ABSTRACT
Breast cancer is the most incidental and deadly neoplasm worldwide; in Mexico, very few epidemiologic reports have analyzed the pathological features and its impact on their clinical outcome. Here, we studied the relation between pathological features and the clinical presentation at diagnosis and their impact on the overall and progression-free survival of patients with breast cancer. For this purpose, we collected 199 clinical records of female patients, aged at least 18 years old (y/o), with breast cancer diagnosis confirmed by biopsy. We excluded patients with incomplete or conflicting clinical records. Afterward, we performed an analysis of overall and progression-free survival and associated risks. Our results showed an average age at diagnosis of 52 y/o (24-85), the most common features were: upper outer quadrant tumor (32%), invasive ductal carcinoma (76.8%), moderately differentiated (44.3%), early clinical stages (40.8%), asymptomatic patients (47.8%), luminal A subtype (47.8%). Median overall survival was not reached, but median progression-free survival was 32.2 months (29.75-34.64, CI 95%) associated risk were: clinical stage (p < 0.0001) symptomatic presentation (p = 0.009) and histologic grade (p = 0.02). Therefore, we concluded that symptom presence at diagnosis impacts progression-free survival, and palpable symptoms are related to an increased risk for mortality.
Subject(s)
Breast Neoplasms , Carcinoma, Ductal, Breast , Adult , Female , Humans , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/pathology , Mexico/epidemiology , Neoplasm Staging , Prognosis , Retrospective Studies , Young Adult , Middle Aged , Aged , Aged, 80 and overABSTRACT
Primary sarcomas of the major blood vessels can be classified based on location in relationship to the wall or by histologic type. Angiosarcomas are malignant neoplasms that arise from the endothelial lining of the blood vessels; those arising in the intimal compartment of pulmonary artery are rare. We report a case of pulmonary artery angiosarcoma in a 36-year old female with pulmonary masses. The patient had no other primary malignant neoplasm, thus excluding a metastatic lesion. Gross examination revealed a thickened right pulmonary artery and a necrotic and hemorrhagic tumor, filling and occluding the vascular lumen. The mass extended distally, within the pulmonary vasculature of the right lung. Microscopically, an intravascular undifferentiated tumor was identified. The tumor cells showed expression for vascular markers VEGFR, VEGFR3, PDGFRa, FGF, Ulex europaeus, FVIII, FLI-1, CD31 and CD34; p53 was overexpressed and Ki67 proliferative rate was increased. Intravascular angiosarcomas are aggressive neoplasms, often associated with poor outcome.
Subject(s)
Diagnostic Errors , Hemangiosarcoma/pathology , Histiocytoma, Malignant Fibrous/pathology , Pulmonary Artery/pathology , Vascular Neoplasms/pathology , Adult , Biomarkers, Tumor/analysis , Biopsy , Cell Proliferation , Chemotherapy, Adjuvant , Female , Hemangiosarcoma/chemistry , Hemangiosarcoma/therapy , Humans , Immunohistochemistry , Phenotype , Pneumonectomy , Predictive Value of Tests , Pulmonary Artery/chemistry , Pulmonary Artery/surgery , Tomography, X-Ray Computed , Treatment Outcome , Vascular Neoplasms/chemistry , Vascular Neoplasms/therapyABSTRACT
Basal cell proliferations within the prostate gland encompass a group of benign and malignant entities. Although basal cell hyperplasia is a common finding, basal cell carcinoma of the prostate gland is a rare tumor that can be mistaken by a benign condition and represents a diagnostic problem in genitourinary pathology. We report a case of basal cell carcinoma in a previously healthy 65-year-old man with urinary symptoms and low prostate-specific antigen. The microscopic findings are presented and the use of immunohistochemical markers classifying basal cell lesions of the prostate discussed.
Subject(s)
Biomarkers, Tumor/analysis , Carcinoma, Basal Cell/diagnosis , Prostatic Neoplasms/diagnosis , Aged , Biomarkers, Tumor/metabolism , Carcinoma, Basal Cell/chemistry , Carcinoma, Basal Cell/immunology , Carcinoma, Basal Cell/pathology , Diagnosis, Differential , Humans , Male , Prostate/metabolism , Prostate/pathology , Prostate-Specific Antigen/analysis , Prostate-Specific Antigen/metabolism , Prostatic Neoplasms/chemistry , Prostatic Neoplasms/immunology , Prostatic Neoplasms/pathology , Sensitivity and SpecificityABSTRACT
AIM: To investigate the presence of human papillomavirus (HPV) in esophageal squamous papilloma (ESP) and determine p16, p53 and Ki67 expression in a Mexican cohort. METHODS: Nineteen cases diagnosed as ESP, corresponding to 18 patients were reviewed; nineteen cases of normal esophageal mucosa were used as negative controls. HPV detection was performed by amplified chromogenic in situ hybridization (ACISH) using a wide spectrum-cocktail probe and PCR. RESULTS: The average age at presentation was 46.3 years (range 28-72 years). Patients included four (22.22%) males and 14 (77.77%) females. The most frequent location was upper third (11 cases), followed by middle third (3 cases) and unknown site (5 cases). Immunohistochemistry (IHC) revealed basal and focal p53 expression in 17 cases (89%); p16 was expressed in eight cases (42.10%) and the Ki67 index ranged from 10% to 30%. HPV was detected in 14 out of 16 cases (87.5%) by ACISH: Twelve showed diffuse nuclear patterns and two showed granular patterns. HPV DNA was identified by PCR in 12 out of 14 cases (85.7%). Low-risk HPV types were detected in the most of the cases. CONCLUSION: This study provides identification of HPV infection in almost 80% of ESP using either ACISH or PCR; overall, all of these lesions show low expression of cell-cycle markers. We suggest ACISH as an alternative diagnostic tool for HPV detection in ESP.
Subject(s)
Esophageal Neoplasms/virology , Papilloma/virology , Papillomaviridae/classification , Papillomaviridae/pathogenicity , Adult , Aged , Case-Control Studies , Cohort Studies , Cyclin-Dependent Kinase Inhibitor p16/metabolism , Esophageal Neoplasms/metabolism , Esophageal Neoplasms/pathology , Female , Human papillomavirus 11/pathogenicity , Human papillomavirus 16/pathogenicity , Human papillomavirus 18/pathogenicity , Human papillomavirus 6/pathogenicity , Humans , In Situ Hybridization , Ki-67 Antigen/metabolism , Male , Mexico , Middle Aged , Papilloma/metabolism , Papilloma/pathology , Polymerase Chain Reaction , Retrospective Studies , Tumor Suppressor Protein p53/metabolismABSTRACT
Vitiligo is a rather common disease characterized by depigmentation of skin and mucosae due to the loss of melanocytes, most likely as a result of autoimmune phenomena. In this study we demonstrated apoptotic markers in residual melanocytes in skin biopsies of patients with vitiligo, as well as the presence of serum antibodies to melanocyte-specific antigens in the vast majority of patients. Moreover, we were able to prove that serum IgG antibodies from vitiligo patients, but not from healthy controls, were capable to penetrate into cultured melanocytes in vitro, and trigger them to engage in apoptosis. Our results are consonant with the theory that melanocyte-specific antibodies are responsible for the deletion of melanocytes through antibody penetration and apoptosis.
Subject(s)
Apoptosis/immunology , Autoantibodies/immunology , Melanocytes/immunology , Vitiligo/immunology , Adolescent , Adult , Animals , Autoantibodies/blood , Autoantigens/immunology , Child , Child, Preschool , Female , Humans , Immunoglobulin G/blood , Infant , Melanocytes/pathology , Middle Aged , Vitiligo/blood , Vitiligo/pathologyABSTRACT
Langerhans cell sarcoma (LCS) is a neoplastic proliferation of Langerhans cells that occurs in lymph nodes, liver, skin, spleen, lung, and bone. We report a case of LCS in a 47-year-old man with a 6-month history of scalp mass and cervical lymphadenopathy. Clinical and pathologic data were available. A histologic examination demonstrated a proliferation of cells with malignant cytologic features. Because of its poorly differentiated morphologic features, hematologic and nonhematologic entities were ruled out by immunohistochemical screening with a broad panel of antibodies. Ultrastructural studies demonstrating Birbeck granules and consistent expression of CD1a, S-100 protein, and langerin by immunohistochemistry were helpful in identifying the Langerhans cell origin.
Subject(s)
Head and Neck Neoplasms/ultrastructure , Langerhans Cells/ultrastructure , Skin Neoplasms/ultrastructure , Cytoplasmic Granules/metabolism , Cytoplasmic Granules/ultrastructure , Gene Expression Regulation, Neoplastic , Head and Neck Neoplasms/metabolism , Humans , Langerhans Cells/metabolism , Male , Middle Aged , Neoplasm Proteins/biosynthesis , Skin Neoplasms/metabolismABSTRACT
Squamous cell carcinoma is a rare thyroid neoplasm that has been described exclusively in adults. We report what appears to be the first example of a primary squamous cell carcinoma of the thyroid gland arising in a background of Hashimoto's thyroiditis in an adolescent female. The tumor was well demarcated, confined to the right thyroid lobe, and did not metastasize, although follow up has been limited. The squamous cell carcinoma was well to moderately differentiated, and the stroma contained an abundant inflammatory infiltrate rich in lymphocytes and eosinophils. The lack of goblet cells, extracellular mucin, and extensive stromal sclerosis excluded the diagnosis of sclerosing mucoepidermoid carcinoma with eosinophilia. Immunohistochemical staining revealed focal expression of cytokeratin 7 and diffuse labeling with cytokeratin AE1/AE3. The squamous cell carcinoma overexpressed p53 protein and showed increased proliferative activity, as evidenced by the high MIB-1 labeling index. In contrast, the tumor did not show immunoreactivity for thyroglobulin or thyroid transcription factor 1.
Subject(s)
Carcinoma, Squamous Cell/complications , Hashimoto Disease/complications , Thyroid Neoplasms/complications , Adolescent , Biomarkers, Tumor/metabolism , Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/pathology , Cell Proliferation , Disease-Free Survival , Female , Hashimoto Disease/metabolism , Hashimoto Disease/pathology , Humans , Keratins/metabolism , Thyroid Neoplasms/metabolism , Thyroid Neoplasms/pathology , Thyroidectomy , Tumor Suppressor Protein p53/metabolismABSTRACT
Fibrocartilaginous dysplasia is a variant of fibrous dysplasia in which extensive cartilaginous differentiation is identified. The amount of cartilage varies from case to case, however, no percentage has been proposed to consider this diagnosis. We present a 6-year-old girl with a two-year history of hip pain. Initial imaging studies of the right femur revealed a lucent lesion of the proximal shaft that extended into the femoral neck with ill-defined borders but well maintained cortex. Computed tomography scan demonstrated increased density of the medullary cavity but the cortex appeared intact. Curettage of the lesion was performed and fragments with cartilaginous appearance were obtained, weighing 45 g in total. Microscopically, the tumor revealed a cartilaginous (60%) and a fibro-osseous (40%) component; the former had increased cellularity and some chondrocytes displayed moderate atypia and binucleation, while the latter showed features of fibrous dysplasia. Areas of endochondral ossification and calcification were also identified. After five years of surgery this child is well and without evidence of recurrence. We discuss the differential diagnosis of this variant of fibrous dysplasia in the pediatric group.
Subject(s)
Cartilage/pathology , Fibrous Dysplasia of Bone/diagnosis , Fibrous Dysplasia of Bone/pathology , Bone Neoplasms/diagnosis , Bone Neoplasms/pathology , Cartilage/diagnostic imaging , Cell Differentiation , Child , Chondrocytes/pathology , Chondrosarcoma/diagnosis , Chondrosarcoma/pathology , Diagnosis, Differential , Female , Fibrous Dysplasia of Bone/diagnostic imaging , Humans , Tomography, X-Ray ComputedABSTRACT
mediante la exploración quirúrgica e identificación de los distomas adultos. El primer caso falleció por insuficiencia hepática y el segundo, recibió tratamiento con prazicuantel y se encuentra estable. Conclusiones: existen al menos cincuenta casos En México, la fasciolosis hepática es la parasitosis más común de la vía biliar. La infestación masiva es común en el ganado vacuno o bovino y en el hombre se presenta rara vez. Sólo existen dos informes previos de este evento y nosotros contribuimos con dos casos más. Presentación de casos. Ambos ocurrieron en pacientes cirróticos por alcohol, con historia de ingesta de berros (Nasturium officinalis) y se manifestaron con ictericia, dolor abdominal y dilatación coledociana. El diagnóstico se estableció de fasciolosis en México desde 1935, la mayoría de los cuales ha sido diagnosticada preoperatoriamente como colelitiasis, a pesar que en la mayoría había historia de ingesta de berros.
Subject(s)
Humans , Male , Middle Aged , Liver Cirrhosis, Biliary/etiology , Fascioliasis , Liver/parasitologyABSTRACT
Mujer de 26 años con un cuadro clínico de síndrome anémico, vómito postprandial y melena intermitente de seis meses de evolución. La homoglobina de ingreso fue de 3.5 g/dL. El estudio endoscópico mostró un tumor que ocupaba el 90 por ciento de la luz duodenal. Se tomaron biopsias que se informaron como duodenitis aguda y crónica erosiva. Con diagnóstico de probable leiomioma, se efectuó laparotomía exploradora con duodenotomía y se resecó un tumor pedunculado que correspondió a un hamartoma de glándulas de Brunner. Esto ocasionó obstrucción duodenal parcial y hemorragia del tubo digestivo, los dos síntomas más comunes de este tumor raro
Subject(s)
Adult , Humans , Female , Adenomatoid Tumor/diagnosis , Adenomatoid Tumor/genetics , Duodenum/pathology , Brunner Glands/pathology , Adenomatous Polyps/diagnosis , Adenomatous Polyps/pathologyABSTRACT
Se presenta el caso de un niño de dos años de edad cistinosis clásica, manifestada por síndrome de Fanconi (glucosuria, aminoaciduria y fosfaturia), raquitismo, talla baja, presencia de cristales de cistina en córnea y daño glomerular progresivo; demostrándose en le biopsia renal por medio de microscopia electrónica el acúmulo de los característicos cristales hexagonales de cistina. Debido a que la frecuencia de esta patología en nuestro país es muy baja, y el cuadro clínico de nuestro paciente es representativo de la variante infantil nefropática, decidimos realizar este informe