Type II intrapancreatic choledochal malignant cyst in adults: duodenopancreatectomy.

A 62-year-old female patient was admitted for abdominal pain and vomiting. Imaging tests revealed a solid-cystic lesion at the head of the pancreas communicating with the distal bile duct. A Todani type II choledochal cyst was diagnosed with neoplastic degeneration after cytological diagnosis with endoscopic ultrasound-guided puncture. The patient was treated with a cephalic duodenopancreatectomy with curative intention.

Cytopathology of undifferentiated (embryonal) sarcoma of the liver.

We have studied one undifferentiated (embryonal) sarcoma of the liver (USL) by fine-needle aspiration cytology (FNAC) and have correlated the cytologic findings with those seen in the histologic sections. The main cytologic and immunocytochemical features were: cellular aspirates, mesenchymal clusters, disparity in individual cell size (small round cells, and multinucleated giant cells, sometimes bizarre), absence of biliary pigment, AFP-negative and vimentin-negative tumor cells, AFP-negative and PAS-positive hyaline globules, and apoptotic cells. Only immunostaining for alpha-1-antitrypsin, alpha-1-antichymotrypsin, and carcinoembryonic antigen were positive in tumor cells in histologic sections. The differential diagnosis should be carried out with rhabdomyosarcomas, hepatoblastomas, malignant fibrous histiocytomas, and poorly differentiated hepatocarcinomas. We think that the cytologic features observed in this case, evaluated both in the appropriate clinical context and in the light of the laboratory findings, may permit the correct diagnosis of this infrequent liver tumor. Nevertheless, more cases need to be studied to assess the reliability of our findings.

Melanocytic schwannoma: the cytologic aspect in fine-needle aspiration cytology (FNAC): report of a case located in the spinal cord.

We describe a case of intramedullary melanocytic schwannoma (MS) studied by means of fine-needle aspiration cytology (FNAC). The main cytologic features were (1) large three-dimensional clusters overshadowed by heavy pigment deposits which tested positive for Fontana Masson (and bleached with potassium permanganate), HMB-45, Vimentin, and S-100 protein; (2) loose syncytial monolayered sheets with very little pigment deposit; and (3) isolated spindle cells with polarized nucleus and tapered, thin cytoplasmic ends. Both the cytologic features and the immunophenotypic profile were nonspecific and on their own were insufficient to allow the diagnosis of MS to be reached. Clinical data and the magnetic resonance image (MRI) in conjunction with the cytologic findings did suggest the diagnosis of intramedullary MS.

Fine-needle aspiration of subacute granulomatous thyroiditis (De Quervain's thyroiditis): a clinico-cytologic review of 36 cases.

Although subacute granulomatous thyroiditis (SGT) is usually diagnose clinically, there are other thyroid conditions that must be ruled out. This task is achieved by means of fine-needle aspiration (FNA). In retrospect, the clinical and cytologic findings seen in 36 SGT cases are reassessed with a view to deciding which findings are most reliable for reaching a confident cytologic diagnosis. These are: the simultaneous presence in the same aspirate of the following cells: 1) follicular cells with intravacuolar granules and/or plump transformed follicular cells; 2) epithelioid granulomas; 3) multinucleated giant cells; 4) an acute and chronic inflammatory dirty background; 5) the absence of the following cells: fire-flare cells, hypertrophic follicular cells, oncocytic cells, and transformed lymphocytes. The absence of one or more of these requirements does not exclude SGT but does increase the number of thyroid conditions that come into the differential diagnosis. In these cases, it is essential to review clinical data carefully and to submit the patient to a close clinical and FNA follow-up.

Mimics of pilomatrixomas in fine-needle aspirates.

This is a review of the fine-needle aspirates (FNAs) of nine pilomatrixomas (PMs) found in a series of 1,500 FNAs performed on skin nodules. The objective is to determine and list the cytologic findings that might mislead the less-experienced cytopathologist and to give him advice on how to avoid such errors. The following recommendations are made: 1) The FNAs should be carried out and the smears interpreted by the same person. 2) Clinical data, particularly age and location, are of paramount importance. 3) Shadow cells are pathognomonic of PMs. 4) Basaloid nuclei with prominent nucleoli should not be overdiagnosed. 5) Use both Papanicolaou and Diff-Quik stains. 6) Think of PM when performing and interpreting aspirations from subcutaneous growths located in the head and neck of young persons.

[An evaluation of the clinical significance of gastric dysplasia: a histological follow-up study]. / Evaluación del significado clínico de la displasia gástrica: estudio de seguimiento histológico.

To evaluate the clinical and prognostic significance of gastric dysplasia, we have carried out a study on 59 patients with histologic data obtained in a sequential way. The initial diagnosis was mild dysplasia in 24 patients, moderate in 18 cases and severe in 17 cases. The length of the follow up varied from one month to 13 years. The results suggest that, whereas cases of mild and moderate intensity tend to stability or regression, severe dysplasia is a reliable marker of high risk of gastric cancer. However, in our series as well as in the experience of others, the time elapsed between the diagnosis of severe dysplasia and the development of gastric carcinoma is usually very short. Because of this, we conclude that a carcinoma was probably already present when the initial biopsy was made. This conclusion emphasizes its diagnostic rather than its prognostic value in most occasions. Of 12 cases in our series which evolved to gastric carcinoma, 4 were diagnosed in an early stage (intramucosal). This fact confirms the importance of the recognition of gastric dysplasia for the early detection and control of these patients.

[Aortoenteric fistula: an unusual cause of gastrointestinal hemorrhage]. / Fístula aortoentérica: una causa inusual de hemorragia digestiva.

The formation of an aortoenteric fistula is an infrequent cause of intestinal bleeding which carries out a bad prognosis. The causes may be diverse and the clinical picture is, occasionally, very unspecific with a high index of suspicion being fundamental in the management of this type of patients. Four cases of aortoenteric fistula which the authors believe to be clearly demonstrative are presented. One of these cases may currently be considered as very rare in Spain due to the etiology of the same. The authors emphasize the importance of exhaustive exploration by oral endoscopy which is able to diagnosis the localization of the bleeding in 80% of the cases. However they also underline the need for laparotomy, particularly in carriers of aortic vascular grafts which are currently the most important risk group, since confirmation of diagnosis by imaging methods may be delayed.

[Giant cell leiomyosarcoma of the spermatic cord: a report]. / Leiomiosarcoma de cordón espermático con células gigantes: una observación.

Presentation of the case of one patient with a leiomyosarcoma of the spermatic cord with presence of numerous giant cells, a remarkably unusual finding. Presence of this type of cells, as well as their positivity for histiocytic markers in immunohistochemical staining, raise considerable problems for the differential diagnosis of this neoplasia with malignant fibrous histiocytomas, which probably requires a different, more aggressive therapeutical approach.

[Paratesticular epithelioid hemangioendothelioma: an infrequent vascular tumor]. / Hemangioendotelioma Epitelioide paratesticular: un tumor vascular poco frecuente.

Paratesticular vascular lesions are very uncommon. One of them, the epithelioid hemangioendothelioma, is a vascular tumour which grows around a vessel and in characterized for presenting epithelioid endothelial cells. Is very rare and it has good prognosis. This paper reports one case of paratesticular epithelioid hemangioendothelioma.

Vómitos y diarrea con importante repercusión general en varón de edad media / Vomiting and diarrhea with important general repercussion in middle aged male

No disponible

Amiloidosis gastrointestinal pseudoneoplásica / Pseudoneoplastic gastrointestinal amyloidosis

No disponible