[Hight resoluton optical microscopy of the cellular cycle in psoriasis patients]. / Estudio con microscopia optica de alta resolucion (MOAR) del ciclo celular en pacientes con psoriasis.

Skin tissue from patients with Psoriasis was analyzed using HROM (High Resolution Optical Microscopy), studying epithelial differentiation and possible structural alterations of the queratinocytes. The samples were taken from 10 patients with histopathologic diagnosis of Psoriasis. This tissue samples where affixed with glutaraldehide buffer-collidine for 48 hours. Later processed with the HROM technique and colored with toluidine blue, metilene blue, basic Fuscine, and silver metenamine. The basal epithelial elements presented ovoid nucleus and most of them had prominent nucleolus. In 7 of the studied cases, the granulose stratus was absent, and thinner in the rest, with nucleus and nucleolus retention. At this level queratinocytes where observed with perinuclear anfofilia, as well as linfocitic and macrophagic infiltrate and union complex where elongated.

Photobiomodulation of pain and inflammation in microcrystalline arthropathies: experimental and clinical results.

OBJECTIVE: This article presents the results of laser therapy in crystal (hydroxyapatite, calcium pyrophosphate, and urates) deposition-induced arthritis in rats and the clinical applications in humans. BACKGROUND DATA: Microcrystalline arthropathies are prevalent among geriatric patients, who are more vulnerable to the side effects of drugs. The effectiveness of laser therapy for pain relief, free of side effects, has been reported in painful conditions. METHODS: Two milligrams of each of the above-mentioned crystals was injected in both joints of the back limbs in three groups of rats; these groups were then treated with laser irradiation. Three other groups received no treatment after the injections. We determined the plasmatic levels of inflammatory markers (fibrinogen, prostaglandin E2, and TNF(alpha)), tissues (prostaglandin E(2)) and conducted anatomopathological studies. Twenty-five patients with acute gout arthritis were randomized into two groups and treated over 5 days: group A, diclofenac 75 mg orally, twice a day; and group B, laser irradiation once a day. Forty-nine patients with knee chronic pyrophosphate arthropathy were randomized into two groups and treated over 21 days; group A, diclofenac 50 mg orally, twice a day; and group B, laser irradiation once a day. Thirty patients with shoulder chronic hydroxyapatite arthropathy were randomized into two groups and treated over 21 days; group A, diclofenac 50 mg orally, twice a day; and group B, laser irradiation once a day. RESULTS: Fibrinogen, prostaglandin E(2), and TNF(alpha) concentrations in the rats injected with crystals and treated with laser decreased significantly as compared with the groups injected with crystals without treatment. Both laser therapy and diclofenac achieved rapid pain relief in patients with acute gouty arthritis without significant differences in efficacy. Laser therapy was more effective than diclofenac in patients with chronic pyrophosphate arthropathy and in patients with chronic apatite deposition disease. CONCLUSION: Laser therapy represents an effective treatment in the therapeutic arsenal of microcrystalline arthropathies.

Localised primary amyloidosis of inguinal lymph node with superimposed bone metaplasia.

We present here a case of localised primary amyloidosis of the right inguinal lymph node in a 42 year old female. On gross examination the specimen was 4.0 x 4.0 x 3.2 cm in size with a tan-pink color and two whitish-yellow areas of hard consistency. Histologically the lymph node was replaced by an eosinophilic amorphous material, alkaline Congo red, crystal violet, thioflavine T and sodium sulphate-alcian blue (SAB). We observed areas of mature bone metaplasia alternating with sheets of plasma cells and clusters of foreign body giant cell reaction. Immunohistochemical study showed anti-lambda chain staining within the amorphous material. The negative clinical history, physical examination, normal serum electrophoresis and bone marrow and rectal biopsy allowed us to make the diagnosis of localised primary amyloidosis of lymph node. The patient is alive and without evidence of disease progression to systemic amyloidosis or plasma cell dyscrasia, after clinical follow-up of seven years.

Endodermal sinus tumor.

Three cases of Endodermal Sinus Tumor are presented and its difference from tumors of the mesonephroma type and associations with the embryoma are pointed out. The three cases were "pure" types and the patients died within 5 months in spite of surgical treatment and chemotherapy. Autopsy showed extensive involvement of peritoneum, diaphragm and pleura.

Estrogen receptors and histopathological evaluation of human breast cancer.

The breast cancers with positive ER, the anaplastic low level and the node non involvement were identified with good prognostic values. The positive estrogen receptors in 52 primary breast carcinomas were correlated with either big or small tumors, with node involvement or without it and either with or without sinus histocitosis reaction. The vascular and lymph infiltration, the undifferentiated and half-differentiated carcinomas, the high stroma component and the high number of mitosis were other parameters with were opposed to positive ER tumors. The prevailing age of the patients was postmenopausal.

[Microcystic serous cystadenoma of pancreas. Clinicopathological and surgical features]. / Cistoadenoma seroso microquístico del páncreas. Aspectos clinicopatológicos y quirúrgicos.

The microcystic serous cystadenoma of pancreas or glycogen "rich" cystadenoma is a rare entity. We studied five case of this cystadenoma in adult patients ages 47-68 (58 was the mean), four of which were women (80%). The clinical presentation was varied. There was a prevalence of expansive manifestations with epigastric pain in three patients, and extrahepatic bile duct obstruction in other two. A distal tumour was revealed by the diagnostic methodology used (ultrasound and TAC) in three patients, and cephalic tumour in two, with a mean size of 8.8 cm. in diameter. A distal pancreatectomy was performed in two patients, a cephalic pancreatoduodenectomy was performed in one in relation with the presence of extrahepatic bile duct carcinoma, and the other two were treated with a partial cephalic pancreatectomy (enucleation). The nosological diagnose was post-surgical in all case of study. A prognosis for every case was dependent of the associated pathology.

Fibromatosis mimicking clinically invasive breast carcinoma.

Our purpose is to report two cases of fibromatosis in two women of 34 and 48 years old respectively that clinically appeared as a invasive breast carcinoma, particularly for the cutaneous retraction they showed. The histopathological diagnosis was done based on specimens studied with the common technique of paraffin embedding and Hematoxilin & Eosin staining. Both patients had firm poorly demarcated nodules with the histopathological pattern of classic fibromatosis. Mammary fibromatosis is an infrequent relapsing entity, not suspected in differential clinical diagnoses. The pathologist should bear it in mind, especially in frozen biopsies.

["Cecal appendix with pellets"]. / "Apendice cecal con perdigones".

A case is presented of caecal appendix with birdshots, in a 38 years-old male patient, with a clinical picture of biliary pathology. An elongated and "heavy" caecal appendix was palpated during cholecystectomy and removed. The pathological study showed the presence of 99 ammunitions or lead birdshots in the appendicular lumen, with a diameter of 1-5 mm, without histologic evidence of active appendicitis. The patient was fond of hunting wild animals and is used to eat them pickled. Pertinent literature is revised and works are commented in relation to the incidence of different foreign bodies in the appendix lumen, clinical picture and complications.

[Latent carcinoma of the thyroid in surgical samples]. / Carcinoma latente de tiroides en materiales quirurgicos.

We present 23 cases of latent thyroid carcinoma which were examined in 356 surgical specimens (incidence: 6.4%), having found a sclerosing variant predominance. Of the total cases that were under study, twenty of them belonged to women (86%), and three to men (14%). Due to the fact that the concepts of latent thyroid carcinoma and occult thyroid carcinoma are often misused as synonyms, regarding both pathologies, we have carefully examined the available literature and therefore, we have made a critic analysis of both entities. We also made a detailed microscopic study of the surgical specimens and included a slice for histopathologic examination, which was evaluated every 5 g of tissue. The purpose of this last study responded to our consideration on the real incidence of latent thyroid carcinoma, which cannot be found in routine studies.

[Eco-guided fine needle aspiration of the thyroid. Algorithm diagnosis]. / Punción aspiración ecoguiada con aguja fina de tiroides (PAEAFT). Algoritmo diagnostico.

Fine needle aspiration (PAAF) of thyroid it has demonstrated to be highly sensitive and specific to establish a diagnosis and to implement the corresponding treatment, these qualities are increased when the guide ecográfica is used: fine needle aspiration of thyroid with ultrasonography guide (PAEAFT). 139 cases of PAEAFT are presented of whose material was carried out extended conventional and thin according to specific technique and they were colored with Haematoxylin and eosin (H & E)--Tint 15 (DIFF-QUIK) and Papanicolaou; analyzing their distribution for sex, age, topography, characteristic of nodules and cytologic diagnoses. The presumptive diagnoses corresponded to: Multinodular Goiter (21.58%)--Hashimoto's thyroiditis (2.87%)--Follicular neoplasm: Under degree (I-II): (57.57%), High degree (III): 2.15%--Hürthle cell tumors (2.87%)--Papilary carcinoma (4.32%). The prevalence corresponded to the female sex (93.52%). The pursuit of the patients was carried out based on the proposed algorithm, modified of that of Gharib, 1997.

[Anorectal malignant melanoma]. / Melanoma maligno anorectal.

The cases of four patients who are carriers of primitive anorectal malignant melanoma are presented, reviewing at the same time the medical literature available. The clinic of all these patients was similar: pain, proctorrhagia, tumors, tenesmus, hemorrhoids and changes in the intestinal rhythm. One of these cases was similar to thrombosed hemorrhoids, and for this reason we believe that all of the parts that are removed should be biopsied. The prognosis of this pathology is in general adverse, notwithstanding the treatment received. There are very few cases on record that have survived more than 5 years, with early diagnosis and treatment with an abdominal-perineal resection. Radiotherapy and chemotherapy can reduce the size of the lesion but it is acknowledged that the prognosis will not change.

[Collagenase production increases in rheumatoid arthritis and osteoarthritis synoviocytes incubated]. / Incremento en la produccion de colagenasa en incubado de sinoviocitos de pacientes con artritis reumatoidea y osteoartrosis.

Cartilage is a specialized connective tissue. It contains few cells into an extracell matrix. The matrix mainly constituents are collagen and proteoglycans. Its degradation depends on synoviocytes activity, that secrete metalloproteases, agents to proteoglycans catabolism. There are two types of synoviocytes: macrophagics (type "A:') and fibroblastics (type "B"). The proteoglycan destruction can be LT-dependent or LT-independent. The aim of this work is synoviocytes function ex vívo study, free immune system influence. In order to do it, heparinized synovial fluid samples were obtained from 6 osteoarthritic (OA) and 6 arthritic (RA) both sex untreated patients, diagnosed according ACR criteria, which disease duration was longer than 6 months. Patients average age was 70 +/- 2 years. Control samples were synovial fluid from traumatic arthritis or non inflammatory bone-muscle pathology. Synovial fluid was centifugated at 1500 g for 30 minutes to isolate synoviocytes. Sediment containing cells was 6 hs incubed with Dulbecco-Eagles media, that has HEPES Gibco (26 mM); NaHCO3 (0.5 g/I); glutamine (2 mM), streptomicine (100 mg/l), G-penicillin (1 U/ml); anphotericine B (2.5 mg/l). Cells calification and viability were cytopathologically determined. Before and after incubation, collagenase activity was measured by ELISA-double-sandwich, using 10 micrograms/ml monoclonal anti-MMPs in phosphate-buffer-saline. The antigen-antibody complex production with inespecific proteins was blocked by bovine seric albumine. Streptavidin peroxidase was added and washed with 2,2,azin,di(3-ethyl-benztazoilinsuiphonic) acid to develop color. The link of labeled antibody by absorbance at 410 nm was determined in ELISA-spectrophothometer. RA patients earlier MMPs synoviocytes production was 1373 +/- 115 ng/ml. Then 6 hs incubation 2143 +/- 132 ng/ml was reached. The increase (56%) had high significance (p < 0.0001). OA earlier MMPs cells production was 276 +/- 23 ng/ml, but after incubation it reached 542 +/- 47 ng/ml. (96% increased with highly significativa difference too: p < 0.0001). Microscopic study was carried out before and after incubation, and shows a lot of synoviocytes with plenty of cytopiasme when the collagenase leveis were highest. On the contrary, when low MMPs production by synovial fluid, as no incubated osteoarthritic material, a few cells containing picnotics nucleous were observed. Significant quantitative differences in AR and OA enzymatic secretion were observed. Although in rheumatoid arthritic MMPs leveis synoviocytes production were 4.6 times than OA levels, after 6 hs incubation percentage of increase in OA cells secretion was highest. Described results confirm MMP-1 synthesis by synoviocytes, and these levels correlate with inflammation, more pronounced in acute (RA) than chronic pathology (OA). Synoviocyte incubation let us to test disease changes in synovial fluid according to cells number and phagocytic activity. Authors agree to assert that synovial fluid may reflect what is happening in an articular cartilago, because SF provides markers of joint disease. MMPs are giving information about pathways involved in OA and RA cartilage degradation.

[Severe acute pancreatitis. Clinical and therapeutic contribution of diagnostic imaging]. / Pancreatitis aguda severa. Aporte clínico y terapéutico del diagnóstico por imágenes.

Ultrasonography and dynamic tomography are used in the study of acute pancreatitis, thus helping to interpret the diverse anatomophysiopathologic variables. We present 41 patients studied by ultrasonography, on admission and twenty-four hours later or more. After seventy-two hours, a dynamic tomography was performed. We did a clinicotomographic correlation assessing necrosis, and multiple Ranson criteria, being complemented with the anatomopathologic study of specimens both in the complications and in the elective biliary surgery. There were three puncture aspirates for bacteriology. Eight (19.5%) patients developed local complications and four (9.75%) presented organ failure. Ultrasonography showed biliopancreatic hypertension in 45% of cases of biliary pancreatitis and was reversible in nature. Dynamic tomography was important in defining morphology and pancreatic necrotic involvement. There were two patients with intrapancreatic necrosis, six with intra and extrapancreatic necrosis and eleven patients who presents a dissemination of the process into the extrapancreatic tissues. The prevalence of glandular necrosis was 24%. Both, ultrasonography and dynamic tomography allowed to the identify a spectrum of lesions representative of cavitated extrapancreatic necrosis and enzymatic pericholecystitis. Likewise, they contributed to define medical treatment as well as indications, opportunities and approaches in the surgical and/or percutaneous treatment of septic complications.

Estudio morfométrico comparativo de la corteza cerebelosa humana en dos grupos etarios / Comparative morphometric study of human cerebellar cortex in two age groups

Histológicamente la corteza del cerebelo humano adulto presenta tres capas constitutivas; la capa molecular, la hilera de los cuerpos de las células de Purkinje y la capa granulosa interna. La sustancia cortical del cerebelo de los embriones de mamífero, así como la de los jóvenes, muestran una capa granular externa. Nuestro objetivo es documentar las diferencias morfológicas entre las capas de la corteza cerebelosa adulta y joven. Se realizaron estudios morfométricos microscópicos en 20 cerebelos de autopsias. Los casos se dividieron en dos grupos, adultos y niños menores de 1 año. Se realizaron cortes en parafina, coloreados con hematoxilina y eosina. La corteza del cerebelo adulto presentó diferencias morfológicas con la de los recién nacidos. En el cerebelo adulto presenta tres capas constitutivas, mientras que en el recién nacido presenta una cuarta capa, la granulosa externa...

Histologically, the adult human cerebellar cortex has three constituent layers, the molecular layer, the row of bodies of Purkinje cells and internal granular layer. The cortex of the cerebellum of mammalian embryos, as well as youth, show external granular layer. Our goal is to document morphological differences between the layers of the cerebellar cortex adult and young. Microscopic morphometric studies were performed in 20 cerebellum autopsied. The cases were divided into two groups, adults and children under 1 year. Paraffin sections were performed, stained with hematoxylin and eosin. The cortex of adult cerebellum showed morphological differences of the newborn. In the adult cerebellum has three constituent layers, whereas in the newborn has a fourth layer, the external granular...

[Parafunicular hemangiopericytoma]. / Hemangiopericitoma parafunicular.

We report a case of right-sided parafunicular hemangiopericytoma in a 72-year-old patient with unilateral cryptorchidism. We describe the outstanding histologic features of this uncommon tumor which permit making a differential diagnosis from other neoplasms.

[Eosinophilic polypoid cystitis with flat carcinoma in situ of the overlying epithelium]. / Cistitis eosinofílica polipoide con carcinoma in situ plano del epitelio suprayacente.

A case of eosinophilic polypoid cystitis with flat carcinoma in situ of the overlying epithelium is described. This is the first case with such an association encountered in our series comprised of 26 bladder surgical specimens and represents an incidence rate of 0.38%. The clinical case described herein is that of a 62-year-old male patient with a clinical picture of hematuria, frequency and urgency. Patient cystoscopic evaluation revealed a congestive and edematous mucosa at the level of the trigone and sessile polyps. Microscopic examination revealed flat urothelium with anisokaryosis, hyperchromatic nuclei, atypical mitosis, and loss of polarity; chorion with diffuse, dense inflammatory infiltrate comprised of eosinophils accounting for greater than 90% of the cell population, plasma cells, mastocytes, edema and vascular congestion. Epithelial erosion and capillary thrombosis were also observed. We discuss the etiology, clinical features and treatment reported elsewhere.