[Cutaneous leiomyomas: a clinicpathological and epidemiological review].

BACKGROUND: Cutaneous, superficial and or suprafascial leiomyoma are divided into three variants: piloleiomyomas (PL), angioleiomyomas (AL) and genital leiomyomas (GL) that include the vulvar, scrotal and areolar forms. This study set out to establish the clinical and histological characteristics and incidence of each variant, and any likely associations with internal neoplasms. METHODS: A review was carried out of 255 cases of cutaneous leiomyomas diagnosed between 1982 and 2018 at the Pathology departments of three hospitals (Navarra and Alicante). Demographic, clinical, histological and immunohistochemical variables were described and compared. RESULTS: The incidence of PL in Navarra was 4.3 cases per million inhabitants a year, with another 20 cases of AL and 1.4 cases of GL. Cutaneous forms make up approximately 3.5% of the total leiomyomas. The population with PL suffered more frequently from breast cancer (OR?=?4.8; CI 95%: 1.3-17.4; p?=?0.006). Nipple leiomyomas are small, accompanied by localised pain, and are predominantly fascicular or solid, with very infrequent effect on the subcutaneous cellular tissue and scarce atypia. This makes for a contrast with the other GLs, which are medium sized and infrequently painful, predominantly nodular, and frequent effect on the subcutaneous tissue and atypia. CONCLUSIONS: The information provided here about the clinical and histological characteristics of the different varieties of leiomyomas indicate that there is a need to reconsider the classification of nipple leiomyomas outside the group of GLs. An association between PL and breast carcinoma was detected, which needs to be confirmed in future studies so as to determine if this leiomyoma is a risk marker for breast cancer.

Leiomiomas cutáneos: revisión clinicopatológica y epidemiológica / Cutaneous leiomyomas: a clinicpathological and epidemiological review

Fundamento: Los leiomiomas cutáneos, superficiales o suprafasciales, se dividen en tres variantes: piloleiomiomas(PL), angioleiomiomas (AL) y leiomiomas genitales (LG) queincluyen las formas vulvares, escrotales y areolares. El objetivo fue establecer las características clinicohistológicas yla incidencia de cada variante, y las posibles asociacionescon neoplasias internas. Material y métodos: Se revisaron 255 casos de leiomiomascutáneos diagnosticados entre 1982 y 2018 en los serviciosde Anatomía Patológica de tres centros hospitalarios (Navarra y Alicante). Se describieron y compararon variables de-mográficas, clínicas, histológicas e inmunohistoquímicas. Resultados: La incidencia en Navarra de PL fue 4,3 casospor año y millón de habitantes, de AL 20 y de LG 1,4. Lasformas cutáneas suponen aproximadamente el 3,5 % deltotal de leiomiomas. La población con PL sufrió más frecuentemente cáncer de mama (OR = 4,8; IC95%: 1,3-17,4;p = 0,006). Los leiomiomas areolares son de pequeño tamaño, acompañados de dolor local, predominantementefasciculares o sólidos, con muy rara afectación del tejidocelular subcutáneo y escasa atipia. Esto contrasta con elresto de LG, de tamaño medio y rara vez dolorosos, predominantemente nodulares, con frecuente afectación deltejido celular subcutáneo y atipia. Conclusiones: Se aporta información sobre las características clinicohistológicas de las distintas variantes de leio-miomas, según las cuales debería replantearse la clasificación de los leiomiomas areolares fuera del grupo de LG. Sedetectó una asociación entre PL y carcinoma de mama quedeberá confirmarse en futuros estudios para determinar sieste leiomioma constituye un marcador de riesgo de cáncerde mama en mujeres.(AU)

Background: Cutaneous, superficial and or suprafascial leio-myoma are divided into three variants: piloleiomyomas (PL),angioleiomyomas (AL) and genital leiomyomas (GL) that include the vulvar, scrotal and areolar forms. This study setout to establish the clinical and histological characteristicsand incidence of each variant, and any likely associationswith internal neoplasms. Methods: A review was carried out of 255 cases of cutaneous leiomyomas diagnosed between 1982 and 2018 at thePathology departments of three hospitals (Navarra and Alicante). Demographic, clinical, histological and immunohis-tochemical variables were described and compared. Results: The incidence of PL in Navarra was 4.3 cases permillion inhabitants a year, with another 20 cases of AL and1.4 cases of GL. Cutaneous forms make up approximately3.5% of the total leiomyomas. The population with PL suffered more frequently from breast cancer (OR = 4.8; CI 95%:1.3-17.4; p = 0.006). Nipple leiomyomas are small, accompanied by localised pain, and are predominantly fascicularor solid, with very infrequent effect on the subcutaneouscellular tissue and scarce atypia. This makes for a contrastwith the other GLs, which are medium sized and infrequently painful, predominantly nodular, and frequent effect on thesubcutaneous tissue and atypia. Conclusions: The information provided here about the clinical and histological characteristics of the different varietiesof leiomyomas indicate that there is a need to reconsiderthe classification of nipple leiomyomas outside the group ofGLs. An association between PL and breast carcinoma wasdetected, which needs to be confirmed in future studies soas to determine if this leiomyoma is a risk marker for breastcancer.(AU)

[Ductal regeneration in vanishing bile duct syndrome in Hodgkin's lymphoma]. / Recuperación ductular en el síndrome de los conductillos biliares evanescent en paciente con linfoma de Hodgkin.

We present the case of a 17-year-old male patient with Hodgkin's lymphoma (nodular sclerosis) in the mediastinum. During the postoperative period treatment with erythromycin was started and the patient developed progressive jaundice and cholestasis. Treatment modified for the lymphoma was initiated, which achieved complete remission and subsequent improvement and resolution of the cholestasis. Histological study of the liver revealed massive loss of bile ducts. After resolution of the cholestasis, consecutive biopsies revealed ductal proliferation. The present report therefore illustrates a case of ductopenia or vanishing bile duct syndrome (VBDS) with ad integrum regeneration of the bile ducts simultaneous with lymphoma remission. Because the 2 possible causes, erythromycin toxicity and Hodgkin's lymphoma, occurred simultaneously, the etiology of the VBDS cannot be definitively established.

[Small cell carcinoma of the bladder. Report of a new case]. / Carcinoma de células pequeñas de vejiga. Aportación de un nuevo caso.

Contribution of a case report of vesical small cell carcinoma (SCC) seen at our Centre and managed with partial cystectomy and systemic chemotherapy (CMT) with M-VAC. SCC is an uncommon neoplasia of the bladder usually associated with an aggressive behaviour. The effectiveness of radical surgery has not been demonstrated, so a conservative treatment was chosen which has allowed to preserve a high quality of life until now, 36 months after diagnosis. The studies of local and distant relapses show no signs of residual disease.

[Chronic intestinal pseudo-obstruction due to intestinal neuronal dysplasia type B (IND B), concerning one case]. / Pseudoobstrucción intestinal crónica por displasia neuronal intestinal tipo B (DNI B), a propósito de un caso.

Intestinal neuronal dysplasia type B (IND B) is an infrequent disease due to hyperplasia of the parasympathetic submucous plexus which causes alteration of intestinal motility, giving rise to symptoms of constipation and subocclusive manifestations. The disease is difficult to diagnose. It requires high clinical suspicion and should include differential diagnosis of patients with repeated subocclusive manifestations in order to make an early and correct diagnosis and avoid complications derived from unnecessary surgery that worsens the prognosis. We present the case of a 33-year-old Moroccan male who was admitted to our hospital on 2 occasions in 11 months, requiring total parenteral nutrition (TPN) for five months. The immunohistochemical analysis of the ileostomy and colostomy stoma led to a diagnosis of IND B. Eighteen months later, the patients is leading a normal life and has recovered the 25 kilos lost following the dietary indications and with the enzymatic supplements.

[Whole body PET/CT imaging for detection of metastatic choroidal melanoma]. / PET/TC de cuerpo completo para la detección de metástasis de melanoma coroideo.

Choroidal melanoma is the most common primary intraocular cancer in adults. Metastases are most commonly found in the liver and are rapidly fatal despite aggressive therapy. These metastases have been reported in the follow-up to 50 % of uveal melanoma. However, recent reports have shown that liver ultrasonography and liver function tests have low sensitivity in the diagnosis of metastatic uveal melanoma. The study reports on a patient with a history of choroidal melanoma. Preoperative medical evaluation, including CT imaging of the abdomen, complete blood count and liver enzymes proved negative. A PET/CT was requested and showed lesions in the liver and lungs. Whole-body PET/CT revealed melanoma metastases. The PET/CT is a sensitive tool for the detection and localization of hepatic and extrahepatic metastatic choroidal melanoma.