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Mediastinal Glomus Tumor: A Case Report and Literature Review.

Jang SH, Cho HD, Lee JH, Lee HJ, Jung HY, Kim KJ, Cho SS, Oh MH - J Pathol Transl Med (2015)

Bottom Line: A glomus tumor in the mediastinum is very uncommon, and only five cases have been reported in the English literature.We recently encountered a 21-year-old woman with an asymptomatic mediastinal mass that measured 5.3 × 4.0 cm.After reviewing this case and previous reports, we analyzed the clinicopathologic features associated with progression of such a tumor.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.

ABSTRACT
A glomus tumor in the mediastinum is very uncommon, and only five cases have been reported in the English literature. We recently encountered a 21-year-old woman with an asymptomatic mediastinal mass that measured 5.3 × 4.0 cm. Surgical excision was performed, and the tumor was finally diagnosed as mediastinal glomus tumor with an uncertain malignant potential. After reviewing this case and previous reports, we analyzed the clinicopathologic features associated with progression of such a tumor.

No MeSH data available.


Related in: MedlinePlus

Macroscopic finding. (A) The tumor displays a sheet-like growth pattern with increased vascularity, and some medium-sized vessels within the tumor has a staghorn appearance. (B) Edematous and myxoid changes are prominent in hypocellular areas. (C, D) Tumor cells have a well-defined cell border and pale to eosinophilic cytoplasm. The nuclei are round and concentrically located with one or two inconspicuous nucleoli. (E) Immunohistochemical staining for smooth muscle actin is positive in tumor cells. (F) CD34 immunohistochemistry is nonreactive in tumor cells.
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f2-jptm-2015-07-02: Macroscopic finding. (A) The tumor displays a sheet-like growth pattern with increased vascularity, and some medium-sized vessels within the tumor has a staghorn appearance. (B) Edematous and myxoid changes are prominent in hypocellular areas. (C, D) Tumor cells have a well-defined cell border and pale to eosinophilic cytoplasm. The nuclei are round and concentrically located with one or two inconspicuous nucleoli. (E) Immunohistochemical staining for smooth muscle actin is positive in tumor cells. (F) CD34 immunohistochemistry is nonreactive in tumor cells.

Mentions: Microscopically, the tumor was enveloped by a variable, thickened fibrous capsule with no evidence of infiltration into adjacent tissue. A solid growth pattern was evident, with prominent vascular structures composed of small- to medium-sized blood vessels. Medium-sized vessels occasionally appeared with staghorn features and myxoid changes in their walls (Fig. 2A). The tumor displayed both low and high cellular areas. The high cellular areas appeared in vague nodular configuration, and the low cellular area had edematous and myxoid change and was present between high cellular areas (Fig. 2A, B). High-powered examination revealed that the tumor was composed of round epithelioid cells, which had clear to eosinophilic cytoplasm with sharply defined borders. The centrally-located vesicular nuclei were round to polygonal, with a mild convoluted contour of nuclear membranes. One or two small inconspicuous nucleoli were noted. Nuclear pleomorphism was not identified (Fig. 2C, D). Mitotic activity was infrequent, observed in fewer than 1/50 high power fields. Atypical mitosis was not found. Lymphovascular or perineural invasion was not observed. Immunohistochemical staining for smooth muscle actin and vimentin showed diffuse and focal positivity, respectively. Tumor cells were not immunoreactive for CD34, calretinin, cytokeratin, desmin, or neuroendocrine markers, including synaptophysin and chromogranin (Fig. 2E, F). Based on the histology and immunohistochemical results, a pathologic diagnosis of glomus tumor with uncertain malignant potential was made. There was no clinicoradiologic evidence of recurrence or metastasis for seven months after surgery.


Mediastinal Glomus Tumor: A Case Report and Literature Review.

Jang SH, Cho HD, Lee JH, Lee HJ, Jung HY, Kim KJ, Cho SS, Oh MH - J Pathol Transl Med (2015)

Macroscopic finding. (A) The tumor displays a sheet-like growth pattern with increased vascularity, and some medium-sized vessels within the tumor has a staghorn appearance. (B) Edematous and myxoid changes are prominent in hypocellular areas. (C, D) Tumor cells have a well-defined cell border and pale to eosinophilic cytoplasm. The nuclei are round and concentrically located with one or two inconspicuous nucleoli. (E) Immunohistochemical staining for smooth muscle actin is positive in tumor cells. (F) CD34 immunohistochemistry is nonreactive in tumor cells.
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4696525&req=5

f2-jptm-2015-07-02: Macroscopic finding. (A) The tumor displays a sheet-like growth pattern with increased vascularity, and some medium-sized vessels within the tumor has a staghorn appearance. (B) Edematous and myxoid changes are prominent in hypocellular areas. (C, D) Tumor cells have a well-defined cell border and pale to eosinophilic cytoplasm. The nuclei are round and concentrically located with one or two inconspicuous nucleoli. (E) Immunohistochemical staining for smooth muscle actin is positive in tumor cells. (F) CD34 immunohistochemistry is nonreactive in tumor cells.
Mentions: Microscopically, the tumor was enveloped by a variable, thickened fibrous capsule with no evidence of infiltration into adjacent tissue. A solid growth pattern was evident, with prominent vascular structures composed of small- to medium-sized blood vessels. Medium-sized vessels occasionally appeared with staghorn features and myxoid changes in their walls (Fig. 2A). The tumor displayed both low and high cellular areas. The high cellular areas appeared in vague nodular configuration, and the low cellular area had edematous and myxoid change and was present between high cellular areas (Fig. 2A, B). High-powered examination revealed that the tumor was composed of round epithelioid cells, which had clear to eosinophilic cytoplasm with sharply defined borders. The centrally-located vesicular nuclei were round to polygonal, with a mild convoluted contour of nuclear membranes. One or two small inconspicuous nucleoli were noted. Nuclear pleomorphism was not identified (Fig. 2C, D). Mitotic activity was infrequent, observed in fewer than 1/50 high power fields. Atypical mitosis was not found. Lymphovascular or perineural invasion was not observed. Immunohistochemical staining for smooth muscle actin and vimentin showed diffuse and focal positivity, respectively. Tumor cells were not immunoreactive for CD34, calretinin, cytokeratin, desmin, or neuroendocrine markers, including synaptophysin and chromogranin (Fig. 2E, F). Based on the histology and immunohistochemical results, a pathologic diagnosis of glomus tumor with uncertain malignant potential was made. There was no clinicoradiologic evidence of recurrence or metastasis for seven months after surgery.

Bottom Line: A glomus tumor in the mediastinum is very uncommon, and only five cases have been reported in the English literature.We recently encountered a 21-year-old woman with an asymptomatic mediastinal mass that measured 5.3 × 4.0 cm.After reviewing this case and previous reports, we analyzed the clinicopathologic features associated with progression of such a tumor.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.

ABSTRACT
A glomus tumor in the mediastinum is very uncommon, and only five cases have been reported in the English literature. We recently encountered a 21-year-old woman with an asymptomatic mediastinal mass that measured 5.3 × 4.0 cm. Surgical excision was performed, and the tumor was finally diagnosed as mediastinal glomus tumor with an uncertain malignant potential. After reviewing this case and previous reports, we analyzed the clinicopathologic features associated with progression of such a tumor.

No MeSH data available.


Related in: MedlinePlus