Atypical meningiona: a case roport

Introduction: Plasma Cell Myeloma or Multiple Myeloma (MM) is the most frequent plasma cell neoplasm of malignant monoclonal gammopathies. Frequently present between the ages of 60 and 70. They are disorders characterized by clonal proliferation of immunoglobulin-secreting plasma cells from a single...

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Autores principales: Madrid Fernandez , T, Saracini , J, Mondino, F, Defazio , D
Formato: Artículo revista
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021
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Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/43207
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id I10-R327-article-43207
record_format ojs
institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
format Artículo revista
topic Atypical meningiona
Meningioma atípico
.
spellingShingle Atypical meningiona
Meningioma atípico
.
Madrid Fernandez , T
Saracini , J
Mondino, F
Defazio , D
Atypical meningiona: a case roport
topic_facet Atypical meningiona
Meningioma atípico
.
author Madrid Fernandez , T
Saracini , J
Mondino, F
Defazio , D
author_facet Madrid Fernandez , T
Saracini , J
Mondino, F
Defazio , D
author_sort Madrid Fernandez , T
title Atypical meningiona: a case roport
title_short Atypical meningiona: a case roport
title_full Atypical meningiona: a case roport
title_fullStr Atypical meningiona: a case roport
title_full_unstemmed Atypical meningiona: a case roport
title_sort atypical meningiona: a case roport
description Introduction: Plasma Cell Myeloma or Multiple Myeloma (MM) is the most frequent plasma cell neoplasm of malignant monoclonal gammopathies. Frequently present between the ages of 60 and 70. They are disorders characterized by clonal proliferation of immunoglobulin-secreting plasma cells from a single progenitor cell. This condition is presented with typical symptoms and signs, such as bone pain, hypercalcemia, bone fractures, kidney damage, anemic syndrome, neurological symptoms and recurrent infections. The objective of our work is report a case of MM, review its medical clinic, form of presentation, macro and microscopic appearance, with its respective immunohistochemistry, immunophenotyping, biological behavior and prognosis, comparing it with other similar cases. Case presentation: It was a 62-year-old woman with severe humeral bone pain. The physical examination and imaging studies suspected a tumor lesion on her humerus, and others were discovered in the ribs, vertebrae and pelvis. A biopsy was taken for pathological analysis, which reported poorly differentiated neoplasia with numerous "plasmacytoid" type cells. Immunohistochemistry was positive for CD138 and CD79a. In addition, a biopsy of the iliac bone marrow was requested, which revealed hypercellularity with interstitial-like infiltration of mature-appearing plasma cells. Immunophenotyping indicated 1.5% of plasma cells, of which 99% presented restriction in the expression of cytoplasmic immunoglobulins, lambda light chain; with the phenotype: CD45-/CD38+/ CD138+/CD56+/ CD19-; linkable to abnormal plasma cells. The multiple osteolytic lesions, conjointly with the data obtained by histopathology, the immunohistochemically profile and the immunophenotyping, were found to be associated to plasma cell myeloma. The patient was treated with chemotherapy, being her evolution favourable with 6 months of follow-up. Conclusions: MM is the most frequent plasma cell neoplasm, characterized by clonal proliferation of immunoglobulin-secreting plasma cells. They are usually classified into secretory or non-secretory MM, being the non-secretory with the most unfavorable prognosis. Our case agree, from the clinical view, the anatomopathological, immunohistochemical and immunophenotypic findings, with what is described in the consulted bibliography.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2021
url https://revistas.unc.edu.ar/index.php/med/article/view/43207
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first_indexed 2024-09-03T21:05:06Z
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spelling I10-R327-article-432072024-04-15T16:19:09Z Atypical meningiona: a case roport Meningioma atípico: reporte de un caso . Madrid Fernandez , T Saracini , J Mondino, F Defazio , D Atypical meningiona Meningioma atípico . Introduction: Plasma Cell Myeloma or Multiple Myeloma (MM) is the most frequent plasma cell neoplasm of malignant monoclonal gammopathies. Frequently present between the ages of 60 and 70. They are disorders characterized by clonal proliferation of immunoglobulin-secreting plasma cells from a single progenitor cell. This condition is presented with typical symptoms and signs, such as bone pain, hypercalcemia, bone fractures, kidney damage, anemic syndrome, neurological symptoms and recurrent infections. The objective of our work is report a case of MM, review its medical clinic, form of presentation, macro and microscopic appearance, with its respective immunohistochemistry, immunophenotyping, biological behavior and prognosis, comparing it with other similar cases. Case presentation: It was a 62-year-old woman with severe humeral bone pain. The physical examination and imaging studies suspected a tumor lesion on her humerus, and others were discovered in the ribs, vertebrae and pelvis. A biopsy was taken for pathological analysis, which reported poorly differentiated neoplasia with numerous "plasmacytoid" type cells. Immunohistochemistry was positive for CD138 and CD79a. In addition, a biopsy of the iliac bone marrow was requested, which revealed hypercellularity with interstitial-like infiltration of mature-appearing plasma cells. Immunophenotyping indicated 1.5% of plasma cells, of which 99% presented restriction in the expression of cytoplasmic immunoglobulins, lambda light chain; with the phenotype: CD45-/CD38+/ CD138+/CD56+/ CD19-; linkable to abnormal plasma cells. The multiple osteolytic lesions, conjointly with the data obtained by histopathology, the immunohistochemically profile and the immunophenotyping, were found to be associated to plasma cell myeloma. The patient was treated with chemotherapy, being her evolution favourable with 6 months of follow-up. Conclusions: MM is the most frequent plasma cell neoplasm, characterized by clonal proliferation of immunoglobulin-secreting plasma cells. They are usually classified into secretory or non-secretory MM, being the non-secretory with the most unfavorable prognosis. Our case agree, from the clinical view, the anatomopathological, immunohistochemical and immunophenotypic findings, with what is described in the consulted bibliography. Introducción: el meningioma es un tumor predominantemente benigno originado en las células meningoepiteliales de la aracnoides, siendo más frecuente en adultos y en mujeres. La OMS clasifica a los meningiomas en tres grados histológicos: grado I (poco agresivo y poco recidivante), grado II (mayor agresividad y recidivas) y grado III (muy agresivo y muy recidivante); los tres grados histológicos presentan patrones celulares variables. El objetivo de este trabajo es reportar un caso de meningioma de la variante atípica (grado II en clasificación de la OMS), repasar su clínica, su apariencia histopatológica y establecer su comportamiento biológico. Presentación del caso: correspondió a una mujer de 64 años con una lesión tumoral meníngea recidivada, localizada en la zona parasagital. La pieza quirúrgica midió 7,2 cm x 4,3 cm. Al corte era homogénea, de color blanquecino-grisáceo. En la microscopía se observó una proliferación de células neoplásicas meningoteliales de tamaño mediano, entre las cuales se intercalaron células de mayor tamaño con núcleos polimorfos y polilobulados que presentaron nucleolos evidentes; la disposición de las mencionadas células neoplásicas fue difusa con sectores de patrón arremolinado. La muestra presentó un bajo recuento mitótico, ausencia de necrosis, estroma edematoso y vasos periféricos con paredes gruesas. Se realizó inmunomarcación con EMA positiva y ki67 como factor de proliferación celular. La paciente fue tratada con radioterapia post-quirúrgica, y continuaba bien y sin recidivas 14 meses después. Conclusiones: el Meningioma Atípico es una neoplasia de la aracnoides, que se presenta habitualmente en mujeres adultas, localizado mayoritariamente en superficie externa del cerebro y menos frecuentemente dentro del sistema ventricular. Generalmente tiene un patrón de crecimiento macroscópico redondeado que acompaña una imagen microscópica caracterizada por más de 4 mitosis por 10 campos de gran aumento, junto con rasgos de atipia. Los meningiomas presentan un crecimiento lento que motivan al paciente a consultar por síntomas difusos o focales, como consecuencia de la compresión del cerebro; las recidivas son más frecuentes en los meningiomas grado II y III. Nuestro caso resultó concordante con la bibliografia consultada, desde el punto de vista de la clínica, los estudios anatomopatológicos y de la inmunohistoquímica. . Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021-10-01 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion https://revistas.unc.edu.ar/index.php/med/article/view/43207 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 78 No. Suplemento (2021): Suplemento JIC XXII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 78 Núm. Suplemento (2021): Suplemento JIC XXII Revista da Faculdade de Ciências Médicas de Córdoba; v. 78 n. Suplemento (2021): Suplemento JIC XXII 1853-0605 0014-6722 Derechos de autor 2021 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0