ABSTRACT
In a series of 100 colorectal adenomas, 23 tubulo-villous adenomas were individualized through the identification of papillae as structures persisting for more than 100 microm in serial sections with a connective axis lined with epithelial cells. In these adenomas, the tubular and villous areas with the highest dysplasia were selected, and a morphometric analysis was undertaken to assess the Index of Structural Atypia, the Nucleo-Glandular Index, and the Nuclear Stratification Index. The AgNor count and the proliferating cell nuclear antigen (PCNA) Label Index (LI) also were performed. The overall mean of each of these indexes was significantly higher in the villous sector than in the tubular one (P < .001). In 16 cases, the semi-objective method of dysplasia gradation showed a superior degree in the papillary sector, whereas it showed an equal degree in the remaining seven lesions. The AgNOR count was significantly different in all cases, with higher values in villous sectors (P < .05). With the exception of one case, this was confirmed by the PCNA LI. The Stratification Index showed significantly different values in 20 cases, whereas the other morphometric indexes showed a less discriminatory result. Our findings objectively show that the degree of dysplasia in tubulo-villous adenomas should be analyzed in the villous sector. The existence of heterogeneous cellular populations has been confirmed both in the structural organization of cells and in some basic parameters such as the cell proliferation rate in colorectal adenomas. Our findings suggest that the occurrence of villous architectural growth is a secondary event in a tubular adenoma. Enhanced cellular proliferation of the villous area allows the progressive substitution of tubular structures.
Subject(s)
Adenoma, Villous/pathology , Colorectal Neoplasms/pathology , Adenoma, Villous/metabolism , Adenomatous Polyps/metabolism , Adenomatous Polyps/pathology , Cell Division , Cell Nucleus , Colorectal Neoplasms/metabolism , Humans , Nucleolus Organizer Region/pathology , Proliferating Cell Nuclear Antigen/metabolism , Prospective Studies , Silver StainingABSTRACT
Las neoplasias del intestino delgado son poco frecuentes. Los carcinoides son el 20 por ciento de éstas. La mayoría son asintomáticos y son hallazgos incidentales, el resto se presenta por sus complicaciones, como cuadros agudos de abdomen, el más frecuente es la oclusión intestinal. El infarto intestino mesentérico y la isquemia intestinal han sido reconocidos como otra presentación muy rara, en estos casos la terapéutica quirúrgica agresiva, a pesar de la gravedad de la presentación, muestra beneficios en el pronóstico. Se presentan 2 casos y se discuten los eventos patogénicos (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Intestinal Neoplasms/complications , Mesenteric Vascular Occlusion/etiology , Carcinoid Tumor/complications , Ischemia/etiology , Intestine, Small/blood supply , Intestinal Neoplasms/epidemiology , Intestinal Neoplasms/secondary , Carcinoid Tumor/diagnosis , Carcinoid Tumor/epidemiology , Prognosis , Survival Rate , Intestinal Obstruction/etiologyABSTRACT
Las neoplasias del intestino delgado son poco frecuentes. Los carcinoides son el 20 por ciento de éstas. La mayoría son asintomáticos y son hallazgos incidentales, el resto se presenta por sus complicaciones, como cuadros agudos de abdomen, el más frecuente es la oclusión intestinal. El infarto intestino mesentérico y la isquemia intestinal han sido reconocidos como otra presentación muy rara, en estos casos la terapéutica quirúrgica agresiva, a pesar de la gravedad de la presentación, muestra beneficios en el pronóstico. Se presentan 2 casos y se discuten los eventos patogénicos
Subject(s)
Humans , Male , Female , Middle Aged , Carcinoid Tumor/complications , Intestinal Neoplasms/complications , Mesenteric Vascular Occlusion/etiology , Carcinoid Tumor , Carcinoid Tumor/diagnosis , Intestinal Neoplasms , Intestinal Neoplasms/secondary , Intestine, Small/blood supply , Ischemia/etiology , Intestinal Obstruction/etiology , Prognosis , Survival RateABSTRACT
Two cases of an unusual finding of capsular pseudoinvasion in follicular thyroid adenomas after fine-needle aspiration (FNA) procedures are reported. These capsular breaches were noted along the hemorrhagic needle track, which traversed the normal peripheral thyroid parenchyma into the lesions. A reparative reaction was seen at some points along one of the tracks. Histologic examination also showed extrusion of the tumor parenchyma through the capsular interruption in one case. Surgical pathologists should be aware of this rare complication of FNA of thyroid follicular adenomas as a differential diagnosis of minimally invasive (encapsulated) follicular carcinoma.
Subject(s)
Adenoma/pathology , Biopsy, Needle/adverse effects , Thyroid Neoplasms/pathology , Diagnosis, Differential , Female , Humans , Middle Aged , Neoplasm InvasivenessABSTRACT
Primary small cell carcinoma of the esophagus, morologically indistinguishable from its counterpart of the lung is a rare tumour with a frequency between 0.05 to 7.6% of all esophageal malignancies. Currently they are divided into oat cell and non oat cell, regarding the presence of neuroendocrine granules. We report 3 cases from our hospital. They were studied clinicopathologically and also examined by electron microscopy.
Subject(s)
Carcinoma, Small Cell/pathology , Esophageal Neoplasms/pathology , Aged , Carcinoma, Small Cell/ultrastructure , Endoscopy , Esophageal Neoplasms/ultrastructure , Female , Humans , Lymphatic Metastasis , Male , Middle Aged , PrognosisABSTRACT
OBJECTIVE: To compare the different diagnostic techniques of Helicobacter Pylori infection, confronting the bacteriological culture to other faster, less expensive and easier techniques, such as the urease test, methylen blue and Gram stained smears, the histopathologic examination of biopsies specimens, and the detection of IgG antibodies anti Helicobacter Pylori. MATERIAL AND METHODS: 43 patients with gastroduodenal symptoms who had not taken NSAIDs and who presented endoscopic signs of inlammation and/or gastroduodenal ulcer were prospectively studied. Biopsies specimens of antrum, gastric fundus and duodenal bulb were taken and processed in the following way: methylen blue and Gram stained smears and Hematoxylin and eosin stained section. Studies were performed in to all the 43 patients. Urease test was performed in the antrum specimens of 37 patients, and inmunologic test by inmunoenzimatic technique (ELISA) in 40 of them. RESULTS: Methylen blue and Gram stained smears: sensitivity (S): 100% and specificity (E): 76% Histopathologic examination (S): 86% (E): 61%, urease test (S) 100% (E) 62.5%, antibodies anti H.P. not possible to calculate. DISCUSSION: The authors have taken the microbiological culture as a reference technique because the isolation and identification of the bacteria are the most important signs of its presence and vitality. Stained smears, histopathologic examination and the urease test are fast, inexpensive techniques with high sensitivity for diagnosis. However, the inmunologic test is reveals better to the prevalence of the infection.
Subject(s)
Helicobacter Infections/diagnosis , Helicobacter pylori/isolation & purification , Adult , Aged , Female , Helicobacter Infections/microbiology , Humans , Male , Middle Aged , Sensitivity and SpecificityABSTRACT
Los carcinomas de células pequeñas (CCP), son neoplasias altamente agresivas, también conocidos como carcinomas de tipo "oat cell" y "non oat cell", carcinoma neuroendócrinos, etc. La mayoría se originan en el pulmón, existe un 5 por ciento que se originan en sitios extrapulmonares. Los originados en esófago son muy raros y representan del 0.05 al 7.6 por ciento de las neoplasias malignas del esófago. Generalmente se presentan en forma diseminada y tienen muy mal pronóstico. Plantean dificultades en el diagnóstico diferencial con otros tumores malignos así como en el tratamiento. Nosotros presentamos 3 casos de CCP primitivos de esófado, discutimos sus características clínicas, histopatológicas y histoquímicas, ultraestructurales, e histogénesis, en relación a la literatura. (AU)
Subject(s)
Middle Aged , Aged , Humans , Male , Female , Esophageal Neoplasms/pathology , Carcinoma, Small Cell/pathology , Esophageal Neoplasms/ultrastructure , Carcinoma, Small Cell/ultrastructure , Lymphatic Metastasis , Endoscopy , PrognosisABSTRACT
Con el objetivo de comparar diferentes técnicas de diagnóstico de Helicobacter pylori, enfrentamos el cultivo bacteriológico con técnicas menos laboriosas, de fácil manipulación, rápidas y menos onerosas, como el test rápido de la ureasa, el frotis con coloración, el estudio histopatológico y la determinación de anticuerpos anti Helicobacter pylori de clase IgG. Se estudiaron en forma prospectiva 43 pacientes de consulta hospitalaria, con sintomatología gastroduodenal. Con signos endoscópicos de inflamación y/o úlcera gastroduodenal. Se tomaron biopsias de Antro, Fundus gástrico y Bulbo duodenal, procesadas de la siguiente manera: a los 43 pacientes, para cada localización se realizó estudio microbiológico (frotis con coloración de Gram y Azul de Metileno, y cultivo en medio selectivo) y estudio histopatológico con cortes coloreados con Hematoxilina - Eosina. En la muestra antral de 37 pacientes se realizó) el test rápido de la ureasa (Clotest, Lab. Delta Westlen). El estudio inmunológico de búsqueda de anticuerpos de clase IgG mediante una técnica inmunoenzimática se hizo en 40 pacientes. Obteniéndose una sensibilidad (S) y una especificidad (E) para el frotis con coloración de 100 por ciento y 76 por ciento respectivamente. Para la antomía patológica: S = 86 por ciento y E = 61 por ciento, el test de la ureasa S = 100 por ciento y E = 62.5 por ciento, anticuerpos anti Helicobacter S = 100 por ciento y E no calculable. Se tomó el cultivo microbiológico como técnica de referencia basándonos en que el aislamiento del germen y su identificación constituye el criterio de presencia y vitalidad del mismo. Siendo el frotis con coloración, la anatomía patológica y el test rápido de la ureasa técnicas de buena presunción diagnóstica de infección presente, rápidas y de bajo costo para nuestro medio. En cambio el estudio inmunológico es de elección para conocer la prevalencia de la infección dado que la misma es de curso lento y los anticuerpos están presentes por tiempo prolongado en los infectados incluso después del tratamiento. (AU)
Subject(s)
Comparative Study , Humans , Male , Female , Adult , Middle Aged , Aged , Helicobacter Infections/diagnosis , Helicobacter pylori/isolation & purification , Gastric Mucosa/microbiology , Urease/metabolism , Azure Stains/diagnosis , Enzyme-Linked Immunosorbent Assay , Endoscopy, GastrointestinalABSTRACT
Primary small cell carcinoma of the esophagus, morologically indistinguishable from its counterpart of the lung is a rare tumour with a frequency between 0.05 to 7.6
of all esophageal malignancies. Currently they are divided into oat cell and non oat cell, regarding the presence of neuroendocrine granules. We report 3 cases from our hospital. They were studied clinicopathologically and also examined by electron microscopy.
ABSTRACT
OBJECTIVE: To compare the different diagnostic techniques of Helicobacter Pylori infection, confronting the bacteriological culture to other faster, less expensive and easier techniques, such as the urease test, methylen blue and Gram stained smears, the histopathologic examination of biopsies specimens, and the detection of IgG antibodies anti Helicobacter Pylori. MATERIAL AND METHODS: 43 patients with gastroduodenal symptoms who had not taken NSAIDs and who presented endoscopic signs of inlammation and/or gastroduodenal ulcer were prospectively studied. Biopsies specimens of antrum, gastric fundus and duodenal bulb were taken and processed in the following way: methylen blue and Gram stained smears and Hematoxylin and eosin stained section. Studies were performed in to all the 43 patients. Urease test was performed in the antrum specimens of 37 patients, and inmunologic test by inmunoenzimatic technique (ELISA) in 40 of them. RESULTS: Methylen blue and Gram stained smears: sensitivity (S): 100
and specificity (E): 76
Histopathologic examination (S): 86
(E): 61
, urease test (S) 100
(E) 62.5
, antibodies anti H.P. not possible to calculate. DISCUSSION: The authors have taken the microbiological culture as a reference technique because the isolation and identification of the bacteria are the most important signs of its presence and vitality. Stained smears, histopathologic examination and the urease test are fast, inexpensive techniques with high sensitivity for diagnosis. However, the inmunologic test is reveals better to the prevalence of the infection.
ABSTRACT
Con el objetivo de comparar diferentes técnicas de diagnóstico de Helicobacter pylori, enfrentamos el cultivo bacteriológico con técnicas menos laboriosas, de fácil manipulación, rápidas y menos onerosas, como el test rápido de la ureasa, el frotis con coloración, el estudio histopatológico y la determinación de anticuerpos anti Helicobacter pylori de clase IgG. Se estudiaron en forma prospectiva 43 pacientes de consulta hospitalaria, con sintomatología gastroduodenal. Con signos endoscópicos de inflamación y/o úlcera gastroduodenal. Se tomaron biopsias de Antro, Fundus gástrico y Bulbo duodenal, procesadas de la siguiente manera: a los 43 pacientes, para cada localización se realizó estudio microbiológico (frotis con coloración de Gram y Azul de Metileno, y cultivo en medio selectivo) y estudio histopatológico con cortes coloreados con Hematoxilina - Eosina. En la muestra antral de 37 pacientes se realizó) el test rápido de la ureasa (Clotest, Lab. Delta Westlen). El estudio inmunológico de búsqueda de anticuerpos de clase IgG mediante una técnica inmunoenzimática se hizo en 40 pacientes. Obteniéndose una sensibilidad (S) y una especificidad (E) para el frotis con coloración de 100 por ciento y 76 por ciento respectivamente. Para la antomía patológica: S = 86 por ciento y E = 61 por ciento, el test de la ureasa S = 100 por ciento y E = 62.5 por ciento, anticuerpos anti Helicobacter S = 100 por ciento y E no calculable. Se tomó el cultivo microbiológico como técnica de referencia basándonos en que el aislamiento del germen y su identificación constituye el criterio de presencia y vitalidad del mismo. Siendo el frotis con coloración, la anatomía patológica y el test rápido de la ureasa técnicas de buena presunción diagnóstica de infección presente, rápidas y de bajo costo para nuestro medio. En cambio el estudio inmunológico es de elección para conocer la prevalencia de la infección dado que la misma es de curso lento y los anticuerpos están presentes por tiempo prolongado en los infectados incluso después del tratamiento.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Helicobacter Infections/diagnosis , Azure Stains , Endoscopy, Gastrointestinal , Enzyme-Linked Immunosorbent Assay , Helicobacter pylori/isolation & purification , Gastric Mucosa/microbiology , Urease/metabolismABSTRACT
Los carcinomas de células pequeñas (CCP), son neoplasias altamente agresivas, también conocidos como carcinomas de tipo "oat cell" y "non oat cell", carcinoma neuroendócrinos, etc. La mayoría se originan en el pulmón, existe un 5 por ciento que se originan en sitios extrapulmonares. Los originados en esófago son muy raros y representan del 0.05 al 7.6 por ciento de las neoplasias malignas del esófago. Generalmente se presentan en forma diseminada y tienen muy mal pronóstico. Plantean dificultades en el diagnóstico diferencial con otros tumores malignos así como en el tratamiento. Nosotros presentamos 3 casos de CCP primitivos de esófado, discutimos sus características clínicas, histopatológicas y histoquímicas, ultraestructurales, e histogénesis, en relación a la literatura.
Subject(s)
Middle Aged , Humans , Male , Female , Carcinoma, Small Cell/pathology , Esophageal Neoplasms/pathology , Carcinoma, Small Cell/ultrastructure , Endoscopy , Lymphatic Metastasis , Esophageal Neoplasms/ultrastructure , PrognosisABSTRACT
Ninety eight rectocolonic lesions up to 10 mm in diameter found in 50 patients were analyzed. The relationship between endoscopic and pathologic diagnosis was established. Emphasis was made on the detection of adenomas based in the following: Yamada III or IV lateral vision, Yamada I and II with smooth but erythematous surface, and in pale with irregular surface lesions. The sensitivity of the method was 92% and the specificity was 72% for adenomas. Six percent of adenomas were pale, with mucous hypersecretion on histopathology, and can be mistaken for hyperplastic polyps. This mucous hypersecretion correlates with low grade dysplasia, which supposedly indicates a lower evolutive risk.
Subject(s)
Adenoma/pathology , Colorectal Neoplasms/pathology , Adult , Aged , Colonoscopy , Female , Humans , Intestinal Polyps/pathology , Male , Middle Aged , Sensitivity and SpecificityABSTRACT
We report biliary lithiasis secondary to infestation with Ascaris lumbricoides in a young man. We review the pathogenesis and clinical features of this condition and discuss the differential diagnosis.
Subject(s)
Ascariasis/complications , Biliary Tract Diseases/complications , Cholelithiasis/etiology , Adult , Biliary Tract Diseases/parasitology , Humans , MaleABSTRACT
A 55 year-old woman underwent a wide surgical excision because a left thigh mass. The histopathological study showed a focal myositis of the vastus lateralis muscle. The patient remains asymptomatic after four years follow-up. The differential diagnosis with soft tissue sarcomas and other inflammatory myopathies is discussed.