Metastasis of malignant pleural mesothelioma to the scalp following chemotherapy: A case report and review of the literature.

Malignant pleural mesothelioma is a neoplasm involving mesothelial cells of the pleura. Both local and distant metastases may develop, although the latter are less common and it is extremely rare for cutaneous metastases to appear as a solitary lesion on the scalp. We present the case of a 54-year-old woman with a 2-year history of unresectable left pleural mesothelioma treated with chemotherapy, who had developed a painful lump on the scalp one month prior to consultation. Skin metastases of mesothelioma must be differentiated from primary neoplasms, and immunohistochemistry is fundamental to determine the origin of such lesions, which can be correctly identified through the use of a panel of markers.

Immunohistochemical distribution of calcium binding proteins in the cochlear nuclear complex of circling mice / Distribución inmunohistoquímica de proteínas de unión a calcio en el complejo nuclear coclear de ratones circulantes

SUMMARY: The term "circling mouse" refers to an animal model of deafness, in which the mouse exhibits circling, head tossing, and hyperactivity, with pathological features including degenerated spiral ganglion cells in the cochlea, and the loss of the organ of Corti. The cochlear nuclear (CN) complex, a part of the auditory brain circuit, is essential to process both ascending and descending auditory information. Considering calcium's (Ca2+) importance in homeostasis of numerous biological processes, hearing loss by cochlear damage, either by ablation or genetic defect, could cause changes in the Ca2+ concentration that might trigger functional and structural alterations in the auditory circuit. However, little is known about the correlation of the central nervous system (CNS) pathology in circling mice, especially of the auditory pathway circuit and Ca2+ changes. This present study investigates the distribution of Ca2+- binding proteins (CaBPs), calbindin D-28k (CB), parvalbumin (PV), and calretinin (CR) by using a free floating immunohistochemical method inthe CN of the wild-type mouse (+/+), the heterozygous mouse (+/cir), and the homozygous (cir/cir) mouse. CaBPs are well known to be an important factor that regulates Ca2+ concentrations. Compared with the dorsal and ventral cochlear nuclei of +/+ and +/ cirmice, prominent decreases of CaBPs' immunoreactivity (IR) in cir/cirmice were observed in the somas, as well as in the neuropil. The present study reportson the overall distribution and changes in the immunoreactivity of CaBPs in the CN of cir/cirmice because ofa hearing defect. This data might be helpful to morphologically elucidate CNS disorders and their relation to CaBPs immunoreactivity related to hearing defects.

RESUMEN: El término "ratón circulante" se refiere a un modelo animal con sordera, en el que el ratón exhibe hiperactividad, movimientos circulares y movimientos de la cabeza, con características patológicas que incluyen células ganglionares espirales degeneradas en la cóclea, un canal de Rosenthal vacío y la pérdida del órgano de Corti. El complejo nuclear coclear (CN), una parte del circuito cerebral auditivo, es esencial para procesar la información auditiva tanto ascendente como descendente. Considerando la importancia del calcio (Ca2+) en la homeostasis de numerosos procesos biológicos, la hipoacusia por daño coclear, por ablación o por defecto genético, podría provocar cambios en la concentración de Ca2+que pueden desencadenar alteraciones funcionales y estructurales en el circuitoauditivo. Sin embargo, existe poca información de la correlación de la patología del sistema nervioso central (SNC) en ratones circulantes, especialmente del circuito de la víaauditiva y los cambios de Ca2+. Este estudio nvestiga la distribución de proteínas de unión a Ca2+ (CaBP), calbindina D-28k (CB), parvalbúmina (PV) y calretinina (CR) mediante el uso de un método inmunohistoquímico de flotaciónlibre en el CN del ratón de tiposalvaje (+/+), el ratón heterocigoto (+/cir) y el ratón homocigoto (cir/cir). Se sabe que los CaBP son un factor importante que regula las concentraciones de Ca2+. En comparación con los núcleos cocleares dorsal y ventral de los ratones +/+ y +/ cir, se observaron disminuciones prominentes de la inmunorreactividad (IR) de CaBPs en los ratonescir/cir en los somas, asícomo en el neuropilo. El presente estudio informa sobre la distribución general y los cambios en la inmunorreactividad de CaBP en el CN de ratones cir/cir debido a un defecto auditivo. Estos datos podrían ser útiles para dilucidar morfológicamente los trastornos del SNC y su relación con la inmunorreactividad de CaBP relacionada con los defectosauditivos.

Tumor adenomatoide pleural / Adenomatoid pleural tumor

Introduction: Adenomatoid tumors are rare benign neoplasms, pleural is a very rare location, reporting only 4 cases worldwide and none in our country. Case report: A 30 year-old female patient, that in the context of a preventive health examination, presents a mediastinal solid mass in the right hemithorax, in the thorax radiography. The lesion of 8 cm x 7 cm x 2.4 cm was surgically removed. Histology shows a lesion compatible with pleural adenomatoid tumor and inmunohistochemistry is positive for markers such as calretinin and cytokeratin 5/6. Discussion: The pleural adenomatoid tumor is an uncommon neoplasm with benign behavior and several differential diagnoses.

Introducción: Los tumores adenomatoides son neoplasias benignas poco frecuentes, cuya ubicación pleural es de muy baja frecuencia, reportándose sólo 4 casos a nivel mundial y ninguno nacional a la fecha. Las muestras parciales en biopsia intraoperaratoria, en ausencia de antecedentes clínico-radiológicos puede representar un desafío diagnóstico. Caso clínico: Paciente de sexo femenino, 30 años que en contexto de un examen preventivo de salud se pesquisa en la radiografía de tórax una masa sólida mediastínica en hemitórax derecho. Se extirpa lesión redondeada de 8 cm. La histología muestra lesión compatible con tumor adenomatoide pleural y la inmunohistoquímica positividad para marcadores Calretinina y Citoqueratina 5/6. Discusión: El tumor adenomatoide pleural en una entidad poco frecuente, de comportamiento benigno, con diversos diagnósticos diferenciales.

Desafios diagnósticos na doença de Hirschsprung: aplicabilidade de novos métodos imunohistoquímicos e endoscópicos / Challenges in the diagnosis in Hirschsprun's disease: applecability of a new immunohistochemical and endoscopic methods

A identificação pré-operatória da zona de transição na Doença de Hirschsprung (DH) tornou-se um passo fundamental para o planejamento cirúrgico, especialmente para a técnica de abaixamento endorretal transanal. O presente estudo tem como objetivo investigar prospectivamente o valor da determinação colonoscópica da zona de transição na avaliação pré-operatória dos pacientes com DH. A colonoscopia foi realizada em doze pacientes com diagnóstico de DH previamente confirmado pela manometria anorretal, enema opaco e biópsia de sucção do reto. Endoscopicamente, o primeiro local com ausência de peristaltismo foi identificado como o início da zona agangliônica. Pouco acima deste ponto, a zona de transição foi marcada através de uma tatuagem com tinta nanquim. Durante o abaixamento endorretal transanal, uma biópsia de congelação envolvendo a espessura total da parede foi sempre realizada. Os resultados da determinação colonoscópica da zona de transição foram comparados com os obtidos pelo enema opaco. A colonoscopia permitiu a identificação da zona de transição em todos os 12 casos (100%). O enema opaco revelou a presença da zona de transição em apenas 7 pacientes (58,3%). A análise das amostras de congelação, obtidas pouco acima das áreas endoscopicamente marcadas, revelou a presença de células ganglionares em todos os casos. A análise histopatológica das peças cirúrgicas confirmou o diagnóstico de DH em todos os casos, assim como a localização da zona de transição no mesmo local previamente tatuado endoscopicamente...

Preoperative identification of the transition zone in Hirschsprung’s disease (HD) has become an essential issue for surgical planning, especially for Transanal Endorectal Pull- Through (TEPT) procedure. The present study aimed to investigate prospectively, the value of endoscopic marking of the transition zone between normal and aganglionic bowel, as a landmark of the location of pull-through procedure for treatment of HD. Colonoscopy was performed on twelve patients with HD diagnosis, previously confirmed by anorectal manometry, contrast enema and rectal suction biopsies. Endoscopically, the first site with absence of motility was identified as the beginning of the aganglionic area. Just above this point, the transition zone was marked with an Indian Ink tattooing. During the TEPT, a full-thickness biopsy for frozen section analysis was performed just above this mark. The results of colonoscopic making were compared with contrast enema. Colonoscopy allowed the identification and tattooing of the junction between normal bowel with peristalsis and aganglionic bowel without peristalsis in all 12 cases (100%). Barium enema revealed the transition zone in 7 patients (58.3%). Frozen samples, obtained just above the marked areas revealed the presence of ganglion cells in all cases and the histopathological analysis of surgical specimens confirmed the diagnosis of HD in all cases and checked the location of the transition zone at the same site previously identified by colonoscopy...

Efecto de la infección por el virus de la rabia sobre la expresión de parvoalbúmina, calbindina y calretinina en la corteza cerebral de ratones / Effect of rabies virus infection on the expression of parvalbumin, calbindin and calretinin in mouse cerebral cortex

Algunas manifestaciones clínicas de la rabia, así como los resultados de experimentos con cultivos celulares y animales de laboratorio han llevado a sugerir que el virus de la rabia afecta la neurotransmisión gabaérgica. En la corteza cerebral existen diferentes tipos de neuronas que sintetizan el neurotransmisor GABA. Éstas se pueden identificar con marcadores neuronales, entre los que se destacan tres proteínas ligadoras de calcio: la parvoalbúmina (PV), la calbindina (CB) y la calretinina (CR). El virus de la rabia se disemina a través de la corteza cerebral pero se desconocen sus posibles efectos citopáticos sobre las neuronas gabaérgicas. Para evaluar el efecto de la rabia sobre estas neuronas, se estudió mediante inmunohistoquímica la expresión de PV, CB y CR en la corteza frontal de ratones normales y ratones infectados con virus 'calle' o virus 'fijo' de la rabia. La PV se expresó en neuronas multipolares dispersas regularmente entre las capas II y VI, y en botones sinápticos que bordeaban el soma de las neuronas piramidales. La inmunorreactividad a CB se manifestó en dos franjas corticales: la primera, en las capas supragranulares II y III en neuronas con somas redondeados e inmersos en un neuropilo intensamente marcado; la segunda, en las capas infragranulares V y VI en neuronas multipolares dispersas y rodeadas por un neuropilo menos reactivo. La CR se expresó en neuronas bipolares con somas fusiformes distribuidas en las seis capas corticales, pero concentradas principalmente en las capas II y III. Hubo una característica común en las muestras infectadas con los dos tipos de virus: la inmunotinción a PV fue más intensa que en las muestras normales. La infección derivada del virus 'calle' no causó alteraciones adicionales en la expresión de las tres proteínas. En contraste, la infección con virus 'fijo' produjo una reducción notable del número de neuronas CB+, así como de la inmunorreactividad a CB en el neuropilo de la corteza frontal. Además, provocó una disminución significativa del tamaño de las neuronas CR+ en la corteza del cíngulo. Estos resultados aportan evidencia histológica en apoyo de la hipótesis según la cual las neuronas gabaérgicas son afectadas por el virus de la rabia.

Some clinical features of rabies and experimental evidence from cell culture and laboratory animals suggest impairment of gabaergic neurotransmission. Several types of gabaergic neurons occur in the cerebral cortex. They can be identified by three neuronal markers: the calcium binding proteins (CaBPs) parvalbumin (PV), calbindin (CB) and calretinin (CR). Rabies virus spreads throughout the cerebral cortex; however, rabies cytopathic effects on gabaergic neurons are unknown. The expression of calcium-binding proteins (CaBPs) parvalbumin (PV), calbindin (CB) and calretinin (CR) was studied in the frontal cortex of mice. The effect of gabaergic neurons was evaluated immunohistochemically. The distribution patterns of CaBPs in normal mice and in mice infected with 'fixed' or 'street' rabies virus were compared. PV was found in multipolar neurons located in all cortical layers except layer I, and in pericellular clusters of terminal knobs surrounding the soma of pyramidal neurons. CB-immunoreactivity was distributed in two cortical bands. One was composed of round neurons enclosed by a heavily labeled neuropil; this band corresponds to supragranular layers II and III. The other was a weakly stained band of neuropil which contained scattered multipolar CB-ir neurons; this corresponds to infragranular layers V and VI. The CR-ir neurons were bipolar fusiform cells located in all layers of cortex, but concentrated in layers II and III. A feature common to samples infected with both types of viruses was a more intense immunoreactivity to PV in contrast to normal samples. The infection with 'street' virus did not cause additional changes in the expression of CaBPs. However, the infection with 'fixed' virus produced a remarkable reduction of CB-immunoreactivity demonstrated by the loss of CB-ir neurons and low neuropil stain in the frontal cortex. In addition, the size of CR-ir neurons in the cingulate cortex was decreased.