Dedicated breast PET value to evaluate BI-RADS 4 breast lesions.

PURPOSE: To evaluate the diagnostic value of dedicated breast PET (dbPET) parallel imaging in mammographically or sonographically detected BI-RADS 4 (Breast Imaging Reporting And Data Systems) lesions. MATERIALS AND METHODS: After institutional review board and patient approvals, 50 consecutive women with 60 BI-RADS 4 breast lesions were prospectively included in the study. All patients underwent Magnetic Resonance Imaging (MRI) and dbPET before biopsy and fusion of both MRI and dbPET images was performed to better locate corresponding lesions. Final findings were compared with histological results. Sensitivity and specificity for dbPET were determined along with their respective 95%-confidence intervals. RESULTS: Histopathology examination revealed 18 malignant lesions (7 in situ and 11 invasive carcinomas) and 42 benign entities. The dedicated breast PET reported no evidence of malignancy in 41 patients, 9 of them with histological diagnosis of neoplasm. Besides, dbPET showed increased metabolically activity in 10 benign lesions and in 9 breast cancers. Two invasive carcinomas were located less than 1 cm from the pectoral muscle, which can explain that they were missed by dbPET because they were outside the field of view (FOV). There were other 6 false negative results, which corresponded to a 0.1 cm invasive lobular carcinoma and 5 in situ carcinomas. Sensitivity and specificity of dbPET were 50% and 76%, respectively. CONCLUSIONS: Our analysis does not allow the recommendation of dbPET for diagnosis of malignancy in BI-RADS 4 mammographic or US abnormalities, mainly due to its high false-negative rate for the detection of in situ carcinomas (85.7%). However, considering the lesions greater than 0.1 cm and included in the FOV, dbPET depicted all invasive carcinomas.

Contralateral axillary drainage in a breast cancer patient without previous surgery history: an unusual pathway / Drenaje axilar contralateral en una paciente con cáncer de mama sin historia de cirugía previa: una vía inusual

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pS2 citosólica y proliferación celular en carcinomas ductales infiltrantes de mama hormonodependientes / Cytosolic pS2 levels and cellular proliferation in ER-positive and PgR-positive infiltrating ductalcarcinomas of the breast

Objetivo: La proteína pS2 (TFF1/pS2) es una molécula inducida por los estrógenos en los carcinomas mamarios. Nosotros hemos querido estudiar su expresión en carcinomas ductales infiltrantes de mama RE + y RP + , correlacionarla con otros parámetros clínico-biológicos y conocer su impacto en la evolución. Material y metodos: La pS2 citosólica fue determinada utilizando un IRMA (CIS. BioInternational. Francia). Hemos analizado, además, las concentraciones citosólicas de catepsina D y activador del plasminógeno tipo tisular (t-AP), así como las del receptor del factor de crecimiento epidérmico (EGFR), oncoproteína erbB2, CD44v5 y CD44v6 en las membranas celulares. El tamaño tumoral, grado histológico (GH), afectación axilar, metástasis a distancia, ploidía, índice de DNA y fase de síntesis celular (FS) fueron también considerados. Resultados: Los tumores pS2-positivos (> 5ng/mg prot.) mostraron mayores concentraciones de catepsina D (p:0,0043) y t-AP (p:0,0089) y fueron, asimismo, menos frecuentemente GH3 (p:0,0231), FS > 7 % (p:0,0005) y FS > 14 % (p:0,0014). Durante el período de seguimiento (i: 1-147; 50,1+/­31,7; mediana 37 meses) los tumores pS2 positivos mostraron menor número de recidivas (5/101 vs 6/69; p:0,059), pero no de muertes por el tumor (1/101 vs 2/6); ns). Conclusiones: Nuestros resultados apoyan la relación inversa de la pS2 con la proliferación celular en los tumores RE+ y RP+, lo cual puede sugerir una nueva función biológica distinta a la de indicadora de la hormonodependencia. Sin embargo, necesitamos tener mayor tiempo de seguimiento para poder precisar si ello incide directamente en la evolución ulterior del tumor

Objective: The trefoil factor 1 (TFF1/pS2) is an estrogen-induced molecule in breast tumours. We wanted to study its expression in ER+ and PgR+ infiltrating ductal carcinomas of the breast (IDCs), and to correlate it with other clinical-biological parameters and the outcome. Material and methods: Cytosolic pS2 levels were measured using an IRMA (CIS. Biointernational. France) in 170 tumors. Likewise we determined the cytosolic levels of cathepsin D and tissue-type plasminogen activator (t-PA), as well as the concentrations of the epidermal growth factor receptor (EGFR), erbB2 oncoprotein, CD44v5 and CD44v6 on cell surfaces. Also the tumour size, histological grade (HG), axillary lymph node involvement, distant metastasis, ploidy, DNA index and of cellular synthesis phase (SP) was taken in account.Results: The pS2-positive (> 5 ng(/mg prot.) tumours showed higher concentrations of cathepsin D (p: 0.0043) and t-PA (p: 0.0089) than the pS2-negative ones. Likewise, they were less frequently HG3 (p: 0.0231), SP > 7 % (p: 0.0005) and SP > 14 % (p:0.0014). During the follow-up time (r: 1-147; 50,1+/­31,7; median 37 months) the pS2-positive tumors showed a less number of recurrences (5/101 vs 6/69; p: 0.059) but not of deaths by the tumor (1/101 vs 2/69). Conclusions: These results support an inverse relationship between pS2 positivity and cellular proliferation in IDCs and suggest a new role of this protein (different of the hormonodependence) in the biology of these breast carcinomas, while further studies will be required to establish the impact of this finding on their outcome

[Cytosolic pS2 levels and cellular proliferation in ER-positive and PgR-positive infiltrating ductal carcinomas of the breast]. / pS2 citosólica y proliferación celular en carcinomas ductales infiltrantes de mama hormonodependientes.

OBJECTIVE: The trefoil factor 1 (TFF1/pS2) is an estrogen-induced molecule in breast tumours. We wanted to study its expression in ER+ and PgR+ infiltrating ductal carcinomas of the breast (IDCs), and to correlate it with other clinical-biological parameters and the outcome. MATERIAL AND METHODS: Cytosolic pS2 levels were measured using an IRMA (CIS. Biointernational. France) in 170 tumors. Likewise we determined the cytosolic levels of cathepsin D and tissue-type plasminogen activator (t-PA), as well as the concentrations of the epidermal growth factor receptor (EGFR), erbB2 oncoprotein, CD44v5 and CD44v6 on cell surfaces. Also the tumour size, histological grade (HG), axillary lymph node involvement, distant metastasis, ploidy, DNA index and of cellular synthesis phase (SP) was taken in account. RESULTS: The pS2-positive (> 5 ng/mg prot.) tumours showed higher concentrations of cathepsin D (p: 0.0043) and t-PA (p: 0.0089) than the pS2-negative ones. Likewise, they were less frequently HG3 (p: 0.0231), SP > 7 % (p: 0.0005) and SP > 14% (p:0.0014). During the follow-up time (r: 1-147; 50,1+/-31,7; median 37 months) the pS2-positive tumors showed a less number of recurrences (5/101 vs 6/69; p: 0.059) but not of deaths by the tumor (1/101 vs 2/69). CONCLUSIONS: These results support an inverse relationship between pS2 positivity and cellular proliferation in IDCs and suggest a new role of this protein (different of the hormone dependence) in the biology of these breast carcinomas, while further studies will be required to establish the impact of this finding on their outcome.

Valor clínico-biológico de la concentración citosólica de ácido hialurónico en adenocarcinomas pulmonares CD44v6 positivos / Clinico-biological value of the cytosol concentration of hyaluronic acid in CD44v6-positive lung adenocarcinomas

• Propósito: El objetivo de este estudio ha sido analizar la influencia de la concentración citosólicade ácido hialurónico (AH) sobre las características clínico-biológicas de adenocarcinomas de pulmónCD44v6 positivos.• Material y métodos: El grupo estudio incluyó 34 muestras tumorales. Dosificamos las concentracionescitosólicas de AH, pS2, catepsina D, t-AP, NSE, cyfra 21.1, CA125 y fracción libre de lahormona gonadotrófica coriónica. También determinamos las concentraciones de EGFR, proteína oncogénicaerbB2, CD44s y CD44v5 en las membranas celulares. Se tuvo presente, asimismo, el estadioclínico, grado histológico, ploidía, índice de DNA y fase de síntesis celular (FS).• Resultados: En el grupo tumoral los valores del índice AH/CD44v6 oscilaron entre 8.5 y 5999(mediana 107) y fueron superiores (p: 0.004) a los observados en 10 muestras de tejido pulmonarnormal de los mismos pacientes. Los adenocarcinomas pulmonares AH/CD44v6 positivos (>107; medianadel grupo) mostraron mayores concentraciones de proteína oncogénica erbB2 (p:0.020) y superioresvalores de FS (p: 0.009) e índice de DNA (p: 0.024). Asimismo, fueron más frecuentementeFS+ (>15 %) (p: 0.026).• Conclusiones: Los resultados obtenidos parecen resaltar la importancia de la concentración citosólicade AH en los adenocarcinomas pulmonares CD44v6 positivos, de tal modo que altos valoresen el índice AH/CD44v6 se asocian con una mayor proliferación e indiferenciación celular, lo cualunido a mayores concentraciones de proteína oncogénica erbB2, sugiere un subgrupo de tumorescon un posible diferente comportamiento. Sin embargo, dada el reducido número de enfermos incluídos,creemos que son necesarios más estudios para poder confirmar nuestros hallazgos

• Purpose: To study the influence of the cytosol hyaluronic acid (HA) concentrations on theclinical and biological features of CD44v6-positive lung adenocarcinomas (LAs).• Material and methods: The study included 34 tissue samples. We determined theconcentration of HA, p52, cathepsin D, t-PA, NSE, cyfra 21.1, CA125, and free beta subunit ofhuman chorionic gonadotrophin in the cytosol, and of EGFR, erbB2 oncoprotein, CD44s and CD44v5on the cell surface. Other parameters considered were clinical stage, histological grade (HG), ploidy,DNA index, and S-phase cell fraction (SF) measured by flow cytometry.• Results: In the tumoral group the HA/CD44v6 index values varied from 8.5 to 5,999 (107,median for the entire group) and were significantly higher (p 0.004) than those observed in 10samples of normal lung tissue obtained from the same patients. The HA/CD44v6-positive (>107)adenocarcinomas had higher concentrations of erbB2 oncoprotein (p: 0.02), and greater values ofglobal SF (p: 0.009) and DNA index (p: 0.024). They were also more frequently SF+ (>15 %).• Conclusions: The results stand out the importance of the cytosol concentration of hyalurinicacid in the CD44v6-positive lung adenocarcinomas, in such a way that high values of theHA/CD44v6 index are associated with a higher proliferation and cellular undifferentiation, which,joined to the higher concentration of erbB2 protein, suggest a subgroup of tumors with a possiblydifferent (poorer ?) outcome. Nevertheless, given the limited number of studied patients, furtherstudies are necessary to confirm our findings

[Hepatic abscess demonstrated by 67Ga-citrate scintigraphy within a diagnosis of fever of unknown origin]. / Absceso hepático demostrado mediante gammagrafía con 67Ga-citrato dentro de un diagnóstico de fiebre de origen desconocido.

We report a case of a 63 year old man who was seen in the hospital because of fever having a possible infectious or oncological origin. A 67Ga scintigraphy was performed and showed high pathological accumulation in the hepatic dome. The patient was re-evaluated and studied with other diagnostic tests including a CT scan, coinciding with the findings in the 67Ga-citrate scintigraphy. A correct final diagnosis of liver abscess was made.

Absceso hepático demostrado mediante gammagrafía con 67Ga-citrato dentro de un diagnóstico de fiebre de origen desconocido / Hepatic abscess demonstrated by 67ga-citrate scintigraphy within a diagnosis of fever of unknown origin

Presentamos el caso de un paciente varón de 63 años de edad que ingresó para estudio de fiebre de posible etiología infecciosa o neoplásica. Se realizó una gammagrafía con 67Ga, presentando un intenso acumulo patológico en cúpula hepática. Tras una nueva valoración del paciente y realizadas otras pruebas complementarias, que incluyeron un TC, coincidente con los hallazgos en la gammagrafía con citrato de 67Ga, se llegó al diagnóstico definitivo de absceso hepático (AU)

We report a case of a 63 year old man who was seen in the hospital because of fever having a possible infectious or oncological origin. A 67Ga scintigraphy was performed and showed high pathological accumulation in the hepatic dome. The patient was re-evaluated and studied with other diagnostic tests including a CT scan, coinciding with the findings in the 67Ga-citrate scintigraphy. A correct final diagnosis of liver abscess was made (AU)