Impact of pre-operative weight loss on non-alcoholic fatty liver disease histopathology and insulin resistance in individuals undergoing bariatric surgery: a propensity matched cross-sectional comparison

ABSTRACT BACKGROUND: The effect of weight loss (WL) on histopathological aspects of non-alcoholic fatty liver disease (NAFLD) may provide further insights into the dynamics of hepatic recovery after WL. OBJECTIVE: To analyze the effects of pre-operative WL on insulin resistance- and NAFLD-related histology in individuals undergoing bariatric surgery (BS) with or without pre-operative WL. DESIGN AND SETTING: A matched cross-sectional study was conducted at a public university hospital and a private clinic in Campinas, Brazil. METHODS: An analytical, observational, cross-sectional study was conducted using prospectively collected databases of individuals who underwent BS and liver biopsy at either a public tertiary university hospital (with pre-operative WL) or a private clinic (without pre-operative WL). Random electronic matching by gender, age, and body mass index (BMI) was performed and two paired groups of 24 individuals each were selected. RESULTS: Of the 48 participants, 75% were female. The mean age was 37.4 ± 9.6. The mean BMI was 38.9 ± 2.6 kg/m2. Fibrosis was the most common histopathological abnormality (91.7%). Glucose was significantly lower in the WL group (92 ± 19.1 versus 111.8 ± 35.4 mg/dL; P = 0.02). Significantly lower frequencies of macrovesicular steatosis (58.3% versus 95.8%; P = 0.004), microvesicular steatosis (12.5% versus 87.5%; P < 0.001), and portal inflammation (50% versus 87.5%; P = 0.011) were observed in the WL group. CONCLUSION: Pre-operative WL was significantly associated with lower frequencies of macro- and mi- crovesicular steatosis, portal inflammation, and lower glycemia, indicating an association between the recent trajectory of body weight and histological aspects of NAFLD.

Hemangioma lobular capilar inusual en un paciente pediátrico. Reporte de caso y revisión de literatura / Unusual capillary lobular hemangioma in a pediatric patient. Case report and literature review

Lobular capillary hemangioma or pyogenic granuloma is a benign non-neoplastic lesion that is mainly presented as a tissue growth in response to irritation or trauma. It is located on the skin or on the mucous membrane, with the oral mucosa being the most frequent, with the gingiva standing out, but also appearing in other places such as the lips, buccal mucosa, palate and tongue, the latter being a very unusual location. This is a report of the case of a pediatric patient who underwent a surgical procedure of frenotomy, and who subsequently presented a lesion due to trauma possibly as a consequence of local anes-thesia, which forced an excisional biopsy, the histopathological diagnosis being capillary lobular hemangioma or pyogenic granuloma. Likewise, a literature review of this type of pathology is presented, with emphasis on its location in the tongue.

Research progress on diagnosis and treatment of granulomatous lobular mastitis / 中国临床药理学与治疗学

Granulomatous lobular mastitis (GLM) is a rare form of chronic inflammatory breast disease which may be sometimes difficult to distinguish from breast cancer. The cause of GLM is unknown, but may be associated with autoimmunity, abnormal hormone levels and infection. While GLM has no specific clinical manifestations, the diagnosis is principally established by histopathology. Therapeutic options for GLM range from observation to various medical treatments, such as steroids, immunosuppressants, and antibiotics, to surgical intervention. However, there are still many difficulties in the clinical diagnosis and treatment of GLM, and there is still no unified diagnosis and treatment consensus. So, we accomplished the present review through reviewing GLM-related domestic and foreign literature, aiming to provide the basis for rational clinical diagnosis and treatment.

Granuloma telangiectásico de cavidad oral en zona anterior

Introducción: El granuloma telangiectásico es una neoplasia benigna de origen epitelial y contenido vascular que se presenta en cavidad oral, de crecimiento lento. Su etiología es atribuible a trauma físico, alteraciones hormonales y al uso de medicamentos, además es inducido por presencia de cálculos y deficiente higiene oral. Objetivo: Describir las características clínicas y patológicas de un granuloma telangiectásico presente en cavidad oral, su patogénesis y el manejo de terapéutico del caso. Presentación del caso: Paciente de 35 años que acude a consulta por presentar una lesión tumoral, en sector anterosuperior derecho, afectando la estética de la paciente. Se efectuó excisión quirúrgica y al realizar el estudio histopatológico se confirmó diagnóstico de granuloma telangiectásico. Conclusión: Los profesionales de la odontología deben conocer todos los aspectos relacionados con el granuloma telangiectásico, etiopatogenia, características clínicas e histológicas, con el objeto de identificar esta patología, establecer diagnósticos diferenciales y poder brindar un diagnóstico adecuado y, por consiguiente, un plan de tratamiento específico para cada caso.

Introduction: The granuloma telangiectásico is a benign neoplasia of epithelial origin and vascular content that occurs in oral cavity with greater predilection in gum, of slow growth. Its etiology is attributable to physical trauma, hormonal alterations and the use of medicines, and is induced by the presence of stones and poor oral hygiene. Objective: to describe the clinical and pathological characteristics of a telangiectatic granuloma present in oral cavity, its pathogenesis and the therapeutic management of the case. Presentation of the case: A 35-year-old patient who attended a dental consultation for presenting a tumor lesion of a soft consistency, located in the right anterior superior sector, affecting the aesthetics of the patient. Surgical excision was performed, detoxification of the exposed area with citric acid, and the histopathological study confirmed the diagnosis of telangiectatic granuloma. Conclusion: Dental professionals must know all the aspects related to telangiectatic granuloma, etiopathogenesis, clinical and histological characteristics, in order to identify this pathology, establish differential diagnoses and be able to provide an adequate diagnosis and therefore a specific treatment plan for each case.

Granuloma piógeno por picadura de insecto

RESUMEN Introducción: El hemangioma lobular capilar es un tumor de tejidos blandos relativamente frecuente. Se conoce que es un desarrollo reactivo focal de tejido fibrovascular o de granulación con proliferación endotelial, que no tiene relación con ninguna bacteria. Se desarrolla rápidamente, sangra con facilidad y se ulcera causando la impresión clínica errónea de un tumor maligno. Objetivo: Contribuir al conocimiento de esta afección para su detección precoz y tratamiento oportuno. Presentación de caso: Paciente masculino, de 6 años de edad, con antecedentes de buena salud, que es traído a consulta porque su madre refiere que desde hace más de un mes, comenzó con una pequeña lesión en la cara después de la picadura de un insecto que creció y sangra con facilidad de manera espontánea o después de algún traumatismo. Al examen dermatológico se constata cuadro cutáneo localizado constituido por lesión única en forma de tumor, de aproximadamente 0,5 cm, de color rojo intenso, que sangra con facilidad con el mínimo roce localizada en la cara. Se trató con criocirugía y se logró eliminación de la lesión casi sin cicatriz aparente. Conclusiones: La extirpación quirúrgica completa se considera el tratamiento de primera línea porque se evitan las recidivas y, al mismo tiempo, puede obtenerse material suficiente para el estudio histopatológico. En los casos con diagnóstico de certeza es útil el uso de criocirugía y electrofulguración para impedir las alteraciones estéticas provocadas por la cirugía.

ABSTRACT Introduction: Capillary lobe hemangioma is a relatively common soft tissue tumor. It is known to be a focal reactive development of fibrovascular or granulation tissue with endothelial proliferation, which is not related to any bacteria. It develops rapidly, bleeds easily and ulcerates causing the clinical erroneous impression of a malignant tumor. Objective: Contribute to the knowledge of this condition for its early detection and timely treatment. Case presentation: Male patient, 6 years old, with a health history, who is brought to consultation because his mother reports that for more than a month he presented a small lesion on the face after the bite of an insect that grew and bleeds easily, spontaneously or after some trauma. The dermatological examination shows a localized skin condition consisting of a single lesion in the form of a tumor, approximately 0.5 cm, of intense red color, which bleeds easily with the minimum friction, and it was located on the face. It was treated with cryosurgery and the removal of the lesion was achieved with almost no apparent scar. Conclusions: Complete surgical removal is considered the first-line treatment because recurrences are avoided and, at the same time, sufficient material can be obtained for histopathological study. In cases with a diagnosis of certainty, the use of cryosurgery and electrofulguration is useful to prevent the aesthetic alterations caused by surgery.

Correlación ecográfica, mamográfica e histopatológica en el diagnóstico de cáncer de mama en Guantánamo, 2010-2015

RESUMEN Introducción: El cáncer de mama se conoce desde épocas remotas, el tumor de mama es la neoplasia maligna más importante en la mujer. Se considera la primera causa de muerte por cáncer en las mujeres en el mundo. Objetivo: Evaluar la correlación ecográfica, mamográfica e histopatológica del carcinoma de mama en la provincia de Guantánamo. Método: Se realizó un estudio observacional, descriptivo, retrospectivo en 140 pacientes durante el período de 2010 a 2015 en el Hospital General Docente "Dr. Agostinho Neto" de Guantánamo. El dato primario se obtuvo del Registro Provincial de Cáncer con diagnóstico de tumor maligno de mama. Resultados: La mayor incidencia de la enfermedad se registró a partir de los 45 años (80 %), el promedio de edad del diagnóstico fue de 57 más menos 15 años. La mama izquierda tuvo una mayor frecuencia a verse afectada con respecto a la mama la derecha (53 % vs. 46 %), fue poco frecuente que ambas mamas se encontrasen afectadas de forma sincrónica (menos del 1 %). El 53 % presentó una lesión de aspecto espiculado en la mamografía, de aspecto sólido en la ecografía y correspondiente a un carcinoma ductal infiltrante por histología. Conclusiones: Existe correlación entre los diagnósticos ecográficos, mamográficos y el diagnóstico definitivo histopatológico del cáncer de mama.

ABSTRACT Introduction: Since ancient times, breast cancer has been studied. It is current the most important invasive neoplasm in women and considered the leading cause of cancer deaths in women worldwide. Objective: To assess the ultrasound, mammographic and histopathological correlation for the diagnosis of breast cancer in Guantanamo province. Method: An observational, descriptive, and retrospective study was conducted in 140 patients during the period 2010-2015 at the Hospital General Docente "Dr. Agostinho Neto" in Guantánamo. The primary information was obtained from the Provincial Registry Database of Cancer with the diagnosis of malignant breast tumor. Results: The highest incidence of the disease was recorded in patients 45 plus years of age (80%), the average age at diagnosis was 57 ± 15 years. The left breast was more frequently affected than the right breast (53% vs. 46%), it was not common for both breasts be affected synchronously (less than 1%). The 53% of patients presented a lesion with a speculated appearance on mammography, solid appearance on ultrasound. This lesion, as per histology criteria, it corresponded to an infiltrating ductal carcinoma. Conclusions: There is a correlation between ultrasound, mammographic diagnoses and the breast cancer related definitive histopathological diagnosis.

RESUMO Introdução: O câncer de mama é conhecido desde a antiguidade, sendo o tumor de mama a neoplasia maligna mais importante na mulher. É considerada a principal causa de morte por câncer em mulheres no mundo. Objetivo: Avaliar a correlação ecográfica, mamográfica e histopatológica do carcinoma de mama na província de Guantánamo. Método: Estudo observacional, descritivo, retrospectivo, realizado em 140 pacientes durante o período de 2010 a 2015 no Hospital General Docente "Dr. Agostinho Neto" de Guantánamo. Os dados primários foram obtidos do Registro Provincial de Câncer com diagnóstico de tumor maligno de mama. Resultados: A maior incidência da doença foi registrada após 45 anos (80%), a média de idade do diagnóstico foi de 57 anos mais ou menos 15 anos. A mama esquerda teve maior frequência de acometimento em relação à mama direita (53% vs. 46%), sendo raro que ambas as mamas fossem acometidas de forma síncrona (menos de 1%). 53% apresentavam lesão com aspecto espiculado na mamografia, aspecto sólido na ultrassonografia e correspondendo a carcinoma ductal infiltrante pela histologia. Conclusões: Existe correlação entre os diagnósticos ultrassonográfico e mamográfico e o diagnóstico histopatológico definitivo de câncer de mama.

Mechanism of Chaihu Qinggantang in Intervening NLRP3/IL-1β Pathway to Treat Granulomatous Lobular Mastitis in Rat Model / 中国实验方剂学杂志

ObjectiveTo investigate the mechanism of Chaihu Qinggantang （CHQGT） in the treatment of granulomatous lobular mastitis （GLM） in the rat model. MethodSixty female rats were divided into a normal group， a model group， a prednisolone group （0.001 8 g·kg-1）， and three CHQGT low-dose， medium-dose， and high-dose groups （4.5， 8.9， 17.8 g·kg-1）. The tissue homogenates mixed with GLM lesion tissue and Fritner's reagent were used for modeling. After modeling， the treatment groups were given corresponding treatment factors， and the normal group and the model group were given the equal volume of normal saline. The changes in mammary gland of rats were observed after 14 d. Hematoxylin-eosin （HE） staining was used to observe the histopathological changes in breast samples. The mRNA expressions of NOD-like receptor thermal protein domain associated protein 3 （NLRP3） inflammasome， Caspase-1， and interleukin-1β （IL-1β） were detected by real-time quantitative fluorescence polymerase chain reaction （Real-time PCR）. The protein expressions of NLRP3， Caspase-1， IL-1β， and IL-18 were detected by Western bolt. ResultAs compared with the normal group， the breasts of rats in the model group were obviously swelling， and mammary gland inflammation index was significantly increased （P<0.01）. Pathological changes included the formation of granuloma centered on the lobule of mammary gland with a large number of inflammatory cells such as lymphocytes and plasma cells. The mRNA expressions of NLRP3， Caspase-1， and IL-1β， and the protein expressions of NLRP3， Caspase-1， IL-1β， and IL18 in the model group were significantly increased （P<0.01）. Compared with the model group， the treatment groups improved breast swelling， and the CHQGT medium and high-dose groups and the prednisolone group reduced inflammation index to some extent after treatment （P<0.05， P<0.01）. The inflammation degree of mammary gland was significantly improved， and inflammatory cells such as macrophages， lymphocytes， and plasma cells were reduced to varying degrees in pathological aspects. The mRNA expressions of NLRP3， Caspase-1， and IL-1β， and the protein expressions of NLRP3， Caspase-1， IL-1β， and IL-18 in the CHQGT high-dose group and the prednisolone group were significantly down-regulated （P<0.05， P<0.01）. ConclusionCHQGT inhibits inflammation and treats GLM in rats. The mechanism is possibly related to the inhibition of NLRP3/IL-1β signaling pathway， which provides a new target for the prevention and treatment of GLM by Qingxiao method.

Hemangioma lobular capilar lingual. Reporte de un caso / Lingual lobular capillary hemangioma. A case report

El hemangioma lobular capilar es una hiperplasia inflamatoria en respuesta a una irritación crónica, la cual da lugar a una lesión exofítica eritematosa debido a la proliferación de tejido fibrovascular. En la boca puede verse en cualquier ubicación, pero es más frecuente en la zona gingival. Se reporta el caso clínico de una paciente embarazada de 38 años que consultó al equipo de Cirugía Maxilofacial del Hospital San José al presentar una lesión tumoral compatible con hemangioma lobular capilar en cara lingual lateral derecha, diagnóstico confirmado con histopatología. El objetivo de este reporte es especificar características y tratamiento de dicha lesión con localización infrecuente.

Lobular capillary hemangioma is an inflammatory hyperplasia in response to chronic irritation, resulting in an exophytic erythematous lesion due to proliferation of fibrovascular tissue. Intraorally, it can appear in any location, but it is more frequent in the gingival region. This article describes a case of a 38-year-old pregnant woman who at- tended the Maxillofacial Surgery Unit at San José Hospital, presenting a tumoral lesion on the right lateral area of the tongue compatible with a lobular capillary hemangioma. The diagnosis was confirmed with histopathology. The aim of this report is to specify the characteristics and treatment of a lesion with infrequent location.

Metachronous breast neoplasms: squamous cell carcinoma and lobular carcinoma in situ within a fibroadenoma

Breast squamous cell carcinoma are rare, occurring in less than 0.1% of all breast carcinomas. This report describes the oncological conduct performed on a patient with a triple negative squamous cell carcinoma in the upper outer quadrant of the right breast. The same patient presented a lobular carcinoma in situ within a fibroadenoma of the contralateral breast, during the follow up period. The association of these two diseases in the same patient has not yet been described in the literature.

Synchronous occurrence of lobular breast carcinoma and granulosa cell tumor of ovary mimicking metastatic lobular breast carcinoma

Breast cancer is one of the main sources of ovarian metastasis. Diffuse sheet of lobular carcinoma cells can strongly mimic granulosa cell tumor (GCT) which itself is a rare ovarian neoplasm constituting <5% of all the ovarian neoplasms. A 55-year-old female presented with a painful lump in the right breast associated with nipple discharge for 4 months, which on radiological and cytological findings was suspicious of an epithelial malignancy. During routine work-up, a solid-cystic lesion in the left ovarian adnexa was identified. The patient underwent right modified radical mastectomy along with left salpingo-oophorectomy. Histopathological and immunohistochemical features confirmed the diagnosis of a synchronous lobular carcinoma breast with GCT ovary. Simultaneous occurrence of Lobular carcinoma breast (LCB) and GCT ovary is extremely rare. Morphologically, these can look similar, raising a suspicion of LCB metastasis to ovary. This is important to differentiate the two for a proper patient management and prognosis

Mastitis granulomatosa idiopática. Análisis descriptivo de 10 casos en una unidad de referencia española / Idiopatic granulomatous mastitis. A descriptive analysis of 10 cases in a Spanish unit of reference

Introducción La mastitis granulomatosa es unaenfermedad infrecuente caracterizada por una inflamación granulomatosa crónica de los lobulillos mamarios. Las opciones de tratamiento siguen siendo controvertidas. Objetivo El objetivo del presente estudio fue analizar nuestra experiencia en el diagnóstico y tratamiento de las pacientes con mastitis granulomatosas, valorando la conveniencia de tratamientos quirúrgicos o tratamientos más conservadores. Material y método Se presenta un estudio retrospectivo y descriptivo de las pacientes diagnosticadas y tratadas en nuestro centro desde enero de 2010 hasta diciembre de 2018. Se analizaron las características clínicas y radiológicas de cada una, así como el tratamiento y su evolución. Resultados Los resultados del estudio fueron los siguientes: • El número de pacientes fue 10; el tiempo medio de seguimiento fue de 10,5 meses (rango 2-49 meses); la mediana de edad fue de 44,5 años (rango 31-81 años);ocho pacientes (80%)se manifestaron como tumoración palpable; el tiempo medio de duración de los síntomas fue de 6,8 meses (rango 2-24 meses); el tamaño medio de la lesión alcanzó los 23,6 mm (rango 12-40); una paciente se clasificó como bi-rads 2, 1 paciente como bi-rads 3, 1 paciente como bi-rads 4y 3 pacientes como bi-rads 5. • El tratamiento fue quirúrgico en 6 ocasiones (4 resecciones y 2 drenajes con biopsia) y médico en 4 ocasiones. Siete de las pacientes (70%) se curaron con el tratamiento efectuado (5 con cirugía y 2 con tratamiento conservador). Tres pacientes presentaron recurrencia o persistencia (1 con cirugía y 2 con tratamiento conservador). Conclusiones La mastitis granulomatosa es una enfermedad infrecuente y de causa desconocida, con tendencia a la recurrencia y cronicidad, cuyo tratamiento es todavía motivo de controversia

Introduction Granulomatous mastitis is an infrequent disease characterized by a chronic granulomatous inflammation of mammary lobules. Treatment options remain controversial. Objective The aim of the present study was to analyze our experience in the diagnosis and treatment of patients with granulomatous mastitis, assessing the convenience of surgical treatments or more conservative treatments. Materials and method This is a retrospective and descriptive study of the patients diagnosed and treated in our center from January 2010 to December 2018. We analyzed the clinical and radiological characteristics of each one, as well as the treatment and its evolution. Results • Number of patients 10; mean time of follow-up 10.5 months (range 2-49 months); median of age 44.5 years (range 31-81 years); eight patients (80%) manifested as a palpable tumor;mean duration of symptoms was 6.8 months (range 2-24 months); mean lesion size of 23.6mm (range 12-40); one patient was classified as bi-rads 2, 1 patient as bi-rads 3, 1 patient as bi-rads 4 and 3 patients as bi-rads 5. • The treatment was surgical 6 times (4 resections and 2 drainages with biopsy) and doctor on 4 occasions. Seven of the patients (70%) were cured with the treatment performed (5 with surgery and 2 with conservative treatment). Three patients presented recurrence or persistence (1 with surgery and 2 with conservative treatment). Conclusions Granulomatous mastitis is an infrequent disease of unknown cause, with a tendency to recurrence and chronicity, whose treatment is still controversial

Comparative analysis of the histopathological and epidemiological profile of ductal and lobular breast carcinomas diagnosed at the Hospital de Clínicas da Universidade Federal do Paraná during the period 2008-2013 / Análise comparativa do perfil histopatológico e epidemiológico dos carcinomas ductal e lobular da mama diagnosticados no Hospital de Clínicas da Universidade Federal do Paraná entre 2008 e 2013

ABSTRACT Introduction: Breast cancer is the second leading cause of cancer death among women worldwide, and epidemiological studies may help understanding its mechanisms. Objective: To carry out a survey of the number of breast cancer cases diagnosed in a period of six years. Methods: The profile of breast cancers diagnosed in a tertiary hospital in Curitiba was compared with the literature, using a retrospective analysis of ductal/special types and lobular breast carcinoma reports issued between 2008 and 2013. Results: Three hundred twenty-seven (91.6%) cases of ductal/special types carcinoma and 30 (8.4%) cases of lobular carcinoma were diagnosed, totaling 357 samples. From these cases, 27 (7.5%) were carcinoma in situ (20 ductal and seven lobular) and 330 (92.4%) were invasive carcinoma (307 invasive ductal/special types and 23 lobular). The prevalence of breast cancer among women was 991% and the majority of patients were older than 50 years of age (67.2%). Regarding the União Internacional de Controle do Câncer/American Joint Committee on Cancer (UICC/AJCC) staging, 49.2% of the ductal/special types tumors were diagnosed in Stages I or II, while 56.6% of lobular carcinomas were diagnosed in Stages II or III/IV. Regarding the Nottingham score, most cases were intermediate grade (43.9%). A total of 61% of the tumors were estrogen receptor positive (ER+) and 54% were progesterone receptor positive (PR+). Moreover, 36.1% presented positive human epidermal growth factor receptor 2 (HER2+), a rate higher than that indicated by the literature. Conclusion: The breast carcinomas evaluated in this study presented a profile similar to that reported in the literature, with some peculiarities inherent to the local pathology service. Nevertheless, the low frequency of in situ cases indicates failure in early diagnosis.

RESUMEN Introducción: El cáncer de mama es la segunda causa de muerte por cáncer entre mujeres alrededor del mundo, y estudios epidemiológicospueden contribuir al entendimiento de sus mecanismos. Objetivos: Determinar el número de casos de carcinoma de mama diagnosticados en un período de seis anos. Método: El perfil de los carcinomas de mama diagnosticados en un hospital terciario de Curitiba ha sido comparado con aquel de la literatura, a través de análisis retrospectivo de historias de carcinoma de mama ductal/tipos especialesy lobulillar de pacientes atendidos entre los anos de 2008y 2013. Resultados: Se han diagnosticado 327 (91,6%) casos de carcinoma ductal/tipos especiales y 30 (8,4%) de carcinoma lobulillar, totalizando 357 muestras. De estos casos, 27 (7,5%) eran de carcinoma in situ (20 ductaly siete lobulillar) y 330 (92,4%), invasores (307 ductal invasor +tipos especialesy 23 lobulillar). La incidencia de tumores de mama en mujeres fue de 99,1%, siendo los pacientes, en su generalidad, mayores de50 anos (67,2%). Con respecto a la estadificación de Unión Internacional Contra el Cáncer/American Joint Committee on Cancer (UICC/AJCC), 49,2% de los tumores ductales + tipos especiales fueron diagnosticados en los estadios I o II, mientras 56,6% de los tumores lobulillares se concentraron en los estadios II o III/IV. En cuanto al sistema de Nottingham, gran parte de los casos era de grado intermediario (43,9%). Un total de 61% de los tumores era receptor de estrógeno positivo (RE+) y 54%, receptor de progesterona positivo (RP+). Por otro lado, 36,1% presentaron el receptor 2 del factor de crecimiento epidérmico humano positivo (HER2+), tasa superior a la indicada en la literatura. Conclusión: Los carcinomas de mama evaluados en este estudio presentaron perfil semejante al expuesto en la literatura, con algunaspeculiaridades inherentes al servicio local. Sin embargo, la baja frecuencia de casos in situ indica fracaso en el diagnóstico precoz.

RESUMO Introdução: O câncer da mama éa segunda causa de morte por câncer entre as mulheres em todo o mundo, e estuáis epidemiológicos podem auxiliar no entendimento dos seus mecanismos. Objetivos: Realizar um levantamento do número de casos dos carcinomas da mama diagnosticados em um período de seis anos. Método: Foi comparado com a literatura o perfil dos carcinomas da mama diagnosticados em um hospital terciário de Curitiba, por meio da análise retrospectiva dos laudos de carcinomas da mama ductal/ tipos especiais e lobular de pacientes atendidos entre os anos de 2008 e 2013. Resultados: Foram diagnosticados 327 (91,6%) casos de carcinoma ductal/tipos especiais e30 (8,4%) de carcinoma lobular, totalizando 357 amostras. Desses casos, 27 (7,5%) eram de carcinoma in situ (20 ductal esete lobular) e330 (92,4%), invasores (307ductal invasor + tipos especiais e 23 lobular). Aprevalência de tumores da mama nas mulheres foi de 99,1%, tendo os pacientes, na sua maioria, mais de 50 anos (67,2%). Em relação ao estadiamento da União Internacional de Controle do Câncer/American Joint Committee on Cancer (UICC/AJCC), 49,2% dos tumores ductal + tipos especiais foram diagnosticados em estadio Iou II, enquanto 56,6% dos tumores lobular concentraram-se nos estadios II ou III/IV Quanto à escala de Nottingham, grande parte dos casos era de grau intermediário (43,9%). Um total de 61% dos tumores eram receptor de estrogênio positivo (RE+) e 54%, receptor de progesterona positivo (RP+). Por outro lado, 36,1% apresentaram receptor 2 de fator de crescimento epidermal humano positivo (HER2+), taxa superior à indicada pela literatura. Conclusão: Os carcinomas da mama avaliados neste estudo apresentaram perfil semelhante ao exposto na literatura, com algumas peculiaridades inerentes ao serviço local. Entretanto, a baixa frequência de casos in situ indica falha no diagnóstico precoce.

Anthropometric Measurements Of External Ear In Tribal Population Of Udaipur District In Rajasthan

Background: The human ears are very important organ of the face. Its structure gives information about age andsex. Anatomically ear is divided into three parts i.e. External ear, Middle ear and Internal ear. External earconsists of auricle (helix, choncha, antihalix, tragus, anti tragus, cymba choncha, cavum choncha), externalauditory meatus. Anthropometric data of present study help in better objective referred material for the aestheticplastic surgeon, sex determination and in industrial ears product design.Material and methods: This anthropometric study was started after taking ethical clearance from the institution.Before taking measurement, the informed written consent was taken from the entire participant selected for thestudy. Number of cases in this study was 119 between the age group of 16 to 26 years and without any acquiredor congenital deformities. The study was conducted on 65 males and 54 females. All measurements were takenfrom digital vernier calliper and recorded in centimetre.Results: In this study the mean and standard deviation (SD) of Total ear height (TEH) of right and left ear in maleand female was 6.08+-0.35 cm,5.97+_0.32 cm and 5.69+_ 0.34 cm, 5.66+_0.37cm. Total Ear width (EW) of right andleft ear in male and female was 2.93+_0.23 cm, 2.95+_ 0.21 cm and 2.55 +_0.23 cm, 2.59 +_0.24 cm. Respectivelylobular Height (LH) of right and left ear in male and female was 1.58 +_0.19 cm, 1.65+_0.16 cm and 1.56+_0.16 cm,1.63 +_0.17 cm. Lobular width (LW) of right and left ear in male and female was 1.7 +_ 0.25 cm, 1.73 +_0.25cm and1.67 +_0.26cm, 1.72 +_ 0.20 cm found.Conclusion: All parameters were found higher in male than female. All the parameters were highly significant.

Mastitis granulomatosa idiopática: características clínicas y tratamiento de una serie de casos / Idiopathic granulomatous mastitis: clinical characteristics and treatment of a series of cases

Resumen OBJETIVO: Describir las características clínicas de la mastitis granulomatosa idiopática y exponer los esquemas de tratamiento indicados a una serie de pacientes. MATERIAL Y MÉTODOS: Estudio retrospectivo y transversal efectuado en una serie de casos de pacientes con mastitis granulomatosa idiopática atendidas entre mayo de 2012 y julio 2013 por el Grupo de Alta Especialidad Ginecológica y Mamaria de la Ciudad de México. A todas las pacientes se les tomó una biopsia escisional, justificada y guiada por un estudio radiológico previo. RESULTADOS: Se incluyeron 21 pacientes de edad promedio de 42 años (DE ± 12.5 años) 7 de 21 estaban en la menopausia, 3 de 21 habían permanecido asintomáticas, 2 de 21 con telorragia, 14 de 21 con tumoración mamaria y 2 de 21 con mastalgia. El reporte radiológico de BIRADS fue: 3 = III, 8 = IVa, 8 = IVb y 2 = IVc. La resección quirúrgica se practicó a 19 de 21 pacientes y a 14 de 19 se les administró, antes de la operación, prednisona. CONCLUSIONES: La combinación del tratamiento médico y quirúrgico mejora el pronóstico funcional y cosmético de las pacientes con mastitis granulomatosa y disminuye el riesgo de coincidencia inadvertida de carcinoma de mama.

Abstract OBJECTIVE: To describe the clinical characteristics of the patients studied with Mastitis idiopathic granulomatous (MGI), also to provide therapeutic tools for these kind of patients. MATERIAL AND METHODS: Retrospective cross-sectional study of 21 patients with MGI who underwent excision, justified and guided by a previous radiological study, with a complete file and a histopathology report that confirmed the pathological entity. Results: We included 21 patients with an average age of 42 years (SD +/- 12.5 years) 7/21 were in the menopause stage. The clinical presentation was: 3 asymptomatic, 2 with sporulation, 14 with mammary tumor and 2 with mastalgia. The radiological report of BIRADS was: 3 = III, 8 = IVa, 8 = IVb and 2 = IVc. Surgical resection was performed at 19/21 and at 14/19, prednisone was administered preoperatively. CONCLUSIONS: The combined use of medical and surgical treatment improves the functional and cosmetic prognosis in the patient, as well as decreases the risk of inadvertent coincidence of a breast carcinoma.

A Case of Pyogenic Granuloma in Larynx

Pyogenic granuloma is one of the benign vascular neoplasm. The nomenclature is misnomer because pyogenic granuloma is not related to infection and granuloma. It represent histopathologically lobular capillary hemangioma. It is most commonly occurred on skin followed by oral cavity such as gingiva, lip, tongue and buccal mucosa. Herein, we report a extremely rare case of pyogenic granuloma which was developed on larynx of a 81 year-old male with review of literature.

CD9 Expression in Tumor Cells Is Associated with Poor Prognosis in Patients with Invasive Lobular Carcinoma / 한국유방암학회지

PURPOSE: We investigated the prognostic significance of CD9 expression in tumor cells of patients with invasive lobular carcinoma (ILC). METHODS: CD9 expression was evaluated by immunohistochemistry in 113 ILC tissue samples. Correlation of CD9 expression with the patients' clinicopathological parameters and overall survival was assessed. RESULTS: CD9 expression was detected in 48 (42.5%) ILC patients. However, no significant relation could be determined between CD9 expression and the clinicopathological parameters of the patient including tumor size, lymph node metastasis, lymphovascular invasion, histologic grade, expression of hormone receptors, human epidermal growth factor receptor 2 status, and Ki-67 labeling index. Patients with CD9 expression had worse overall survival (p = 0.051) and disease-free survival (DFS, p = 0.014) compared to patients without CD9 expression. Multivariate analysis revealed that CD9 expression was an independent prognostic factor for DFS (p = 0.049). CONCLUSION: CD9 expression in tumor cells could be a significant prognostic marker in patients with ILC.

A Case of Intravenous Pyogenic Granuloma Originating in the External Jugular Vein / 대한이비인후과학회지

Intravenous pyogenic granuloma (IVPG), also known as intravenous lobular capillary hemangioma, is an extremely rare form of vascular tumor which derives from the lumen of a vein of the head and neck and upper extremities. The treatment of choice is complete local excision of a small portion of the vein. Since first report in 1979, IVPG has been reported in no more than 60 reports abroad. To our knowledge, IVPG originating in the external jugular vein has never been reported in Korea but has important clinical implication. Accurate preoperative diagnosis of neck mass originating in jugular vein is important to plan operative procedures to avoid vascular injury, excessive bleeding, or incomplete excision. Preoperative radiologic examinations such as ultrasonography, computed tomography are useful as first-line diagnostic tools for differential diagnosis of movable neck mass. With a review of literature, the author reports a case of IVPG arising from the left external jugular vein in a 31-year-old male who complained about a palpable neck mass. This patient was successfully managed by ligation and excision of the vein without any complication and no recurrence was found after 6 months.

Dermatoscopy: an auxiliary resource for the diagnosis of poroid neoplasms

Abstract: Poroid neoplasms are benign epithelial proliferations with eccrine sweat gland differentiation. They are a challenging diagnosis because of the clinical heterogeneity, being able to mimic several malignant neoplasms. They are classified into classic poroma, hidroacanthoma simplex, dermal duct tumor and poroid hidradenoma. Association of histological subtypes occurs in more than 25% of cases. We report a case of a combined poroid neoplasia of classical poroma and poroid hidradenoma, reviewing its dermatoscopic features.

Invasive lobular carcinomas treated at Hospital de Clínicas of UFPR: incidence, characteristics and clinical outcome / Carcinomas lobulares invasores de mama tratados no Hospital de Clínicas da UFPR: incidência, características e evolução clínica

Objective: The aim of this study is to depict the clinical and epidemiological profile of patients treated for invasive lobular carcinoma (ILC) at Hospital das Clínicas of Universidade Federal do Paraná (HC-UFPR) over the course of ten years and to evaluate the variation of ILC dimensions on imaging exams by comparing them to real-size lesions identified in surgical specimens. Methods: Patients undergoing breast surgical procedures at HC-UFPR from 2005 to 2014 were selected. Out of these, 36 were diagnosed with ILC and had their medical files sought after clinical, epidemiological, therapeutic and prognosis characteristics. The variance of tumor sizes in imaging methods and anatomopathological descriptions were also studied. Results: Patients' mean age at diagnosis was 59.6 years. Most of them were classified as clinical stages II (40%) and III (26.7%) by the time they were diagnosed. The majority of tumors were HER2 negative (77.2%) and estrogen-receptor positive (90%). The surgical treatment was radical in 74.2% of the cases. 31.4% of the patients underwent both mammography and ultrasonography screening and 45.7% underwent only one of them. None of the patients were submitted to magnetic resonance imaging (MRI). Conclusion: Data found about patients with invasive lobular carcinoma at HC-UFPR is in accordance with the medical literature, including incidence rates and tumor characteristics. The variance of tumor sizes in imaging exams and surgical specimen was not statistically significant

Objetivo: O estudo busca caracterizar o perfil clínico epidemiológico referente às pacientes tratadas por carcinoma lobular invasor de mama (CLI) no Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR) em um período de dez anos e avaliar as variações das dimensões dos CLI nos exames de imagem quando comparadas ao real tamanho das lesões identificadas nas peças de anatomia patológica. Métodos: Foram selecionadas pacientes submetidas a procedimentos cirúrgicos de mama no HC-UFPR entre os anos de 2005 e 2014, dentre as quais 36 apresentaram diagnóstico de CLI. Seus prontuários foram analisados para avaliação de características clínicas, epidemiológicas, terapêuticas e prognósticas. Também foi avaliada a discrepância dos valores de tamanho do tumor em métodos de imagem em relação ao descrito nos laudos anatomopatológicos. Resultados: A s p acientes c om d iagnóstico d e C LI tinham média de idade no diagnóstico de 59,6 anos. O diagnóstico foi feito, em sua maioria, nos estádios clínicos II (40%) e III (26,7%). Houve maior negatividade (77,2%) para HER2 e positividade (90%) para receptor de estrógeno. O tratamento cirúrgico foi radical em 74,2% das pacientes. Em exames de imagem, 31,4% das pacientes realizaram mamografia e ultrassonografia em conjunto, 45,7% fizeram apenas um dos exames e nenhuma realizou ressonância magnética. Conclusão: Observou-se que a casuística de patologias mamárias do HC-UFPR está de acordo com a literatura em relação à incidência e às características próprias dos CLI. A análise da discrepância dos tamanhos dos tumores em exames de imagem em relação às peças cirúrgicas não obteve resultados significativos estatisticamente

Manejo diagnóstico-terapéutico de las lesiones mamarias atípicas / Diagnostic-therapeutic Management of Atypical Breast Lesions

Las lesiones mamarias se dividen histológicamente en dos grandes grupos, malignas y benignas. Las lesiones malignas pueden ser de origen ductal o lobulillar, siendo el carcinoma ductal infiltrante la neoplasia invasiva más frecuente. Las lesiones benignas se clasifican en no proliferativas, proliferativas sin atipias y proliferativas con atipias. Dentro de los dos últimos grupos se encuentran entidades que conllevan un alto riesgo de desarrollar carcinoma de mama, como pueden ser la hiperplasia ductal atípica, la cicatriz radial o la neoplasia lobular. Revisamos en qué consisten dichas entidades y cuáles son sus características principales en imagen, fundamentalmente en mamografía y ecografía. Si tras realizar una biopsia se obtiene uno de esos diagnósticos histológicos, es importante analizar las características imagenológicas y el tipo de procedimiento realizado (número de cilindros obtenidos, calibre de aguja...), para realizar un adecuado manejo posterior. En algunos casos la actitud a seguir será la extirpación quirúrgica completa de la lesión, mientras que en otros se podrá realizar una extirpación percutánea (mediante biopsia con aguja de vacio), o incluso seguimiento estricto por imagen. Mediante diferentes casos mostraremos nuestra experiencia y analizaremos la literatura vigente para recordar esas entidades y llegar a un consenso adecuado sobre el manejo de las mismas.

Breast lesions are divided histologically into two large groups, malignant and benign. Malignant lesions may be of ductal or lobular origin, with infiltrating ductal carcinoma being the most frequent invasive neoplasm. Benign breast lesions are classified as proliferative, proliferative without atypia and proliferative with atypia. Within the last two classifications are entities that carry a high risk of developing breast carcinoma, such as atypical ductal hyperplasia, radial scar or lobular neoplasia. We review what these entities consist of and what are their fundamental characteristics in image, fundamentally in mammography and ultrasound. When we perform one of these histological diagnoses after a biopsy, it is important to analyze the radiological characteristics and the type of procedure performed (number of cylinders, needle gauge ...) to perform an appropriate posterior management. In some cases the attitude to be followed will be the complete surgical removal of the lesion, while in others a percutaneous excision (through vacuum needle biopsy) or even strict image follow-up may be performed. Through different cases we will show our experience and analyze current literature to remember these entities and reach an adequate management consensus.