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2.
Curr Urol Rep ; 20(10): 59, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31478111

RESUMO

PURPOSE OF REVIEW: The purpose of this review is to summarize the most current literature regarding the most important aspects to consider when developing a center of excellence for prostate imaging and biopsy. RECENT FINDINGS: Multiparametric MRI (mp-MRI) has changed the way we diagnose and treat prostate cancer. This imaging modality allows for more precise identification of areas suspicious in terms of harboring prostate cancer, enabling performance of targeted mp-MRI-guided biopsies that have been demonstrated to yield superior cancer detection rates. Centers worldwide are increasingly adopting this technology. However, obtaining results comparable with those findings published in the literature can be challenging. The imaging and biopsy process entails the need for a multidisciplinary team including a dedicated radiologist, urologist, and pathologist. Adequate mp-MRI interpretation for accurate lesion identification, acquaintance with the biopsy technique selected, and precise characterization of Gleason Score/Grade Groupings are equal determinants of accurate biopsy results. Furthermore, all specialists are required to attain appropriate learning curves to ensure optimal results. In this review, we characterize crucial aspects to consider when developing a center of excellence for prostate imaging and biopsy as well as insights regarding how to implement them.


Assuntos
Instalações de Saúde/normas , Biópsia Guiada por Imagem/normas , Imagem por Ressonância Magnética/métodos , Neoplasias da Próstata/diagnóstico por imagem , Biópsia/métodos , Biópsia/normas , Humanos , Biópsia Guiada por Imagem/métodos , Curva de Aprendizado , Masculino , Gradação de Tumores , Equipe de Assistência ao Paciente/normas , Desenvolvimento de Programas/normas , Neoplasias da Próstata/patologia , Estados Unidos
3.
Front Immunol ; 10: 1394, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31281317

RESUMO

In colorectal cancer (CRC), cancer-associated fibroblasts (CAFs) are the most abundant component from the tumor microenvironment (TM). CAFs facilitate tumor progression by inducing angiogenesis, immune suppression and invasion, thus altering the organization/composition of the extracellular matrix (i.e., desmoplasia) and/or activating epithelial-mesenchymal transition (EMT). Soluble factors from the TM can also contribute to cell invasion through secretion of cytokines and recently, IL-33/ST2 pathway has gained huge interest as a protumor alarmin, promoting progression to metastasis by inducing changes in TM. Hence, we analyzed IL-33 and ST2 content in tumor and healthy tissue lysates and plasma from CRC patients. Tissue localization and distribution of these molecules was evaluated by immunohistochemistry (using localization reference markers α-smooth muscle actin or α-SMA and E-cadherin), and clinical/histopathological information was obtained from CRC patients. In vitro experiments were conducted in primary cultures of CAFs and normal fibroblasts (NFs) isolated from tumor and healthy tissue taken from CRC patients. Additionally, migration and proliferation analysis were performed in HT29 and HCT116 cell lines. It was found that IL-33 content increases in left-sided CRC patients with lymphatic metastasis, with localization in tumor epithelia associated with abundant desmoplasia. Although ST2 content showed similarities between tumor and healthy tissue, a decreased immunoreactivity was observed in left-sided tumor stroma, associated to metastasis related factors (advanced stages, abundant desmoplasia, and presence of tumor budding). A principal component analysis (including stromal and epithelial IL-33/ST2 and α-SMA immunoreactivity with extent of desmoplasia) allowed us to distinguish clusters of low, intermediate and abundant desmoplasia, with potential to develop a diagnostic signature with benefits for further therapeutic targets. IL-33 transcript levels from CAFs directly correlated with CRC cell line migration induced by CAFs conditioned media, with rhIL-33 inducing a mesenchymal phenotype in HT29 cells. These results indicate a role of IL-33/ST2 in tumor microenvironment, specifically in the interaction between CAFs and epithelial tumor cells, thus contributing to invasion and metastasis in left-sided CRC, most likely by activating desmoplasia.

4.
Cell Adh Migr ; 13(1): 33-40, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30160193

RESUMO

Neuroblastoma (NB) is the most common pediatric extracranial solid tumor. It arises during development of the sympathetic nervous system. Netrin-4 (NTN4), a laminin-related protein, has been proposed as a key factor to target NB metastasis, although there is controversy about its function. Here, we show that NTN4 is broadly expressed in tumor, stroma and blood vessels of NB patient samples. Furthermore, NTN4 was shown to act as a cell adhesion molecule required for the migration induced by Neogenin-1 (NEO1) in SK-N-SH neuroblastoma cells. Therefore, we propose that NTN4, by forming a ternary complex with Laminin γ1 (LMγ1) and NEO1, acts as an essential extracellular matrix component, which induces the migration of SK-N-SH cells.

5.
Cancer Immunol Immunother ; 67(12): 1897-1910, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29600445

RESUMO

Immunotherapy based on checkpoint blockers has proven survival benefits in patients with melanoma and other malignancies. Nevertheless, a significant proportion of treated patients remains refractory, suggesting that in combination with active immunizations, such as cancer vaccines, they could be helpful to improve response rates. During the last decade, we have used dendritic cell (DC) based vaccines where DCs loaded with an allogeneic heat-conditioned melanoma cell lysate were tested in a series of clinical trials. In these studies, 60% of stage IV melanoma DC-treated patients showed immunological responses correlating with improved survival. Further studies showed that an essential part of the clinical efficacy was associated with the use of conditioned lysates. Gallbladder cancer (GBC) is a high-incidence malignancy in South America. Here, we evaluated the feasibility of producing effective DCs using heat-conditioned cell lysates derived from gallbladder cancer cell lines (GBCCL). By characterizing nine different GBCCLs and several fresh tumor tissues, we found that they expressed some tumor-associated antigens such as CEA, MUC-1, CA19-9, Erb2, Survivin, and several carcinoembryonic antigens. Moreover, heat-shock treatment of GBCCLs induced calreticulin translocation and release of HMGB1 and ATP, both known to act as danger signals. Monocytes stimulated with combinations of conditioned lysates exhibited a potent increase of DC-maturation markers. Furthermore, conditioned lysate-matured DCs were capable of strongly inducing CD4+ and CD8+ T cell activation, in both allogeneic and autologous cell co-cultures. Finally, in vitro stimulated CD8+ T cells recognize HLA-matched GBCCLs. In summary, GBC cell lysate-loaded DCs may be considered for future immunotherapy approaches.


Assuntos
Vacinas Anticâncer/imunologia , Vacinas Anticâncer/uso terapêutico , Neoplasias da Vesícula Biliar/terapia , Animais , Antígenos de Neoplasias/imunologia , Biomarcadores , Vacinas Anticâncer/efeitos adversos , Linhagem Celular Tumoral , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Neoplasias da Vesícula Biliar/genética , Neoplasias da Vesícula Biliar/imunologia , Neoplasias da Vesícula Biliar/metabolismo , Regulação da Expressão Gênica , Resposta ao Choque Térmico , Humanos , Imunoterapia/efeitos adversos , Imunoterapia/métodos , Ativação Linfocitária/genética , Ativação Linfocitária/imunologia , Macrófagos/imunologia , Macrófagos/metabolismo , Monócitos/imunologia , Monócitos/metabolismo , Linfócitos T/imunologia , Linfócitos T/metabolismo
6.
Rev Med Chil ; 145(8): 1021-1027, 2017 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-29189860

RESUMO

BACKGROUND: 99mTc-sestamibi parathyroid SPECT scintigraphy is a useful tool in the pre-operative study of hyperparathyroidism. False negatives (FN) have been reported in 5.7-14% of the examinations. AIM: To characterize 99mTc-sestamibi FN in cases referred for primary hyperparathyroidism (PHP) to a university hospital. MATERIAL AND METHODS: Descriptive retrospective analysis. We included patients with PHP, studied with SPECT scintigraphy, operated at our center between 2008 and 2015. Clinical and surgical data were recorded; biopsies of the FN were blindly reviewed by one pathologist. RESULTS: One hundred twenty one scintigraphies fulfilled the inclusion criteria. Seven (5.8%) were negative and 114 positive. There was no difference in age, sex and PTH levels between FN and true positive scintigraphies. At surgery, one FN case had two hyperplasic glands and two cases had ectopic glands. Pathology reported adenoma in three cases, hyperplasia in three and carcinoma in one. The largest diameter of the lesion was lower in FN (1.3 and 2.1 cm respectively, p = 0.02) and the proportion of adenomas was higher in true positive cases (29% and 75% respectively; p < 0.01). The interval between scintigraphy and parathyroidectomy was greater in FN with a median of 92 days (range 20 days-3.2 years, p < 0.01). The percentage of oxyphilic cells observed was similar in both groups. CONCLUSIONS: FN parathyroid SPECT scintigraphies in PHP are uncommon. They corresponded to lesions under the equipment's resolution limit and resulted in longer time lags between scintigraphy and surgery.


Assuntos
Hiperparatireoidismo Primário/diagnóstico por imagem , Glândulas Paratireoides/diagnóstico por imagem , Compostos Radiofarmacêuticos , Tecnécio Tc 99m Sestamibi , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Adenoma/diagnóstico por imagem , Adenoma/patologia , Adulto , Idoso , Carcinoma/diagnóstico por imagem , Carcinoma/patologia , Reações Falso-Negativas , Feminino , Humanos , Hiperparatireoidismo Primário/patologia , Hiperplasia/diagnóstico por imagem , Hiperplasia/patologia , Masculino , Pessoa de Meia-Idade , Glândulas Paratireoides/patologia , Neoplasias das Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides/patologia , Padrões de Referência , Valores de Referência , Estudos Retrospectivos , Estatísticas não Paramétricas
7.
Oncotarget ; 8(48): 84006-84018, 2017 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-29137400

RESUMO

Basal Cell Carcinoma (BCC) is one of the most diagnosed cancers worldwide. It develops due to an unrestrained Sonic Hedgehog (SHH) signaling activity in basal cells of the skin. Certain subtypes of BCC are more aggressive than others, although the molecular basis of this phenomenon remains unknown. We have previously reported that Neogenin-1 (NEO1) is a downstream target gene of the SHH/GLI pathway in neural tissue. Given that SHH participates in epidermal homeostasis, here we analyzed the epidermal expression of NEO1 in order to identify whether it plays a role in adult epidermis or BCC. We describe the mRNA and protein expression profile of NEO1 and its ligands (Netrin-1 and RGMA) in human and mouse control epidermis and in a broad range of human BCCs. We identify in human BCC a significant positive correlation in the levels of NEO1 receptor, NTN-1 and RGMA ligands with respect to GLI1, the main target gene of the canonical SHH pathway. Moreover, we show via cyclopamine inhibition of the SHH/GLI pathway of ex vivo cultures that NEO1 likely functions as a downstream target of SHH/GLI signaling in the skin. We also show how Neo1 expression decreases throughout BCC progression in the K14-Cre:Ptch1lox/lox mouse model and that aggressive subtypes of human BCC exhibit lower levels of NEO1 than non-aggressive BCC samples. Taken together, these data suggest that NEO1 is a SHH/GLI target in epidermis. We propose that NEO1 may be important in tumor onset and is then down-regulated in advanced BCC or aggressive subtypes.

8.
Rev. méd. Chile ; 145(8): 1021-1027, ago. 2017. tab, graf
Artigo em Espanhol | LILACS-Express | ID: biblio-902580

RESUMO

Background: 99mTc-sestamibi parathyroid SPECT scintigraphy is a useful tool in the pre-operative study of hyperparathyroidism. False negatives (FN) have been reported in 5.7-14% of the examinations. Aim: To characterize 99mTc-sestamibi FN in cases referred for primary hyperparathyroidism (PHP) to a university hospital. Material and Methods: Descriptive retrospective analysis. We included patients with PHP, studied with SPECT scintigraphy, operated at our center between 2008 and 2015. Clinical and surgical data were recorded; biopsies of the FN were blindly reviewed by one pathologist. Results: One hundred twenty one scintigraphies fulfilled the inclusion criteria. Seven (5.8%) were negative and 114 positive. There was no difference in age, sex and PTH levels between FN and true positive scintigraphies. At surgery, one FN case had two hyperplasic glands and two cases had ectopic glands. Pathology reported adenoma in three cases, hyperplasia in three and carcinoma in one. The largest diameter of the lesion was lower in FN (1.3 and 2.1 cm respectively, p = 0.02) and the proportion of adenomas was higher in true positive cases (29% and 75% respectively; p < 0.01). The interval between scintigraphy and parathyroidectomy was greater in FN with a median of 92 days (range 20 days-3.2 years, p < 0.01). The percentage of oxyphilic cells observed was similar in both groups. Conclusions: FN parathyroid SPECT scintigraphies in PHP are uncommon. They corresponded to lesions under the equipment's resolution limit and resulted in longer time lags between scintigraphy and surgery.

9.
Infect Agent Cancer ; 10: 27, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26330890

RESUMO

BACKGROUND: A few viruses have been detected in prostate cancer, however their role in the development of this malignancy has not been determined. The aim of this study was to analyze the presence and functionality of human papillomavirus (HPV) and polyomaviruses (BKPyV and JCPyV) in prostate carcinomas in Chilean patients. METHODS: Sixty-nine primary prostate carcinomas were analyzed for the presence of HPV, BKPyV and JCPyV using standard polymerase chain reaction protocols. In addition, when samples were positive for HPyV, large T antigen (TAg) transcripts were analyzed using reverse transcriptase PCR. RESULTS: HPV and JCPyV were not detected in any specimens (0/69, 0 %); whereas, BKPyV was detected in 6/69 PCas (8.7 %). We did not find a statistically significant association between the presence of BKPyV and age (p = 0.198) or Gleason score (p = 0.268). In addition, 2/6 (33 %) BKPyV positive specimens showed detectable levels of TAg transcripts. CONCLUSIONS: There was no association between HPV or JCPyV presence and prostate cancer development. The presence of BKPyV in a small subset of prostate carcinomas in Chilean patients could indicate that this virus plays a potential role in prostate cancer development and requires further investigation.

11.
Int J Oncol ; 44(3): 647-54, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24424718

RESUMO

Prostate cancer (PC) is a leading male oncologic malignancy wideworld. During malignant transformation, normal epithelial cells undergo genetic and morphological changes known as epithelial-mesenchymal transition (EMT). Several regulatory genes and specific marker proteins are involved in PC EMT. Recently, syndecans have been associated with malignancy grade and Gleason score in PC. Considering that SNAIL is mainly a gene repressor increased in PC and that syndecan promoters have putative binding sites for this repressor, we propose that SNAIL might regulate syndecan expression during PC EMT. The aim of this study was to analyze immunochemically the expression of SNAIL, syndecans 1 and 2 and other EMT markers in a tissue microarray (TMA) of PC samples and PC cell lines. The TMAs included PC samples of different Gleason grade and benign prostatic hyperplasia (BPH) samples, as non­malignant controls. PC3 and LNCaP cell lines were used as models of PC representing different tumorigenic capacities. Semi-quantitative immunohistochemistry was performed on TMAs and fluorescence immunocytochemistry and western blot analysis were conducted on cell cultures. Results show that SNAIL exhibits increased expression in high Gleason specimens compared to low histological grade and BPH samples. Accordingly, PC3 cells show higher SNAIL expression levels compared to LNCaP cells. Conversely, syndecan 1, similarly to E-cadherin (a known marker of EMT), shows a decreased expression in high Gleason grades samples and PC3 cells. Interestingly, syndecan 2 shows no changes associated to histological grade. It is concluded that increased SNAIL levels in advanced PC are associated with low expression of syndecan 1. The mechanism by which SNAIL regulates the expression of syndecan 1 remains to be investigated.


Assuntos
Neoplasias da Próstata/genética , Sindecana-1/biossíntese , Sindecana-2/biossíntese , Fatores de Transcrição/biossíntese , Animais , Linhagem Celular Tumoral , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Gradação de Tumores , Hiperplasia Prostática/genética , Hiperplasia Prostática/patologia , Neoplasias da Próstata/patologia , Fatores de Transcrição da Família Snail , Sindecana-1/metabolismo , Sindecana-2/metabolismo , Análise Serial de Tecidos , Fatores de Transcrição/metabolismo
12.
Rev. otorrinolaringol. cir. cabeza cuello ; 74(2): 151-154, 2014. ilus
Artigo em Espanhol | LILACS | ID: lil-726166

RESUMO

Los pólipos linfangiomatosos son malformaciones congénitas de tipo hamartomatosas caracterizados histológicamente por una proliferación linfática vascular con distintos grados de componente fibroso, adiposo y linfático, cubiertos por un epitelio escamoso. Dado a que se conocen por distintos nombres en la literatura, sólo se han descrito alrededor de 30 casos de pólipos linfagiomatosos como tal. De etiopatogenia desconocida, se presentan como una masa polipoidea o papilomatosa en las amígdalas palatinas, con sintomatología variable. Su diagnóstico definitivo es histológico tras una resección completa. No se han reportado casos de malignización ni recurrencia. En el presente trabajo se reporta el caso de un paciente de 5 años con historia de crecimiento amigdalino bilateral de dos años de evolución. La biopsia definitiva demuestra una poliposis linfangiomatosa de amígdalas palatinas y adenoides.


Lymphangiomatous polyps are hamartomatous congenital malformations. They are histologically characterized by a vascular lymphatic proliferation associated with fibrous, adipose and lymphatic components covered by squamous epithelium. There are only 30 cases described in the literature by the name of lymphangiomatous polyp, since it has multiple denominations. Even though their etiopathogenesis is unknown, their clinical presentation is described as a polypoid mass in the palatine tonsils, which may have multiple manifestations. The diagnosis is made histologically after complete resection. There have not been reports of malignant transformation nor recurrence. We present a case of a five year old patient with history of bilateral palatine tonsil growth. Final biopsy described lymphangiomatous polyps of adenoids and palatine tonsils.


Assuntos
Humanos , Masculino , Pré-Escolar , Hamartoma/patologia , Hamartoma/cirurgia , Tonsila Palatina/patologia , Tonsila Palatina/cirurgia , Adenoidectomia , Tonsila Faríngea/patologia , Tonsila Faríngea/cirurgia , Pólipos/patologia , Tonsilectomia
13.
Rev. chil. urol ; 78(2): 71-75, ago. 2013. graf
Artigo em Espanhol | LILACS | ID: lil-774060

RESUMO

Introducción: La infertilidad masculina afecta aproximadamente al 7por ciento de los hombres, presentándose hasta el 15 por ciento de ellos con azoospermia. El conocimiento del tipo de azoospermia (obstructiva o no obstructiva) y la localización de la falla (pre-testicular, testicular o post-testicular) es vital para conocer el pronóstico de fertilidad de la pareja y plantear un plan terapéutico adecuado. Actualmente, la extracción de espermatozoides desde epidídimo o testículo de pacientes azoospérmicos, y la posterior inyección intracitoplásmática de éstos (ICSI, por sus siglas en inglés) ha permitido obtener embriones viables para su posterior transferencia. Materiales y métodos: Estudio descriptivo retrospectivo de 42 parejas infértiles con diagnóstico de azoospermia; que se sometieron a biopsia testicular, ICSI y posterior transferencia de embriones, entre los años 2004 y 2012. Se lleva a cabo un análisis de la edad de los pacientes, resultados de la histopatología testicular y su asociación con los resultados de la fertilización asistida. Resultados: 42 pacientes azoospérmicos se sometieron a biopsia testicular y extracción de espermatozoides en el mismo acto quirúrgico. La edad promedio de los pacientes fue de 36 años para los hombres y 32 años para las mujeres. En el análisis histológico de los tejidos testiculares, el 31por ciento de los pacientes presentaban espermatogénesis conservada (EC), el 35.7 por ciento atrofia mixta (AM), el 14.3 por ciento hipoespermatogénesis (HE), el 14.3 por ciento detención de la maduración (DM) y un 4.8 por ciento presentaba otras histologías. Lograron embarazo clínico 14 de 42 parejas (33,3 por ciento), siendo la tasa de embarazo específica por patología de 38,5 por ciento para EC, 26.7 por ciento para AM, 50 por ciento para HE, 16,7 por ciento para DM y 50 por ciento para las otras histologías. 12 de las 42 parejas realizaron más de un ciclo de transferencias...


Introduction: Male infertility affects approximately 7percent of men, presenting up to 15 percent with azoospermia. Knowing the type of azoospermia (obstructive or non-obstructive) and the location of the problem (pre-testicular, testicular and post-testicular) is vital to recognize the fertility prognosis of the couple and present a proper treatment plan. Currently, the extraction of sperm from epididymis or testis of azoospermic patients, and subsequent intracytoplasmic sperm injection (ICSI) has yielded viable embryos for transfer. Materials and Methods: Retrospective study of 42 infertile couples diagnosed with azoospermia, who underwent testicular biopsy, ICSI and subsequent embryo transfer, between 2004 and 2012. We performed an analysis of the patients’ age, testicular histopathology results and their association with assisted fertilization outcome. Results: 42 azoospermic patients underwent testicular biopsy and sperm extraction in the same surgery. The average age of patients was 36 years for men and 32 years for women. Histologic analysis of testicular tissue showed that 31 percent of patients had normal spermatogenesis (NS), 35.7 percent mixed atrophy (MA), 14.3 percent hypospermatogenesis (HS), 14.3 percent maturation arrest (MTA) and 4.8 percent had other histologies. 14 of 42 couples achieved clinical pregnancy (33.3 percent), with a specific pregnancy rate of 38.5 percent for NS, 26.7 percent for MA, 50 percent for HS, 16.7 percent for MTA and 50 percent for other histologies. 12 of 42 couples underwent more than one transfer cycle. Conclusions: The use of ICSI is a suitable alternative for infertile couples with severe male factor. The results of this technique are favorable for most histologies. Patients with MA exhibit sertoli solo syndrome and / or tubular sclerosis foci associated to regions with normal spermatogenesis, enabling the sperm extraction for ICSI.


Assuntos
Humanos , Masculino , Adulto , Feminino , Gravidez , Azoospermia/terapia , Infertilidade Masculina/terapia , Taxa de Gravidez , Injeções de Esperma Intracitoplásmicas , Azoospermia/patologia , Biópsia , Fertilização , Infertilidade Masculina/patologia , Técnicas de Reprodução Assistida , Estudos Retrospectivos , Espermatogênese , Testículo/patologia
14.
Rev Chilena Infectol ; 29(4): 455-8, 2012 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-23096550

RESUMO

Actinomycosis is an infrequent infection caused by bacteria from Actinomyces genus that manifests as a chronic, suppurative and progressive disease. It's more common in men. Thoracic actinomycosis occurs in 15% of the cases, and infection of the chest wall is less frequent. The clinical presentation mimics tuberculosis or neoplastic processes. In this article we present the case of a 63 year-old man with no comorbidity, with pulmonary actinomycosis involving the chest wall mimicking a neoplastic process, basing the diagnosis on histopathologic findings.


Assuntos
Actinomicose/diagnóstico , Neoplasias Pulmonares/diagnóstico , Infecções Respiratórias/diagnóstico , Actinomicose/microbiologia , Diagnóstico Diferencial , Humanos , Pulmão/microbiologia , Masculino , Pessoa de Meia-Idade , Infecções Respiratórias/microbiologia , Parede Torácica/microbiologia
15.
Arch Esp Urol ; 65(7): 713-6, 2012 Sep.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-22971770

RESUMO

OBJECTIVE: To report an unusual case of renal tumor and review the literature. METHODS: We present a 20 years old female with a history of acute right pyelonephritis. The ultrasound study revealed a tumor-like image in the lower pole of the right kidney . The CT-scan showed a mixed solid and cystic mass of 7 cm. in the lower pole of the right kidney. RESULTS: A right laparoscopic partial nephrectomy was performed. The total operative time was 90 minutes, with 24 minutes of warm ischemia. The estimated blood loss was 50 ml. and the length of stay (LOS) 36 hours. The pathology findings confirm a mixed epithelial and stromal tumor (MEST) of the kidney. CONCLUSION: Mixed epithelial and stromal tumor (MEST) of the kidney is a benign and rare condition that doesn't show a clear difference with other renal tumors in image studies. Nephron-sparing surgery with margin study is the standard treatment when is feasible.


Assuntos
Carcinoma/patologia , Neoplasias Renais/patologia , Neoplasias Complexas Mistas/patologia , Células Estromais/patologia , Carcinoma/cirurgia , Feminino , Humanos , Neoplasias Renais/cirurgia , Neoplasias Complexas Mistas/cirurgia , Nefrectomia , Pielonefrite/diagnóstico por imagem , Pielonefrite/etiologia , Pielonefrite/patologia , Tomografia Computadorizada por Raios X , Ultrassonografia , Adulto Jovem
16.
Arch. esp. urol. (Ed. impr.) ; 65(7): 713-716, sept. 2012. ilus
Artigo em Espanhol | IBECS | ID: ibc-102684

RESUMO

OBJETIVO: Reportar el caso de un tumor renal infrecuente y revisión de la literatura. MÉTODOS: Presentamos una paciente de sexo femenino de 20 años de edad con antecedente de pielonefritis aguda derecha y que en estudio ecográfico se constató una imagen de aspecto tumoral en polo inferior del riñón derecho interpretada en primera instancia como teratoma. La tomografía computada mostró una masa solido-quística de 7 cm. de diámetro en polo inferior renal derecho. RESULTADOS: Se realizó una nefrectomía parcial laparoscópica en un tiempo operatorio de 90 minutos y de isquemia caliente de 24 minutos. El sangrado estimado fue de 50 ml. y la estadia hospitalaria fue de 36 horas. El estudio histopatológico informó un tumor benigno estromal-epitelial de riñón. CONCLUSIÓN: El tumor benigno estromal-epitelial (MEST) de riñón es una entidad rara que no presenta una clara diferencia con otros tumores renales en el preoperatorio. Corresponde a un hallazgo en el estudio histológico. La cirugía conservadora es el tratamiento estándar siempre que sea factible de realizar (AU)


OBJECTIVE: To report an unusual case of renal tumor and review the literature. METHODS: We present a 20 years old female with a history of acute right pyelonephritis. The ultrasound study revealed a tumor-like image in the lower pole of the right kidney . The CT-scan showed a mixed solid and cystic mass of 7 cm. in the lower pole of the right kidney. RESULTS: A right laparoscopic partial nephrectomy was performed. The total operative time was 90 minutes, with 24 minutes of warm ischemia. The estimated blood loss was 50 ml. and the length of stay (LOS) 36 hours. The pathology findings confirm a mixed epithelial and stromal tumor (MEST) of the kidney. CONCLUSION: Mixed epithelial and stromal tumor (MEST) of the kidney is a benign and rare condition that doesn’t show a clear difference with other renal tumors in image studies. Nephron-sparing surgery with margin study is the standard treatment when is feasible (AU)


Assuntos
Humanos , Feminino , Adulto Jovem , Tumor Misto Maligno/diagnóstico , Neoplasias Renais/diagnóstico , Pielonefrite/etiologia , Nefrectomia , Células Estromais/patologia , Células Epiteliais/patologia
17.
Rev. méd. Chile ; 140(9): 1116-1125, set. 2012. ilus
Artigo em Espanhol | LILACS | ID: lil-660068

RESUMO

Background: The usefulness of positron emission tomography (PET) with fluorine-deoxyglucose (FDG) in sarcomas and non-sarcoma non-epithelial (NSNE) tumors is not clearly defined. Aim: To report a Chilean experience with NSNE tumors evaluated using PET with FDG. Material and Methods: Retrospective review of the database of a PET laboratory. Demographic data, indications and metabolic findings were compared with conventional imaging in 88 adults and children with diverse bone and soft tissue sarcomas as well as 24 gastrointestinal stromal tumors (GIST), 6 pleural malignant mesotheliomas in adults, and 9 medulloblastomas in children. Results: FDG showed good concordance with conventional imaging in NSNE tumors. It was helpful for staging, restaging, follow-up after treatment and for the detection of new not previously suspected lesions. Conclusions: PET with FDG could have a prognostic role and help in patient management, mainly in musculos-keletal and high grade or less differentiated sarcomas. In GIST, it was a good tool for immunotherapy control.


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Neoplasias , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Sarcoma , Estudos Retrospectivos
18.
Rev. chil. infectol ; 29(4): 455-458, ago. 2012. ilus
Artigo em Espanhol | LILACS | ID: lil-649832

RESUMO

Actinomycosis is an infrequent infection caused by bacteria from Actinomyces genus that manifests as a chronic, suppurative and progressive disease. It's more common in men. Thoracic actinomycosis occurs in 15% of the cases, and infection of the chest wall is less frequent. The clinical presentation mimics tuberculosis or neoplastic processes. In this article we present the case of a 63 year-old man with no comorbidity, with pulmonary actinomycosis involving the chest wall mimicking a neoplastic process, basing the diagnosis on histopathologic findings.


La actinomicosis es una infección poco común causada por bacterias del género Actinomyces que se manifiesta como una enfermedad crónica, supurativa y progresiva. Es más frecuente en hombres. La actinomicosis torácica se presenta en 15% de los casos, siendo el compromiso de pared torácica aún menos frecuente. La presentación clínica simula procesos neoplásicos o tuberculosis. Se describe el caso de un hombre de 63 años, sin co-morbilidad, con una actinomicosis pulmonar con compromiso de pared torácica que simuló ser un proceso neoplásico. El diagnóstico fue confirmado por los hallazgos histopatológicos.


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Actinomicose/diagnóstico , Neoplasias Pulmonares/diagnóstico , Infecções Respiratórias/diagnóstico , Actinomicose/microbiologia , Diagnóstico Diferencial , Pulmão/microbiologia , Infecções Respiratórias/microbiologia , Parede Torácica/microbiologia
19.
Rev Med Chil ; 140(9): 1116-25, 2012 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-23354632

RESUMO

BACKGROUND: The usefulness of positron emission tomography (PET) with fluorine-deoxyglucose (FDG) in sarcomas and non-sarcoma non-epithelial (NSNE) tumors is not clearly defined. AIM: To report a Chilean experience with NSNE tumors evaluated using PET with FDG. MATERIAL AND METHODS: Retrospective review of the database of a PET laboratory. Demographic data, indications and metabolic findings were compared with conventional imaging in 88 adults and children with diverse bone and soft tissue sarcomas as well as 24 gastrointestinal stromal tumors (GIST), 6 pleural malignant mesotheliomas in adults, and 9 medulloblastomas in children. RESULTS: FDG showed good concordance with conventional imaging in NSNE tumors. It was helpful for staging, restaging, follow-up after treatment and for the detection of new not previously suspected lesions. CONCLUSIONS: PET with FDG could have a prognostic role and help in patient management, mainly in musculoskeletal and high grade or less differentiated sarcomas. In GIST, it was a good tool for immunotherapy control.


Assuntos
Fluordesoxiglucose F18 , Neoplasias/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Sarcoma/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
20.
Biol Res ; 45(3): 297-305, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23283439

RESUMO

Prostate cancer (PCa) is the most frequently diagnosed malignancy in men worldwide. Chemotherapy response is very poor and resistance to hormone-based treatments is frequent in advances stages. Recently, tumor-initiating cells or cancer stem cells (CSCs) have been identified in several cancers, including PCa. These cells are thought to be responsible for therapy resistance, relapse and metastasis. In the present work, enriched populations of CSCs were obtained using a mixed procedure that included differential clone-forming ability, sphere growing induction (prostatospheres) and magnetic-associated cell sorting (MACS). Also, stem marker expression was determined in PCa biopsies of different histological grades and metastasis samples. The signature for stem markers of the isolated CSCs was CD133+/CD44+/ABCG2+/ CD24-. Expression of stem markers (CD133, CD44, and ABCG2) was higher in medium Gleason biopsies than in lower and higher grades, and lymph-node and bone metastasis samples. These results suggest that the CSCs in PCa reach an important number in medium Gleason grades, when the tumor is still confined into the gland. At this stage, the surgical treatment is usually with curative intention. However, an important percentage of patients relapse after treatment. Number and signature of CSCs may be a prognosis factor for PCa recurrence.


Assuntos
Antígenos CD/análise , Regulação Neoplásica da Expressão Gênica , Células-Tronco Neoplásicas/patologia , Neoplasias da Próstata/genética , Biomarcadores Tumorais/análise , Biópsia , Neoplasias Ósseas/secundário , Separação Celular , Humanos , Imuno-Histoquímica , Metástase Linfática/patologia , Masculino , Gradação de Tumores , Metástase Neoplásica , Recidiva Local de Neoplasia , Prognóstico , Neoplasias da Próstata/patologia , Ensaio Tumoral de Célula-Tronco
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