The histopathology of the skin basal cell carcinoma with areas of intermediate differentiation. A metatypical carcinoma?

The histopathology of the skin basal cell carcinomas (BCCs) with areas of intermediate differentiation (ID) has been investigated. In a series of 127 BCCs, areas of ID were found in 28 tumors (22%), and also in an additional 10 cases of other series. These areas consisted of compact masses of cells without peripheral palisading, and with intermediate differentiation between basal and squamous cells. In comparison with the common undifferentiated BCCs, the BCCs with the ID areas may behave in a more aggressive fashion, since they displayed more precocious ulceration in small tumors (p less than 0.001), greater infiltrative features (p less than 0.001), more atypical cells (p less than 0.001) with increased nuclear-cytoplasmic ratio and more mitoses (p less than 0.001). The relation of such basal cell carcinomas to the metatypical carcinoma of the skin was discussed. Metatypical carcinoma, however, has been poorly defined and thus has no general acceptance in the literature. The new definition of the basosquamous cell carcinoma and the presence of intermediate areas of differentiation in this tumor were emphasized, and it was suggested that metastatic basal cell carcinoma and metatypical carcinoma may be the same tumor.

[Skin cancer (apropos of a statistical study)]. / Acerca do carcinoma de pele (a propósito de uma estatística).

Statistic data about the incidence of cutaneous carcinoma in the region of Campinas (Sao Paulo). 1174 cutaneous cancers are reviewed. There are no differences between the localizations and distribution of the skin cancer in this regions and another countries with intense sun radiation. The preponderant localizations are the exposed areas, mainly the fronto-facial region. The author emphasizes the practical importance of the correct diagnosis of the lesions seated on the exposed areas of the skin. The convenience of early treatment of a precancer of a carcinogenic dermopathy is emphasized.

Diffuse necrosis of the renal medulla in an infant.

A case of diffuse and bilateral necrosis of the renal medulla in an infant aged 2-1/2 months is reported. The possible causes of such severe lesion are discussed. Gastroenteritis, hypotensive state and use of a nephrotoxic drug (gentamicin) are considered to be important pathogenetical factors acting simultaneously in this patient.

[Systemic candidiasis with localization in the brain. Anatomo-clinical study of 5 cases]. / Candidiase sistemica com localização encefalica. Estudo anatomo-clinico de cinco casos

Central nervous system involvement in Candida septicaemia is rare and not more than four cases have been published in Brazil. Five new cases of systemic candidiasis with cerebral lesions are reported. All patients (four adults and a child) had serious underlying diseases and were submitted to heavy long-term antibiotic therapy with multiple drugs. Seizures in one case and neck stiffness in another were the only neurologic signs that could be attributed to candidiasis. In no case were the lesions severe enough to be considered an immediate cause of death. In three patients, no macroscopic changes were evident in the brain, but microabscesses and granulomata were observed on microscopical examination; another patient had two gross areas with necrotic and haemorrhagic appearance in the cerebral hemispheres; the child had only two microscopic granulomata. The aetiological agent was demonstrated by Grocott's methenamine silver technique in all cases. Involvement of organs other than the central nervous system could be demonstrated in three autopsies. Discussion is confined mainly to such aspects as the contributory factors in the pathogenesis of systemic candidiasis as well as the marked rise in the incidence of this condition in the past few decades. It is suggested that the frequence of monilial septicaemia in Brazil may be far more serious than apparent from the scarcity of reported cases.

An ependymoblastoma of the pons.

A case of ependymoblastoma of the pons in a child is reported, the first so far described in this location. The case adds further evidence for the acceptance of ependymoblastomas as a specific variety of primitive human glioma.