Hepatitis herpética en paciente hematológico / No disponible

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[Usefulness of transbronchial punction and mediastinoscopy in mediastinal nodal staging of non-microcytic bronchogenic carcinoma. Preliminary study]. / Utilidad de la punción transbronquial y la mediastinoscopia en la estadificación ganglionar mediastínica del carcinoma broncogénico no microcítico. Estudio preliminar.

Preliminary study to compare the sensitivity and specificity of transbronchial needle aspiration (TBNA) and mediastinoscopy/anterior mediastinotomy (MED/AMED) and/or thoracotomy for staging of mediastinal nodes in non-small cell carcinoma. To determine the sensitivity and specificity of computerized tomography (CT) as a screening technique. Thirty-three patients with non-small cell carcinoma but no remote metastasis and good lung function were evaluated. A chest CT scan was performed before bronchoscopy in 27 patients and before surgery in the others. Nodular areas considered diseased based on CT images were staged by TBNA. When CT images were not available before bronchoscopy. TBNA for staging was performed in the subcarinal region. Results by TBNA were compared with those obtained by MED/AMED and/or thoracotomy. The prevalence of metastatic nodular disease was 47%. CT detected enlarged mediastinal nodes in 24 patients; the images were considered normal in 9 patients. Sensitivity and specificity of CT was 93% and 54%, respectively, with a positive predictive value (PPV) of 68% and negative predictive value (NPV) of 87.5%. The sensitivity and specificity of MED/AMED were 73% and 100%, respectively; PPV was 100% and NPV was 75%. The sensitivity and specificity of TBNA were 36% and 92%, respectively; PPV was 83% and NPV was 57%. The pneumothorax with pleural empyema suffered by one patient after MED could have been avoided, given that the earlier TBNA was positive. TBNA is a safe, useful technique for staging nodes in non-small cell carcinoma. Although the sensitivity of TBNA is lower than that of MED, regions that are difficult to reach with the latter technique can be sampled by TBNA. Furthermore, MED can be rendered unnecessary by positive TBNA results. CT imaging of the chest is sensitive but its specificity is low for detecting ganglial metastasis.

Primary malignant lymphoma of the kidney: case report and literature review.

We report on a 65-year-old white woman who was hospitalized because of symptoms of an acute adrenocortical insufficiency. A CT scan revealed the presence of a large mass in the left kidney that infiltrated the adrenal gland. Fine needle aspiration cytology of the mass under imaging control failed to achieve a correct diagnosis, and nephrectomy was undertaken with a preoperative diagnosis of renal cell carcinoma. However, the frozen section reveals a neoplasm of large lymphoid cells with a diffuse growth pattern. Immunohistochemistry confirms the B-cell nature of the neoplasm (CD20+). The final diagnosis was non-Hodgkin B-cell high grade centroblastic lymphoma (KIEL classification). Postoperative studies failed to show lymph node or bone marrow infiltration by neoplastic cells. We found reports on only 60 malignant lymphomas, considered to be primary to the kidney. They usually affect middle-aged people, can be diagnosed with imaging techniques, and seem to show a better prognosis than other types of lymphoma.

Effects of alcoholization on the rat hippocampus.

The effects of ethanol intoxication on the hippocampus (H) has been studied in 18 (5 died) Sprague-Dawley rats (group A), 5 other rats served as control (group C). The weight of the animals at the beginning of experiment was 135-140 g and, at the end, 234 g for group A and 240 g for group C. Both groups were given a liquid diet. In group A, the ethanol provided 36% of the total calories; in group C these calories were supplied as dextrin-maltose. The average of the diet alcoholemia was 159.6 mg/100 ml. After 70 days of alcohol intake, the rats were transcardially perfused, and brain and liver were removed. The liver of the alcoholic rats exhibited an intense steatosis, and the H showed important modifications in number of neurons as well as in nuclear size. The neuron loss in group A, with respect to group C was: highly significant (P less than 0.001) for CA2; very significant (P less than 0.01) for CA3 and CA4; in CA1 and GD the reduction was not significant. In spite of neuron loss, the nuclear area showed a reduction in size: highly significant in CA2 and CA4; very significant in GD, but in CA2 and CA3 the reduction did not reach statistical significance. These results confirm the lethal influence of ethanol on some neurons, and the limited ability of the remnant neurons to compensate for neuronal loss.

Oncocytic adenocarcinoma arising in Warthin's tumor.

Warthin's tumor (adenolymphoma) is a monomorphous adenoma of the salivary glands well characterized histologically. Its clinical evolution is almost invariably benign, the malignant change being extremely unusual. We present the case of a 67 year-old man with a right retromandibular tumor which has evolved over a two year period, with peripheral involvement of V, VI and VII cranial nerves on the same side, and direct invasion of intracranial structures. The biopsy revealed a classic adenolymphoma which shows foci of well differentiated adenocarcinoma. Transitional areas between benign and malignant epithelium were evident. In addition, histological findings support the hypothesis of the origin of adenolymphoma from epithelial ducts trapped in the regional lymphatic tissue.

Glycogenosis with amylopectinoid deposits in a 13-year-old girl.

We present a clinical study and muscle biopsy of a 13-year-old female who suffered hypertrophic cardiomyopathy, hepatosplenomegaly and myopathy of prolonged evolution. The muscle biopsy showed a glycogenosis with deposits of amylopectin-like material. Differential diagnosis was made with basophilic degeneration of the myocardium, and with "polyglucosan bodies disease." In the existing literature we found only one case of juvenile amylopectinosis, and another four adult cases.

Hyperplastic polyposis of the colorectum and adenocarcinoma in a 24-year-old man.

Hyperplastic polyps in the large intestine are considered common after the age of 40, devoid of neoplastic transformation capability, and have a well-defined histological picture. Nevertheless, there exists evidence that hyperplastic polyps can present with adenomatous areas, eventually leading to carcinoma. There has been a suggestion in certain cases that a transformational sequence might exist in the genesis of colorectal cancer: hyperplastic polyp-adenoma-adenocarcinoma. Adenocarcinoma resulting from a pure hyperplastic polyp has also been described. These data have generated reconsideration of the significance of hyperplastic polyps in relation to cancer. In this paper we present a 24-year-old man with adenocarcinoma of the colon who underwent a right hemicolectomy. Twenty-eight hyperplastic polyps were found in the surgical specimen. Two of these polyps had adenomatous areas. The patient died 18 months after the surgical resection.

Spinal topography of the projection of the auricular nerve in the rabbit: a transganglionic WGA-HRP study.

The central projections of the nervous branches supplying the rabbit's concha auriculae have been determined by means of the transganglionic transport of WGA-HRP. Labeling appeared in trigeminal, C2 and C3 ganglion cells, but terminals were observed only at spinal levels (C2 and C3). There, they formed a wedge-shaped column of label centered mainly in lamina II; scattered terminals appeared in lamina III and I. These terminals constitute the afferent link of the pathway that accounts for the analgesia obtained after electrical stimulation of the concha auriculae.