RESUMEN
In contrast to primary central nervous system lymphomas (PCNSLs) that occur in immunocompetent patients, most of those that occur in immunosuppressed patients are associated with Epstein-Barr virus (EBV). BCL-2-related proteins either block or promote cell death, forming homo- or heterodimers with each other. LMP-1, EBV latent protein, has been shown to upregulate BCL-2 and BCL-XL. This observation suggests that these proteins may be involved in the transformation process of EBV-infected cells. Twenty-three cases of PCNSLs were studied: 12 of the patients were immunosuppressed, and 11 were immunocompetent. For all cases, we collected clinical information, histologic data, and immunophenotype and tested for the presence of EBV (EBER-1, LMP-1). Apoptosis was assessed by the TdT-mediated dUTP-biotin nick-end labeling method and quantified by image analysis. In three cases, electron microscopy was performed. The BCL-2 family proteins (BCL-2, BCL-X, MCL1, and BAX) and p53 expression were studied by immunohistochemistry on paraffin slides. All cases were classified as diffuse large B-cell lymphomas. PCNSLs in immunosuppressed patients were characterized by EBV association, necrosis, important gliosis, and numerous macrophages. There was no significant difference between the two groups regarding the TdT-mediated dUTP-biotin nick-end labeling staining (P = .08). In contrast, PCNSLs in immunosuppressed patients were shown to express high levels of BCL-2, BCL-X, and BAX in more than 80% of tumor cells in 7, 10, and 11 cases, respectively. In immunocompetent patients, only one case showed a high level of BCL-2 expression in more than 80% of the cells, whereas BCL-X and BAX were overexpressed in two cases. These differences are significant (P < .05). In contrast, there was no significant difference between the two groups in MCL-1 expression. Besides EBV association and necrosis, PCNSLs related to immunosuppression are characterized by an overexpression of BCL-2-related proteins, without dramatically modifying their susceptibility for apoptosis.
Asunto(s)
Neoplasias Encefálicas/metabolismo , Huésped Inmunocomprometido , Linfoma de Células B/metabolismo , Linfoma de Células B Grandes Difuso/metabolismo , Proteínas Proto-Oncogénicas c-bcl-2/biosíntesis , Proteínas Proto-Oncogénicas/biosíntesis , Adulto , Anciano , Anciano de 80 o más Años , Apoptosis , Neoplasias Encefálicas/patología , Neoplasias Encefálicas/virología , Femenino , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/aislamiento & purificación , Humanos , Técnicas para Inmunoenzimas , Hibridación in Situ , Etiquetado Corte-Fin in Situ , Linfoma de Células B/patología , Linfoma de Células B/virología , Linfoma de Células B Grandes Difuso/patología , Linfoma de Células B Grandes Difuso/virología , Masculino , Persona de Mediana Edad , ARN Viral/metabolismo , Proteínas de la Matriz Viral/metabolismo , Proteína X Asociada a bcl-2 , Proteína bcl-XAsunto(s)
Enfermedades del Íleon/etiología , Obstrucción Intestinal/etiología , Mesotelioma/complicaciones , Mesotelioma/diagnóstico , Neoplasias Peritoneales/complicaciones , Neoplasias Peritoneales/diagnóstico , Antineoplásicos/uso terapéutico , Biopsia , Terapia Combinada , Dispepsia/etiología , Humanos , Enfermedades del Íleon/cirugía , Obstrucción Intestinal/cirugía , Masculino , Mesotelioma/terapia , Persona de Mediana Edad , Neoplasias Peritoneales/terapia , PronósticoRESUMEN
We report a translocation (X;1)(p11.2;q21) associated with a nontubulopapillary renal cell carcinoma in a 23-year-old woman. To our knowledge this the first report of such an association. A review of the previously published cases of renal cell carcinoma with t(X;1) and its cytogenetic variants with Xp11.2 anomalies is included. The role of this karyotype abnormality as a clinical marker is discussed. The Xp11.2 abnormality could be a primary abnormality characterizing a particular type of RCC appearing in children and young adults of both sexes and in which the histological aspect is not specific.
Asunto(s)
Carcinoma de Células Renales/genética , Cromosomas Humanos Par 1 , Neoplasias Renales/genética , Translocación Genética , Cromosoma X , Adulto , Femenino , Humanos , MasculinoRESUMEN
Intratesticular location of leiomyoma is unusual. A single case has been published in the literature. We report a case of what we consider to be an intratesticular leiomyoma, with a description of its pathology, a discussion of its differential diagnosis and histogenesis.
Asunto(s)
Leiomioma/patología , Neoplasias Testiculares/patología , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Carcinoma Hepatocelular/terapia , ADN sin Sentido , Terapia Genética , Factor I del Crecimiento Similar a la Insulina/genética , Neoplasias Hepáticas Experimentales/terapia , Neoplasias Hepáticas/terapia , Animales , Antígenos Virales de Tumores/genética , Antitrombina III/genética , Antitrombina III/fisiología , Apoptosis , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/patología , Humanos , Etiquetado Corte-Fin in Situ , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/patología , Neoplasias Hepáticas Experimentales/genética , Complejo Mayor de Histocompatibilidad , Ratones , Ratones Transgénicos , Regiones Promotoras Genéticas , Virus 40 de los Simios/genética , Células Tumorales CultivadasRESUMEN
Carcinoma in situ (CIS) of the testis is recognized to be a precursor of cancer. Radiological examinations are not sufficient to improve the diagnosis. So the diagnosis is made by testicular biopsy. The indications are controlateral testis biopsy in man with testicular cancer and risk factors (cryptorchidism, dysgenetic gonads...) and extragonadic germ cell tumors. The authors review the risk factors. Chemotherapy is not sufficient to eradicate the CIS. A dose of 16 Gy of localized radiation is curative, excludes bilateral orchidectomy and preserves androgen function and azoospermic patient.
Asunto(s)
Biopsia , Carcinoma in Situ/patología , Neoplasias Testiculares/patología , Biopsia/métodos , Carcinoma in Situ/diagnóstico por imagen , Carcinoma in Situ/etiología , Humanos , Masculino , Selección de Paciente , Radiografía , Reproducibilidad de los Resultados , Factores de Riesgo , Sensibilidad y Especificidad , Neoplasias Testiculares/diagnóstico por imagen , Neoplasias Testiculares/etiologíaRESUMEN
A patient with a filarial infection due to Loa loa, received single oral dose of ivermectin A few hours after, he has presented a severe renal impairment. Native of the Cameroons, he was also treated for malaria. A renal biopsy has been done, because of chronic proteinuria. It has showed microfilariae in glomeruli, thickening of the basement membrane and a segmental and focal mesangial hyalinosis. By immunofluorescence microscopy there were granular deposits of IgM and C3 along this membrane. Electron microscopy has showed subepithelial electron- dense deposits. This suggests that the renal disease is immunologically induced. During the therapy, adverse reactions seemed to be related with massive liberation of filarial antigens. This is well known with diethylcarbamazine but also now, sometimes with ivermectin.
Asunto(s)
Filaricidas/efectos adversos , Ivermectina/efectos adversos , Enfermedades Renales/inducido químicamente , Loiasis/tratamiento farmacológico , Adulto , Animales , Antígenos Helmínticos/inmunología , Membrana Basal/patología , Complemento C3/análisis , Filaricidas/uso terapéutico , Humanos , Inmunoglobulina M/análisis , Ivermectina/uso terapéutico , Riñón/inmunología , Riñón/parasitología , Riñón/patología , Enfermedades Renales/parasitología , Enfermedades Renales/patología , Masculino , Microscopía ElectrónicaRESUMEN
The authors describe a case of Dirofilaria repens subcutaneous dirofilariasis, in a resident of Corsica (France). Epidemiological and morphological features are related for various species of Dirofilariasis. These data, mainly based on clinical history, are usually sufficient to exclude other forms of subcutaneous filariosis, especially tropical.
Asunto(s)
Dirofilariasis/patología , Enfermedades Cutáneas Parasitarias/patología , Adulto , Animales , Dirofilaria/aislamiento & purificación , Dirofilariasis/diagnóstico , Dirofilariasis/parasitología , Humanos , Masculino , Enfermedades Cutáneas Parasitarias/diagnóstico , Enfermedades Cutáneas Parasitarias/parasitologíaAsunto(s)
Linfoma de Burkitt/virología , Enfermedad de Castleman/virología , ADN Viral/aislamiento & purificación , Infecciones por Herpesviridae/virología , Herpesviridae/aislamiento & purificación , Sarcoma de Kaposi/virología , Adulto , Anciano , Linfoma de Burkitt/epidemiología , Enfermedad de Castleman/epidemiología , Comorbilidad , Femenino , Seronegatividad para VIH , Infecciones por Herpesviridae/epidemiología , Enfermedad de Hodgkin/epidemiología , Enfermedad de Hodgkin/virología , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Factores de Riesgo , Sarcoma de Kaposi/epidemiología , Conducta Sexual/estadística & datos numéricos , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/virología , Abuso de Sustancias por Vía Intravenosa/epidemiologíaAsunto(s)
Herpesvirus Humano 8 , Sarcoma de Kaposi/epidemiología , Sarcoma de Kaposi/virología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Sarcoma de Kaposi/clasificación , Sarcoma de Kaposi/patología , Distribución por Sexo , Análisis de SupervivenciaRESUMEN
In this case report concerning a testicular tumor, the difficulty of discriminating between embryonic carcinoma with granulomatous reaction and anaplastic seminoma is described. According to the literature and the findings of the present case, the value of immunohistochemical investigations is emphasized, especially the use of anti cytokeratin antibody in the diagnosis of embryonic carcinoma. Therapeutic issues stress the importance of such a diagnosis. Furthermore the immunohistochemical identification of embryonic carcinoma in every case should lead to a new classification of the so-called anaplastic seminoma's entity.
Asunto(s)
Carcinoma Embrionario/diagnóstico , Seminoma/diagnóstico , Neoplasias Testiculares/diagnóstico , Adulto , Carcinoma Embrionario/patología , Diagnóstico Diferencial , Humanos , Masculino , Neoplasias Testiculares/patologíaRESUMEN
An otherwise healthy 21-year-old man with no evidence or family history of Von Recklinghausen's neurofibromatosis presented a posterior mediastinal mass detected on routine chest radiographs. The findings of standard light microscopy, ultrastructural examination and immunohistochemical studies suggested the working hypothesis of an unusual malignant "Triton" tumour: -arising in a pre-existing de novo ganglioneuroma; -fortuitously detected; -predominantly made of multinucleated spindle cells with only ultrastructural and immunohistochemical rhabdomyoblastic differentiation.
Asunto(s)
Ganglioneuroma/patología , Neoplasias del Mediastino/patología , Neoplasias de la Vaina del Nervio/patología , Neurilemoma/patología , Neoplasias del Sistema Nervioso Periférico/patología , Adulto , Diferenciación Celular/fisiología , Diagnóstico Diferencial , Humanos , MasculinoRESUMEN
This report describes a case of acute promyelocytic leukemia (APL) M3. At diagnosis, the specific t(15;17) translocation was observed. After chemotherapy including retinoic acid, a complete remission was achieved and the karyotype became normal. At relapse of the M3 leukemia, the t(15;17) clone was no longer observed but a t(3;6) translocation was then detected. Several hypotheses for this unusual cytogenetic course of APL are discussed.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Cromosomas Humanos Par 15 , Cromosomas Humanos Par 17 , Cromosomas Humanos Par 3 , Cromosomas Humanos Par 6 , Leucemia Promielocítica Aguda/genética , Translocación Genética , Tretinoina/uso terapéutico , Adulto , Médula Ósea/patología , Mapeo Cromosómico , Citarabina/administración & dosificación , Daunorrubicina/administración & dosificación , Humanos , Cariotipificación , Leucemia Promielocítica Aguda/tratamiento farmacológico , Leucemia Promielocítica Aguda/patología , Masculino , Reacción en Cadena de la Polimerasa , RecurrenciaRESUMEN
A chest x-ray showing a large tumor-like opacity in the left lower lobe and endoscopy visualizing a budding mass suggested a diagnosis of bronchial carcinoma in a 55-year old, tobacco-smoking Cambodian who consulted for hemoptysis and altered general status. Histological study of bronchial biopsies allowed differential diagnosis of cryptococcosis. Serologic tests for human immunodeficiency virus were negative and there was no other cause of immunodepression. Left lower lobectomy was performed at the German hospital of the APRONUC in Phnom Penh. Examination of the surgical specimen confirmed massive bronchopulmonary cryptococcosis. Two months after the procedure the patient was readmitted for neuromeningial cryptococcosis that responded well to fluconazole. Another relapse occurred 5 months later and was treated using the same drug. The patient is currently in remission. An increasingly common deep mycosis that is serious but curable with proper treatment, cryptococcosis deserves the full attention of physicians working in Cambodia where, as in other tropical zones, it is likely that this infection will progress with the incidence of AIDS. Symptoms can be misleading, suggesting neuromeningial or pulmonary tuberculosis. The value of India ink smear which should be performed in all patients presenting lymphocytic meningitis with hypoglycorrhachia must be emphasized. In the present case bronchoscopy was useful to distinguish from bronchopulmonary cancer.
Asunto(s)
Criptococosis , Inmunocompetencia , Enfermedades Pulmonares Fúngicas , Meningitis Criptocócica , Cambodia , Terapia Combinada , Criptococosis/diagnóstico , Criptococosis/terapia , Diagnóstico Diferencial , Fluconazol/uso terapéutico , Humanos , Enfermedades Pulmonares Fúngicas/diagnóstico , Enfermedades Pulmonares Fúngicas/terapia , Masculino , Meningitis Criptocócica/diagnóstico , Meningitis Criptocócica/terapia , Persona de Mediana Edad , Neumonectomía , RecurrenciaRESUMEN
This case of a 63 year old man reports the simultaneous development of hepatic cholangiocarcinoma and fibrosarcoma of the sacrum 45 years after the systemic injection of Thorotrast. The characteristic radiologic aspect was an important criteria for diagnosis. Biopsies have confirmed the histology of both tumors. We describe the way to thorotrastosis diagnosis and characteristic malignant tumors, especially cholangiocarcinoma, induced by Thorotrast.
Asunto(s)
Neoplasias Óseas/etiología , Colangiocarcinoma/etiología , Neoplasias Hepáticas/etiología , Neoplasias Primarias Múltiples/etiología , Traumatismos por Radiación/complicaciones , Dióxido de Torio/efectos adversos , Colangiocarcinoma/diagnóstico por imagen , Resultado Fatal , Fibrosarcoma/etiología , Humanos , Neoplasias Hepáticas/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Neoplasias Primarias Múltiples/diagnóstico , Sacro , Factores de Tiempo , Tomografía Computarizada por Rayos XRESUMEN
A tumour of the posterior mediastinum was removed via thoracoscopy. The histology report was a triton tumour. This is a rare (less than 80 cases reported in the literature) malignant tumour of the nervous system: malignant schwannoma with rhabdomyoblastic differentiation. The characteristics of this rare tumour and the consequences of videoassisted surgery in this specific case are discussed: a second access is required to widen the thoracotomy and complementary radiotherapy is needed.
Asunto(s)
Endoscopía , Neoplasias del Mediastino/cirugía , Neurilemoma/cirugía , Adulto , Humanos , Masculino , Neoplasias del Mediastino/epidemiología , Neoplasias del Mediastino/patología , Neurilemoma/epidemiología , Neurilemoma/patología , Pronóstico , ToracoscopíaRESUMEN
One case of a solitary pulmonary nodule occurring in a 54-year-old woman with history of breast carcinoma is presented. Histological examination of the surgical specimen excluded breast carcinoma metastasis and revealed an inflammatory pseudotumor. Principal clinico-pathological findings in previously reported cases are described. Inflammatory pseudotumors may exhibit, as in our case, some nuclear atypia making the diagnosis sometimes difficult with malignancy.
Asunto(s)
Granuloma de Células Plasmáticas del Pulmón/patología , Neoplasias de la Mama/patología , Diagnóstico Diferencial , Femenino , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundario , Persona de Mediana Edad , Granuloma de Células Plasmáticas del Pulmón/diagnósticoRESUMEN
Pathological examination of testicular tumours demonstrates the heterogeneity of the histological types encountered. Germ cell tumours, with one or several components, represent 95% of all testicular tumours. The distinction between these various types is always based on morphological criteria, but may also be facilitated by the use of immunolabelling techniques on fixed sections. The local and regional extension and the distinction between seminomatous and non-seminomatous germ cell tumours are important criteria in the subsequent therapeutic strategy. At the present time, there is no consensus concerning the selection of other histoprognostic criteria, which may be observed in the primary tumour it its metastases. Residual masses also have a variable histology and their pathophysiology is sometimes difficult to interpret.
Asunto(s)
Neoplasias Testiculares/patología , Biomarcadores de Tumor , Diagnóstico Diferencial , Humanos , Masculino , Estadificación de Neoplasias , Neoplasias Testiculares/clasificación , Neoplasias Testiculares/diagnósticoRESUMEN
Pathological examination of testicular tumours demonstrates the heterogeneity of the histological types encountered. Germ cell tumours, with one or several components, represent 95% of all testicular tumours. The distinction between these various types is always based on morphological criteria, but may also be facilitated by the use of immunolabelling techniques on fixed sections. The local and regional extension and the distinction between seminomatous and non-seminomatous germ cell tumours are important criteria in the subsequent therapeutic strategy. At the present time, there is no consensus concerning the selection of other histoprognostic criteria, which may be observed in the primary tumour it its metastases. Residual masses also have a variable histology and their pathophysiology is sometimes difficult to interpret.