RESUMEN
We present a case of a 52-year-old Caucasian male who underwent a laparoscopic nephrectomy for an atrophic kidney and was found to have two unexpected, synchronous kidney cancers. He had a remote history of testicular cancer complicated by lymphadenopathy and external ureteral compression. Over time, he developed an atrophic left kidney from obstructive uropathy. Years later, due to flank pain and renal scintigraphy showing minimal function, a laparoscopic nephrectomy was performed. Final pathology demonstrated papillary renal-cell carcinoma (RCC) and tubulocystic RCC. Tubulocystic RCC is a rare neoplasm thought to be an indolent subset of collecting duct carcinoma, but was identified as a unique entity in 2004. Currently, there are â¼100 cases of this neoplasm in the literature.
RESUMEN
Earlier age at menarche is a major risk factor for breast cancer. Our previous study identified Nrip1 (also known as Rip140) as a candidate gene for delaying female sexual maturation (FSM) and found that knocking out Nrip1 could significantly delay FSM in mice. To investigate the effects of NRIP1 in breast cancer we used human cell lines and tissue arrays along with an in vivo study of DMBA-induced carcinogenesis in Nrip1 knockout mice. Analysis of tissue arrays found that NRIP1 is elevated in tumors compared to cancer adjacent normal tissue. Interestingly, in benign tumors NRIP1 levels are higher in the cytosol of stromal cells, but NRIP1 levels are higher in the nuclei of epithelial cells in malignancies. We also found overexpression of NRIP1 in breast cancer cell lines, and that suppression of NRIP1 by siRNA in these cells significantly induced apoptosis and inhibited cell growth. Furthermore, in vivo data suggests that NRIP1 is upregulated in DMBA-induced breast cancer. Importantly, we found that DMBA-induced carcinogenesis is suppressed in Nrip1 knockdown mice. These findings suggest that NRIP1 plays a critical role in promoting the progression and development of breast cancer and that it may be a potential therapeutic target for the new breast cancer treatments.
Asunto(s)
Proteínas Adaptadoras Transductoras de Señales/genética , Apoptosis/genética , Neoplasias de la Mama/genética , Proliferación Celular/genética , Proteínas Nucleares/genética , 9,10-Dimetil-1,2-benzantraceno , Proteínas Adaptadoras Transductoras de Señales/metabolismo , Animales , Western Blotting , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/patología , Ciclo Celular/genética , Línea Celular , Línea Celular Tumoral , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Inmunohistoquímica , Células MCF-7 , Neoplasias Mamarias Experimentales/inducido químicamente , Neoplasias Mamarias Experimentales/genética , Neoplasias Mamarias Experimentales/metabolismo , Ratones Noqueados , Microscopía Fluorescente , Proteínas Nucleares/metabolismo , Proteína de Interacción con Receptores Nucleares 1 , Interferencia de ARN , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
BACKGROUND: Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-guided FNAB) is highly sensitive and specific in cytologic diagnosis and clinical staging of malignant neoplasms of the gastrointestinal tract, pancreas, liver, and lymph nodes. However, no study has been performed to evaluate its accuracy, sensitivity, specificity, and the cytomorphologic features of suspected primary ampullary tumors. METHODS: All EUS-guided FNABs of suspected primary ampullary lesions at the University of California Irvine Medical Center (Orange, CA) from January 1998 to September 2004 were retrospectively retrieved. The number of passes necessary to arrive at a preliminary diagnosis during adequacy assessment was documented. The cytologic features were analyzed with endosonographic correlation. Follow-up information was also collected. RESULTS: Thirty-five patients were found, 17 men and 18 women. The mean age of the patients was 68.9 years (range, 34-87 yrs). Adenocarcinoma was diagnosed in 13 patients. Atypical cells were found in six patients, four of which were suspicious for adenocarcinoma and two of which were consistent with reactive atypia. Adenoma was diagnosed in two patients and carcinoid tumor in one. Thirteen patients had a diagnosis that was negative for malignant cells. The average number of aspiration passes was 2.4 (range, 1-6 passes). Follow-up information was available in 27 patients. There were three false-negative results and no false-positive results. The sensitivity, specificity, and the positive and the negative predictive values were 82.4%, 100%, 100%, and 76.9%, respectively. The diagnostic accuracy was 88.8%. The consistent cytologic features in specimens that were positive or suspicious for adenocarcinoma included high cellularity, single cells, 3-dimensional cell balls, high nuclear-to-cytoplasmic ratio, prominent nucleoli, coarse/uneven distribution of chromatin, and necrosis. CONCLUSIONS: EUS-guided FNAB was accurate, sensitive, and specific in the assessment of suspected primary ampullary masses. Adenoma presented a diagnostic challenge and endosonographic correlation was instrumental to increase the diagnostic accuracy.