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FeocromocitomaDr. Luis Humberto Cruz ContrerasResidente de anatomía patológicatomatetumedicina.wordpress.com
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Epidemiología
•T Raro
•1 por 100 000 hab
•Cualquier edad
•Pico en 5ª década
•10% en niños
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•Esporádicos
•Asociados a
▫MEN 2 (A yB)
▫Neurofibromatosis 1
▫Sx Von Hippel Lindau
▫Sx Familiares
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Clínica
• Resultado de Producción de catecolaminas
• Hipertensión episódica / Intermitente
• Ansiedad
• Taquicardia
• Palpitaciones
• Temblor
• Pérdida de peso
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Laboratorio
•Catecolaminas
•Metanefrinas
•Ac. Vanililmandélico
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Otros
•TAC
•RM
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Macro
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Gross appearance of adrenal pheochromocytoma. The tumor shown in A has a markedly variegated appearance. The lower half of the specimen shown in B was fixed in Zenker fluid and has acquired the typical dark brown color indicative of a positive chromaffin reaction.
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Gross appearance of adrenal pheochromocytoma. The tumor shown in A has a markedly variegated appearance. The lower half of the specimen shown in B was fixed in Zenker fluid and has acquired the typical dark brown color indicative of a positive chromaffin reaction
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•Generalmente > a 1 cm
•Promedio 4 cm
•Peso 90 gr
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Clínica
•10% Son malignos
•Sobrevida a 5 años …. 50%
•Sitios más comunes de METS
▫Ganglios, Hueso, Pulmones
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Patrones histopatológicos
•Nidos
•Trabecular•Solido
•Cél. Ahusadas
•Células pequeñas
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Histopatología
•Abudante citoplasma
•Finamente granular
•Eosinófilo, Basofílico, Anfofílico
•NO presentan cápsula
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•Cuerpo hialinos citoplásmicos
•Vacuolas
•Inclusiones nucleares
•Núcleo blando a pleomórfico
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Adrenal pheochromocytoma. A shows the typical “Zellballen” configuration, whereas B makes evident the abundant granular amphophilic cytoplasm of the tumor cells
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Adrenal pheochromocytoma. A shows the typical “Zellballen” configuration, whereas B makes evident the abundant granular amphophilic cytoplasm of the tumor cells
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Feocromocitoma Maligno
METS a ganglios y a distancia
NO hay criterios histológicos / clínicos claros
Necrosis e invasión vascular
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IHQ
Cromogranina
Sinaptofisina
NSE (Enolasa Neuronal
específica)
Neurofilamentos
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Diferencial
Neoplasias
adrenocorticales
Macro: Amarillo-naranja
Metástasi
s
IQH CK, PS 100