The spectrum of glomerular disease between the years 2003 and 2015 in Columbia: A review of 12,613 cases.

BACKGROUND: The prevalence of glomerular disease (GD) varies according to the different socio-demographic characteristics of each population. For the first time we present the prevalence of the different forms of GD among patients from several different areas of Columbia. METHODS: Data from 12,613 renal biopsies studied at our University Hospital between 2003 and 2015 was reviewed. Pathology results were classified according to a list of renal diseases proposed by various authors. RESULTS: Focal segmental glomerulosclerosis was present in 22%, IgA disease in 21%, Lupus nephritis in 17%, membranous glomerulonephritis in 13% and thin basal membrane disease in 9%. CONCLUSIONS: This study confirms that focal segmental glomerulosclerosis and IgA disease are the most prevalent GDs found in Columbian patients. This is the first study to analyze GDs in a Columbian population and we recommend that a national registry system be created to collect comprehensive information from future research.

Proximal-Type Epithelioid Sarcoma: Report of an Unusual Case in the Uterine Cervix.

Epithelioid sarcoma is a rare malignant mesenchymal neoplasm (less than 1% of all sarcomas) with epithelioid morphology. Among the 2 subtypes, proximal represents only one-third of cases and commonly involves deep tissues of pelvic region, including the perineum, genital area, and groin, and occurs more frequently in older patients who present a more aggressive course. In the female genital tract, proximal-type epithelioid sarcoma (PES) mainly affects the vulva and is extremely uncommon in the uterus. To our knowledge, only a few cases of PES involving the cervix and uterine body have been previously reported in the literature. We report a 23-year-old woman who presented with abnormal vaginal bleeding. She was found to have a cervical mass, which was resected and diagnosed as a hemangioendothelioma. However, 2 months later, the mass recurred and the histopathological analysis at our institution demonstrated a PES confined to the uterine cervix. It is important to include this neoplasm in the differential diagnosis of epithelioid tumors that can involve the female genital tract because it has a significant impact on prognosis and treatment.

The spectrum of glomerular disease between the years 2003 and 2015 in Columbia: a review of 12.613 cases / El espectro de enfermedades glomerulares entre los años 2003 y 2015 en Colombia: una revisión de 12.613 casos

Background. The prevalence of glomerular disease (GD) varies according to the different socio-demographic characteristics of each population. For the first time we present the prevalence of the different forms of GD among patients from several different areas of Columbia. Methods. Data from 12,613 renal biopsies studied at our University Hospital between 2003 and 2015 was reviewed. Pathology results were classified according to a list of renal diseases proposed by various authors. Results. Focal segmental glomerulosclerosis was present in 22%, IgA disease in 21%, Lupus nephritis in 17%, membranous glomerulonephritis in 13% and thin basal membrane disease in 9%. Conclusions. This study confirms that focal segmental glomerulosclerosis and IgA disease are the most prevalent GDs found in Columbian patients. This is the first study to analyze GDs in a Columbian population and we recommend that a national registry system be created to collect comprehensive information from future research (AU)

Antecedentes. La prevalencia de las enfermedades glomerulares varía según las características sociodemográficas de cada población. Por primera vez presentamos la prevalencia de las diferentes formas de enfermedad glomerular (EG) entre pacientes de varias regiones de Colombia. Método. Se revisaron los datos de 12.613 biopsias renales estudiadas en nuestro hospital universitario entre los años 2003 y 2015. Se clasificaron los resultados anatomopatológicos según una lista de enfermedades renales propuesta por varios autores. Resultados. Se encontró glomeruloesclerosis focal y segmentaria en el 22%, enfermedad IgA en el 21%, nefritis lupoide en el 17%, glomerulonefritis membranosa en el 13% y enfermedad de la membrana basal delgada en el 9%. Conclusiones. Nuestro estudio confirma que la glomeruloesclerosis focal y segmentaria y la enfermedad IgA son los más prevalentes entre pacientes colombianos. Esto es el primer estudio que ha analizado EG en la población colombiana, y recomendamos la creación de un registro nacional para recopilar y completar información de investigaciones futuras (AU)

Comparación entre las técnicas de citocentrifugado y base líquida SurePathTM para procesamiento de muestras no ginecológicas / Comparison between cytocentrifugation techniques and liquid-based SurePathTM for the processing of non-gynaecological specimens

Objetivo: Evaluar el uso de base líquida de manera rutinaria para muestras no ginecológicas en nuestro laboratorio mediante una verificación de la validación y comparación de características morfológicas y la concordancia diagnóstica entre dos técnicas: citología convencional por citocentrífugado (CS) y citología de base líquida SurePathTM (CBL). Metodología: Consecutivamente se procesaron un total de 109 muestras no ginecológicas por las dos técnicas, usando una sola muestra dividida, la mitad de la muestra para cada técnica. Todas las láminas fueron revisadas por el mismo citopatólogo evaluando: celularidad, preservación, presencia de elementos que oscurecen (inflamación, hemorragia, moco, otros) y presencia de grupos de diagnóstico para cada categoría de diagnóstico final. Retrospectivamente se realizó una evaluación de conformidad con la biopsia de seguimiento cuando estaba disponible. Resultados: Se observó una concordancia buena por categoría diagnóstica en el 84% de las muestras, con un índice Kappa bueno (0,65). La proporción en categorías: negativo, atípicos y positivas fue del 69%, 18% y 11% para citología de base líquida y el 83%, 7% y 9% para citología convencional por citocentrífugado. Conclusión: La citología de base líquida es una técnica equiparable a la citología convencional por citocentrífugado (concordancia diagnóstica buena, índice kappa 0,6) y es superior en calidad ya que presenta una preservación inmediata de la muestra, un fondo limpio y menos elementos que oscurecen permitiendo un mejor examen morfológico.

Objective: The objective of this study was to evaluate the routine use of liquid based cytology for non-gynecologic specimens in our laboratory, comparing morphological characteristics and diagnostic agreement between the two techniques: conventional cytology cytospin, and SurePath liquid-based cytology. Study design: A total of 109 consecutive non-gynecologic specimens were processed, split into two, and then prepared using the two techniques. All slides were reviewed by the same cytopathologist, who evaluated: cellularity, preservation, obscuring elements (inflammation, bleeding, mucus, etc.), and presence of diagnostic groups for each final diagnostic category. When available, an evaluation of the biopsy was performed retrospectively. Results: Good agreement was observed by diagnostic category in 84% of specimens, with a good Kappa index (0.65). The proportion for each category: negative, atypical, and positive was 69%, 18%, and 11%, respectively, for cases processed by liquid-based cytology and 83%, 7%, and 9%, respectively, for conventional cytology cytospin. Conclusion: Liquid based cytology is equivalent to conventional cytology cytospin when cases are grouped by category (good agreement, kappa index 0.651), and is superior in quality because the specimen is well preserved, has a clean background and fewer obscuring elements allowing a better morphological examination.

Esclerosis hepatoportal como causa de hipertensión portal no cirrótica en un paciente colombiano infectado con VIH / Hepatoportal Sclerosis as a Cause of Portal Hypertension in a Colombian HIV patient without Cirrhosis

Antecedentes: la esclerosis hepatoportal se manifiesta como hipertensión portal no cirrótica. Su etiología parece estar relacionada con alteraciones idiopáticas en la microvasculatura hepática. Las manifestaciones de la esclerosis hepatoportal incluyen sangrado de vías digestivas altas, pancitopenia, esplenomegalia e hipertensión portal no cirrótica. Presentamos el primer caso reportado en Colombia de esclerosis hepatoportal en un paciente con serología positiva para el virus de la inmunodeficiencia humana (VIH). Métodos: paciente masculino de 60 años de edad, VIH-positivo, quien ingresa a nuestra institución por hemorragia de vías digestivas alta (várices esofágicas y fúndicas) y ascitis, cuyo manejo requirió la toma de biopsia hepática. Resultados: se realizó biopsia Trucut de hígado que evidenció la presencia de 6 a 8 espacios porta con parénquima arquitectónico conservado que demostró fibrosis perivenular y dilatación sinusoidal pericentral severa. Conclusión: la esclerosis hepatoportal es una causa de morbilidad en pacientes VIH-positivos. Debe considerarse en cada paciente que manifiesta hipertensión portal no cirrótica asociada con hemorragia de la vía digestiva alta. Sin embargo, una investigación adicional es imprescindible con el fin de describir la relación entre el desarrollo de alteraciones intrahepáticas (microtrombosis), la patogénesis del VIH y el uso de terapia antirretroviral, particularmente el uso de didanosina.

Background: Hepatoportal sclerosis manifests as non-cirrhotic portal hypertension. Its etiology appears to be related to alterations in the idiopathic micro-vasculature of the liver. Manifestations of hepatoportal sclerosis include upper gastrointestinal bleeding, pancytopenia, splenomegaly and non-cirrhotic portal hypertension. We present the first reported case of hepatoportal sclerosis in Colombia which occurred in an HIV positive patient. Methods: A 60-year-old male HIV patient positive was admitted to our institution because of ascites and upper digestive tract bleeding due to esophageal and fundal varices. Management required taking a liver biopsy. Results: A Tru-Cut biopsy needle was used to take a liver biopsy sample percutaneously. The biopsy revealed six to eight portal tracts with preserved architectural parenchyma, perivenular fibrosis and severe pericentral sinusoidal dilatation. Conclusions: Hepatoportal sclerosis is a cause of morbidity in HIV-positive patients and should be considered in each patient manifesting non-cirrhotic portal hypertension associated with upper gastrointestinal bleeding. However, further research is necessary to describe the relationship between the development of intrahepatic alterations (microthrombosis), HIV, and the use of anti-retroviral therapy, particularly the use of didanosine.