ABSTRACT
El cáncer de mama en hombres representa menos del 1% de los cánceres en el sexo masculino y casi el 1% de los cánceres de mama. Existe debido a su muy baja incidencia una falta de estudios clínicos aleatorizados. Desde el año 2008 hasta la fecha hemos diagnosticado cuatro cánceres en hombres, las edades comprendidas entre 49 y 61 años,correspondiendo a estadios IIB (2), in situ bilateral (1), IIIB(1), histológicamente eran: dos carcinoma ductal infiltrante, un Paget con nódulo palpable y un bilateral. El presente trabajo pretende dar a conocer el caso de un paciente masculino diagnosticado y tratado en nuestra institución, con cáncer de mama bilateral
The breast cancers in the men represent less than 1% of all cancers in the male population, and only 1% of all the breast cancers. Because his low incidence, there are absence of a randomized clinical studies. Since the 2008 years to the present, we were diagnoses for men breast cancers in the age between 49 and 61 years old. 2 corresponded to IIB stage, bilateral in situ (1) stage IIB (1), histological there are: 2 ductal and infiltrante, one Paget disease with palpable node an one bilateral. The present work is known a clinical case of male patient diagnoses and treatment in our institution with bilateral breast cancer
Subject(s)
Middle Aged , Carcinoma, Ductal, Breast , Incidence , Breast Neoplasms, Male/pathology , Breast Neoplasms, Male/therapy , Medical OncologyABSTRACT
Determinar características clínicas y patológicas del cáncer de mama en menores de 40 años diagnosticadas entre 2005 y 2010. Se realizó un estudio descriptivo, retrospectivo. De 52 493 evaluaciones mastológicas realizadas se reportaron 287 casos de cáncer de mama, 71 (24,74%) fueron en mujeres menores de 40 años. El mayor número de casos entre 36-40 años, 48 casos (66,67%). Mayor incidencia de carcinoma ductal infiltrante 53 casos (73,61%). Grado nuclear, predominantemente II y III. De 71 pacientes, 68 (95,77%) presentaron nódulos. Predominó estadio IIA y IIB, 40 casos (56,34%). La inmunohistoquímica, solo fue reportada en 43 pacientes (59,72%), 19 (47,5%) presentaron RE, RP, Her2 negativos, 14 (35%) RE, RP, Her2 positivos, 3 (6,98%) RE, RP positivos y Her 2 negativo, 2 (4,65%) RE neg, RP positivos y Her 2 negativos, 3 (6,98%) solo reporte RE positivos, no reportados RP y Her2,1 (22,33%)RE y RP positivos, Her 2 no reportado, 1 (22,33%) RE y RP negativo y Her 2 positivo dudoso. Las mujeres menores de 40 años con diagnóstico de cáncer de mama representan el 24,74% de todas las pacientes con este patología, 68 (95,77%) presentaron lesiones palpables, predominando estadio IIA, IIB, 40 (56,34%), hace necesario realizar mamografía diagnóstica en pacientes sintomáticas de cualquier edad, iniciar campañas de concientización, sugiriéndola como se hace nuestro centro a partir de 35 años
The clinical pathological features of breast cancer in patients under 40 diagnosed to 2005-2010. We performed retrospective descriptive study Of a total of 52 493, reported 287 cases of breast cancer, of these 71 cases (24.74%) were in women under 40 years. The age distribution the largest number of cases among 36-40 years 48 cases (66.67%). Histological type: Increased incidence of ductal carcinoma 53 cases (73.61%). Nuclear grade predominant II and III. 71 patients, 68 (95.77%) had nodules. Stage, predominantly IIA and IIB 40 cases (56.34%). Regarding immunohistochemistry, was only reported in 43 patients (59.72%), 19 (47.5%) had ER, PR, Her2 negative, 14(35%) had ER, PR, Her2 positive, 3 (6,98%) had ER, PR positive, Her 2 negative, 2 (4.65%) ER neg, PR positive, Her 2 negative, 3 (6.98%) report only ER-positive, PR andHer2 unreported, 1 (22.33%) ER and PR positive, Her 2 unreported, 1 (22.33%) ER and PR negative and HER2 positive doubtful. Women under 40 diagnosed with breast cancer accounting for 24.74% ofall patients with this pathology, of these, 68 (95.77%) had palpable lesions. Stage predominantly IIA and IIB 40cases (56.34%), making it necessary to perform diagnostic mammography in symptomatic patients of any age, andinitiate awareness campaigns for the start of the investigation, suggesting it as does our center from 35 years old
Subject(s)
Female , Breast Neoplasms/diagnosis , Breast Neoplasms/pathology , Breast Neoplasms/therapy , Prognosis , Medical OncologyABSTRACT
Trypanosoma cruzi causes a pan-infection, Chagas disease, in American mammals through fecal transmission by triatomine insects, resulting in an acute phase parasitemia with intracellularity mainly in the myocells and cells of the central nervous system (CNS).The parasites, due to the immune response, then decrease in number, characteristic of the life-long chronicity of the disease. We infected a mouse model with isolates obtained from reservoirs and vectors from rural and urban endemic areas in Venezuela. Intracellular proliferation and differentiation of the parasite in astrocytes, microglia, neurons, endothelial cells of the piarachnoid, cells of the Purkinje layer, and spinal ganglion cells, as well as extracellularly in the neuropil, were evaluated during the acute phase. Damages were identified as meningoencephalitis, astrocytosis, reactive microglia, acute neuronal degeneration by central chromatolysis, endothelial cell hyperplasia, edema of the neuropil, and satellitosis. This is the first time that satellitosis has been reported from a mammal infected with T. cruzi. Intracellular T. cruzi and inflammatory infiltrates were found in cardiac and skeletal myocytes and liver cells. No parasitism or alterations to the CNS were observed in the chronic mice, although they did show myocarditis and myocitis with extensive infiltrates. Our results are discussed in relation to hypotheses that deny the importance of the presence of tissue parasites versus the direct relationship between these and the damages produced during the chronic phase of Chagas disease. We also review the mechanisms proposed as responsible for the nervous phase of this parasitosis.
Subject(s)
Central Nervous System Diseases/parasitology , Chagas Disease/parasitology , Disease Models, Animal , Host-Parasite Interactions , Trypanosoma cruzi/pathogenicity , Animals , Central Nervous System/parasitology , Central Nervous System/pathology , Central Nervous System Diseases/pathology , Chagas Disease/pathology , Mice , VenezuelaABSTRACT
La colangitis esclerosante primaria es una enfermedad hepatobiliar progresiva caracterizada por una inflamación crónica con fibrosis periductal de los conductos biliares intra y extrahepáticos que producen constricciones y ectasia generalizadas del tracto biliar. Se presenta el caso de un escolar masculino de 12 años de edad, quien inicio enfermedad actual a partir de los 5 años de edad cuando presentó dolor abdominal recurrente localizado en epigastrio y mesogastrio, leve a moderada intensidad, tipo cólico. A partir de los 8 años de edad se anexó tinte ictérico en piel y mucosa, con orinas coloreadas en forma intermitente. A los 10 años de edad, el 16/06/2008, el dolor abdominal aumenta en intensidad acompañado de nauseas, recibió tratamiento con sucralfato y ranitidina sin mejoría por lo que el 19/06/2008 se hospitalizó. Se le realizó exámenes de laboratorio que reportó elevación de las transaminasas, fosfatasa alcalina y gamma glutamil transpeptidasa. Tomografía abdominal signos sugestivos de colangitis por lo que se realizó serología para algunos virus hepatotropos, colangioresonancia y posteriormente biopsia hepática corroborándose el diagnóstico de colangitis esclerosante primaria. Aunque es una enfermedad colestásica frecuentes en el adulto debe ser tomada en cuenta en niños para hacer un diagnóstico precoz y posterior seguimiento
Primary sclerosing cholangitis is a disease progressive hepatobiliary characterized by chronic inflammation with bile duct intra periductal fibrosis and extrahepatic that produce widespread biliary tract constrictions and ectasia. The case of a male school of 12 years of age who start current illness from 5 years of age when he presented recurrent abdominal pain located in the epigastrium and mesogastrio, mild to moderate intensity, cramping occurs. From the age of 8 was annexed on skin and mucosa, icteric dye with urine colored intermittently. To 10 years of age, 16/06/2008, abdominal pain increases in intensity accompanied of nausea, he received treatment with sucralfate and ranitidine without improvement for what 06 19, 2008 hospitalized. Laboratory tests which reported elevation of transaminases, alkaline phosphatase and gamma-glutamyl transpeptidase was carried out. Abdominal CT signs suggestive of cholangitis by what took place some virus serology hepatotropic, Magnetic Resonance Cholangiography and then liver biopsy corroborating the diagnosis of primary sclerosing cholangitis. Although is a disease common in the adult cholestatic should be taken into account in children to make an early diagnosis and subsequent follow-up
Subject(s)
Child , Cholangitis, Sclerosing/diagnosis , Cholangitis, Sclerosing/pathology , Cholangitis, Sclerosing/drug therapy , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Gastroenterology , PediatricsABSTRACT
Analizar las características de las microcalcificaciones en un grupo de pacientes clasificados como clase III, IV y V; y correlacionarlos con los resultados histológicos. Entre mayo 2004 y mayo 2009 se biopsiaron 165 pacientes bajo guía estereotáxica de las cuales 7 fueron clase III, 142 clase IV y 16 clase V. Se analizaron: por número, área, forma y distribución para establecer la clase mastológica y se correlacionaron con la histología. La clase mastológica predominante fue clase IV 142 pacientes (86,06 por ciento), clase V 16 pacientes (9,70 por ciento) y clase III 7 pacientes (4,24 por ciento), las características morfológicas predominantes fueron las microcalcificaciones amorfas (43,03 por ciento), el resultado histopatológico de las microcalcificaciones amorfas agrupadas se relacionan en mayor porcentaje con lesiones benignas 58,9 por ciento, mientras que las microcalcificaciones granulares segmentarias se relacionan predominantemente con lesiones proliferativas malignas 85,61 por ciento y 80 por ciento respectivamente, el fibroadenoma mamario fue el más frecuente con 20 casos (22,47 por ciento), de las lesiones proliferativas típicas la adenosis esclerosante fue predominante en 40 casos (59,70 por ciento), de lesiones proliferativas atípicas, la atipia epitelial plana tuvo mayor incidencia 7 (58,33 por ciento) y la patología maligna el carcinoma intraductal con 27 casos (50,94 por ciento). Existe correlación entre la morfología y distribución de las microcalcificaciones con respecto al resultado de anatomía patológica, microcalcificaciones amorfas agrupadas se relacionan con patología benigna, mientras que microcalcificaciones granulares segmentarias y amorfas segmentarias se correlacionan con patología proliferativa y maligna.
Analyzing the characteristics of micro calcifications biopsy under stereotactic guidance in group of patients classified class III, IV, V, correlate with histological results. In service imaging and intervention of unit Mastology, Barcelona period May 2004-May 2009 biopsied 206 patients were guided by stereotaxic micro calcifications which 7 were class III 142 class IV 16 class V. Analyzed number, area, shape, and distribution to establish the class mastologic and correlated with histological. 181 patients with diagnosis of microcalcifications, which are considered suspect classification BIRADS. The class was predominant s IV 142 patients (86.06 percent), followed by class V 16 patients (9.70 percent) class III and 7 patients (4.24 percent), the predominant morphological feature were clustered amorphous micro calcifications (43.03 percent), with regard to histopathologic results are clustered amorphous microcalcifications associated with greater percentage benign lesions 58.9 percent, while the segmental granular and amorphous microcalcifications relate predominantly segmental proliferative and malignant lesions and 80 percent 85.61 percent respectively, of the lesions found fibroadenoma was the most frequent with 20 cases (22.47 percent), proliferative lesions typical of sclerosing adenosis was predominant 40 cases (59.70 percent) atypical proliferative lesions, flat epithelial atypia had higher incidence 7 (58.33 percent) malignant pathology the intraductal carcinoma 27 cases (50.94 percent). Correlation between morphology distributions of micro calcifications on the outcome pathologic clustered amorphous micro calcifications associated with benign disease, while segmental granular amorphous micro calcifications correlated with segmental proliferative and malignant.
Subject(s)
Humans , Female , Epithelial Cells/metabolism , Fibroadenoma/physiopathology , Mammography/methods , Mastitis/etiology , Breast Neoplasms/pathology , Stereotaxic Techniques/trends , Biopsy/methods , Calcification, Physiologic , Carcinoma, Ductal, Breast/pathologyABSTRACT
El carcinoma adenoideo quístico de la mama es inusual se presenta con una frecuencia menor al 1 por ciento. La presentación de este caso está relacionada con la rareza del mismo, incidencia de 0,1 por ciento. Paciente femenina 56 años de edad, menarquía: 15 años. IIIG, IP, IC, IA. Menopausia: 2002. No recibe terapia hormonal. No antecedentes personales y/o familiares de patología mamaria. Consulta a nuestra unidad por control, examen físico: normal. Mamografía: mamas con moderada cantidad de tejido fibroglandular, evidencia opacidad nodular en unión de cuadrantes inferiores mama derecha. Eco mamario: imagen aspecto sólido bordes regulares, ubicada en cuadrantes inferiores de mama derecha de 6,1 mm x 7,1 mm x 7,0 mm, se corresponde con opacidad nodular mamográfica. Evaluación mastológica clase IV. Se recomienda evaluación histológica de la lesión a través de técnica de biopsia ecoguiada. Anatomía patológica: carcinoma adenoideo quístico. Grado nuclear II, actividad mitótica atípica presente. Desmoplasia estromal severa. Estudio de inmunohistoquímica: CK7+ (células secretoras), CK7/CK14+(células adenoescamosas), colágeno tipo IV. Se realiza mastectomía parcial oncológica derecha, previa localización y confirmación por imagen márgenes por corte congelado más ganglio centinela. Anatomía patológica: carcinoma adenoideo quístico de 0,7 cm. Grado nuclear I. Actividad mitótica atípica presente. Bordes de resección quirúrgica, margen adicional libres de lesión. Patología mamaria adicional: ectasia ductal y condición fibroquística. Ganglio linfático centinela uno sin evidencia de neoplasia. En marzo de 2009, paciente acude a control, donde se realiza evaluación mastológica concluyéndose clase IIRF.
Adenoid cystic breast carcinoma is rare variant occurring less than 1 percent. The presentation of this case is related to the rarity of it, because the incidence of this tumor in the breast is 0.1 percent. Female patient, 56 years old, menarche: 15 years. III pregnancy: IB, IP, IA. Menopause: 2002. Not receiving substitutive hormone therapy. No personal and family history of breast pathology. She came in August, 2007 for breast evaluation, physical examination: Normal. Mammography: Breast with moderate amount of fibroglandular tissue, nodular opacity in union of lower quadrants right breast. Breast ultrasound: Solid image, with regular edges, located at junction of lower quadrants right breast, measuring 6.1 mm x 7.1 mm x 7.0 mm, which corresponds with nodular mammographic opacity. Mastological evaluation class IV. Histological evaluation of lesion, using the technique of microbiopsia ecoguide. Pathology report: Adenoid cystic carcinoma, nuclear grade II. This atypical mitotic activity, stromal desmoplasia severe. Immunohistochemistry: CK7 + (secretory cells), CK7/CK14 + (Adenosquamous cell), type IV collagen. Partial mastectomy was performed in oncology right after echolocate confirmation by imaging, margins cut more frozen sentinel node. With pathology report: Adenoid cystic carcinoma of 0.7 cm. nuclear grade I, atypical mitotic activity, edge of surgical resection and additional margin free of injury. Additional mammary pathology: Fibrocystic status, ductal ectasia. A sentinel lymph node without evidence of malignancy; March 2009, the patient comes to control, where assessment is completed mastological class IIRF.
Subject(s)
Humans , Female , Middle Aged , Carcinoma, Adenoid Cystic/diagnosis , Carcinoma, Adenoid Cystic/therapy , Palpation , Neoplasm Recurrence, Local/physiopathologyABSTRACT
Reportar un caso de tumor de células granulares de la mama, neoplasia generalmente benigna, de origen schwanniano que simula a menudo, clínica y radiológicamente un carcinoma mamario. Descripción de un caso clínico y revisión de la literatura. Paciente femenina de 33 años de edad con nódulo en mama derecha, evaluación mastológica clase V (Lesión de alta sospecha). Se propone y efectúa microbiopsia ecoguiada: Fibroadenoma mamario. Debido a la discordancia de los resultados, se realiza mastectomía parcial derecha con guía y control radiológico y corte congelado negativo para malignidad. Biopsia definitiva: Tumor de células granulares. Inmunohistoquímica: Inmunorreacción positiva en las células tumorales con proteína S100 y enolasa neuronal específica. 1. El tumor de células granulares de la mama aunque es una entidad poco frecuente y de carácter benigno, simula clínica y radiológicamente un carcinoma mamario, por tanto debe incluirse como diagnóstico diferencial. 2. La histogénesis del tumor de células granulares de la mama sigue en discusión. 3. El tumor en general es benigno y solitario, pero puede recidivar y sufrir transformación neoplásica (raro pero posible y publicado), por lo cual las pacientes deben ser estrictamente seguidas.
The objective of this work is to report a granular cells breast tumor case, generally benign neoplasia, of Schwann cells origin that often simulates a breast carcinoma. Description of a clinical case and literature revision. A 33 years old female patient, with right breast nodule attended to a mastology evaluation, which was concluded class V (Highly suspicious lesion). And ultrasound guided core biopsy was done. The pathology report was breast fibroadenoma. Due to the disagreement of the results with the suspicious images, she was offered with image guided right partial mastectomy plus preoperative frozen section which was report negative for malignancy. The definitive biopsy: Granular cells Breast Tumor. Immunohistochemical: Positive immunoreactivity in the tumor cells with protein S100 and enolase neuronal specific. 1. Granular cells breast tumors are not a frequent entity. Although is benign, it clinically and radiological simulates a breast carcinoma. 2. Histogenesis of granular cells breast tumor continues in discussion. 3. The tumor in general is benign and solitary, but it can recur and experiment malignant conversion (unusual but possible and published), for this reasons the patients should be strictly followed up.