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Quiste mediastínico de origen mülleriano: importancia del estudio inmunohistoquímico
Laura Barona García
, Jose Antonio Ruiz Maciá
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Servicio de Anatomía Patológica, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Murcia, España
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Se realizó exéresis mediante cirugía torácica video-asistida (VATS) uniportal derecha. El estudio histopatológico reveló varias formaciones quísticas tapizadas por un epitelio aplanado, cúbico y cilíndrico ciliado sobre un estroma fibroso, mostrando positividad inmunohistoquímica para receptores de estrógenos (RE), receptores de progesterona (RP) y proteína del tumor de Wilms (Wt1) (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">La presencia de un quiste de origen mülleriano en mediastino posterior fue descrita por primera vez por Hattori en 2005. Su origen es aún desconocido y son lesiones infrecuentes con pocos casos descritos<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a>. Suelen ocurrir en mujeres perimenopáusicas y se ha asociado a obesidad, historia ginecológica y terapia hormonal sustitutiva. Siguen un curso benigno sin haberse descrito recurrencias. El quiste mülleriano o quiste de Hattori debe ser incluido en el diagnóstico diferencial de los quistes de mediastino posterior y para su diagnóstico es imprescindible el estudio histológico e inmunohistoquímico, ya que de lo contrario son fácilmente confundibles con quistes broncogénicos<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a>.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:1 [ "es" => array:2 [ "titulo" => "Graphical abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0010"></elsevierMultimedia></p></span>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1519 "Ancho" => 1000 "Tamanyo" => 388207 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A) Tomografía axial computarizada donde se observa una lesión quística de 2,5<span class="elsevierStyleHsp" style=""></span>cm localizada en mediastino posterior. B) Formación quística de paredes delgadas sobre un estroma fibroso revestida por epitelio monoseriado. C) Detalle del epitelio cilíndrico ciliado no estratificado que tapiza el quiste (H&E; B: ×40, C: ×400). D) El epitelio de revestimiento muestra inmunotinción positiva para WT1, receptores de progesterona (E) y receptores de estrógenos (F) (D-F: ×100).</p>" ] ] 1 => array:5 [ "identificador" => "fig0010" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 1009 "Ancho" => 1333 "Tamanyo" => 205250 ] ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ciliated cyst of probable mullerian origin arising in the posterior mediastinum" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Hattori" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Virchows Arch." "fecha" => "2005" "volumen" => "446" "paginaInicial" => "82" "paginaFinal" => "84" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cysts of the posterior mediastinum showing mullerian differentiation (Hattori's cysts)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "V. Thomas-de-Montpréville" 1 => "E. Dulmet" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann Diagn Pathol." "fecha" => "2007" "volumen" => "6" "paginaInicial" => "417" "paginaFinal" => "420" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000005700000012/v2_202112040821/S0300289620301083/v2_202112040821/es/main.assets" "Apartado" => array:4 [ "identificador" => "21422" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Clinical Images / Imágenes clínicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005700000012/v2_202112040821/S0300289620301083/v2_202112040821/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289620301083?idApp=UINPBA00003Z" ]
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