Breast-implant-associated anaplastic large-cell lymphoma.

Breast-implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is an uncommon, recently recognized disease that seems to occur only in relation with implants with textured surfaces. Most cases present with late-onset peri-implant effusion or fluid collections that develop more than 12 months after insertion of the implant. The diagnosis is reached by cytological analysis of fluid samples obtained by ultrasound-guided fine-needle aspiration. These patients usually have a good prognosis after surgical removal of the implant. A small percentage of patients present with a nodule or mass adjacent to the implant that usually develops late. In these cases, the diagnosis is reached by the histological analysis of core-needle biopsy specimens. These patients have a worse prognosis and require a combination of surgery and systemic chemotherapy. The main immunophenotypic characteristics of this lymphoma are intense expression of CD30 and a lack of expression of anaplastic lymphoma kinase (ALK). Here we present a case of BIA-ALCL in a patient with implants with a textured surface that presented with peri-implant effusion and incipient formation of a millimetric nodule and was treated with removal of the implant and bilateral capsulectomy. It is important to point out that the disease requires multidisciplinary management and that the Spanish Agency of Medicines and Medical Devices (AEMPS) should be notified when the diagnosis is confirmed.

Breast-implant-associated anaplastic large-cell lymphoma. / Linfoma anaplásico de células grandes asociado a implantes mamarios.

Breast-implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is an uncommon, recently recognized disease that seems to occur only in relation with implants with textured surfaces. Most cases present with late-onset peri-implant effusion or fluid collections that develop more than 12 months after insertion of the implant. The diagnosis is reached by cytological analysis of fluid samples obtained by ultrasound-guided fine-needle aspiration. These patients usually have a good prognosis after surgical removal of the implant. A small percentage of patients present with a nodule or mass adjacent to the implant that usually develops late. In these cases, the diagnosis is reached by the histological analysis of core-needle biopsy specimens. These patients have a worse prognosis and require a combination of surgery and systemic chemotherapy. The main immunophenotypic characteristics of this lymphoma are intense expression of CD30 and a lack of expression of anaplastic lymphoma kinase (ALK). Here we present a case of BIA-ALCL in a patient with implants with a textured surface that presented with peri-implant effusion and incipient formation of a millimetric nodule and was treated with removal of the implant and bilateral capsulectomy. It is important to point out that the disease requires multidisciplinary management and that the Spanish Agency of Medicines and Medical Devices (AEMPS) should be notified when the diagnosis is confirmed.

Clasificación y características del cáncer de intervalo en el programa de detección precoz de cáncer de mama en el Principado de Asturias / Classification and characteristics of interval cancers in the Principality of Asturias's breast cancer screening program

Objetivo. Revisar y clasificar los carcinomas de intervalo ( CI ) del programa de detección precoz de cáncer de mama del Principado de Asturias (PDPCM). Como objetivo secundario se plantea la descripción de sus características anatomopatológicas, así como de su tamaño y estadio en el momento del diagnóstico. Material y métodos. Se incluyeron los CI del PDPCM correspondientes al período 2003-2007. Se clasificaron según el protocolo de los programas de detección precoz de cáncer de mama, mediante doble lectura sin consenso ni enmascaramiento, con arbitrio. Hubo 10 lectores diferentes, todos ellos radiólogos del PDPCM. Resultados. No pudo ser clasificado el 33,7% del total de CI; del resto, el 40,67% se etiquetaron de intervalos verdaderos, el 31,4% como falsos negativos, el 23,7% como signos mínimos y el 4,23% se consideraron ocultos. El 70% de los CI se diagnosticaron en el segundo año del período entre cribados y un 71,7% tras un cribado subsiguiente. El 76,9% resultaron carcinomas ductales infiltrantes, el 61,1% se detectó en estadio II , y el 78,7% eran mayores de 10 mm cuando fueron diagnosticados. Conclusiones. La tasa de CI y la proporción de falsos negativos son superiores a las recomendadas por las guías europeas de calidad. El diagnóstico del CI es más tardío que el de los tumores detectados dentro del PDPCM. El estudio de los CI conlleva una importante labor formativa para los radiólogos del PDPCM(AU)

Objective. To review and classify the interval cancers found in the Principality of Asturias's Breast Cancer Screening Program (PDPCM). A secondary objective was to determine the histological characteristics, size, and stage of the interval cancers at the time of diagnosis. Material and methods. We included the interval cancers in the PDPCM in the period 2003-2007. Interval cancers were classified according to the breast cancer screening program protocol, with double reading without consensus, without blinding, with arbitration. Mammograms were interpreted by 10 radiologists in the PDPCM. Results. A total of 33.7% of the interval cancers could not be classified; of the interval cancers that could be classified, 40.67% were labeled true interval cancers, 31.4% were labeled false negatives on screening, 23.7% had minimal signs, and 4.23% were considered occult. A total of 70% of the interval cancers were diagnosed in the year of the period between screening examinations and 71.7% were diagnosed after subsequent screening. A total of 76.9% were invasive ductal carcinomas, 61.1% were stage II when detected, and 78.7% were larger than 10 mm when detected. Conclusions. The rate of interval cancers and the rate of false negatives in the PDPCM are higher than those recommended in the European guidelines. Interval cancers are diagnosed later than the tumors detected at screening. Studying interval cancers provides significant training for the radiologists in the PDPCM(AU)

[Classification and characteristics of interval cancers in the Principality of Asturias's Breast Cancer Screening Program]. / Clasificación y características del cáncer de intervalo en el programa de detección precoz de cáncer de mama en el Principado de Asturias.

OBJECTIVE: To review and classify the interval cancers found in the Principality of Asturias's Breast Cancer Screening Program (PDPCM). A secondary objective was to determine the histological characteristics, size, and stage of the interval cancers at the time of diagnosis. MATERIAL AND METHODS: We included the interval cancers in the PDPCM in the period 2003-2007. Interval cancers were classified according to the breast cancer screening program protocol, with double reading without consensus, without blinding, with arbitration. Mammograms were interpreted by 10 radiologists in the PDPCM. RESULTS: A total of 33.7% of the interval cancers could not be classified; of the interval cancers that could be classified, 40.67% were labeled true interval cancers, 31.4% were labeled false negatives on screening, 23.7% had minimal signs, and 4.23% were considered occult. A total of 70% of the interval cancers were diagnosed in the year of the period between screening examinations and 71.7% were diagnosed after subsequent screening. A total of 76.9% were invasive ductal carcinomas, 61.1% were stage II when detected, and 78.7% were larger than 10mm when detected. CONCLUSIONS: The rate of interval cancers and the rate of false negatives in the PDPCM are higher than those recommended in the European guidelines. Interval cancers are diagnosed later than the tumors detected at screening. Studying interval cancers provides significant training for the radiologists in the PDPCM.

[Oncoprotein p21-ras expression in epidermoid carcinoma of the laryngopharynx]. / Expressión de las oncoproteínas p21-ras en el carcinoma epidermoide faringolaríngeo.

Ras genes can acquire transforming properties by qualitative and quantitative mechanisms. The mutated products of ras oncogenes (p21 protein) exhibit a decreased ability to hydrolyze GTP that lead to the stabilization of ras proteins in their active state and cause a continuous flow of signal transduction which may result in malignant transformation. These biochemical aberrant properties can also be achieved by an increased expression of the normal p21 protein. In this work we have analyzed the presence of ras gene mutations and the overexpression of the oncogene product p21 in the same series of squamous cell carcinoma of pharynx and larynx. Of 13 cases studied we have detected mutations in seven cases and in nine we have observed overexpression of the p21 protein. There is no correlation between ras mutations and overexpression of the p21 protein.

[Clinicopathologic prognostic factors in laryngeal and pharyngolaryngeal tumors. I. Carcinoma of the pyriform sinus]. / Factores pronósticos clinicopatológicos en los tumores laríngeos y faringolaríngeos. I. Carcinoma del seno piriforme.

Prognostic factors of pyriform sinus carcinomas were studied in 122 patients. The 5-year determinate survival was 25.8%. Factors that implied a bad prognosis were an advanced local and nodal stage, and the degree of differentiation. At variance, alcohol and tobacco abuse, age, previous tracheostomy, involvement of surgical margins and local complications had not any prognostic significance.

[Primary tumors of the external auditory canal]. / Tumores primarios del conducto auditivo externo.

Primary tumors of the external auditory canal (EAC) are rare, their etiology is uncertain and their prognosis, dim. The most effective therapy combines both surgery and radiotherapy. This study reviews the literature and shows the results from 13 cases, treated between 1981-1991. This series proves a clear prevalence for the epidermoid tumors (10 out of 13) and we call the attention on their poor prognosis even in those tumors confined to EAC. The types of treatment and their complications as well, were reviewed.

[CT in the study of laryngeal carcinoma]. / La TC en el estudio del carcinoma de laringe.

The advances in conservative surgery regarding larynx carcinoma makes necessary nowadays a more precise staging than was required before. In this work we describe our experience with the 54 cases which were studied in our center from March 1988 until October 1990. The radiological findings using CT were correlated with those by clinical exploration and checked by pathology in all cases.

[The value of patent-blue and transcutaneous pO2 in predicting the viability of skin flaps treated pharmacologically]. / Valor del patent-blue y de la pO2 transcutánea en la predicción de la viabilidad de los colgajos cutáneos tratados farmacológicamente.

The effect of the patent-blue and the transcutaneous pO2 in the prediction of random flaps viability in the rat were studied. A control group of 12 rats and 8 study groups of 12 rats each were used. Different drugs were injected in the study groups: chlorpromazine, pentoxifylline, terbutaline, allopurinol, phenoxybenzamine, naftidrofuryl, hydralazine and trimetazidine. The stained area of the flap was significantly greater with pentoxifylline, phenoxybenzamine and trimetazidine. The surviving area was notably larger than the stained area, without any correlation between them. The preoperative values of pO2 showed a wide distribution, decreasing considerably in the immediate postoperative. After 48 hours pO2 values at least reached the preoperative levels. No correlation between pO2 measurements and the surviving area of the flap were observed.

[Parathyroid autotransplant in thyroid surgery]. / Autotrasplante de paratiroides en la cirugía tiroidea.

The postoperative hypoparathyroidism was studied in 176 patients that underwent a total o a wide subtotal thyroidectomy. The rate of this complication was compared between patients receiving a parathyroid autotransplantation (75 cases) and patients that did not. A 2.9% of non-transplanted patients developed a permanent hypoparathyroidism, that was observed in a 1.3% of non-transplanted patient. At variance, a transient hypoparathyroidism was twice more frequently observed in the transplanted group.

[The association of hypernephroma and dysfunction of the pyeloureteral junction. Apropos of a case]. / Asociación de hipernefroma y disfunción de la unión pieloureteral. A propósito de un caso.

We report on a patient with a tumor coexisting with a congenital condition. The foregoing conditions are discussed separately and their clinical and radiological features are described and compared with the findings commonly reported elsewhere. Finally, the conclusions relative to this uncommon case and its atypical mode of presentation are put forward.