Diagnosis of hairy leukoplakia by exfoliative cytologic methods.

The cytologic characteristics of hairy leukoplakia (HL) are described based on the findings observed in four lesions. All cases were confirmed by histologic study, and Epstein-Barr virus DNA was detected by means of in situ hybridization of tissue sections. All smears from the lesions exhibited a distinctive appearance and three types of epithelial changes were observed: (1) intranuclear inclusions of Cowdry type A, (2) intranuclear inclusions with a ground-glass appearance, and (3) clumping and margination of chromatin around the nuclear membrane. Other findings were the presence of bacterial colonies in all lesions and Candida organisms in three of them. The results of this study suggest that conventional exfoliative cytologic examination may prove to be a useful, simple, cost-effective, and reliable method to diagnose hairy leukoplakia.

[Detection of Epstein-Barr virus DNA in hairy leukoplakia by in situ hybridization]. / Detección de DNA del virus de Epstein-Barr en la leucoplasia vellosa por hibridación in situ.

BACKGROUND: Hairy leukoplakia (HL) is one of the commonest oral lesions associated with infection with the human immunodeficiency virus (HIV). This entity is regarded to be related to replicative Epstein-Barr virus (EBV) infection, in the epithelial cells of the oral mucosa. The present study was aimed at demonstrating the presence of EBV in 19 biopsy specimens, with clinical and histologic diagnosis of HL. METHODS: In situ hybridization technique was performed with a biotinylated probe employing formalin-fixed paraffin-embedded sections. RESULTS: All cases exhibited a hybridization signal restricted to nuclei of keratinocytes that displayed a cytopathic effect in the routine microscopic study. The hybridization signal was confined to the nuclei of a large number of intermediate and superficial cell layers, and occasionally of the parakeratin surface. CONCLUSIONS: It appears to exist a close relation between the presence of EBV and the development of HL. In situ hybridization technique with a biotinylated EBV DNA probes is a useful diagnostic tool, that allows a highly accurate diagnosis of HL, specially in those lesions with doubtful clinical and histopathological appearances. The HL represents the first known non-tumoral epithelial lesion associated to EBV infection.

[Idiopathic benign stenosis of the choledochus]. / Estenosis benigna idiopática del colédoco.

Two cases of benign idiopathic choledochal stricture are reported, an extremely uncommon condition. Diagnosis is difficult on clinical grounds and it can only be ascertained by pathological examination. The clinical and radiological picture mimicks that of malignant obstructive jaundice, even during the operation. This leads to oncologic resection with morbidity and mortality rates disproportionately high for a benign condition.

[Perianal Paget's disease]. / Enfermedad de Paget perianal.

Perianal Paget's disease is a rare entity and often the recognition is delayed because of previous erroneous diagnoses. Biopsy is the only means that provides diagnosis. Treatment should be radical as the disease often recurs and is associated with other malignancies. The detailed management of one case is reported.

[Endometrial carcinoma of the prostate. Report of a case]. / Carcinoma endometroide de próstata. A propósito de un caso.

Endometrial Carcinoma is an uncommon intraductal prostatic tumour, the origin (either from prostatic epithelium or Müellerian) and management (traditional hormonal therapy vs. progestagens) of which has been the subject of vigorous debate. Currently and with the help of the immunohistochemical techniques its origin has finally been confirmed as being prostatic, thus justifying the use of the traditional hormonal therapy applied in prostate acinous carcinoma. The paper contributes one case of Endometrial Carcinoma confirmed by immunohistochemical techniques, as well as a review of the main landmarks in the study of these tumours.

Human papillomavirus in an epidermoid cyst of the sole in a non-Japanese patient.

Several patients with an epidermoid cyst of the sole have recently been described in Japan. In these cases human papillomavirus was found in the wall and in the content of the cyst. We report the first documented case outside of Japan in which human papillomavirus has been demonstrated in an epidermoid cyst of the sole.

Recall phenomenon with the unusual presence of eccrine squamous syringometaplasia.

The recall phenomenon is an inflammatory reaction limited to a previously X-irradiated field when the patient is treated months or years later with certain drugs. Only a few cases have been reported in dermatological journals. We report a patient with lymphoma who was treated with low-dose abdominal irradiation and high-dose irradiation to the knees and who, 2 months later, when chemotherapy was started, developed a pronounced inflammatory reaction limited to the areas treated with high-dose irradiation. A skin biopsy specimen showed features of radiation damage, marked epidermal changes and extensive eccrine squamous syringometaplasia. This case of the recall phenomenon is of interest because we have found that there is apparently a radiation dose threshold for this event, and because this is the first report of its association with eccrine squamous syringometaplasia.

Halo eczema in melanocytic nevi.

A case of halo eczema in melanocytic nevi is reported. Immunohistochemical techniques using monoclonal antibodies distinguished this condition from halo nevus. The lack of the expression of interleukin 2 receptor by T lymphocytes in the infiltrate suggest that the process is probably different from that of the allergic contact dermatitis.

[Malignant rhabdoid tumor of the kidney: 2 cases and a review of the literature]. / Tumor rabdoide maligno renal: presentación de dos casos y revisión de la literatura.

Report of the microscopic, ultrastructural and immunohistochemical findings of two malignant rhabdoid tumors of the kidney in two males aged 2 1/2 and 19 months. The incidence of this tumor in our files is 1.9% of all the renal tumors of infancy. Both cases were formally considered to be rhabdomyosarcomatous variants of nephroblastomas. Microscopically a slightly cohesive polygonal cell proliferation is shown. The cells have intracytoplasmatic hyaline inclusions ultrastructurally identifiable as intermediate filament bundles, showing positivity to vimentin in the immunohistochemical technique. Malignant rhabdoid tumors are referred to as very aggressive tumors with a poor response to treatment and a high mortality rate. Association with central nervous tumors and hypercalcemia has been reported. The clinical and pathologic features make it possible to differentiate them from nephroblastomas, although the histogenesis is not definitely established.

Idiopathic palmoplantar hidradenitis.

Idiopathic plantar hidradenitis (IPH) is a recently described condition primarily affecting healthy children who develop tender lesions localized to the plantar or lateral aspects of the feet with histologic findings similar to those seen in neutrophilic eccrine hidradenitis (NEH), although with certain notable exceptions including the absence of syringosquamous metaplasia and the presence, in most cases, of neutrophilic abscesses adjacent to eccrine coils. Since its original description, three additional patients have been reported, one with palmoplantar lesions, extending the disease's clinical spectrum to include palmar as well as plantar surfaces. We report on a healthy 8-year-old girl with tender, erythematous nodules on palms and soles and review the literature on this subject.