Anthelmintic activity of Stevia multiaristata extract against Echinococcus granulosus sensu stricto.

Cystic echinococcosis is a zoonotic disease caused by the larval stage of the parasite Echinococcus granulosus sensu lato. The available anti-parasitic treatment is mostly limited to a continuous administration of albendazole. However, due to its numerous side-effects and efficacy of around 50%, there is a need to find new drugs to improve the treatment for this disease. In the current study, the in vitro and in vivo efficacy of a Stevia multiaristata extract against E. granulosus sensu stricto (s.s.) was demonstrated. Stevia multiaristata extract (100 and 50 µg mL−1) caused a quick viability decrease on protoscoleces which was consistent with the observed tegumental alterations. Loss of turgidity was detected in 95 ± 3.4% of cysts incubated with S. multiaristata extract during 2 days (100 µg mL−1) and the collapse of the germinal layer was observed in 60 ± 9.3% of cysts treated with 100 µg mL−1 of the S. multiaristata extract during 4 days. The half maximal effective concentration value was 69.6 µg mL−1 and the selectivity index for E. granulosus s.s. cysts was 1.9. In this clinical efficacy study, the treatment of infected mice with the S. multiaristata extract (50 mg kg−1) caused a significant decrease in the weight of the cysts compared with the control group. These results coincided with the tissue damage observed in the cysts at the ultrastructural level. In conclusion, we observed high protoscolicidal and cysticidal effects, and significant reduction in the weight of the cysts in experimentally infected mice following treatment with the S. multiaristata extract.

Linfoma anaplásico de células grandes asociado a implante mamario. Reporte de un caso y revisión de la literatura. / Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) - Argentinian case

El linfoma anaplásico de células grandes asociado a implantes mamarios LACG-AI o BIA-ALCL, abreviatura en inglés de "Breast Implant Associated-Anaplastic Large Cell Lymphoma", es una nueva entidad reconocida por la OMS desde el 2016, de rara incidencia y que aún plantea muchos interrogantes. Desde su primera mención en 1997 (J. Keech - B. Creech) su incidencia ha ido en aumento. En julio de 2020, 953 casos en el mundo según el Registro de la Sociedad Americana de Cirujanos Plásticos (PROFILE), y las publicaciones se multiplican exponensialmente año a año demostrando el interés que suscita. Se ha descripto una fuerte asociación con las superficies texturizadas de los implantes mamarios y con el tipo de material (mayor textura "grado 4" y cubierta de poliuretano mayor riesgo) llegando a describirse tasas tan altas omo 1/2830 en Australia/Nueva Zelanda. Su presentación clínica en casi el 75% es bajo la forma de un seroma tardío y el tiempo de exposición promedio ronda entre los 7 a 11 años. El diagnóstico histo-patológico integra el examen morfológico con la caracterización molecular, visualizándose grandes célular anaplásicas CD30 (+), ALK (-). El tratamiento quirúrgico, capsulectomía bilateral en estadios tempranos es el gold standard. Su pronóstico es excelente con exérsis completas. Objetivo: actualizar la información sobre esta novel enfermedad y comentar un caso propio que presenta todas las características descriptas en la literatura, siendo el 14° registrado en Argentina

The anaplastic large cell lymphoma associated with breast implants, LACCG-AI o BIA-ALCL abbreviation in English, is an entity recognized by the WHO since 2016 of rare incidence and that still raises many questions. Since its firts mention in 1997 (J. Keech - B. Creech) its incidence has been increasing, In july 2020, 953 cases in the world according to the Registry of the America Society of Plastic Surgeons (PROFILE), and the publications multiply exponentially year after year, demonstrating the interest it arouses, A strong association has been described with the textured surfaces of breast implants and with the type of material (greater texture "grade 4" and higher risk polyurethane cover), reaching rates as high as 1/2830 in Australia / New Zealand. Its clinical presentation in almost 75% is in the form of a late seroma and the average exposure time is between 7 to 11 years. The pathological anatomical diagnosis integrates the morphological examination with the molecular characterization, visualizing large anaplastic CD30 (+), ALK (-) cells. Surgical treatment, bilateral capsulectomy in early stages, is the gold standard. Her prognosis is excellent with complete exeresis. Objetive: to update the information on this novel disease and comment on an own case that presents all the characteristics described in the literature, the 14th being registered in Argentina

Embolia colesterínica en miembro superior izquierdo asociado a fístula arteriovenosa / Cholesterol embolism in the left upper limb associated with venous artery fistula

RESUMEN El embolismo por cristales de colesterol (ECC) es una complicación de la enfermedad arterioesclerótica en la que el desprendimiento de fragmentos de placa de ateroma, principalmente de grandes arterias, provoca oclusión de pequeños vasos. Esta entidad, también llamada ateroembolia o síndrome de los dedos del pie azules, es más frecuente en pacientes de edad avanzada y después de procedimientos invasivos intravasculares. Se manifiesta con cianosis, livedo reticularis, necrosis y úlceras asociado a manifestaciones renales y gastrointestinales. Se presenta un paciente trasplantado renal y portador de fístula arteriovenosa trombosada izquierda con ateroembolia localizada en mano homolateral.

ABSTRACT The cholesterol crystal embolism (ECC) is a complication of arteriosclerotic disease in which the detachment of fragments of atheromatous plaque mainly from large arteries, causes occlusion of small vessels. This entity, also called atheroembolism or blue toe syndrome, is more common in elderly patients and after intravascular invasive procedures. It manifests with cyanosis, livedo reticularis, necrosis and ulcers associated with renal and gastrointestinal manifestations. We present a renal transplant patient with a left thrombosed arteriovenous fistula with atheroembolism located in homolateral hand.

Tumores neuroendocrinos: Experiencia interdisciplinaria del hospital privado de comunidad / Neuroendocrine tumors: Interdisciplinary experience of the Private Community Hospital

Resumen Los tumores neuroendocrinos (TNE) constituyen un grupo heterogéneo de neoplasias poco frecuentes con un aumento sostenido de la incidencia en los últimos años. Se originan en las células neuroendocrinas, los más frecuentes son los del sistema gastrointestinal y la mayoría son esporádicos, aunque pueden ser parte de síndromes hereditarios. El manejo de esta patología es interdisciplinario y el endocrinólogo tiene un rol activo en estos grupos. Evaluamos retrospectivamente pacientes con diagnóstico de TNE en un periodo de 18 años (01/01/2000 al 31/12/2017). Ciento cinco pacientes presentaron TNE, la edad promedio al momento del diagnóstico fue de 57,6 años y predominó el sexo femenino (64%). Predominaron los de origen gastroenteropancreático (TNEGEP) bien diferenciados y de bajo grado, el 39% se presentó con metástasis al momento del diagnóstico, el 11% de ellos fueron funcionantes (gastrinoma e insulinomas), el 17% presento síndrome carcinoide, el 94% de ellos recibió algún tipo de tratamiento y el 29% recibió análogos de somatostatina (ASS). No hubo diferencia en la cantidad de casos entre el carcinoma medular de tiroides (dos de ellos con NEM-2) y los broncopulmonares donde predominó el carcinoide típico. Los TNE tímicos fueron de gran tamaño y uno de ellos como parte de NEM -1. Los feocromocitomas fueron esporádicos, unilaterales y curaron con la cirugía y los de origenovárico fueron menos frecuentes. Conclusiones: La incidencia de los TNE está en aumento en todo el mundo, se presentan alrededor de la sexta década, sin predominancia de género y la mayoría son esporádicos. Nuestra casuística tiene la limitación de ser un trabajo retrospectivo que incluye casi dos décadas y donde la clasificación de los TNE ha sufrido grandes cambios. Sin embargo, no existe en la literatura argentina una serie con mayor número de casos reportados por una única institución, de una patología poco frecuente y constituye un significativo aporte a la epidemiología de estos tumores en nuestro país.

Abstract One hundred and five patients were diagnosed with NETs. The mean age of presentation was 57.6 years (R: 18/86). Patients were predominantly female (64%), with an increase in presentation of 50% in recent years. Well differentiated, low-grade GEPNETs were predominant. Metastases at the time of diagnosis were seen in 39% of patients. In 11% of them, tumors were functional (gastrinoma and insulinomas). Carcinoid syndrome was present 17% of the patients and 29% received somatostatin analogues (AS). There were no differences presentation between medullary thyroid carcinoma (two of them were part of a MEN-2 syndrome) and those of bronchopulmonary localization, where the typical carcinoid predominated. Thymic NETs were frequently large at diagnosis and in one patient, the tumor was part of a MEN-1 syndrome. Pheochromocytomas were sporadic, unilateral and were cured with surgery. The ovarian were the least common in our series.

Impacto de los márgenes quirúrgicos positivos en pacientes post-prostatectomía radical / Positive surgical margins impact in patients after radical prostatectomy

Introducción: Debido a la relativa frecuencia de márgenes quirúrgicos positivos (MP) en las piezas de prostatectomías radicales, es importante para el urólogo entender la etiología e implicancias de estos hallazgos. Se define como un MP a la presencia de tejido tumoral que llega hasta la superficie prostática pintada con "tinta china". Objetivo: Mostrar el impacto de los MP en los pacientes sometidos a prostatectomía radical. Pacientes y Métodos: Se realizó un estudio retrospectivo, descriptivo y comparativo, analizando los datos de 106 pacientes sometidos a prostatectomía radical entre mayo de 1994 y octubre del 2005. Los criterios de exclusión fueron estadios pT3c, pT4 y/o N1. Se evaluaron variables de estadificación clínica: Gleason y antígeno prostático específico (PSA) pretratamiento, tacto rectal y volumen prostático por ecografía transrectal; variables del estudio patológico: Gleason de la pieza y T patológico; y variables evolutivas: recaída bioquímica (punto de corte de PSA mayor de 0,04 ng/ml y 0,2 ng/ml).Resultados: Fueron excluidos 18 pacientes; 22 pacientes presentaron MP (20,7 por ciento) y 66 márgenes negativos (MN) (62 por ciento). No hubo diferencias significativas en cuanto a las variables clínicas analizadas: PSA promedio 9,7 vs 11,16, Gleason pretratamiento menor7 57 por ciento vs 45 por ciento, tacto positivo 48 por ciento vs 38 por ciento, volumen prostático por ecografía transrectal: 54,7 cc vs 50,6 cc, para el grupo de MP y MN respectivamente. Al analizar las variables patológicas, no encontramos una diferencia estadísticamente significativa entre los MP y los MN en cuanto a la recaída bioquímica: Gleason menor 7 ( MN 28 ptes. 42 por ciento, MP 5 ptes. 23 por ciento) vs Gleason mayor o igual a 7 (MN 37ptes. 58 por ciento, MP 17ptes 77 por ciento) (pigual0,1). Estadío patológico del tumor: pT2 (MN 56 ptes. 85 por ciento, MP 19ptes: 86 por ciento) vs pT3a (MN 10 ptes.: 15 por ciento, MP 3 ptes.14 por ciento). Al realizar el análisis de l...

Impacto de los márgenes quirúrgicos positivos en pacientes post-prostatectomía radical / Positive surgical margins impact in patients after radical prostatectomy

Introducción: Debido a la relativa frecuencia de márgenes quirúrgicos positivos (MP) en las piezas de prostatectomías radicales, es importante para el urólogo entender la etiología e implicancias de estos hallazgos. Se define como un MP a la presencia de tejido tumoral que llega hasta la superficie prostática pintada con "tinta china". Objetivo: Mostrar el impacto de los MP en los pacientes sometidos a prostatectomía radical. Pacientes y Métodos: Se realizó un estudio retrospectivo, descriptivo y comparativo, analizando los datos de 106 pacientes sometidos a prostatectomía radical entre mayo de 1994 y octubre del 2005. Los criterios de exclusión fueron estadios pT3c, pT4 y/o N1. Se evaluaron variables de estadificación clínica: Gleason y antígeno prostático específico (PSA) pretratamiento, tacto rectal y volumen prostático por ecografía transrectal; variables del estudio patológico: Gleason de la pieza y T patológico; y variables evolutivas: recaída bioquímica (punto de corte de PSA mayor de 0,04 ng/ml y 0,2 ng/ml).Resultados: Fueron excluidos 18 pacientes; 22 pacientes presentaron MP (20,7 por ciento) y 66 márgenes negativos (MN) (62 por ciento). No hubo diferencias significativas en cuanto a las variables clínicas analizadas: PSA promedio 9,7 vs 11,16, Gleason pretratamiento menor7 57 por ciento vs 45 por ciento, tacto positivo 48 por ciento vs 38 por ciento, volumen prostático por ecografía transrectal: 54,7 cc vs 50,6 cc, para el grupo de MP y MN respectivamente. Al analizar las variables patológicas, no encontramos una diferencia estadísticamente significativa entre los MP y los MN en cuanto a la recaída bioquímica: Gleason menor 7 ( MN 28 ptes. 42 por ciento, MP 5 ptes. 23 por ciento) vs Gleason mayor o igual a 7 (MN 37ptes. 58 por ciento, MP 17ptes 77 por ciento) (pigual0,1). Estadío patológico del tumor: pT2 (MN 56 ptes. 85 por ciento, MP 19ptes: 86 por ciento) vs pT3a (MN 10 ptes.: 15 por ciento, MP 3 ptes.14 por ciento). Al realizar el análisis de l...(AU)

Impacto de los márgenes quirúrgicos positivos en pacientes post-prostatectomía radical / Positive surgical margins impact in patients after radical prostatectomy

Introducción: Debido a la relativa frecuencia de márgenes quirúrgicos positivos (MP) en las piezas de prostatectomías radicales, es importante para el urólogo entender la etiología e implicancias de estos hallazgos. Se define como un MP a la presencia de tejido tumoral que llega hasta la superficie prostática pintada con "tinta china". Objetivo: Mostrar el impacto de los MP en los pacientes sometidos a prostatectomía radical. Pacientes y Métodos: Se realizó un estudio retrospectivo, descriptivo y comparativo, analizando los datos de 106 pacientes sometidos a prostatectomía radical entre mayo de 1994 y octubre del 2005. Los criterios de exclusión fueron estadios pT3c, pT4 y/o N1. Se evaluaron variables de estadificación clínica: Gleason y antígeno prostático específico (PSA) pretratamiento, tacto rectal y volumen prostático por ecografía transrectal; variables del estudio patológico: Gleason de la pieza y T patológico; y variables evolutivas: recaída bioquímica (punto de corte de PSA mayor de 0,04 ng/ml y 0,2 ng/ml).Resultados: Fueron excluidos 18 pacientes; 22 pacientes presentaron MP (20,7 por ciento) y 66 márgenes negativos (MN) (62 por ciento). No hubo diferencias significativas en cuanto a las variables clínicas analizadas: PSA promedio 9,7 vs 11,16, Gleason pretratamiento menor7 57 por ciento vs 45 por ciento, tacto positivo 48 por ciento vs 38 por ciento, volumen prostático por ecografía transrectal: 54,7 cc vs 50,6 cc, para el grupo de MP y MN respectivamente. Al analizar las variables patológicas, no encontramos una diferencia estadísticamente significativa entre los MP y los MN en cuanto a la recaída bioquímica: Gleason menor 7 ( MN 28 ptes. 42 por ciento, MP 5 ptes. 23 por ciento) vs Gleason mayor o igual a 7 (MN 37ptes. 58 por ciento, MP 17ptes 77 por ciento) (pigual0,1). Estadío patológico del tumor: pT2 (MN 56 ptes. 85 por ciento, MP 19ptes: 86 por ciento) vs pT3a (MN 10 ptes.: 15 por ciento, MP 3 ptes.14 por ciento). Al realizar el análisis de l...(AU)

Cytohistologic correlation of nuclear grade in breast carcinoma.

OBJECTIVE: To compare the nuclear grade (NG) in cytologic material (CNG) obtained from breast fine needle aspiration biopsies (FNABs) with the NG observed in surgical biopsies (BNG) of the same tumors. STUDY DESIGN: The study group consisted of 135 breast carcinomas with both FNAB and biopsy. Most of them were invasive ductal carcinomas. Cytologic aspirates and tissue sections were graded simultaneously by the three authors using a multiheaded microscope. Fisher's modification of Black's nuclear grading scheme was used. RESULTS: There was agreement between CNG and BNG in 70.37% of tumors. The percentage coincidence was slightly greater for NG 3. CONCLUSION: Nuclear grade can be easily established on FNAB. The lack of correlation (29.63%) may have been due to tumor heterogeneity and observer subjectivity when assigning nuclear grade.

[Expression of p53 and bcl-2 in colorectal adenomas and carcinomas]. / Expresión de p53 y de bcl-2 en adenomas y carcinomas colorrectales.

Recent publications have associated p53 and bcl-2 genes in the process of neoplastic transformation. As the colonic adenoma-carcinoma sequence is an adequate natural model for carcinogenesis, it was considered interesting to analyze the expression of bcl-2 and p53 in these neoplasms. Seventy three adenomatous polyps (adenomas) and 60 adenocarcinomas of the colon and rectum were studied. Adenomas showed mild dysplasia in 16, moderate in 27, severe in 15 and focal carcinoma in the remaining 15. Adenocarcinomas surpassed the deep muscle layer in every case and were moderately differentiated. The studied gene expression was analized immunohistochemically using antibodies bcl-2 from Dako and p53 from Novocastra, both at a 1:100 dilution. Cytoplasmic stain for bcl-2 and nuclear stain for p53 above 10% of the cells were considered positive for each gene respectively. Results showed that there was accumulation of p53 protein in 26/58 (45%) adenomas with different grades of dysplasia. This result is similar to the reactivity found in adenomas with focal carcinoma where 8/15 (53%, p = 0.4) were positive but different from adenocarcinomas which were positive in 47/60 (78%, p = 0.0001). Regarding bcl-2, positivity was found in 53/73 (73%) of all the adenomas whereas adenocarcinoma showed expression in 14/60 (23%, p = 0.0000). When adenomas were grouped according to their degree of dysplasia and the existence of focal carcinoma, a diminishing frequency of reactivity for bcl-2 was found and when adenomas with three different grades of dysplasia were fused together, 47/58 (81%) were positive and this was compared with adenomas having focal carcinoma, 6/15 (40%) and with adenocarcinoma, 14/60 (23%), they showed significant differences (p = 0.001 and p = 0.0000 respectively). The analysis of the frequency of expression for both genes studied in the different lesions described yielded an inverse relation between them. This study allows the conclusion that the expression of bcl-2 is an early event in carcinogenesis and that it is replaced by mutation of p53 as the neoplastic change progresses.

[Reproducibility of nuclear grade in breast neoplasm. A multicenter experience]. / Reproducibilidad del grado nuclear en el cáncer de mama. Una experiencia multicéntrica.

Nuclear grade is considered a valuable prognostic factor in mammary carcinomas. Since the histological diagnosis of most of these tumors is made by "non expert" pathologists, it was considered interesting to find out the reproducibility of general pathologists to define the nuclear grade. In order to do this, a series of 15 mammary carcinomas, 10 of them randomly selected and 5 because they were considered difficult to classify for nuclear grade, were examined separately by 10 general pathologists. In a first round of observation, each one of them graded the cases according to their own criteria as used routinely, and for a second round they followed a written guide. An analysis of variance was applied to the data and no significant differences were found between observers, neither in the randomly selected cases nor in the total series. The written guide, surprisingly, instead of lowering the differences, increased them. Analysis of the individual performance of observers showed two of them having a great variation between both rounds of observation, and this was considered to influence the results of the whole group. Interobserver performance to discriminate high grade tumors (G3) from the rest, showed a good correlation in all the participants. These results allow us to conclude that in this series, examined by general pathologists, an acceptable reproducibility was observed, specially when high risk tumors were being identified.

Diagnostic value of p53 protein in the study of serous effusions.

The differential diagnosis between neoplastic and reactive mesothelial cells is one of the most frequent problems in the study of serous effusions. We assessed the utility of the immunohistochemical determination of p53 protein as a marker of malignancy in 34 embedded blocks of neoplastic fluids and 30 nonneoplastic effusions. Eleven (32.4%) of the tumor fluids were positive for this antibody, while all the nonneoplastic fluids were negative. A specificity of 100% and a sensitivity of 59% were observed. The immunohistochemical determination of p53 protein seems to be helpful in the differential diagnosis of effusions; its principal limitation is its relatively low sensitivity.

[Idiopathic myelofibrosis with extramedullary hematopoiesis foci in the skin and testicles. Report of a case]. / Mielofibrosis idiopática con focos de hematopoyesis extramedular en piel y testículo. Presentación de un caso.

Idiopathic myelofibrosis (IMF) is a clonal chronic myeloproliferative syndrome characterized by the proliferation of the three haemopoietic series and the marrow connective tissue and by the development of extramedullary haemopoiesis in the liver, spleen and lymph nodes. Cutaneous extramedullary haemopoiesis is an uncommon event and we could not find any reported cases of testicular involvement in this disease. We report the case of a 28 year-old male with diagnosis of idiopathic myelofibrosis in November 1988. During the course of the disease, three years later, he developed a tumor on his right testis. Histologic examination showed extramedullary haemopoiesis with cells of the myeloid, erythroid and megakaryocyte series, in the interstice. Eight months later, numerous red-purple papules and nodules developed on the patients's trunk. The biopsy of a skin lesion revealed an infiltration of the dermis by myeloid, erythroid cells and few megakaryocytes. The patient's clinical condition worsened, and he died in February 1993 following progressive deterioration of the general condition. We describe a case of IFM with extramedullary hemopoiesis involving the skin and the testis pointing out the rarity of these localization.

Carcinomas indiferenciados de nariz y senos paranasales: estudio clínicopatológico e inmunohistoquímico / Undifferentiated carcinoma of the nose and paranasal sinuses: a clinicopathological and immunohistochemical study

Se estudiaron 22 casos de carcinomas omdoferenciados (CI) de nariz y senos paranasales desde el punro de vista clínico-patológico e inmunohistoquímico. Se observaron 16 tumores sinusales y 6 nasales. Histológicamente había 11 Cl de células pequeñas, 7 de la variante intermedia y 4 casos de Cl de células grandes. Inmunohistoquímicamente casi todos los tumores, salvo 3 Cl de células pequeñas fueron positivos con algún ,arcador epitelial, siendo el más sensible el EMA y luego la citoqueratina observándose también una frecuente inmunoreactividad con los marcadores neuroendócrinos, con positividad de 5 Cl de células pequeñas, 6 de la variante intemedia y 3 de células grandes. De 18 pacientes con seguimiento, 3 fallecieron por su tumor, 9 estaban vivos con evidencias de enfermedad y 5 estaban sin evidencias de la enfermedad. Tuvieron una mejor evolución aquellos con Cl de variante intermedia y Cl de células grandes y también pacientes tratados con cirugia complementada con radioterapia con o sin quimioterapia

Carcinomas indiferenciados de nariz y senos paranasales: estudio clínicopatológico e inmunohistoquímico / Undifferentiated carcinoma of the nose and paranasal sinuses: a clinicopathological and immunohistochemical study

Se estudiaron 22 casos de carcinomas omdoferenciados (CI) de nariz y senos paranasales desde el punro de vista clínico-patológico e inmunohistoquímico. Se observaron 16 tumores sinusales y 6 nasales. Histológicamente había 11 Cl de células pequeñas, 7 de la variante intermedia y 4 casos de Cl de células grandes. Inmunohistoquímicamente casi todos los tumores, salvo 3 Cl de células pequeñas fueron positivos con algún ,arcador epitelial, siendo el más sensible el EMA y luego la citoqueratina observándose también una frecuente inmunoreactividad con los marcadores neuroendócrinos, con positividad de 5 Cl de células pequeñas, 6 de la variante intemedia y 3 de células grandes. De 18 pacientes con seguimiento, 3 fallecieron por su tumor, 9 estaban vivos con evidencias de enfermedad y 5 estaban sin evidencias de la enfermedad. Tuvieron una mejor evolución aquellos con Cl de variante intermedia y Cl de células grandes y también pacientes tratados con cirugia complementada con radioterapia con o sin quimioterapia (AU)

[Undifferentiated carcinoma of the nose and paranasal sinuses. A clinicopathologic and immunohistochemical study]. / Carcinomas indiferenciados de nariz y senos paranasales. Estudio clinicopatológico e inmunohistoquímico.

A clinico-pathological and immunohistochemical study of 22 cases of undifferentiated carcinoma (UC) of the nose and paranasal sinuses is presented. There were 6 nasal and 16 sinusal lesions. Eleven were small cell, 7 of the intermediate type and 4 of the large cell type. All the large cell UC originated in the sinuses. Immunohistochemically all but three of the UC (all small cell) were positive for an epithelial marker. EMA was better in this study than cytokeratin and CEA (19, 14 and 8 positive cases). Neuroendocrine markers were positive in 5 cases of the large cell UC (Table I). Of the 18 cases with follow up, 3 patients died of their tumor, 9 were alive with disease and 5 were with no evidence of disease after an average of 36 months. Patients with UC of the intermediate variant and large cell type had a better prognosis than those of the small cell type (Table 2). Cases treated with surgery and radiation therapy with or without chemotherapy had a better prognosis than those treated with either one of those treatments alone. This study shows that many of the UC of the nose and sinuses have a neuroendocrine phenotype and although they are aggressive neoplasms they seem to be not as lethal as suggested in the literature.

Carcinomas indiferenciados de nariz y senos paranasales. Estudio clinicopatológico e inmunohistoquímico. / [Undifferentiated carcinoma of the nose and paranasal sinuses. A clinicopathologic and immunohistochemical study]

A clinico-pathological and immunohistochemical study of 22 cases of undifferentiated carcinoma (UC) of the nose and paranasal sinuses is presented. There were 6 nasal and 16 sinusal lesions. Eleven were small cell, 7 of the intermediate type and 4 of the large cell type. All the large cell UC originated in the sinuses. Immunohistochemically all but three of the UC (all small cell) were positive for an epithelial marker. EMA was better in this study than cytokeratin and CEA (19, 14 and 8 positive cases). Neuroendocrine markers were positive in 5 cases of the large cell UC (Table I). Of the 18 cases with follow up, 3 patients died of their tumor, 9 were alive with disease and 5 were with no evidence of disease after an average of 36 months. Patients with UC of the intermediate variant and large cell type had a better prognosis than those of the small cell type (Table 2). Cases treated with surgery and radiation therapy with or without chemotherapy had a better prognosis than those treated with either one of those treatments alone. This study shows that many of the UC of the nose and sinuses have a neuroendocrine phenotype and although they are aggressive neoplasms they seem to be not as lethal as suggested in the literature.

Chronic myocardial damage in experimental T. cruzi infection of a New World primate, Cebus sp. monkey.

Eighteen Cebus apella monkeys, (juvenile and adult of both sexes) were inoculated five years ago, with three Trypanosoma cruzi strains (CA1, n = 10; Colombian, n = 4 and Tulahuen, n = 4), either by conjunctival or intraperitoneal route, once or repeatedly. Parasitological, hematological, serological, enzymatic, radiographic, electro and echocardiographic findings have been previously published and they are similar to those observed in human pathology. The most frequent electrocardiographic alteration was right branch bundle block. Six animals, chosen at random, were sacrificed. Those sacrificed 20 to 25 months post-first inoculation showed focal accumuli of leukocytes with myocytolysis. Foci of diffuse interstitial fibrosis with mild infiltrate of leukocytes among fibers were observed in the animals sacrificed 36 to 47 months post-inoculation. No parasites were seen. The lesions were more prominent in the ventricular walls and the septum. The fact that the infiltrates were predominant in the animals sacrificed at a shorter time after first inoculation and that fibrosis was more severe in those sacrificed at a longer time suggests that there is a progression of the infiltrative lesions to fibrosis, with a leukocytic activity indicative of a chronic phase. These lesions are similar to those described in human chronic Chagas' disease. This would demonstrate that this model is useful in evaluating a progress in the knowledge of the pathogenesis which is still a controversial issue, immunology, immunogenesis and chemotherapeutic agents of the chronic and indeterminate phases of this disease.

Diagnóstico de carcinomas indiferenciados con marcadores epiteliales / Diagnosis of undifferentiated carcinomas with epithelial markers

Con el objeto de determinar el valor diagnóstico de una serie de marcadores epiteliales se estudiaron 25 carcinomas indifenciados y 5 carcinomas indiferenciados de pequeñas células. Como grupo control positivo fueron marcados 16 carcinomas epidermoides o adenocarcinomas y como control negativo, 5 linfomas malignos. fueron utilizados sueros monoclonales contra queratina (AE1) y el antígeno epitelial de membrana (EMA) y policlonal para la demostración de antígeno carcinoembrionario (ACE). El método de marcación utilizado fue el de peroxidads-antiperoxidasa para ACE y el complejo acidinabiotina par AE1 y EMA. Del grupo control positivo todos los tumores fueron positivo con EMA, uno negativo con AE1, 20(80%) con EMA y 17(68%) con ACE. Tomando en cuenta los 3 marcadores, fueron positivos 24 de los 25 tumores (96%). Los carcinomas indiferenciados de pequeñas células y los linfomas malignos fueron negativos. Este trabajo confirma la utilidad de los marcadores epiteliais como ayuda diagnóstica para la tipificación de neoplasias indifernciadas. El empleo simultáneo de vários marcadores mejora los resultados

Diagnóstico de carcinomas indiferenciados con marcadores epiteliales / Diagnosis of undifferentiated carcinomas with epithelial markers

Con el objeto de determinar el valor diagnóstico de una serie de marcadores epiteliales se estudiaron 25 carcinomas indifenciados y 5 carcinomas indiferenciados de pequeñas células. Como grupo control positivo fueron marcados 16 carcinomas epidermoides o adenocarcinomas y como control negativo, 5 linfomas malignos. fueron utilizados sueros monoclonales contra queratina (AE1) y el antígeno epitelial de membrana (EMA) y policlonal para la demostración de antígeno carcinoembrionario (ACE). El método de marcación utilizado fue el de peroxidads-antiperoxidasa para ACE y el complejo acidinabiotina par AE1 y EMA. Del grupo control positivo todos los tumores fueron positivo con EMA, uno negativo con AE1, 20(80%) con EMA y 17(68%) con ACE. Tomando en cuenta los 3 marcadores, fueron positivos 24 de los 25 tumores (96%). Los carcinomas indiferenciados de pequeñas células y los linfomas malignos fueron negativos. Este trabajo confirma la utilidad de los marcadores epiteliais como ayuda diagnóstica para la tipificación de neoplasias indifernciadas. El empleo simultáneo de vários marcadores mejora los resultados (AU)