11.00 – 11.30 lecture: helena barroca paediatric cytology
TRANSCRIPT
Helena Barroca
Paediatric cytology
Microbiology
Cytobloc
Cytology
Flow cytometry
Cytogenetics
ISH
PCR
Cytospin
PAS Grocott
Ziehl Neelsen Gram
Immunostains
TOPOGRAPHY
AIM
Quickness
Treatment
Tumour
Reactive
infectious
Treatment
Reactive
infectious
Ziehl Neelsen
Giemsa
“Reactive”/ Tumour
reactive granulomatous
BK? Hansen's disease?
Cat scratch disease? Sarcoidosis?
FISH
Lymphoma
MICROBIOLOGY PCR
Enlarged lymph nodes
• African boy
• 12 years Grocott
Enlarged lymph nodes
• 10 months boy
Cervical enlarged lymph nodes
• 10 months boy
Cervical enlarged lymph nodes
S100
CD68
FNB- ADVANTAGES
Quickness
Treatment
Tumoral
Reactive
infectious
massive lesion centered in the nasopharynx of 3.7 x 5.5 x 2.0 cm
New born
skeletal muscle
epithelium
glial tissue
pigmented epithelium
cystic lymphangioma?
Teratoma?
Neuroblastoma?
Esthesioneuroblastoma?
Rhabdomyosarcoma?
Teratoma
Jaw lesions
Prognoma
Ossifying fibroma
Fibromatosis colli
Male, 11 year- old nodular lesion with the mastoid process? multiple lytic lesions of the cranial calotte
CD 1 a
Langerhans cell histiocytosis
Renal tumours
WILMS Mesoblastic nephroma Rhabdoid tumour Clear cell tumour Metanephric adenoma Renal cell carcinoma
WILMS
Metanephric adenoma Papillary carinoma
Renal epithelia
WILMS
Mesoblastic nephroma Fibromatosis Clear cell sarcoma
Small round cell T Rhabdoid T
Clear cell sarcoma
Renal tumours-Differential diagnosis
Mesenchyma Blastema Epithelium
WILMS
Mesenchyma
mesoblastic nephroma
Fibromatosis
Tumour Cytogenetics
Mesoblastic nephroma
t(12;15)(p13;q25)
Renal tumours
Wilms
Epithelia
CD57 -
CD57 +
Renal tumours
BRAF mutation
Metanephric adenoma
Renal tumours Wilms
Blastema
WT1
NB WT1 -
CD56 +
NSE +
Sinaptophysin +
Ewing
t(11;22)(q24;q12))
WT1 -
CD56 +
NSE +
Sinaptophysin +
CD99 +
Fli1 +
Renal tumours WILMS
Blastema
Rhabdoid T
WT1
CK: positive (dot) Vimentin:positive(dot) INI1: negative WT1: negative Del chr 22
Clear cell sarcoma
Vimentin:positive INI1: positive WT1: negative CD56:positive t(10;17), del(14)(q24.1q31.1)
Vimentin:positive INI1: positive WT1: positive CD56:positive
Germ cell tumours TERATOMA
SEMINOMA
EMBRYONAL CARCINOMA
YOLK SAC TUMOUR
WILM´S
PLAP CD117
Germ cell tumours
SEMINOMA
Male, 17 years-old
Surgical removal of a testicle 2 years before
Several enlarged lymph nodes
Cam 5.2 -
CD30 -
CD117 +
PLAP +
OCT4 +
Seminoma
male 15 years-old
mediastinal mass and cervical lymphadenopathy
Germ cell tumours
Cam 5.2
PLAP
Imunocitoquimica:
Cam 5.2 +
Alpha fetoprotein +
PLAP +
NUT -
CD30 -
YOLK SAC TUMOR
LYMPHOMAS AND RETICULOENDOTHELIAL NEOPLASMS ICCC II National Cancer Institute 35 SEER Paediatric Monograph Constance L. Percy, Malcolm A. Smith, Martha Linet, Lynn A. Gloeckler Ries, Debra L. Friedman
Lymphomas
Non Hodgkin Lymphomas
• Burkitt L
• Lymphoblastic L
• Anaplastic Large Cell L
• Diffuse Large B cell L
• Follicular L
Hodgkin Lymphoma
CD30 CD15
Differential diagnosis with : -Primary mediastinal B-cell
lymphoma with sclerosis -Anaplastic T cell lymphoma
CD30 + CD15 + Pax5 + CD3 - CD20 - ALK -
Male, 4 years-old
Cervical adenomegaly and mediastinal mass
CD30
Hodgkin Lymphoma
Burkitt Lymphoma
Burkitt Lymphoma
Burkitt Lymphoma
FISH
Female child
13 years-old
Bo
ne m
arr
ow
sm
ea
r Burkitt L ???
Flow cytometry
CD20 –
CD79b –
CD3 –
CD5 –
CD38 –
CD138 –
CD10 –
CD11c –
Cd103 –
FMC7 –
CD56 +
…….
k/l – •Diferential diagnosis:
•PNET
•Synovial sarcoma
•Rhabdomyosarcoma
•Desmoplastic small round cell tumour
Case nº1
RMS
Immunostains
CD45: neg
CD56 NCAM: pos
Synaptophysin : pos focal
Desmin: pos
Myogenin : pos
CD99: neg
PNET
Rhabdomyosarcoma
Synovial sarcoma
PAX3 (2q35) Dual Color Break Apart probe
Dia
gno
sis
Pro
gno
sis
Final diagnosis
Rhabdomyosarcoma
Sebire et al. Applied Immunohistochemistry & Molecular Morphology 2005;13:1-5
•PNET
•Undifferentiated nasopharynx carcinoma
•Synovial sarcoma
•Rhabdomyosarcoma
•Desmoplastic small round cell tumour
•Mesenchymal chondrosarcoma
•Merkel cell carcinoma
•Non-Hodgkin lymphoma
Lymphoblastic Lymphoma
CD3
Tdt
CD34