatocellular carcinoma. CD 34 and VEGF positivity was 20.9% and 46.5% in stage 1 and 2 fibrosis while it was 75% and 80% in stage 3 and 4 fibrosis respectively. VEGF appeared more common as compared to CD 34 in early fibrosis. Conclusion: Angiogenesis was present in 45.5% cases of chronic liver disease. It was proportional to the increase in stage of fibrosis. Expression of VEGF was commonly found in early stages of fibrosis. Hence, therapeutic strategies of inhibiting VEGF expression may be of importance in preventing the progression of chronic liver disease in its early stage.

RESUMO: Objectivo: Realizar a medida da área vascular tumoral e a contagem individual dos microvasos, demonstrados por imuno-histoquímica, em imagens de campos microscópicos de carcinoma de células não pequenas dos pulmões, verificando a correlação dessas medidas com a sobrevida dos pacientes. Tipo do estudo: transversal e observacional. Material e métodos: O material foi proveniente de peças cirúrgicas de 107 pacientes com carcinoma de células não pequenas dos pulmões tratados no Pavilhão Pereira Filho â Santa Casa de Porto Alegre. A partir de cortes de tecido incluídos em parafina, foi realizada imuno-histoquímica com o anticorpo monoclonal anti-CD 34 (clone QB-End10; DAKO Corporation). A área vascular tumoral e a contagem de microvasos foram obtidas com o auxílio do programa de computador Image Pro Plus â 3.0. Resultados: A sobrevida média, em cinco anos, nos casos com alta área vascular (utilizando a média das áreas como ponto de corte) foi 21,7 meses±2,5, sendo significativamente menor (P < 0,0001) do que os de baixa área vascular, com 38,9 meses±3,0. O coeficiente de correlação entre a medida de área de microvasos e a contagem numérica destes foi 0,5 (P = = 0,001). A área vascular tumoral apresentou maior correlação com a sobrevida (coef. correlação â 0,48/P=0,001) do que a contagem numérica dos microvasos tumorais (coef. de correlação â 0,2 / P=0,03). Não foi encontrada correlação significativa entre a medida de área de microvasos e classificação histológica do tumor, sistema TNM, estado linfonodal e estadiamento clínico. Conclusão: A medida de área vascular tumoral, estabelecida com auxílio de computador, pode ser utilizada como um factor prognóstico para o carcinoma de células não pequenas dos pulmões.REV PORT PNEUMOL IX (1): 19-32 ABSTRACT: Objective: To accomplish the tumor vascular area measure and the microvessel count, shown by immunohistochemistry, in non small cell lung cancer (NSCLC) microscopic images, and verify the correlation between these measurements and patients survival. Design: cross-sectional and observational. Material and methods: The material was deriving from 107 NSCLC surgical specimens in Pavilhão Pereira Filho â Santa Casa, Porto Alegre. Immunohistochemistry with anti-CD 34 monoclonal antibody (QB-End10; DAKO Corporation) was performed on paraffin-embedded tissue sections. The tumoral vascular area and the microvessel count were obtained by Image Pro Plus â 3.0 program. Results: The 5-year survival rate of high vascular area group (the cut-off was the mean of areas) was 21.7 months±2.5, significantly lower (P < 0.0001) than the low vascular area cases, 38.9 months±3.0. The correlation coefficient between microvessel area and microvessel count was 0.5 (P=0.001). The tumoral vascular area shown higher correlation to survival (correlation coefficient: â0.48 / P=0.001) than the tumoral microvessel count (correlation coefficient: â0.2 / P=0.03). There was not any significant correlation between the microvessel areas and the histological type, the TNM, the lymph nodes status and the clinical staging. Conclusion: The tumoral vascular area measurement, with computed assistance, can be used as a prognostic marker in NSCLC.REV PORT PNEUMOL IX (1): 19-32 Palavras-chave: Angiogénese, CD 34, Imuno-histoquímica, Carcinoma de células não pequenas dos pulmões, Análise de imagem, Key-words: Angiogenesis, CD 34, Immunohistochemistry, NSCLC, Image analysis

Statement of the Problem: Ameloblastoma is the most common odontogenic tumor which is slow-growing, locally invasive and exhibit specific biologic behavior and high recurrence rate. Likewise, odontogenic keratocyst is a developmental odontogenic cyst that has a high recurrence rate and aggressive behavior. There are limited studies considering the relationship between the angiogenesis factors and the biologic behavior of these lesions. Purpose: the aim of this study was to evaluate the mean density of vessels in odontogenic keratocysts and ameloblastoma and investigate its possible relationship with biological behavior of these lesions. Materials and Method: In this descriptive-analytic cross-sectional study, 40 cases, comprising 10 odontogenic keratocysts and 30 ameloblastomas (10 plexiform, 10 follicular, and 10 unicystic type) were selected and were stained immuno-histochemically with CD34 and CD105. The micro vessel density was assessed and compared in all groups. T- test for the independent samples’ One- way Anova, Wilcoxon test and Tukey tests were adopted for statistical analysis. Results: A statistically significant difference was observed in mean vascular density (MVD) between the odontogenic keratocyst and ameloblastoma groups concerning the CD105 and CD34 markers (p= 0.005, p= 0.000, respectively). The MVD was significantly higher in ameloblastomas than odontogenic keratocyst. MVD with CD34 was significantly higher than MVD with CD105 in ameloblastomas (p= 0.00). Conclusion: It can be suggested that angiogenesis might be one of the mechanisms that is more possible to contribute the aggressive biological behaviors in ameloblastoma rather than odontogenic keratocyst.

OBJETIVOS Describir el caso de un paciente con un hemangiopericitoma paratesticular y realizar una revision de la literatura. METODOS Se describio el caso clinico de un paciente con hemangiopericitoma paratesticular. Se realizo una busqueda exhaustiva de la literatura en diferentes bases de datos con las que se sustento la discusion del caso. RESULTADOS Se presento el caso de un varon de 64 anos con una masa de crecimiento progresivo en el escroto derecho, quien fue sometido a reseccion completa de la masa. El resultado de la patologia reporto hemangio pericitoma/tumor fibroso solitario y se presenta el manejo instaurado. CONCLUSIONES Se presento un caso poco frecuente de hemangiopericitoma paratesticular. La mayoria de estos tienen un comportamiento benigno, sin embargo se debe tener en cuenta los criterios de malignidad para tomar decisiones con respecto a su manejo.

Background: Odontogenic epithelium plays an important role in the histogenesis of odontogenic tumors of the jaws. Ameloblastomas, which arise from odontogenic epithelium, are considered benign with little tendency to metastasize. Tumors require an adequate supply of oxygen and a way to remove their waste products. This can be achieved by angiogenesis. In situ quantification of the microvessel density (MVD) is a usual method for assessing angiogenesis. Moreover, angiogenesis may differ in subtypes of ameloblastomas and could play a role in determining the pattern of tumor growth. Aim: The aim of the present study was to demonstrate the expression of cluster of differentiation (CD34) in variants of ameloblastomas and to correlate and compare their expression to the aggressive behavior. Materials and Methods: A retrospective cross-sectional study which included forty paraffin blocks was conducted after obtaining ethical committee clearance. Ten cases of pyogenic granuloma were used as a positive control and thirty cases were of solid multicystic ameloblastoma (SMA), unicystic ameloblastoma (UA) and desmoplastic ameloblastomas. Angiogenesis was assessed using CD34 antigen and was immunohistochemically localized. Statistical analysis was carried out for comparative analysis with the help of ANOVA test, Kolmogorov–Smirnov test and least significance difference test. Results: A significant correlation was obtained between the MVD of all the three variants, i.e., SMA, UA and desmoplastic ameloblastomas which was statistically significant (P < 0.05). Conclusion: Increased MVD in the three variants, i.e., SMA, UA and desmoplastic ameloblastoma seen in the present study could suggest that the angiogenesis has an important role in tumor progression and aggressiveness of ameloblastomas.

OBJETIVOS El Tumor Fibroso Solitario (TFS) es una neoplasia poco frecuente que fue descrita por primera vez en la pleura, pero puede aparecer en diferentes localizaciones. Su presencia en la zona inguinal es extremadamente rara. METODOS RESULTADOS: Presentamos el caso de un varon de 74 anos con masa inguinoescrotal derecha de 50 anos de evolucion. Tras extirpacion quirurgica de la misma es diagnosticado de tumor fibroso solitario. CONCLUSIONES La inmensa mayoria de los tumores fibrosos solitarios se comportan de manera benigna. Un pequeno porcentaje se comporta de modo mas agresivo, con recurrencia local y metastasis. Su tratamiento es eminentemente quirurgico, pero despues debemos realizar seguimiento a largo plazo en todos los casos.

Objetivo: Añadir a la literatura un caso clínico poco frecuente de tumor fibroso solitario pararrenal, analizando las características anatomo-patológicas del mismo así como su pronóstico mediante una revisión bibliográfica de la literatura al respecto. Métodos/Resultados: Presentamos el caso clínico de un varón de 36 años que consultó por dolor cólico en fosa renal derecha, siendo diagnosticado de masa sólida en polo inferior riñón derecho, motivo por el que fue sometido a una nefrectomía radical derecha. El estudio histológico de la pieza evidenció la presencia de un tumor fibroso solitario pararrenal. Conclusiones: El tumor fibroso solitario es una neoplasia muy poco frecuente siendo su localización pararrenal aún menos frecuente, siendo una tumoración de comportamiento benigno en hasta un 90 % de casos. En su diagnóstico resulta clave el estudio inmunohistoquímico.

El término tumor fibroso solitario designa una entidad patológica bien definida. Inicialmente descrito como tumor pleural, el aparecimiento de estas neoformaciones en otras localizaciones ha comenzado a ser descrito con mayor frecuencia. Actualmente se acepta la posibilidad de que estas neoplasias se puedan desarrollar virtualmente en todos los departamentos anatómicos. La rareza de esta patología no ha permitido hasta el momento esclarecer su histogénesis, así como otros aspectos relacionados con el comportamiento clínico, aspectos de tratamiento y de definición de pronóstico. El diagnóstico diferencial es importante, particularmente cuando la localización es extratorácica, para evitar confundirlo con neoplasias mesenquimatosas notablemente más agresivas. Los autores presentan dos casos adicionales de este tipo de neoplasia. En el primer caso la neoplasia se localizaba en la pelvis y fue responsable por uropatía obstructiva, descubierta accidentalmente en el transcurso de un traumatismo renal. El segundo caso es referente a un tumor de este tipo histológico localizado a nivel del cordón espermático. A propósito de los mismos se realiza una revisión del tema, teniendo como base la literatura disponible.

Dermatofibrosarcoma protuberans (DFSP) is a rare skin tumor of the dermal layer. Incidence is only about one case per million per year. It is a cutaneous soft tissue sarcoma that rarely metastasizes but it has got a malignant potential in 2% of cases. The challenge with DFSP is that the malignant potential of this tumor depends on the components histologically and on immunohistochemistry. The second challenge is that these tumors cannot be diagnosed on fine needle aspiration and require a core or incisional biopsy. Only in nodular stage we have to diagnose DFSP. This case presented in a male patient simulating malignancy of breast and fine needle aspiration cytology was inconclusive. The treatment also poses a challenge as not all surgeons are well versed with Moh′s surgery and hence here local wide resection was done. All margins were free. Although chemotherapy forms a part of treatment, it is reserved for large and recurrent tumors.