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Table of Contents   
LETTER TO THE EDITOR  
Year : 2017  |  Volume : 10  |  Issue : 1  |  Page : 261-263
Myopericytom


Department of Pathology, SRTR Government Medical College, Ambajogai, Maharashtra, India

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Date of Web Publication5-May-2017
 

How to cite this article:
Swami SY, Gupta H, D'Costa G. Myopericytom. Ann Trop Med Public Health 2017;10:261-3

How to cite this URL:
Swami SY, Gupta H, D'Costa G. Myopericytom. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Sep 17];10:261-3. Available from: http://www.atmph.org/text.asp?2017/10/1/261/205556
Sir/Madam,

The term “myopericytoma” (MPC) was endorsed by the World Health Organisation (WHO) in 2002.[1] MPC presents as a benign, slow-growing nodule, and may occasionally be painful.[2] There is a predilection for lesions to involve the distal extremities; however, tumors can, in addition, arise at other sites, including the proximal extremities and the neck.[1],[3]


   Case Report Top


An 80-year-old female, presented with a painful swelling over the left palm since 1.5 years. There was no history of trauma. On gross examination, a single tiny tissue bit was received of size 0.5 cm × 0.5 cm × 0.5 cm, firm in consistency, and greyish-white in colour. Histopathology [Figure 1] and [Figure 2] revealed well-circumscribed tumor tissue composed of plenty of vascular channels lined by concentrically arranged myoid cells that blend with the surrounding stroma as well. Stroma was scanty with sparse chronic inflammatory cells.
Figure 1: Well-circumscribed tumor tissue composed of plenty of vascular channels [H and E; 10×]

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Figure 2: Vascular channels are lined by concentrically arranged myoid cells that also blend with surrounding stroma containing sparse lymphocytes [H and E; 40×]

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Immunoprofile showed actin positivity [Figure 3], focal CD34 positivity [Figure 4], and desmin negativity [Figure 5] in the tumor tissue.
Figure 3: IHC: Diffuse Actin positivity

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Figure 4: IHC: Focal CD34 positivity

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Figure 5: IHC: Desmin negativity

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After correlating the immunohistochemical pattern with the histopathologic features of the lesion, a final diagnosis of MPC was established.


   Discussion Top


MPCs are unusual groups of superficial lesions with prominent vessels surrounded by concentrically arranged myoid cells that blend with similar stromal cells. These lesions appear to be the hybrid between hemangiopericytomas (HPC) and angiomyomas (AM), but unlike HPC, they express both actin and desmin.[4] AM usually lacks the characteristic perivascular growth of neoplastic cells typically seen in MPC. Immunohistochemically, most tumor cells of AM and MPC are positive for smooth muscle actin (SMA). Desmin is diffusely positive in AM, whereas most MPCs are negative for desmin.[1],[3],[5]

Application of strict morphological criteria and appropriately selective immunohistochemical markers will help in distinguishing MPC from its mimics.

Immunohistochemically, the tumour cells express positive reactivity for alpha-SMA (α-SMA),[5] muscle-specific actin,[5],[6] and vimentin,[7] and are negative for desmin [5] and CD34.[7]

MPCs are almost always benign. Most do not recur following excision; those that do are likely to be poorly marginated. Rare examples of malignant MPC have been reported.[3],[8]

It is possible that cytogenetic and/or molecular genetic studies may suggest methods for classifying these types of lesions in the future.[5]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
McMenamin ME. Myopericytoma. In: Fletcher CD, Unni KK, Mertens F, editors. WHO Classification of Tumors: Tumors of Soft Tissue and Bone. Lyon, France: IARC Press; 2002.  Back to cited text no. 1
    
2.
Numata I, Nakagawa S, Hasegawa S, Aiba S. A myopericytoma of the nose. Acta Derm Venereol 2010;90:192-3.  Back to cited text no. 2
[PUBMED]    
3.
Mentzel T, Dei Tos AP, Sapi Z, Kutzner H. Myopericytoma of skin and soft tissues: Clinicopathologic and immunohistochemical study of 54 cases. Am J Surg Pathol 2006;30:104-13.  Back to cited text no. 3
[PUBMED]    
4.
Enzinger and Weiss's. Perivascular tumors. In: Schmitt W, editor. Soft Tissue Tumors. 4th ed. St Louis: Missouri Mosby; 2001. p. 1019.  Back to cited text no. 4
    
5.
Matsuyama A, Hisaoka M, Hashimoto H. Angioleiomyoma: A clinicopathologic and immunohistochemical reappraisal with special reference to the correlation with myopericytoma. Hum Pathol 2007;38:645-51.  Back to cited text no. 5
[PUBMED]    
6.
Sadahira C, Yoneda K, Moriue T, Takai I, Kushida Y, Haba R, et al. Periungual myopericytoma. J Am Acad Dermatol 2006;54:1107-8.  Back to cited text no. 6
[PUBMED]    
7.
Dray MS, McCarthy SW, Palmer AA, Bonar SF, Stalley PD, Marjoniemi V, et al. Myopericytoma: A unifying term for a spectrum of tumors that show overlapping features with myofibroma. A review of 14 cases. J Clin Pathol 2006;59:67-73.  Back to cited text no. 7
[PUBMED]    
8.
McMenamin ME, Fletcher CD. Malignant myopericytoma: Expanding the spectrum of tumours with myopericytic differentiation. Histopathology 2002;41:450-60.  Back to cited text no. 8
[PUBMED]    

Top
Correspondence Address:
Dr. Sunil Y Swami
Bhagwanbaba Chowk, Gitta - Road, Shepwadi. Taluka: Ambajogai, Beed, Ambajogai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.205556

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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]



 

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