[Squamous cell carcinoma arising on an epidermal inclusion cyst: a case presentation and review of the literature]. / Carcinoma epidermoide desarrollado sobre quiste de inclusión epidérmica cutáneo. Presentación de un nuevo caso y revisión de la literatura.

Epidermal inclusion cysts are very common lesions that very rarely undergo malignant transformation-in the English-language literature we have only found 18 adequately documented cases. We present the case of a man with a 2-month history of a retroauricular skin lesion in which histological study revealed squamous cell carcinoma arising on an epidermal inclusion cyst. Cysts that grow rapidly, reach a large size, ulcerate, develop a fistula, or that do not respond to medical treatment, and those that recur should be excised completely and histological study performed of the whole lesion.

Carcinoma epidermoide desarrollado sobre quiste de inclusión epidérmica cutáneo. Presentación de un nuevo caso y revisión de la literatura / Squamous Cell Carcinoma Arising on an Epidermal Inclusion Cyst: A Case Presentation and Review of the Literature

El quiste de inclusión epidérmica es una lesión muy común, siendo muy poco frecuente la transformación maligna del mismo. En la bibliografía en lengua inglesa solamente hemos encontrado 18 casos publicados que estuvieran adecuadamente documentados. Presentamos el caso de un varón con una lesión cutánea retroauricular de dos meses de evolución, cuyo estudio anatomopatológico mostró un carcinoma epidermoide que tenía su origen en un quiste de inclusión epidérmica. Los quistes de crecimiento rápido, aquellos que alcanzan gran tamaño, los que se ulceran, los que fistulizan y no responden al tratamiento médico y aquellos que presentan recurrencias deben extirparse completamente y estudiarse histológicamente en su totalidad (AU)

Epidermal inclusion cysts are very common lesions that very rarely undergo malignant transformation—in the English-language literature we have only found 18 adequately documented cases. We present the case of a man with a 2-month history of a retroauricular skin lesion in which histological study revealed squamous cell carcinoma arising on an epidermal inclusion cyst. Cysts that grow rapidly, reach a large size, ulcerate, develop a fistula, or that do not respond to medical treatment, and those that recur should be excised completely and histological study performed of the whole lesion (AU)

[Juvenile xanthogranuloma of the penis]. / Xantogranuloma juvenil de pene.

We report a case of juvenile xanthogranuloma of the penis in a 30 year old patient with clinical suspicion of epidermoid cyst. Histology and ethiopathogenesis are reviewed, with special emphasis on the differential diagnosis with other similar lesions with worst prognosis.

Xantogranuloma juvenil de pene / Juvenile xantogranuloma of the penis

Presentamos un caso de xantogranuloma juvenil de pene en un paciente de 30 años de edad que clínicamente fue diagnosticado de quiste de inclusión epidérmica. Describimos la histología y etiopatogenia de la lesión haciendo hincapié en el diagnóstico diferencial con otras lesiones similares con pronóstico adverso (AU)

We report a case of juvenile xanthogranuloma of the penis in a 30 year old patient with clinical suspicion of epidermoid cyst. Histology and ethiopathogenesis are reviewed, with special emphasis on the differential diagnosis with other similar lesions with worst prognosis (AU)

[Soft tissue metastases by micropapillary bladder carcinoma. Metastatic disease]. / Metástasis en partes blandas por un carcinoma micropapilar de vejiga.

Micropapillary transitional cell carcinoma is a rare (incidence of 0.7%) and highly aggressive variant of bladder carcinoma. Morphologically, it is characterized by small tight clusters of neoplastic cell floating in clear spaces resembling lymphatic channels. Its usual presentation is like a high grade and stage carcinoma and most often is associated with a variable component of conventional carcinoma or other variants. The usual sites of bladder cancer metastases are the lymph nodes, lungs, bone and liver. Soft tissues metastases from transitional cell carcinoma of the bladder occur infrequently. We report the cases of a 77-year-old man presenting with an abdominal soft tissue mass a six years after local excision of a micropapillary bladder carcinoma.

Metástasis en partes blandas por un carcinoma micropapilar de vejiga / Soft tissue metastases by micropapillary bladder carcinoma. Metastatic disease

El carcinoma micropapilar es una variante infrecuente de carcinoma vesical (incidencia del 0.7%) con comportamiento clínico agresivo. Histológicamente está constituido por nidos pequeños de células uroteliales dispuestas en lagunas que simulan invasión vascular y se suelen asociar a estadios clínicos avanzados y alto grado histológico. Estos tumores generalmente se asocian a otras variantes histológicas de carcinoma transicional. Los tumores de vejiga suelen metastatizar a ganglios linfáticos, pulmón, hueso e hígado, pero son excepcionales las metástasis a partes blandas. Presentamos el caso de un varón de 77 años que presentó una masa metástasica en partes blandas de pared abdominal a los 6 años de realizarle resección de un carcinoma transicional variante micropapilar de vejiga

Micropapillary transitional cell carcinoma is a rare (incidence of 0.7%) and highly aggressive variant of bladder carcinoma. Morphologically, it is characterized by small tight clusters of neoplastic cell floating in clear spaces resembling lymphatic channels. Its usual presentation is like a high grade and stage carcinoma and most often is associated with a variable component of conventional carcinoma or other variants. The usual sites of bladder cancer metastases are the lymph nodes, lungs, bone and liver. Soft tissues metastases from transitional cell carcinoma of the bladder occur infrequently. We report the cases of a 77-year-old man presenting with an abdominal soft tissue mass a six years after local excision of a micropapillary bladder carcinoma

[Conjunctival inclusion cyst after strabismus surgery by hang-back recession]. / Quiste conjuntival de inclusión tras cirugía de estrabismo según técnica de retroinserción en asa.

CASE REPORT: A 24-year-old woman, with a history of infantile esotropia and DVD operated on in infancy, had strabismus surgery performed by us. Four months later she presented with a cystic lesion that recurred after drainage and medical treatment. Complete excision of the cystic lesion was therefore performed. DISCUSSION: The epithelial cells implanted on the sclera at the time of the most recent surgery may have been the origin of inclusion cyst which developed after the strabismus surgery. This suggests a possible relationship with the scleral suture as the mechanism of cyst formation, independent of the muscle position. Complete excision is the recommended treatment for large cysts.

Quiste conjuntival de inclusión tras cirugía de estrabismo según técnica de retroinserción en asa / Conjunctival inclusion cyst after strabismus surgery by hang-back recession

Caso clínico: Mujer de 24 años con antecedentes de endotropía congénita más DVD operada en la infancia. Se realiza intervención quirúrgica y cuatro meses tras la cirugía presenta una lesión quística que recidiva tras drenaje y tratamiento médico. Se realiza exéresis completa de la lesión. Discusión: El origen de los quistes de inclusión conjuntivales tras cirugía de estrabismo sería la implantación escleral de células epiteliales. Sugerimos la relación con la sutura escleral como mecanismo de formación, independientemente de la posición del músculo. El tratamiento de elección en los quistes de gran tamaño es la resección completa

Case report: A 24-year-old woman, with a history of infantile esotropia and DVD operated on in infancy, had strabismus surgery performed by us. Four months later she presented with a cystic lesion that recurred after drainage and medical treatment. Complete excision of the cystic lesion was therefore performed. Discussion: The epithelial cells implanted on the sclera at the time of the most recent surgery may have been the origin of inclusion cyst which developed after the strabismus surgery. This suggests a possible relationship with the scleral suture as the mechanism of cyst formation, independent of the muscle position. Complete excision is the recommended treatment for large cysts

[Expression of cytokeratin 5 and calretinin in clear-cell renal cell carcinoma]. / Expresión de citoqueratina 5 y calretinina en el carcinoma renal de células claras.

PURPOSE: Cytokeratin 5 (CK5) and calretinin have been useful in different studies as immunohistochemical markers suggestive of mesothelioma, and their expression is analyzed for the histological differential diagnosis with adenocarcinomas, specially when confronting with metastatic tumors of unknown origin. We have analyzed the expression of CK5 and calretinin in clear cell renal cell carcinoma. METHODS: A series of 63 clear cell renal cell carcinomas was studied. 46 of these cases were embedded in two tissue arrays, and a second group, of 17 cases, was constituted by conventional paraffin blocks from high-grade tumors (grade 4 of Fuhrman). Immunohistochemical staining was performed with monoclonal antibodies against CK5 and calretinin, following the labeled sptreptavidin-biotin technique. RESULTS: No positivity for calretinin was observed in any case, while CK5 was focally expressed, in an isolated group of cells, in 1 of the 63 cases (1,59%) which corresponded to a high-grade carcinoma (grade 4 of Fuhrman). CONCLUSIONS: Expression of calretinin was not observed in clear cell renal cell carcinoma and positivity for CK5 occurred only in one case, in a very small proportion of tumor cells. Therefore, in practice, although the positivity for these markers cannot completely exclude renal cell carcinoma, this result is very rare in this tumor and other diagnostic posibilities should be considered.

[Expression of CD10 and renal cell carcinoma marker in clear cell renal cell carcinoma: analysis on tissue arrays]. / Expresión de CD10 y del marcador de carcinoma renal en el carcinoma renal de células claras: análisis en matrices tisulares.

OBJECTIVES: CD10 and renal cell carcinoma (RCC) marker antibodies react against proteins of the epithelium of the renal proximal tubule, being expressed by renal cell carcinomas. The frequence and pattern of expression of both markers are analysed in a series of clear cell renal cell carcinomas. METHOD: Two tissue arrays were used, which were composed of cylinders obtained with a 16G needle from 40 paraffin blocks that corresponded to clear cell renal cell carcinomas. The labeled streptavidin-biotin technique was performed (LSAB2, Dako) using CD10 and RCC monoclonal antibodies (Novocastra), testing different antigen retrieval methods for RCC. Immunoreactivity was evaluated as + (isolated cells or focal staining); ++ (moderate) and +++ (extense). RESULTS: Thirty cases (75%) were positive for CD10: 12 +; 5 ++ and 13 +++. The best antigen retrieval method for RCC was a double enzyme digestion (trypsin + protease). Twenty cases (50%) were positive for RCC: 7 +; 5 ++ and 8 +++. Four cases out of the 20 immunoreactive for RCC were negative for CD10. The 16 remaining cases also expressed CD10. CONCLUSIONS: CD10 and RCC are often expressed by clear cell renal cell carcinomas, and they may be useful markers to suggest a renal origin of carcinomas. RCC is less sensitive than CD10. Staining for both of them is usually focal, and thus sensitivity of these techniques decreases when small samples are investigated, such as tissue arrays. The antigen retrieval method is essential for RCC immunohistochemical detection, obtaining the best results with the use of proteolytic enzymes.

[Verrucous carcinoma of the penis arising from a lichen planus. A true preneoplastic lesion?]. / Carcinoma verrucoso de pene desarrollado sobre un liquen plano. Una auténtica lesión preneoplásica?

INTRODUCTION: Up to 30% of squamous cell carcinomas of the penis arise from a lichen sclerosus, but very few reports in which lichen planus was the preexisting lesion have been published. We report a male with verrucous carcinoma of penis that developed in an area of lichen planus. CLINICAL CASE: A 53-year-old male presented with an exophytic tumor on the glans penis that had been present for about 6 months. The lesion developed in a previously biopsied area of lichen planus hypertrophicus. After excision, histological diagnosis was verrucous carcinoma. COMMENT: The development of any subtype of squamous cell carcinoma of penis in a lichen planus can be coincidental, or a neoplastic transformation of lichen planus can take place.

Expresión de Citoqueratina 5 y Calretinina en el carcinoma renal de células claras / Expression of cytokeratin 5 and calretinin in clear cell renal cell carcinoma

Objetivo: La citoqueratina 5 (CK5) y la calretinina se han revelado en numerosos estudios como marcadores inmunohistoquímicos sugestivos de mesotelioma y su análisis se utiliza para el diagnóstico diferencial histológico con adenocarcinomas, especialmente ante metástasis de origen desconocido. En el presente estudio hemos analizado la expresión de CK5 y calretinina en el carcinoma renal de células claras. Métodos: Se estudió un total de 63 casos de carcinoma renal de células claras. De ellos, 46 fueron incluidos en dos matrices tisulares (“tissue arrays”), y un segundo grupo, de 17 casos, estuvo constituido por bloques convencionales de tumores de alto grado (grado 4 de Fuhrman). Se realizaron tinciones inmunohistoquímicas con anticuerpos monoclonales anti CK5 y anti calretinina, mediante el método de estreptavidina marcada con peroxidasa-biotina. Resultados: No se obtuvo positividad en ninguno de los casos para calretinina, mientras que la CK5 se expresó focalmente, en células aisladas, en 1 de los 63 casos (1,59%), que correspondió a un carcinoma de alto grado (grado 4 de Fuhrman). Conclusiones: En el carcinoma renal de células claras no hemos observado expresión de calretinina y la positividad para CK5 ha ocurrido de manera aislada y en un porcentaje muy pequeño de células tumorales. Por tanto, en la práctica si bien la positividad para estos marcadores no excluye de manera absoluta carcinoma de células renales, dicho resultado es muy improbable en este tumor y obliga a considerar otras opciones diagnósticas

Purpose: Cytokeratin 5 (CK5) and calretinin have been useful in different studies as immunohistochemical markers suggestive of mesothelioma, and their expression is analyzed for the histological differential diagnosis with adenocarcinomas, specially when confronting with metastatic tumors of unknown origin. We have analyzed the expression of CK5 and calretinin in clear cell renal cell carcinoma. Methods: A series of 63 clear cell renal cell carcinomas was studied. 46 of these cases were embedded in two tissue arrays, and a second group, of 17 cases, was constituted by conventional paraffin blocks from high-grade tumors (grade 4 of Fuhrman). Immunohistochemical staining was performed with monoclonal antibodies against CK5 and calretinin, following the labeled sptreptavidin-biotin technique. Results: No positivity for calretinin was observed in any case, while CK5 was focally expressed, in an isolated group of cells, in 1 of the 63 cases (1,59%) which corresponded to a high-grade carcinoma (grade 4 of Fuhrman). Conclusions: Expression of calretinin was not observed in clear cell renal cell carcinoma and positivity for CK5 occurred only in one case, in a very small proportion of tumor cells. Therefore, in practice, although the positivity for these markers cannot completely exclude renal cell carcinoma, this result is very rare in this tumor and other diagnostic posibilities should be considered

Condromatosis sinovial. Estudio de 39 pacientes / Synovial chondromatosis. A study of 39 patients

Objetivo: Estudiar las manifestaciones clínicas, el empleo de las técnicas de diagnóstico por la imagen y la evolución de las condromatosis sinoviales en nuestra área sanitaria. Pacientes y métodos: El hospital POVISA tiene vinculada una población de 127.000 habitantes. Se revisaron retrospectivamente las historias clínicas de todos los pacientes de nuestra área sanitaria en los que se estableció histológicamente el diagnóstico de condromatosis sinovial entre enero de 1992 y diciembre de 2003. Resultados: Se recogieron 38 condromatosis de localización articular, todas monoarticulares, y 1 extraarticular, que correspondieron a 20 varones y a 19 mujeres, cuya edad (media ± DE) en el momento del diagnóstico fue de 56,5 ± 12,7 años (rango: 16-79 años). La principal localización articular fue la rodilla (15; 39,5%), seguida de la cadera (8; 21%) y de la temporomandibular y codo, ambas en 3 (7,9%) pacientes. Se documentó una artropatía previa en 18 (18/38; 47,4%) pacientes. El período sintomático previo al diagnóstico fue de 25,4 ± 34 meses. Las manifestaciones clínicas más frecuentes fueron el dolor articular (100%), la restricción de la movilidad (77%) y la tumefacción (57%). Se realizaron radiografías simples en todos los pacientes y sugirieron el diagnóstico en 20 (51,3%) de ellos. Los hallazgos de la resonancia magnética orientaron al diagnóstico en 12 (80%) de los 15 pacientes en los que se solicitó. En todos los casos se procedió a la extracción de los cuerpos libres y a una sinovectomía que se realizó por vía artroscópica en 6. Fue necesario colocar una prótesis articular (cadera o rodilla) en 16 (42%) pacientes. Durante el seguimiento posquirúrgico (23,7 ± 5,3 meses) no se identificó ningún caso de condrosarcoma y la tasa de recidivas fue baja (7,9%). Conclusiones: En nuestro medio, casi la mitad (47,4%) de las condromatosis sinoviales asentaron sobre una articulación previamente dañada, la demora del diagnóstico superó los 2 años y fue necesaria una prótesis de cadera o rodilla en el 42% de los pacientes(AU)

Objective: To study the clinical manifestations, use of diagnostic imaging techniques and outcome of patients with synovial chondromatosis in our health area. Patients and methods: POVISA Hospital provides health services to a population of 127,000 inhabitants. The clinical histories of all the patients in this area who were histologically diagnosed with synovial chondromatosis between January 1992 and December 2003 were reviewed. Results: There were 38 cases of joint chondromatosis, all monoarticular, and one case of extra-articular chondromatosis in 20 men and 19 women aged 56.5 ± 12.7 years (mean ± SD) at diagnosis (range: 16-79 years). The main joint affected was the knee (15; 39.5%), followed by the hip (8; 21%) and the temporomandibular joint and elbow, both of these in three patients (7.9%). Previous arthropathy was recorded in 18 patients (18/38, 47.4%). Symptom duration prior to diagnosis was 25.4 ± 34 months. The most frequent clinical manifestations were joint pain (100%), restricted movement (77%) and swelling (57%). Plain radiographs were carried out in all patients and suggested the diagnosis in 20 (51.3%). Magnetic resonance imaging findings led to a diagnosis in 12 out of 15 patients in whom this procedure was required (80%). In all patients loose bodies were removed and synovectomy was performed by arthroscopic procedures in six. In 16 patients (42%) total joint replacement was required. The mean postoperative follow-up was 23.7 ± 5.3 months. No cases of chondrosarcoma were identified and the recurrence rate was low (7.9%). Conclusions: In our setting, almost half (47.4%) of the cases of synovial chondromatosis occurred in a previously damaged joint: the correct diagnosis was delayed by more than 2 years and total arthroplasty was required in 42% of the patients(AU)

Expresión de CD10 y del marcador de carcinoma renal en el carcinoma renal de células claras: análisis en matrices tisulares / Expression of CD10 and renal cell carcinoma marker in clear cell renal cell carcinoma: analysis on tissue arrays

Objetivos: Los anticuerpos CD10 y marcador de carcinoma renal (MCR) reaccionan frente a proteínas del epitelio normal del túbulo contorneado proximal, expresándose por tanto en los carcinomas de células renales. Se analizan la frecuencia y el patrón de expresión de ambos marcadores inmunohistoquímicos en una serie de carcinomas renales de células claras. Método: Se han utilizado dos matrices tisulares (“tissue arrays”) constituidas por cilindros obtenidos con aguja 16G de 40 bloques de parafina correspondientes a carcinomas renales de células claras. Se realizó técnica de estreptavidina marcada - biotina (LSAB2, Dako) con anticuerpos monoclonales CD10 y MCR (Novocastra), ensayándose para este último distintos métodos de recuperación antigénica. Se valoró la positividad como + (aislada o muy focal); ++ (moderada) y +++ (extensa). Resultados: Con CD10 fueron positivos 30 casos (75%): 12 +; 5 ++ y 13 +++. Con respecto a MCR, el mejor método de desenmascaramiento antigénico fue un doble tratamiento enzimático (tripsina + proteasa). Se encontró positividad para MCR en 20 casos (50%): 7+; 5 ++ y 8 +++. De los 20 casos positivos para MCR, cuatro habían sido negativos para CD10. Los otros 16 expresaban también CD10. Conclusiones: CD10 y MCR se expresan con frecuencia en los carcinomas renales de células claras, por lo que pueden ser marcadores útiles para sugerir en un carcinoma un origen renal. MCR presenta menor sensibilidad que CD10. Al ser la expresión de ambos habitualmente focal, la sensibilidad de estas técnicas es menor cuando se utilizan muestras pequeñas, como son las matrices tisulares. En la técnica IHQ para MCR resulta crucial el método de desenmascaramiento antigénico, obteniéndose los mejores resultados con el uso de enzimas proteolíticos

Objectives: CD10 and renal cell carcinoma (RCC) marker antibodies react against proteins of the epithelium of the renal proximal tubule, being expressed by renal cell carcinomas. The frequence and pattern of expression of both markers are analysed in a series of clear cell renal cell carcinomas. Method: Two tissue arrays were used, which were composed of cylinders obtained with a 16G needle from 40 paraffin blocks that corresponded to clear cell renal cell carcinomas. The labeled streptavidin-biotin technique was performed (LSAB2, Dako) using CD10 and RCC monoclonal antibodies (Novocastra), testing different antigen retrieval methods for RCC. Immunoreactivity was evaluated as + (isolated cells or focal staining); ++ (moderate) and +++ (extense). Results: Thirty cases (75%) were positive for CD10: 12 +; 5 ++ and 13 +++. The best antigen retrieval method for RCC was a double enzyme digestion (trypsin + protease). Twenty cases (50%) were positive for RCC: 7 +; 5 ++ and 8 +++. Four cases out of the 20 immunoreactive for RCC were negative for CD10. The 16 remaining cases also expressed CD10. Conclusions: CD10 and RCC are often expressed by clear cell renal cell carcinomas, and they may be useful markers to suggest a renal origin of carcinomas. RCC is less sensitive than CD10. Staining for both of them is usually focal, and thus sensitivity of these techniques decreases when small samples are investigated, such as tissue arrays. The antigen retrieval method is essential for RCC immunohistochemical detection, obtaining the best results with the use of proteolytic enzymes

Carcinoma verrucoso de pene desarrollado sobre un liquen plano. ¿una auténtica lesión preneoplásica? / Verrucous carcinoma of the penis arising from a lichen planus. A true preneoplastic lesion?

Introducción: Hasta un 30% de carcinomas epidermoides de pene se desarrollan sobre un liquen escleroso, mientras que hay muy pocos casos publicados en los que la lesión preexistente sea un liquen plano. Se presenta un carcinoma verrucoso de pene desarrollado sobre un área de liquen plano. Caso clínico: Un varón de 53 años consultó por presentar un tumor exofítico en glande de 6 meses de evolución, que había crecido sobre una lesión biopsiada 2 años antes, y diagnosticada como liquen plano hipertrófico. Tras su extirpación, el diagnóstico histológico fue de carcinoma verrucoso. Comentario: el desarrollo de cualquier variante de carcinoma epidermoide de pene sobre un liquen plano puede ser meramente casual, o por el contrario podría ser una transformación neoplásica del mismo

Introduction: up to 30% of squamous cell carcinomas of the penis arise from a lichen sclerosus, but very few reports in which lichen planus was the preexisting lesion have been published. We report a male with verrucous carcinoma of penis that developed in an area of lichen planus. Clinical case: a 53-year-old male presented with an exophytic tumor on the glans penis that had been present for about 6 months. The lesion developed in a previously biopsied area of lichen planus hypertrophicus. After excision, histological diagnosis was verrucous carcinoma. Comment: the development of any subtype of squamous cell carcinoma of penis in a lichen planus can be coincidental, or a neoplastic transformation of lichen planus can take place

[Synovial chondromatosis. A study of 39 patients]. / Condromatosis sinovial. Estudio de 39 pacientes.

OBJECTIVE: To study the clinical manifestations, use of diagnostic imaging techniques and outcome of patients with synovial chondromatosis in our health area. PATIENTS AND METHODS: POVISA Hospital provides health services to a population of 127,000 inhabitants. The clinical histories of all the patients in this area who were histologically diagnosed with synovial chondromatosis between January 1992 and December 2003 were reviewed. RESULTS: There were 38 cases of joint chondromatosis, all monoarticular, and one case of extra-articular chondromatosis in 20 men and 19 women aged 56.5±12.7 years (mean±SD) at diagnosis (range: 16-79 years). The main joint affected was the knee (15; 39.5%), followed by the hip (8; 21%) and the temporomandibular joint and elbow, both of these in three patients (7.9%). Previous arthropathy was recorded in 18 patients (18/38, 47.4%). Symptom duration prior to diagnosis was 25.4±34 months. The most frequent clinical manifestations were joint pain (100%), restricted movement (77%) and swelling (57%). Plain radiographs were carried out in all patients and suggested the diagnosis in 20 (51.3%). Magnetic resonance imaging findings led to a diagnosis in 12 out of 15 patients in whom this procedure was required (80%). In all patients loose bodies were removed and synovectomy was performed by arthroscopic procedures in six. In 16 patients (42%) total joint replacement was required. The mean postoperative follow-up was 23.7±5.3 months. No cases of chondrosarcoma were identified and the recurrence rate was low (7.9%). CONCLUSIONS: In our setting, almost half (47.4%) of the cases of synovial chondromatosis occurred in a previously damaged joint: the correct diagnosis was delayed by more than 2 years and total arthroplasty was required in 42% of the patients.

[Primary non-Hodgkin large B-cell lymphoma of bladder. Report of a case]. / Linfoma no hodgkin B de célula grande primario de vejiga. Presentación de un caso.

INTRODUCTION: primary genitourinary lymphomas are uncommon. Among them, bladder lymphomas are extremely unusual tumors, with clinico-radiological features similar to urothelial carcinomas of bladder. Histopathological, immunohistochemical and molecular studies are compulsory for the diagnosis. We report a case of this tumor. CLINICAL CASE: An 80-year-old woman was admitted to our hospital with hematuria. Abdominal ultrasound and cystoscopy revealed an infiltrating bladder tumor involving the right lateral wall. After transuretral biopsy, a diagnosis of non-Hodgkin large B-cell lymphoma was made. Neither clinical symptoms nor radiological findings showed disseminated disease, indicating that the tumor was localized in the bladder. After chemotherapy, the patient is disease-free after 9 months follow-up. COMMENT: if a bladder tumor with uncommon histopathological features is found, lymphoma should be excluded, because chemotherapy avoids cystectomy.

Linfoma No Hodgkin B de célula grande primario de vejiga. Presentación de un caso / Primary Non Hodgkin large B-cell lymphoma of bladder. Report of a case

Introducción: Los linfomas primarios del tracto genitourinario son raros. Dentro de ellos, los de vejiga son extremadamente infrecuentes, con características clínico-radiológicas indistinguibles de las de los carcinomas uroteliales, por lo que para su diagnóstico es necesario estudio histopatológico, inmunohistoquímico y molecular. Presentamos un caso de este tipo de tumor. Caso clínico: una mujer de 80 años consultó en nuestro hospital por hematuria. La ecografía abdomina ly la cistoscopia mostraron una tumoración vesical infiltrante en pared lateral derecha. Tras biopsia por resección transuretral, se diagnosticó como linfoma no Hodgkin B de célula grande, que fue considerado primario de vejiga al no existir signos clínicos ni radiológicos de afectación en otras topografías. La paciente recibió quimioterapia y está actualmente libre de enfermedad tras 9 meses de seguimiento. Comentario: ante una tumoración vesical de características histopatológicas poco habituales, la posibilidad de un linfoma debe ser tenida en cuenta, ya que el tratamiento quimioterápico permite conservar la vejiga (AU)

Introduction: primary genitourinary lymphomas are uncommon. Among them, bladder lymphomas are extremely unusual tumors, with clinico-radiological features similar to urothelial carcinomas of bladder. Histopathological, immunohistochemical and molecular studies are compulsory for the diagnosis. We report a case of this tumor. Clinical case: An 80-year-old woman was admitted to our hospital with hematuria. Abdominal ultrasound and cystoscopy revealed an infiltrating bladder tumor involving the right lateral wall. After transuretral biopsy, a diagnosis of non-Hodgkin large B-cell lymphoma was made. Neither clinical symptoms nor radiological findings showed disseminated disease, indicating that the tumor was localized in the bladder. After chemotherapy, the patient is disease-free after 9 months follow-up. Comment: if a bladder tumor with uncommon histopathological features is found, lymphoma should be excluded, because chemotherapy avoids cystectomy (AU)

Enfermedad de Erdheim-Chester e histiocitosis de células de Langerhans. ¿Una asociación fortuita? / Erdheim-Chester disease and Langerhans histiocytosis. A fortuitous association?

La enfermedad de Erdheim-Chester es una histiocitosis sistémica de origen desconocido, histológicamente distinta de la histiocitosis de células de Langerhans, que se caracteriza por lesiones óseas esclerosantes de distribución simétrica, con predominio en las diáfisis y metáfisis de huesos largos. No está clasificada dentro de las histiocitosis malignas, no obstante, su curso clínico suele ser agresivo, con escasa respuesta a los diversos tratamientos ensayados. Excepcionalmente, se han descrito casos con hallazgos anatomopatológicos de la enfermedad de ErdheimChester asociados a la presencia de histiocitos de Langerhans. Presentamos un nuevo paciente en el que se identificaron cambios radiográficos compatibles con enfermedad de Erdheim-Chester pero cuyo estudio histológico mostró una histiocitosis de células de Langerhans y cursó con ostealgias, mialgias, diabetes insípida, exoftalmos, lesiones óseas esclerosantes bilaterales y simétricas así como un síndrome cerebeloso (AU)

Tumor de células de Sertoli-Leydig de ovario, con extenso componente heterólogo intestinal y elevación de alfa-fetoproteína / Ovarian Sertoli-Leydig cell tumour with an extensive heterologous intestinal component and raised alphafetoprotein

El tumor de células de Sertoli-Leydig de ovario es poco frecuente. Es predominantemente sólido pero puede haber áreas quísticas; cuando tiene abundante componente heterólogo de tipo intestinal puede ser predominantemente quístico. El contenido de células de Sertoli y de Leydig es variable, y puede ser muy escaso. Este conjunto de hechos puede llevar a confundir esta lesión con un tumor mucinoso quístico. En algunas ocasiones se ha descrito elevación de AFP, lo que obliga a plantear el diagnóstico diferencial con un tumor de células germinales. El tumor de células de Sertoli-Leydig se presenta el 80 por ciento de las veces en un estadio IA, y dado que en general se presenta en mujeres jóvenes en edad fértil, el tratamiento es conservador, y una anexectomía simple es suficiente. El pronóstico, generalmente bueno, está en función del estadio y del grado de diferenciación. Se presenta el caso de una paciente de 25 años de edad con polimenorreas, aumento del volumen abdominal y elevación de AFP sérica (AU)