Could We Consider Ultrasound-Guided Minimally Invasive Autopsy as a Part of POCUS?

We present a 3-patient case series that support the use of ultrasound guided minimally invasive autopsy (MIA). This technique has a high diagnostic accuracy in specific clinical settings. It makes easier to diagnose pathologies once the patient has died, avoiding body deformation, with a notable reduction in sample processing time compared to the open autopsy study and, therefore, a shorter overall diagnostic response time. MIA shows some similarities with point of care ultrasound (POCUS), like examination protocols or that they can be performed at the bedside.

[Mucinous tubular and spindle cell renal cell carcinoma: two novel cases and a literature review.] / Carcinoma mucinoso tubular y de células fusiformes renal: aportación de 2 nuevos casos y revisión de la literatura.

INTRODUCTION: Mucinous tubularand spindle cell carcinomas (MTSC) are a relativelyrare subtype of renal cell carcinoma (RCC) . Thesetumors are composed by tubular and spindle cellareas within a mucinous stroma. They are generallylow-grade nuclei tumors and limited to the kidney, sothey usually have a favorable prognosis. We report twonew cases of MTSC treated at our institution. MATERIALS AND METHODS: We reviewed therenal tumors surgery database of our hospital from2008 to 2019, selecting patients diagnosed with CMTF.We evaluated clinicopathological data and evolution ofthe patients. We also reviewed the published literatureto compare it with our findings. RESULTS: Two patients were included in the study,a 50-year-old male (case 1) and a 55-year-old female(case 2). The diagnosis was made by ultrasound asan incidental fi nding in case 1 and during the studyof fl ank pain in case 2. Treatment was surgical withpartial and radical nephrectomy respectively. After amean follow-up of 70 months, both patients are aliveand disease-free. CONCLUSION: Mucinous tubular and spindle cellcarcinomas (MTSC) is a rare renal tumor, approximatelytwo hundred cases have been published. Thereare questions yet to be answered about their diagnosisand behaviour so it is of utmost importance to reportnew cases in order to increase our knowledge and improvepatient care.

INTRODUCCIÓN: Los carcinomasmucinosos tubulares y de células fusiformes (CMTF)son un subtipo relativamente infrecuente de carcinomarenal (CCR). Están compuestos por célulastubulares y fusiformes con un estroma mucinoso.Generalmente son tumores de bajo grado y estánlimitados al riñón, por lo que habitualmente tienenbuen pronóstico. Reportamos dos nuevos casos deCMTF tratados en nuestra institución. MATERIAL Y MÉTODOS: Se realizó una revisiónde todos los tumores renales intervenidos en nuestrohospital desde el año 2008 has ta el año 2019, seleccionandolos pacientes diagnosticados de CMTF.Se evaluaron las características clinicopatológicasy la evolución de los pacientes. Así mismo, se realizóuna revisión exhaustiva de la literatura publicadapara comparar los hallazgos descritos con los denuestros casos. RESULTADOS: Dos pacientes fueron incluidos enel estudio, un varón de 50 años ( caso 1) y una mujer de55 años ( caso 2). El diagnóstico fue ecográfico, de forma incidental en el caso 1 y a partir del estudio de undolor en flanco, en el caso 2. El tratamiento fue quirúrgicomediante nefrectomía parcial y radical respectivamente.Tras un seguimiento medio de 70 meses ambospacientes están vivos y libres de enfermedad. CONCLUSIÓN: El carcinoma mucinoso tubular yde células fusiformes (CMTF) es un tumor renal infrecuente,habiéndose publicado aproximadamente doscentenares de casos. Aún hay incógnitas que resolversobre su diagnóstico y comportamiento, de ahí la importanciade reportar nuevos casos que nos permitanaumentar su conocimiento y mejorar el manejo denuestros pacientes.

Fine-needle aspiration cytology of mammary myofibroblastoma: a report of six cases.

OBJECTIVE: To evaluate cytologic features of mammary myofibroblastoma in order to establish the possibility of precise preoperative recognition. STUDY DESIGN: This was a multi-institutional study of 6 patients with myofibroblastoma (5 men and 1 woman) in which preoperatively fine-needle aspiration cytology was performed. Four cases showed classical histologic features, 1 corresponded to the cellular variant and the remaining 1 to the fibrous form. RESULTS: Except for 1 case, smears were cellular and distributed as irregular aggregates and single cells. Most groups showed a small amount of metachromatic stroma and capillaries. Cells retained cytoplasm and showed a spindle-to-plump oval morphology with moderate pleomorphism. Nuclear pleomorphism was present and was relevant in 1 case. Intranuclear pseudoinclusions and mast cells were present in 3 cases. No epithelial clusters were seen. Due to hypercellularity and pleomorphism 1 case was considered as suspicious for malignancy. The remaining 5 were diagnosed as low-grade mesenchymal lesions, and myofibroblastoma was suggested in 3. CONCLUSION: Cytologic features of myofibroblastoma reflect what is seen on histology. When such findings are correlated with image studies, preoperative recognition can be possible. This is especially true for male patients in whom the tumor is relatively frequent.

[Paratesticular liposarcoma. Clinical and pathological study of three cases and review of the literature]. / Liposarcomas paratesticulares. Estudio clinicopatológico de tres casos y revisión de la literatura.

OBJECTIVES: Paratesticular liposarcomas are rare; most published cases are single cases. We report the clinical, histological and immunohistochemical characteristics of three cases of paratesticular liposarcomas. METHODS: We performed clinical, histological and immunohistochemical studies with expression of ki 67 and p 53 markers in three cases of tumors of the spermatic cord. RESULTS: Patient age ranged from 36 to 67 years, with a mean of 54 years. All tumors were big, multinodular and predominant histological type was well-differentiated (2/3), being one case undifferentiated (1/3). All cases were treated by surgical excision; one of them had a relapse five years later (33%) as a low-grade undifferentiated liposarcoma. None of the patients have developed metastases after a long follow-up (10, 7, and 5 yr.). CONCLUSIONS: Paratesticular liposarcomas have favourable prognostic markers (histological type, low proliferation index Ki 67 and p 53). The evaluation of this masses should be based on imaging tests, but a biopsy is necessary to determine their nature both in the case of primary tumors and recurrences. Surgical treatment should include complete excision with free margins to avoid recurrences.