Placas pretibiales con atrofia central / No disponible

No disponible

Lesiones serocostrosas en mucosa labial / No disponible

No disponible

Lesión granulomatosa en antebrazo / Granulomatous lesion in the forearm

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No disponible

Placas pigmentadas atereiopeladas de localización flexural / Pigmented velvetic plates in flexure located

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Edema y fisuración del labio inferior / Oedema and fisure of the lower lip

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High-grade prostate intraepithelial neoplasia shares cytogenetic alterations with invasive prostate cancer.

BACKGROUND: High-grade prostate intraepithelial neoplasia (PIN) is the most likely precursor of prostate adenocarcinoma. However, the relationship between this lesion and prostate cancer has not yet been established. The detection of cytogenetic changes in the lesions prior to prostate adenocarcinoma would be useful in demonstrating such a pathogenic relationship. METHODS: Twenty eight high-grade PIN cases were found among 57 specimens of radical prostatectomy performed for clinically localized prostate cancer. Fluorescence in situ hybridization (FISH) analysis using centromeric probes to enumerate chromosomes 7, 8, 10, and 12 was performed to study the numerical chromosome alterations. FISH analysis was carried out over isolated nuclei obtained from high-grade PIN areas and prostate cancer foci in the same prostatectomy specimen. RESULTS: Of the 28 suitable cases it was possible to complete the study in 26 tumor and 20 PIN areas. The remaining cases were excluded because of insufficient tissue or poor preservation. Cytogenetic alterations (aneuploidy) were found in 16 of the 26 (62%) tumors studied. The most frequent chromosome alteration was trisomy 7, detected in 12 (75%) aneuploid tumors, followed by monosomy 8 present in 5 (31%) aneuploid tumors. Trisomy 7 was also the most frequent isolated chromosome alteration since it was detected in 7 (44%) tumors. Thirteen of 20 (65%) PIN cases were aneuploid when studied by FISH. Trisomy 7, trisomy 8, and monosomy 8 were the most common cytogenetic alterations in the 20 PIN areas studied, being observed in nine (45%), six (30%), and four (20%) cases, respectively. FISH analysis showed a high correlation (75% cases) in ploidy and pattern of cytogenetic alterations between high-grade PIN areas and the paired prostate cancer focus in the same specimen. CONCLUSIONS: The above results show a cytogenetic link between high-grade PIN and prostate cancer, suggesting that the former could be an early form of prostate cancer.

p53 expression predicts progression and poor survival in T1 bladder tumours.

OBJECTIVES: Histological grade (G) is the only parameter proved to have prognostic value for progression in T1 transitional cell carcinoma (TCC) of the bladder, although it is considered inaccurate to make clinical decisions on individuals. The aim of the present study was to evaluate the prognostic relevance of p53 expression in T1 TCC of the bladder. METHODS: Clinical records of 207 patients with T1 TCC of the bladder were reviewed for clinical parameters reported to influence the evolution of superficial bladder cancer. Among these 207 patients, 40 developed muscle-invasive disease (20 G2 and 20 G3). A retrospective case-control study was then carried out comparing the latter 40 tumours with 40 control tumours matched by grade, sex, age, number and size of the tumours, chemical exposure and presence of carcinoma in situ. p53 immunostaining with monoclonal antibody was performed in these two groups. RESULTS: Histological grade was the only clinical parameter that influenced evolution. p53 expression correlated with tumour progression, since it was observed in 21 out of 24 p53-positive tumours and in only 20 of 56 p53-negative tumours (p<0.0001), showing a specificity of 93. 5% and a sensitivity of 53%. p53 expression correlated as well with patient survival, being 39% in patients with p53-positive tumours and 80% in patients with p53-negative tumours at 60 months (p<0. 0001). CONCLUSIONS: p53 protein expression has prognostic value for survival and progression in T1 bladder tumours and can be used for early detection of poor-prognosis T1 bladder tumours.

Numeric alterations in chromosomes 7 and 8 detected by fluorescent in situ hybridization correlate with high-grade localized prostate cancer.

OBJECTIVE: To compare the ability of flow cytometry (FCM) and fluorescent in situ hybridization (FISH), using a small set of 4 enumeration chromosome probes to detect aneuploidy in prostate tumors, and to correlate it with histological grade and pathological stage. METHODS: Among 28 suitable cases, 21 could be analyzed by FISH and FCM techniques. DNA centromeric probes were used in FISH analysis to enumerate chromosomes 7, 8, 10 and 12. RESULTS: (a) Of the 21 cases studied by FISH, 5 were diploid, 14 aneuploid and 2 were tetraploid. When studied by FCM, these tumors were: 14 diploid, 6 aneuploid, and 1 tetraploid. FISH proved to have a higher ability for detecting DNA aneuploidy than FCM while been equally specific, since all tumors aneuploid by FCM were also found to be aneuploid by FISH. (b) Of the 14 aneuploid tumors, 12 were of high histological grade, while only 2 of the 7 nonaneuploid were of high grade. A statistically significant association was observed between high histological grade and FISH aneuploidy (p = 0.033). (c) All the aneuploid tumors showed chromosome 7 and/or 8 aneusomy. Trisomy 7 and monosomy 8 were the most frequent alterations present in 56 and 42% of the aneuploid tumors, respectively. CONCLUSION: FISH analysis of chromosome 7 and 8 alterations proved to be more sensitive than FCM in the detection of aneuploid prostate tumors. This aneuploidy was significantly associated with a poor pathological prognosis.

[Secondary bladder lymphoma in a patient with AIDS]. / Linfoma vesical secundario en paciente con SIDA.

Contribution of one case of non-Hodgkin lymphoma (NHL) with vesical involvement, that presented clinically with urological symptomatology. Vesical involvement is typical of NHL, and is becoming more frequent in association with the increased number of AIDS patients under immunosuppressive therapy. It should be expected that this currently unusual entity will become more common in the future.

[Unilateral spontaneous adrenal hematoma: an unusual cause of retroperitoneal hemorrhage]. / Hematoma suprarrenal espontáneo unilateral una causa excepcional de hemorragia retroperitoneal.

Presentation of one case of spontaneous retroperitoneal haemorrhage in a 72 year-old male, his first symptom being a left retrothoracic pain of sudden onset. The supplementary studies performed (ultrasound, CAT and MNR) pointed to the adrenal gland as the origin of the haemorrhage. Faced eith the uncertainty of the etiological diagnosis, a left supra-renalectomy was conducted which confirmed the pathological anatomy of the piece and the presence of massive haematoma of the suprarenal gland with no other pathological data. The clinical, diagnostic and therapeutical aspects are discussed.

Neurogenic bladder in patients with acquired immunodeficiency syndrome.

We have performed a urodynamic study on 3 patients with acquired immunodeficiency syndrome (AIDS), presenting with a neurogenic bladder. The first patient had an ascending myelitis of probable herpetic origin, the second patient had a cerebral abscess caused by Toxoplasma gondii, and the third patient had an AIDS dementia complex. The urodynamic study showed an areflexic detrusor in the first 2 patients, and a hyperreflexic detrusor in the third patient.

[Priapism after intracavernous injection of PgE1 in two cases of impotence following total cysto-prostatectomy]. / Priapisme après injection intracaverneuse de PgE1 dans deux cas d'impuissance après cystoprostatectomie totale.

The authors report two cases of priapism of more than six hours, following intracavernous injection of 15 and 10 mcg PgE1 respectively, in six patients with impotence after radical cystoprostatectomy. Bearing in mind the proven safety of intracavernous injection of PgE1 in the treatment and diagnosis of erectile dysfunction, such a proportion of priapism in this group of patients has called our attention. It is probably due to an increased in the PgE1 intracavernous metabolism, due to the ligation of the penile venous drainage during surgery.

[Acute peritonitis as a clinical manifestation of xanthogranulomatous pyelonephritis]. / Peritonitis aguda como manifestación clínica de pielonefritis xantogranulomatosa.

Xanthogranulomatous pyelonephritis can become clinically apparent in a variety of manners. The paper contributes a very infrequent presentation; a picture of acute peritonitis following non-focal generalized toxic syndrome and haematuria episodes.

False positive values of PAP and PSA in complicated and non-complicated benign prostatic hypertrophy.

Cancer of the prostate has become the most frequent form of cancer in men. Different tests have been used in cancer of the prostate, including prostate acid phosphatase (PAP) and the prostate specific antigen (PSA). Their value as diagnostic screening is disputed, as it is known that there are false positives for both markers in benign prostate conditions. In order to explain their possible diagnostic value, we studied 112 patients with well-documented benign prostate hyperplasia. The data included in this study were: estimated weight, urinary infection, bladder catheter and histopathological study. By using as cut-off 4 ng/ml for PAP and 10 ng/ml for PSA we found a percentage of false positives of 13% and 14% respectively. These percentages were in relation to the weight of the gland in each cases and in the case of PSA to the patient's clinical situation (infection, catheter).

Tumores vesicales de células transicionales en pacientes menores de 20 años / Transitional cell vesical tumors in patients younger than 20 years old

En los dos últimos decenios han sido motivo de numerosas revisiones los tumores de células transicionales en personas menores de 20 años de edad. Se presenta un estudio retrospectivo de seis pacientes con tumores vesicales de urotelio que, en el momento de iniciarse la sintomatología, tuvieran edad de 20 años o menor. En todos los casos el primer signo fue la hematuria, y el diagnóstico se confirmó entre dos y 60 meses después. El tratamiento de elección fue la electrorresección transuretral y, en un caso, consistió en cistectomía parcial con reimplantación de los uréteres. Se trata de carcinomas de buen pronóstico, por su baja tendencia invasora que se pone de manifiesto en la revisión bibliográfica y se confirma en esta serie. Es un padecimiento poco frecuente (0.4 por ciento) en este grupo etario; sin embargo, se debe tener en cuenta en el diagnóstico diferencial de la hematuria en el paciente joven. Se proponen la ecografía y la citología urinarias como métodos para el seguimiento de estos tumores.

[Adrenal myelolipoma: our experience and a review]. / Mielolipoma suprarrenal: nuestra experiencia y revisión de conjunto.

Four additional cases of adrenal myelolipoma that had been treated at our hospital are reported. All patients were male, aged 31-59 years. The largest diameter of the tumor ranged from 7-10 cm. Only one of the cases was symptomatic (arterial hypertension). In the remaining 3 patients with unremarkable clinical findings, the tumor and been detected incidentally during patient evaluation with CT and ultrasound (US) for other pathologies. Treatment was by surgery for the symptomatic case. For the remaining 3 patients, we adopted a conservative approach that included regular CT or US control evaluation. Treatment of this tumor type continues to be a controversy. Our therapeutic approach is described and the literature reviewed.