Is prophylactic gastrectomy indicated for healthy carriers of CDH1 gene mutations associated with hereditary diffuse gastric cancer?

INTRODUCTION: hereditary diffuse gastric cancer (HDGC) is a recently reported hereditary cancer syndrome. Patients with suspected HDGC must be under surveillance via endoscopy and multiple biopsies. As an alternative, some studies suggest prophylactic gastrectomy (PG) for disease carriers. The goal of this article was to report our experience with a CDH1 mutation positive family who underwent PG. PATIENTS AND METHODS: the index case was a 34-year-old female diagnosed with diffuse gastric adenocarcinoma and massive carcinomatosis. There was a family history of gastric adenocarcinoma in seven family members. A genetic study identified the c.1577G>A mutation, in exon 11 of the CDH1 gene via sequencing analysis. RESULTS: this mutation was also present in other six family members, who subsequently underwent prophylactic gastrectomy. The pathology study of resected gastric segments revealed multiple microscopic foci of adenocarcinoma in five of these individuals. These foci were not detected in the multiple endoscopies performed before surgery. CONCLUSIONS: we recommend prophylactic gastrectomy for CDH1 mutation carriers even in the absence of lesions during endoscopic screening.

Utility of 18 fludeoxyglucose in preoperative positon-emission tomography-computed tomography (PET-CT) in the early diagnosis of exocrine pancreatic cancer: A study of 139 resected cases. / Utilidad de la 18-fluorodeoxiglucosa en la tomografía por emisión de positrones-tomografía computarizada (PET-TC) preoperatoria en el diagnóstico precoz del cáncer de páncreas exocrino: estudio en 139 casos resecados.

INTRODUCTION: In pancreatic ductal adenocarcinoma (PDA), surgical resection is the only curative treatment, but due to its late clinical presentation only 15-25% patients are candidates for curative resection. The aim of this prospective, single-center study is to determine the diagnostic utility of preoperative PET-CT for early detection of PDA and early panIN lesions. METHODS: We studied the histopathological features of PDA and different panIN lesions in 139 surgical samples from patients undergoing pancreatic resection (from 2010-2014), comparing these results with preoperative PET-CT and MDCT study. For tumor diagnosis in PET-CT maximum standard SUV 2.5 was used. Pancreatic baseline SUVmax is the maximum uptake of the radiotracer 18-2FDG on the ROI curve determined for the area of the normal pancreas after pathological reassessment with areas not affected by tumours or preneoplastic lesions. Tumour Uptake Index is the ratio between the tumour SUVmax and pancreatic baseline SUVmax. RESULTS: Using an standard maximum SUV value of 2.5, PET-CT sensitivity was 77.7% (108 of the 139 cases) against 75.5% (105 of the 139 cases) of MDCT. But when we combined this value with maximum SUV of normal pancreatic tissue from each patient, PET-CT sensitivity improved its value to 94.9%. CONCLUSION: A combination of studies of PET-CT in tumor and non-tumor tissue of each patient might be a very useful diagnostic tool not only for preoperative diagnosis of PDA, but also for early panIN lesions.

Groove pancreatitis vs. pancreatic adenocarcinoma: A review of 8 cases. / Pancreatitis del surco versus adenocarcinoma de páncreas: a propósito de 8 casos.

INTRODUCTION: Groove pancreatitis (PS) is an uncommon clinical situation and radiologically it can mimic carcinoma of the periampullary area. The aim of this paper is to study a series of 8 patients who underwent surgery with preoperative diagnosis of pancreatic head mass and subsequent pathological diagnosis of PS. METHODS: In our series, 6 were men and 2 women, with an average age of 51,9 years. Before surgery, all patients had epigastric abdominal pain requiring analgesia at high doses. The preoperative analytical CEA and Ca 19.9 were normal in all patients. Imaging studies showed intrapancreatic solid lesions in 6 of the 8 patients, and in the remaining 2 one papillary mass of 5 and 6cm, respectively, that caused stenosis in the duodenal luz. EUS neoplastic cells were negative in all patients. RESULTS: The immediate postoperative evolution was satisfactory, there are no complications. In our series, no patients have died. The long-term follow-up, in 7 of the 8 patients, has been excellent with disappearance of abdominal pain and improvement of nutritional status. The remaining patient had frequent recurrent episodes of acute pancreatitis, and at 60 months, presented a pseudocyst that has required a Roux-en-Y cystojejunostomy. CONCLUSIONS: PS must be included in the differential diagnosis of pancreatic lesions, which may include carcinoma of the periampullary area and other causes of chronic pancreatitis.

Hepatoportal sclerosis clinical different evolutionary stages: presentation of 3 cases and literature review.

Hepatoportal sclerosis (HPS) is characterized by presinusoidal intrahepatic portal hypertension associated with splenomegaly and anemia in patients with non-cirrhotic liver. Liver biopsy is essential, especially to rule out other processes. Being a disease of unknown etiology, the majority of cases have been described in eastern countries. However, it may be an underdiagnosed disease in the West. Symptoms are related to portal hypertension and the clinical spectrum is wide, ranging from anemia with normal liver function tests to bleeding due to esophageal varices. Treatment is directed to the complications and the prognosis is better than in patients with cirrhosis.We report three cases of HPS presenting at different clinical stages and the findings of liver biopsies, the clinical outcomes and a review of scientific literature.

Preliminary Results of a Minimally Invasive Microsurgical Approach to Sinus Floor Elevation and Bone Reconstruction Using a Palatal Septum Window.

The aim of this case report was to present the preliminary results of a novel microsurgical approach to sinus floor elevation and bone augmentation. This technique was used to treat four patients in whom an implant could not be placed in the maxillary first molar position because of insufficient bone height. The maxillary first molar was extracted, and a sinus access window was created in the palatal area of the bony interradicular septum. The sinus membrane with the palatal septum fragment was elevated, and the sinus space between and above the roots was filled with xenograft. Alveolar preservation was done with xenograft and a nonresorbable membrane. Bone augmentation was evaluated 6 months after preservation by computed tomography and histology; clinical, radiologic, and histologic bone reconstruction were seen, allowing placement of implants. The novel approach utilized in this study demonstrated positive preliminary results in bone reconstruction with reduced morbidity.

Biocompatibility of a HA/ß-TCP/C Scaffold as a Pulp-Capping Agent for Vital Pulp Treatment: An In Vivo Study in Rat Molars.

Bioceramic materials possess desirable biological properties, highlighting their non-reactivity and osteoconductivity. Their use has been extended in vital pulp treatment. The purpose of this study was to evaluate and compare the effects of beta-tricalcium phosphate (ß-TCP), hydroxyapatite (HA), and collagen (C) scaffold with mineral trioxide aggregate (MTA) on the vital pulp of rat molars. Thirty-two molars of Sprague-Dawley rats underwent direct pulp capping with ß-TCP/HA/C (n = 16) and MTA (n = 16). After 30 days, the following parameters were evaluated in the tested samples: the degree of pulp inflammation and pulp vitality, the presence of reparative dentin, the homogeneity of the odontoblastic layer, and the presence of pulp fibrosis. No statistically significant differences were observed between HA/ß-TCP/C and MTA in terms of the degree of inflammation (p = 0.124). Significant differences were found in reparative dentin formation between the treatment groups (p = 0.0005). Dentin bridge formation was observed in the MTA-treated group. The local action of HA/ß-TCP/C is similar to that of MTA when used as an agent for pulp vital treatment in terms of absence of inflammation and maintenance of pulp vitality, although there are significant differences between both materials regarding the formation of dentin bridges.

Desmoplastic nested spindle cell tumor of the liver in an adult.

Desmoplastic spindle cell tumor of the liver is a recently described and extremely unusual neoplasm that affects children and young adults. We report 1 case in a 33-year-old man. The patient had abdominal pain and dyspepsia. Abdominal examination showed that the liver was enlarged and palpable until umbilical region. Laboratory studies demonstrated positive serologic markers to hepatitis B virus. All other analytical studies were irrelevant. Computed tomography revealed a large tumor mass in left hepatic lobe showing heterogeneous densities, with hyperdense peripheral areas, as multiple nodular calcifications of less than 1 cm. In the central part of the mass, a big hypodense area was observed. There was no evidence of extrahepatic disease. Grossly, the tumor was well circumscribed with multiple nodular calcifications. The tumor was characterized by the presence of cohesive nests of bland spindle cells arranged in short fascicles and surrounded by desmoplastic stroma, intermixed with epithelioid cells. Mitotic activity was very low. Extensive osteoid formation was seen inside the cell nests. The tumor cells showed cytoplasmic reactivity for vimentin and pan-cytokeratin. The cells of desmoplastic stroma were immunoreactive for actin. The biologic behavior is still uncertain with only 5 published cases, but current information suggests that they are low-grade tumors with an indolent course. The clinical and morphologic features of this tumor are very similar to those of tumors previously reported as "nested stromal-epithelial tumor of liver" and "ossifying stromal-epithelial tumor of liver." We describe the histologic, immunohistochemical, and molecular genetic features of a case of desmoplastic spindle cell tumor of the liver and review the literature.

Melatonin as an Agent for Direct Pulp-Capping Treatment.

Melatonin plays an essential role in the regulation of bone growth. The actions that melatonin exerts on odontoblasts may be similar to its action on osteoblasts. This research aimed to evaluate the pulp response to melatonin used for direct pulp capping to evaluate the antioxidant effect of melatonin administered orally and its influence on dental pulp. Direct pulp capping was performed on the upper molars of Sprague Dawley rats using melatonin or Mineral Trioxide Aggregate (MTA). The study groups were: MTA; Melatonin; MTA + Melatonin administered orally; and Melatonin + Melatonin administered orally. In the latter two groups, the animals drank water dosed with melatonin ad libitum (10 mg/100 mL). After 30 days, the animals were sacrificed, and 5 ml of blood, the kidneys, and the liver were extracted in order to evaluate oxidative stress using thiobarbituric acid reactive substances testing (TBARS). Fragments of the maxilla containing the study molars were prepared for histological evaluation. The degree of pulp inflammation and pulp necrosis, the presence of reparative dentin and dentin bridging the pulp chamber, the presence and regularity of the odontoblastic layer, and the presence of pulp fibrosis were evaluated. No significant differences were found between the four study groups for any of the studied histological variables. The oral administration of melatonin did not modify the local effects of MTA or melatonin on dental pulp, or reduce basal-level oxidative stress. The effect of melatonin on pulp is similar to that of MTA and may be used as an agent for direct pulp capping.

Utilidad de la 18-fluorodeoxiglucosa en la tomografía por emisión de positrones-tomografía computarizada (PET-TC) preoperatoria en el diagnóstico precoz del cáncer de páncreas exocrino: estudio en 139 casos resecados / Utility of 18 fludeoxyglucose in preoperative positon-emission tomography-computed tomography (PET-CT) in the early diagnosis of exocrine pancreatic cancer: A study of 139 resected cases

INTRODUCCIÓN: El único tratamiento curativo del cáncer de páncreas (CP) es la exéresis quirúrgica, pero debido a su presentación clínica tardía solo el 15-25% de los pacientes son candidatos a resección curativa. El objetivo de este trabajo, prospectivo y unicéntrico, es determinar la utilidad de la PET-TC preoperatoria en el diagnóstico precoz del CP, en su estadificación y en la detección de estadios precursores de la enfermedad en una serie de 139 pacientes sometidos a intervención quirúrgica con «intención curativa» y con el diagnóstico histológico de adenocarcinoma ductal. MÉTODOS: Hemos estudiado las características histopatológicas del CP y de las diferentes lesiones panIN en las piezas quirúrgicas de 139 pacientes sometidos a resección pancreática durante el periodo 2010-2014, comparando estos resultados con los datos preoperatorios de una tomografía computarizada multidetector con contraste trifásico (TCMD) y una PET-TC en la que la captación de glucosa fue determinada por el SUV, considerando malignidad por encima de 2,5. RESULTADOS: En nuestra serie, la sensibilidad de la PET-TC para el diagnóstico tumoral fue del 77,7% (108 de los 139 casos) versus el 75,5% (105 de los 139 casos) para la TCMD. Cuando combinamos este valor máximo del SUV tumoral con el SUV máximo de tejido pancreático normal de cada paciente, la sensibilidad diagnóstica de la PET-TC para el CP asciende al 94,9% (132 de los 139 casos). CONCLUSIÓN: Una combinación de los estudios del PET-TC en el tejido tumoral y no tumoral de cada paciente puede ser una herramienta diagnóstica muy útil no solo para el diagnóstico preoperatorio del CP, sino también para las lesiones panIN

INTRODUCTION: In pancreatic ductal adenocarcinoma (PDA), surgical resection is the only curative treatment, but due to its late clinical presentation only 15-25% patients are candidates for curative resection. The aim of this prospective, single-center study is to determine the diagnostic utility of preoperative PET-CT for early detection of PDA and early panIN lesions. METHODS: We studied the histopathological features of PDA and different panIN lesions in 139 surgical samples from patients undergoing pancreatic resection (from 2010-2014), comparing these results with preoperative PET-CT and MDCT study. For tumor diagnosis in PET-CT maximum standard SUV 2.5 was used. Pancreatic baseline SUVmax is the maximum uptake of the radiotracer 18-2FDG on the ROI curve determined for the area of the normal pancreas after pathological reassessment with areas not affected by tumours or preneoplastic lesions. Tumour Uptake Index is the ratio between the tumour SUVmax and pancreatic baseline SUVmax. RESULTS: Using an standard maximum SUV value of 2.5, PET-CT sensitivity was 77.7% (108 of the 139 cases) against 75.5% (105 of the 139 cases) of MDCT. But when we combined this value with maximum SUV of normal pancreatic tissue from each patient, PET-CT sensitivity improved its value to 94.9%. CONCLUSION: A combination of studies of PET-CT in tumor and non-tumor tissue of each patient might be a very useful diagnostic tool not only for preoperative diagnosis of PDA, but also for early panIN lesions

Pancreatitis del surco versus adenocarcinoma de páncreas: a propósito de 8 casos / Groove pancreatitis vs. pancreatic adenocarcinoma: A review of 8 cases

INTRODUCCIÓN: La pancreatitis del surco (PS) es una entidad poco frecuente que clínica y radiológicamente puede simular un carcinoma del área periampular. El objetivo de este trabajo es presentar una serie de 8 pacientes que fueron intervenidos quirúrgicamente con el diagnóstico preoperatorio de masa en cabeza pancreática, con un diagnóstico anatomopatológico definitivo de PS. Metodos: En nuestra serie, 6 eran hombres y 2 mujeres y tenían una edad media de 51,9 años. Previamente a la cirugía, todos los pacientes presentaban dolor abdominal en epigastrio que requería analgesia a altas dosis. En la analítica preoperatoria, el CEA y el Ca 19.9 fueron normales en todos los pacientes. Los estudios de imagen mostraron lesiones sólidas intrapancreáticas en 6 de los 8 pacientes, y en los 2 restantes una masa mamelonada de 5 y 6 cm, respectivamente, que estenosaba la luz duodenal. La ecoendoscopia fue negativa para células neoplásicas en todos los pacientes. RESULTADOS: La evolución durante el postoperatorio inmediato fue satisfactoria, sin complicaciones. En nuestra serie, no ha fallecido ningún paciente. La evolución a largo plazo, en 7 de los 8 pacientes, ha sido excelente, con desaparición del dolor abdominal y mejoría del estado nutricional. El caso restante ha tenido frecuentes episodios de pancreatitis aguda recidivante y, a los 60 meses, ha presentado un seudoquiste que ha precisado una quistoyeyunostomía en Y de Roux. CONCLUSIONES: La PS debe incluirse en el diagnóstico diferencial de lesiones pancreáticas, que pueden incluir carcinoma del área periampular y otras causas de pancreatitis crónica

INTRODUCTION: Groove pancreatitis (PS) is an uncommon clinical situation and radiologically it can mimic carcinoma of the periampullary area. The aim of this paper is to study a series of 8 patients who underwent surgery with preoperative diagnosis of pancreatic head mass and subsequent pathological diagnosis of PS. METHODS: In our series, 6 were men and 2 women, with an average age of 51,9 years. Before surgery, all patients had epigastric abdominal pain requiring analgesia at high doses. The preoperative analytical CEA and Ca 19.9 were normal in all patients. Imaging studies showed intrapancreatic solid lesions in 6 of the 8 patients, and in the remaining 2 one papillary mass of 5 and 6 cm, respectively, that caused stenosis in the duodenal luz. EUS neoplastic cells were negative in all patients. RESULTS: The immediate postoperative evolution was satisfactory, there are no complications. In our series, no patients have died. The long-term follow-up, in 7 of the 8 patients, has been excellent with disappearance of abdominal pain and improvement of nutritional status. The remaining patient had frequent recurrent episodes of acute pancreatitis, and at 60 months, presented a pseudocyst that has required a Roux-en-Y cystojejunostomy. CONCLUSIONS: PS must be included in the differential diagnosis of pancreatic lesions, which may include carcinoma of the periampullary area and other causes of chronic pancreatitis

¿Está indicada la gastrectomía profiláctica en pacientes sanos portadores del gen CDH1 para el cáncer gástrico difuso hereditario? / Is prophylactic gastrectomy indicated for healthy carriers of CDH1 gene mutations associated with hereditary diffuse gastric cancer?

Introducción: el cáncer gástrico difuso hereditario (CGDH) constituye uno de los síndromes de cáncer hereditario recientemente comunicados. Aquellos pacientes con sospecha de CGDH deben ser vigilados con endoscopia y toma múltiples de biopsias. Como alternativa, algunos autores proponen la realización de gastrectomía profiláctica (GP) en los portadores de la enfermedad. El objetivo de este trabajo es presentar nuestra experiencia con una familia portadora de la mutación CDH1 a los que se realizó una GP. Pacientes y métodos: nuestro caso índice corresponde a una mujer de 34 años que se diagnosticó de un adenocarcinoma gástrico difuso con carcinomatosis masiva. Presentaba antecedentes familiares de adenocarcinoma gástrico en siete ascendientes. Se realizó un estudio genético mediante secuenciación de CDH1, en el cual se encontró la mutación c1577G>A en el exón 11 del gen CDH1. Resultados: esta mutación estaba también presente en otros seis familiares de la paciente, a los que se les realizó una gastrectomía profiláctica. La anatomía patológica de los estómagos de estos pacientes informó de múltiples focos microscópicos de adenocarcinoma en cinco de ellos, a pesar de que en las numerosas endoscopias realizadas antes de la cirugía no fueron detectados. Conclusiones: recomendamos realizar una gastrectomía profiláctica en los pacientes portadores del gen CDH1 a pesar de ausencia de lesiones tumorales en el screening endoscópico

Introduction: hereditary diffuse gastric cancer (HDGC) is a recently reported hereditary cancer syndrome. Patients with suspected HDGC must be under surveillance via endoscopy and multiple biopsies. As an alternative, some studies suggest prophylactic gastrectomy (PG) for disease carriers. The goal of this article was to report our experience with a CDH1 mutation positive family who underwent PG. Patients and methods: the index case was a 34-year-old female diagnosed with diffuse gastric adenocarcinoma and massive carcinomatosis. There was a family history of gastric adenocarcinoma in seven family members. A genetic study identified the c.1577G>A mutation, in exon 11 of the CDH1 gene via sequencing analysis. Results: this mutation was also present in other six family members, who subsequently underwent prophylactic gastrectomy. The pathology study of resected gastric segments revealed multiple microscopic foci of adenocarcinoma in five of these individuals. These foci were not detected in the multiple endoscopies performed before surgery. Conclusions: we recommend prophylactic gastrectomy for CDH1 mutation carriers even in the absence of lesions during endoscopic screening

Esclerosis hepatoportal en estadios clínicos evolutivos diferentes: presentación de 3 casos y revisión de la literatura / Hepatoportal sclerosis clinical different evolutionary stages: presentation of 3 cases and literature review

La esclerosis hepatoportal se caracteriza por hipertensión portal intrahepática presinusoidal asociada a esplenomegalia y anemia en pacientes con un hígado no cirrótico. La biopsia hepática es fundamental, sobre todo para descartar otros procesos. Se trata de un cuadro de etiología desconocida cuya gran mayoría de los casos se ha descrito en países orientales, si bien podría estar infradiagnosticada en Occidente. Se manifiesta con síntomas asociados a la hipertensión portal y el espectro clínico es muy amplio: desde anemia con pruebas de función hepática normales hasta hemorragia por varices esofagogástricas. Su tratamiento es el de las complicaciones y el pronóstico es mejor que en los pacientes con cirrosis. Presentamos tres casos de EHP que presentan estadios clínicos diferentes, así como los hallazgos de las biopsias hepáticas, su evolución clínica posterior y una revisión de la literatura científica(AU)

Hepatoportal sclerosis (HPS) is characterized by presinusoidal intrahepatic portal hypertension associated with splenomegaly and anemia in patients with non-cirrhotic liver. Liver biopsy is essential, especially to rule out other processes. Being a disease of unknown etiology, the majority of cases have been described in eastern countries. However, it may be an underdiagnosed disease in the West. Symptoms are related to portal hypertension and the clinical spectrum is wide, ranging from anemia with normal liver function tests to bleeding due to esophageal varices. Treatment is directed to the complications and the prognosis is better than in patients with cirrhosis. We report three cases of HPS presenting at different clinical stages and the findings of liver biopsies, the clinical outcomes and a review of scientific literature(AU)

Cristales de sevelamer asociados a lesión de la mucosa del tracto gastrointestinal. Presentación de 2 casos, revisión de la literatura y diagnóstico diferencial morfológico con los cristales de kayexalato / Sevelamer crystals associated with mucosal lesions of the gastrointestinal tract. A report of 2 cases with emphasis on the morphological differential diagnosis with kayexalate crystals and a review of the literature

Sevelamer es un quelante no absorbible del fosfato, usado para tratar la hiperfosfatemia en pacientes con enfermedad renal crónica. La morfología de sevelamer ha sido descrita en un artículo recientemente publicado por Swanson et al., en el que se hace la primera descripción histológica de esta resina en el tracto gastrointestinal. En este artículo informamos de la presencia de cristales de sevelamer asociados a lesión mucosa en 2 pacientes con insuficiencia renal crónica en tratamiento con este fármaco, que presentaron apendicitis aguda perforada con peritonitis el primer caso, y úlceras esofágicas el segundo. Realizamos la descripción histológica de los cristales de sevelamer y hacemos un diagnóstico diferencial morfológico con los cristales de kayexalato, otra resina también usada en pacientes con enfermedad renal crónica (AU)

Sevelamer is a non-absorbable phosphate binder used to treat hyperphosphatemia in patients with chronic renal disease. Sevelamer morphology has been described in a recently published article by Swanson et al., in which the first histological description of this resin in the gastrointestinal tract is made. In this article we report the presence of sevelamer crystals associated with mucosal injury in 2 patients with chronic renal failure treated with this drug; one of them suffered acute perforated appendicitis with peritonitis and other developed oesophageal ulcers. We describe the histology of sevelamer crystals and the morphological differential diagnosis with kayexalate crystals, another resin used in chronic renal disease (AU)

Pancreatitis del surco. Presentación de dos casos en piezas de duodenopancreatectomía / Groove pancreatitis: two cases in surgical pancreatoduodenectomy specimens

La pancreatitis del surco representa una forma segmentaria de pancreatitis crónica que afecta la región periduodenal, entre la pared duodenal y el páncreas. Esta entidad es poco frecuente y posee ciertas características clínico patológicas que permiten identificarla preoperatoriamente. Esta condición ha recibido varios nombres entre estos: distrofia quística del páncreas heterotópico, hamartoma pancreático del duodeno, quiste paraduodenal y mioadenomatosis del páncreas. Presentamos dos casos de pancreatitis del surco en piezas de duodenopancreatectomía en hombres de 39 y 50 años, ambos bebedores de alcohol. Los estudios de imagen mostraron en ambos lesiones quísticas intrapancreáticas. Histológicamente se observó engrosamiento de la mucosa duodenal, hiperplasia severa de las glándulas de Brunner, proliferación miofibroblástica con formaciones quísticas, entremezclada con tejido pancreático e inflamación crónica. Esta entidad entra en el diagnóstico diferencial de las lesiones pseudotumorales pancreáticas que pueden simular carcinoma(AU)

Groove pancreatitis is a form of chronic segmental pancreatitis affecting the periduodenal region between the duodenum and the head of the páncreas. This uncommon entity has distinct clinicopathological features which facilitate its preoperative diagnosis. It is also been known as cystic dystrophy in heterotopic páncreas, pancreatic hamartoma of the duodenum, paraduodenal cyst and adenomyomatosis of the páncreas. We present two cases of groove pancreatitis in adult males aged 39 and 50, both alcohol drinkers, who had undergone pancreatoduodenectomy. Imaging studies showed cystic intrapancreatic lesions. Histologically, a large duodenal wall with prominent myofibroblastic proliferation and cysts admixed with pancreatic tissue and cronic inflammation was seen. Groove pancreatitis may be confused with carcinoma(AU)

Diagnósticos Críticos en Anatomía Patológica: una contribución a la seguridad clínica del paciente hospitalizado / Critical diagnoses in pathology: a contribution to the clinical safety of the hospitalized patient

Los Diagnósticos Críticos en Anatomía Patológica han sido recientemente introducidos y son equiparables a los establecidos a nivel clínico, de forma que, situaciones clínicas concretas pueden precisar de un diagnóstico rápido (ya sea por parte del patológo o del citopatólogo) y del contacto urgente con el clínico con el fin de facilitar una intervención clínica urgente o instaurar un tratamiento determinado, de los que el paciente se beneficiaría. Basándonos en la experiencia diaria, presentamos diferentes situaciones clínico-patológicas en las que el diagnóstico es crítico (AU)

Critical diagnoses in surgical pathology and cytology have recently been introduced in a similar way to critical values in clinical pathology (laboratory medicine). Thus, some situations require that the clinician be informed urgently of the diagnosis in order to facilitate rapid clinical intervention or treatment and ensure that the patient receives optimal care. Based on day to day experience, this article provides examples of different situations in which critical diagnoses in pathology are necessary (AU)