Prevalence and distribution of human papillomavirus findings in swab specimens from gynaecology clinics of the east coast of Spain.

The objective of this study was to determine the prevalence of human papillomavirus (HPV) among females in the east coast of Spain. A total of 1956 women visiting gynaecology clinics for routine check-ups were included in the study. Swabs were analyzed for HPV DNA by consensus polymerase chain reaction followed by direct sequencing. The overall HPV prevalence was 12.99%. HPV vaccine types 6, 11, 16 and 18 were detected in 6.13% of female participants.

Distribution of human papillomavirus types in women from Valencia, Spain, with abnormal cytology.

OBJECTIVE: To determine human papillomavirus (HPV) types among cervical smears using polymerase chain reaction (PCR) and to contribute to the knowledge of human papillomavirus genotype distribution and prevalence of oncogenic types in cervical lesions in Spain. STUDY DESIGN: Consensus PCR and direct s quencing of PCR products (DNA HPV typing) were used in a retrospective study to determinate the type or types of HPVon 974 cytology smears of women with abnormal cytology results. RESULTS: Of 974 smears, 79.8% were high-risk (H-R) HPVs, 19.7% low-risk (L-R) HPVs, 4.6% indeterminate-risk (I-R) HPVs, considering both single and multiple infections. Multiple infections were detected in 4.7% of the cytologies. We detected 40 different HPV types: 17 H-R (HPV26 not detected), 10 L-R (HPVs 40 and HPV 61 not detected) and 13 I-R. The highest percentage of H-R HPV was found in those women with a cytologic high grade squamous intraepithelial lesion (HSIL) (87.4%). HPV 16 was the most frequent genotype. CONCLUSION: There was a significantly her prevalence rate of H-R HPV in HSIL than in low grade squamous intraepithelial lesion (LSIL) and atypical squamous cells of undetermined significance (ASC-US) (p < 0.01). HPV 16 (39.5%) was the most frequent genotype, with a significantly higher prevalence rate of this type in HSIL than in LSIL and ASC-US (p < 0.05 and p < 0.001, respectively). The study of the distribution of HPV and the presence of oncogenic HPV types in our population is important to assess the cost effectiveness of the current vaccines.

Analysis of c-kit expression in small cell lung cancer: prevalence and prognostic implications.

c-kit, a growth factor receptor with tyrosine kinase activity, plays an important role in the biology of cancer. Its expression has been documented in several malignancies. We performed a retrospective study in 85 patients diagnosed with small cell lung cancer (SCLC) to determine the prevalence and role of c-kit as a possible prognostic marker in this lung cancer malignancy. Demographic and clinical data were obtained from patient charts. c-kit, analyzed as immunohistochemical expression in paraffin-embedded tumour tissues, was observed in 60% of patients. All patients were former or present smokers. At diagnosis, 46% of the patients had limited disease (LD) and 54% extended disease (ED). c-kit expression was observed in 59% of LD and 61% of ED patients (p=0.4). Patients received a median of 4 cycles first-line combination chemotherapy (platinum and etoposide). In LD patients, time to progression (TTP) was 11.5 months in c-kit (+) versus 5.9 in c-kit (-) patients (p=0.14), and median survival 15.4 and 12.8 months, respectively (p=0.33). In the ED group, TTP was 5.5 months in c-kit (+) versus 3.8 in c-kit (-) patients (p=0.34), whereas median survival was 6.3 and 7.9 months, respectively (p=0.45). With the limited number of patients in mind, our findings tended towards an association between c-kit expression and survival in the LD group.

Lymphoepithelioma-like carcinoma of the uterine cervix.

CONTEXT: It has been proposed that Epstein-Barr virus (EBV) plays a role in the etiology of lymphoepithelioma-like carcinoma (LELC) in diverse anatomic locations. In contrast to Asian women, Western women have a low prevalence of LELC of the uterine cervix, and EBV genomes have not been identified. OBJECTIVE: To assess the presence of EBV in LELC of the uterine cervix in 4 white Western women. DESIGN: We collected 4 cases of LELC of the uterine cervix between 1990 and 2000. We performed histologic and immunohistochemical analyses of formalin-fixed, paraffin-embedded tumor samples. We amplified tumor DNA with polymerase chain reaction to detect EBV, human papillomavirus, and simian virus 40 DNAs. RESULTS: Immunohistochemically, tumor cells were positive for cytokeratins and showed strong expression of p53 and MIB-1. Staining for the oncoprotein c-Erb-B2 was focally positive, and staining for Bcl-2 and progesterone receptors was negative. Only one case showed focal nuclear staining for estrogen receptors. All cases had a dense infiltrate of mature lymphocytes expressing T-cell antigens CD45RO, CD3, and CD8. Polymerase chain reaction analysis did not detect EBV, human papillomavirus, or simian virus 40 DNA sequences in any of the 4 cases. One case had positive serologic results for anti-EBV antibodies, indicating a mild or chronic infection. CONCLUSIONS: LELC of the uterine cervix shows the immunohistochemical profile of an aggressive tumor in spite of its good prognosis, in which CD8 cytotoxic suppressor lymphocytes could play an important role. Based on our results, the role of EBV, human papillomavirus, or simian virus 40 in the pathogenesis of LELC of the uterine cervix in Western women remains unclear.

Transformation of vulvar pseudolymphoma (lymphoma-like lesion) into a marginal zone B-cell lymphoma of labium majus.

Lymphomas arising in the female genital tract are extremely uncommon. Diffuse large B-cell lymphoma and follicular lymphoma are the most common types. We describe the case of an 80-year-old woman with a recurrent lesion in the vulva initially diagnosed as a lymphoma-like lesion and evolving 7 years later into a marginal zone B-cell lymphoma (lymphoplasmacytic lymphoma). Diagnosis was based on the monotypic pattern of the plasmacellular component and the clonal rearrangement of immunoglobulin heavy chain genes. No previous cases of vulvar marginal zone B-cell lymphoma arising in the context of a persistent lymphoma-like lesion have been reported. We highlight the importance of differentiating benign from malignant lymphoid infiltrates in the vulva.

Angiolymphoid hyperplasia with eosinophilia involving the cubital nerve.

A tumor involving cubital nerve was resected and studied; it was classified as an angiolymphoid hyperplasia with eosinophilia (ALHE). Immunohistochemical and molecular study was done both to confirm the reactive nature of the process and rule out the presence of clonal T or B cell rearrangement. This lesion has been designated as epitheloid hemangioma [Coindre (1994) Ann Pathol 14:426]. Typically, ALHE occurs in the skin and the subcutaneous tissue, and extracutaneous involvement is rare. No cases of ALHE affecting a nerve have been described, but a case of Kimura's disease, the lesions of which have repeatedly been confused with ALHE, has been reported involving median nerve.

Pseudotumor de rinofaringe tuberculoso / Tuberculous Pseudotumor of the Rhinopharynx

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Tratamiento conservador del adenocarcinoma de endometrio. Obtención de dos gestaciones con recién nacidos sanos / Conservative treatment of endometrial adenocarcinoma followed by two pregnancies with healthy neonates

Se presenta un caso de adenocarcinoma de endometrio bien diferenciado en una mujer de 30 años, sin hijos, cuya lesión se trató con gestágenos y resección histeroscópica. Tras el tratamiento se consiguió una gestación normal, que se siguió, durante 18 meses, de una anticoncepción con un dispositivo intrauterino (DIU) de levonorgestrel. Tras retirar el DIU se consiguió otra gestación normal. Finalmente, completados los deseos reproductivos, se practicó una histerectomía total con doble anexectomía. Se comentan los aspectos éticos, diagnósticos y terapéuticos, así como las incertidumbres que tuvimos que afrontar, incluida la posibilidad de progresión de las lesiones y defunción de la paciente (AU)

We present the case of a 30-year-old childless woman who was diagnosed with a well-differentiated endometrial adenocarcinoma. The patient chose conservative treatment consisting of megestrol and hysteroscopic resection. After this treatment, a normal pregnancy ensued, followed by contraception with an intrauterine device (IUD) delivering levonorgestrel for 18 months. After removal of the IUD, a second normal pregnancy occurred. After the second pregnancy, the patient had no desire for more children and a total hysterectomy with bilateral salpingo-oophorectomy was performed. We discuss the ethical, diagnostic and therapeutic dilemmas posed by this case, including the possibility of progression and patient death (AU)