11.00 – 11.30 Lecture: Helena Barroca Paediatric cytology

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