Role of selective intra-arterial embolization in benign liver tumors. / Papel de la embolización selectiva intraarterial en los tumores hepáticos benignos.

OBJECTIVE: To present cases of symptomatic benign liver tumors diagnosed and treated with intra-arterial embolization before surgery. MATERIAL AND METHODS: We present the cases of 7 patients diagnosed with symptomatic benign liver tumors that required treatment: 1 focal nodular hyperplasia, 2 giant cavernous hemangiomas, 1 hepatic adenomatosis, and 3 hepatic adenomas. Once the feeding arteries were identified, tumors were embolized with polyvinyl alcohol particles (500µm-700µm) and then the feeding artery was plugged with coils if there was an arterial pedicle to ensure the total vascular exclusion of the tumor. The surgical intervention took place 4 to 7 days after embolization. RESULTS: All 7 patients were women (age range, 23-74 years); presurgical intra-arterial embolization was done in 6. In 1 patient with adenomatosis, embolization was done to control intraparenchymal hepatic hemorrhage. In the 6 patients who underwent surgery, the tumor was completely excised and no intraoperative bleeding events or postoperative complications occurred. CONCLUSIONS: Provided there is a consensus among the multidisciplinary team, embolization is a useful option in the perioperative management of giant and/or symptomatic benign liver tumors.

[Herpes simplex 1 virus Mollaret meningitis]. / Meningitis de Mollaret por virus herpes simple 1.

Mollaret meningitis is a rare disease characterized by recurrent and self-limited episodes of aseptic meningitis. It is considered a disease with benign etiology and it has been related to viral infections: Epstein-Barr virus and herpes simplex virus (HSV), type 2 most frequently. Herpes simplex 1 virus has been rarely isolated in the cerebrospinal fluid in patients with Mollaret meningitis; to this end culture, expansion with PCR, and inmunoblot has been utilized. In this article a case of Mollaret meningitis related to type 1 HSV is described. The interest is the demonstration of the herpes simplex virus type 1 within the cytoplasm of the Mollaret cells with a immunohistochemical technique (ABC-peroxidase method) using monoclonal antibodies anti HSV-1 in order to support the diagnosis, being this the first case described in the literature.

[Study of cathepsin D levels in invasive bladder cancer and its stroma. Correlation with tumor stage, cytological grade, lymph node metastasis and survival]. / Estudio de los niveles de catepsina D en el tumor vesical infiltrante y en su estroma, y de su correlación con el estadio tumoral, grado citológico, afectación ganglionar y supervivencia.

OBJECTIVE: The aim of this study was to evaluate cathepsin D as a prognostic marker in invasive bladder cancer and to determine its relationship with stage, grade, lymph-node metastasis and survival too. MATERIAL AND METHODS: An immunohistochemical staining of 32 radical cystectomy specimens suffering from transitional cell carcinoma was performed, using a monoclonal antibody anti-cathepsin D (Novocastra). We made a semicuantitative measurement of the cathepsin D expression in the tumor and in the peritumoral stroma in a 400 x microscopic high power field. Patient population was composed of 31 men and 1 woman with a mean age of 63.25 years. The mean follow up was 23.6 months. Stage was classified with the WHO 1997 classification. Grade was classified with the ISUP/WHO 1998 classification. For the statistical analysis the Chi-square test, Pearson's test R, the Kaplan Meier method and the log-rank test were used. RESULTS: The pathological stages of the surgical specimens were as follows: pTo:3.1% (1), pT1:12.5% (4), pT2:15.6% (5), pT3:34.4% (11). (p < 0.001) A high cytologic grade was found in 81.25% of the tumors. There was a 43.8% progression rate and 40.6% mortality. There was no statistically significant relationship among Cathepsin's D levels in the stroma and lymph node metastases, stage, or grade (p = 0.473, p = 0.604, p = 0.2423). There was no statistically significant relationship among Cathepsin's D levels in the tumor and lymph node metastases, stage or grade (p = 0.496, p = 0.722 and p = 0.461). The cathepsin D levels, neither in the stroma nor in the tumor, showed no influence neither on the disease free intervals nor in the survival rates (p = 0.785; p = 0.355 and p = 0.614; p = 0.601 respectively). CONCLUSIONS: Immunohistochemical Cathepsin D levels do not seem to play a role in the prognostic of transitional tumors of the urinary bladder.

[Primary neural leprosy. Report of a case]. / Lepra neural primaria. A propósito de un caso.

We present the clinical manifestations and morphological characteristics in a case from a patient with familial history of leprosy that presented peripheral neuropathy without cutaneous lesions. The nerves affected showed a loss of myelinated and unmyelinated fibers as well as chronic inflammatory infiltrate. The presence of Hansen's bacillus was demonstrated in macrophages, Schwann cells, endothelial cells, and fibroblasts at light and ultrastructural levels. In this case, the demonstration of the bacillus in the biopsy of peripheral nerve confirmed the diagnosis.

[Prune belly syndrome. Necropsy study of 2 cases]. / Síndrome de Prune Belly. Estudio necrópsico de dos casos.

The authors report two cases of Prune Belly syndrome (female and male newborn) with urethral obstruction and other associated malformations: imperforate anus, vaginal septae and bicornuate uterus in the female case; unilateral anorchia and hyaline membrane disease in the male. These findings support the mechanical pathogenic theory. In the cytogenetic studies no chromosomal abnormalities were detected. Both karyotypes were normal.

[Angiodysplasia of the colon and Crohn's disease. A study with vascular resin casts]. / Angiodisplasia de colon y enfermedad de Crohn. Estudio con moldes vasculares de resina.

All the previous studies which have associated arteriovenous malformations of the colon with chronic inflammatory disease have always been performed on a diseased intestine. This study, which uses the intravascular injection of resin, shows morphological evidence that angiodysplasia of the colon and intestinal inflammatory disease can coexist independently. This fact suggests that in cases of severe hemorrhage in a patient with inflammatory disease of the small intestine, it cannot simply be assumed that it originates in the macroscopically abnormal intestine, and that angiographic examination is a wise measure to rule out the possibility of arteriovenous malformations in the "normal" intestine.