[Clear cell renal cell carcinoma metastasized by a breast ductal carcinoma]. / Carcinoma renal de células claras metastatizado por carcinoma ductal de mama.

OBJECTIVE: To report a clear cell renal cell carcinoma recipient of a metastasizing ductal carcinoma of the breast: A tumor-to-tumor metastasis. METHODS: A 71 year-old woman with a past history of breast carcinoma, diagnosed 12 years before, underwent a nephrectomy for an incidental kidney mass found in a routine imaging examination. RESULTS: Histological examination revealed foci of ductal carcinoma of the breast in an otherwise typical clear cell renal cell carcinoma of the kidney. Immunohistochemical examination confirmed a metastasis of an infiltrating breast carcinoma to a clear cell renal cell carcinoma (positive to GATA3, hormonal receptors and mamoglobin) in a clear cell renal cell carcinoma (positive to PAX8, CD10 and vimentin). CONCLUSIONS: Awareness of this phenomenon should always be kept in mind by urologist in patients with a known history of a previous malignancy and by pathologists when finding a renal tumor with an unusual or dimorphic morphology. Immunohistochemistry plays an important role to establish the exact diagnosis.

Jacalin, another marker for histiocytes in paraffin-embedded tissues.

Jacalin is a lectin which reacts with D-galactose. We have tested jacalin on 75 samples of different formalin- and alcohol-fixed tissues. A consistent cytoplasmic stain of the histiocytes was observed in paraffin-embedded tissues in all cases studied of reactive sinus histiocytosis, macrophages in clear centres of follicular hyperplasia, in tuberculosis granulomas and in osteoclast-like giant cells in a breast carcinoma. We failed to find any clear binding of jacalin to the cells of eosinophilic granulomas, giant cell tumors of tendon sheath, pleomorphic malignant fibrous histiocytomas, Hodgkin's disease, melanomas, nevi or signet ring cell carcinomas of the breast and stomach. It seems that jacalin is a good marker for free histiocytes/macrophages, not for fixed histiocytes and tumors related to them. This lectin might play a role in differential diagnosis with histiocyte mimicking processes.

Adenomatoid tumors. Immunohistochemical study and histogenesis.

Four testicular adenomatoid tumors were studied by immunohistochemistry, using the following antibodies to cytokeratin, epithelial membrane antigen, carcinoembryonic antigen, and factor VIII-related antigen. Cytokeratin and epithelial membrane antigen demonstrated a different pattern of positive immunostaining while carcinoembryonic antigen and factor VIII-related antigen proved constantly negative. Our findings support a mesothelial origin for adenomatoid tumors.

Breast tumors: immunoglobulins in axillary lymph nodes.

The immunohistochemical determination of immunoglobulins IgA, IgG and IgM in axillary lymph nodes from 50 unselected breast ductal carcinomas disclosed that lymph nodes with IgG-positive lymphoid follicles and/or metastasized lymph nodes with IgM-positive lymphoid cells are statistically related to breast tumors with a high histologic grade and more than 3 lymph node metastases.

Correlation of histologic grade and lymph node status with some histopathologic discriminants in breast cancer.

In fifty non selected ductal carcinomas of the breast we found that a marked tumoral inflammatory infiltrate (P less than 0.025), perinodal tumoral infiltrate (P less than 0.01), sinus catarrh (P less than 0.05), follicular hyperplasia (P less than 0.025), mixed pattern in lymph nodes (P less than 0.01) and with 54 years of age or younger (P less than 0.01) correlated significantly with lymph node metastases and/or high histologic grade. On the contrary, elastosis (P less than 0.05), scanty or absent inflammatory infiltrate (P less than 0.01), sinus histiocytosis (P less than 0.001) and endothelial hyperplasia were statistically related to low histologic grade and/or lack of metastases. Elastosis is considered a defensive host response. Groups of lymphocytes in the perinodal fat is usually found in metastasized lymph nodes and may indicate metastasis should be sought in a lymph node which otherwise seems to be tumor-free.

[Malignant fibrohistiocytoma of the spermatic cord]. / Fibrohistiocitoma maligno del cordón espermático.

A malignant fibrous histiocytoma (MFH) of the spermatic cord is presented and a review of the literature has been performed. The patient here presented survived for eight years and is probably cured of his tumour. In general, MFHs of the spermatic cord have a good prognosis, even when they attain a big size. They have a worse evolution when satellite nodules are present. Although more experience is needed. It is our feeling, that a spermatic MFH smaller than 8 cm, without any satellite nodule and less than 25% nuclei positive to MIB-1 (cell proliferation marker), may have a conservative therapy, including only tumorectomy.

[Enterovesical fistula secondary to leiomyosarcoma]. / Fístula enterovesical secundaria a leiomiosarcoma.

We report an unusual case of an enterovesical fistula caused by leiomyosarcoma infiltrating the intestinal wall and urinary bladder. The patient had previously presented recurrent urinary tract infection for one year. Although he has residual tumor, so far this elderly patient has survived for three years post-operatively without further antineoplastic treatment.