RESUMEN
AIMS: To find a possible correlation of Ki67 antigen and proliferating cell nuclear antigen (PCNA) with prognosis in anorectal malignant melanoma. METHODS AND RESULTS: Thirty patients with anorectal malignant melanoma were studied. The percentage of tumour cells stained for Ki67 and PCNA in paraffin sections was assessed. Mode of treatment (local excision or abdominoperineal resection), depth of tumour invasion, attempt at cure as defined by complete tumour excision and absence of distant metastases at presentation, tumour blood vessel invasion, and tumour necrosis, as well as Ki67 and PCNA, were all correlated with survival. By univariate analysis, PCNA, Ki67, attempt at cure, local excision (and not abdominoperineal resection), and depth of invasion were all significantly associated with longer survival. By multivariate analysis, only PCNA was significantly associated with survival, while Ki67 showed a significant positive correlation with PCNA. With a cut-off point of 40%, patients with lower Ki67 scores showed survival advantage over those with higher Ki67 scores (P=0.0004). With a cut-off point of 80%, patients with lower PCNA scores showed survival advantage over those with higher PCNA scores (P=0.0001). The staining for proliferation markers was also associated with depth of tumour invasion. CONCLUSIONS: Ki67 and PCNA immunostaining in paraffin sections may be useful for the prediction of survival in patients with anorectal malignant melanoma. Larger studies are needed to confirm our results.
Asunto(s)
Biomarcadores de Tumor/metabolismo , Melanoma/mortalidad , Neoplasias del Recto/mortalidad , Anciano , Anciano de 80 o más Años , División Celular , Femenino , Humanos , Inmunohistoquímica , Antígeno Ki-67/metabolismo , Neoplasias Hepáticas/secundario , Masculino , Melanoma/irrigación sanguínea , Melanoma/patología , Melanoma/cirugía , Persona de Mediana Edad , Necrosis , Valor Predictivo de las Pruebas , Antígeno Nuclear de Célula en Proliferación/metabolismo , Neoplasias del Recto/irrigación sanguínea , Neoplasias del Recto/patología , Neoplasias del Recto/cirugíaRESUMEN
We report an immunocompromised patient who developed a cutaneous infection caused by acremonium which is a rare opportunistic fungi. With the increasing number of immunocompromised patients opportunistic fungal infection can cause serious diseases and early recognition is mandatory.
Asunto(s)
Acremonium/aislamiento & purificación , Dermatomicosis/diagnóstico , Infecciones Oportunistas/diagnóstico , Anciano , Antifúngicos/uso terapéutico , Dermatomicosis/complicaciones , Dermatomicosis/tratamiento farmacológico , Dermatomicosis/patología , Resultado Fatal , Humanos , Huésped Inmunocomprometido , Cetoconazol/uso terapéutico , Enfermedades Pulmonares Obstructivas/complicaciones , Infecciones Oportunistas/complicaciones , Infecciones Oportunistas/tratamiento farmacológico , Infecciones Oportunistas/patologíaRESUMEN
We describe a 55-year-old woman with pulmonary lymphangioleiomyomatosis. The patient died of respiratory failure 9 years after diagnosis. An autopsy confirmed the diagnosis and disclosed multiple soft-tissue tumors, including a large solitary fibrous tumor of the lung, a huge cavernous hemangioma of the liver, a meningioma of the right pontocerebellar angle, and a focus of nodular stromal hyperplasia of the ovary. In addition, endocrine tumors, including a papillary carcinoma of the thyroid gland and a parathyroid adenoma, were also found. There was no evidence of tuberous sclerosis or angiomyolipoma of the kidney. The connection between pulmonary lymphangioleiomyomatosis and tuberous sclerosis is discussed.