Metastatic poorlydifferentiatedadenocarcinoma of the sternum unsolved diagnosticallyby immunohistochemicalstaining:a case repo

• Main Author: Perpustakaan UGM, i-lib
• Format: Article NonPeerReviewed
• Published: [Yogyakarta] : Universitas Gadjah Mada 2010
• Subjects: Jurnal i-lib UGM
• Online Access: https://repository.ugm.ac.id/28123/; http://i-lib.ugm.ac.id/jurnal/download.php?dataId=11186
• Institution: Universitas Gadjah Mada

ABSTRACT A 42 year-old male admitted to Dr. Sardjito Hospital, Yogyakarta because of a painful sternal mass that was becoming larger since 6 months before hospitalized. He was diagnosed as malignant thymoma based on microscopic examination of specimen obtained from FNAB. Histological examination from biopsy specimen showed a tumor, composed of epithelial cells and arranged in nests, solid, partly tubular and glandular structures considered thymic carcinoma with differential diagnosis a poorly differentiated adenocarcinoma. PAS staining was positive and PASdiastase was negative, considered that the cytoplasm contained glycogen. The tumor cells showed expression of polykeratin (CAM5.2, TTF1, and CD10). Neurogenic and neuroendocrine markers (5100, CD56, CD57). mesothelial markers (calretinin,EMA),and mesenchymal markers (vimentin, CD6,S,desmin, SMA) are negative. The impression was metastatic adenocarcinoma. In case of metastatic one could consider a metastasis of a lung adenocarcinoma or thyroid carcinoma (TTF1+, but CD10 expression did not fit) and renal cell carcinoma (CD10 +, but TTF1 did not fit). The final considered diagnosis was poorly differentiated adenocarcinoma, metastasis from the lung, thyroid, or kidney. The aim of this presented article is to report a difficultcase of metastatic poorly differentiated adenocarcinoma of the sternum in which immunohistochemical staining could not solve the morphological diagnostic problems, to emphasize the importance of clinicalinformation and good morphologicevaluation to determine the diagnosis.