Pineda-Daboin KM, Rosas-García MI, Rosas-García G, Rosas-Uribe A

Idioma: Español
Referencias bibliográficas: 50
Paginas: 29-34
Archivo PDF: 256.49 Kb.

RESUMEN

Antecedentes: los linfomas mesentéricos son poco frecuentes y la mayor parte se originan de tumores primarios gastrointestinales, ováricos o retroperitoneales.
Objetivo: conocer la frecuencia y variedades histopatológicas de los linfomas que afectan el mesenterio, así como la importancia de los estudios inmunofenotípicos para su identifi cación y distinción con las diferentes lesiones benignas y malignas que los simulan.
Material y métodos: se obtuvieron 30 expedientes de los archivos de la sección de Patología Linfohematopoyética del Instituto Anatomopatológico, Facultad de Medicina, de la Universidad Central de Venezuela, durante 15 años. La información clínica se obtuvo de las solicitudes que acompañaban a las biopsias o material quirúrgico adquiridos por laparotomías (29 casos) y con aguja fi na (1 caso).
Resultados: de los 30 expedientes se registraron 28 linfomas no Hodgkin y 2 de Hodgkin (16 varones y 14 mujeres con límite de edad de 18 meses a 75 años). En 12 pacientes, los linfomas no Hodgkin eran difusos de células grandes; en otros 12 de tipo Burkitt difusos; en 3 de células pequeñas hendidas centrofoliculares o centrocíticos (dos difusos y uno folicular grado I) y una paciente con linfoma difuso linfoplasmocitario. Los dos linfomas de Hodgkin fueron nodulares esclerosantes,
Conclusiones: los tumores mesentéricos pertenecen, principalmente, a linfomas no Hodgkin difusos de células grandes y de linfocitos B en pacientes adultos, y de tipo Burkitt en los pediátricos. Su diferenciación con otros procesos benignos y malignos, primarios y secundarios, requiere el estudio histológico e inmunofenotípico.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Colby TV, Hoppe RT, Warnke RA. Hodgkin’s disease: a clinicopathologic study of 659 cases. Cancer 1982;49:1848-58.

2. Franssila KD, Heiskala MK, Rapola J. Non-Hodgkin’s lymphomas in childhood. A clinicopathologic and epidemiologic study in Finland. Cancer 1987;59:1837-46.

3. Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer 1972;29:252-60.

4. Hausner RJ, Rosas-Uribe A, Wickstrum DA, Smith PC. Non- Hodgkin’s lymphoma in the fi rst two decades of life. A pathological study of 30 cases. Cancer 1977;40:1533-47.

5. Paryani S, Hoppe RT, Burke JS, Sneed P, et al. Extralymphatic involvement in diffuse non-Hodgkin’s lymphoma. J Clin Oncol 1983;1:682-8.

6. Rosai J. Mesentery. In: Rosai and Ackerman’s Surgical Pathology. 1st ed. Philadephia: Saunders WB, 2004;pp:2389-91.

7. Rosas-Uribe A, Fernández CR, Gutiérrez EM. Linfomas en el Hospital Militar “Dr.Carlos Arvelo” de Caracas, Venezuela en un período de 20 años (1961-1980). Patología (México) 1982;20:61-76.

8. Rosas-Uribe A. Linfomas en las dos primeras décadas de la vida: características histopatológicas en 93 pacientes. Patología (México) 1985;23:5-20.

9. Rosas-Uribe A, Barberena E. Linfomas e infi ltrados linfoides y/o hiperplasias (”seudolinfomas”) extraganglionares: características clínicas y patológicas en 280 pacientes. Patología (México) 1994;2:211-23.

10. Torti FM, Portlock CR, Rosenberg SA, Kaplan HS. Extralymphatic Hodgkin’s disease-prognosis and response to therpy. Am J Med 1981;70:487-92.

11. van Krieken JHJM, Otter R, Hermans J, van Groningen K, et al. Malignant lymphoma of the gastrointestinal tract and mesentery. A clinico-pathologic study of the signifi cance of histologic classifi cation. Am J Pathol 1989;135:281-9.

12. Wright D, Mckeever P, Carter R. Childhood non-Hodgkin´s lymphomas in the United Kingdom: fi ndings from the UK Children’s Cancer Study Group. J Clin Pathol 1997;50:128-34.

13. Jaffe ES, Harris NL, Stein H, Vardiman JW. Pathology and genetics of hematopoietic and lymphoid tissues. World Health Organization Classifi cation of tumors. 1st ed. Lyon: IARC Press, 2001.

14. Kojima M, Matsumoto M, Miyazawa Y, Shimizu, et al. Follicular lymphoma with prominent sclerosis (“sclerosing variant of follicular lymphoma”) exhibiting a mesenteric bulky mass resembling infl ammatory pseudotumor. Report of three cases. Pathol Oncol Res 2007;13:74-77.

15. Moriki T, Takahashi T, Wada M, Ueda S, et al. Follicular dendritic cell tumor of the mesentery. Pathol Res Pract 1997;193:629-39.

16. Yenarkan P,Thoeni RF, Hanks D. Case 107: lymphoma of the mesentery. Radiology 2007;242:628-31.

17. Alizadeh AA, Eisen MB, Davis RE, Ma C, et al. Distinct types of diffuse large B-cell lymphoma identifi ed by gene expression profi ling. Nature 2000;403:503-11.

18. Asoglu D, Porter L, Donohve JH, Cha SS. Laparoscopy for the deffi nitive diagnosis of intra-abdominal lymphoma. Mayo Clinic Proc 2005;80:625-31.

19. Cafferty LL, Katz RL, Ordoñez NG, Carrasco CH, Cabanillas FR. Fine needle aspiration diagnosis of intraabdominal and retroperitoneal lymphomas by a morphologic and immunocytochemical approach. Cancer 1990;65:72-77.

20. Chan JKC. Advances in immunohistochemistry: Impact on surgical pathology practice. Sem Diag Pathol 2000;17:170-7.

21. Chu PG, Chang KL, Arber DA, Weiss LM. Immunophenotyping of hematopoietic neoplasms. Sem Diag Pathol 2000;17:236- 56.

22. Frizzera G, Wu D, Inghirani G. The usefulness of immunophenotyping and genotypic studies in the diagnosis and classifi cation of hematopoietic and lymphoid neoplasms. An update. Am J Clin Pathol 1999;111:s13-s39.

23. Hokama A, Nakamoto M, Kinjo F, Fujita J. “ The sandwich sign” of mesenteric lymphoma. Eur J Hematol 2006;77:363-4.

24. Sen F, Vega F, Medeiros LJ. Molecular genetic methods in the diagnosis of hematologic neoplasms. Sem Diag Pathol 2002;19:72-93.

25. Sheth S, Horton M, Garland MR, Fishman EK. Mesenteric neoplasms CT appearances of primary and secondary tumors and differential diagnosis. Radiographics 2003;23:457- 73.

26. Stetler-Stevenson M, Braylan RC. Flow cytometric analysis of lymphomas and lymphoproliferative disorders. Sem Hematol 2001;38:111-23.

27. Al-Nafussi A, Wong NACS. Intra-abdominal spindle cell lesions: a review and practical aids to diagnosis . Histopathol 2001;38:387-402.

28. Amato RJ, Ellerhost JA, Ayala AG. Intra-abdominal desmoplastic cell tumor. Report and discussion of fi ve cases. Cancer 1996;78:845-51.

29. Bernardo DE, Stavrou M, Bourne R, Bogomoletz WV. Primary carcinoid tumor of the mesentery. Hum Pathol 1984;15:796- 8.

30. Devoe K, Weidner N. Immunohistochemistry of small round-cell tumors. Sem Diag Pathol 2000;17:216-24.

31. De Young BR, Wick MR. Immunohistologic evaluation of metastatic carcinomas of unknown origin: An algorithmic approach. Sem Diag Pathol 2000;17:184-93.

32. González-Crussi F, Sotelo–Avila C, de Mello DE. Primary peritoneal, omental, and mesenteric tumors in childhood. Sem Diag Pathol 1986;3:122-37.

33. Jones MA, Clement PB, Young RH . Primary yolk sac tumors of the mesentery. A report of two cases. Am J Clin Pathol1994;101:42-47.

34. Kerrigan SA, Turnnir RT, Clement PB, Young RH, Churg A. Diffuse malignant epithelial mesotheliomas of the peritoneum in women: a clinicopathologic study of 25 patients. Cancer 2002;94:378-85.

35. Meis JM, Enzinger FM. Infl ammatory fi brosarcoma of the mesentery and retroperitoneum. A tumor closely simulating infl ammatory pseudotumor. Am J Surg Pathol 1991;15:1146- 56.

36. Miettinen M, Monihan JM, Sarlomo-Rikala M. Gastrointestinal stromal tumors/smooth muscle tumors (GIST) primary in the omentum and mesentery. Am J Surg Pathol 1999;23:1109-18.

37. Morán CA, Wick MR, Suster S. The role of immunohistochemistry in the diagnosis of malignant mesothelioma. Sem Diag Pathol 2000;17:178-83.

38. Ordoñez NG, el-Naggar AK, Ro JY, Silva EG, Mackay B. Intra-abdominal desmoplastic small round cell tumor: a light microscopic immunocytochemical, ultrastructural and fl ow cytometric study. Hum Pathol 1993;24:850-65.

39. Reith JD, Goldblum JR, Lyles RH, Weiss SW. Extragastrointestinal (soft tissue) stromal tumors: an analysis of 48 cases with emphasis on histological predictors of outcome. Mod Pathol 2000;13:577-85.

40. Roth MJ, Medeiros LJ, Elenitoba-Jhonson K, Kuchino M, et al. Extramedullary myeloid cell tumors: an immunohistochemical study of 29 cases using routinely fi xed and processed paraffi n embedded tissue sections. Arch Pathol Lab Med 1995;119:790-8.

41. Aranda FI, López JI, Prat J. Angiofollicular lymph node hyperplasia associated with amyloidosis. Surg Pathol 1989;2:241- 7.

42. Bowne WB, Lewis JJ, Filippa DA, Niesvizky R, et al. The management of unicentric and multicentric Castleman’s disease: a report of 16 cases and review of the literature. Cancer 1999;85:706-17.

43. Burke AP, Sobin LH, Shekitka KM, Fedespiel BH, Helwig EB. Intra-abdominal fi bromatosis. A pathologic analysis of 130 tumors with comparison of clinical subgroups. Am J Surg Pathol 1990;14:335-41.

44. Coffi n CM, Watterson J, Priest JR, Dehner LP. Extrapulmonary infl ammatory myofi broblastic tumor (infl ammatory pseudotumor). A clinical subgroups. Am J Surg Pathol 1995;19:859-72.

45. Emory TS, Mohihan JM, carr NI, Sobin LH. Sclerosing mesenteritis, mesenteric panniculitis and mesenteric lipodystrophy: A single entity? Am J Surg Pathol 1997;21:393-8.

46. Fazzi P, Solfanelli S, Morelli G. Sarcoidosis: single bulky mesenteric lymph node mimicking a lymphoma. Sarcoidosis 1995;12:75-77.

47. Grigg A, Landgren A. Infective mesenteric adenitis masquerading as relapsed non-Hodgkin’s lymphoma. Leuk Lymphoma 2004;45:2517-9.

48. Pilon VA, Gómez LG, Butler JJ. Systemic amyloidosis associated with a benign mesenteric lymphoid mass. Am J Clin Pathol 1982;78:112-6.

49. Treissman SP, Gillis DA, Lee CL, Giacomantonio M, Resch L. Omental-mesenteric infl ammatory pseudotumor. Cytogenetic demonstration of genetic changes and monoclonality in one tumor. Cancer 1994;73:1433-7.

50. Wilson JD, Montague CJ, Salcuni P, et al. Heterotopic mesenteric ossifi cation (“intra-abdominal myositis ossifi cans”): report of fi ve cases. Am J Surg Pathol 1999;23:1464-70.