[Cardiac involvement in polymyositis--dermatomyositis associated with Sjogren's syndrome]. / Compromiso cardiaco en polimiositis--dermatomiositis asociada a síndrome de Sjögren.

A 41 years old woman with polymyositis-dermatomyositis with cardiac involvement is presented. The patient evolved with congestive heart failure, the electrocardiogram showed a left anterior hemiblock, lack of progression of R waves from V1 to V4 and unspecific ST and T alterations. Echocardiogram and cardiac catheterization showed global ventricular disfunction and pulmonary hypertension. An endomyocardial biopsy performed at the apex of the right ventricle showed mononuclear inflammatory infiltration, myocardial fiber degeneration and fibrosis. Initially, the patient responded well to diuretic, vasodilator and steroid therapy. Posteriorly she developed an atrial flutter that required electrical cardioversion and later died suddenly during the course of an acute pneumonia.

[Extracorporeal uterine endometrial stromal type sarcoma]. / Sarcoma de tipo estroma endometrial extracorporales uterinos.

Three extracorporal uterine endometrial stromal-like sarcomas are reported. One of them was a bilateral ovarian sarcoma, with extensive infiltration and vascular compromise of paratubarian tissues, parametrium, omentum, and periureteral tissue. Endometriotic foci were also found in the ovaries and periureteral tissue. The other two cases corresponded to localized polypoid lesions of the endocervical and vaginal mucosa, respectively. None of these cases was associated with endometriosis. Histologically, the tumors were made up of rounded cells, with scant cytoplasm, numerous small vessels and low mitotic index. The findings correspond to those of low grade endometrial stromal sarcomas. The present cases emphasize the multipotentiality of müllerian organs. Not only different types of paramesonephric epithelial tumors can develop from these organs, but also different müllerian sarcomas.

Histoplasmosis duboisii (African histoplasmosis). An African case reported from Chile with ultrastructural study.

A case of histoplasmosis duboisii in a 30 year-old engineer is presented. The diagnosis was made with the help of light microscopy, electron microscopy and cultures. Although diagnosed in Chile, the patient probably acquired the disease in the endemic African area, more precisely in the Ivory Coast. Differential diagnosis between Histoplasma capsulatum var. capsulatum and Histoplasma capsulatum var. duboisii is based primarily on the larger in-vivo yeast form size of the latter. Electron microscopy study, the first done on the duboisii variety of Histoplasma capsulatum in human material to our knowledge, was not essential for this purpose. Differential diagnosis between Histoplasma capsulatum var. duboisii and Blastomyces dermatitidis is based on morphological tissue changes and mycologic characteristics. Once more, a case of an "exotic" or geographically restricted disease is detected far from its endemic area, thanks to easier means of transportation. Earth is a shrinking planet.