[Clinical and epidemiological characteristics of an influenza outbreak in military personnel-Trujillo, Peru, 2008]. / Características clínico-epidemiológicas de un brote de influenza A en personal militar de Trujillo, Perú 2008.

We describe an acute febrile respiratory infection outbreak in a military unit in Trujillo, Peru. Cases were identified using the influenza like illness (ILI) definition of the Ministry of Health. Nasal swab samples used for a rapid influenza test (RIT) and pharyngeal swab samples for viral isolation were taken. For influenza A, genotyping of a partial sequence of the hemagglutinin region was performed. The rate attack was 82.9%. Fifty-nine cases appeared between April 1 and 8, 2008; 58 came from the military unit (MU) #1 and one from the MU #2. The RIT identified 40 cases of influenza A and 43 cases were confirmed through cell culture. Isolations were genetically similar to the A H1N1 Brisbane strain. Early detection of outbreaks in confined locations such as military bases permits immediate action in preventing disease propagation.

Características clínico-epidemiológicas de un brote de influenza A en personal militar de Trujillo, Perú 2008 / Clinical and epidemiological characteristics of an influenza outbreak in military personnel - Trujillo, Peru 2008

Se describe un brote de infección respiratoria febril aguda en una unidad militar de Trujillo, Perú. Se usó la definición de caso de síndrome gripal del Ministerio de Salud, se tomo hisopado nasal para prueba rápida de influenza (PRI) e hisopado faríngeo para aislamiento viral en cultivo celular. La genotipificación de influenza A fue por secuenciamiento genético de una región del gen de hemaglutinina teniendo como base vacunal de 2008. Se presentaron 59 casos entre el 01 y 08 de abril de 2008, la tasa de ataque fue de 82,9 por ciento. La PRI identificó a 40 casos positivos de influenza A y 43 casos fueron confirmados mediante cultivo celular. Los aislamiento fueron genéticamente similares con la cepa A H1N1 Brisbane. La detección precoz de un brote en lugares cerrados como las bases militares permite actuar de manera inmediata para prevenir su diseminación.

We describe an acute febrile respiratory infection outbreak in a military unit in Trujillo, Peru. Cases were identified using the influenza like illness (ILI) definition of the Ministry of Health. Nasal swab samples used for a rapid influenza test (RIT) and pharyngeal swab samples for viral isolation were taken. For influenza A, genotyping of a partial sequence of the hemagglutinin region was performed. The rate attack was 82.9 percent. Fifty-nine cases appeared between April 1 and 8, 2008; 58 came from the military unit (MU) number1 and one from the MU number2. The RIT identified 40 cases of influenza A and 43 cases were confirmed through cell culture. Isolations were genetically similar to the A H1N1 Brisbane strain. Early detection of outbreaks in confined locations such as military bases permits immediate action in preventing disease propagation.

Invasive carcinomas of the male breast: a morphologic study of the distribution of histologic subtypes and metastatic patterns in 778 cases.

The current investigation was conducted to evaluate the proportional distribution of the various histologic subtypes (including newly recognized variants) of male breast carcinomas, to determine whether any histologic subtypes occur with a frequency that is markedly discordant with the expected frequencies from published data on parallel female breast tumors. We also aimed to document the distribution of malignancies metastatic to the breast. Seven hundred fifty-nine archived cases of primary invasive carcinoma involving the male breast were retrieved and sub-categorized into histologic subtypes according to contemporary criteria. Six hundred forty-three (84.7%) tumors were pure infiltrating ductal carcinoma (IDC) not otherwise specified. The most common of the remainder included papillary carcinoma with invasion in the form of IDC (n = 34), mixed IDC and mucinous carcinoma (n = 26), and pure mucinous carcinoma (n = 21). In 19 cases, metastases from other sites involved the breast, most commonly (58%) cutaneous melanoma. Invasive carcinoma of the male breast appears to display a morphologic spectrum and distribution of histologic subtypes that is comparable to those of the female breast, with some expected variation. Compared with published experience on their female counterparts, there is a two-fold increase in the frequency of invasive papillary carcinoma in the male breast. Finally, the most common tumor metastatic to the male breast in this series was cutaneous melanoma.

Periductal stromal tumor: a rare lesion with low-grade sarcomatous behavior.

Biphasic breast tumors with benign ductal elements and a sarcomatous stroma lacking a phyllodes architecture are a source of diagnostic problems, particularly because of the lack of an appropriate designation. At the Armed Forces Institute of Pathology, we have used the term "periductal stromal sarcoma" to distinguish these from phyllodes tumors. All cases coded as periductal stromal sarcoma or PDSH were retrieved from the files of the Armed Forces Institute of Pathology. Cases that fulfilled the following criteria were included in this study. The histologic features of periductal stromal sarcoma were defined as 1) a predominantly spindle cell stromal proliferation of variable cellularity and atypia around open tubules and ducts devoid of a phyllodes pattern, 2) one or more often multiple nodules separated by adipose tissue, 3) stromal mitotic activity of >/=3/10 high power fields, and 4) stromal infiltration into surrounding breast tissue. Criteria for periductal stromal hyperplasia included 1) nodular, bland stroma growing as cuffs around normal or altered ducts, 2) no to minimal atypia, and 3) at most 0-2 stromal mitotic figures per 10 high power fields. Immunohistochemistry was used to further characterize these neoplasms. Of the cases retrieved, 20 qualified as periductal stromal sarcoma and seven as periductal stromal hyperplasia. Patients with periductal stromal sarcoma ranged in age from 37 to 89 years (mean 55.3 years). The tumors measured 0.2-6.0 cm (mean 2.97 cm). Eighteen patients had excisional biopsies and two had partial mastectomies. Overall follow-up time ranged from 1 to 72 months (mean 25.3 months) with two patients (10%) showing recurrence or probable metastasis. The neoplastic cells of periductal stromal sarcoma were at least focally immunoreactive for CD34 (13 of 15), CD117 (6 of 15), less reactive for actin (HHF35, 2 of 15), and negative for estrogen and progesterone receptors. Periductal stromal sarcoma is a useful descriptive designation for generally low-grade biphasic tumors with sarcomatous stroma that do not have features of a phyllodes tumor. The development of focal phyllodes pattern in the recurrent tumor as well as development of a specific soft tissue sarcoma in one of the above cases suggest that some and possibly all periductal stromal sarcoma may evolve into a phyllodes tumor with time. Given the presence of infiltrative margins, excision with a rim of uninvolved tissue is required.