[Minimal prostatic adenocarcinomas in the biopsy treated with radical prostatectomy]. / Adenocarcinomas minimos de próstata en la biopsia sometidos a prostatectomía radical.

FUNDAMENTALS: Valuation about clinical pathologyc facts of patients having undergone a radical prostatectomy due to a minimal prostate adenocarcinoma shown at the biopsy. METHODS: Retrospective analysis of patients having undergone a radical prostatectomy due to a minimal prostate adenocarcinoma shown at the biopsy in front of the remaining radical prostatectomies. RESULTS: In 20 patients (7.6%) out of the 260 having undergone a radical prostatectomy between 1992 and 2004 the biopsy was informed as "minimal adenocarcinoma". These patients ranged 58 to 73 years with PSA levels from 5.2 to 17.1 ng/ml. Everyone except one were clinically T1c. At the definitive pathological study the Gleason was 6, 4, 3 and 2 in 3, 3, 8 and 4 patients respectively, with one having a minimal adenocarcinoma not graded and another one with a PIN ?. 3 showed only 1 focus with a tumoral volume less than 5% of the tissue (84.2% with significant tumor or multifocal). The final staging was 1 pT0 (PIN ?), 7 pT2a, 11 pT2b and 1 pT3a (62.5% bilaterals). Relating to the remaining patients under prostatectomy, patients with minimal adenocarcinoma presented significative differences in Gleason sum (p < 0.029) and staging (p = 0.02); no in PSA mean (p = 0.243). SUMMARY: Minimal adenocarcinomas of the prostate at the biopsy are significant but do present lower staging and grading in relation with the rest of patients.

Adenocarcinomas mínimos de próstata en la biopsia sometidos a prostatectomía radical / Minimal prostatic adenocarcinomas in the biopsy treated with radical prostatectomy

Fundamento: Valoración de datos clínico-patológicos de pacientes sometidos a prostatectomía radical por mínimo adenocarcinoma prostático en la biopsia. Métodos: Análisis retrospectivo de pacientes intervenidos de prostatectomía radical por mínimo adenocarcinoma, frente al resto de prostatectomías radicales. Resultados: En 20 pacientes (7,6 %), de los 260 sometidos a prostatectomía radical entre 1992 y 2004, se definió la biopsia como 'mínimo adenocarcinoma'. Tenían edades entre 58 y 73 años y los PSA entre 5,2 y 17,1 ng/ml. Todos, excepto uno eran clínicamente T1c. En la anatomía-patológica definitiva el Gleason fue de 6, 4, 3 y 2, en 3, 3, 8 y 4 pacientes respectivamente, con uno con mínimo adenocarcinoma no graduado y sólo un PIN-III en otro. Tres presentaron un solo foco con un volumen tumoral inferior al 5% del tejido (el 84,2 % con tumor significativo). El estadio final fue 1 pT0 (PIN III), 7 pT2a, 11 pT2b y 1 pT3a (62,5% bilaterales). Con respecto al resto de pacientes prostatectomizados, los pacientes con mínimo adenocarcinoma presentaron diferencias significativas en los Gleason (p=0,029) y los estadios (p= 0,02); no en la media del PSA (p=0,243). CONCLUSIONES: Los adenocarcinomas de próstata mínimos en la biopsia son significativos, aunque presentan estadios y grados inferiores al resto (AU)

Fundamentals: Valuation about clinical pathologyc facts of patients having undergone a radical prostatectomy due to a minimal prostate adenocarcinoma shown at the biopsy. Methods: Retrospective analysis of patients having undergone a radical prostatectomy due to a minimal prostate adenocarcinoma shown at the biopsy in front of the remaining radical prostatectomies. Results: In 20 patients (7,6%) out of the 260 having undergone a radical prostatectomy between 1992 and 2004 the biopsy was informed as 'minimal adenocarcinoma'. These patients ranged 58 to 73 years with PSA levels from 5.2 to 17.1 ng./ml. Everyone except one were clinically T1c. At the definitive pathological study the Gleason was 6, 4, 3 and 2 in 3, 3, 8 and 4 patients respectively, with one having a minimal adenocarcinoma not graded and another one with a PIN III. 3 showed only 1 focus with a tumoral volume less than 5% of the tissue (84.2% with significant tumor or multifocal). The final staging was 1 pT0 (PIN III ), 7 pT2a, 11 pT2b and 1 pT3a (62.5% bilaterals). Relating to the remaining patients under prostatectomy, patients with minimal adenocarcinoma presented significative differences in Gleason sum (p < 0.029) and staging (p = 0.02); no in PSA mean (p =0,243). Summary: Minimal adenocarcinomas of the prostate at the biopsy are significant but do present lower staging and grading in relation with the rest of patients (AU)

Anatomía Patológica en Cirugía Menor (Atención Primaria) / No disponible

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[Morphology of severe mycoses. Role of the pathologist in the diagnosis]. / Expresión morfológica de las infecciones fúngicas graves. Participación del patólogo en el diagnóstico.

Mycoses are diseases caused by fungi. To be regarded as pathogenic, a fungus has to be able to complete a number of steps in order to initiate infection. Although culture remains the gold standard to diagnose the causative agent, presumptive identification of these fungi in histologic slides is of great value because invasion is only demonstrated in tissue sections. When culture is not available, histopathologic examination may be the sole source of information about the nature of the infection. To make a diagnosis, the pathologist needs to be familiar with the morphologic appearance of the different types of fungi, and has also to be aware of the limitations in their identification. The purpose of this work is to review the current problems on this subject, specially referring to the most frequent severe mycoses of our environment.

[Adrenal gland myelolipoma. Report of a new case]. / Mielolipoma suprarrenal. Aportación de un nuevo caso.

OBJECTIVE: We report a new case of symptomatic myelolipoma of the adrenal gland. We analyse clinical, diagnostic, histopathologic and therapeutic aspects. METHOD AND RESULTS: Surgical excision was performed by lumbotomy. The patient was asymptomatic after surgery. DISCUSSION: Adrenal myelolipoma is norfunctioning benign tumour constituted by fat tissue and small islands of haemathopoyetic in a variable rate. The patients are usually asymptomatic. In symptomatic patients the most common symptoms are nonspecific abdominal pain, haematuria and hypertension. The diagnosis is achieved by ultrasound, CT and PAFF. The management is controversial: Surgical treatment or watching are options depending on the size and/or symptoms.