Expression of so-called adhesion proteins and DNA cytometric analysis in malignant parotid tumours as predictors of clinical outcome.

Tumours of the salivary glands are rare, and account for only 0.5-1% of all tumours. We have analysed the cytoarchitectural structure of such tumours by studying 3 binding proteins that act on different parts of the glandular epithelial architecture: e-cadherin, laminin, and CD44. We analysed the DNA using image cytometry to evaluate ploidy, S-phase, and 5c exceeding rate, and to compare the biological aggressiveness of the proteins. Our goal was to correlate the degree of structural integrity and the histological grade of the injury, and to try to find new biological factors that would help to predict the evolution of disease in the salivary glands. The immunoexpression pattern of the so-called adhesion proteins of the salivary glands, when combined, yields important data about the aggressiveness of malignant neoplasms, and provides useful tools with which to predict the biological evolution of malignant lesions.

Contribución del tabaquismo como factor de riesgo cardiovascular en la aparición de un segundo evento isquémico / Contribution of smoking as cardiovascular risk factor in the appearance of a second ischemic event

Introducción y objetivos: Valorar la repercusión del consumo de tabaco y su cese, en pacientes que han presentado un infarto agudo demiocardio y su seguimiento a 5 años. Material y métodos: Se incluyeron sólo fumadores activos (64 casos), excluyéndose exfumadores, no fumadores y fallecidos en el mismo evento y se realizó seguimiento a 5 años, analizándose: sexo, edad, factores de riesgo asociados, eventos cardiovasculares posteriores, y características del IAM de los que abandonaron el tabaco y de los que persistíaél. Las variables cuantitativas con distribución normal se expusieron con la media, con la mediana si la distribución no era normal. La comparación de variables cualitativas continuas se utilizaron test paramétricos y no paramétricos (χ2 y U de Mann-Whitney). Resultados: A los 5 años el 37,5% (24/64) continúan fumando (edad media 59,43 años) y el 62,5% (40/64) abandonaron el tabáquico (edad media 53, 58 años). Los pacientes que continuaban fumando presentabanun mayor riesgo de presentar episodio cardiovascular que los que abandonaban el hábito tabáquico (70,8% vs 17,5%), existía una mayor mortalidad y un peor grado funcional. Conclusiones: La persistencia del tabaquismo después de un IAM se asocia a mayor riesgo de padecer un segundo episodio cardiovascular respecto a los pacientes que dejan de fumar. Se debería incidir en desarrollo de protocolos de deshabituación tabáquica con el fin de aumentar el porcentaje de éxito en los pacientes cardiovasculares (AU)

Material and methods: 310 myocardial infarctions that occurred in 1998 were analysed, in the follow-up were included the active smokers(64 patients), excluding the ex-smokers, non-smokers and the deceased in the same cardiovascular event, a study has been conducted of these five years later, analysing sex, age, existence of risk factors associated with the consumption of tobacco and characteristics of those that abandoned the use of tobacco and those that persisted in its use, following cardiovascular events, characteristics of the myocardial infarction. The quantitative variables with normal distribution were exposed with the average and with the median if the distribution was not normal. In the comparison of continuous cualitative variables, parametric and non parametrictests were used (χ2 and U of Mann-Whitney). Results: After 5 years, 37.5% (40/64) abandoned smoking, and 24 (37.5%) persisted in its consumption. The average age of the groups was 53.58 and 59.43 years old respectively. After 5 years, the patients that continued smoking presented a higher risk of presenting a cardiovascular episode than those that abandoned their smoking habit (70.8% vs 17.5%) as well as a higher mortality rate end worse functioning level. Conclusions: The persistence of tobacco use after a myocardial infarction is associated with a higher risk of having a second cardiovascular event in respect to the patients that stopped smoking. We should incite in the development of protocols of stop smoking with the end of increasing the percentage of success in cardiovascular patients (AU)

Tumores sincrónicos de glándula salivar. A propósito de dos casos / No disponible

Presentamos dos casos de pacientes con tumores sincrónicos deglándula salivar. El primero se refiere a dos tumores benignos en la mismaglándula parótida, mientras que el segundo caso se trata de una lesiónmaligna y otra benigna en glándulas parótida y submaxilar ipsilaterales.Los dobles tumores sincrónicos homolaterales de glándula salivar son muyinfrecuentes, suponiendo menos del 0,3% de los tumores de esta localización.La bibliografía revisada refiere 42 casos entre los que sólo 9 presentanun tumor maligno y otro benigno.El diagnóstico citológico preoperatorio, junto con una exhaustiva inspecciónmacroscópica intraoperatoria son las claves para detectar los segundostumores, habitualmente más pequeños y no detectados en estudiosprevios, y así adecuar el procedimiento terapéutico

We present two new cases of synchronous tumorsof the salivary gland. The first one refers to two benign tumorsin the same parotid gland, while second one shows a benignlesion and a malignant tumor in two ipsilateral salivaryglands.The appearance of synchronous multiple unilateral parotidtumors of different histologic types is extremely rare, accountingfor less than 0.3%; this is usually a Warthin´s Tumorassociated to other tumors. The current literature has beenreviewed and 42 cases have been found entailing two differentparotid tumors coexisting. Of these 11 referred to adenolymphomaassociated with pleomorphic adenoma.Preoperative cytological diagnosis, as well as an exhaustiveintraoperative inspection are the clues to discover nonidentifiedsecond tumors

El papel modulador de p16ink4a en la infección por el virus del papiloma humano / Modulator role of p16ink4a in human papillomavirus infection

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Strongyloides stercolaris infection mimicking a malignant tumour in a non-immunocompromised patient. Diagnosis by bronchoalveolar cytology.

Autoinfective strongyloidiasis is often fatal in immunosuppressed patients or in immunocomprised hosts. An interesting case of Strongyloides stercolaris hyperinfection was seen in an immunocompetent patient. This report describes a case of fatal strogyloidiasis in a 79 year old man, who had suffered gastrointestinal discomfort for years, and who presented because of respiratory illness. A chest radiograph showed an irregular mass close to the mediastinum and interstitial infiltrates, but blood eosinophilia was not observed. Cytological examination of the samples obtained from bronchial aspiration and brushing identified several filariform larvae. Thus, cytology was essential for the correct diagnosis in this patient and is a very reliable method to diagnose lung parasitosis.

Alteraciones inmunológicas en pacientes epilépticos asociadas a la localización del foco epileptógeno / Immunological disorders in epileptic patients are associated to the epileptogenic focus localization

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Carcinoma epidermoide de uretra y glande ¿dos tumores independientes? / Epidermoid carcinoma of the urethra and glans penis two independent tumors?

Un varón de 64 años fue tratado en nuestro hospital por presentar una gran tumoración en el glande peneano. Durante el acto quirúrgico se detectó otra neoformación en la uretra. El estudio microscópico mostró un carcinoma epidermoide concomitante en glande peneano y uretra sin tejido afectado entre ambos tumores

A 64 years-old man is treated in our hospital presenting a big tumor in glans penis. During the surgical act, another neoplasm is detected in the urethra. The microscopic study showed a concomintant epidermoid carcinoma of glans penis and urethra with non-affected tissue between both tumors

Fibroma ameloblástico versus quiste folicular hiperplásico / Ameloblastic fibroma versus hyperplastic follicular cyst

El fibroma ameloblástico (FA) es un tumor odontogénico mixto, compuesto por tejido mesenquimal y epitelio odontogénico, representando el 2 por ciento de los tumores odontogénicos, mientras que el quiste dentígero o folicular (QF), el segundo quiste odontogénico en frecuencia, está compuesto exclusivamente por tejido conjuntivo laxo (mesénquima), si bien, el saco fibroso puede contener restos de epitelio odontogénico incluidos, dando lugar a una imagen histológica muy similar.La importancia de esta diferenciación radica en el tratamiento, que es ligeramente más agresivo en el FA y en el comportamiento biológico, ya que el FA puede derivar en un sarcoma ameloblástico, y el QF puede evolucionar hacia ameloblastoma y más raramente carcinoma mucoepidermoide. (AU)

Primary anaplastic large cell lymphoma of the testis.

Anaplastic large cell lymphoma (ALCL) was first described by Stein et al. in 1985, at that time neoplastic cells were labeled by the monoclonal antibody CD30. ALCL was included as a differentiate entity in the reviewed Kiel and REAL classification. ALCL carries the t (2; 5) (p23; q35) translocation; the absence of ALK kinase from normal lymphoid cells indicates that immunohistochemical expression of ALK is specific for the (2; 5) translocation. This disease is characterized by a diffuse proliferation of large anaplastic cells with kidney-shaped/horse-shoe nuclei. A distinguishing feature is a perinuclear eosinophilic region that represents a prominent Golgi apparatus. These cells are named hallmark-cells being almost pathognomonic. Immunohistochemically the most important features are that tumor cells consistently express CD30 and EMA on the cell membrane and in the Golgi region, while ALK immunostaining is usually both, cytoplasmic and nuclear. To our knowledge only two cases of primary ALCL of the testis have been reported. Hereby we present a case of a typical ALCL expressing ALK and CD30, which presented with subcutaneous nodules and bilateral testicular mass, without systemic involvement.

[Epidermoid carcinoma of the urethra and glans penis: two independent tumors?]. / Carcinoma epidermoide de uretra y glande: dos tumores independientes?

A 64 years-old man is treated in our hospital presenting a big tumor in glans penis. During the surgical act, another neoplasm is detected in the urethra. The microscopic study showed a concomintant epidermoid carcinoma of glans penis and urethra with non-affected tissue between both tumors.

Carcinoma neuroendocrino de fosa nasal ¿una entidad independiente? / Neuroendocrine carcinoma of nasal fossa. An independant entity?

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Fine needle aspiration cytology of mammary hamartoma: a review of nine cases with histological correlation.

Mammary hamartoma is a breast lesion rarely reported by fine-needle aspiration cytology (FNAC). We report on our experience of FNAC in nine cases confirmed by biopsy. We searched hospital case files for mammary hamartoma or similar lesions (fibrolipomas, lipomas, fibromas, etc.), and cases included were only those in which both FNAC and a histopathological study had been performed. The cytological features that were analysed included epithelial components, mesenchymal fragments and isolated cells dispersed in the background. The patients ranged in age from 25 to 58 years (mean 40 years), and the lesions were predominantly in the right breast and upper outer quadrant. The duration varied from 1 to 20 years. Mammographic features were characteristic revealing well-circumscribed masses of heterogeneous radiodensity and by ultrasonography were hypoechoic without calcification. Grossly, these lesions were oval to round, well-demarcated masses, ranging in diameter from 10 to 80 mm. The tumours were firm, rubbery and white, consisting largely of dense fibroconnective tissue with variable amounts of adipose tissue and glandular elements. Cytological samples showed two components, epithelial and mesenchymal. The cellularity was variable and was composed of lobular cells forming acini, ductal cells, occasional apocrine and foamy cells; myoepithelial cells and isolated naked nuclei were also observed. Adipose tissue and dense fibrous tissue were observed, occasionally with epithelial cells attached, and this finding was an important feature for diagnosis. We considered that the cytological findings could help to diagnose mammary hamartoma, FNAC making a rapid and very important technique for the diagnosis of this pathology.

[Skin metastasis of urothelial bladder tumor]. / Metástasis cutánea de tumor urotelial vesical.

We want to present a case of tranticional cell bladder carcinoma, where the first sign of disease progression was the appearance of a skin metastase. An unusual manifestation in a patient without another metastatic lesions.

¿Tejido hematopoyético en líquido cefalorraquídeo? / Hematopoietic tissue in cerebrospinal fluid

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Metástasis cutánea de tumor urotelial vesical / Skin metastases of urothelial cancer of the bladder

Queremos presentar un caso de carcinoma vesical de células transicionales, donde el primer signo de progresión de la enfermedad fue la aparición de una metástasis cutánea. Una manifestación inusual en un paciente sin otras lesiones metastásicas (AU)

[Neuroendocrine carcinoma of the nasal fossa. An independent entity?]. / Carcinoma neuroendocrino de fosa nasal. Una entidad independiente?

We present one case of a neuroendocrine carcinoma of nasal fossa and paranasal sinuses, of aggressive behavior, which has been controlled with chemo-radiotherapy after a double postsurgical recurrence. We do a literature revision emphasizing the anatomopathologic differentiation of these tumors with the olfactory neuroblastomas, and the therapeutic controversies in advanced stages.