RESUMO
BACKGROUND & AIMS: A patient exposed to aerosolized lye and ingested kerosene was followed up for 16 years with chronic esophagitis before developing verrucous esophageal squamous carcinoma. The aim of this study was to elucidate the pathogenesis of the carcinoma. METHODS: Multiple biopsy specimens were graded according to the severity of esophagitis and dysplasia. Molecular biological techniques and immunocytological assay were used to look for human papillomavirus infection, p53 mutations, loss of heterozygosity for TP53 and chromosome 8 markers, and ras mutations. RESULTS: Morphological features of the chronic esophagitis in this patient were similar to the precancerous lesions from high-risk areas for esophageal squamous cancer and the precancerous lesions induced in rats by N-methyl-N-nitrosoaniline. Gastroesophageal acid reflux and human papillomavirus infection were ruled out. No loss of heterozygosity of p53 or for chromosome 8 markers was found. Mutations of the ras oncogene were not identified. By immunocytological assay overexpression of p53 was identified only in the invasive portion of the carcinoma. CONCLUSIONS: In this patient, verrucous squamous carcinoma evolved from chronic esophagitis, squamous papillary hyperplasia, and dysplasia. Although exogenous carcinogens may have been important, they probably did not act by causing loss of heterozygosity or ras mutations. p53 overexpression occurred late.
Assuntos
Carcinoma Verrucoso/etiologia , Neoplasias Esofágicas/etiologia , Esofagite/complicações , Querosene/efeitos adversos , Lixívia/efeitos adversos , Aerossóis , Idoso , Carcinoma Verrucoso/induzido quimicamente , Carcinoma Verrucoso/metabolismo , Doença Crônica , Neoplasias Esofágicas/induzido quimicamente , Neoplasias Esofágicas/metabolismo , Esofagite/patologia , Feminino , Humanos , Imuno-Histoquímica , Proteína Supressora de Tumor p53/metabolismoRESUMO
These case reports describe two patients with acquired immune deficiency syndrome (AIDS) who presented with acute right lower quadrant pain. Appendiceal involvement with Kaposi's sarcoma accounted for the clinical presentation, and was confirmed histologically. This association emphasizes the diagnostic confusion that may be caused by acute abdominal conditions in the AIDS population. Abdominal pain may result from AIDS-related or unrelated processes; appropriate operative intervention requires recognition of the various diagnostic possibilities.
Assuntos
Dor Abdominal/etiologia , Síndrome da Imunodeficiência Adquirida/complicações , Neoplasias do Apêndice/complicações , Sarcoma de Kaposi/complicações , Adulto , Humanos , MasculinoRESUMO
Four immunosuppressed patients with a rapidly evolving, febrile, respiratory distress syndrome were found at autopsy to have Aspergillus pseudomembranes of their lower tracheobronchial tree. Steroids, neutropenia, broad spectrum antibiotic use, and alcoholism appear to be predisposing risk factors. Bronchoscopy may reveal the pathology but antemortem diagnosis is difficult because of the low yield of sputum cultures and fulminant nature of the disease.
Assuntos
Aspergilose , Bronquite/microbiologia , Traqueíte/microbiologia , Adulto , Aspergilose/etiologia , Bronquite/mortalidade , Bronquite/patologia , Feminino , Humanos , Terapia de Imunossupressão/efeitos adversos , Masculino , Pessoa de Meia-Idade , Traqueíte/mortalidade , Traqueíte/patologiaRESUMO
The term mesenchymoma refers to a group of mixed tumors that are composed of two or more mesenchymal elements, excluding fibrous tissue, not ordinarily found together within the same tumor. Mesenchymomas occur most commonly in the renal and perirenal regions with rare occurrence in the breast. We describe what to our knowledge is the first report of a giant benign mesenchymoma of the breast. The clinical presentation, course, and treatment of a patient with this condition is discussed. Clinicians should be aware that benign mesenchymomas may involve the breast and simulate a malignant breast neoplasm.