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Blood ; 135(4): 274-286, 2020 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-31738823


Pediatric large B-cell lymphomas (LBCLs) share morphological and phenotypic features with adult types but have better prognosis. The higher frequency of some subtypes such as LBCL with IRF4 rearrangement (LBCL-IRF4) in children suggests that some age-related biological differences may exist. To characterize the genetic and molecular heterogeneity of these tumors, we studied 31 diffuse LBCLs (DLBCLs), not otherwise specified (NOS); 20 LBCL-IRF4 cases; and 12 cases of high-grade B-cell lymphoma (HGBCL), NOS in patients ≤25 years using an integrated approach, including targeted gene sequencing, copy-number arrays, and gene expression profiling. Each subgroup displayed different molecular profiles. LBCL-IRF4 had frequent mutations in IRF4 and NF-κB pathway genes (CARD11, CD79B, and MYD88), losses of 17p13 and gains of chromosome 7, 11q12.3-q25, whereas DLBCL, NOS was predominantly of germinal center B-cell (GCB) subtype and carried gene mutations similar to the adult counterpart (eg, SOCS1 and KMT2D), gains of 2p16/REL, and losses of 19p13/CD70. A subset of HGBCL, NOS displayed recurrent alterations of Burkitt lymphoma-related genes such as MYC, ID3, and DDX3X and homozygous deletions of 9p21/CDKN2A, whereas other cases were genetically closer to GCB DLBCL. Factors related to unfavorable outcome were age >18 years; activated B-cell (ABC) DLBCL profile, HGBCL, NOS, high genetic complexity, 1q21-q44 gains, 2p16/REL gains/amplifications, 19p13/CD70 homozygous deletions, and TP53 and MYC mutations. In conclusion, these findings further unravel the molecular heterogeneity of pediatric and young adult LBCL, improve the classification of this group of tumors, and provide new parameters for risk stratification.

Artigo em Inglês | MEDLINE | ID: mdl-31501265


PTEN is a major tumor-suppressor protein whose expression and biological activity are frequently diminished in sporadic or inherited cancers. PTEN gene deletion or loss-of-function mutations favor tumor cell growth and are commonly found in clinical practice. In addition, diminished PTEN protein expression is also frequently observed in tumor samples from cancer patients in the absence of PTEN gene alterations. This makes PTEN protein levels a potential biomarker parameter in clinical oncology, which can guide therapeutic decisions. The specific detection of PTEN protein can be achieved by using highly defined anti-PTEN monoclonal antibodies (mAbs), characterized with precision in terms of sensitivity for the detection technique, specificity for PTEN binding, and constraints of epitope recognition. This is especially relevant taking into consideration that PTEN is highly targeted by mutations and posttranslational modifications, and different PTEN protein isoforms exist. The precise characterization of anti-PTEN mAb reactivity is an important step in the validation of these reagents as diagnostic and prognostic tools in clinical oncology, including their routine use in analytical immunohistochemistry (IHC). Here, we review the current status on the use of well-defined anti-PTEN mAbs for PTEN immunodetection in the clinical context and discuss their potential usefulness and limitations for a more precise cancer diagnosis and patient benefit.

NPJ Precis Oncol ; 3: 11, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30993208


Anti-PTEN monoclonal antibodies (mAb) are arising as important tools for immunohistochemistry (IHC) and protein quantification routine analysis in clinical oncology. Although an effort has been made to document the reliability of tumor tissue section immunostaining by anti-PTEN mAb, and to standardize their IHC use in research and in the clinical practice, the precise topological and biochemical definition of the epitope recognized by each mAb has been conventionally overlooked. In this study, six commercial anti-PTEN mAb have been validated and characterized for sensitivity and specificity by IHC and FISH, using a set of prostate and urothelial bladder tumor specimens, and by immunoblot, using PTEN positive and PTEN negative human cell lines. Immunoblot precise epitope mapping, performed using recombinant PTEN variants and mutations, revealed that all mAb recognized linear epitopes of 6-11 amino acid length at the PTEN C-terminus. Tumor-associated or disease-associated mutations at the PTEN C-terminus did not affect subcellular localization or PIP3 phosphatase activity of PTEN in cells, although resulted in specific loss of reactivity for some mAb. Furthermore, specific mimicking-phosphorylation mutations at the PTEN C-terminal region also abolished binding of specific mAb. Our study adds new evidence on the relevance of a precise epitope mapping in the validation of anti-PTEN mAb for their use in the clinics. This will be substantial to provide a more accurate diagnosis in clinical oncology based on PTEN protein expression in tumors and biological fluids.

Sci Rep ; 8(1): 6613, 2018 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-29700339


Early diagnosis of laryngeal squamous cell carcinoma (LSCC) at the stage of dysplasia could greatly improve the outcome of affected patients. For the first time we compared the mutational landscape of non-progressing dysplasia (NPD; n = 42) with progressing dysplasia (PD; n = 24), along with patient-matched LSCC biopsies; a total of 90 samples. Using targeted next-generation sequencing identified non-synonymous mutations in six genes (PIK3CA, FGFR3, TP53, JAK3, MET, FBXW7), and mutations were validated by Sanger sequencing and/or qPCR. Analysis was extended in silico to 530 head and neck (HNSCC) cases using TCGA data. Mutations in PIK3CA and FGFR3 were detected in PD and LSCC cases, as well as other HNSCC cases, but absent in NPD cases. In contrast, mutations in JAK3, MET and FBXW7 were found in NPD cases but not PD, LSCC or other HNSCC cases. TP53 was the most frequently mutated gene in both PD and NPD cases. With the exception of R248W, mutations were mutually exclusive. Moreover, five of seven PD mutations were located in motif H2 of p53, whereas none of the NPD mutations were. In summary, we propose that the mutational profile of laryngeal dysplasia has utility for the early detection of patients at risk of progression.

Predisposição Genética para Doença , Neoplasias Laríngeas/genética , Neoplasias Laríngeas/patologia , Mutação , Lesões Pré-Cancerosas/genética , Lesões Pré-Cancerosas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Alelos , Substituição de Aminoácidos , Biomarcadores Tumorais , Biologia Computacional/métodos , Análise Mutacional de DNA , Progressão da Doença , Feminino , Perfilação da Expressão Gênica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica , Estadiamento de Neoplasias , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco
Arch Esp Urol ; 70(8): 732-735, 2017 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-28976348


Renal cell carcinoma is an unpredictable malignancy. Sometimes, metastases are the disease debut. On the other hand, metastases could present years after treatment of the primary tumor. Four clinical cases of atypical metastases in the head and neck location are presented: parotid gland, mandibular bone, attached molar gingiva and masticator space. Physiopathology, clinics, histology and management of metastatic renal cell carcinoma at those anatomical regions are reviewed.

Carcinoma de Células Renais , Neoplasias Renais , Neoplasias Bucais , Carcinoma de Células Renais/secundário , Humanos , Neoplasias Renais/patologia , Neoplasias Bucais/secundário
Pathology ; 49(7): 731-739, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29074044


DNMT1 is a target of approved anti-cancer drugs including decitabine. However, the prognostic value of DNMT1 protein expression in R-CHOP-treated diffuse large B-cell lymphomas (DLBCLs) remains unexplored. Here we showed that DNMT1 was expressed in the majority of DLBCL cases (n = 209/230, 90.9%) with higher expression in germinal centre B-cell-like (GCB)-DLBCL subtype. Low and negative DNMT1 expression (20% cut-off, n = 33/230, 14.3%) was predictive of worse overall survival (OS; p < 0.001) and progression-free survival (PFS; p < 0.001). Nonetheless, of the 209 DNMT1 positive patients, 33% and 42% did not achieve 5-year OS and PFS, respectively, indicating that DNMT1 positive patients showed considerably heterogeneous outcomes. Moreover, DNMT1 was frequently expressed in mitotic cells and significantly correlated with Ki-67 or BCL6 expression (r = 0.60 or 0.44, respectively; p < 0.001). We demonstrate that DNMT1 is predictive of DLBCL patients' survival, and suggest that DNMT1 could be a DLBCL therapeutic target due to its significant association with Ki-67.

Biomarcadores Tumorais/metabolismo , DNA (Citosina-5-)-Metiltransferase 1/metabolismo , Antígeno Ki-67/metabolismo , Linfoma Difuso de Grandes Células B/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Murinos , Protocolos de Quimioterapia Combinada Antineoplásica , Linfócitos B/patologia , Ciclofosfamida , Intervalo Livre de Doença , Doxorrubicina , Feminino , Centro Germinativo/patologia , Humanos , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/metabolismo , Linfoma Difuso de Grandes Células B/patologia , Masculino , Pessoa de Meia-Idade , Prednisona , Prognóstico , Rituximab , Vincristina , Adulto Jovem
Arch. esp. urol. (Ed. impr.) ; 70(8): 732-735, oct. 2017. ilus
Artigo em Espanhol | IBECS | ID: ibc-167266


El carcinoma renal es un tumor de evolución imprevisible. A veces las metástasis son el debut de la enfermedad, mientras que en otras, éstas se manifiestan años tras el tratamiento del primario. Se presentan 4 casos clínicos de metástasis atípicas de carcinoma renal en región de cabeza y cuello: glándula parótida, hueso mandibular, encía adherida molar y espacio masticador. Se revisa la fisiopatología, clínica, histología y manejo del cáncer renal metastásico en esas localizaciones (AU)

Renal cell carcinoma is an unpredictable malignancy. Sometimes, metastases are the disease debut. On the other hand, metastases could present years after treatment of the primary tumor. Four clinical cases of atypical metastases in the head and neck location are presented: parotid gland, mandibular bone, attached molar gingiva and masticator space. Physiopathology, clinics, histology and management of metastatic renal cell carcinoma at those anatomical regions are reviewed (AU)

Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Metástase Neoplásica/patologia , Carcinoma de Células Renais/patologia , Neoplasias Renais/patologia , Neoplasias Maxilomandibulares/patologia , Neoplasias das Glândulas Salivares/secundário , Neoplasias Bucais/secundário , Estadiamento de Neoplasias/métodos
Exp Mol Pathol ; 99(3): 537-45, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26341140


Huntingtin-interacting protein 1-related (HIP1R) is an endocytic protein involved in receptor trafficking, including regulating cell surface expression of receptor tyrosine kinases. We have previously shown that low HIP1R protein expression was associated with poorer survival in diffuse large B-cell lymphoma (DLBCL) patients from Denmark treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone). In this multicenter study, we extend these findings and validate the prognostic and subtyping utility of HIP1R expression at both transcript and protein level. Using data mining on three independent transcriptomic datasets of DLBCL, HIP1R transcript was preferentially expressed in germinal center B-cell (GCB)-like DLBCL subtype (P<0.01 in all three datasets), and lower expression was correlated with worse overall survival (OS; P<0.01) and progression-free survival (PFS; P<0.05) in a microarray-profiled DLBCL dataset. At the protein level examined by immunohistochemistry, HIP1R expression at 30% cut-off was associated with GCB-DLBCL molecular subtype (P=0.0004; n=42), and predictive of OS (P=0.0006) and PFS (P=0.0230) in de novo DLBCL patients treated with R-CHOP (n=73). Cases with high FOXP1 and low HIP1R expression frequency (FOXP1(hi)/HIP1R(lo) phenotype) exhibited poorer OS (P=0.0038) and PFS (P=0.0134). Multivariate analysis showed that HIP1R<30% or FOXP1(hi)/HIP1R(lo) subgroup of patients exhibited inferior OS and PFS (P<0.05) independently of the International Prognostic Index. We conclude that HIP1R expression is strongly indicative of survival when utilized on its own or in combination with FOXP1, and the molecule is potentially applicable for subtyping of DLBCL cases.

Biomarcadores Tumorais/análise , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Proteínas de Transporte Vesicular/biossíntese , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Murinos , Protocolos de Quimioterapia Combinada Antineoplásica , Área Sob a Curva , Ciclofosfamida , Intervalo Livre de Doença , Doxorrubicina , Feminino , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Linfoma Difuso de Grandes Células B/mortalidade , Masculino , Pessoa de Meia-Idade , Prednisona , Prognóstico , RNA Mensageiro/análise , Curva ROC , Rituximab , Sensibilidade e Especificidade , Análise Serial de Tecidos , Proteínas de Transporte Vesicular/análise , Vincristina , Adulto Jovem
Eur J Nucl Med Mol Imaging ; 42(9): 1378-89, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25952280


PURPOSE: The objective of this study was to determine the incremental staging information provided by positron emission tomography/computed tomography (PET/CT) and its impact on management plans in patients with untreated stage III-IV head and neck squamous cell carcinoma (HNSCC). METHODS: We prospectively studied, between September 2011 and February 2013, 84 consecutive patients [median age 63.5 years (39-84); 73 men] with histologically confirmed HNSCC. First, based on a conventional work-up (physical examination, CT imaging of the head, neck and chest), the multidisciplinary Head and Neck Tumour Board documented the TNM stage and a management plan for each patient, outlining the modalities to be used, including surgery, radiation therapy (RT), chemotherapy or a combination. After release of the PET/CT results, new TNM staging and management plans were agreed on by the multidisciplinary Tumour Board. Any changes in stage or intended management due to the PET/CT findings were then analysed. The impact on patient management was classified as: low (treatment modality, delivery and intent unchanged), moderate (change within the same treatment modality: type of surgery, radiation technique/dose) or high (change in treatment intent and/or treatment modality → curative to palliative, or surgery to chemoradiation or detection of unknown primary tumour or a synchronous second primary tumour). TNM stage was validated by histopathological analysis, additional imaging or follow-up. Accuracy of the conventional and PET/CT-based staging was compared using McNemar's test. RESULTS: Conventional and PET/CT stages were discordant in 32/84 (38 %) cases: the T stage in 2/32 (6.2 %), the N stage in 21/32 (65.7 %) and the M stage 9/32 (28.1 %). Patient management was altered in 22/84 (26 %) patients, with a moderate impact in 8 (9.5 %) patients and high impact in 14 (16.6 %) patients. PET/CT TNM classification was significantly more accurate (92.5 vs 73.7 %) than conventional staging with a p value < 0.001 (McNemar's test). CONCLUSION: PET/CT should be implemented in the routine imaging work-up of stage III-IV HNSCC.

Carcinoma de Células Escamosas/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Imagem Multimodal , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Feminino , Fluordesoxiglucose F18 , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Prospectivos , Sensibilidade e Especificidade
APMIS ; 123(7): 596-603, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26010683


MYC and BCL2 gene translocations and protein expression have recently demonstrated to be of prognostic significance in systemic diffuse large B-cell lymphoma (DLBCL). However, their role in primary central nervous system DLBCL (CNS-DLBCL) prognosis has been scarcely analyzed. We studied the immunophenotype, the status of the MYC, BCL2, and BCL6 genes and the clinical features of a series of 42 CNS-DLBCL and evaluated their prognostic significance. We found high MYC protein expression in 43% of cases, and this was associated with lower overall survival (OS). Cases with concurrent expression of MYC and BCL2 showed a lower OS, although the difference did not reach statistical significance. Translocations involving the MYC or BCL2 genes were not detected. The BCL6 gene was frequently translocated, but was unrelated to survival. We conclude that MYC protein expression detected by immunohistochemistry identifies a CNS-DLBCL subset with worse prognosis and may contribute to a more accurate risk stratification of CNS-DLBCL patients.

Sistema Nervoso Central/patologia , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/genética , Proteínas Proto-Oncogênicas c-myc/metabolismo , Adulto , Sistema Nervoso Central/citologia , Proteínas de Ligação a DNA/genética , Proteínas de Ligação a DNA/metabolismo , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Imunofenotipagem , Hibridização in Situ Fluorescente , Linfoma Difuso de Grandes Células B/patologia , Masculino , Prognóstico , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Proteínas Proto-Oncogênicas c-bcl-6 , Proteínas Proto-Oncogênicas c-myc/genética , Estudos Retrospectivos
Rev. esp. patol ; 44(4): 229-231, oct.-dic. 2011. ilus
Artigo em Espanhol | IBECS | ID: ibc-91547


La metaplasia escamosa descamativa queratinizante del tracto urinario es una enfermedad poco frecuente que puede simular un proceso neoplásico. Se presenta un ejemplo típico de esta entidad en una paciente de 71 años de edad con una larga historia de cólicos de repetición. El estudio radiológico mostró una lesión sospechosa, ocupante de espacio, en el muñón ureteral de una nefrectomía previa, y el examen histológico mostró metaplasia escamosa del urotelio y abundante descamación córnea en la luz formando masas irregulares(AU)

Keratinizing desquamative squamous metaplasia of the urinary tract is a rare condition that may mimic neoplasia. We report a characteristic case occurring in a 71-year old woman with a long previous history of recurrent nephritic colic. Imaging studies showed a suspicious mass in the ureteral stump of a previous nephrectomy. Histology revealed squamous metaplasia of the urothelium with abundant keratinizing material in the lumen forming irregular masses(AU)

Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias de Células Escamosas/patologia , Cólica/complicações , Cólica/diagnóstico , Urotélio/patologia , Neoplasias de Células Escamosas/complicações , Neoplasias de Células Escamosas , Urotélio
Rev. esp. patol ; 42(4): 263-275, oct.-dic. 2009.
Artigo em Espanhol | IBECS | ID: ibc-75777


Antecedentes: La médula renal constituye un intrincadosistema de túbulos, vasos sanguíneos e intersticio pococonocido por la mayor parte de los patólogos generales.Métodos: Amplia revisión de la literatura sobre la médularenal y de archivo de toda su patología. Resultados: Se pormenorizandatos de interés para el patólogo sobre el desarrollonormal y patológico, la anatomía microscópica, histologíae inmunohistoquímica, la fisiología, la patología dela diferenciación medular (displasia renal multiquística,enfermedades poliquísticas renales autosómicas dominantey recesiva, enfermedad quística medular) la patología inflamatoria(pielonefritis xantogranulomatosa, malacoplaquia),las displasias, y las neoplasias (oncocitoma, tumor oncocíticoatípico, carcinoma renal de células cromófobas, carcinomade los túbulos colectores, carcinoma urotelial, otros carcinomas,fibroma renomedular y tumores metastáticos) deesta topografía. Conclusiones: El conocimiento compendiadode la génesis, del funcionamiento y de la patologíamedular renal, tanto del desarrollo, como inflamatoria yneoplásica, redundará en un mayor interés por esta zona delriñón que habitualmente pasa desapercibida para el patólogoasistencial(AU)

Background: The renal medulla is composed of a complexsystem of tubules, blood vessels and interstitium,which the general pathologist often are unfamiliar with.Methods: An in depth review of the literature and of materialfrom our archives related to the pathology of the renalmedulla was made. Results: Interesting data on normal andabnormal development, microscopic anatomy, histology,immunohistochemistry, physiology, and pathology, includingrenal medulla differentiation disorders (multicysticrenal dysplasia, adult and infantile type polycystic diseases,cystic medullary disease), inflammatory diseases (xanthogranulomatouspyelonephritis, malakoplakia) and neoplasias(oncocytoma, atypical oncocytic tumour, chromophoberenal cell carcinoma, collecting duct carcinoma, urothelialcarcinoma, other carcinomas, renomedullary fibroma andmetastatic tumours), was reviewed. Conclusions: A comprehensiveknowledge of the genesis, function, and pathologyof the renal medulla would result in a greater interestbeing taken in an area often ignored by pathologists(AU)

Humanos , Masculino , Feminino , Medula Renal/patologia , Imuno-Histoquímica/métodos , Imuno-Histoquímica , Rim/anatomia & histologia , Rim/patologia , Hiperplasia/patologia , Medula Renal/anatomia & histologia , Medula Renal/fisiopatologia , Adenoma Oxífilo/patologia , Adenoma Oxífilo , Carcinoma de Células de Transição/patologia , Rim/embriologia , Rim/crescimento & desenvolvimento , Nefrite Intersticial/embriologia , Nefrite Intersticial/patologia
Ann Diagn Pathol ; 12(5): 378-80, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18774505


Mature cystic teratomas of the ovary containing prostatic remnants are reported in 2 women aged 31 and 20 years. Both cases showed the expected histology of mature teratomas with a mixture of ecto- and endodermal structures lying in a fibrous stroma. In both cases, the foci of prostate tissue were composed of typical prostatic glands arranged in acinar structures. One case displayed a transitional cell-lined duct resembling the urethra. Prostate glands showed intense positive immunostaining with prostatic specific antigen and prostatic acidic phosphatase. Focal images suggesting high-grade prostatic intraepithelial neoplasia were detected in 1 case. The literature on this unusual finding in these common tumors is reviewed and commented on.

Neoplasias Ovarianas/patologia , Próstata/patologia , Teratoma/patologia , Fosfatase Ácida , Adulto , Biomarcadores Tumorais/análise , Feminino , Humanos , Masculino , Neoplasias Ovarianas/química , Neoplasias Ovarianas/cirurgia , Ovariectomia , Próstata/química , Antígeno Prostático Específico/análise , Neoplasia Prostática Intraepitelial/química , Neoplasia Prostática Intraepitelial/patologia , Neoplasias da Próstata/química , Neoplasias da Próstata/patologia , Proteínas Tirosina Fosfatases/análise , Teratoma/química , Teratoma/cirurgia , Resultado do Tratamento
Rev. esp. patol ; 41(3): 183-188, jul.-sept. 2008. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-76719


Antecedentes: La invasión de las vesículas seminales esun dato histológico de mal pronóstico en el cáncer de próstata.En la mayor parte de los casos es un hallazgo accidentalya que los pacientes con signos clínicos o histológicos deenfermedad extraprostática no se tratan mediante cirugía enla mayor parte de protocolos al uso. Nuestra intención escuantificar este hallazgo histológico en una serie homogéneade prostatectomías radicales y correlacionarlo con los hallazgosen las biopsias previas. Métodos: Durante un periodo de8 años (1998-2005), 363 pacientes con cáncer de próstatafueron tratados mediante prostatectomía radical en el Hospitalde Basurto. Los pacientes fueron seleccionados para lacirugía en función de la combinación de la estadificación clínica,niveles de PSA sérico y datos obtenidos de la biopsiaprevia. Los datos obtenidos en las prostatectomías se correlacionaron(rho de Spearman) con varios hallazgos histológicosprocedentes de las biopsias. Resultados: Se detectóinvasión seminal en 37 pacientes (10,2%). La invasiónmicroscópica de las vesículas seminales se correlacionó conlos milímetros totales de cáncer (media 20 mm, r=0,397),con el número de focos de tumor (media 3,8, r=0,383), conla invasión de ambos lados prostáticos (r=0,256), con elíndice de Gleason >7 (r=0,306), con la invasión perineural(r=0,318), y con el PIN de alto grado (r=0,142) en las biopsias,y con el índice de Gleason >7 (r=0,357), con el PIN dealto grado (r=0,211), con la extensión extraprostática(r=0,480), y con la invasión de márgenes quirúrgicos(r=0,287), invasión perineural (r=0,847), y afectación delápex (r=0,307), en las prostatectomías. Conclusiones: Lainvasión de las vesículas seminales es un hallazgo frecuenteen las piezas de prostatectomía radical, incluso después deuna selección correcta de pacientes para cirugía (..) (AU)

Background: Seminal vesicle invasion is a finding ofbad prognosis in prostate cancer. Its discovery in radicalprostatectomies is accidental in most cases becausepatients with clinical or histological evidence of extraprostaticdisease are not surgically treated in most clinical protocols.Our aim is to quantify this finding in a homogeneousseries of radical prostatectomies and to correlate itwith core biopsy findings. Methods: Over an 8-year period(1998-2005), a total of 363 patients with prostate cancerunderwent radical prostatectomy at Basurto Hospital. Thecombination of clinical staging, PSA levels and core biopsydata indicated the candidates for surgery. Data obtainedin prostatectomies were correlated (Spearman’s rho) withseveral histological parameters in biopsies. Results: Radicalprostatectomies showed seminal vesicle invasion in 37cases (10.2%). Microscopic seminal vesicle invasion correlatedwith total millimetres of cancer (average 20 mm,r=0.397), number of tumour foci (average 3.8, r=0.383),bilateral invasion (r=0.256), Gleason Index (GI) >7(r=0.306), perineurial invasion (r=0.318), and high gradePIN (HGPIN) (r=0.142) in biopsies, and with GI >7(r=0.357), HGPIN (r=0.211), extraprostatic extension(r=0.480), and margin (r=0.287), perineurial (r=0.847),and apex (r=0.307) invasions, in prostatectomies. Conclusions:Seminal invasion is a frequent finding in prostatectomies,even after a correct selection of patients for surgery.This finding correlates to tumour volume parameters,bilateral invasion, and other morphologic parameters ofbad prognosis in prostate cancer (AU)

Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/complicações , Invasividade Neoplásica/patologia , Glândulas Seminais/patologia , Neoplasias da Próstata/cirurgia , Prognóstico
Rev. esp. patol ; 41(3): 211-214, jul.-sept. 2008. ilus
Artigo em Espanhol | IBECS | ID: ibc-76724


Caso clínico: Se presenta el caso de un paciente de 78años de edad al que se descubren dos neoplasias epitelialesindependientes y sincrónicas en el mismo riñón El tumordominante, el que llevó al paciente al médico y por el cualse realizó la nefrectomía corresponde a un carcinoma decélulas claras típico. El tumor secundario, localizado a 4cm. del tumor principal, fue detectado en el estudio macroscópicode la pieza quirúrgica y corresponde a un carcinomade células cromófobas. El patrón de inmunohistoquímica esel característico y esperado en cada tumor, y confirma laespecificidad de cada uno de ellos. Discusión: Se revisa yse discute la literatura actual relacionada con la coexistenciade diversos tumores de la misma o de distinta estirpe histológicaen el riñón (AU)

Case report: A case of double, independent and synchronousrenal epithelial neoplasms occurring in a 78 yearoldman is reported. The main tumour, the one that led thepatient to consult and the cause of nephrectomy, is a typicalclear cell renal cell carcinoma. The secondary tumour,located 4 cm from the main tumour, was discovered in grossexam and corresponded to a chromophobe cell renal cellcarcinoma. Immunohistochemistry is the expected in suchtumours. Discussión: We review and discuss current literaturerelated to the coexistence of various tumours of thesame or different histological type in the kidney (AU)

Humanos , Masculino , Idoso , Neoplasias Renais/patologia , Neoplasias Primárias Múltiplas/patologia , Carcinoma/patologia , Neoplasias Renais/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Carcinoma/diagnóstico , Imuno-Histoquímica
Rev. esp. patol ; 41(2): 117-121, abr. -jun. 2008. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-68296


Antecedentes: El incremento en el diagnóstico del cáncer de próstata en la última década en nuestros hospitales ha llevado consigo un aumento similar en el número de prostatectomías radicales. En este trabajo se analizan las diferencias histológicas observadas entre los pacientes tratados con cirugía radical en los años 1999 y 2006 y se evalúa la evolución habida en la indicación de cirugía radical en un lapso de 7 años. Métodos: Se analizan de forma comparativa los datos histológicos de las prostatectomías radicales, y de sus biopsias transrectales previas, diagnosticadas en 1999 y en 2006. Sólo se han incluido en el análisis los casos con la totalidad de los datos evaluables tanto en la biopsia como en la cirugía. En las biopsias transrectales se valoran la afectación uni o bilateral, el número de focos de tumor, los milímetros totales de tumor, la presencia de PIN de alto grado, el índice de Gleason, y la invasión perineural. En las prostatectomías radicales se evalúa el estadio (pT), el índice de Gleason, la presencia de PIN de alto grado, la invasión de los bordes, la afectación del ápex, la invasión perineural y vascular, la extensión extraprostática, y la invasión de las vesículas seminales. El estudio estadístico comparativo entre ambos grupos se realiza mediante pruebas de c2, t de Student, y Mann-Whitney. Resultados: El estudio incluye 24 prostatectomías radicales de 1999 y 50 de 2006. El pT es significativamente más bajo en 2006 que en 1999 (p=0,032). Asimismo, hay mayor número de carcinomas organo-confinados en 2006 (p=0,034). Además, la extensión extraprostática del cáncer y la invasión de vesículas seminales son significativamente menores en 2006 (p=0,090 y p=0,011, respectivamente). Conclusiones: En 2006, entre los pacientes que han sido tratados con cirugía radical, se observa una disminución significativa en el estadio tumoral. El número de casos con extensión extraprostática y con invasión de vesículas seminales es, asimismo, menor

Background: The increase in number of prostate cancer diagnoses in the last decade is accompanied by a similar increase in the number of radical prostatectomy specimens. We analyse the histological differences between patients treated with radical surgery in 1999 and in 2006. The evolution in the indications for surgery is also evaluated. Methods: Histological data in core biopsies and radical prostatectomies of cases diagnosed in 1999 and 2006 have been compared. Only cases with complete histological information have been included in the study. Bi/unilateral tumour invasion, number of tumour foci, total millimetres of cancer, high-grade PIN, Gleason index, and perineurial invasion have been evaluated in core biopsies. Pathological staging, Gleason index, high-grade PIN, margin status, apex invasion, perineurial and vascular permeation, extraprostatic extension and seminal vesicle invasion have been analysed in radical prostatectomies. The statistical study included c2, Student’s t, and Mann-Whitney test. Results: The study includes 24 radical prostatectomies in 1999 and 50 in 2006. The pathological staging is significantly lower in 2006 than in 1999 (p=0.032). Similarly, organ-confined disease is more frequent in 2006 (p=0.034). Extraprostatic extension and seminal vesicle invasion by prostate adenocarcinoma are significantly lower in 2006 (p=0.090 y p=0.011, respectively). Conclusions: Prostate adenocarcinoma patients treated with radical surgery in 2006 are at a lower stage compared with 1999 cases

Humanos , Masculino , Neoplasias da Próstata/patologia , Biópsia/estatística & dados numéricos , Prostatectomia/estatística & dados numéricos , Prostatectomia/métodos , Hiperplasia Prostática/patologia , Antígeno Prostático Específico , Ressecção Transuretral da Próstata , Biópsia/métodos
Head Neck Pathol ; 2(2): 83-91, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20614328


Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive variant of cancer that mainly arises in the upper aerodigestive tract. This study reviews the clinico-pathological features and follow-up of a series of cases occurring in the head and neck. During a 32-year period (1974-2005), a total of 40 BSCCs have been diagnosed in the head and neck in our Institution. Males predominated in the series (35M/5F). The average age was 60.2 years (range, 40-85). Tobacco and alcohol consumption was found in more than 80% of the cases. Topographic distribution was as follows: larynx and hypopharynx, 22 cases (55%); oropharynx, 12 cases (30%); and oral cavity 6 cases (15%). The basaloid component predominated in 29 cases (72.5%). Vasculo-lymphatic invasion was detected in 5 cases (12.5%). Lymph node metastases were seen in 25 cases (62.5%, levels II and III in the neck dissection). Local recurrences appeared in 11 cases (27.5%) and distant metastases in 6 (15%). In 7 cases (17.5%) a second primary tumour was detected. The 2002 TNM staging was as follows: Stage I, 5 cases (12.5%); Stage II, 7 cases (17.5%); Stage III, 8 cases (20%), and Stage IV, 20 cases (50%). On follow-up, 21 cases (52.5%) are alive and 19 (47.5%) died of disease. Three- and 5-year overall survival was 50% and 38.5%, respectively. A significant shorter survival was detected in node positive patients (P<0.05).

Carcinoma Basoescamoso/diagnóstico , Neoplasias Bucais/diagnóstico , Neoplasias Otorrinolaringológicas/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Basoescamoso/mortalidade , Carcinoma Basoescamoso/secundário , Feminino , Humanos , Neoplasias Hipofaríngeas/diagnóstico , Neoplasias Hipofaríngeas/mortalidade , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/mortalidade , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/mortalidade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Neoplasias Primárias Múltiplas , Neoplasias Orofaríngeas/diagnóstico , Neoplasias Orofaríngeas/mortalidade , Neoplasias Otorrinolaringológicas/mortalidade , Taxa de Sobrevida