Pleural Effusion as a Potential Complication of Foreign Body Reaction to Silicone Breast Implants: A Case Study.

Breast augmentation surgery, like any other surgery, has potential complications, including the less common complication of pleural effusion. We present a unique case of a 44-year-old female who developed pleuritic chest pain and shortness of breath 10 days after her breast augmentation surgery, with no prior history of cardiac or autoimmune conditions. The temporal relationship between the surgery and the onset of symptoms suggested a possible direct link to the implants. Imaging showed a small- to moderate-sized left pleural effusion, and pleural fluid analysis revealed findings suggestive of a foreign body reaction (FBR), including evidence of mesothelial and inflammatory cells with a lymphocyte percentage of 44% and monocytes of 30%. The patient received intravenous steroids at a dose of 40 mg every eight hours for three days while hospitalized, followed by a tapered oral dose of steroids upon discharge, for over three weeks. Follow-up imaging studies showed complete resolution of the pleural effusion. The diagnosis of pleural effusion resulting from FBR to silicone gel-filled breast implants involves a clinical history, cytopathological examination, and the exclusion of other potential causes. This case highlights the importance of considering FBR as a potential cause of pleural effusion post-breast augmentation surgery.

A Case of Malignant Brenner Tumor of the Ovary Incidentally Found in a Patient with Deep Vein Thrombosis.

We present the case of a 73-year-old woman who was incidentally found to have a malignant Brenner tumor (MBT) of the ovary during an evaluation for deep vein thrombosis (DVT). The patient presented with swelling in her left leg, non-healing ulcers, weakness, and numbness in her lower limbs. Imaging studies revealed a large multiloculated cystic mass with areas of calcification in the left adnexa extending to the upper abdomen toward the gallbladder fossa. The patient underwent exploratory laparotomy with removal of the ovarian cyst, later diagnosed as a focal MBT in a background of borderline Brenner tumor. Brenner tumors of the ovary are a rare subtype of ovarian neoplasm that accounts for less than 2% of all ovarian tumors. MBTs are even rarer, comprising less than 5% of all Brenner tumors. To our knowledge, this is the first reported case of an MBT incidentally found in a patient with DVT.

Angioleiomyoma of the Hand: A Report of Two Cases.

We present a case series of two rare cases of angioleiomyoma of the hand, an infrequent type of benign tumor. In the first case, a 41-year-old female presented with a left thumb mass that had increased in size over two years. Imaging studies revealed a destructive lesion involving the first webspace with infiltration of the first metacarpal, and the mass was initially suspected to be a sarcoma. However, a percutaneous image-guided fine-needle aspiration (US-FNA) and ultrasound-guided core-needle biopsy (USG-CNB) of the left-hand mass confirmed the diagnosis of angioleiomyoma. The mass was surgically excised, and the final diagnosis was consistent with the earlier USG-CNB. In the second case, a 63-year-old man with end-stage renal disease presented for consultation regarding dialysis access creation. During the examination, a large, soft, mobile mass adjacent to the wrist on the medial aspect of his hand was identified. This was presumed to be a lipoma. However, the histopathology report revealed a benign angioleiomyoma measuring 3.2 cm, which had been completely excised during the surgery. This case report highlights the importance of considering angioleiomyoma in the differential diagnosis of soft tissue masses and the utility of US-FNA and USG-CNB in diagnosing these tumors.

Pulmonary Mycetoma With a Concomitant Reactivation of Pulmonary Tuberculosis Infection: A Case Report and Clinical Pathological Review.

Tuberculosis is a bacterial infection caused by Mycobacterium tuberculosis. It primarily affects the lungs but can also spread to other body parts. One of the possible symptoms of pulmonary tuberculosis (TB) is hemoptysis. In the case of TB, aspergillomas can develop in the cavitary lesions of TB and result in a deteriorating clinical situation. The current case report describes a 63-year-old female previously treated for TB who presented with hemoptysis, fever, and a 4 cm focal density in the right upper lobe on chest X-ray. The patient was found to have concomitant TB and aspergillosis, manifesting as a pulmonary aspergilloma. The co-occurrence of TB and aspergillosis can occur, particularly in patients with weakened immune systems. This case report highlights the importance of considering concomitant TB and pulmonary mycetoma in patients with a history of treated TB who present with pulmonary symptoms.

Posterior Mediastinal Mass: An Uncommon Presentation of a Branchial Cleft Cyst.

Branchial cleft anomalies are a heterogeneous group of congenital disorders that theoretically emerge due to incomplete obliteration of the branchial apparatus, components of the six main pairs of pharyngeal arches, during embryonic development. They can result in a cyst, a sinus, or a fistula. For a congenital lateral neck mass, they represent the most common diagnosis in pediatric neck pathology. Its location is usually in the cervical area, anterior to the sternocleidomastoid muscle. In adults, they present with symptoms such as acute suppurative thyroiditis and recurrent cervical abscess. In this paper, we report the case of a 54-year-old Hispanic woman with a recent history of a left posterior mediastinal mass, detected on computed tomography (CT) scan while studying her recent onset of asthma. The patient underwent an assisted thoracoscopic excision. During the procedure, the mass appeared to be a very large cyst; on histopathological examination, the cyst was determined to be a branchial cleft cyst. To our knowledge, this is the first reported case of this entity located in the posterior mediastinum in an adult patient. Being an unusual and interesting case, it highlights the idea of considering these anomalies when establishing a differential diagnosis of a posterior mediastinal mass.

Amebic Liver Abscess Complicated With a Pleural Effusion: A Case Report.

Amebiasis is a fecal-oral transmitted parasitic infection caused by the protozoan Entamoeba histolytica, and is generally seen in migrants and travelers of endemic areas. Extraintestinal infection often involves the liver, causing amebic liver abscesses. Twenty to thirty percent of these patients have pleuropulmonary involvement as a complication. The diagnosis is based on clinical, imaging, and serology studies.  A 35-year-old male from New Guinea presented to the emergency department with right upper quadrant pain that radiates to the right shoulder, epigastric pain, and fever. Laboratory results showed an increase in hepatic enzymes; days later leukocytosis was reported. Ultrasound revealed hepatomegaly with heterogeneous masses, and three complex cystic hepatic abscesses were found on a CT scan. Percutaneous drainage was placed. Chest X-ray showed bilateral pleural effusion that required a thoracentesis days after. A pigtail catheter was placed. Three amebic antibody tests were performed with a negative result for the first time, equivocal on the second time, and a positive result on the last one. Twenty-six days later the patient was discharged. Amebiasis is a rare and benign condition in the United States, that can cause abdominal cramping, watery diarrhea, and weight loss. A very low percentage of patients will develop an amebic liver abscess, which can be fatal. Amebic liver abscess may rupture and spread to the peritoneum, pleural space, or pericardium. The serum antigen followed by the serology test contributes to the accurate diagnosis. The first antibody amebic test performed on a patient, has a high probability of a false negative result, due to this possibility, the test must be repeated. Metronidazole remains the drug of choice, and therapeutic aspiration is occasionally required as an adjunct to antiparasitic therapy.

Neuroendocrine Carcinoma of the Uterine Cervix With Metastases to the Thyroid Gland: A Case Report and Clinical Pathological Review.

Thyroid metastasis from a neuroendocrine carcinoma (NEC) is atypical, and the most common site of origin is the lung. We present the case of a 48-year-old lady with a history of NEC in the uterine cervix, classified initially as a p16-positive high-grade endocervical adenocarcinoma with endometrioid differentiation in a cervical biopsy. The patient, after having a thyroid ultrasound due to thyroid nodules, showing a multinodular goiter and suspicious nodules, and a subsequent fine-needle aspiration with a diagnosis of papillary thyroid carcinoma, presented to our hospital for a total thyroidectomy. Histologically, there were metastatic high-grade carcinoma foci within the thyroid, consistent with metastasis from the cervical primary tumor based on the morphology and immunohistochemical stains, the tumor was re-classified as an NEC. The thyroid gland is an uncommon site for metastasis from primary sites, and a very rare site for an NEC origin; besides, this tumor type is infrequent in the uterine cervix and bears an unfavorable prognosis when present. Therefore, when encountering a high-grade metastatic tumor within the thyroid, an NEC has to be considered in the differential diagnosis for a prompt diagnosis and an appropriate treatment.

Metastatic Ovarian Mucinous Carcinoma Presenting as Ileocecal Adenocarcinoma: A Case Report.

Colorectal invasion is an unusual late-stage presentation of metastatic primary mucinous ovarian cancer. In this article, we report a fatal case of a 65-year-old female who presented to our clinic with progressive weight loss, severe constipation, and postprandial early satiety. She underwent an esophagogastroduodenoscopy (EGD) and colonoscopy. Direct visualization during colonoscopy revealed acute inflammation with ulceration and highly atypical glands in the ileocecal valve. The initial biopsy was unremarkable, and a repeat biopsy was performed due to high suspicion of malignancy. The repeat biopsy revealed poorly differentiated, invasive colon adenocarcinoma with partial mucinous features. The patient was referred to the surgery service. While planning for surgical resection, they obtained a CT abdomen and pelvis, which revealed a large ovarian mass and peritoneal carcinomatosis. Immunohistochemistry for the tumor cells was positive for pancytokeratin and cytokeratin 7, partially positive (up to 20%) for cytokeratin 20 and CDX2, and negative for estrogen receptors, monoclonal carcinoembryonic antigen (CEA), and synaptophysin. This immunophenotypic pattern is strongly consistent with metastatic mucinous carcinoma of ovarian origin.

A Novel Starch from Talisia floresii Standl Seeds: Characterization of Its Physicochemical, Structural and Thermal Properties.

Colok seed (Talisia floresii Standl) represents 80% of the total fruit weight and is obtained from trees that grow mainly in Yucatan Peninsula. The aim of this work was the physicochemical characterization from colok starch seeds as an alternative to conventional sources and to identify its characteristics for potential applications in different industrial sectors. Starch yield was 42.1% with low levels of lipids, ashes and fibers. The amylose content was 33.6 ± 1.15%. The gelatinization temperature was 85 ± 0.25 °C. Color analysis resulted in a starch with an intermediate luminosity, reflecting a dark color. Finally, in morphology, starch granule exhibited an average size of 18.7 µm, spherical, uniform and without fractures. Overall results demonstrated that isolated colok starch can be used in food products that require high processing temperatures, such as sauces, cookies, noodles, bread and food packages.

Primary Intraosseous Malignant Peripheral Nerve Sheath Tumor of the Humerus: Report of a Rare Case.

Malignant peripheral nerve sheath tumors (MPNSTs) usually arise in the soft tissues. Intraosseous MPNSTs are rare. They may arise de novo but are typically associated with neurofibromatosis type 1 (NF1) and radiation therapy. Our patient is a 58-year-old female patient that presented with right shoulder pain. An MRI showed a shoulder mass, and percutaneous bone biopsy demonstrated morphology suggestive of an MPNST; besides, on immunohistochemistry, SOX10 was positive, and H3K27me3 expression was entirely lost. The patient underwent total resection of the right proximal humerus and endoprosthetic shoulder reconstruction, followed by radiation therapy and chemotherapy. Only a few cases in the mandible, spine, maxilla, ulna, metacarpal, tarsal, and one in the humerus have been published. In this paper, we contribute with an additional case of primary intraosseous MPNST in the humerus and a brief literature review.

Primary breast lymphoma with sudden death.

Primary breast lymphoma is a rare form of extranodal lymphoma. B cells constitute the most common type involving the breast. T cells represents only 3%. Even though lymphomas have a high predilection to metastasize to the heart, there are no specific clinical or radiological findings, and most of the cases are diagnosed at autopsy. We discuss the case of a 49-year-old woman with primary breast lymphoma who presented with sudden death. Autopsy revealed a primary T-cell lymphoma of the breast with tumoral infiltration of the atrioventricular node and transmural myocardial permeation with focal necrosis.

Histopatología del prúrigo solar / Histopathology of solar prurigo

Antecedentes. El prúrigo solar o actínico (PS) es una de las enfermedades de la piel más comúnmente observadas en nuestro medio, particularmente en la edad pediátrica, en nuestra institución ocupa el lugar 14 con el 1.34 por ciento en frecuencia. Representa una reacción anormal a la luz solar y en su patogénesis participan diversos factores, principalmente inmunogenéticos y ambientales. Aunque sus caracteres clínicos están bien precisados, sus criterios histopatológicos no están aún bien documentados. Material y método. Se llevó a cabo un estudio retrospectivo y observacional para analizar los cambios histopatológicos en 20 muestras de piel provenientes de 20 pacientes en edad pediátrica con PS; los datos más relevantes y constantes se presentan en forma de criterios que se pretende sean útiles para el diagnóstico a través del microscopio de luz. Resultados. Veinte biopsias de piel de 20 niños con PS de más de un año de evolución, diez de cada sexo, todos mestizos o indígenas habitantes del Distrito Federal y áreas vecinas a éste mostraron lesiones recientes y tardías, con cambios epiteliales y dérmicos. Los cambios más constantes fueron: pápulas espongióticas, usualmente con hiperplasia epidérmica psoriasiforme, frecuentemente con exocitosis, en asociación con infiltrados linfocitarios perivasculares e intersticiales, superficiales y medios usualmente con eosinófilos, incontinencia del pigmento, dentro y fuera de melanófagos, y extravasación de eritrocitos. Conclusiones. El PS es una enfermedad inflamatoria de la piel cuyo diagnóstico histopatológico es factible de ser establecido en biopsias de lesiones tempranas o tardías sobre la base de dichos criterios: espongiosis e hiperplasia epidérmica psoriasiforme en asociación con un infiltrado linfocitario perivascular e intersticial, superficial y medio, con eosinófilos.

Alteraciones del ciclo celular en cáncer de mama / Cell cycle alterations in breast cancer

Avances de los mecanismos de la oncogénesis han revelado una estrecha relación con los del ciclo celular y la apoptosis. El paso de la célula a través del ciclo celular depende de una serie de fosforilaciones y desfosforilaciones y de cinasas específicas que activan a las ciclinas. En las células de mamíferos, las cinasas CDK4/6, CDK2, CDK2 y p34 están ligadas a las ciclinas D, E, A, y B, en ese orden y respectivamente cuando la célula progresa de la fase G1 hacia la mitosis. Cuando el ADN se altera, por causas intrínsecas o extrínsecas, los retenes de control deben parar al ciclo para que el daño pueda ser reparado. Si no se puede reparar el ADN, se induce la apoptosis. En el cáncer, los retenes de supervisión no funcionan y el genoma inestable de la célula cancerosa se repara. Algunos de estos cambios ocurren en el cáncer de mama y se discuten en esta revisión

Esterilidad masculina y su asociación con patología genital y factores ambientales / Male sterility and its association with genital pathology and environmental facotrs

La calidad del semen puede ser afectada por una gran serie de factores pues existe evidencia de que, padecimientos como el varicocele, criptorquidia, orquistis e infecciones bacterianas, así como la exposición a agentes físicos como el calor, o sustancias químicas, o la ingesta de alcohol y drogas, pueden afectar la calidad del semen. El objetivo del presente trabajo es investigar el riesgo que implica la exposición a estos factores en la calidad del semen. El estudio se efectuó en forma prospectiva en un grupo de varones de la Clínica de Infertilidad de la Unidad de Biología de la Reproducción del Hospital Universitario "Dr. J.E. González". Se estudiaron 99 pacientes a quienes se les aplicó un cuestionario intencionado sobre antecedentes de exposición a factores ambientales y de patología urológica ya resuelta. Se practicó espermatobioscopia y se clasificó conforme a los parámetros de la OMS. Se formaron dos grupos: los que tenían espermatobioscopia normal (n=25) y los que fueron anormales (n=74). Se aplicó el estadístico de razón de incidencias, Xi cuadrada y riesgo atribuible para determinar el impacto que los diferentes factores pudieran tener sobre la calidad del semen. Las alteracione encontradas en el semen fueron: astenozoospermia (n=58), hipospermia (n=22), oligozoospermia (n=18), teratozoospermia (n=7), polizospermia (n=7) y azoospermia (n=6). Los resultados de las pruebas estadísticas mencionadas indican que en estas alteraciones existe factor de riesgo asociado al uso del tabaco, exposición a químicos, a agresores físicos y de anomalías anatómicas corregidas anteriormente. Se considera que la obtención de esta información es de gran ayuda ya que al eliminar factores desfavorables, se mejora el ambiente para lograr una espermatogénesis en circunstancias óptimas