Lesiones hiperpigmentadas asintomáticas en escote y área periareolar / Asymptomatic hyperpigmented lesions in neck and periareolar area

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[Cutaneous collagenous vasculopathy: a case report and review of the literature]. / Vasculopatía colágena cutánea: aportación de un caso y revisión de la literatura.

Cutaneous collagenous vasculopathy is an idiopathic microangiopathy first described in 2000 by Salama and Rosenthal.It must not be confused with generalized essential telangiectasia. To date, all patients have been white men over the age of 50 years, most of whom had multiple pathologies, were taking multiple drugs, and had no family history of similar conditions or hemorrhagic disorders. The disease is characterized by the development of various numbers of telangiectases on the limbs, lower abdomen, chest, or back, with no involvement of the mucosas or nail bed. Histopathology shows dilated superficial cutaneous vessels with perivascular deposits of periodic acid-Schiff diastase-positive, eosinophilic hyaline material that exhibits positive immunoreactivity to collagen IV. We report a new case in a 68-year-old man with symmetrically distributed telangiectases on his forearms, lower abdomen, posterior thighs, lower legs, and dorsum of the feet.

Vasculopatía colágena cutánea: aportación de un caso y revisión de la literatura / Cutaneous Collagenous Vasculopathy: A Case Report and Review of the Literature

La vasculopatía colágena cutánea es una microangiopatía idiopática descrita por Salama y Rosenthal en el año 2000. Debe distinguirse de la telangiectasia esencial general. Hasta la fecha, todos los pacientes son varones caucásicos de más de 50 años de edad, en su mayoría con pluripatología y multimedicados, sin evidencia de historia familiar de procesos similares ni trastornos hemorrágicos. Se caracteriza por el desarrollo de múltiples telangiectasias cutáneas dispuestas de forma variable en las extremidades, la zona baja del abdomen, el pecho o la espalda, sin afectación de mucosas ni del lecho ungueal. La histopatología evidencia vasos cutáneos superficiales dilatados, con depósito perivascular de un material hialino eosinofílico que se tiñe con PAS-diastasa y que muestra inmunorreactividad de anticuerpos frente al colágeno IV. Describimos un nuevo caso en un varón de 68 años de edad con telangiectasias distribuidas de forma simétrica en los antebrazos, la región baja del abdomen, la cara posterior de los muslos, las piernas y el dorso de los pies (AU)

It must not be confused with generalized essential telangiectasia. To date, all patients have been white men over the age of 50 years, most of whom had multiple pathologies, were taking multiple drugs, and had no family history of similar conditions or hemorrhagic disorders. The disease is characterized by the development of various numbers of telangiectases on the limbs, lower abdomen, chest, or back, with no involvement of the mucosas or nail bed. Histopathology shows dilated superficial cutaneous vessels with perivascular deposits of periodic acid-Schiff diastase-positive, eosinophilic hyaline material that exhibits positive immunoreactivity to collagen IV. We report a new case in a 68-year-old man with symmetrically distributed telangiectases on his forearms, lower abdomen, posterior thighs, lower legs, and dorsum of the feet (AU)

[Cutaneous ciliated cyst of the scrotal skin. A case report with discussion of pathogenesis]. / Quiste cutáneo ciliado en piel escrotal. Descripción de un caso con discusión patogénica de la entidad.

Cutaneous ciliated cyst (CCC) is a rare benign lesion predominantly occurring in the lower limbs of young women and exceedingly rare in males. Here, we report a case involving a previously unreported site (i.e., scrotal skin) in a 15-year-old male. We also describe pathologic and immunonohistochemical findings, review the pertinent literature and discuss their pathogenetic mechanisms. We propose that CCC could represent a morphologic pattern encompassing several pathogenetically different entities. Data we provide support the hypothesis that at least a part of CCC, specially those occurring in males, could have their origin in ciliated metaplasia of apocrine sweat glands.

Quiste cutáneo ciliado en piel escrotal. Descripción de un caso con discusión patogénica de la entidad / Cutaneous ciliated cyst of the scrotal skin. A case report with discussion of pathogenesis

El quiste cutáneo ciliado (QCC) es una lesión benigna muy infrecuente, que aparece predominantemente en extremidades inferiores de mujeres jóvenes. En varones es una lesión aún más rara. En esta nota se presenta un caso de quiste cutáneo ciliado en piel escrotal de un varón de 15 años, se describen características histológicas e inmunohistoquímicas, se revisa la bibliografía al respecto y se realiza una discusión patogénica de la entidad. Se plantea que el QCC puede ser en realidad un patrón morfológico que engloba varias entidades patogénicamente diferentes. Los datos aportados en nuestro caso apoyan la teoría de que al menos un grupo de QCC, y en especial los acaecidos en pacientes de sexo masculino, podrían tener su origen en la metaplasia ciliada de glándulas sudoríparas apocrinas (AU)

Cutaneous ciliated cyst (CCC) is a rare benign lesion predominantly occurring in the lower limbs of young women and exceedingly rare in males. Here, we report a case involving a previously unreported site (i.e., scrotal skin) in a 15-year-old male. We also describe pathologic and immunonohistochemical findings, review the pertinent literature and discuss their pathogenetic mechanisms. We propose that CCC could represent a morphologic pattern encompassing several pathogenetically different entities. Data we provide support the hypothesis that at least a part of CCC, specially those occurring in males, could have their origin in ciliated metaplasia of apocrine sweat glands (AU)

Tumor carcinoide de vagina / Carcinoid tumor of the vagina

Se presenta el caso de una paciente de 32 años, con nódulo en introito vaginal. Histológicamente corresponde a un tumor bien delimitado que expresa positividad inmunohistoquímica para cromogranina, estrógenos y AE1/AE3. Tras 5 años de evolución, demuestra comportamiento biológico benigno sin evidencia de recidivas ni metástasis. En la bibliografía revisada sólo hay descritos 2 casos de tumor carcinoide vaginal, ambos con componente de adenocarcinoma asociado y con comportamiento clínico muy agresivo, con fallecimiento de las pacientes en menos de un año. Por todo ello, en nuestra opinión, se trata de un tumor carcinoide puro benigno primario de vagina, neoplasia no descrita previamente en esta localización en la bibliografía revisada y contrapartida benigna de dichos tumores de estirpe neuroendocrina (AU)

A vaginal nodule in a 32-year-old woman is reported. Histologically, the nodule corresponded to a well delimited tumor with chromogranin, estrogen and AE1/AE3 expression. After a 5-year follow-up, benign behavior has been observed, with no recurrence or metastasis. We found only two cases of vaginal carcinoid tumor in the literature reviewed; both occurred in association with adenocarcinoma and showed aggressive behavior, with both patients dying within 1 year. In our opinion, the case reported herein was a primary benign vaginal carcinoid tumor. To the best of our knowledge, this type of tumor in this location has not previously been described and constitutes a benign counterpart to the above-mentioned neuroendocrine tumors (AU)

Tumor de células granulares de próstata diagnosticado en biopsia transrectal. ¿Qué actitud tomar? / Granular cell tumour of prostate diagnosed by transrectal biopsy. Which therapeutic attitude?

El tumor de células granulares (TCG) es una neoplasia de derivación neural, relativamente frecuente en localización subcutánea y en cavidad oral. En próstata es excepcional, con un solo caso descrito en la literatura indexada de las últimas tres décadas. Presentamos el caso de un varón de 63 años con clínica de prostatismo, próstata aumentada de tamaño e incremento de cifras de PSA sérico, al que en biopsia transrectal por aguja se le diagnostica TCG. Dada la excepcionalidad de la neoplasia no existe un protocolo de actuación establecido. Planteamos el dilema clínicopatológico que representa el diagnóstico de una neoplasia de estas características y proponemos la actitud más adecuada a seguir

Granular cell tumour (GCT) is not an uncommon tumour of neural origin usually located on subcutaneous tissues and oral cavity. In prostate gland is exceptional, with only one case reported on the indexed literature of the last three decades. We report a case of a 63-year-old man presented with urinary complaints, enlarged prostate and increased PSA levels. The patient subsequently underwent transrectal needle biopsy which revealed GCT. The clinicpathological dilemma originated after this diagnosis is discused and the most suitable follow-up is proposed

[Granular cell tumour of prostate diagnosed by transrectal biopsy. Which therapeutic attitude?]. / Tumor de células granulares de próstata diagnosticado en biopsia transrectal. Qué actitud tomar?

Granular cell tumour (GCT) is not an uncommon tumour of neural origin usually located on subcutaneous tissues and oral cavity. In prostate gland is exceptional, with only one case reported on the indexed literature of the last three decades. We report a case of a 63-year-old man presented with urinary complaints, enlarged prostate and increased PSA levels. The patient subsequently underwent transrectal needle biopsy which revealed GCT. The clinicpathological dilemma originated after this diagnosis is discused and the most suitable follow-up is proposed.

[Nephrogenic adenoma of the bladder: metaplasia or embryologic alteration?]. / Adenoma nefrogénico vesical: metaplasia o alteración embriológica?

OBJECTIVES: To present a new case of nephrogenic adenoma of the bladder and to review the current concepts on the etiopathogenesis of this lesion. CLINICAL CASE: Seventy years old female with repetitive haematuria who was diagnosed as having a nephrogenic adenoma of the bladder which was extirpated by cold biopsy forceps. No tumoral relapse was detected after 16 months of follow up. DISCUSSION: In the light of the present knowledges, the origin of nephrogenic adenoma is a phenomenon of urothelial metaplasia due to a chronic irritative stimulus wich would lead a cellular proliferation with potentialities to originate mesonephric tissues and which starting point could be on not completely involutioned mesonephric cellular rests and/or on de-differentiated mature urothelial cells.

[Inflammatory pseudomotor of the bladder. A diagnostic and therapeutic dilemma]. / Pseudotumore infiammatorio vescicale. Un dilemma diagnostico e terapeutico.

Inflammatory pseudotumor is a reactive benign lesion which can be very difficult to distinguish from some malignant bladder tumors like sarcomas or sarcomatoid carcinoma. The aim of this study was to present a new case of inflammatory pseudotumor and to review the present diagnostic and therapeutic criteria for this lesion. A 72-year-old female was admitted to the emergency room due to important hematuria. Transurethral resection of a bladder tumor located in the left lateral wall was performed. Pathologic studies were suggestive of inflammatory pseudotumor, but a mixoid leiomyosarcoma couldn t be completely discarded and a partial cystectomy with ipsilateral lymphadenectomy were carried out. Immunohistochemical studies were positive for vimentin, desmin, smooth muscle actin and cytoqueratins while epithelial membrane antigen and S-100 protein were negative. The patient is disease free after a year follow-up. When diagnosis is certain, complete transurethral resection is the treatment of choice. However, if there is no total pathologic confirmation, if it is a very wide lesion or if it is recurring after endoscopic resection, a partial cystectomy is suggested.

Adenoma nefrogénico vesical: ¿metaplasia o alteración embriológica? / Nephrogenic adenoma of the bladder: metaplasia or embriological disturbance?

OBJETIVOS: Presentación de un nuevo caso de adenoma nefrogénico vesical, y revisar los conocimientos actuales sobre la etiopatogenia de esta lesión. CASO CLÍNICO: Mujer de 70 años con hematuria de repetición que es diagnosticada de un adenoma nefrogénico vesical, que fue extirpada mediante biopsia fría. No se ha detectado recidiva de la neoformación tras 16 meses de seguimiento. DISCUSIÓN: A la luz de los conocimientos actuales, el origen del adenoma nefrogénico podría estar en un fenómeno de metaplasia urotelial secundario a un estímulo irritativo crónico, que induciría una proliferación celular con potencialidad para generar tejido mesonéfrico, y cuyo origen podría encontrarse en restos celulares mesonéfri-cos incompletamente involucionados y/o en la desdiferenciación de células uroteliales maduras (AU)