Growing solitary fibrous tumor of the prostate during COVID-19 pandemic.

Solitary fibrous tumor (SFT) is an uncommon neoplasm tipically located on the pleura (Chick et al., 2013 Mar). Althought prostatic cancer tend to be adenocarcinoma, prostatic solitary fibrous tumor might be a rare cause of prostatic growth. They usually are asymptomatic although they can produce lower urinary tract symptoms (LUTS). Diagnosis is anatomopathological although Magnetic Resonance (MRI) can be useful to evaluate local and metastatic involvement (Liu et al., 2019). An adequate treatment is the most important prognostic factor and it involves complete surgical resection. We report an 85-year-old male that had an enormous SFT with LUTS treated with surgery which was delayed because of COVID-19 pandemic.

Multi-organ pathological findings associated with COVID-19 in postmortem needle core biopsies in four patients and a review of the current literature.

Coronavirus disease 2019 (COVID-19) has spread worldwide, resulting in significant morbidity and mortality. Histopathological findings are essential in understanding its pathogenesis and we present our findings from postmortem core needle biopsies in an attempt to share information that may shed some light on this severe pandemic. Different organ samples from four patients with PCR-confirmed COVID-19 at the Infanta Sofía Hospital (Madrid) were studied during the months of April and May, 2020 by six pathologists using routine stains, histochemistry and immunohistochemistry. Results were compared with other reported cases. All patients had a clinical diagnosis of pneumonia and biopsies revealed lung damage in the majority. Heart, liver, spleen and kidney were also studied and abnormalities were found in all cases and are extensively described. The histopathology of organs affected by COVID-19 is vital to the understanding of this disease and its sequelae.

A non-randomized prospective study on the diagnostic performance of perineal prostatic biopsy, directed via diffusion nuclear resonance, in patients with suspected prostate cancer and previous negative transrectal prostate biopsy.

BACKGROUND: A definition of the best strategy is necessary to optimize the follow-up of patients with previous negative transrectal guided ultrasound biopsy (TRUS-GB) and the persistence of raised prostate-specific antigen (PSA).The purpose of this study was to evaluate the prostate cancer (PCa) diagnostic rate of targeted transperineal ultrasound guided biopsy (TPUS-GB) with cognitive multiparametric magnetic resonance imaging (mpMRI) registration with concurrent systematic biopsy in patients with previous negative systematic TRUS-GB and persistently elevated PSA levels. MATERIALS AND METHODS: In this prospective study conducted at the University Infanta Sofia Hospital from April 2016 to November 2017, patients with one previous negative systematic TRUS-GB and persistently high PSA levels were referred for mpMRI prostate scans. All patients underwent systematic TPUS-GB and those patients with suspicious findings on mpMRI scans, Pirads 3 and 4-5, underwent a subsequent cognitive guidance mpMRI-TPUS-GB. RESULTS: In total, 71 patients were included in this study. Suspicious findings on mpMRI scans prior to TPUS-GB were found in 50 patients (70.4%). 16 patients were diagnosed with prostate cancer (22.5%), of whom 14 (87.5%) had a mpMRI scan with Pirads 3 or Pirads 4-5. Patients with Pirads 3, 4 or 5 showed negative results in almost all cores taken by concurrent systematic TPUS-GB. CONCLUSIONS: Cognitive mpMRI-TPUS fusion biopsy is a useful tool to diagnose PCa in patients with previous negative prostate biopsy. The samples obtained from the suspicious areas in the mpMRI detect more cases of intermediate and high risk PCa compared to the samples obtained at random or from non-suspicious areas.

Multi-organ pathological findings associated with COVID-19 in postmortem needle core biopsies in four patients and a review of the current literature / Hallazgos patológicos multiorgánicos asociados a COVID-19 a través de biopsias con aguja gruesa postmortem y revisión de la literatura actual

Coronavirus disease 2019 (COVID-19) has spread worldwide, resulting in significant morbidity and mortality. Histopathological findings are essential in understanding its pathogenesis and we present our findings from postmortem core needle biopsies in an attempt to share information that may shed some light on this severe pandemic. Different organ samples from four patients with PCR-confirmed COVID-19 at the Infanta Sofía Hospital (Madrid) were studied during the months of April and May, 2020 by six pathologists using routine stains, histochemistry and immunohistochemistry. Results were compared with other reported cases. All patients had a clinical diagnosis of pneumonia and biopsies revealed lung damage in the majority. Heart, liver, spleen and kidney were also studied and abnormalities were found in all cases and are extensively described. The histopathology of organs affected by COVID-19 is vital to the understanding of this disease and its sequelae

La enfermedad de coronavirus 2019 (COVID-19) ha afectado de forma mundial causando intensa morbimortalidad. Los hallazgos patológicos son claves para entender su patogénesis. A través de biopsias con aguja gruesa postmortem, intentamos responder a las incógnitas que giran en torno a la severidad de esta infección. Se enviaron muestras de cuatro pacientes COVID-19 positivos al servicio de Anatomía Patológica del Hospital Infanta Sofía (Madrid) en los meses de Abril y Mayo 2020. Se estudiaron a través de distintas técnicas y los resultados se compararon con la literatura, buscando similitudes y peculiaridades. Todos los pacientes tenían un diagnóstico de neumonía. Las biopsias mostraron daño pulmonar en la mayoría. El resto de los órganos estudiados fueron: corazón, hígado, bazo y riñón. Se encontraron características distintivas en muchos, las cuales fueron descritas exhaustivamente. En conclusión, el análisis microscópico de los órganos afectados por COVID-19 es importante para comprender ésta enfermedad y sus posibles consecuencias

Prospective nonrandomized study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy to magnetic resonance imaging with subsequent MRI-guided biopsy in biopsy-naïve patients.

BACKGROUND: To evaluate the diagnostic efficacy in cancer prostate (PCa) of Multiparametric prostate magnetic resonance imaging (mp-MRI) targeted biopsy compared to standard systematic transrectal ultrasound-guided biopsy (TRUSGB) in biopsy-naïve patients. METHODS: A total of 168 biopsy-naïve men with clinical suspicion of PCa due to elevated PSA levels and/or an abnormal digital rectal examination were consecutively enrolled from July 2011 to July 2014. All patients underwent TRUSGB. Patients with equivocal (Pi-rads 3) or suspicious lesion (Pi-rads 4-5), were additionally biopsied using two cores, by the same operator (cognitive technique). RESULTS: Among the 168 cases, mp-MRI was equivocal for PCa (Pi-rads 3) in 46 subjects (27.4%) and suspicious (Pi-rads 4, 5) in 40 cases (23.8%). Of the 69 patients with PCa, standard TRUSGB showed Gleason ≥7 in 75% of patients with Pirads 3 and 77.8% in cases with Pirads 4-5 on mp-MRI. Among the 40 patients with Pi-rads 4-5 lesion on the MRI, cognitive mp-MRI-guided biopsy (MRCGB) detected a higher number of cases of PCa with a Gleason score equal or superior to 7 (90%) with a higher negative predictive value (97.5%) than cases with Pi-rads 3 lesion or subjects with TRUSGB alone. CONCLUSIONS: mp-MRI followed by selective biopsy seems to be a valuable tool to improve the diagnosis of intermediate and high risk PCa compared to standard TRUSGB.

Vacunas VPH: lesiones de cérvix y tipos virales asociadosen la Comunidad de Madrid / HPV vaccines: cervical lesions and associated viral types in the metropolitan area of Madrid

Objetivos: El propósito de este estudio ha sido determinarla prevalencia de los tipos de virus del papiloma humano(VPH) implicados en lesiones de cérvix uterino en laComunidad de Madrid, con dos finalidades: valorar el beneficioque proporcionará la próxima implantación de la vacunaanti-VPH tetravalente (tipos: 6, 11, 16 y 18) y tratar deestablecer prioridades para el desarrollo de una segundageneración de vacunas. Material y métodos: Se incluyeronen el estudio 1026 biopsias con lesión de cérvix, recogidasen un periodo de tres años (2005-2007), de las cuales seseleccionaron los casos que cumplieron 3 requisitos:demostración histológica de lesión escamosa intraepitelial(SIL) o carcinoma invasor, presencia de ADN viral por reacciónen cadena de polimerasa (PCR) y tipificación de almenos un tipo viral de VPH. Resultados: De los 331 casosque cumplían estos 3 requisitos, en el 86% se aislaron virusde alto riesgo y en el 14% de bajo riesgo. Los virus de altoriesgo prevalentes fueron: 16 (34%), 31 (12%), 58 (10%),33 (8%), 52 (8%), 18 (7%), 66 (6%) y 53 (6%) y los de bajoriesgo: 6 (58%) y 11 (36%). No se observaron variacionessignificativas en la distribución de los tipos virales durantelos tres años del periodo de estudio. Conclusiones: Sintener en cuenta la posibilidad de reacciones de inmunizacióncruzadas, la implantación de la vacuna tetravalente ennuestro medio protegería frente al 94% de las lesiones causadaspor genotipos de bajo riesgo y frente al 41% de lascausadas por genotipos de alto riesgo. Para que la vacunacióntenga un fuerte impacto en la carga de la enfermedad ypoder prescindir del cribado se necesitarán nuevas vacunascon propiedades mejoradas (AU)

Objectives: The object of the current study was todetermine the prevalence of human papillomavirus (HPV)types associated with uterine cervical lesions in the metropolitanarea of Madrid for two reasons: to assess the benefitof impending implementation of the anti-HPV tetravalentvaccine (6, 11, 16 and 18 types) and to attempt to establishpriorities for the future development of secondgeneration vaccines. Materials and Methods: From a totalof 1026 biopsies from cervical lesions collected in a threeyear period (2005-2007), 331 specimens were selected thatfulfilled the following 3 requirements: histological evidenceof squamous intraepithelial lesions (SIL) or invasive carcinoma,presence of viral DNA by polymerase chain reaction(PCR) and the presence of at least one HPV type.Results: It was found that high-risk types were present in86% of cases, whereas a low-risk type was detected in theremaining 14%. The more prevalent types of high-risk viruseswere: 16 (34%), 31 (12%), 58 (10%), 33 (8%), 52 (8%),18 (7%), 66 (6%) and 53 (6%). Low-risk types were: 6(58%) and 11 (36%). No significant variations in the distributionof viral type during the three year period of thestudy were observed. Concusions: It was concluded that,not considering potential cross immunizing reactions,implementation of the tetravalent vaccine in our communitywould protect 94% and 41% of women against lesionscaused by low risk and high-risk genotypes respectively.Therefore, if the purpose of vaccination is to make a strongimpact on cervical cancer and avoid screening, new, improvedvaccines will be required (AU)