Contribuição da imuno-histoquímica no diagnóstico do câncer de próstata / Immunohistochemistry contribution to the diagnosis of prostate cancer

INTRODUCTION: Efforts for the identification of prostate cancer in the initial clinical and pathological stages led to an increase in the number of biopsies, sometimes making the histological diagnosis of adenocarcinoma difficult. This is due to the presence of minimal carcinoma or atypical glands suspicious for carcinoma, also known as atypical small acinar proliferation (ASAP). In these cases, the use of immunohistochemistry (IHC) has become a common practice in laboratories of pathology. OBJECTIVES: The aims of this study were to assess the incidence of diagnoses of ASAP and minimal adenocarcinoma in two laboratories of pathology and to evaluate the contribution of IHC and repeat biopsy to the diagnosis of prostate cancer. METHODS: We reviewed 641 sets of modified sextant needle biopsies of the prostate performed in two laboratories of pathology between January 2005 and December 2010. IHC using 34âE12 and p63 antibodies was performed on 35 of 73 (11.38%) cases diagnosed as ASAP and on 7 (1.1%) cases diagnosed as minimal adenocarcinoma. RESULTS: The incidence of ASAP diagnosis was 11.38% (n = 73). IHC was performed in 35 of the 73 ASAP cases and provided conclusive results in 31 cases (88.57%), resulting in a final diagnosis of adenocarcinoma in 19 patients (54.28%), benign lesions in 12 patients (34 28%); only 4 (11.42%) were inconclusive. CONCLUSION: The results suggest that IHC should be routinely used in evaluation of borderline biopsies and in ASAP cases. IHC strongly contributes to the diagnosis of prostate cancer.

INTRODUÇÃO: Os esforços de detecção precoce do câncer de próstata, identificados em fases clínicas e patológicas iniciais, levou ao aumento no número de biópsias e, por vezes, indefinição do diagnóstico histológico de adenocarcinoma devido à presença de carcinomas mínimos ou alterações pseudoneoplásicas, como proliferação atípica de pequenos ácinos (PAPA). Nesses casos, o uso da imuno-histoquímica (IMH) para evidenciar a presença de células basais tornou-se uma prática comum em laboratórios de patologia. OBJETIVOS: O presente estudo visa a avaliar a incidência de PAPA e de adenocarcinoma mínimo em dois laboratórios de patologia do interior, bem como avaliar a contribuição da IMH e da rebiópsia no diagnóstico do câncer de próstata. MÉTODOS: Foram revistas 641 biópsias de próstata por agulha realizadas entre janeiro de 2005 e dezembro de 2010. Dos 73 casos diagnosticados como PAPA (11,38%), 35 foram submetidos ao exame imuno-histoquímico, usando anticorpos anti-34ßE12 e p63, assim como sete casos diagnosticados como adenocarcinoma mínimo (1,1%). Resultados: Os resultados mostraram que a técnica foi conclusiva em 31 casos (88,57%), com diagnóstico final de adenocarcinoma em 19 pacientes (54,28%); 12 (34,28%) com lesões benignas; e apenas quatro (11,42%) inconclusivos (PAPA). CONCLUSÃO: Os resultados sugerem que IMH deve ser rotineiramente usada em biópsias limítrofes e casos de PAPA, pois contribui significativamente para o diagnóstico de câncer de próstata.

Acinic cell carcinoma of the salivary glands: a literature review

Acinic cell carcinoma [ACC] is a low-grade malignant salivary neoplasm that constitutes approximately 17% of primary salivary gland malignancies. In the head and neck region, the parotid gland is the preddominant site of origin and women are usually more frequently diagnosed than men. Previous radiation exposure and familial predisposition are some of the risk factors for ACC. A slowly enlarging mass lesion in the tail of the parotid gland is the most frequent presentation. The diagnosis is usually confirmed with a fine needle aspiration biopsy, and surgical excision is the main treatment of this malignant neoplasm. Other treatment modalities such as radiotherapy may be indicated in some cases. ACC has a significant tendency to recur, to produce metastases [cervical lymph nodes and lungs], and may have an aggressive evolution. Therefore, long-term follow-up is mandatory after treatment

Mixed exocrine-endocrine pancreatic carcinoma in childhood.

A 7-year-old boy with mixed exocrine-endocrine pancreatic cancer is presented. This may be the second reported case of such a tumor in childhood.