RESUMEN
Actinomycosis is an uncommon bacterial disease caused by actinomyces. Cervicofacial infection accounts for more than 60% of all cases. However, nasal and paranasal sinus involvement has rarely been described. We report herein a case of a patient presenting with middle turbinate actinomycosis.
RESUMEN
The identification of the mutations that drive lung cancer have furnished new targets for the treatment of non-small cell lung cancer (NSCLC) and led to the development of targeted therapies such as tyrosine kinase inhibitors that are used to combat the molecular changes promoting cancer progression. Furthermore, biomarkers identified from gene analysis can be used to detect early lung cancer, determine patient prognosis, and monitor response to therapy. In the present study we analyzed the molecular profile of seventy-three Tunisian patients with lung adenocarcinoma (LAD). Mutational analyses for EGFR and KRAS were performed using direct sequencing, immunohistochemistry or MassARRAY. Anaplastic lymphoma kinase (ALK) rearrangement was evaluated by immunohistochemistry using the D5F3 clone, and p53 expression was also assessed. The median age of patients at diagnosis was 61 years (range 23-82 years). Using different methodologies, EGFR mutations were found in 5.47% of patients and only exon 19 deletions "E746-A750 del" were detected. KRAS mutations were present in 9.58% of cases, while only one patient was ALK-positive. Moreover, abnormal immunostaining of p53 was detected in 56.16% of patients. In conclusion, the detected rates of EGFR and KRAS mutation and ALK rearrangement were lower than those found in European and Asian countries, whereas, abnormal p53 expression was slightly more frequent. Furthermore, given the small sample size of this study, a more comprehensive analysis of this patient set is warranted.
Asunto(s)
Adenocarcinoma del Pulmón/genética , Variación Genética , Adenocarcinoma del Pulmón/patología , Anciano , Quinasa de Linfoma Anaplásico/genética , Receptores ErbB/genética , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mutación/genética , Proteínas Proto-Oncogénicas p21(ras)/genética , Fumar/efectos adversos , Proteína p53 Supresora de Tumor/genética , TúnezRESUMEN
Infiltrating ductal carcinoma (IDC) of the breast is a result of genetic alterations that affect the regulation of the cell cycle check-point and apoptosis. The aim of the present study was analysis using immunohistochemical localization of mouse double minute-2 (mdm2), p16INK4a, p53, bax and bcl-2 markers in Tunisian patients with breast IDC and to determine if there was correlation with the major clinico-pathological parameters and with survival of patients. We showed that the expression of p53, p16INK4a, mdm2, bcl-2, and bax was observed in 46.3%, 20.7%, 38%, 50% and 11.9% of cases, respectively. Statistical analysis revealed that positive expression of mdm2 was associated with larger tumors (P=0.013), whereas bax positivity was more prevalent in younger patients and in tumors of smaller size (P=0.008 and P=0.012 respectively). Furthermore, the expression of p16INK4a correlated with advanced grade (P<0.0001), triple negative tumors (ER-/PR-/HER2-, P=0.001) and mdm2 expression (P=0.017). The absence of nuclear p53 accumulation was predictive of good prognosis as well as when it was associated with negative expression of p16INK4a. Our findings suggest that among the biomarkers tested, p16INK4a might have a useful clinical and prognostic significance in infiltrating ductal carcinoma of the breast.
Asunto(s)
Biomarcadores de Tumor/metabolismo , Neoplasias de la Mama/diagnóstico , Carcinoma Ductal de Mama/diagnóstico , Inhibidor p16 de la Quinasa Dependiente de Ciclina/metabolismo , Proteína p53 Supresora de Tumor/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/mortalidad , Carcinoma Ductal de Mama/metabolismo , Carcinoma Ductal de Mama/mortalidad , Femenino , Humanos , Estimación de Kaplan-Meier , Persona de Mediana Edad , Análisis Multivariante , Pronóstico , Modelos de Riesgos Proporcionales , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , Proteínas Proto-Oncogénicas c-mdm2/metabolismo , Receptores de Estrógenos/metabolismo , Receptores de Progesterona/metabolismo , Túnez , Proteína X Asociada a bcl-2/metabolismoRESUMEN
BACKGROUND: Ewing's sarcoma (ES) is a rare tumour accounting for 10% of primary malignant bone tumours in children and 3% of all childhood malignancies. ES belongs to a group of small round cell tumours. AIM: In this review, we will describe the main clinicopathological features of this rare tumour and discuss its prognosis. METHODS: We report a retrospective study of 29 cases of ES, of which 4 were extraosseous, diagnosed over a period 11 years (January 1989 - December 1999). Clinicopathological data were described. Hematoxylin-eosin staining and immunohistochemical study were reviewed. RESULTS: 12 patients were male and 17 were female (ratio: 0,8) with a median age of 16 years. 62,5% of tumours were located in flat bone and 33,3% in long bone. The medium size of the tumor was 10,6 cm (range:3-25cm). 27,5% of patients presented with metastatic disease at time of diagnosis. Microscopically, tumour tissue was composed of round, small, blue cells with fine granular chromatin. Tumour cells strongly coexpressed CD99 and vimentin (100%). Systemic treatment consisted of adjuvant chemotherapy (84,2%). Local control was based on and surgery (57,9%) or radiation therapy (36,8%). A good response to chemotherapy was obtained in 37.5%; 13,7% of patients were alive without disease (medium follow up: 169 mois); 34,5% of patients developed metastases (medium follow up : 23 months) and 10,3% developed recurrences (medium follow up :13 months). CONCLUSION: Our study emphasizes two points : the great size of the tumor and the frequent location in flat bone which may explain the poor prognosis of Ewing sarcoma in our series despite the multidisciplinary treatment.
Asunto(s)
Neoplasias Óseas/patología , Sarcoma de Ewing/patología , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Neoplasias Pulmonares/secundario , Masculino , Estudios Retrospectivos , Adulto JovenRESUMEN
INTRODUCTION: Epigenetic gene silencing is one of the major causes of inactivation of tumor-suppressor genes in many human cancers. MATERIALS AND METHODS: The aim of the present study was to determine the methylation status of the promoter region CpG islands of four cancer-related genes RASSF1A, RARbeta2, CDH1, and p16 ( INK4a ) in 78 breast cancer specimens and to evaluate whether the methylation status is associated with estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu) together with the major clinico-pathological parameters. RESULTS: We showed that the methylation frequencies ranged from 19.6% (p16 ( INK4a )) to 87% (RASSF1A) in primary breast tumors of Tunisian patients. Aberrant methylation of RARbeta2 was observed in 66.6% of cases and associated with age at diagnosis (P = 0.043), while CDH1 was methylated in 47.4% of tumors and was correlated with tumor size (P = 0.013). RASSF1A presented the highest percentage of methylation (87%) and was strongly associated with poor survival (P = 0.014), with age (P = 0.048), and tumor stage (P = 0.033). Loss of ER and PR was strongly associated with GIII tumors (P = 0.000 and 0.037 respectively) while HER2/neu was associated with lymph node involvement (P = 0.026) and 5-year survival rate (P = 0.028). CONCLUSIONS: Our preliminary findings suggested that aberrant methylation of RASSF1A and RARbeta2 occurs frequently in Tunisian breast cancer patients compared with others. Furthermore, RASSF1A hypermethylation could be used as a potential marker of poor prognosis.
Asunto(s)
Biomarcadores de Tumor/genética , Neoplasias de la Mama/genética , Neoplasias de la Mama/mortalidad , Metilación de ADN , Receptores de Ácido Retinoico/genética , Proteínas Supresoras de Tumor/genética , Adulto , Anciano , Antígenos CD , Biomarcadores de Tumor/metabolismo , Neoplasias de la Mama/metabolismo , Cadherinas/genética , Carcinoma Ductal de Mama/genética , Carcinoma Ductal de Mama/mortalidad , Islas de CpG/genética , Inhibidor p16 de la Quinasa Dependiente de Ciclina/genética , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Inmunohistoquímica , Persona de Mediana Edad , Estadificación de Neoplasias , Reacción en Cadena de la Polimerasa , Receptor ErbB-2/metabolismo , Receptores de Estrógenos/metabolismo , Receptores de Progesterona/metabolismo , Análisis de Supervivencia , Túnez/epidemiologíaRESUMEN
Wegener's granulomatosis (WG) is a disease of unknown etiology characterized by necrotizing granulomatous vascularitis. The upper and lower respiratory tract and kidney involvements are very common; however, its presentation as bilateral renal masses is unusual. We report a case of a 59-year-old female patient who presented with multiple bilateral renal masses. The patient presented with sinusal and ocular symptoms suggestive of WG, and positive antineutrophil cytoplasmic antibodies (c-ANCA) with an anti-PR3 pattern. Histopathologic examination of the renal biopsy specimen revealed granulomatous inflammation with vasculitis and fibrinoid necrosis. The patient management, including prednisone and cyclophosphamid, induced a marked improvement of the renal masses. This case illustrates that WG should be considered in the differential diagnosis of renal masses.
Asunto(s)
Anticuerpos Anticitoplasma de Neutrófilos , Granulomatosis con Poliangitis/diagnóstico , Granulomatosis con Poliangitis/patología , Riñón/patología , Vasculitis/patología , Biopsia , Carcinoma de Células Renales/diagnóstico , Carcinoma de Células Renales/patología , Diagnóstico Diferencial , Ojo/patología , Femenino , Humanos , Riñón/diagnóstico por imagen , Riñón/cirugía , Persona de Mediana Edad , Necrosis/patología , RadiografíaRESUMEN
Cyclooxygenase 2 (COX-2) an inducible form of COX is frequently up-regulated in many human tumours. The expression of COX-2 in nasopharyngeal carcinoma (NPC) and its relationship to clinicopathological features were studied in Tunisian patients. COX-2 mRNA was detected in 91% of tumour tissues. Immunohistochemical analysis showed that COX-2 protein was strongly detected in tumour cells and the staining was mainly cytoplasmic. In contrast, COX-2 mRNA and protein were very low or undetectable in normal nasopharyngeal mucosa. Our result showed a significant association of COX-2 overexpression with the lymph node involvement, however, no correlation was observed with age, tumour stage, histological type and distant metastasis. Moreover, we showed that all tumour specimens co-overexpressed COX-2 and the EBV oncoprotein LMP1 corroborating the fact that LPM1 is known to induce COX-2. Altogether, our data suggests that the COX-2 is overexpressed in NPC biopsies and that is linked to the lymph node involvement.
Asunto(s)
Carcinoma de Células Escamosas/metabolismo , Ciclooxigenasa 2/metabolismo , Péptidos y Proteínas de Señalización Intracelular/metabolismo , Neoplasias Nasofaríngeas/metabolismo , Proteínas de Neoplasias/metabolismo , Proteínas Adaptadoras Transductoras de Señales , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Proteínas del Citoesqueleto , Femenino , Humanos , Proteínas con Dominio LIM , Metástasis Linfática , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , ARN Mensajero/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Regulación hacia Arriba , Adulto JovenRESUMEN
BACKGROUND: The prevalence of diabetic patients with endstage renal disease is increased overall the word. Renal biopsy is sometimes necessary to precise the type of renal damage. AIM: To precise the type and the frequency of non diabetic nephropathy in diabetic patients. METHODS: We enrolled retrospectively during 17 years, 72 diabetic patients who had a renal biopsy. RESULTS: A non diabetic nephropathy was found in 69.5 % of them. Its presence was correlate to the presence of hematuria and the absence of diabetic retinopathy. We can successfully treated nine patients with minimal-change nephrotic syndrome and one patient with crescentic glomerulonephritis. CONCLUSION: Renal biopsy must be done in diabetic patient with hematuria or in the absence of diabetic retinopathy.
Asunto(s)
Diabetes Mellitus/epidemiología , Nefropatías Diabéticas/diagnóstico , Riñón/patología , Insuficiencia Renal/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Biopsia con Aguja Fina , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Musculoskeletal symptoms are not infrequent in leprosy and, when inaugural, may be difficult to differentiate from other conditions, most notably rheumatoid arthritis. We report the case of a 24 year-old man with a 5 year history of intermittent inflammatory arthritis and fever. Physical findings and radiographs were normal initially. Several years later, he had severe wasting of the hand muscles, stocking-glove sensory loss, burn scars on the hands, and plantar ulcers. Electrophysiological test results indicated sensory-motor neuropathy with predominant demyelination. Laboratory tests showed inflammation without immunological abnormalities. A prominent endoneurial inflammatory infiltrate composed of mononuclear cells was seen on a nerve biopsy specimen, suggesting leprosy. A family study then revealed that the patient's aunt had been diagnosed with leprosy. Dapsone, clofazimine, and rifampin were given. The joint manifestations and laboratory tests for inflammation improved. However, no changes were noted in the neurological symptoms.
Asunto(s)
Artritis/diagnóstico , Artritis/patología , Lepra Dimorfa/diagnóstico , Lepra Dimorfa/patología , Adulto , Artritis/etiología , Enfermedad Crónica , Clofazimina/uso terapéutico , Dapsona/uso terapéutico , Diagnóstico Diferencial , Quimioterapia Combinada , Electrofisiología , Humanos , Leprostáticos/uso terapéutico , Lepra Dimorfa/complicaciones , Lepra Dimorfa/fisiopatología , Masculino , Sistema Musculoesquelético/fisiopatología , Neuronas/patología , Neuronas/fisiología , Radiografía , Rifampin/uso terapéutico , Dedos del Pie/diagnóstico por imagenRESUMEN
Nasopharyngeal carcinoma (NPC) occurs with a striking geographic distribution, it is endemic in certain areas of Southeast Asia and North Africa. NPC is tightly linked to Epstein-Barr virus (EBV), however, only a small subset of EBV genes are expressed, among them the latent membrane protein 1 (LMP1). LMP1 is considered as the main EBV oncoprotein and its 30 bp deleted-variant has been reported to be more prevalent in biopsies of NPC. We have assessed the 30 bp deletion and the XhoI polymorphisms of the BNLF1 gene in 30 peripheral bloods of NPC patients and 62 nasopharyngeal biopsies, 42 being confirmed as undifferentiated nasopharyngeal carcinoma and 20 are normal nasopharyngeal epithelium cells. Our results show that 100% of individuals retained the XhoI restriction site. A rare NPC variant, having a 69 bp deletion in the C-terminus region of the BNLF1 gene, covering the 30 bp deletion, was found in two NPC biopsies. The deleted 30 and 69 bp deleted-variants are significantly (p = 0.006) more frequent in NPC (71.42%) than in control biopsies (52%). In peripheral blood of NPC patients, the deleted-variants (47%) are also lower than in tumor tissues (p = 0.0004), suggesting that the deletion could be associated with a risk of tumor genesis. Direct repeats, located at the extremities of the 30 and 69 bp deletions, should be involved in this process. We propose that other deletions could be found since another similar direct repeat is present at the vicinity of the former ones.
Asunto(s)
Carcinoma/virología , Eliminación de Gen , Neoplasias Nasofaríngeas/virología , Proteínas Oncogénicas Virales/genética , Recombinación Genética , Proteínas de la Matriz Viral/genética , Adolescente , Adulto , Anciano , Secuencia de Aminoácidos , Biopsia , Carcinoma/inmunología , Carcinoma/patología , Niño , Humanos , Linfocitos/virología , Persona de Mediana Edad , Datos de Secuencia Molecular , Neoplasias Nasofaríngeas/inmunología , Neoplasias Nasofaríngeas/patología , Nasofaringe/patología , Mapeo Restrictivo , Alineación de Secuencia , TúnezRESUMEN
BACKGROUND: Undifferentiated nasopharyngeal carcinomas are rare in a majority of countries but they occur at a high incidence in South China and to a lesser extent in North Africa. They are constantly associated with the Epstein-Barr virus (EBV) regardless of patient geographic origin. In North Africa, the distribution of NPC cases according to patient age is bi-modal with a large group of patients being around 50 years old (80%) and a smaller group below 25 years old. We and others have previously shown that the juvenile form of NPC has distinct biological characteristics including a low amount of p53 and Bcl2 in the tumor tissue and a low level of anti-EBV IgG and IgA in the peripheral blood. RESULTS: To get more insight on potential oncogenic mechanisms specific of these two forms, LMP1 abundance was assessed in 82 NPC patients of both groups, using immuno-histochemistry and semi-quantitative evaluation of tissue staining. Serum levels of anti-EBV antibodies were simultaneously assessed. For LMP1 staining, we used the S12 antibody which has proven to be more sensitive than the common anti-LMP1 CS1-4 for analysis of tissue sections. In all NPC biopsies, at least a small fraction of cells was positively stained by S12. LMP1 abundance was strongly correlated to patient age, with higher amounts of the viral protein detected in specimens of the juvenile form. In contrast, LMP1 abundance was not correlated to the presence of lymph node or visceral metastases, nor to the risk of metastatic recurrence. It was also independent of the level of circulating anti-EBV antibodies. CONCLUSION: The high amount of LMP1 recorded in tumors from young patients confirms that the juvenile form of NPC has specific features regarding not only cellular but also viral gene expression.
Asunto(s)
Envejecimiento/metabolismo , Neoplasias Nasofaríngeas/patología , Neoplasias Nasofaríngeas/virología , Metástasis de la Neoplasia , Proteínas de la Matriz Viral/metabolismo , Adolescente , Adulto , África del Norte/epidemiología , Anciano , Niño , Femenino , Regulación Viral de la Expresión Génica , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Nasofaríngeas/epidemiología , Proteínas de la Matriz Viral/genética , Proteínas de la Matriz Viral/aislamiento & purificaciónRESUMEN
Localised pulmonary amyloïdosis is exceptional. Tracheobronchial symptoms are the most frequent. We report a case of a 68 year-old man complaining of cough and breathlessness. Bronchoscopy showed a submucosal infiltration with stenosis of left upper and lower bronchi. Multiples biopsy were performed and concluded to amyloïdosis of AL type. Our objective is to describe the anatomopathologic aspects of localised pulmonary amyloïdosis and to discuss its pathogeny.
Asunto(s)
Amiloidosis/patología , Enfermedades Bronquiales/patología , Anciano , Humanos , MasculinoRESUMEN
Nasopharyngeal carcinomas (NPCs) are consistently associated with the Epstein-Barr virus (EBV). As Bcl-2 and Bcl-X are co-expressed in EBV-transformed B-lymphocytes, we attempted to determine their status in malignant NPC cells. A retrospective series of 100 NPC specimens from untreated Tunisian patients was investigated by immuno-histochemistry. Twenty seven of the patients were below 30 years old and therefore classified in the "juvenile" form of north African NPCs. Bcl-2 and Bcl-X expression was assessed semi-quantitatively using a score based on the percentage of positive cells and staining intensity. Intense Bcl-X expression was detected in malignant cells of 100% biopsy samples with similar scores for patients below 30 years or those aged 30 or over. Bcl-2 was detected in 89% biopsies but its expression differed considerably between the samples. The average Bcl-2 score was much lower for patients under 30 years (4.4+/-1.5 compared to 6.5+/-2 for older patients; P<10(-6)). Multivariate analysis demonstrated that no other clinical parameter, except the primary tumor size, was correlated to the Bcl-2 score. Bcl-X and Bcl-2 are co-expressed in 89% of NPCs whereas their expression is mutually exclusive in other head and neck carcinomas (particularly squamous cell carcinomas, SCC). The constantly high expression of Bcl-X is consistent with it being induced by the EBV protein Epstein-Barr nuclear antigen 1 (EBNA1), as recently reported in a murine model. The contrasted levels of Bcl-2 expression in the two age groups strengthen the hypothesis that these clinical forms result from distinct oncogenic mechanisms.
Asunto(s)
Carcinoma/genética , Regulación Neoplásica de la Expresión Génica , Neoplasias Nasofaríngeas/genética , Proteínas Proto-Oncogénicas c-bcl-2/análisis , Adolescente , Adulto , África/epidemiología , Edad de Inicio , Anciano , Carcinoma/epidemiología , Carcinoma/patología , Niño , Femenino , Genes bcl-2 , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Neoplasias Nasofaríngeas/epidemiología , Neoplasias Nasofaríngeas/patología , Proteínas Proto-Oncogénicas c-bcl-2/biosíntesis , Proteína bcl-XRESUMEN
Clear cell carcinoma (CCC) of the ovary is uncommon. In young patients, this tumor may simulate a yolk sac tumor. In this case, the morphologic distinction between these tumors is often difficult but the immunohistochemical staining for CA125 and alpha foeto protein (AFP) and the response to chemotherapy are particularly helpful to resolve this problem of differential diagnosis. We report a case of a 17 year old patient who was operated for a tumor of the right ovary. The diagnosis of a yolk sac tumor was first suggested. However, because of the non response to chemotherapy, a second laparotomy was performed; the definitive pathologic examination concluded to the diagnosis of a CCC of the ovary. The young age and the immunohistochemical staining for AFP are unusual and misleading features for a CCC. Our objective about this particular case is to discuss the anatomoclinical aspects of the CCC of the ovary and to prove the role of immunohistochemistry in the differential diagnosis.
Asunto(s)
Adenocarcinoma de Células Claras/diagnóstico , Tumor del Seno Endodérmico , Neoplasias Ováricas/diagnóstico , Adenocarcinoma de Células Claras/patología , Adenocarcinoma de Células Claras/cirugía , Adolescente , Antígeno Ca-125/análisis , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Neoplasias Ováricas/patología , Neoplasias Ováricas/cirugía , alfa-Fetoproteínas/análisisRESUMEN
Primary ovarian leiomyosarcoma is extremely rare and generally affects post menopausal women. It is usually unilateral and more than 10 cm in diameter. Its histogenesis is not clear its prognosis seems to be improved by radical surgery and adjuvant therapy. We report a case of a 54 year-old, nulliparous, post menopausal woman who had abdominal distention. Physical examination revealed a large pelvi-abdominal mass. The excision of tumor with bilateral salpingo-oophorectomy and hysterectomy was carried out. A diagnosis of bilateral ovarian epithelioid leiomyosarcoma was made on pathological examination with immunohistochemistry. Adjuvant chemotherapy was given. After 3 months of follow up, abdominal sonography revealed a peritoneal recurrent tumor with hepatic metastasis. Our objectives are to discuss the histopathological features and the prognosis of this tumor.
Asunto(s)
Leiomiosarcoma/diagnóstico , Neoplasias Ováricas/diagnóstico , Biomarcadores de Tumor/análisis , Quimioterapia Adyuvante , Trompas Uterinas/cirugía , Femenino , Humanos , Histerectomía , Inmunohistoquímica , Leiomiosarcoma/patología , Leiomiosarcoma/cirugía , Neoplasias Hepáticas/diagnóstico por imagen , Neoplasias Hepáticas/secundario , Menopausia , Persona de Mediana Edad , Neoplasias Ováricas/patología , Neoplasias Ováricas/cirugía , Ovariectomía , Pronóstico , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
This study has been realized to determine epidemiological profile and clinico-pathologic aspects of male breast cancer in the south of Tunisia. We has counted and analysed all male breast cancers diagnosed in the general surgery department of the Sfax university teaching hospital with proof pathologic or to defect cytologic of malignancy, between 1989 and 2000. In the court of these years 23 new cases of mammary cancer has been diagnosed at the man. The average patient age was 68 years (extremes 40 and 95 years). According to TNM classification of 1988, 4.3% were classified T1, 26.1% T2, 8.6% T3 and 61% T4; 22% of tumors were M1. Histology found: 3 in-situ carcinomas (13%), 18 ductular infiltrating carcinomas (79%), 1 papillary cystadenocarcinoma, and 1 neuro-endocrin tumor. The clinic profile of male breast cancer in our country rest again relatively little frequent and its clinic profile resist alarming. To get better prognosis it is important to increase information and to promote early detection.
Asunto(s)
Neoplasias de la Mama Masculina/patología , Carcinoma Intraductal no Infiltrante/patología , Cistadenocarcinoma Papilar/patología , Tumores Neuroendocrinos/patología , Adulto , Edad de Inicio , Anciano , Anciano de 80 o más Años , Neoplasias de la Mama Masculina/epidemiología , Neoplasias de la Mama Masculina/cirugía , Carcinoma Intraductal no Infiltrante/epidemiología , Carcinoma Intraductal no Infiltrante/cirugía , Cistadenocarcinoma Papilar/epidemiología , Cistadenocarcinoma Papilar/cirugía , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Tumores Neuroendocrinos/epidemiología , Tumores Neuroendocrinos/cirugía , Pronóstico , Túnez/epidemiologíaRESUMEN
INTRODUCTION: Progressive multifocal leukoencephalitis (PML) must be evoked in patients presenting with a systemic disease during which multiple neurological deficiencies rapidly worsen. OBSERVATION: A 17 year-old girl suffering from histologically confirmed polymyositis was treated with corticosteroids. Two years after the diagnosis she exhibited global signs of cerebral damage with fever and magnetic resonance imaging evoked leukoencephalitis. COMMENTS: An affection of the central nervous system, PML is characterised by the existence of multiple areas of demyelination in the hemispheric white substance of the cerebral trunk and sometimes the cerebellum, whereas the grey substance is usually spared. This entity occurs more frequently in HIV-infected patients, but also in patients in whom the immunodeficiency may have other causes, such as the treatment for a systemic disease for example.
Asunto(s)
Leucoencefalopatía Multifocal Progresiva/diagnóstico , Polimiositis/complicaciones , Adolescente , Antiinflamatorios/administración & dosificación , Antiinflamatorios/uso terapéutico , Biopsia , Electroencefalografía , Femenino , Humanos , Imagen por Resonancia Magnética , Músculos/patología , Polimiositis/tratamiento farmacológico , Polimiositis/patología , Prednisona/administración & dosificación , Prednisona/uso terapéutico , Factores de TiempoRESUMEN
Epstein-Barr virus (EBV)-associated nasopharyngeal carcinomas (NPC) are much more sensitive to chemotherapy than other head and neck carcinomas. Spectacular regressions are frequently observed after induction chemotherapy. However, these favorable responses are difficult to predict and often of short duration. So far there have been only few experiments to investigate the mechanisms which underline the cytotoxic effects of anti-neoplastic drugs against NPC cells. In addition, these studies were performed almost entirely on EBV-negative cell lines therefore not truly representative of NPC cells. For the first time, we have used two EBV-positive NPC tumor lines derived from a North African (C15) and a Chinese (C666-1) patient as in vitro targets for a panel of anti-neoplastic agents. Doxorubicin, taxol and in a lesser extent cis-platinum efficiently inhibited NPC cell proliferation at clinically relevant concentrations, but all three agents failed to induce apoptosis. However, massive apoptosis of C15 cells was achieved when doxorubicin (1 microM) was combined with a farnesyl-transferase inhibitor, BIM 2001 (5 microM). Moreover, this apoptotic process was associated with a caspase-dependent early cleavage of the TNF-receptor associated factor 1 (TRAF-1) molecule, a signaling adaptor which is specifically expressed in latently EBV-infected cells. TRAF-1 cleavage might become a useful indicator of chemo-induced apoptosis in EBV-associated NPCs.