Cambios en la tendencia histológica del cáncer pulmonar / Changes in lung cancer's histological trend

El cáncer pulmonar se establece como la segunda causa de muerte en países desarrollados y en algunos en vías de desarrollo. Su diagnóstico es tardío, sus opciones de resección y su curación aun con terapias adyuvantes son limitadas, lo que incide en la pobre sobrevida a 5 años, es por ello que se necesitan mayores esfuerzos para combatir el hábito del tabaco, principal agente etiológico. Material y Métodos: Se trata de un estudio descriptivo transversal en pacientes adultos atendidos de 01 de enero del 2011 al 31 de diciembre del 2021, ingresados al servicio de cirugía del Hospital San Vicente de Guatemala, con diagnósticos de cáncer pulmonar, masa pulmonar, derrame pleural o nódulo pulmonar solitario. Resultados: Se atendieron 202 pacientes con diagnósticos presuntivos de cáncer pulmonar, no encontrando diferencias significativas en relación al sexo. La edad mayormente afectada se estableció entre los 50 y 70 años. Prevalecieron los estadíos IIIA, IIIB y IV basados en los hallazgos clínicos, tomográficos y transoperatorios y solo al 10% se le sometió a una cirugía de resección pulmonar mayor. Los cánceres de células no pequeñas NSCLC fueron reportados en el 68.7% y el adenocarcinoma fue la variedad más frecuente con el 54.95% sobre el 7.29% del epidermoide. La mortalidad a los treinta días se estableció en 2.97%. Conclusión: El adenocarcinoma pulmonar ocupa el primer lugar en la incidencia de los cánceres pulmonares, desplazando así al carcinoma epidermoide popularizado desde la mitad del siglo pasado. Esta tendencia en el cambio histológico está firmemente asociado a las modificaciones en los hábitos del fumar (AU)

Lung cancer is established as the second cause of death in developed countries and in some developing ones. Its diagnosis is late, its resection options and its cure even with adjuvant therapies are limited, which affects the poor survival at 5 years, which is why greater efforts are needed to combat the tobacco habit, the main etiological agent. Material and Methods: This is a cross-sectional descriptive study in adult patients treated from January 1, 2011 to December 31, 2021, admitted to the surgery service of the Hospital San Vicente de Guatemala, with diagnoses of lung cancer, lung mass, effusion pleural or solitary pulmonary nodule. Results: 202 patients with presumptive diagnoses of lung cancer were treated, finding no significant differences in relation to sex and the most affected age was established between 50 and 70 years. Stages IIIA, IIIB, and IV prevailed based on clinical, tomographic, and intraoperative findings, and only 10% underwent major lung resection surgery. NSCLC non-small cell cancers were reported in 68.7% and adenocarcinoma was the most frequent variety with 54.95% over 7.29% of epidermoid. Thirty-day mortality was established at 2.97%. Conclusion: Pulmonary adenocarcinoma occupies the first place in the incidence of lung cancers, thus displacing squamous cell carcinoma popularized since the middle of the last century. This trend in histological change is strongly associated with changes in smoking habits.

Association of raised serum progesterone level with ovulation trigger and histology of endometrium in stimulated cycles

Abstract This was a forthcoming study of those patients, who undergo in-vitro fertilization (IVF) and freeze-all embryo, who acquiesce for the study. The number of participated patients (n=350) in this study, underwent for IVF. The blood sample was collected from patients to evaluate the level of serum progesterone in vacuum vials on the day of ovulation trigger. After 36 hrs of ovulation trigger, ovum picked up was done. Quantitative methods were used to estimate the level of serum progesterone through the electrochemiluminescence immunoassay and correlation of serum progesterone with embryo transfer (ET) outcomes. Main outcome of this current study was to evaluate the value of mean serum progesterone level i.e.0.868± 0.712 ng/ml and 0.88±0.723 ng/ml was found in case of pregnancy positive and negative respectively, at p=0.216 value. In antagonist (n=40) and agonist (n=310) cases, it was 8(20%) and 37(11.94%) PL occurrence was noted at p=0.143 respectively. An overall value of the premature lutenization (PL) occurrences was 13.63% and 15.25% observed in both positive and negative cases of pregnancy at p=0.216 respectively. This study concluded that 12.66% of PL occurrences were recorded in the case of IVF. Study results proved, there were no significant effect of PL on pregnancy outcomes.

Operable gastric adenocarcinoma with different histological subtypes: Cancer-specific survival in the United States.

BACKGROUND/AIMS: Gastric signet ring cell carcinoma (GSRC), a subtype of adenocarcinoma, has been considered a histological type with poor survival. We aimed to compare the survival outcomes between patients with GSRC and patients with gastric non-signet ring cell adenocarcinoma (NGSRC) and constructed a nomogram to predict gastric adenocarcinoma-specific survival (GCSS). PATIENTS AND METHODS: We identified 10,031 patients with gastric adenocarcinoma (GA) from the surveillance, epidemiology, and end results (SEER) database and stratified them into two histological type groups: GSRC and NGSRC. We used propensity score matching and identified 4304 patients (training cohort) to assess the effect of the histological type on GCSS with Kaplan-Meier curves, and constructed a predictive nomogram. The accuracy of the nomogram was tested on the remaining 5727 patients (validation cohort) with concordance index (C-index) values, calibration curves, and receiver operating characteristic (ROC) curve analysis. RESULTS: We found that the histological type SRC was not associated with significantly poor survival (5-year survival rate: 46.1% vs 46.7%, P = 0.822). GSRC patients had similar GCSS rates compared to those with NGSRC in each tumor, node, and metastasis (TNM) stage (allP > 0.05). The nomogram showed that histological type was a relatively weak predictor of survival. The C-index value of the nomogram for predicting survival was 0.720, similar to that in the validation cohort (0.724). CONCLUSIONS: Patients with GSRC had a similar prognosis to those with NGSRC. The proposed nomogram allowed a relatively accurate survival prediction for operable GA patients after gastrectomy.

Prognostic Effects of Predominant Histologic Subtypes in Resected Pulmonary Adenocarcinomas

Background: Predominant histologic subtypes have been reported as predictors of survival of patients with pulmonary adenocarcinoma. Aims: To evaluate the predictive value of histologic classification in resected lung adenocarcinoma using the classification systems proposed by the International Association for the Study of Lung Cancer, American Thoracic Society, European Respiratory Society, and World Health Organization (2015). Study Design: Cross-sectional study. Methods: The histologic classification of a large cohort of 491 patients with resected lung adenocarcinoma (stages I-III) was retrospectively analyzed. The tumors were classified according to their predominant component (lepidic, acinar, papillary, solid, micropapillary, and mucinous), and their predictive values were assessed for clinicopathologic characteristics and overall survival. Results: The patient cohort comprised 158 (32.2%) patients with solid predominant, 150 (30.5%) with acinar predominant, 80 (16.3%) with papillary predominant, 75 (15.3%) with lepidic predominant, 22 (4.5%) with mucinous, and 5 (1.0%) with micropapillary subtype, and 1 (0.2%) with adenocarcinoma in situ. Overall 5-year survival of 491 patients was found to be 51.8%. Patients with lepidic, acinar, and mucinous adenocarcinoma had 70.9%, 59.0%, and 66.6% 5-year survival, respectively, and there was no statistically significant difference between them. Whereas patients with solid, papillary, and micropapillary predominant adenocarcinoma had 41.0%, 40.5%, and 0.0% 5-year survival, respectively. Compared to other histologic subtypes, patients with solid and papillary predominant adenocarcinoma had significantly lower survival than those with lepidic (p<0.001, p=0.002), acinar (p<0.001, p=0.008), and mucinous (p=0.048, p=0.048) subtypes, respectively. The survival difference between patients with solid subtype and those with papillary subtype was not statistically significant (p=0.67). Conclusion: Solid and papillary histologic subtypes are poor prognostic factors in resected invasive lung adenocarcinoma.

Medical Devices; Hematology and Pathology Devices; Classification of a Cervical Intraepithelial Neoplasia Test System. Final order.

The Food and Drug Administration (FDA or we) is classifying the cervical intraepithelial neoplasia (CIN) test system into class II (special controls). The special controls that apply to the device type are identified in this order and will be part of the codified language for the CIN test system's classification. We are taking this action because we have determined that classifying the device into class II (special controls) will provide a reasonable assurance of safety and effectiveness of the device. We believe this action will also enhance patients' access to beneficial innovative devices, in part by reducing regulatory burdens.

Gastritis crónica atrófica: concordancia endoscópica, histológica, lesiones asociadas y aplicación de la cromoendoscopia virtual / Chronic atrophic gastritis: endoscopic and histological concordances, associated injuries and application of virtual chromoendoscopy

INTRODUCCIÓN: Debido a la pobre concordancia entre la endoscopía y la histología, la biopsia gástrica sigue siendo el patrón de oro para el diagnóstico de gastritis crónica. La atrofia es el marcador actual de progresión de gastritis crónica. El sistema de cromoendoscopía virtual, permite una mejor observación de la mucosa gástrica. OBJETIVO: Evaluar la concordancia entre el sistema de clasificación endoscópica de Kimura-Takemoto y el sistema histológico OLGA (Operative Link for Gastritis Assessment), así como evaluar la aplicación de la cromoendoscopia virtual. METODOLOGÍA: Se realizó un estudio prospectivo y longitudinal de cohorte, en 138 pacientes, usando el sistema endoscópico de Kimura y Takemoto (K-T) con y sin el uso de cromoendoscopia virtual, comparándolas con los hallazgos histológicos del sistema OLGA. Además se determinó las lesiones gástricas asociadas según estadio de atrofia histológica. RESULTADOS: La concordancia entre la endoscopia convencional y el sistema OLGA fue de 0.859 y con el sistema de la cromoendoscopia virtual fue de 0.822. Las lesiones preneoplásicas y neoplásicas estuvieron asociadas a estadios III y IV de OLGA CONCLUSIONES: La correlación endoscópica e histológica de los dos sistemas, es muy buena, con o sin el uso de cromoendoscopía virtual.

INTRODUCTION: Due to the poor agreement between endoscopy and histology, the gastric biopsy continues being the gold standard for the diagnosis of atrophic chronic gastritis. The Virtual chromoendoscopy system allows better observation of the gastric mucosa OBJECTIVE: Evaluate the agreement between the Kimura-Takemoto's endoscopic system classification and the histological system of OLGA (Operative for Link Assessment Gastritis), as well as to evaluate the application of the virtual chromoendoscopy METHODOLOGY: A prospective and longitudinal study of cohorts, 138 patients was include, using endoscopic system of atrophy by Kimura and Takemoto (K-T), with conventional optical and with the use of seventh filter of virtual chromoendoscopy, then comparing with the histological findings of the OLGA pathology system, also were determinate injuries associated with respect to stage OLGA RESULTS: The kappa index of agreement between conventional endoscopy and the system OLGA was 0.859 and with the system of virtual chromoendoscopy was 0.822, the preneoplasic and neoplastic gastric lesions were associate to stages III and IV of atrophy CONCLUSIONS: The endoscopic and histological correlation with both systems isvery good, with or without the use of virtual chromoendoscopy.

Fabrication and characterization of solid lipid microparticles of ketoprofen

Solid lipid microparticles (SLMs) loaded with ketoprofen were prepared by single emulsion-solvent evaporation method, in which glyceryl monostearate and Tween 80 were employed. The particle size was found to be 99.80±2.1μm. Microparticles observed by scanning electron microscope (SEM) showed spherical shape. The entrapment efficiency (EE %) and drug loading capacity (DL %) were found to be 72.60±1.6 % and 17.98±0.7% respectively. Results of stability evaluation showed relatively long term stability after storage at 4˚C for 3 months. The in-vivo study revealed slightly better per cent inhibition of pain i.e. 74% in comparison with 68% produced by plain drug(AU)

Las micropartículas lipídicas sólidas (MLS) cargadas con ketoprofeno se han preparado a través del método de evaporación del disolvente en emulsión simple, en el que se ha utilizado monoestearato de glicerilo y Tween 80. El tamaño de la partícula ha resultado ser de 99,80±2,1 μm. Las micropartículas observadas a través del microscopio electrónico de barrido (MEB) han mostrado una forma esférica. La eficacia de compresión (EC %) y la capacidad de concentración (CC %) del fármaco han resultado ser de 72,60±1,6% y 17,98±0,7% respectivamente. Los resultados de la evaluación de estabilidad han mostrado una estabilidad relativa a largo plazo después de una conservación a 4˚C durante 3 meses. El estudio in vivo ha revelado un ligero mejor porcentaje de inhibición del dolor, es decir, un 74% en comparación con un 68% producido por un fármaco corriente(AU)

Papulosis linfomatoide en la infancia: presentación de 9 casos y revisión de la literatura / Lymphomatoid Papulosis in Children: Report of 9 Cases and Review of the Literature

Introducción: La papulosis linfomatoide es un proceso linfoproliferativo de células T CD30+ poco frecuente y de pronóstico excelente que generalmente afecta a adultos y, en menor medida a niños, por lo que tanto el espectro clínicopatológico como el riesgo de progresión a otro tipo de linfoma en el grupo pediátrico no está bien establecido. Objetivo: Analizar las características de la papulosis linfomatoide infantil a partir de la descripción de nuevos casos y de la revisión de la literatura. Material y método: Se realizó un estudio retrospectivo de 9 pacientes menores de 18 años diagnosticados de papulosislinfomatoide atendidos en nuestro servicio entre 1995 y 2009. Resultados: Se incluyeron 7 niños y 2 niñas de edades entre 2 y 17 años. Las lesiones de papulosis linfomatoide se vieron precedidas en 2 casos y seguidas en 1 de otras compatibles con pitiriasis liquenoide aguda. La resolución de las lesiones fue espontánea, dejando hiperpigmentación (77%) o hipopigmentación postinflamatoria (23%) y cicatrices en el 77% de los casos. Histológicamente todos los casos presentaron el patrón tipo A de papulosis linfomatoide. El estudio molecular mostró monoclonalidad en los 3 casos en los que fue realizado. Conclusiones: La papulosis linfomatoide infantil es una entidad rara que se manifiesta clínicamente como la forma adulta. Esta enfermedad linfoproliferativa, que ocasionalmente se asocia a pitiriasis liquenoide aguda, muestra hallazgos histológicos compatibles con el patrón histiocitoide o tipo A. El desarrollo de otros procesos linfoproliferativos malignos en el seguimiento posterior es menos frecuente en la papulosis linfomatoide infantil comparado con la variante adulta. La frecuente asociación de pitiriasis liquenoide y de papulosis linfomatoide encontrada en nuestro análisis, así como la dificultad que supone en algunos casos el diferenciar entre ambos procesos, permite sugerir que ambas patologías podrían formar parte de un espectro clínico-patológico común (AU)

Background: Lymphomatoid papulosis is a rare lymphoproliferative T cell CD30+ disease with excellent prognosis which affects almost exclusively adult patients, being rarely in the childhood; thus the clinic and pathologic spectrum and the risk of evolution to another type of lymphoma are not well defined in the pediatric group. Objective: The aim of this article is to analyze the characteristics of infantile lymphomatoid papulosis and review the literature. Material and method: A retrospective study analyzing the characteristics of 9 patients aged up to 18 diagnosed of lymphomatoid papulosis attended in our department from 1995 to 2009 was performed. Results: The study included 7 boys and 2 girls aged between 2 and 17. Pityriasis lichenoides acuta's lesions appeared associated before and after lymphomatoid papulosisŒ development in 2 and 1 cases respectively.The lesions resolved spontaneously, leaving a postinflammatory hyperpigmentation (77%) or hypopigmentation (23%). The development of varioliform scars occurred in over 77% of cases. Histologically, all cases showed features compatible with type A of lymphomatoid papulosis. Molecular studies showed monoclonality in the 3 cases in which this technique was done. Conclusions: Infantile lymphomatoid papulosis is a rare entity clinically manifested as the adult form. This lymphoproliferative disease, which is occasionally associated with pityriasis lichenoides acuta, shows features compatible with the type A or histiocytoid pattern in the histological analysis. The development of other lymphoproliferative disorders is less frequent in the infantile form than in the adulthood. The prevalent association among pityriasis lichenoides and lymphomatoid papulosis observed in our analysis, as well as the difficulties which supposed to differentiate between these two pathologies in various cases, suggest that those entities could be part of a common clinical and pathological spectrum (AU)

Aportes a la Educación Médica: Glosario virtual de Histología Humana Clínicamente Orientado / Contributions to medical education: virtual glossary of clinically oriented human histology

El proceso de comunicación en Educación Médica requiere de claridad y precisión terminológica. Sinembargo, en los textos especializados de la disciplina Histología diferentes estructuras, células y tejidos continúandenominándose con términos imprecisos, basados en el nombre de grandes maestros o descubridores, analogías de forma, sinónimos y epónimos. Si bien desde hace muchos años se viene trabajando a nivel internacional paraunificar la terminología en Ciencias Morfológicas, en la práctica esto no ha sucedido. Por otro lado, cuando el residente de Anatomía Patológica comienza el cursado de la especialidad, los conocimientos de Histología son unaherramienta fundamental ya que se hace necesario revisar y rescatar los conceptos normales de células y tejidos. Para reconocer los cambios biopatológicos de células y tejidos es necesario conocer sus características estructurales y funcionales normales. Para contribuir a la formación de los estudiantes de Histología y de los residentes de Anatomía Patológica, superando las contradicciones terminológicas y consolidando los conocimientos histológicos normales, hemosrealizado un Glosario ilustrado de Histología, clínicamente orientado.

The communication process in Medical Education requires clarity and terminological precision (1). withoutBut in specialized texts Histology discipline different structures, cells and tissues continuedenominating with vague terms, based on the name of masters or discoverers, such analogies, synonyms and eponyms. While for many years been working internationally forunify terminology in Morphological Sciences, in practice this has not happened. On the other hand, when the resident of Pathology begins completed specialty, knowledge of Histology are aessential tool as it is necessary to review the concepts and rescue normal cells and tissues. To recognize pathobiological changes of cells and tissues is necessary to know its normal structural and functional characteristics.To contribute to the training of students of Histology and Pathology residents, overcoming the contradictions terminology and consolidating normal histological knowledge, wemade an illustrated Glossary of Histology, clinically oriented. Glossary means a list of specific words.

A visual coding system in histopathology and its consensual acquisition.

Divergent descriptions of histopathologic images induce inter- and intra-observer variability in diagnosis. Even though a controlled terminology exists to describe medical imaging, pathologists do not always agree on the visual representation of the descriptive terms. The main purpose of our work is to define a methodology to build a standardized visual coding system unambiguously characterizing the terms of a microglossary. The methodology follows two steps: 1) the acquisition of experts' descriptions of images using the microglossary and 2) a consensus derivation. The procedure was applied on a set of 85 histopathological images of breast tumors described by two experts. Among the 339 objects selected in images, 176 were detected by both experts, 77% localized at the same place and 25% also identically labeled. The microglossary was enriched and illustrated via the resulting consensual descriptions. The contribution of this work supports relevant indexing of biomedical images and image-related information.

The clinical utility of the Revised European-American Lymphoma (R.E.A.L.) Classification: preliminary results of a prospective study in patients with non-Hodgkin's lymphoma from a single centre.

BACKGROUND: The clinical applicability of the Revised European-American Lymphoma (R.E.A.L.) Classification has been demonstrated in several retrospective studies. The present, ongoing study was initiated to evaluate the clinical and pathological utility of the R.E.A.L. Classification compared with the Working Formulation (WF) in a prospective fashion, in an unselected patient population treated at a single institution. PATIENTS AND METHODS: Prospective data were collected on 596 biopsies from 557 patients referred with an initial diagnosis of lymphoma. After initial histologic review, 465 biopsies from 441 patients were confirmed as non-Hodgkin's lyphoma (NHL), 412 of which could be classified in R.E.A.L. and WF. RESULTS: According to WF criteria, 25% were low grade, 58% intermediate grade and 2% high grade, 14% could not be allocated to a WF subtype. According to R.E.A.L., 46% were diffuse large B cell, 19% follicle centre lymphoma, 6% marginal zone, 6% small lymphocytic, 4% mantle cell, and 3% T-cell anaplastic large cell. For those with B-cell NHL, 7% were unclassifiable in WF compared with 1% in R.E.A.L. Corresponding figures for T-cell NHL were 68% and 3%, respectively. CONCLUSIONS: Preliminary results confirm the clinical utility of the R.E.A.L. Classification in a single institution setting, demonstrating that cases were more readily sub-typed in R.E.A.L. compared with WF. Frequencies are comparable with I.L.S.G. data. Further follow up with large patient numbers is on-going to analyse survival data with reference to clinical prognostic factors.

Pautas recomendables para el tratamiento quirúrgico de los carcinomas basocelulares / Basal cell carcinoma treatment guidelines

En el presente trabajo se enuncian pautas de tratamiento quirúrgico y de seguimiento de los carcinomas basocelulares de la piel. Para tales efectos se utiliza fundamentalmente la clasificación histológica del Dr. Jorge Abulafia, cuyos conceptos dividen a los mencionaados epiteliomas basocelulares en siete diferentes entidades que se describen. Se establece un protocolo general o conducta de tratamiento para estas afecciones encarando la cirugía resectiva y la eventual reparación posterior