Prognostic value of lymphovascular and perineural invasion in squamous cell carcinoma of the tongue.

OBJECTIVE: The objective of this study was to investigate the association between survival rate and lymphovascular invasion (LVI) and perineural invasion (PNI) in the tumor invasive front (TIF) of squamous cell carcinoma of the tongue (TSCC). STUDY DESIGN: Seventy patients with TSCC were included. The retrospective analysis included demographic, clinical, and histopathologic data. Tissue blocks containing the TIF were stained with anti-α-smooth muscle actin and anti-S100 to detect LVI and PNI, respectively. Overall survival (OS) and disease-specific survival (DSS) were assessed using Pearson's chi-square test, Kaplan-Meier method, and Cox regression. RESULTS: LVI and PNI were detected in 61.4% and 78.6% of the TSCC samples at the TIF, respectively. LVI and PNI were present in 54.3% of the cases and were associated with advanced clinical stage, lymph node resection, metastatic nodes, and lower survival (P < .05). The 5-year OS and DSS rates were 44% and 52%, respectively. Multivariate analysis showed that primary tumors >3.0 cm (hazard ratio = 4.29; P = .004) and a concomitant presence of LVI and PNI at the TIF (hazard ratio = 4.0; P = .012) were independent predictors for worse DSS. CONCLUSION: LVI and PNI, identified by immunostaining at the TIF, are potential prognostic markers of TSCC.

Conferencia clínico patológica (CPC): paciente previamente sana con insuficiencia respiratoria debida a neumonía intersticial / Clinico-pathological conference (CPC): a previously healthy patient with respiratory insuficiency due to intersticial pneumonia

Se presenta y discute el caso de una mujer de 40 años, sin antecedentes relevantes, quien ingresó al hospital Universitario San Vicente Fundación, por presentar síntomas respiratorios durante 20 días. Se diagnosticó sida de novo y neumonía intersticial asociada, todo lo cual progresó hasta la falla ventilatoria, que fue refractaria al tratamiento dirigido hacia los oportunistas identificados, debido a lo cual se produjo una falla orgánica múltiple que causó la muerte.

We present the case of a 40-year-old woman, with no remarkable past medical history, who was admitted to San Vicente Foundation University Hospital, in Medellín, Colombia; she complained of respiratory symptoms lasting 20 days. Interstitial pneumonia associated with AIDS was diagnosed, which progressed to respiratory failure that did not respond to therapy directed against the opportunistic infections that were identified. She finally developed multiorgan failure that caused death.