[The value of laminin-322 staining in distinguishing between keratoacanthoma, keratoacanthoma with areas of squamous cell carcinoma, and crateriform squamous cell carcinoma]. / Utilidad de la tinción con laminina-332 para diferenciar queratoacantoma, queratoacantoma con áreas de carcinoma epidermoide y carcinoma epidermoide crateriforme.

INTRODUCTION: Keratoacanthoma is a fast-growing crateriform skin tumor. Approximately 25% of such tumors undergo malignant transformation and develop areas of squamous cell carcinoma (SCC). The presence of laminin-322 has been associated with progression to invasive forms of SCC. The aim of this study was to determine whether or not immunohistochemical staining for laminin-322 would be of value in distinguishing between keratoacanthomas, keratoacanthomas with areas of squamous cell carcinoma, and SCCs. MATERIAL AND METHODS: Seventy-four lesions were selected from the pathology archives of our hospital and divided into 4 groups: 20 keratoacanthomas without SCC, 20 keratoacanthomas with areas of squamous cell carcinoma, 20 invasive SCCs (8 with crateriform morphology) unrelated to keratoacanthoma, and 14 problem lesions (keratoacanthomas with areas suggestive of SCC). All 74 lesions were stained for laminin-322. RESULTS: Laminin-322 staining was strongly positive both in areas of SCC in keratoacanthomas with malignant transformation and in invasive SCCs (mostly at the invasive front of the SCC). However, in benign keratoacanthomas, it was only weakly positive and furthermore it was confined to isolated cells or small groups of cells. The 14 problem lesions were reexamined after laminin-322 staining and 8 were diagnosed as keratoacanthomas with incipient SCC and 6 as keratoacanthomas without SCC. CONCLUSIONS: Laminin-322 staining is different in keratoacanthomas and SCCs and would thus be a useful test for differentiating keratoacanthomas from both invasive SCCs and keratoacanthomas with areas of squamous cell carcinoma. It would also be of value in diagnosing keratoacanthomas with areas suggestive of SCC or with incipient SCC.

[Immunohistochemical staining of p16 in squamous cell carcinomas of the genital and extragenital area]. / Tinción inmunohistoquímica p16 en carcinomas epidermoides del área genital y extragenital.

BACKGROUND AND OBJECTIVES: Positive immunostaining for the tumor suppressor protein p16 is associated with the presence of mucosal or αsubtypes of human papillomavirus (HPV) in cervical and genital squamous cell carcinoma (SCC). The aim of this study was to determine whether p16 immunostaining is also associated with mucosal HPV in extragenital SCC. MATERIAL AND METHODS: Paraffin sections of lesions located in the genital region (8 genital warts, 3 intraepidermal SCCs, and 7 invasive SCCs) and extragenital area (29 intraepidermal SCCs corresponding to Bowen disease and 10 invasive SCCs) were stained for p16 by immunohistochemistry. Mucosal HPV was detected by polymerase chain reaction (PCR). RESULTS: In the genital area, p16 immunostaining was negative in genital warts and positive in all 3 intraepidermal SCCs and 2 invasive SCCs (29%). Mucosal HPV was detected in 6 genital warts and 2 intraepidermal SCCs (100% after exclusion of 3 lesions that could not be analyzed by PCR) and in the 2 invasive SCCs that were positive for p16. In the extragenital area, 19 intraepidermal SCCs (95%) and 2 invasive SCCs (20%) were immunopositive for p16. Mucosal HPV was detected in 4 intraepidermal SCCs (p16 immunopositive) and 1 invasive SCC (p16 immunonegative). In intraepidermal SCCs, p16 immunostaining facilitated the identification of dermal microinfiltration or invasion of normal skin appendages. CONCLUSIONS: According to our results, unlike in genital SCCs, p16 immunopositivity is independent of the presence of HPV in extragenital SCCs. Compared with intraepidermal SCCs, the absence of p16 protein in invasive SCCs in the extragenital area would indicate progression of the disease.

[Solar elastosis in cutaneous squamous cell carcinoma]. / Elastosis solar en carcinomas espinocelulares cutáneos.

INTRODUCTION: Solar elastosis, or basophilic degeneration of collagen, may be a histologic sign of chronic sun damage. MATERIAL AND METHODS: We reviewed 222 cases of squamous cell carcinoma (SCC) to identify the presence of solar elastosis and its possible invasion of the upper, middle, or deep reticular dermis. We also analyzed clinical variables such as SCC location, location in exposed areas of the skin, age, sex, and immunosuppression. Patients included had undergone surgical excision of an SCC. RESULTS: Severe solar elastosis was found in most cases (182 patients, 82%): 87 extended to the middle reticular dermis and 95 had reached the deep reticular dermis. Only 6 (2.7%) patients had no solar elastosis. In some cases elastosis was so severe that it had affected the subcutaneous cellular tissue or venous or arteriolar walls. Deeper solar elastosis was significantly associated with older age and female sex. CONCLUSIONS: Solar elastosis was found in most patients with SCC and seems to indicate chronic severe solar damage. Exposure to ultraviolet radiation would be the main cause of SCC, although other factors might also be implicated, particularly in patients who did not have severe solar elastosis. Systemic or localized immunosuppression was associated with nearly all the SCC cases studied, consistent with the marked immunosuppressant effects of sun exposure, the aging process, or both.

[Clear cells in cutaneous squamous cell carcinoma]. / Las células claras en el carcinoma espinocelular cutáneo.

INTRODUCTION: Although few cases of squamous cell carcinoma (SCC) with clear cells have been published, we believe that these cells are often present in SCC. MATERIAL AND METHODS: We studied 249 SCCs, analyzing a number of clinical and histological variables. Various immunohistochemical techniques (immunoperoxidase method) were used to determine whether adnexal differentiation was present. RESULTS: There were 96 SCCs with a proportion of clear cells of over 25 %. Advanced or established SCCs and SCCs associated with Bowen disease contained a larger proportion of clear cells. We defined 2 histological patterns: a) clear cells around the keratin pearls of SCCs arising from pre-existing actinic keratosis and with indirect signs of human papilloma virus infection in hair follicles; and b) clear cells that simulate adnexal differentiation in lesions arising on pre-existing Bowen disease lesions. There were also 19 carcinomas with true adnexal differentiation. DISCUSSION: Clear cells are frequently observed in SCC, though large numbers of clear cells are present only in certain SCCs. The appearance of clear cells in SCCs is progressive and they are only present in more advanced SCC. The presence of clear cells is suggestive of adnexal differentiation; however, in the majority of cases, their presence is due to infiltration of normal adnexal structures by the cells of pagetoid Bowen disease. True adnexal differentiation exists only in a small percentage of cases (7.6 % in our study). The histological pattern described as clear cells around keratin pearls practically rules out this differentiation.

'Bowenoid wart': wart with bowenoid histological changes? Report of 9 cases.

INTRODUCTION: Cases of lesions that simulate Bowen's disease have been previously described in the literature. CASE REPORT: Nine exophytic verruca-like lesions with histological findings of Bowen's disease (BD) are described. All cases had a rapid growth, and were located on the face and neck of elderly patients with chronic solar skin damage. We carried out p16 immunohistochemical staining using the immunoperoxidase technique, which was negative in all cases. DISCUSSION: We think that these 9 lesions are only histologically mimicking BD, and could be a subtype of verruca ('bowenoid wart'). These lesions could be provoked by nononcogenic human papillomavirus (HPV), as in other cases previously described. The p16 staining was negative in all cases, in contrast with most BD cases. It would be interesting to study whether positive p16 staining is related to oncogenic HPV, whereas negative p16 staining could be associated with low or nononcogenic HPV; thus, more studies are needed.

[Epidermodysplasia verruciformis-like cells as histologic markers of immunosuppression: review of 229 squamous cell carcinomas]. / Las células tipo epidermodisplasia verruciforme como marcador histológico de inmunodepresión: revisión de 229 carcinomas espinocelulares.

INTRODUCTION: Epidermodysplasia verruciformis (EV) is associated with greater susceptibility to infection by certain oncogenic subtypes of human papillomavirus (HPV). Among other histologic findings, large, clear, oval or rounded cells (EV cells) are observed in the granular layer in EV, and some authors consider these cells to be markers of immunosuppression. MATERIAL AND METHODS: We analyzed 229 squamous cell carcinomas (SCC) to determine whether EV cells were present and to assess whether their presence was associated either with localized or cutaneous immunosuppression (tumors with signs of severe chronic actinic damage or severe stasis dermatitis) or with systemic immunosuppression (immunocompromised or elderly patients). RESULTS: We observed EV cells in 33 SCC. No statistically significant relationship was observed between the presence of EV cells and immunosuppression. We performed polymerase chain reaction in 8 lesions, but the results were not informative as the DNA was denatured. CONCLUSIONS: We found no relationship between the presence of EV cells and localized or systemic immunosuppression, possibly because the sample was inadequate (almost all SCC studied were associated with signs of immunosuppression, irrespective of the presence or absence of EV cells). Further studies will be required to compare lesions associated with immunosuppression with those in which immunosuppression is absent. The presence of EV cells may be the result of cytopathic effects of certain HPV subtypes, such as HPV 5 or 8, but this will need to be demonstrated using techniques such as polymerase chain reaction.

[Cutaneous squamous cell carcinoma and human papillomavirus]. / Carcinoma espinocelular cutáneo y papilomavirus (VPH).

The relationship between mucosal human papillomavirus (HPV) and cervical carcinoma or anogenital squamous cell carcinoma (SCC) is becoming increasingly evident, whereas a link between HPV and other cutaneous SCCs is less clear. Recent studies have reported links between epidermodysplasia-verruciformis-associated HPV and extragenital cutaneous SCC, particularly in immunosuppressed patients, although immunocompetent patients have also been affected. Mucosal HPV could also be linked to some types of Bowen disease and certain SCCs of the fingers, oropharyngeal mucosa, etc. We review the possible oncogenic mechanisms involving mucosal HPV and epidermodysplasia-verruciformis-associated HPV. Most SCCs could be explained by the combined action of HPV, immunosuppression, and the oncogenic and immunosuppressive effect of UV radiation. HPV might be associated with worse prognosis of SCC, with implications for clinical practice including greater risk of metastasis.

A correlation between age and Actinomyces in the adenotonsillar tissue of children.

The purpose of this study was to investigate the presence of actinomyces in adenotonsillar disease, recurrent infections, or tonsillar hypertrophy in children. The study included 64 patients, ranging in age from 2 to 16 years, who had elective adenotonsillar surgery to treat either adenotonsillar hypertrophy (36 children) or recurrent adenotonsillitis (28 children). Adenotonsillar Actinomyces was present in 30 children (48%). No statistical significance was found between Actinomyces and recurrent adenotonsillitis or adenotonsillar hypertrophy. However, there was a statistically significant relationship identified between the presence of actinomycosis and age, with a greater occurrence of actinomycosis in children between 5 and 16 years old.

[Histochemical differences between submucous glands and Goblet cells of the supraglottis. A study on hamsters]. / Diferencias histoquímicas entre las glándulas submucosas y las células caliciformes de la supraglotis. Estudio en el hámster.

In order to know the differences between the submucosal glands and the goblet cells of the supraglottic mucosa, a lectin histochemistry study was performed in 4 larynx of hamster (Mesocricetus auratus). The results show a strong reactivity to HPA and N-WGA lectins in the submucosal glands. Also reactivity to N-PNA and UEA-1 was present in the submucous glands but not in the goblet cells.

[Cavernous hemangioma of the larynx in an adult. Endolaryngeal excision]. / Hemangioma cavernoso de laringe en el adulto. Exéresis por vía endolaríngea.

We present a case of cavernous laryngeal hemangioma in an elderly lady. The limited surface of the lesion and its location and implantation basis as well allowed an endolaryngeal surgery.

[Lymphoepithelial cysts of the parotid gland. Its association with immunodeficiency virus infection]. / Quistes linfoepiteliales de glándula parótida: su relación con la infección por virus de la inmunodeficiencia humana.

Lymphoepithelial cysts of the parotid gland are frequently associated with HIV disease. We describe a case of a patient positive for HIV antibodies, stade A2, and extracapsular, bilateral and symmetric lymphoepithelial cysts of the parotid. The diagnosis was achieved by biopsy following a cervicotomy. A prior needle-biopsy procedure was disappointing. Literature review and discussion about the source and envolvement of those cysts linked to HIV-infection.

[Histochemical study with lectins in nasal polyposis]. / Estudio histoquímico con lectinas de las células plasmáticas en la poliposis nasal.

Histochemical study done with lectins is useful in order to differentiate between several carbohydrates from glycoproteins and glycolipides present in cellular membranes. Plasma cells and eosinophils are very frequent findings in nose mucous of patients with nasal polyposis. Histochemistry with lectins of plasma cells show a reactivity of the cellular cytoplasma to ConA while the external cellular membrane stains with PNA.

[Complete regression of a Warthin's tumor following the aspiration cytopuncture]. / Regresión total de un tumor de Warthin tras citopunciòn aspirativa.

This paper reports a rare case of a 69-year-old man bearing a right parotid lump, measuring near 5 cm diameter, which diagnosis resulted a Warthin's tumor. The used procedure to reach the diagnosis was aspiration through a fine needle. Two months after the laboratory diagnosis--so within the preoperative term--we can corroborate the clinical and radiological missing of the growth. Review and analysis of etiologic and pathogenic mechanisms.

[Kikuchi and Fujimoto disease ]. / Enfermedad de Kikuchi y Fujimoto.

Kikuchi-Fujimoto disease (KF) is a new and uncommon malady of unknown etiology, first described in Japan. Clinically runs with neck adenopathies no larger than 2 cm diameter. Young women are more frequently affected. Main features are fever and nocturnal swelling in half of cases. Laboratory findings are not diagnostically helpful and positive diagnosis is only reliable upon ganglion's histology. Be unaware of this sickness can arise confusion with a malignant lymphoma. The illness is harmless and autolimited in a few months term. We report a new case of KF disease, diagnosed through excision biopsy, after a previous needle biopsy had awakened one's suspicion about a non Hodgkin lymphoma.

[Eosinophils in nasal mucosa of patients with nasal polyps: preliminary histochemical study]. / Los eosinófilos en la mucosa nasal de pacientes con poliposis nasal: estudio histoquímico preliminar mediante lectinas.

Glycoproteins and glycolipids play an important role in cellular biological specificity. The use of lectins as histochemical probes may be useful in studying the nasal mucosa. Eosinophils are a common finding in the nasal mucosa of patients with nasal polyposis. Histocytochemistry of eosinophils in the nasal mucosa of such patients revealed reactivity to all lectins used in this study except LTA. This suggests that alpha-L-fucose was not present in the eosinophils of the nasal mucosa of patients with nasal polyposis and asthma.

[Inflammatory pseudotumor of the parotid gland]. / Seudotumor inflamatorio de glándula parótida.

An inflammatory pseudotumor is a rare clinicopathologic condition of unknown etiology and benign course, mimicking sometimes other malignant entities under the clinic and pathologic viewpoint. Our case sitting inside the left parotid salivary gland in an 70-year-old male, was at first diagnosed as epidermoid carcinoma and consequently operated. The biopsy disclose in the mass removed a pseudotumor measuring 3 cm diameter not malignant, lodging inside a microscopic growth of Warthin type. Revue of the literature, of diagnostic findings and mode of management, suggering besides its possible etiopathogenic relation with the inflammatory pseudotumor.