Pulmonary Large Cell Neuroendocrine Carcinoma Associated With Lambert-Eaton Syndrome.

Lambert-Eaton syndrome is a rare paraneoplastic disorder of the neuromuscular junction, characterized by impaired release of acetylcholine, which causes proximal muscle weakness, depressed tendon reflexes, and autonomic changes. Most cases of Lambert-Eaton syndrome present in small-cell lung carcinoma, and only a few cases have been reported in other lung subtypes. Herein, we report a case of 69 years old male patient with Lambert-Eaton syndrome as a rare association with a pulmonary large-cell neuroendocrine carcinoma, which presented 5 months before neoplasm diagnosis. A lobectomy was auspiciously performed. A review of the literature is also presented.

Prenatal indole-3-carbinol administration activates aryl hydrocarbon receptor-responsive genes and attenuates lung injury in a bronchopulmonary dysplasia model.

Hyperoxia-hypoxia exposure is a proposed cause of alveolar developmental arrest in bronchopulmonary dysplasia in preterm infants, where mitochondrial reactive oxygen species and oxidative stress vulnerability are increased. The aryl hydrocarbon receptor (AhR) is one of the main activators of the antioxidant enzyme system that protects tissues and systems from damage. The present study aimed to determine if the activation of the AhR signaling pathway by prenatal administration of indole-3-carbinol (I3C) protects rat pups from hyperoxia-hypoxia-induced lung injury. To assess the activation of protein-encoding genes related to the AhR signaling pathway (Cyp1a1, Cyp1b1, Ugt1a6, Nqo1, and Gsta1), pup lungs were excised at 0, 24, and 72 h after birth, and mRNA expression levels were quantified by reverse transcription-quantitative polymerase chain reaction assays (RT-qPCR). An adapted Ratner's method was used in rats to evaluate radial alveolar counts (RACs) and the degree of fibrosis. The results reveal that the relative expression of AhR-related genes in rat pups of prenatally I3C-treated dams was significantly different from that of untreated dams. The RAC was significantly lower in the hyperoxia-hypoxia group (4.0 ± 1.0) than that in the unexposed control group (8.0 ± 2.0; P < 0.01). When rat pups of prenatally I3C-treated dams were exposed to hyperoxia-hypoxia, an RAC recovery was observed, and the fibrosis index was similar to that of the unexposed control group. A cytokine antibody array revealed an increase in the NF-κB signaling cascade in I3C-treated pups, suggesting that the pathway could regulate the inflammatory process under the stimulus of this compound. In conclusion, the present study demonstrates that I3C prenatal treatment activates AhR-responsive genes in pup's lungs and hence attenuates lung damage caused by hyperoxia-hypoxia exposure in newborns.

Metastatic colorectal micropapillary carcinoma presenting as lymphangitic lung carcinomatosis.

Pulmonary lymphangitic carcinomatosis denotes the infiltration of tumor cells into the lung parenchymal lymphatic channels. Breast, lung, stomach, and colon adenocarcinoma are the most common origin of this invasion pattern. The micropapillary variant of colorectal adenocarcinoma has a high rate of lymph node metastases and poor overall survival. A 49 year-old man with a 6 months history of persistent cough and a relevant occupational chemical exposure had a computed tomography that showed bilateral interstitial lung infiltrates. The lung biopsy demonstrated a micropapillary adenocarcinoma with diffusely obstruction of the lung parenchymal lymphatics. The immunohistochemistry confirmed a colorectal origin. The colonoscopy evidenced a mass with identical morphology. Colorectal micropapillary carcinoma with metastatic lung lymphangitic carcinomatosis can occur, as a persistent cough, as presenting symptom in extraordinarily rare cases. To the best of our knowledge, this is the first case of an alive patient with colorectal metastatic micropapillary carcinoma presenting with lymphangitic lung carcinomatosis.

Una nueva forma de aprender patología: laboratorio virtual de patología / A novel approach to learn pathology: virtual pathology laboratory

INTRODUCCIÓN: Aprender patología es un reto que requiere el desarrollo de habilidades para la identificación de estados anormales del cuerpo humano, trastornos funcionales y causas que los producen. MATERIAL Y MÉTODOS: El objetivo de este estudio fue evaluar si la incorporación de recursos en línea con imágenes digitales, diapositivas y un sistema de gestión de aprendizaje proporciona una enseñanza práctica y efectiva para los estudiantes de medicina, dentro y fuera del aula. El estudio se realizó durante 2015, con una muestra de 83 estudiantes del curso de Patología II. Se utilizó un instrumento para medir el grado de satisfacción del alumno, mediante una escala Likert del 1 al 5, que va de totalmente en desacuerdo hasta totalmente de acuerdo. Se utiliza un acercamiento cuantitativo para realizar un análisis descriptivo de las valoraciones otorgadas. RESULTADOS: Con una media del 4,78, los alumnos indican una clara aceptación por el Laboratorio virtual de patología, basándose en la calidad de los casos e imágenes disponibles. Además, respecto a si la enseñanza mediante la exposición a casos clínicos con soporte de imágenes digitalizadas les ha sido útil para su formación práctica en la medicina, se obtuvo una media de 4,48. CONCLUSIONES: Las respuestas obtenidas por los estudiantes indican que la propuesta tiene ventajas considerables, como facilidad en el acceso a las imágenes y la información, fomento del aprendizaje autodirigido y colaborativo, así como apoyo a la construcción del conocimiento; sin embargo, aún existen retos y limitaciones propias del formato, como una menor interacción directa con el profesor

INTRODUCTION: Learning pathology is a challenge that requires the development of skills for the identification of abnormal states in the human body, as well as its functional disorders and causes. MATERIAL AND METHODS: This study assesses whether an online approach, that combines digital images, online slides and a learning management system, provides a practical and effective teaching method for medical students, both inside and outside the classroom. In 2015, an online survey was conducted with a sample of (83) students of the Pathology class, in order to assess student satisfaction with a Virtual Pathology Lab. A 1 to 5 Likert scale was used, where 1 meant total disagreement, and 5 for total agreement. The selected method is quantitative to provide a descriptive analysis of student perceptions. RESULTS: A mean score of 4.78 was obtained, indicating a clear acceptance of the Virtual Pathology Lab, based on the quality of the cases and images available. As regards students' beliefs that learning with clinical cases, digital images, and digitalised slides has been useful for their medical practical training, a mean score of 4.48 media was achieved. CONCLUSIONS: The responses by students indicate considerable advantages, including that all students have easy access to images and course information. It favours self-directed, as well as collaborative learning. However, there are still few limitations inherent to the format, such as less direct interaction with the teacher