Autoantibodies against P53 protein in patients with transitional cell carcinoma of the bladder.

Cellular accumulation and conformational changes of mutant p53 could act as immunogens for auto-antibodies (auto-Abs) generation when altered p53 from tumoral cells reaches the blood stream. Our main objective was to compare the presence and clinical implications of p53-antibodies in serum with the immunohistochemical (IHC) tissue overexpression of protein p53 in patients with transitional cell carcinoma of the bladder, evaluating their association with bladder cancer parameters and their prognostic value. The study comprised 59 patients with bladder cancer (group 1) and 15 healthy controls (group 2). Serum p53-Abs were measured by ELISA. Mutant p53 protein IHC overexpression was examined from paraffin embedded tissues using monoclonal DO-7 Ab. Serum p53-Abs were detected in 14/59 and IHC P53 was positive in 24/59 patients from group 1. All p53-Abs positive patients had IHC p53 positive tumors, but some patients with IHC positive immunoreactivity showed undetectable p53-Abs. None of the healthy controls had detectable p53-Abs. Titres of p53-Abs were associated with stage and grade. P53 overexpression was dependent on stage, grade, pattern of growth and focality. P53 Abs showed a significant prognostic value for disease free survival (p = 0.0059) and life expectancy (p < 0.0005) and for IHQ p53 for life expectancy (p = 0.0033). Patients with positive P53 Abs showed a higher probability for a shorter survival OR = 6.38 (1.77-22.99) than those who were positive for IHQ p53 OR = 4.00 (1.31-12.8) or those who were negative for p53 Abs and/or IHQ p53. The measurement of p53 Abs in serum appeared to be a simple determination which might reflect the p53 status and might help in the selection of those bladder cancer patients with a worse prognosis.

Phyllodes tumor in ectopic breast tissue of the vulva.

Phyllodes tumor arising from ectopic breast tissue of the vulva is an extremely rare occurrence. A case is reported in a 34-year-old nulligravida woman, presenting as a nodule on the left labium majus. A simple excision was carried out, and no recurrence has been detected after 18 months of follow-up.

Phyllodes tumor of the breast with actin inclusions in stromal cells: diagnosis by fine-needle aspiration cytology.

The occurrence of hyaline inclusions in stromal cells in fibroepithelial tumors of the breast is very uncommon. These inclusions, characteristic of infantile digital fibromatosis, are comprised of actin filaments. This report illustrates a case of a benign phyllodes tumor of the breast with inclusion bodies, identified by fine-needle aspiration. Histologically, many of the stromal cells contained round intracytoplasmic inclusions, with positivity for smooth muscle actin.

[Intestinal obstruction secondary to endometriosis of the colon]. / Obstrucción intestinal secundaria a endometriosis de colon.

Endometriosis is defined as the presence of endometrial tissue outside the uterine cavity. Although in most cases it is a benign disorder, it may be aggressive producing local invasion and even metastasis. Endometrial implantation has been reported in many organs including the small and large intestine leading to acute or chronic symptomatology. The clinical picture of intestinal obstruction is due to stenosis produced by the adherences or fibrosis caused by endometrial sloughing. We present a case of intestinal endometriosis with clinical manifestation of obstruction of the colon. This disorder should be included in the differential diagnosis of fertile females presenting intestinal obstruction with no other predisposing factors.

[Etiology of upper gastrointestinal bleeding of peptic origin: role of Helicobacter pylori and NSAIDs]. / Etiología de la hemorragia digestiva alta de origen péptico: papel de Helicobacter pylori y los antiinflamatorios no esteroideos.

INTRODUCTION: Upper gastrointestinal bleeding continues to be a severe and frequent complication in ulcerative disease. Etiologic diagnosis in these patients is highly important in order to initiate appropriate treatment and prevent bleeding recurrence. OBJECTIVE: 1. To investigate the prevalence of Helicobacter pylori infection and use of NSAIDs in patients with upper gastrointestinal hemorrhage of peptic origin. 2. To analyze the strategy used for the diagnosis of H. pylori in our previous work. PATIENTS AND MEHTODS: Seventy-three patients with endoscopically-diagnosed upper gastrointestinal bleeding of peptic origin were included in the study. The use of NSAIDs was investigated. H. pylori infection was diagnosed if one of the following tests was positive: urease test, histology, breath test. RESULTS: H. pylori infection was found in 92% of duodenal ulcers and in 88% of gastric ulcers. Fifty-six percent of the patients had taken NSAIDs. Excluding these patients resulted in an H. pylori infection rate of 96.7%. The diagnosis was based on urease test in 46%. In the remaining patients, breath test and histology were required. CONCLUSIONS: The main etiology in patients with upper gastrointestinal bleeding of peptic origin is H. pylori infection followed by the use of NSAIDs, and these two factors frequently coexist. The strategy of performing a urease test and, when this is negative, performing histological study and a breath test, is valid and allows a diagnosis of H. pylori infection to be made even if patients are receiving treatment that could make diagnosis difficult.

[Rhabdomyoma in the adult]. / Rabdomioma del adulto.

Rhabdomyoma in adults is a rare benign tumor of the skeletal muscle that usually arises in the head and neck region. We report a new case of this rare tumor located in the tongue. The treatment, evolution, and anatomo-pathologic findings are described.

[Localized laryngeal amyloidosis. Endoscopic surgery with CO2 laser]. / Amiloidosis laríngea localizada. Cirugía endoscópica con láser CO2.

Laryngeal amyloidosis is a very rare disease. In the upper airways, the most common localization is the laryngeal organ, particularly the supraglotic region. Usually laryngeal amyloidosis is a localized primary form, although it has occasionally been reported in conjunction with system amyloidosis. We are reporting a new case of localized primary laryngeal amyloidosis in the right arytenoid mucosa in a 66 years old woman who underwent CO2 laser endoscopic surgery.

Plasmacitosis cutánea: una infrecuente enfermedad cutánea a tener en cuenta / Cutaneous Plasmacytosis: A Rare Diagnosis to Bear in Mind

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[Perifollicular xanthomatosis as a key histological finding in Fox-Fordyce disease]. / Xantomatosis perifolicular: hallazgo histológico clave en la enfermedad de Fox-Fordyce.

Fox-Fordyce disease is a rare skin condition characterized by the presence of multiple pruritic follicular papules in areas rich in apocrine glands, such as the axillae, mammary areolae, or genital regions. There is a high degree of variability in the histological findings seen in Fox-Fordyce disease. In addition to those described as typical of this entity, such as dilation of the infundibulum and hyperkeratosis and spongiosis of the infundibular epithelium, many other histological changes can be observed. We report the case of a 21-year-old woman with Fox-Fordyce disease and highlight the importance of perifollicular xanthomatosis as a key histological finding in the diagnosis of the disease.

[Protocol proposal for the histological report of the primary tumor in patients with cutaneous melanoma from the Task Force for Cutaneous Melanoma of the Valencian Community]. / Propuesta de protocolo para el informe histológico del tumor primario de los pacientes con un melanoma cutáneo del Grupo de Trabajo para el Melanoma Cutáneo de la Comunidad Valenciana.

This text compiles a histological protocol proposal for cutaneous melanoma agreed by the Task Force for Cutaneous Melanoma of the Valencian Community. It brings together the protocol itself and, in addition, includes a description of each of the proposed variables that has shown to have a greater prognostic impact in previous works.

Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) treated with 2-chlorodeoxyadenosine.

Sinus histiocytosis with massive lymphadenopathy (SHML) or Rosai-Dorfman disease (RDD) is a rare but well-defined histiocytic proliferative disorder of unknown etiology that usually presents with cervical lymphadenopathy, fever, leukocytosis, and hypergammaglobulinemia in an otherwise healthy child. Although many patients undergo spontaneous remission, a subset of patients with systemic disease has a more serious course. For those patients with a poor outcome, steroids and chemotherapeutic agents such as etoposide or 6-mercaptopurine plus low dose methotrexate have been used. We present a child with a massive cervical lymphadenopathy treated with 2-chlorodeoxyadenosine (2-CdA, cladribine) after other approaches failed.

Changes in skull components of the squirrel monkey evoked by growth and nutrition: an experimental study.

Twenty weanling 6-month-old male squirrel monkeys were allotted to the following treatments: 1) first control animals were killed at weaning; 2) second control animals were killed when 24 months old; and 3) malnourished animals were fed on a low-protein diet and killed at age 24 months. Lateral and vertical teleradiographies were taken. Growth of the neurocranial and splanchnocranial components were measured by volumetric (size estimators) and morphometric (shape estimators) indices. All facial components grew. The neurocranial components showed a heterogeneous behavior: The anteroneural component remained stable, and the increase of the midneural component was compensated by a decrease in the posteroneural component. Malnutrition affected the growths of 1) the craniofacial complex, 2) the splanchnocranium, and 3) the respiratory and midneural components. Growth influenced skull shape through 1) increases of the splanchnocranium and the midneural component relative to the neurocranium; 2) decreases of the masticatory and optic components relative to the splanchnocranium, and 3) decreases of the anteroneural and posteroneural components relative to the neurocranium. Malnutrition influenced skull shape through the relationship between the anteroneural component and the neurocranium. These results confirmed the existence of functional interrelationships among the cranial components. A new approach to craniological studies is suggested.

Comparison of diagnostic methods for Helicobacter pylori infection in patients with upper gastrointestinal bleeding.

BACKGROUND: Accuracy of the most frequently used tests for diagnosing Helicobacter pylori infection in patients with upper gastrointestinal bleeding of peptic origin is determined. METHODS: Seventy-eight patients with endoscopically-proven upper gastrointestinal bleeding of peptic origin were included. The presence of H. pylori was considered when observed from the histology or, if negative, when serology and breath test were both positive. Accuracy of the rapid urease test was estimated in accordance with results obtained with other diagnostic methods. RESULTS: Lesions causing gastrointestinal bleeding were 56 duodenal ulcers, 13 gastric ulcers, 7 pyloric channel ulcers, 13 acute lesions of the gastric mucosa and 16 erosive duodenitis. H. pylori infection was present in 68 patients (87.2%). Forty-four patients had received non-steroidal anti-inflammatory drugs. The sensitivity/specificity (%) of the diagnostic methods was 48.5/100 for the rapid urease test, 91/77.8 for the breath test, 89.5/80 for serology and 86.3/100 for histology. The prior consumption of proton-pump inhibitors and antibiotics induced false-negative results in the rapid urease test and breath test, with no effect on serology and histology. CONCLUSIONS: The prevalence of H. pylori infection in patients with upper gastrointestinal bleeding from peptic lesions is high. Sensitivity of the rapid urease test for diagnosing H. pylori is low in this setting. Cases with negative rapid urease test need the combination of two or more additional tests if diagnosis is to be achieved. Cases with positive rapid urease test do not need further investigation for diagnosis.