ΔNp73 and its effector targets promote colorectal peritoneal carcinosis and predict survival.

Peritoneal metastasis of colorectal origin appears in ~10-15% of patients at the time of diagnosis and in 30-40% of cases with disease progression. Locoregional spread through the peritoneum is considered stage IVc and is associated with a poor prognosis. The development of a regional therapeutic strategy based on cytoreductive surgery, and hyperthermic intra-abdominal chemotherapy has significantly altered the course of the disease. Although recent evidence supports the benefits of cytoreductive surgery, the benefits of hyperthermic intra-abdominal chemotherapy are, however, still a matter of debate. Understanding the molecular alterations underlying the disease is crucial for developing new therapeutic strategies. Here, we evaluated the involvement in peritoneal dissemination of the oncogenic isoform of TP73, ΔNp73, and its effector targets in in vitro and mouse models, and in 30 patients diagnosed with colorectal peritoneal metastasis. In an orthotopic mouse model, we observed that tumor cells overexpressing ΔNp73 present a higher avidity for the peritoneum and that extracellular vesicles secreted by ΔNp73-upregulating tumor cells enhance their dissemination. In addition, we identified that tumor cells overexpressing ΔNp73 present with dysregulation of genes associated with an epithelial/mesothelial-to-mesenchymal transition (MMT) and that mesothelial cells exposed to the conditioned medium of tumor cells with upregulated ΔNp73 present a mesenchymal phenotype. Lastly, ΔNp73 and its effector target RNAs were dysregulated in our patient series, there were positive correlations between ΔNp73 and its effector targets, and MSN and ITGB4 (ΔNp73 effectors) predicted patient survival. In conclusion, ΔNp73 and its effector targets are involved in the peritoneal dissemination of colorectal cancer and predict patient survival. The promotion of the EMT/MMT and modulation of the adhesion capacity in colorectal cancer cells might be the mechanisms triggered by ΔNp73. Remarkably, ΔNp73 protein is a druggable protein and should be the focus of future studies. © 2024 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.

[Splenic lymphangioma. A rare tumour. Presentation of 3 cases and a literature review]. / Linfangioma esplénico. Un tumor raro. Presentación de 3 casos y revisión de la bibliografía.

BACKGROUND: Lymphangiomas are benign tumours, considered to be congenital malformations of the lymphatic system that predominately affect children, with only a few cases reported in adults. The most common sites of these lesions are the neck (75%) and axillary region (20%), but rarely found in the spleen. OBJECTIVE: A description is presented of 3 cases of incidentally detected splenic lymphangioma, one in a child and in 2 adults, respectively, as well as a literature review. CLINICAL CASES: After a clinical and physical examination, all patients had an abdominal ultrasound, CT scan and a complete splenectomy, followed by a histopathological study on the removed spleen. Two patients were asymptomatic, and the paediatric patient referred to intermittent abdominal pain without other symptoms. The clinical and physical examinations related to the mass were negative. The final diagnosis was based on a combination of radiological and histopathological findings. Total splenectomy was undertaken in all cases without complications. CONCLUSIONS: Splenic lymphangioma is very rare, and more so in adults. This condition is often asymptomatic and is incidentally detected by imagenology due to any other differet cause. The final diagnosis should be based on a combination of clinical, radiological, and histopathological findings. Splenectomy is the treatment of choice and the prognosis is good.

Inflammatory pseudotumour of the spleen associated with splenic tuberculosis.

Inflammatory pseudotumor (IPT) of the spleen is an uncommon entity with an uncertain aetiology. Inflammatory pseudotumors present diagnostic difficulties because the clinical and radiological findings tend to suggest a malignancy. The symptoms include weight loss, fever, and abdominal pain. Most cases of splenic IPT present solitary relatively large well circumscribed masses on imaging. The diagnosis in the majority of the cases is made after histopathologic study of splenectomy specimens. The IPTs that occur in the spleen and liver are typically associated with Epstein-Barr virus. Thirty-seven percent of all new cases of active tuberculosis infection are extrapulmonary tuberculosis and tuberculous lymphadenitis the most commonly occurring form of extrapulmonary tuberculosis. We report the case of an inflammatory pseudotumor of the spleen associated with splenic tuberculous lymphadenitis in a 50-year-old female patient who was preoperatively diagnosed with a malignant spleen tumour based on her history of breast of carcinoma.

Carcinoma de células en anillo de sello de la ampolla de Vater / Signet ring cell carcinoma of the ampulla of Vater

Introducción El carcinoma de células en anillo de sello de la ampolla de Vater es una entidad infrecuente, con menos de 20 casos descritos en la literatura. El objetivo de este artículo es presentar dos pacientes con esta patología y realizar una revisión de los estudios previos. Observación clínica Los dos pacientes ingresaron por ictericia obstructiva. En la ecografía y la tomografía computarizada abdominales se apreció una dilatación de la vía biliar intra y extrahepática. En la duodenoscopia, se visualizó una masa excrecente de la ampolla de Vater que, histológicamente, presentaba células con características típicas de células en anillo de sello. Se realizaron una duodenopancreatectomía cefálica con linfadenectomía y una pancreatectomía total respectivamente. Discusión El carcinoma de células en anillo de sello de la ampolla de Vater ha sido descrito únicamente en casos aislados en la literatura. Por este motivo, sus características clínicopatológicas y su pronóstico aún no están bien definidos (AU)

Introduction: Signet ring cell carcinoma of the ampulla of Vater is a rare entity and less than20 cases have been described in the literature. We report the cases of two patients with thisdisease and provide a literature review of previous studies. Case report: We describe two patients with obstructive jaundice. Abdominal ultrasonographyand abdominal computed tomography showed dilatation of the intrahepatic and common bileduct. Duodenoscopy indicated a protruding mass on the ampulla of Vater. Histopathologicalexamination showed round cells and their nuclei were located on one side with prominentsignet-ring features. One patient underwent a cephalic pancreatoduodenectomy with lymphadenectomyand the other a total pancreatectomy. Discussion: Signet ring cell carcinoma of the ampulla of Vater has only been described in isolatedcases in the literature. Therefore, the clinicopathological features and prognosis of this diseasehave not yet been well defined (AU)

Creación de ascitis artificial para el tratamiento mediante radiofrecuencia percutánea del hepatocarcinoma cercano al diafragma / Percutaneous radiofrequency ablation with artificial ascites for hepatocellular carcinoma adjacent to the diaphragm

La cirugía constituye la primera línea de tratamiento curativo en el hepatocarcinoma (CHC). Sin embargo, una gran mayoría no se puede beneficiar de la misma debido al avanzado estadio tumoral, disfunción hepática severa o mala condición clínica. Por ello, se han introducido varias técnicas de ablación guiadas por imagen. Entre ellas, la radiofrecuencia percutánea (RFp) constituye una alternativa eficaz como tratamiento curativo. Sin embargo, la localización de la lesión cerca de estructuras como el diafragma o el tracto gastrointestinal, limita esta técnica debido al riego de daño térmico colateral y a un tratamiento incompleto por mala visualización. La introducción de ascitis artificial previa puede separar el CHC de los órganos adyacentes y mejorar la ventana acústica. El objetivo de este estudio fue evaluar la viabilidad, seguridad y eficacia de la RFp con ascitis artificial para el tratamiento del CHC adyacente al diafragma (AU)

Surgical resection is the first-line curative treatment of hepatocellular carcinoma (HCC). However most patients are unable to undergo surgical resection because of advanced tumoral stage, severe liver dysfunction or poor clinical status. Therefore, image-guided tumor ablation techniques have been introduced for the treatment of unresectable HCC. Among them, radiofrequency ablation (RFA) has been demonstrated to be an effective alternative curative therapy. However, local ablative therapy for tumors located close to structures such as the diaphragm or gastrointestinal tract is technically challenging because of the risk of collateral thermal damage to nearby structures or incomplete treatment of the HCC resulting from poor visibility on sonography. The introduction of artificial ascites can separate adjacent organs from the tumor and improve the sonic window. The aim of this study was to evaluate the feasibility, safety and efficacy of RFA with artificial ascites for HCC adjacent to the diaphragm (AU)

[Percutaneous radiofrequency ablation with artificial ascites for hepatocellular carcinoma adjacent to the diaphragm]. / Creación de ascitis artificial para el tratamiento mediante radiofrecuencia percutánea del hepatocarcinoma cercano al diafragma.

Surgical resection is the first-line curative treatment of hepatocellular carcinoma (HCC). However most patients are unable to undergo surgical resection because of advanced tumoral stage, severe liver dysfunction or poor clinical status. Therefore, image-guided tumor ablation techniques have been introduced for the treatment of unresectable HCC. Among them, radiofrequency ablation (RFA) has been demonstrated to be an effective alternative curative therapy. However, local ablative therapy for tumors located close to structures such as the diaphragm or gastrointestinal tract is technically challenging because of the risk of collateral thermal damage to nearby structures or incomplete treatment of the HCC resulting from poor visibility on sonography. The introduction of artificial ascites can separate adjacent organs from the tumor and improve the sonic window. The aim of this study was to evaluate the feasibility, safety and efficacy of RFA with artificial ascites for HCC adjacent to the diaphragm.

Prehepatic portal hypertension produces increased mast cell density in the small bowel and in mesenteric lymph nodes in the rat.

BACKGROUND: Because most of the characteristics of the portal hypertensive enteropathy can be explained on the basis of increased levels of mast cell mediators, the purpose of the present paper was to study mast cell splanchnic infiltration. METHODS: Duodenum, jejunum, ileum and mesenteric lymph node complex infiltration by mast cells was assayed by a stereological technique in control rats (group I; n = 5) and in an experimental model of portal hypertension (the portal vein-stenosed rat, group II; n = 5) at 6 weeks after operation. RESULTS: Intestinal and mesenteric lymph node complex infiltration by mast cells increased in the animals with partial portal vein ligation. The mast cell density progressively increased distally along the small bowel. The mast cell increase in the mesenteric lymph node complex in portal vein-stenosed rats was greater than in the duodenum (P = 0.001), jejunum (P = 0.006) and ileum. CONCLUSION: The rise of mast cells density in the small bowel and mesenteric lymph node complex in rats with partial portal vein ligation suggests that these cells are involved in the etiopathogenesis of experimental portal prehepatic hypertensive enteropathy.

Supervivencia del cáncer de mama diagnosticado como lesión mamaria no palpable / Survival in nonpalpable breast cancer diagnosed as nonpalpable breast lesions

Introducción. El carcinoma de mama no palpable supone alrededor del 30 por ciento de todos los cánceres de mama debido al uso generalizado de la mamografía. El objetivo de este trabajo es determinar la supervivencia de las pacientes con cáncer de mama diagnosticado como lesión mamaria no palpable. Material y métodos. Se analizó de manera retrospectiva el historial clínico de 110 pacientes con lesiones mamarias no palpables. La lesión mamográfica se clasificó como microcalcificaciones, nódulo y distorsiones o asimetría. En las pacientes con carcinoma se realizó cirugía conservadora si cumplían los siguientes criterios: estadios 0, I o II, proporción volumen mamario/tumoral aceptable, lesión solitaria, microcalcificaciones focales y paciente conforme con el tratamiento. Resultados. En el estudio histológico 64 lesiones (57,6 por ciento) fueron carcinomas. En la clasificación TNM patológica el 32,7 por ciento pertenecían al estadio 0, el 43,6 por ciento al I y el 23 por ciento al II. Se realizó cirugía conservadora en 108 pacientes (98 por ciento). La supervivencia global ha sido del 100 por ciento y la supervivencia libre de enfermedad del 95 por ciento, con una recidiva local del 5 por ciento. Conclusiones. El estudio de las lesiones mamarias no palpables permite diagnosticar a un mayor número de pacientes con cáncer de mama en estadio temprano, realizar cirugía conservadora en un mayor número de pacientes e incrementar la supervivencia libre de enfermedad y la supervivencia global (AU)