[Gastric solitary plasmacytoma associated with +Helicobacter pylori infection]. / Plasmocitoma solitario gástrico asociado a infección por Helicobacter pylori.

Solitary gastric plasmacitomas are infrequent tumors. They account for 5% of the extramedullary plasmacitomas. We report an unusual case in a 14 years old boy. The patient has had gastric symptoms for 2 years prior to an endoscopic examination. A fungating, ulcerated lesion was observed in the antrum. The biopsies showed a monoclonal, Lambda positive, diffuse, plasmocitic proliferation infiltrating the mucosa. Also a moderate number of Helicobacter pylori were identified in the gastric pits and numerous lymphoid follicules were observed in the deep portion of the mucosa. In view of the presence of HP infection the patient was treated with Orneprazole and Clarithromycin. Endoscopic examination and biopsies performed 3 and 5 months later showed a complete remission of the gastric lesion. At the time of this report the patient is in good physical condition, has recovered his weight and has grown 5 cm. Differential diagnosis with plasmo limpho in chronic gastritis and with lympheicitic lymphoma with plasmocitoid features had to be done. The macroscopic appearance of the gastric lesion, the absence of other inflammatory cells and monoclonality of the plasmocitic infiltration ruled out chronic gastritis. The negative staining for CD 20 as well as the abscence of lymphoid cells in the mucosal infiltrate give support: to the diagnosis of plasmocitoma. The close association between gastric MALT lymphoma and HP infection has been reported as well as its regression after antibiotic treatment for its erradication. In our review of the literature we failed to find any references to the association of HP with gastric plasmocitoma nor to its regression after antibiotic therapy.

Plasmocitoma solitario gástrico asociado a infección por Helicobacter pylori / Gastric solitary plasmacytoma associated to Helicobacter pylori infection

Los plasmocitomas solitarios gástricos son tumores infrecuentes y representan el 5 por ciento de los plasmocitomas extramoleculares. Estos presentan algunas características que los diferencian de los plasmocitomas óseos, independientemente de su localización, como son: una mayor sobrevida con terapia conservadora local, infrecuentes metástasis óseas y prolongadas remisiones. Estas condiciones de su evolución y algunas características histológicas han llevado a algunos autores a considerar un origen común con linfomas MALT de bajo grado. Al momento del diagnóstico la mayoría de los casos presenta invasión total o de la mayor parte de la pared gástrica. Los plasmocitomas pueden producir o no inmunoglobulinas y su tratamiento de elección es el quirúrgico. Presentamos un caso inusual de plasmocitoma extramedular, en un varón de 14 años, que solamente invadaría la mucosa gástrica, estaba a sociado a la presencia de Helicobacter Pilori y curó con el tratamiento indicado para su erradicación.

Plasmocitoma solitario gástrico asociado a infección por Helicobacter pylori / Gastric solitary plasmacytoma associated to Helicobacter pylori infection

Los plasmocitomas solitarios gástricos son tumores infrecuentes y representan el 5 por ciento de los plasmocitomas extramoleculares. Estos presentan algunas características que los diferencian de los plasmocitomas óseos, independientemente de su localización, como son: una mayor sobrevida con terapia conservadora local, infrecuentes metástasis óseas y prolongadas remisiones. Estas condiciones de su evolución y algunas características histológicas han llevado a algunos autores a considerar un origen común con linfomas MALT de bajo grado. Al momento del diagnóstico la mayoría de los casos presenta invasión total o de la mayor parte de la pared gástrica. Los plasmocitomas pueden producir o no inmunoglobulinas y su tratamiento de elección es el quirúrgico. Presentamos un caso inusual de plasmocitoma extramedular, en un varón de 14 años, que solamente invadaría la mucosa gástrica, estaba a sociado a la presencia de Helicobacter Pilori y curó con el tratamiento indicado para su erradicación. (AU)

Presacral carcinoid tumors: report of three cases and review of the literature.

The clinical, microscopic, immunohistochemical, and ultrastructural features of three carcinoid tumors of the presacral region are reviewed. All tumors occurred in young women and did not involve the rectum. The predominant microscopic pattern was trabecular. The differential diagnosis included paraganglioma and myxopapillary ependymoma. Immunohistochemically, neuroendocrine markers and low molecular weight cytokeratins were expressed in all cases. Neurosecretory granules were identified in the single case studied by electron microscopy. One case was associated with a tailgut cyst (retrorectal cystic hamartoma). Two patients were treated with complete local excision and are free of disease 3 and 4 years after surgery. One case metastasized to both breasts and recurred locally after an incomplete excision. This report expands the already long list of sites where carcinoid tumors can arise. The frequent association of these tumors with tailgut cysts and their histologic similarities to rectal carcinoid tumors suggest that the most likely derivation of presacral carcinoid tumors is from hindgut rests.

[Granulomatous colitis associated with diverticular disease. Report of a case]. / Colitis granulomatosa asociada a enfermedad diverticular. Presentación de un caso.

We report the case of a 71 years old lady with clinical and radiological evidence of colonic obstruction due to diverticulosis. A segmentary resection of the sigmoid colon was performed and the diagnosis of diverticulosis and Crohn's disease was made in the surgical specimen. The patient is doing well and no further extension of the colonic granulomatosis has been found 8 months after surgery. In spite of the great frequency of diverticulosis in the elderly its association with Crohn's disease is quite uncommon. This is probably due to the infrequency of colonic Crohn's disease in this population, particularly of the segmentary type. A few cases of segmentary colonic Crohn's disease that were cured after resection have been published. Even though the postoperative period of our patient is too short for making a good prognosis. Crohn's disease is a chronic relapsing disease and frequency of recurrences is closely related with long term evolution.

Elastolosis de la dermis reticular alta / Upper reticular dermal elastosysis

Se presenta un paciente de sexo femenino, 27 años de edad, con pápulas agminadas y placas de superficie cutánea finamente plegada, distribuídas en forma simétrica en tronco y miembros superiores. La histopatología demostró la ausencia en banda de fibras elásticas en la dermis reticular alta (EDRA). La EDRA es una enfermedad rara, adquirida,idiopatica,sin compromiso sistemico,asintomática,que evoluciona lentamente y se autolimita. Las exposiciones solares pueden intervenir en la patogenia de la afección. Los principales diagnósticos diferenciales a considerar son: cutis laxa y su variante clínica la elastolisis postinflamatoria y cutis laxa; anetodermia; nevo anelástico; y elastolisis perifolicular(AU)

Elastolosis de la dermis reticular alta / Upper reticular dermal elastosysis

Se presenta un paciente de sexo femenino, 27 años de edad, con pápulas agminadas y placas de superficie cutánea finamente plegada, distribuídas en forma simétrica en tronco y miembros superiores. La histopatología demostró la ausencia en banda de fibras elásticas en la dermis reticular alta (EDRA). La EDRA es una enfermedad rara, adquirida,idiopatica,sin compromiso sistemico,asintomática,que evoluciona lentamente y se autolimita. Las exposiciones solares pueden intervenir en la patogenia de la afección. Los principales diagnósticos diferenciales a considerar son: cutis laxa y su variante clínica la elastolisis postinflamatoria y cutis laxa; anetodermia; nevo anelástico; y elastolisis perifolicular

[Colitis caused by cytomegalovirus in acquired immunodeficiency syndrome. Report of 2 cases of autopsy]. / Colitis por citomegalovirus en el síndrome de inmunodeficiencia adquirida. Presentación de 2 casos de autopsia.

Two autopsy cases of CMV colitis in AIDS are reported. Intestinal manifestations lasted 2 and 5 months in each case and included: diarrhea and abdominal colic pain. The causes of death were: disseminated CMV infection in case 1 and miliary tuberculosis in case 2. In case 1 small ulcers were apparent in the ileum and the cecum. Microscopic foci of necrosis were also observed. Case showed: sigmoid dilatation with mucosal hemorrhages, small acute ulcers and submucosal fibrosis in the transverse portion of the colon. In both cases cytomegalic inclusion bodies within the endothelial cells of the capillaries at the bottom and the margin of the ulcers were observed. We compare our findings with those in other recently published cases.

Colitis por citomegalovirus en el síndrome de inmunodeficiencia adquirida. Presentación de 2 casos de autopsia / [Colitis caused by cytomegalovirus in acquired immunodeficiency syndrome. Report of 2 cases of autopsy]

Two autopsy cases of CMV colitis in AIDS are reported. Intestinal manifestations lasted 2 and 5 months in each case and included: diarrhea and abdominal colic pain. The causes of death were: disseminated CMV infection in case 1 and miliary tuberculosis in case 2. In case 1 small ulcers were apparent in the ileum and the cecum. Microscopic foci of necrosis were also observed. Case showed: sigmoid dilatation with mucosal hemorrhages, small acute ulcers and submucosal fibrosis in the transverse portion of the colon. In both cases cytomegalic inclusion bodies within the endothelial cells of the capillaries at the bottom and the margin of the ulcers were observed. We compare our findings with those in other recently published cases.

Colitis por citomegalovirus en el síndrome de inmunodeficiencia adquirida. Presentación de 2 casos de autopsia. / [Colitis caused by cytomegalovirus in acquired immunodeficiency syndrome. Report of 2 cases of autopsy]

Two autopsy cases of CMV colitis in AIDS are reported. Intestinal manifestations lasted 2 and 5 months in each case and included: diarrhea and abdominal colic pain. The causes of death were: disseminated CMV infection in case 1 and miliary tuberculosis in case 2. In case 1 small ulcers were apparent in the ileum and the cecum. Microscopic foci of necrosis were also observed. Case showed: sigmoid dilatation with mucosal hemorrhages, small acute ulcers and submucosal fibrosis in the transverse portion of the colon. In both cases cytomegalic inclusion bodies within the endothelial cells of the capillaries at the bottom and the margin of the ulcers were observed. We compare our findings with those in other recently published cases.

Frecuencia de microcarcinomas en piezas de tiroidectomías / Frecuency of microcarcinoma in specimens of thyroidectomy

En el examen de 110 piezas quirúrgicas de tiroidectomías totales o parciales, se hallaron 8 carcinomas ocultos o microcarcinomas, según la definición de Sampson: "tumores tiroideos de 1,5cm o menos de diámetro, no sospechados clínicamente". Se hallaron más frecuentemente en tiroides que presentaron tiroiditís de Hashimoto asociada a adenoma folicular (2 casos) y en hiperplasias difusas ( 2 casos). El tamaño promedio fue de 4mm; 6 de los casos fueron de tipo papilar, los restantes de tipo folicular y medular, uno de cada uno. Dos casos fueron descubiertos después del diagnóstico de las metástasis ganglionares. Todos fueron pacientes de sexo femenino, cuyas edades variaron entre 19 y 56 años. No se encontraron diferencias histológicas significativas entre los casos con o sin metástasis. Se discuten los resultados comparándolos con las series de otros autores (AU)