Paratesticular Extramedullary Hematopoiesis in Children.

IF 3.7 3区 医学 Q2 MEDICAL LABORATORY TECHNOLOGY
Elisabetta Kuhn, Letterio Runza, Antonio Di Cesare, Umberto Gianelli
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引用次数: 0

Abstract

Context.—: Extramedullary hematopoiesis (EMH) is an uncommon occurrence, usually associated with hematologic disorders, but it rarely presents as an isolated finding.

Objective.—: To determine the frequency, immunomorphologic features, and clinicopathologic background of EMH in orchiectomies from pediatric patients.

Design.—: All orchiectomy specimens removed from children from 2008 to 2020 in our institution were retrospectively reviewed. Biopsies and neoplasias were excluded. The EMH diagnosis was rendered when hematopoietic cell precursors were present. Immunohistochemical stainings were performed to characterize the hematopoietic components.

Results.—: Seventy-nine orchiectomies from 77 children (mean age, 5 years; range, 0-17 years) were included in our study. Forty-three patients (55.8%) underwent surgery for testicular atrophy, 30 (39.0%) for torsion, and 4 (5.2%) for intersex conditions. EMH was identified in 6 of 79 orchiectomies (7.6%), all performed for testicular torsion. All patients but one were newborns, and the remaining patient was 15 years old. No patient had evidence of a hematologic disorder. All EMH foci were in a background of reactive changes with a variable extension, either in the epididymis (4 cases) or in the deferens duct (2 cases). Immunostaining confirmed an association of myeloid (myeloperoxidase+) and erythroid precursors (E-cadherin+) in all 6 cases. One case also presented rare megakaryocytes, and one showed benign TdT+ B-cell precursors.

Conclusions.—: To our knowledge, this is the first study that demonstrates EMH as a common finding in orchiectomy samples, especially from newborns. Despite the lack of pathologic potential, it is important to recognize EMH in order to avoid misdiagnosis.

儿童睾丸旁髓质外造血。
上下文。--:髓外造血(EMH)是一种罕见的疾病,通常与血液系统疾病有关,但很少作为单独的发现。目标。--:确定儿童睾丸切除术中EMH的频率、免疫形态学特征和临床病理背景。设计。--:我们对2008年至2020年在我们机构从儿童身上取出的所有睾丸切除标本进行了回顾性审查。排除了活检和肿瘤。当存在造血细胞前体时,诊断为EMH。进行免疫组织化学染色以表征造血成分。结果。--:我们的研究包括77名儿童(平均年龄5岁;范围0-17岁)的79例睾丸切除术。43名患者(55.8%)接受了睾丸萎缩手术,30名患者(39.0%)接受了扭转手术,4名患者(5.2%)接受了双性疾病手术。79例睾丸切除术中有6例(7.6%)发现EMH,均为睾丸扭转。除一名患者外,其余患者均为新生儿,其余患者为15岁。没有任何患者有血液系统疾病的证据。所有EMH病灶均在附睾(4例)或输精管(2例)发生具有可变延伸的反应性变化。免疫染色证实,在所有6例病例中,骨髓细胞(髓过氧化物酶+)和红系前体(E-钙粘蛋白+)存在关联。一例还表现出罕见的巨核细胞,一例表现出良性TdT+B细胞前体。结论。--:据我们所知,这是第一项证明EMH在睾丸切除术样本中常见的研究,尤其是在新生儿中。尽管缺乏病理潜能,但为了避免误诊,识别EMH是很重要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.20
自引率
2.20%
发文量
369
审稿时长
3-8 weeks
期刊介绍: Welcome to the website of the Archives of Pathology & Laboratory Medicine (APLM). This monthly, peer-reviewed journal of the College of American Pathologists offers global reach and highest measured readership among pathology journals. Published since 1926, ARCHIVES was voted in 2009 the only pathology journal among the top 100 most influential journals of the past 100 years by the BioMedical and Life Sciences Division of the Special Libraries Association. Online access to the full-text and PDF files of APLM articles is free.
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