Timoma de estadio avanzado asociado a síndromes paraneoplásicos con buena respuesta a los corticosteroides orales y tacrolimus tópico / Advanced-Stage Thymoma Associating Multiple Paraneoplastic Syndromes with Good Response to Oral Corticosteroids and Topical Tacrolimus

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[Acral eruptive nevi after chemotherapy in children with acute lymphoblastic leukemia]. / Nevos acrales eruptivos tras quimioterapia en niños afectados de leucemia linfoblástica aguda.

Eruptive melanocytic nevi have mainly been associated with blistering cutaneous diseases and with immunosuppression, particularly after renal allograft transplantation, hematological neoplasms, or HIV infection. Thus, immunosuppression has been suggested to increase the possibility of melanocyte proliferation. We report two cases of children with acute lymphoblastic leukemia who, after receiving chemotherapy, developed severe motor polyneuropathy, and sudden onset of multiple melanocytic nevi on the soles.

Nevos acrales eruptivos tras quimioterapia en niños afectados de leucemia linfoblástica aguda / Acral eruptive nevi after chemotherapy in children with acute lymphoblastic leukemia

La aparición repentina de múltiples nevos melanocíticos se ha relacionado fundamentalmente con enfermedades ampollosas cutáneas y con estados de inmunosupresión, especialmente tras trasplante renal alogénico, neoplasias hematológicas, o asociados a infección por el virus de la inmunodeficiencia humana. Por este motivo, se ha sugerido que la inmunosupresión favorecería la proliferación de los melanocitos. Describimos 2 casos de niños afectados por una leucemia linfoblástica aguda que, tras recibir quimioterapia, sufrieron una severa polineuropatía motora y la aparición súbita de múltiples nevos melanocíticos, fundamentalmente de localización plantar

Eruptive melanocytic nevi have mainly been associated with blistering cutaneous diseases and with immunosuppression, particularly after renal allograft transplantation, hematological neoplasms, or HIV infection. Thus, immunosuppression has been suggested to increase the possibility of melanocyte proliferation. We report two cases of children with acute lymphoblastic leukemia who, after receiving chemotherapy, developed severe motor polyneuropathy, and sudden onset of multiple melanocytic nevi on the soles

Precalcaneal congenital fibrolipomatous hamartoma: a report of four cases.

Four infants had soft, skin-colored nodules in the midline plantar region of the heels since birth. The lesions were asymptomatic, bilateral, and symmetric, and measured approximately 1 cm in diameter. Their size increased in proportion to the growth of the child. In three infants the lesions persisted at 1 year of age, while in the fourth they remained at age 12 years. The nodules were not associated with any other disease or abnormality. A review of the literature revealed only one Argentinean series comprising four cases, and two communications at international pediatric congresses by French and American authors who reported five and three cases, respectively. We describe four additional cases of precalcaneal congenital fibrolipomatous hamartoma and comment on their histopathologic and ultrastructural characteristics.

Healing of the patellar tendon donor defect created after central-third patellar tendon autograft harvest. A long-term histological evaluation in the lamb model.

Patellar tendon donor defect (PTDD) healing after patellar tendon autograft (PTA), was evaluated in 12 lambs (24 knees), by means of conventional histology, immunohistochemistry and image analysis. The results of this study indicate that the PTDD is replaced by a tissue that does not assume the histological characteristics of a normal patellar tendon. Both the Hoffa fat pad (HFP) and the paratenon play an important role in the healing process, although qualitative and quantitative chronological differences were found, which supports the concept of a "two-time process". The HFP initiates the repair process, and is the main active proliferative tissue compartment during the first week. Once the process is established, the paratenon and, in particular, its synovial lining, starts proliferative activity and virtually substitutes that of the HFP, which rapidly loses activity in a few days. Moreover, donor-site morbidity after PTA could be the result of histological changes in the patellar tendon and environs in only a few cases. We have found inflammatory and neural changes in the refilled PTDD that could explain the anterior knee pain after PTA. Likewise, we have observed loss of Golgi corpuscles in the refilled PTDD, which could lead to proprioceptive loss after ACL reconstruction with PTA. Finally, we have observed shrinkage of the PTDD scar that could contribute to the etiopathogenia of a patella infera.

Quantitative analysis of nerve changes in the lateral retinaculum in patients with isolated symptomatic patellofemoral malalignment. A preliminary study.

Neural damage in 16 lateral retinacula excised at the time of Insall proximal realignments or isolated lateral retinacular releases performed in patients with symptomatic patellofemoral malalignment was evaluated by means of conventional histology and immunohistochemical and morphometric analyses. A relationship between clinical and histologic findings was found. An increase in the proportion of innervated tissue was correlated with anterior knee pain syndrome. We found a significant relationship between total neural area and pain. The group with moderate pain had the highest number of nerves and the highest neural area. In reference to total neural area and pain, there was a significant difference only between the patients with moderate pain and those with light pain, but not between patients with severe pain and those with moderate pain. The group with severe pain also showed a high neural area, although with a lower number of nerves. The severe-pain group had the largest nerves (24% of nerve fibers surpassing 25 microns diameter) in a zonal disposition, in which there were groups of nerve fibers in some fields and no nerve fibers in others. The group with moderate pain had an increase in medium and small nerve fibers (mean diameter, 18 microns), predominantly of tiny perivascular fibers. Moreover, we believe that instability in patients with patellofemoral malalignment can be explained in part because of loss of proprioception due to neural damage.

[Sjogren's syndrome: a new diagnostic approximation]. / Síndrome de Sjögren: una nueva aproximación diagnóstica.

At presentation the history of a 51 years old woman with xerostomia and dry keratoconjunctivitis sicca (KCS) with a development of ten months. Investigations revealed the presence in serum of antibodies against cytoplasmic antigens SS-A (Ac anti-Ro/SS-A), antinuclear antibodies (ANAS), and rheumatoid factor (RF). The test with Rose of Bengal was positive, and in the salivary gammagraphy made with pertecnate-99 m Tc it was observed a decreased of the captation and excretion of the designer for the salivary glands. The histopathology and immunohistochemical study of the minor salivary glands showed the presence of a focal lymphocytic sialadenitis (fls) and a predominance of lymphocytes CD4+. It was diagnosed a primary Sjögren a Syndrome (SSP) and the patient was treated with salivary substitutes and artificial tears. We analyse the current diagnostic criteria of the group of studies of the European Community for the SS. We emphasize the importance of the histologics and immunohistochemical study that with the rest of the complementary test will let us to distinguish not only the different forms of presentation of the illness, but also those of all the patients with pathologies which are very prevalent in our environment nowadays, such as the infections by virus C of the hepatitis (VCH) and the human immunodeficiency (VIH).

[Pseudoaneurysm of the splenic artery and chronic pancreatitis]. / Seudoaneurisma de la arteria esplénica y pancreatitis crónica.

The arterial pseudoaneurysm (AS) are a complication uncommon though very serious of the pancreatitis acute or chronic. We present the case of a male of 55 years with a pancreatitis chronic, developed within a pseudocyst pancreatic with break to left renal cell forming a hematoma perirrenal and perforation duodenal with massive gastrointestinal hemorrhage hypovolemic and death of the patient. We analyze theirs different forms of clinic presentation, the difficulties diagnostics found and the possible treatments that they could improve their results.