Pancreatic collision tumor: mucinous cystadenoma and celar cell renal cell carcinoma metastasis

We present a clinical, radiological, surgical, and pathological correlation case of a 49-year-old woman with a prior nephrectomy due to a clear cell renal cell carcinoma, who was then diagnosed with a multilocular cystic lesion in the pancreatic tail after a routine ultrasound. Computed tomography and magnetic resonance cholangiopancreatography showed a multilocular cystic lesion with a hypervascular wall nodule in the pancreas. The patient underwent a distal pancreatectomy and had a final diagnosis of pancreatic mucinous cystadenoma with an associated component of clear cell renal cell carcinoma (collision tumor of the pancreas). (AU)

Sarcina ventriculi a rare pathogen

Sarcina ventriculi is a gram-positive bacterium, able to survive in extreme low pH environment. It's first description dates from 1842, by John Goodsir. Since then, just a few cases have been reported. In veterinary medicine, especially in ruminants, it causes bloating, vomiting, gastric perforation and death of the animal. It is commonly associated with delayed gastric emptying or obstruction to gastric outlet, although it's pathogenicity in humans is not fully understood. We report two cases with identification of the bacteria in gastric specimens stained with hematoxylin-eosin staining, in different clinical settings. The first patient is a young female patient, presenting cardiac arrest and death after gastric perforation and the second patient an adult male presenting with gastric adenocarcinoma, treated with partial gastrectomy followed by adjuvant chemoradiation. In our literature review, we identified forty-five cases reporting Sarcina ventriculi appearance, with a sudden increase since 2010.

Expressão de imunomarcadores em carcinomas epidermoides de boca / Expression of biological markers in oral squamous cell carcinomas

Squamous cell carcinomas are the most commonly diagnosed oral malignancy, accounting for about 90% of all malignant oral lesions. Detection of the condition at early stages is rare; as a result, the clinical and histological characteristics and prognosis of this tumor have not been extensively investigated. The objective of this study was to evaluate clinical and microscopic features of squamous cell carcinomas using immunohistochemical analysis and assessing biological markers of angiogenesis and tumor vascular activity (anti-CD31, anti-CD34, Factor VIII), cell proliferation (Ki-67), and loss of cell suppression (p53). Tolonium chloride 1% was used to determine the optimal biopsy site. Six patients seen at the Stomatology Service of a university hospital in Canoas, southern Brazil, with a suspected diagnosis of squamous cell carcinoma were analyzed. All patients were male, with a mean age of 56.6 years, and four had a white skin color. Lesions were detected in the tongue4 and tonsillar pillar2. All diagnoses were confirmed by microscopy (hematoxylin-eosin staining). Immunohistochemical analysis revealed p53 expression in 5 of the cases, Ki-67 in 6, and anti-CD34 in 1; anti-CD31 and Factor VIII were not detected in any patient. Our findings suggest an important contribution of tumor markers in the diagnosis and prognosis of these malignancies, as well as in treatment planning.

O carcinoma epidermoide é a neoplasia maligna bucal mais frequentemente diagnosticada, correspondendo a aproximadamente 90% de todas lesões malignas bucais. Sua detecção nos estágios iniciais da doença é rara; como resultado, tem sido difícil avaliar o comportamento clínico e histológico e o prognóstico deste tumor. O objetivo deste estudo foi avaliar clínica e microscopicamente o carcinoma epidermoide através de análise imuno-histoquímica, avaliando imunomarcadores tumorais angiogênicos e de atividade vascular tumoral (anticorpos anti-CD31, anti-CD34, Fator VIII), de proliferação celular (Ki-67) e de perda de supressão celular (p53). Azul de toluidina a 1% foi utilizado para determinar o local ideal da biópsia incisional. Foram analisados seis pacientes oriundos do Serviço de Estomatologia do hospital universitário localizado em Canoas, sul do Brasil, com hipótese diagnóstica de carcinoma epidermoide. Todos os pacientes eram do sexo masculino, com idade média de 56,6 anos, e quatro tinham pele branca. As lesões foram detectadas na língua4 e no pilar amigdaliano2. Todos os diagnósticos foram confirmados por microscopia (hematoxilina-eosina). A análise imuno-histoquímica revelou expressão de p53 em 5 dos casos, Ki-67 em 6 e anti-CD34 em 1; anti-CD31 e Fator VIII não apresentaram expressividade. Nossos resultados sugerem uma contribuição importante dos marcadores tumorais no diagnóstico e prognóstico dessas neoplasias, bem como no planejamento terapêutico.

Valor prognóstico da correlação imunoistoquímica do Ki-67 e p53 em carcinomas epidermóides da laringe / Prognostic value of the immunohistochemistry correlation of Ki-67 and p53 in squamous cell carcinomas of the larynx

Os fatores prognósticos histológicos podem colaborar para determinar a evolução desta neoplasia. OBJETIVO: Correlacionar a expressão imunoistoquímica do p53 e Ki-67 com idade, grau histológico, comprometimento de linfonodos e estadiamento patológico de pacientes com carcinomas epidermóides de laringe. MÉTODO: Foram avaliados trinta casos consecutivos de carcinomas epidermóides de laringe, submetidos à técnica de imunoistoquímica para verificar a expressão dos anticorpos p53 e Ki-67. RESULTADO: A idade média foi de 56,2 anos e a imunoexpressão dos marcadores foi mais observada no grupo com mais de 50 anos de idade, especialmente a do anticorpo Ki-67 (p=0,032). Não houve relação do p53 e Ki-67 com o comprometimento de linfonodos. O Ki-67 se expressou em 70 por cento nos casos de alto grau histológico e 80 por cento nos de baixo, enquanto o p53 em 70 por cento apenas nos de alto grau. O estadiamento patológico mostrou que no grupo dos carcinomas avançados a expressão do p53 foi de 61,5 por cento, enquanto o Ki-67 mostrou positividade para os casos precoces (100 por cento) e avançados (73,1 por cento). CONCLUSÃO: Não houve diferenças significantes entre a imunoexpressão do p53 e do Ki-67 em carcinomas epidermóides de laringe, exceto no grupo de pacientes com mais de 50 anos, onde a expressão do Ki-67 foi significativamente maior.

Prognostic histological factors may contribute to determine the evolution of this neoplasia. AIM: To correlate p53 and Ki-67 immunohistochemical expression with age, histological degree, lymph node involvement and pathological staging in patients with laryngeal epidermoid carcinomas. METHODS: We assessed thirty consecutive cases of laryngeal epidermoid carcinomas submitted to immunohistochemistry to check the expression of p53 e Ki-67 antibodies. RESULTS: Mean age was of 56.2 years and the immunoexpression of the markers was observed in the group with more than 50 years of age, especially that o the ki-67 antibody (p=0.032). There was no relation between p53 and Ki-67 with lymph node involvement. Ki-67 was expressed in 70 percent of the high histology level cases and in 80 percent in the low histology ones; while p53 was of 70 percent only in the high level cases. Pathology staging showed that in the group of advanced carcinomas, p53 expression was of 61.5 percent, while Ki-67 proved positive for the early cases (100 percent) and advanced (73.1 percent). CONCLUSION: There were no significant differences between p53 and Ki-67 immunoexpression in laryngeal epidermoid carcinoma, except in the group of patients with more than 50 years of age, when Ki-67 expression was significantly higher.