ABSTRACT
Las enfermedades neurodegenerativas que cursan con demencia constituyen un problema de salud pública cada vez más importante, especialmente por el envejecimiento de la población. La radiología aporta datos diagnósticos y pronósticos significativos en estos procesos que es necesario conocer. Recientemente se han modificado algunas de las clasificaciones de estas enfermedades, incorporando sobre todo criterios patológicos, inmunohistoquímicos y genéticos. En este trabajo se revisan los distintos aspectos radiológicos y patológicos de las principales enfermedades que cursan con demencia. Para ello se aporta nuestra experiencia con los cerebros del banco de tejidos neurológicos de nuestra comunidad, a los que se les realizaron estudios de resonancia magnética posmortem antes del estudio histológico. Las imágenes de correlación radiopatológica de estos estudios se presentan para ilustrar la exposición (AU)
Neurodegenerative diseases that course with dementia represent a public health problem that is growing in importance, mostly due to the aging of the population. Imaging techniques provide essential diagnostic and prognostic information. Some classifications of these diseases have recently been modified through the incorporation of histological, immunohistochemical, and genetic criteria. This article reviews the different radiological and pathological aspects of the most common diseases that course with dementia. We studied brains from our communitys tissue bank with postmortem MRI and posterior histological examination and illustratet his exposition with images from the radiopathologic correlation (AU)
Subject(s)
Humans , Dementia , Magnetic Resonance Spectroscopy/methods , Cadaver , Tissue Banks , Alzheimer Disease , Dementia, Vascular , Frontotemporal Lobar DegenerationABSTRACT
Neurodegenerative diseases that course with dementia represent a public health problem that is growing in importance, mostly due to the aging of the population. Imaging techniques provide essential diagnostic and prognostic information. Some classifications of these diseases have recently been modified through the incorporation of histological, immunohistochemical, and genetic criteria. This article reviews the different radiological and pathological aspects of the most common diseases that course with dementia. We studied brains from our community's tissue bank with postmortem MRI and posterior histological examination and illustrate this exposition with images from the radiopathologic correlation.
Subject(s)
Dementia/pathology , Magnetic Resonance Imaging , Autopsy , Brain Diseases/complications , Brain Diseases/pathology , Dementia/complications , Humans , Neurodegenerative Diseases/complications , Neurodegenerative Diseases/pathologyABSTRACT
OBJETIVO: Los tumores del estroma metanéfricoson neoplasias renales infantiles raramente diagnosticadasen adultos. Este trabajo revisa la clasificación, incidencia y evolución de este grupo de neoplasias así como las particularidades de los casos diagnosticados en adultos.MÉTODO: Describimos dos casos de tumores del estroma metanéfrico en adultos, de 72 y 77 años respectivamente. Ambos se presentaron como grandes masas abdominales de más de 4 Kg. cada una, que fueron resecadas completamente.Sin recibir ningún otro tratamiento adyuvante, 4 y 10 años después de la intervención los pacientes se encuentran asintomáticos.RESULTADOS: Histológicamente se trata de lesiones capsuladas,de células fusiformes de patrón vagamente nodular,que incluye áreas hipercelulares y otras hipocelulares alrededor de estructuras vasculares o epiteliales. No existePalabras clave: Tumor del estroma metanéfrico. Nefromamesoblástico. Adenofibroma. Tumor renal.atípia citológica ni mitosis pero sí extensa necrosis y fibrosis.Las células del estroma son positivas para vimentina y CD-34, y las epiteliales para antígeno de membrana epitelial(EMA) y citoqueratinas. Inicialmente fueron diagnosticadoscomo nefromas mesoblásticos del adulto. Actualmente han sido revisados conforme a la nueva clasificación de la OMS (2002) y corresponden al grupo de los tumores metanéfricos.CONCLUSIÓN: Los tumores metanéfricos son tumores benignos pediátricos ocasionalmente diagnosticados en adultos. Existen tres formas en función del predominio del componente epitelial, del estromal o la presencia de ambos.Su tratamiento es quirúrgico con un pronóstico excelente
OBJETIVE: Metanephric Stromal Tumors (MST) are pediatric renal neoplasms not very common in adults. This study revises its classification, incidence and evolution and also some specific characteristics of the cases diagnosed in adults.METHODS: We present two cases of MST diagnosed in adults of 72 and 77 years old respectively. Abdominal pain due to a more than 4Kg. mass was the initial presentation in both cases. The tumors were completely resected. Four and ten years after excision patients are alive without disease.RESULTS: Characteristic histologic features include aproliferation of fusocellular cells with alternating cellularity that imparts a nodular appearance and onion-skin cuffing around entrapped renal tubules or vascular structures. No mitoses or atypia was found but extensive necrosis and fibrosis were present. A majority of stromal cells werevimentine and CD-34 positive. Stains for CK and EMAhighlighted entrapped native tubules. Both cases werepreviously classified as mesoblastic nephromas. According to the 2002 ONS classification of tumours of the urinary system, they have been revised and re-classified as MST.CONCLUSION: MST are pediatric benign tumors exceptionally diagnosed in adults. Metanephric stromal tumors are divided into 3 categories based on the presence of epithelial cells, stroma and epithelial cells plus stromal. Complete excision is the treatment of choice and the prognosis is excellent
Subject(s)
Male , Aged , Humans , Kidney Neoplasms/diagnosis , Kidney Neoplasms/surgeryABSTRACT
Los adenomas productores de aldosterona (síndrome deConn) son responsables de la mayoría de los casos de hiperaldosteronismoprimario. Se trata de tumores benignos depequeño tamaño, generalmente menores de 2 cm, localizadosen la corteza suprarrenal, bien delimitados y casi siempreúnicos. La presencia de dobles adenomas ipsilaterales esexcepcional, ocurre aproximadamente en el 8% de los adenomassuprarrenales.Presentamos el caso de una mujer de 59 años hipertensa,refractaria al tratamiento médico los últimos años a laque se descubre un tumor suprarrenal funcionante, secretorde aldosterona. Se realiza suprarrenalectomía laparoscópicay el estudio histológico de la pieza muestra la presencia dedos adenomas corticales. El mayor de ellos se encuentraconstituido por células fasciculares y el menor por célulashíbridas y glomerulosas. Además este último recoge otrohecho poco frecuente, aparecen inclusiones eosinófilas citoplasmáticasque corresponden a cuerpos de espironolactona.Se trata de estructuras multilaminares rodeadas de unhalo claro que miden entre 2 y 12 μm, están relacionadascon el uso de este fármaco pero no con la dosis ni la duracióndel tratamiento.Es la primera vez que se describe en la literatura la asociaciónde adenomas múltiples y la presencia de cuerpos deespironolactona, según la revisión bibliográfica realizada
Primary aldosteronism is due to an aldosterone-producingadenoma (Conn´s syndrome). This benign tumor isusually small, less than 2 cm diameter, sharply demarcatedand generally solitary. Only in a small percentage of cases(8%) unilateral double adenomas have been reported.A 59-year-old woman with a past medical history ofarterial hypertension presented no response to her antihypertensivemedication. An aldosterone secreting adrenocorticaltumor was found. After laparoscopic adrenalectomy,microscopical examination revealed the presence of twocortical adenomas. In the biggest tumor the most commoncellular population was fasciculata cells while in the smallone, we could found hybrid and glomerulosa cells. In thelatter spironolactone bodies were also found. These bodiesare normally found while the patient is taking spironolactonebut with no apparent correlation to dosage or duration oftreatment was reported.According to our literature review this is the first timethat the association of double cortical adenoma with spironolactonebodies is reported
Subject(s)
Female , Middle Aged , Humans , Adrenocortical Adenoma/pathology , Adrenal Cortex Neoplasms/pathology , Spironolactone/adverse effects , Adrenalectomy , Hyperaldosteronism/complicationsABSTRACT
OBJECTIVES: Clinical and pathological study of eight cases of localized amyloidosis of the seminal vesicles. Review of the literature. METHODS: Immunohistochemical and histochemical study in surgical specimens. RESULTS: Two of the eight cases studied for amyloidosis in seminal vesicles, were obtained from radical prostatectomy specimens; patients had prior androgen deprivation therapy for two months. Four cases were obtained from radical cistoprostatectomy specimens because of urothelial carcinoma and the last two cases were diagnosed by transrectal prostatic needle biopsy which including a portion of seminal vesicle. Amyloidosis of seminal the vesicle is permanganate-sensitive; A-Amyloid, laminin, amyloid P protein and collagen IV negative. CONCLUSION: Localized amyloidosis ot the seminal vesicle is not an unusual finding. The incidence increases with age. The histochemical and immunohistochemical features are different from other amyloid deposits.
Subject(s)
Amyloidosis/pathology , Genital Diseases, Male/pathology , Seminal Vesicles/pathology , Adenocarcinoma/complications , Adenocarcinoma/surgery , Age Factors , Aged , Amyloid/analysis , Amyloidosis/complications , Amyloidosis/diagnosis , Biomarkers/analysis , Biopsy, Needle , Carcinoma, Transitional Cell/complications , Carcinoma, Transitional Cell/surgery , Congo Red , Cystectomy , Genital Diseases, Male/complications , Genital Diseases, Male/diagnosis , Humans , Incidental Findings , Male , Middle Aged , Prostatectomy , Prostatic Neoplasms/complications , Prostatic Neoplasms/surgery , Staining and Labeling , Urinary Bladder Neoplasms/complications , Urinary Bladder Neoplasms/surgeryABSTRACT
OBJECTIVE: To report two cases of papillary cystadenoma of the epididymis. METHODS: Clinical and pathological study of 2 male patients 48 and 26-year-old respectively, presenting with a solid, painful mass in the head of the epididymis. The nodules were removed. RESULTS: Pathological analysis showed two papillary cystadenomas of the epididymis. CONCLUSIONS: Papillary cystadenoma of the epididymis is an epithelial tumor of unclear origin. It is associated with von Hippel-Lindau disease and infertility. They are uncommon and benign.
Subject(s)
Cystadenoma, Papillary/pathology , Epididymis/pathology , Testicular Neoplasms/pathology , Adult , Cystadenoma, Papillary/diagnostic imaging , Cystadenoma, Papillary/surgery , Epididymis/diagnostic imaging , Epididymis/surgery , Humans , Male , Middle Aged , Testicular Neoplasms/diagnostic imaging , Testicular Neoplasms/surgery , Ultrasonography , Urologic Surgical Procedures, Male/methodsABSTRACT
OBJETIVO: Presentamos 2 casos de cistoadenoma papilar de epidídimo. MÉTODOS: Estudio clínico y anatomopatológico de 2 pacientes varones de 48 y 26 años de edad con una masa sólida, dolorosa en la cabeza del epidídimo. Los nódulos fueron extirpados quirúrgicamente. RESULTADOS: El análisis histológico demostró que se trataba de 2 cistoadenomas papilares de epidídimo. CONCLUSIONES: El cistoadenoma papilar de epidídimo es un tumor epitelial de origen incierto, asociado a la enfermedad de von Hippel-Lindau y a infertilidad. Son tumores poco frecuentes y benignos (AU)
Subject(s)
Middle Aged , Adult , Male , Humans , Urologic Surgical Procedures, Male , Cystadenoma, Papillary , Epididymis , Testicular NeoplasmsABSTRACT
Presentamos el caso de un varón de 39 años diagnosticado de un osteocondroma en la sexta costilla izquierda. Tres años después, en un control radiológico; se objetivó una tumoración de gran tamaño en relación con la misma costilla. Ante una posible malignización se realizó la extirpación qui-rúrgica de la lesión.Histológicamente se confirmó la naturaleza cartilaginosa benigna del tumor costal y la exis-tencia de un saco compartimental revestido fundamentalmente por epitelio sinovial con áreas papilares de metaplasia condroide. (AU)
