The PI3K/AKT-mTOR pathway may also play a role in these tumors, with increased PI3K/AKT being reported in PA, particularly those with anaplasia
Izquierda: el corte histologico muestra la anaplasia
celular marcada y mitosis atipicas presentes.
Microscopic examination of tumor mass revealed high degree of cellular anaplasia
, pleomorphism and varying degree of mitotic activity, spindle to stellate shaped cells with elongated plumpy nuclei arranged in form of interlacing bundles (Fig.
Hematoxylin and eosin stains showed nests of cells with eosinophilic cytoplasm separated by a hyalinized stroma, with no evidence of anaplasia
or invasion, consistent with a Paraganglioma.
Anisocytosis and anisokaryosis were moderate, while pleomorphism and anaplasia
 Large tumor size, high cellularity, anaplasia
, high Ki-67 expression, and high mitotic activity seem to be associated with adverse outcomes.
Ha marcada e universal hiperplasia e anaplasia
Pathological examination revealed generally low to moderate cellularity, low mitotic index of 1/50 high-power fields (HPF), low nuclear anaplasia
and absence of necrosis.
The most commonly used systems are based on the degree of anaplasia
of the tumor cells.
Features suggestive of malignancy include a tumor diameter greater than 5 cm, necrosis, hemorrhage, cellular anaplasia
, and a high mitotic rate ([greater than or equal to] 4/10 hpf).
(27) Cellular anaplasia
, loss of polarity, discohesion, nuclear enlargement, hyperchromasia, pleomorphism and atypical mitoses are the histopathological hallmarks of CIS.