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Patología Revista Latinoamericana

2011, Número 1

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Patol Rev Latinoam 2011; 49 (1)


Neoplasias malignas de anexos cutáneos. Experiencia con 247 casos

Fernández DJR

Idioma: Español
Referencias bibliográficas: 71
Paginas: 11-24
Archivo PDF: 857.16 Kb.


RESUMEN

Las neoplasias malignas de anexos cutáneos son poco frecuentes; sin embargo, es importante conocerlas porque muchas son de evolución rápida y mortal, pero su diagnóstico puede representar para el patólogo general alto grado de dificultad debido a su gran similitud con su contraparte benigna y también porque el diagnóstico diferencial entre ellas mismas y con algunas neoplasias metastásicas (glándula salival y mama) puede ser problemático. No hay ningún marcador clínico que nos ayude al diagnóstico, aunque generalmente son mayores de 2.5 cm. En la histopatología lo más relevante es la silueta irregular y asimétrica; las células neoplásicas pueden exhibir cambios atípicos leves hasta polimorfismo acentuado; generalmente las mitosis atípicas son escasas (una por campo de 40 X); la necrosis comedónica, invasión neural, vascular y linfática son frecuentes. La inmunohistoquímica es de utilidad sólo en algunos casos. El tratamiento de elección es la resección quirúrgica amplia, con disección ganglionar regional electiva.


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