Anaplastic extraosseous (extramedullary) plasmacytoma in the right nostril / Plasmocitoma anaplásico extraóseo (extramedular) en la fosa nasal derecha

Extraosseous (extramedullary) plasmacytomas are rare plasma cell neoplasms that can result in an erroneous and/or delayed diagnosis as often they are not considered in the differential diagnosis due to their rarity. Furthermore, the anaplastic type is one of the most difficult to recognize in biopsies. We report the case of a patient with an extraosseous plasmacytoma occluded in the right nostril. Its prompt and accurate diagnosis resulted in early treatment and a good outcome, despite the tumour being anaplastic with the risk of progressing into a plasma cell myeloma. The patient shows no recurrence or disease progression after 10 years of follow-up. Our case highlights the clinical and pathological characteristics of this rare disorder that should be considered in order to improve diagnostic criteria and thus early treatment. We also reviewed the pertinent literature

Los plasmocitomas extraóseos (extramedulares) son neoplasias de células plasmáticas que a menudo resultan en diagnósticos erróneos y/o retrasados, debido a que con poca frecuencia se consideran dentro del diagnóstico diferencial y donde el tipo anaplásico es una de las formas más difíciles de reconocer en las biopsias. Aquí describimos el caso de un paciente con un plasmocitoma extraóseo ocluido en la fosa nasal derecha, donde el diagnóstico oportuno y adecuado permitió proporcionar un tratamiento temprano con buenos resultados a pesar de ser un tipo anaplásico con riesgo de progresar a mieloma de células plasmáticas. El seguimiento de 10 años después del diagnóstico mostró que el paciente experimentó una respuesta completa sin recurrencia o progresión de la enfermedad. Nuestro caso destaca las características clínicas y patológicas que los médicos deben considerar al tratar a pacientes con esta enfermedad infrecuente para mejorar los criterios de diagnóstico y proporcionar un tratamiento más oportuno

Anaplastic extraosseous (extramedullary) plasmacytoma in the right nostril.

Extraosseous (extramedullary) plasmacytomas are rare plasma cell neoplasms that can result in an erroneous and/or delayed diagnosis as often they are not considered in the differential diagnosis due to their rarity. Furthermore, the anaplastic type is one of the most difficult to recognize in biopsies. We report the case of a patient with an extraosseous plasmacytoma occluded in the right nostril. Its prompt and accurate diagnosis resulted in early treatment and a good outcome, despite the tumour being anaplastic with the risk of progressing into a plasma cell myeloma. The patient shows no recurrence or disease progression after 10 years of follow-up. Our case highlights the clinical and pathological characteristics of this rare disorder that should be considered in order to improve diagnostic criteria and thus early treatment. We also reviewed the pertinent literature.

Safe Administration of Carbon Nanotubes by Intravenous Pathway in BALB/c Mice.

Carbon nanotubes (CNTs) are nanomaterials with multiple possible uses as drug carriers or in nanovaccine development. However, the toxicity of CNTs administered intravenously in in vivo models has not been fully described to date. This work aimed to evaluate the toxic effect of pristine multi-walled CNTs (UP-CNTs), purified (P-CNTs), or CNTs functionalized with fluorescein isothiocyanate (FITC-CNTs) administered by intravenous injection in BALB/c mice. Biochemical and histopathological parameters were analyzed at 1, 14, 29, and 60 days post-exposure. Pristine CNTs were the most toxic nanoparticles in comparison with P-CNTs or FITC-CNTs, increasing serum AST (≈ 180%), ALT (≈ 300%), and LDH (≈ 200%) levels at one day post-exposure. The urea/creatinine ratio suggested pre-renal injury at the 14th day accompanied of extensive lesions in kidneys, lungs, and liver. Biochemical and histological findings in mice exposed to P-CNTs had not significant differences compared to the controls. A lower toxic effect was detected in animals exposed to FITC-CNTs which was attributable to FITC toxicity. These results demonstrate that the purification process of CNTs reduces in vivo toxicity, and that toxicity in functionalized CNTs is dependent on the functionalized compound. Therefore, P-CNTs are postulated as potential candidates for safe biomedical applications using an intravenous pathway.

Biological and toxicological evaluation of Rhus trilobata Nutt. (Anacardiaceae) used traditionally in mexico against cancer.

BACKGROUND: Rhus trilobata Nutt. (Anacardiaceae) (RHTR) is a plant of Mexico that is traditionally used as an alternative treatment for several types of cancer. However, the phytochemical composition and potential toxicity of this plant have not been evaluated to support its therapeutic use. Therefore, this study aimed to evaluate the biological activity of RHTR against colorectal adenocarcinoma cells, determine its possible acute toxicity, and analyze its phytochemical composition. METHODS: The traditional preparation was performed by decoction of stems in distilled water (aqueous extract, AE), and flavonoids were concentrated with C18-cartridges and ethyl acetate (flavonoid fraction, FF). The biological activity was evaluated by MTT viability curves and the TUNEL assay in colorectal adenocarcinoma (CACO-2), ovarian epithelium (CHO-K1) and lung/bronchus epithelium (BEAS-2B) cells. The toxicological effect was determined in female BALB/c mice after 24 h and 14 days of intraperitoneal administration of 200 mg/kg AE and FF, respectively. Later, the animals were sacrificed for histopathological observation of organs and sera obtained by retro-orbital bleeding for biochemical marker analysis. Finally, the phytochemical characterization of AE and FF was conducted by UPLC-MSE. RESULTS: In the MTT assays, AE and FF at 5 and 18 µg/mL decreased the viability of CACO-2 cells compared with cells treated with vehicle or normal cells (p ≤ 0.05, ANOVA), with changes in cell morphology and the induction of apoptosis. Anatomical and histological analysis of organs did not reveal important pathological lesions at the time of assessment. Additionally, biochemical markers remained normal and showed no differences from those of the control group after 24 h and 14 days of treatment (p ≤ 0.05, ANOVA). Finally, UPLC-MSE analysis revealed 173 compounds in AE-RHTR, primarily flavonoids, fatty acids and phenolic acids. The most abundant compounds in AE and FF were quercetin and myricetin derivates (glycosides), methyl gallate, epigallocatechin-3-cinnamate, ß-PGG, fisetin and margaric acid, which might be related to the anticancer properties of RHTR. CONCLUSION: RHTR exhibits biological activity against cancer cells and does not present adverse toxicological effects during its in vivo administration, supporting its traditional use.

Comment on article "Diagnostic rentability of close pleural biopsy: Tru-cut vs. Cope" / Comentario al artículo "Rentabilidad diagnóstica de la biopsia pleural cerrada: Tru-cut frente a Cope"

In this letter to the editor it is discussed the use of Tru-cut needle in pleural biopsy and its profitability for the diagnosis of mesothelioma; it is exposed as well its usefulness, having the appropriate training, to obtain guiding results in obese people.

En esta carta al editor se discute el uso de la aguja Tru-cut en la biopsia pleural y lo rentable que resulta para el diagnóstico de casos de mesotelioma; también se expone su utilidad, con un adiestramiento adecuado, para obtener resultados diagnósticos orientadores en gente obesa.

[Auricular sporotrichosis. Atypical case report simulating bacterial cellulitis]. / Esporotricosis del pabellón auricular. Comunicación de un caso atípico simulando una celulitis bacteriana.

Sporotrichosis is the most common subcutaneous or implantation mycosis in Mexico. The case of a preauricular cutaneous-fixed sporotrichosis simulating atypical bacterial cellulitis is reported in an elderly patient with no history of trauma. The biopsy showed a suppurative granuloma with scarce yeast. Sporothrix schenckii was identified in the culture and confirmed by molecular biology. She was treated with itraconazole and a clinical and mycological cure was obtained. The case of atypical presentation is presented, coming from a semi-arid zone with extreme weather.

Esporotricosis del pabellón auricular: comunicación de un caso atípico simulando una celulitis bacteriana / Auricular sporotrichosis: atypical case report simulating bacterial cellulitis

Resumen La esporotricosis es la micosis subcutánea o por implantación más frecuente en México. Se comunica el caso de una esporotricosis cutánea-fija preauricular que simuló una celulitis bacteriana atípica, en una paciente anciana sin antecedente de traumatismo. La biopsia mostró un granuloma supurativo con presencia de levaduras escasas. En el cultivo se identificó Sporothrix schenckii que se confirmó por biología molecular. Se trató con itraconazol obteniéndose una curación clínica y micológica. Se presenta el caso de presentación atípica, proveniente de una zona semidesértica con clima extremo.

Sporotrichosis is the most common subcutaneous or implantation mycosis in Mexico. The case of a preauricular cutaneous-fixed sporotrichosis simulating atypical bacterial cellulitis is reported in an elderly patient with no history of trauma. The biopsy showed a suppurative granuloma with scarce yeast. Sporothrix schenckii was identified in the culture and confirmed by molecular biology. She was treated with itraconazole and a clinical and mycological cure was obtained. The case of atypical presentation is presented, coming from a semi-arid zone with extreme weather.

Prenatal Exposure to Sodium Arsenite Alters Placental Glucose 1, 3, and 4 Transporters in Balb/c Mice.

Inorganic arsenic (iAs) exposure induces a decrease in glucose type 4 transporter (GLUT4) expression on the adipocyte membrane, which may be related to premature births and low birth weight infants in women exposed to iAs at reproductive age. The aim of this study was to analyze the effect of sodium arsenite (NaAsO2) exposure on GLUT1, GLUT3, and GLUT4 protein expression and on placental morphology. Female Balb/c mice (n = 15) were exposed to 0, 12, and 20 ppm of NaAsO2 in drinking water from 8th to 18th day of gestation. Morphological changes and GLUT1, GLUT3, and GLUT4 expression were evaluated in placentas by immunohistochemical and image analysis and correlated with iAs and arsenical species concentration, which were quantified by atomic absorption spectroscopy. NaAsO2 exposure induced a significant decrease in fetal and placental weight (P < 0.01) and increases in infarctions and vascular congestion. Whereas GLUT1 expression was unchanged in placentas from exposed group, GLUT3 expression was found increased. In contrast, GLUT4 expression was significantly lower (P < 0.05) in placentas from females exposed to 12 ppm. The decrease in placental GLUT4 expression might affect the provision of adequate fetal nutrition and explain the low fetal weight observed in the exposed groups.

Morphological Findings in Trophozoites during Amoebic Abscess Development in Misoprostol-Treated BALB/c Mice.

During amoebic liver abscess (ALA) formation in susceptible animals, immune response is regulated by prostaglandin E2 (PGE2) dependent mechanisms. The aim of this study was to analyze the effect of misoprostol (MPL), a PGE1 analogue, on ALA formation in BALB/c mice. Male mice from BALB/c strain were intrahepatically infected with 7.5 × 10(5) trophozoites of E. histolytica strain HM1:IMSS and treated with 10(-4) M of MPL daily until sacrifice at 2, 4, and 7 days postinfection (p.i.). ALA formation was evaluated at 2, 4, and 7 days postinfection; trophozoite morphology was analyzed using immunohistochemistry and image analysis. Results showed an increase in frequency of ALA formation in infected and MPL-treated mice only at 2 days p.i. (P = 0.03). A significant diminution in the size of trophozoites was detected in abscesses from mice independently of MPL treatment (from 5.8 ± 1.1 µm at 2 days p.i. to 2.7 ± 1.9 µm at 7 days p.i.) compared with trophozoites dimensions observed in susceptible hamsters (9.6 ± 2.7 µm) (P < 0.01). These results suggest that MPL treatment may modify the adequate control of inflammatory process to allow the persistence of trophozoites in the liver; however, natural resistance mechanisms cannot be discarded.

Derrame pleural vasculítico / Vasculitic pleural effusion

No disponible

[Systemic lymphoma cells with T precursor condition of extreme female genital tract. A case report and literature review]. / Linfoma linfoblástico sistémico de células precursoras T con afección extrema del aparato genital femenino. Reporte de un caso y revisión de la bibliografía.

Primary female genital tract non Hodgkin's lymphoma is a rare presentation for a common disease in the childhood, and its classification as primary extranodal lymphoma is still controversial. There are a few cases reported as a primary precursor B-cell lymphoblastic lymphoma of the female genital tract, but there is not any case reported as primary precursor T-cell lymphoblastic lymphoma of the ovary in childhood. Herein we describe a 16 years old young woman with bilateral ovarian tumors, paraaortic lymphoadenophaty and disseminate disease to the female genital tract including extension of the tumor to neighboring organs like the omentum and the appendix. Exploratory laparatomy were performed with bilateral salpingo-oophorectomy, hysterectomy, omentectomy, appendectomy, pelvic and para-aortic lymphadenectomy, pelvic washings and with biopsy of vaginal vault. The chemotherapy regimen comprised of CHOP (Cyclophosphamide, Hydroxydaunorubicin, Oncovin, Prednisone/Prednisolone) and methotrexate, 3 months later presents left facial hemiparesia follow by right facial hemiparesia, 7 months later presents more Central Nervous System (CNS) complications and apparently was complicated with acute lymphocitic leukemia and after 16 months from the diagnosis, following by a torpid evolution, the pacient finally died.

[National Program of Continuous Academic Development for the General Physician (PRONADAMEG). The Chihuahua City experience]. / Programa Nacional de Actualización y Desarrollo Académico para el Médico General (PRONADAMEG). Experiencia en Chihuahua capital.

The aim of this work is to report on the experience obtained during 8 years of the Programa Nacional de Actualización y Desarrollo Académico para el Medico General (PRONADAMEG) in Chihuahua City in Northern Mexico. During this period, 276 general physicians enrolled in PRONADAMEG and 140 concluded their training, with end effectiveness of 50.7%.

Biopsia por aspiración con aguja delgada en lesiones torácicas. Análisis de 60 casos en un Hospital General de Zona / Thinn needle aspiration biopsy in thoracic lesions. Analysis of 60 casos in a General Zone Hospital

El objetivo del trabajo fue demostrar la utilidad de la biopsia por aspiración con aguja delgada (BAAD) de lesiones torácicas en un hospital de segundo nivel, que no contaba con la tecnología idónea para localizar las lesiones, verbigracia: tomografía computarizada, fluoroscopía, intensificador de imágenes y ultrasonografía. Con el empleo de estudios radiológicos simples posteroanteriores y laterales y el trazo de coordenadas verticales y horizontales, se puncionaron 77 pacientes. En 60 (77.9 por ciento) se obtuvo material apropiado, en 7 (11.6 por ciento) casos fue necesario puncionar en dos ocasiones. La BAAD demostró neoplasia maligna en 46 (76.7 por ciento) pacientes y enfermedad benigna en 14 (23.3 por ciento). Los diagnosticos más frecuentes fueron carcinoma epidermoide en 20 (33.3 por ciento) casos, carcinoma indiferenciado en 7(11.6 por ciento) y carcinoma bronquioloalveolar en 7 (11.6 por ciento). En 12 pacientes se practicó biopsia a cielo abierto y en 2 necropsia, en todos ellos hubo correlación con el diagnóstico de la BAAD. Cuatro (6.6 por ciento) pacientes se complicaron con neumotórax, en 3 se resolvió espontáneamente y uno amerito aplicación de sello de agua. Se demostró la utilidad de la BAAD en tórax en un hospital con recursos tecnológicos limitados, se diagnosticó 77.9 por ciento de los enfermos con un costo ínfimo, sin mortalidad y con mínima morbilidad

Apencitis aguda: análisis clinicopatológico de 200 casos / Clinico-pathological study of 200 cases of acute appendicitis

Los objetivos de este trabajo fueron a) realizar un análisis de 200 pacientes adultos con apendicitis aguda; b) correlacionar los datos clínicos con los hallazgos de laboratorio, radiológicos e histopatológicos. Material y Métodos: en todos los pacientes se recabaron datos clínicos y se practicaron biometría hemática, examen general de orina (EGO), radiografías de abdomen y estudio histopatológico. Resultados: fueron 98 hombres y 102 mujeres; 66.5 por ciento tuvieron entre 15 y 25 años. Todos presentaron dolor abdominal, 56.5 por ciento náusea y vómito, 49 por ciento fiebre, 10.5 por ciento diarrea y 6 por ciento síntomas urinarios. Hubo complicaciones postquirúrgicas en 24.5 por ciento. En 82.5 por ciento se encontró leucocitosis mayor de 10,000 y en 45 por ciento alguna alteración del EGO; 56.5 por ciento de las radiografías resultó anormal. El estudio histopatológico reveló apendicitis simple en 16.5 por ciento, hemorrágica en 8 por ciento, purulenta en 22 por ciento, hemopurulenta en 30.5 por ciento y perforada en 21 por ciento. Conclusiones: el diagnóstico de apendicitis es eminentemente clínico, 17.5 por ciento de los pacientes mostraron fórmula blanca y estudios radiológicos normales, respectivamente.

Patología quirúrgica del apéndice cecal: análisis de 8.950 casos / Surgical pathology of the cecal appendix: analysis of 8.950 cases

Se reclasificó la patologia quirúrgica del apéndice cecal. El diagnóstico clínico emitido con mayor frecuencia fue apendicitis aguda ( 80.5%). Los diagnósticos histopatológicos de revisión más frecuentes fueron apendicitis aguda (72%), apendicitis aguda con abscesos (36.2%), apéndice perforado (18.2%), apéndice cecal normal (11.2%), periapendicitis (4.1%), apendicitis crónica (2.5%), diverticulosis adquirida (1.7%), diverticulitis (1.2%), parasitosis (2.7%), apendicitis amibiana (1.1%) y neoplasias (1.2%). Se practicaron 558 apendicectomías profilácticas y en 158 casos (28.3%) se encontraron diferentes alteraciones patológicas. En 8.092 pacientes se emitión el diagnóstico clínico de apendicitis aguda o amibiana y en 2,067 (25.5%) no se apreciaron alteraciones que repercutieran clínicamente. De los 6,444 casos de apendicitis aguda, 5,559 (86.2%) el diagnóstico clínico coincidió con el histopatológico de revisión. En 12,788 diagnóstico histopatológicos se identificaron 4,877 discrepancias (38.1%) entre el diagnóstico intencionado de revisión y el de rutina