Social brain, social dysfunction and social withdrawal.

The human social brain is complex. Current knowledge fails to define the neurobiological processes underlying social behaviour involving the (patho-) physiological mechanisms that link system-level phenomena to the multiple hierarchies of brain function. Unfortunately, such a high complexity may also be associated with a high susceptibility to several pathogenic interventions. Consistently, social deficits sometimes represent the first signs of a number of neuropsychiatric disorders including schizophrenia (SCZ), Alzheimer's disease (AD) and major depressive disorder (MDD) which leads to a progressive social dysfunction. In the present review we summarize present knowledge linking neurobiological substrates sustaining social functioning, social dysfunction and social withdrawal in major psychiatric disorders. Interestingly, AD, SCZ, and MDD affect the social brain in similar ways. Thus, social dysfunction and its most evident clinical expression (i.e., social withdrawal) may represent an innovative transdiagnostic domain, with the potential of being an independent entity in terms of biological roots, with the perspective of targeted interventions.

[Synchronous malignant fibrous histiocytomas in ileal and atrial locations]. / Histiocitoma fibroso maligno de localización sincrónica ileal y auricular.

Diagnosis of malignant fibrous histiocytoma in ileal and atrial locations is uncommon and diagnosis of synchronous lesions in both locations is exceptional. We present the case of a 60-year-old woman with a malignant fibrous histiocytoma in both locations. Malignant fibrous histiocytoma is an aggressive neoplasm. Definitive diagnosis is histological. Immunochemistry helps to establish the differential diagnosis with other entities.

Hibernoma de cavidad oral. Una entidad infrecuente / Oral cavity hibernoma: a rare condition

El hibernoma es un tumor adiposo benigno que morfológicamente rememora la grasa fetal. Su presencia a nivel oral es excepcional. Presentamos un caso de hibernoma de cavidad oral, revisamos la entidad y mostramos los distintos diagnósticos diferenciales (AU)

A hibernoma is a benign adipose tumour that morphologically resembles foetal fat. Its presence at oral level is exceptional. A case of an oral cavity hibernoma is presented, with a review of the condition and a description of the different differencial diagnoses (AU)

[The usefulness of the filtration-adhesion method in urine cytology]. / Utilidad del método de filtración-adhesión en citología urinaria.

OBJECTIVES: To compare the cytocentrifugation cellular concentration method for urine cytology with the filtration-adhesion method, mainly evaluating their diagnostic efficacy and their inconveniences. METHODS: Voiding urine samples from 100 patients were processed by cytocentrifugation and filtration-adhesion to detect neoplastic cells. RESULTS: The filtration-adhesion method is superior to cytocentrifugation in the detection of neoplastic cells, without false positive results. The inconveniences are similar in both methods. CONCLUSIONS: The filtration-adhesion method is simple, low-cost, and more sensitive than cytocentrifugation for the detection of malignant cells.

[Ureteral carcinoma. The mute in urological pathology]. / Carcinoma ureteral. El convidado de piedra de la patología urológica.

OBJECTIVE: Although urine cytology plays an important role in the diagnosis of lower urinary tract neoplasias, it should be complemented with other diagnostic tests for the diagnosis of upper urinary tract tumors. METHODS: We present one case of synchronic transitional cell carcinoma of the ureter and bladder papilary neoplasia and carcinoma in situ. RESULTS: The persistent positivity of urine cytology in patients treated for lower urinary tract lesions without evidence of lesion in that level should raise the suspicion of upper urinary tract lesions. CONCLUSIONS: Ureteral carcinoma is an aggressive neoplasia and early diagnosis may be beneficial and also have repercussions in the ipsilateral kidney function.

[Testicular choriocarcinoma with pure histological pattern. Necropsy study in a representative case]. / Coriocarcinoma testicular con patron histologico puro. Estudio necropsico de un caso representativo.

OBJECTIVE: Pure testicular choriocarcinoma is a relatively infrequent neoplasia with an ominous prognosis. METHODS: We report the necropsy study of a 21-year old male patient with generalized metastases of a primary pure testicular choriocarcinoma. RESULTS: The aggressiveness of this neoplasia is demonstrated by extensive tumor dissemination in early stages, in which testicular clinical manifestations are often absent. CONCLUSIONS: In front of any choriocarcinoma it is imperative to perform an extensive sampling of the lesion with the aim to detect possible foci of germ cell neoplasia which constitute a mixed pattern.

[Lymphoepithelioma-like undifferentiated carcinoma of the bladder. Case report]. / Carcinoma indiferenciado de vejiga con patrón de linfoepitelioma. Presentación de un caso.

OBJECTIVE: High-grade lymphoepithelioma-like urothelial carcinoma is a rare neoplasia in the bladder, and its relationship with Epstein-Barr virus has not been demonstrated. METHODS: We report the case of an old male presenting with recurrent hematuria diagnosed of this tumor. RESULTS: These are neoplasias with a great lymphocyte component, sometimes predominant, which may lead to histological confusion with inflammatory processes like chronic cystitis or even lymphomas. CONCLUSIONS: Despite their infiltrative character and high cytological and architectural grade their prognosis is better than urothelial carcinomas of the same grade and stage, but this only applies for pure forms and those with predominant lymphoepithelioma-like pattern.

[Polypoid cystitis associated with glandular cystic cystitis]. / Cistitis polipoide asociada a cistitis quística glandular.

OBJECTIVE: Polypoid cystitis and intestinal metaplasia are well-known lesions of the bladder. METHODS: We report the case of one patient with both lesions identified synchronically in the bladder. RESULTS: Although these lesions are not neoplastic, there are evidences supporting a possible degeneration of the metaplastic epithelium to adenocarcinoma. CONCLUSIONS: The diagnosis of both lesions is histological and there are not clinical tests or image studies that could enable identification of the real nature of these lesions.

[Sarcomatoid renal carcinoma with malignant heterologous elements: case report]. / Servicios de Anatomía Patológica del Hospital de Jerez de la Frontera, Cádiz y del Hospital Universitario Virgen Macarena, Sevilla, España.

OBJECTIVE: The sarcomatoid pattern represents the histological type of renal carcinoma with the poorest prognosis, receiving the grade 4 of the Furhman classification consistently. METHODS: We report the case of a 80-year-old male who underwent nephroureterectomy with the pathologic diagnosis of sarcomatoid renal carcinoma with areas of chondro and osteosarcoma, as well as squamous cell differentiation. It is an exceptional case because it is rare to find all these elements in the same tumor. RESULTS: The study of the surgical specimen enables in most cases the identification of some of the classic histological patterns of renal carcinoma, nevertheless an immunohistochemical study is of great value for proper classification of the neoplasia and differential diagnosis with other renal lesions, mainly sarcomas. CONCLUSIONS: The presence of malignant heterologous elements, as in our case, will confirm the prognosis of these neoplasias, which really don't have an effective treatment.

[Renal pelvis mucinous carcinoma. Case report]. / Carcinoma mucinoso de pelvis renal. A propósito de un caso.

OBJECTIVE: There is some controversy in the terminology used for transitional cell tumors with mucinous differentiation. METHODS: We report the case of a 50-year-old male with history of recurrent lithiasis whose radological tests discovered a heterogeneous renal pelvis lesion. RESULTS: The histologic study of the lesions determined the diagnosis of transitional cell carcinoma of the renal pelvis with ample mucinous differentiation. CONCLUSIONS: They are rare tumors in such location and the mucinous differentiation does not seem to influence prognosis.

[Ureteral endometriosis. Case report]. / Endometriosis ureteral. A propósito de un caso.

OBJECTIVES: Ureteral endometriosis is a rare entity which may produce urinary tract obstruction with subsequent loss of renal function if treatment is not undertaken early due to its asymptomatic but locally aggressive course. METHODS/RESULTS: We report one case of intrinsic ureteral endometriosis with unilateral renal failure (renal atrophy) and unresectable periureteral fibroinflammatory thickening involving vascular or visceral structures. CONCLUSIONS: We emphasize the diagnostic and therapeutic importance of a high degree of clinical suspicion about this entity, mainly in patients with history of genital endometriosis.

[Predominantly cystic renal metanephric adenoma. Case report]. / Adenoma metanéfrico renal de predominio quístico. A propósito de un caso.

OBJECTIVES: Metanephric adenoma is a relatively unfrequent asymptomatic embryogenic renal tumor which is generally diagnosed by an abdominal diagnostic tests indicated for other reasons. Differential diagnosis with benign and malignant tumors has to be performed. METHODS/RESULTS: We report one case of metanephric adenoma with intense necrotic-hemorrhagic and cystic changes with a size not previously referred in the literature. CONCLUSIONS: Cystic and hemorrhagic changes in benign renal tumors make differential diagnosis with malignant tumors mandatory Surgery is necessary in almost all cases and histologic study will give the diagnosis.

Sarcoma sinovial bifásico pulmonar: presentación de un caso y revisión de la literatura / Biphasic synovial sarcoma of the lung: report of a case and review of the literature

Introduction: Synovial sarcoma is an aggressive neoplasm described in several locations but is uncommon in the lung. Method: We report a case of biphasic synovial sarcoma of the lung stressing the histologic and immunohistochemical characteristics, genetics and differential diagnosis. Results: a biphasic pattern and SYT-SSX translocation were demostrated. Comments: histology and immuno-histochemistry lead to diagnosis most of the times but the typical translocation is definitive.

Introducción: El sarcoma sinovial es una neoplasia agresiva que aun habiendo sido descrita en múltiples localizaciones, resulta sumamente infrecuente en localización pulmonar. Método: Presentamos un caso de sarcoma sinovial bifásico de localización pulmonar haciendo hincapié en sus características histológicas inmunohistoquímicas y genéticas así como en su diagnóstico diferencial. Resultados: La neoplasia mostraba un patrón bifásico bien caracterizado. El estudio genético demostró la translocación SYT-SSX. Comentarios: Si bien la histología y la inmunohistoquímica permiten en la mayoría de los casos el diagnóstico del sarcoma sinovial, es la translocación genética la que define verdaderamente esta entidad.

Cistitis polipoide asociada a cistitis quística glandular / Polypoid cystitis associated with glandular cystic cystitis

Objetivo: La cistitis polipoide y la metaplasia intestinal son dos lesiones de sobra conocidas a nivel vesical. Métodos: Presentamos el caso de un paciente en cuya vejiga se identificaron ambas lesiones de modo sincrónico. Resultado: Si bien ambas lesiones son no neoplásicas, existen evidencias que apuestan por una posible degeneración del epitelio metaplásico hacia adenocarcinoma. Conclusiones: El diagnóstico de ambas lesiones es histológico no existiendo pruebas clínicas ni estudios de imagen que permitan identificar la verdadera naturaleza de dichas lesiones (AU)

Objective: Polypoid cystitis and intestinal metaplasia are well-known lesions of the bladder. Methods: We report the case of one patient with both lesions identified synchronically in the bladder. Results: Although these lesions are not neoplastic, there are evidences supporting a possible degeneration of the metaplastic epithelium to adenocarcinoma. Conclusions: The diagnosis of both lesions is histological and there are not clinical tests or image studies that could enable identification of the real nature of these lesions (AU)

Carcinoma indiferenciado de vejiga con patrón de linfoepitelioma. Presentación de un caso / Lymphoepithelioma-like undifferentiated carcinoma of the bladder. Case report

Objetivo: El carcinoma urotelial de alto grado con patrón de linfoepitelioma es una neoplasia infrecuente a nivel vesical en la que no se ha logrado demostrar relación con la infección por el virus de Epstein-Barr. Métodos: Presentamos el caso de un paciente de edad avanzada que tras presentar episodios de hematuria recurrente fue diagnosticado de esta singular entidad. Resultados: Se trata de neoplasias con gran componente linfocitario, en ocasiones mayoritario, que pueden prestarse a confusión histológica con procesos inflamatorios como cistitis crónicas e incluso con linfomas. Conclusiones: Pese a su carácter infiltrante y a su alto grado citológico y arquitectural su pronóstico resulta ser mejor que el de los carcinomas uroteliales del mismo grado y estadio si bien ello sólo es aplicable a las formas puras y aquellas en las que el patrón de linfoepitelioma es predominante (AU)

Objective: High-grade lymphoepithelioma-like urothelial carcinoma is a rare neoplasia in the bladder, and its relationship with Epstein-Barr virus has not been demonstrated. Methods: We report the case of an old male presenting with recurrent hematuria diagnosed of this tumor. Results: These are neoplasias with a great lymphocyte component, sometimes predominant, which may lead to histological confusion with inflammatory processes like chronic cystitis or even lymphomas. Conclusions: Despite their infiltrative character and high cytological and architectural grade their prognosis is better than urothelial carcinomas of the same grade and stage, but this only applies for pure forms and those with predominant lymphoepithelioma-like pattern (AU)

Coriocarcinoma testicular con patron histologico puro. Estudio necropsico de un caso representativo / Testicular choriocarcinoma with pure histological pattern. Necropsy study in a representative case

Objetivo: El coriocarcinoma puro testicular es una neoplasia relativamente infrecuente que conlleva un pronóstico ominoso. Métodos: Presentamos el estudio necrópsico de un paciente varón de 21 años con metástasis generalizadas de un coriocarcinoma puro primario de testículo. Resultados: La agresividad de esta neoplasia queda demostrada con la amplia diseminación tumoral en estadios precoces en que la clínica testicular suele estar ausente. Conclusiones: Ante todo coriocarcinoma es imperativo realizar un muestreo exhaustivo de la lesión con el fin de detectar posibles focos de neoplasia de células germinales que constituyan un patrón mixto (AU)

Objective: Pure testicular choriocarcinoma is a relatively infrequent neoplasia with an ominous prognosis. Methods: We report the necropsy study of a 21-year-old male patient with generalized metastases of a primary pure testicular choriocarcinoma. Results: The aggressiveness of this neoplasia is demonstrated by extensive tumor dissemination in early stages, in which testicular clinical manifestations are often absent. Conclusions: In front of any choriocarcinoma it is imperative to perform an extensive sampling of the lesion with the aim to detect possible foci of germ cell neoplasia which constitute a mixed pattern (AU)

Tinción dual p16 + ki 67. Un paso más en cuanto a la especificidad de citologías ginecológicas / p16/Ki-67 dual staining. A step forward in the specificity of gynecological cytology

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