Fine-needle aspiration cytopathology in the diagnosis of Wilms tumor.

BACKGROUND/PURPOSE The International Society of Paediatric Oncology (SIOP) protocol for Wilms tumor (WT) includes preoperative chemotherapy as the initial approach. However, an inadequate treatment may be performed in case of histological misdiagnosis. We evaluated the impact of fine-needle aspiration cytopathology (FNAC) in the diagnosis of unilateral WT in our group of patients. MATERIALS AND METHODS A retrospective descriptive study of patients with diagnosis of unilateral WT who underwent FNAC prior to neoadjuvant chemotherapy between 1993 and 2009 was performed. We reviewed the cytological diagnosis obtained by ultrasound-guided FNAC and the histological correlation with the resected specimens. RESULTS FNAC was performed in 66 patients with unilateral WT. In 57 of the 58 patients with positive FNAC for WT, the final diagnosis was correct (PPV: 98.2%). In 8 cases with negative FNAC for WT, the final diagnosis was positive for WT in 3 patients (NPV: 62.5%). Sensitivity was 95% and specificity was 83.3%. No complications were found associated with the procedure, except for an episode of haematuria, which resolved spontaneously. CONCLUSIONS FNAC is a useful and feasible technique in children that may confirm the suspected diagnosis of unilateral WT, avoiding inadequate preoperative chemotherapy in case of a non-Wilms renal tumor.

Fine-needle aspiration cytopathology in the diagnosis of Wilms tumor

BACKGROUND/PURPOSE The International Society of Paediatric Oncology (SIOP) protocol for Wilms tumor (WT) includes preoperative chemotherapy as the initial approach. However, an inadequate treatment may be performed in case of histological misdiagnosis. We evaluated the impact of fine-needle aspiration cytopathology (FNAC) in the diagnosis of unilateral WT in our group of patients. MATERIALS AND METHODS A retrospective descriptive study of patients with diagnosis of unilateral WT who underwent FNAC prior to neoadjuvant chemotherapy between 1993 and 2009 was performed. We reviewed the cytological diagnosis obtained by ultrasound-guided FNAC and the histological correlation with the resected specimens. RESULTS FNAC was performed in 66 patients with unilateral WT. In 57 of the 58 patients with positive FNAC for WT, the final diagnosis was correct (PPV: 98.2%). In 8 cases with negative FNAC for WT, the final diagnosis was positive for WT in 3 patients (NPV: 62.5%). Sensitivity was 95% and specificity was 83.3%. No complications were found associated with the procedure, except for an episode of haematuria, which resolved spontaneously. CONCLUSIONS FNAC is a useful and feasible technique in children that may confirm the suspected diagnosis of unilateral WT, avoiding inadequate preoperative chemotherapy in case of a non-Wilms renal tumor (AU)

Successful treatment of orbital rhabdomyosarcoma in two infants using chemotherapy alone.

Two infants, 2 months and 13 months of age, were found to have orbital embryonal rhabdomyosarcomas (ERMS). Because of the adversities associated with either surgical exenteration or curative doses of radiation therapy, they were treated with chemotherapy alone. They survive disease-free 5 and 9 years after diagnosis with excellent cosmesis and normal vision. This approach may be suitable for similarly small (< 2 cm in diameter) ERMS in other sites.

[Primary pulmonary leiomyoma. Presentation of 3 cases]. / Leiomioma pulmonar primitivo. Presentación de tres casos.

Pulmonary leiomyoma is a benign tumor of mesodermal origin, very rare of which only three cases have been described on the Spanish scientific literature. We present our experience with three new cases and discuss the clinical and therapeutic characteristics of these neoplasms according to their topographical localization. We insist on the need of a gynecological revision when females are affected, because its possible association with uterine tumors.

[Angiomyolipoma of the kidney. Comments on 3 recent cases]. / Angiomiolipoma renal. Comentarios sobre tres recientes observaciones.

We report another three cases of renal angiomyolipoma with different modes of presentation and treatment. Two cases are considered to be of particular interest; one patient presented chyluria in the course of the disease and Wunderlich's syndrome posteriorly, and in the other patient the presenting features were extrarenal. The diagnostic and therapeutic possibilities are discussed and attention is focussed on the conservative approach whenever possible.

[Herpes simplex and herpes varicella-zoster. Cytological and ultrastructural study]. / Herpes simple y herpes zoster varicela. Estudio citológico y ultraestructural.

Nuclear staining qualities, and cell morphology depart from normal when epithelial cells are infected by herpes virus hominis and herpes varicella-zoster (1). The cytopathic changes produced by both viruses are similar and constant enough to be considered characteristic of the infection. Since the skin vesicles are readily accessible for examination, it is easy to scrape infected cells from the floor of the exposed blister and establish the diagnosis. The simplest and most common method would be by light microscopy utilizing conventional staining. When the circumstances warrant it and the facilities are available, the virus itself can be demonstrated by electron microscopy with material obtained in the same fashion. This paper deals with two cases in which the initial diagnosis of the disease was made by cytologic examination and the presence of virus subsequently verified by electron microscopy.

Intracardiac heterotopia--mesenchymal and endodermal.

A case is reported of an intracardiac 'epithelial heterotopia' with a predominant mesenchymal component. This is thought to have resulted from the differentiation of aberrant primitive cell(s) displaced into the heart during its development. Though microscopically resembling a myxoma, this lesion is clearly distinguished by the presence of glandular structures. The myxoid component exhibited a startling invasiveness which resulted in occlusion of the superior vena cava, causing symptoms very early in life and death at the age of 6 months.