Tumor P70S6K hyperactivation is inversely associated with tumor-infiltrating lymphocytes in triple-negative breast cancer.

PURPOSE: Triple-negative breast cancer (TNBC) is characterized by large heterogeneity and relative lack of available targeted therapies. To find therapeutic strategies for distinct patients with TNBC, several approaches have been used for TNBC clustering, including recently immune and phosphoproteomic patterns. Based on 70-kDa ribosomal protein S6 kinase (P70S6K)-TNBC clustering, the current study explores the immune profiling in TNBC tumors. METHODS: Stromal tumor-infiltrating lymphocytes (sTILs) were evaluated in human TNBC tumor samples. Furthermore, immunohistochemistry staining for CD8, CD4, Foxp3, and CD20 was performed in tissue microarrays (TMA) sections. RESULTS: Histological analysis showed decreased sTILs, CD20+ cells, and CD8+/CD4+ ratio in high phosphorylated P70S6K (p-P70S6K) tumors. Moreover, p-P70S6K score was directly correlated with CD4+ and Foxp3+ T cells, while it was inversely correlated with CD8+/CD4+ and CD8+/Foxp3+ ratios. CONCLUSION: sTIL infiltration and lymphocyte profiling vary in the context of hyperactivation of P70S6K in TNBC tumors.

Oxyphil cells in primary hyperparathyroidism: a clinicopathological study.

BACKGROUND: The role of oxyphil cells (OxC) in primary hyperparathyroidism (PHPT) still remains controversial. Historically, they were believed to be involuted cells. However, they could play an important role in hormone secretion. The clinical behavior of OxC-rich adenomas and preoperative PHPT localization tests have been widely studied. The aim of this study is to analyze the implications of OxC in PHTP. METHODS: A retrospective cohort study of patients undergoing parathyroidectomy for PHPT was conducted. Additionally, we included normal glands removed in the context of PHPT or inadvertently during a thyroidectomy. All glands were reviewed independently by three researchers, performing a semi-quantitative analysis of the percentage of OxC. Groups with < 25% OxC and > 75% OxC were compared. RESULTS: In the period 2010-2017, 238 patients and 261 removed glands were included (8.8% OxCA > 75%). There were no differences in symptomatology and levels of preoperative calcium, parathormone, or 25-OH vitamin. Patients with OxCA > 75% had worse preoperative glomerular filtration rate (81.2 vs. 69.7 mL/min/1.73 m2; p = 0.043). They also had a trend towards larger size and weight (17 vs. 20 mm, p = 0.135 and 562 vs. 875 mg, p = 0.495), while ultrasound was found to have better accuracy (48.3% vs. 73.7%; p = 0.035). There were no normal glands with a content of OxC > 75%. CONCLUSIONS: Our study suggests that phosphocalcic metabolism is not influenced by the presence of a high content of OxC in the parathyroid glands. A high content of OxC seems to be exclusive to pathologic glands and could be related to the deterioration of renal function in patients with PHPT.

Fine needle aspiration cytology of a myxoid adrenocortical adenoma. A case report.

The myxoid variant of adrenocortical (AC) tumors is characterized by peculiar histologic features that differ from conventional ones. It shows a prominent myxoid stromal component and is composed of small cells with mild atypia arranged in cords, pseudoglandular structures and microcysts. Reflecting the rarity of this variant, very few cytologic descriptions are available. We describe one case in a 41-year-old woman with a previous diagnosis of breast carcinoma and BRCA1 mutation. During follow-up controls, an adrenal tumor was discovered. Fine needle aspiration cytology and Tru-Cut biopsies were performed simultaneously. Smears showed numerous groups of cohesive cells of intermediate to small size. Within the largest groups, aggregates of myxoid metachromatic material were evident. This myxoid material could also be observed as isolated acellular fragments. While the cytoplasm of most tumoral cells was homogenously stained some showed small vacuoles. Histologically, the tumor grew, forming anastomosing cords, separated by myxoid material that determined microcystic spaces. Immunohistochemistry was characteristic of AC myxoid tumor. After surgery, pathologic analysis confirmed this diagnosis. The tumor showed no necrosis or invasion, had a low mitotic index (3/50 high power fields) and Ki-67 proliferative index of 15%. According to the different diagnostic systems the tumor was classified as an adenoma. In conclusion, the myxoid variant of AC tumors shows peculiar cytologic features. If unaware of the existence of this variant, it can easily be misinterpreted as a metastatic tumor.

Amiloidosis derivada del factor quimiotáctico de leucocitos 2 (ALECT2): a propósito de un caso / LECT2-associated renal amyloidosis (ALECT2): A case report

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Cauterization of the germinal nail matrix using phenol applications of differing durations: a histologic study.

BACKGROUND: Phenol has been used for more than 60 years in the treatment of ingrown toenails. Many reports have documented the safety and effectiveness of phenol matricectomy, although with variable treatment application times. OBJECTIVE: We performed research to determine the application time required for phenol matricectomy for complete denaturation of the nail matrix to occur at a concentration of 88%. Identifying the optimal time required to destroy the germinal matrix without causing further soft-tissue damage should reduce the potential for complications. METHODS: Thirty anatomic cadaveric fresh hallux samples were used to perform phenol matricectomy. The applications were for 1 to 6 minutes using 10 samples per time point and analyzed by hematoxylin-eosin staining to determine the presence or absence of the basal or germinal layer of the nail bed epithelium (NBE). RESULTS: After a 1-minute application of 88% phenol solution, only superficial damage to the NBE was noted, with the basal layer primarily intact. After a 2-minute application, the nail plate was avulsed with a thin basal layer remaining. After a 3-minute application, full-thickness necrosis of the NBE was noted in 6 of the 10 specimens. After 4-, 5-, and 6-minute applications, full-thickness necrosis of the NBE was noted and the basal layer was completely destroyed in all 30 specimens. LIMITATIONS: The study was performed in cadaveric fresh specimens. CONCLUSIONS: Application of 88% phenol solution for at least 4 minutes is necessary for complete destruction of the nail matrix, creating an environment that avoids nail regrowth.

Metástasis testicular como primera manifestación de un carcinoma renal oculto. A propósito de un caso y revisión de la literatura / Testicular metastasis as the first manifestation of occult renal carcinoma. A case report and review of the literature

Presentamos un caso de un varón de 56 años con un nódulo en el testículo derecho. Los hallazgos histológicos revelaron una neoplasia epitelial bien delimitada constituida por nidos de células claras separados entre sí por finos tractos conectivo-vasculares. Con el diagnóstico de metástasis de carcinoma renal de células claras, una ecografía de ambos riñones reveló una masa renal derecha de 6,5cm de dimensión máxima. Es necesario tener en mente la posibilidad de una metástasis testicular de un tumor primario desconocido en adultos dado que la metástasis puede constituir la primera manifestación de la enfermedad(AU9

A 56 year old man presented with a nodule in the right testis. Microscopically, the well delimitated epithelial neoplasm consisted of nests of clear cells separated by a vascular network. An initial diagnosis of metastatic, clear cell type renal cell carcinoma was made. Subsequent bilateral renal ultrasound revealed a 6.5cm right renal mass. The possibility that testicular tumours in adults could be metastatic and the first manifestation of an occult primary tumour should be considered(AU)

Pseudoneoplasia calcificante del sistema nervioso central. A propósito de un caso y revisión de la literatura / Calcifying pseudoneoplasm of the central nervous system. A case report and a review of the literature

Presentamos el caso de una mujer de 55 años, inmunocompetente,con resección de un meningioma hace 12 años,que en la misma localización de su resección previa mostróen la tomografía computerizada una masa intraaxial calcificada.Se realizó craneotomía y se resecó la masa en su totalidad.Macroscópicamente la lesión consistía en múltiplesfragmentos irregulares de consistencia dura, que medían de2 a 3 cm en su eje mayor. Microscópicamente se observó unamatriz de apariencia condromixoide, de patrón nodular,rodeada por una empalizada de células epitelioides y fusiformesen continuidad con parénquima cerebral, tejidofibroso y hueso lamelar. La lesión se diagnosticó de pseudoneoplasiacalcificante del neuroeje, también descrita comolesión fibro-ósea del sistema nervioso central. La pseudoneoplasiacalcificante del SNC es una lesión muy infrecuentey está considerada como un proceso reactivo por la mayoríade los investigadores. Se han publicado casos asociados conmeningioangiomatosis. Por lo que sabemos, este es el primercaso de pseudoneoplasia calcificante intracraneal asociada ahistoria previa de meningioma en la misma localización (AU)

55-year-old immunocompetent woman, with a historyof a resected meningioma 12 years previously, was found tohave an intraaxial calcified mass in the same area of the previoustumour by CT. A craniotomy was performed and themass was completely excised. Macroscopically, the lesionconsisted of multiple fragments of irregular, gritty, almostcalcified tissue, measuring approximately 2 to 3 cm inmaximum diameter. Microscopically, the lesion was seen tohave a chondromyxoid-like matrix in a nodular patternsurrounded by a palisade of spindle or epithelioid cells incontinuity with cerebral parenchyma, fibrous tissue andlamellar bone. The lesion was diagnosed as a calcifyingpseudotumour of the neural axis, also known as fibroosseuslesion of the central nervous system. Fibro-osseuslesions of the central nervous system are uncommon lesionsconsidered to be a reactive phenomenon by most authors.Cases associated with meningioangiomatosis have beenreported. To our knowledge, this is the first case of intracranialcalcifying pseudoneoplasm associated with a previoushistory of meningioma in the same location (AU)

Meningioma cordoide. A propósito de un caso y revisión de la literatura / Chordoid meningioma. Report of a case and review of the literature

El término meningioma cordoide fue usado por primeravez en 1988 para describir un tumor meníngeo que afectaba aindividuos jóvenes y que se presentaba con anemia microcíticay/o disgammaglobulinemia. Presentamos un caso de estavariante poco frecuente, que corresponde a menos del 0,5% detodos los meningiomas. Corresponde a una mujer de 69 añossin otras patologías de interés. La lesión se manifestó condolores de cabeza severos. La resonancia magnética cerebralmostró una masa tumoral supratentorial dependiente demeninge. Microscópicamente se evidenció una proliferaciónneoplásica dispuesta en lóbulos constituida por células epitelioidesy fusiformes que mostraban vacuolización del citoplasmay que descansaban sobre una matriz mixoide, basófila.Las células tumorales expresaban antígeno epitelial demembrana (EMA) y no mostraban reactividad con proteínaácida glial fibrilar, proteína S-100 ni citoqueratina. La neoplasiafue diagnosticada de meningioma cordoide (grado II de laclasificación de la Organización Mundial de la Salud)

The term chordoid meningioma was first used in 1988to describe a meningeal tumor among young people associatedwith microcytic anemia and/or dysgammaglobulinemia.We present a case of this rare variant, which comprisesless than 0.5% of all meningiomas. A 69-yr-old femalecomplained of severe headache with unremarkable physicalexamination. Brain magnetic resonance revealed a supratentorialtumoral mass with dependence of meninges. Histologically,the tumor mainly consisted of cords of vacuolatedcells in an abundant myxoid and basophilic matrix. Thetumor cells expressed epithelial membrane antigen (EMA)but not glial fibrillary acid protein (GFAP), S-100 protein orcytokeratin. The neoplasm was diagnosed chordoid meningiomagrade II of the Word Health Organization (WHO) (AU)

Miointimoma del glande del pene. A propósito de un caso y revisión de la literatura / Myointimoma of the glans penis. Report of a case and review of the literature

El término «miointimoma» fue usado por primera vez en el año 2000 para describir una proliferación miointimal característica que afecta al cuerpo esponjoso del glande del pene. Presentamos un caso de esta lesión mesenquimal infrecuente en un paciente de 68 años con un nódulo en el glande peneano. Los hallazgos histológicos revelaron una lesión mesenquimal sin relación con el epitelio que afectaba a los cuerpos esponjosos. Esta lesión consistía en una proliferación de células fusiformes sin atipia citológica, con arquitectura plexiforme y de localización intravascular. Revisamos la literatura y comentamos los diferentes diagnósticos diferenciales

The term «myointimoma» was first used in 2000 to describe a distinctive myointimal proliferation involving the corpus spongiosum of the glans penis. We present a case of this unusual mesenchymal lesion in a 68-yr-old male with a nodule located in the glans penis. The histological findings revealed a mesenchymal lesion not related to epithelium involving the corpus spongiosum. The process consists of non-atypical intravascular proliferation of spindle cells, with plexiform architecture. We review the literature and discuss the differential diagnostic possibilities

Miointimoma del glande del pene. A propósito de un caso y revisión de la literatura / Myointimoma of the glans penis. Report of a case and review of the literature

El término «miointimoma» fue usado por primera vez en el año 2000 para describir una proliferación miointimal característica que afecta al cuerpo esponjoso del glande del pene. Presentamos un caso de esta lesión mesenquimal infrecuente en un paciente de 68 años con un nódulo en el glande peneano. Los hallazgos histológicos revelaron una lesión mesenquimal sin relación con el epitelio que afectaba a los cuerpos esponjosos. Esta lesión consistía en una proliferación de células fusiformes sin atipia citológica, con arquitectura plexiforme y de localización intravascular. Revisamos la literatura y comentamos los diferentes diagnósticos diferenciales

The term «myointimoma» was first used in 2000 to describe a distinctive myointimal proliferation involving the corpus spongiosum of the glans penis. We present a case of this unusual mesenchymal lesion in a 68-yr-old male with a nodule located in the glans penis. The histological findings revealed a mesenchymal lesion not related to epithelium involving the corpus spongiosum. The process consists of non-atypical intravascular proliferation of spindle cells, with plexiform architecture. We review the literature and discuss the differential diagnostic possibilities