Caso Interesante - Tuberculosis - Bulas - Biopsia
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Departamento de Patología.Dra. Marta Evelyn Echeverría M.
Biopsia BS-13-3497
Biopsia BS-13-4024
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BS-13-3497 21-8-13
Paciente Femenino 45años
Historia más de un año de tos conexpectoración, fiebre, perdida de peso 10libras. Baciloscopías de esputo negativas.
FBB: Mucosa bronquial pálida y secreciónLóbulo Inferior Izquierdo.
Impresión Diagnóstica: Sospecha de TBpulmonar.
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Macroscópico:5 muestras quevariaron entre 0.1y 0.3cms
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BS-13-4024 20-9-13
Paciente Femenino 45años
Infiltrado Miliar Bilateral Pulmonar.
Biopsia Pulmón Derecho.
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Macroscópico:Muestra fusiformeque midió 3.5 x 1.5 x0.7cms. El tejido esde color castañoclaro con áreasmarrón.
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CARCINOMA BRONQUIOLOALVEOLAR DE TIPO MUCINOSO, PULMÓN
DERECHO (BIOPSIA POR VATS)
DIAGNOSTICO
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• Carcinoma BA Mucinoso.
• Carcinoma BA No Mucinoso.
• Incidencia 1-5%
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• 50% Nódulos solitarios periféricos asintomáticos.
• Pueden ser numerosos nódulos bilaterales
• Consolidación lobar.
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CBA Mucinoso
• Células columnares altas con abundantecitoplasma lleno de mucina.
• Núcleos basales y pequeños.
• Septas delgadas.
• Inclusiones citoplásmicas.
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CBA No Mucinoso
• Células columnares a cuboidales.
• Septas pueden estar engrosadas.
• Pueden formar seudopapilas.
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INMUNOHISTOQUIMICA
• No es necesaria.• Queratina.• EMA
BAC No Mucinoso TTF1 +CK7 +
BAC Mucinoso TTF1 –CK7 +
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Diagnostico Diferencial
• Hiperplasia florida de Neumocitos tipo 2.
• Hiperplasia adenomatosa Atípica.
• Adenoma alveolar papilar.
• Hemangioma Esclerosante.
• Cistadenoma Mucinoso.
• Tumor mucinoso quístico de malignidad incierta.
• Carcinoma Mucinoso.
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