[Primary pancreatic plasmacytoma]. / Plasmocitoma pancreático primario.

Extramedullary plasmacytomas are uncommon malignant plasma cell tumors that present outside the bone marrow; 80% of extramedullary plasmacytomas are located in the upper respiratory tract, and gastrointestinal plasmacytomas are rare. We present the case of an asymptomatic 65-year-old man in whom a pancreatic mass was found incidentally. The lesion was determined to be a pancreatic plasmacytoma after fine-needle aspiration cytology and surgical resection. No clinical, laboratory, or imaging findings indicative of multiple myeloma or association with other plasmacytomas were found, so the tumor was considered to be a primary pancreatic plasmacytoma.

[Metastasis in the glans of prostatic adenocarcinoma. Apropos of a case]. / Metástasis en glande de adenocarcinoma prostático. A propósito de un caso.

Case of an 83 year-old male with metastatic penis cancer located at the glans, secondary to moderately differentiated prostatic adenocarcinoma. There was early metastasis clinically expressed as several painful and ulcerous nodes at the glans corona and paraphimosis. The clinical rareness of metastasis in a porous body (glans) as opposed to the more frequent cavernous ones is outlined. Diagnosis was made through biopsy. Treatment is complex since neither radiotherapy, chemotherapy or hormonal-therapy appear to be effective. Occasionally, in the event of solitary nodes partial penectomy should be indicated. Usually, the only feasible treatment is palliative. Presence of such type of metastasis should always be considered as a sign of poor prognosis.

[Encrusted cystitis. Review of the literature and report of a case]. / Cistitis incrustada. Revisión de conjunto y aportación de un caso.

Alkaline encrusted cystitis is an infrequent process, almost forgotten by urologists. It tends to appear complicating an underlying cystopathy. Consists in a vesical inflammatory state, characterized by precipitation and incrustation of calcareous (phosphate, carbonate) and ammonium-magnesium salts on the vesical mucosa, their genesis being conditioned by the existence of pre-existing mucosa damage, urinary infection by urolithic microorganisms and alkaline urine. The present paper discloses an exceptional case of incrusted cystopathy with alkaline urine associated to uroinfection by E. coli (microorganism of uncertain and questionable urolithic activity). Treatment with urinary antiseptics, acetohydroxamic acid associated with curettage and UTR of calcareous plates was resolutive. With regard to the present cases, we review the limited literature available on the coexistence of incrusted cystitis and E. coli uroinfection and discuss the mechanisms through which E. coli could induce formation of lithiasis and incrustations in the urinary tract.

[Pulmonary lymphangioleiomyomatosis. Description and course of 2 cases]. / Linfangioleiomiomatosis pulmonar. Descripción y evolución de dos casos.

Pulmonary lymphangioleiomyomatosis (LAM) is a rare, serious, chronic disease whose etiology is unknown and which affects young women almost exclusively. It produces typical clinical and radiological characteristics. Diagnosis is confirmed on finding histological evidence of irregular proliferation of the smooth muscle cells of the lungs. Treatment is not usually effective and there is rapid worsening of the pulmonary function leading to serious respiratory failure which often results in the patients death. We present two cases of LAM in women, one of whom was 33 and the other 38. In the first case the patient had all the pulmonary findings described in the literature, while the second also had bilateral renal angiomyolipomas. We discuss the histological, radiological and clinical characteristics and evolution of both cases, as well as the treatment given. We also review the literature. It is concluded that LAM should be suspected in young women who have dyspnea, cough and/or hemoptysis and an interstitial radiological pattern, especially when associated with a pleural effusion or pneumothorax.

[Peritoneal mesothelioma: the importance of ultrastructural study. A report of 2 cases and a review of the Spanish literature]. / Mesotelioma peritoneal: importancia del estudio ultraestructural. Aportación de dos casos y revisión de la literatura española.

Two cases of peritoneal mesothelioma (PM), with ultrastructural study, of females who lived in a rural area without asbestos exposition history are described and the Spanish literature reviewed. We highlight the association with severe autoimmune hemolytic anemia, due to the presence of cold agglutinins, in one patient without relationship to drugs or concomitant diseases. We focus on the need for thorough and multiple biopsies through laparoscopy to avoid false negative. We believe that there are no totally specific morphological data on mesothelioma, which means that the initial study is based on optical microscopy performed with hematoxylin-eosin and PAS-diastase stain using the electronic microscopy to confirm the diagnosis.

[Abscessing rhombencephalitis caused by Listeria in an iummunodepressed patient]. / Rombencefalitis abscesificante por Listeria en paciente inmunodeprimido.

The cerebral trunk infection by Listeria monocytogenes is a very rare process, with only 24 described cases and only 2 in immunodepressed patients. We present a new case of cerebral trunk encephalitis caused by Listeria in a patient diagnosed of Polyarteritis nodosa on steroids and cyclophosamide treatment and fatal evolution, and whose hemoculture, spinal fluid culture and cranial CT scan did not contribute to the diagnosis. A necrotizing lesion in the protuberance with mesencephalic extension was observed in the necropsy study in which intra- and extracellular Gram + and silver positive bacilli were detected. Since L. monocytogenes was suspected as the causative agent, indirect immunofluorescence was performed on histological preparations with hyperimmune anti-L. monocytogenes serum giving a clearly positive result. In our case, this technique permitted the etiological diagnosis in the absence of positive cultures.

[Adrenal myelolipoma. Report of a case and review of the literature]. / Mielolipoma suprarrenal. Aportación de un caso y revisión de la literatura.

OBJECTIVES: Herein we describe an additional case of myelolipoma of the adrenal gland, an uncommon tumor of the adrenal cortex, that had been incidentally discovered during abdominal US evaluation of the biliary tree. The clinical features, diagnosis and treatment of the condition are discussed. METHODS: Surgical treatment of the biliary tree and myelolipoma was performed through a Chevron transversal incision during the same surgical session. RESULTS: Surgery achieved good results and the postoperative course was unremarkable. CONCLUSIONS: Myelolipoma is a benign nonfunctioning tumor of the adrenal cortex comprised of adipose and hematopoietic tissue. It is usually asymptomatic and incidentally discovered during diagnostic evaluation for other pathologies. The diagnosis is made by US, CT and MRI. There is no agreement on whether surgical treatment is warranted.

Cytophotometric DNA measurements in medullary thyroid carcinoma.

The prognostic significance of objectively measured karyometric variables (ploidy pattern, nuclear roundness, area, elongation, chromatin texture, and nearest nucleus distance) was investigated in relation to clinical (stage and type of disease) and morphologic (histologic patterns) variables in 27 patients with the diagnosis of medullary thyroid carcinoma (MTC). The DNA and karyometric measurements of Feulgen-stained nuclei were made with a video cytometry system. The five-year and ten-year adjusted survival rates were 74.4 +/- 10.1% and 59.5 +/- 15.6%, respectively. Cox's survival analysis for mortality showed that only stage, age, sex, and 5N exceeding rate had predictive value (overall P = 0.0012) in decreasing order. Patients with the best prognosis were young females with clinical Stage I disease and low 5N exceeding rate tumors. When karyometric and histometric variables were considered by themselves survival correlates with the standard deviation (SD) of the nearest nuclear distance and nuclear elongation; that is, patients with crowded, high cellularity tumors and elongated cells had the worst prognosis. In univariate analyses only clinical stage correlated with adjusted survival rate. Multivariate survival analysis for morbidity showed that patients in Stages greater than or equal to II and high SD of ploidy values were free of symptoms for short intervals. When morphometric data were considered alone, patients with high variance in the chromatin texture and highly variable nuclear areas had shorter asymptomatic intervals.