Primary conjunctival amyloidosis and allergic conjunctivitis. / Amiloidosis conjuntival primaria y conjuntivitis alérgica.

Primary conjunctival amyloidosis is a rare disease of unknown origin, secondary to the deposit of amyloid material within the conjunctiva itself, producing a tumour. In the case presented, the concurrence of allergic conjunctivitis and chronic eye scratching could be triggers of the excessive production of immunoglobulins. The deposit of insoluble immunoglobulin light chains located within the conjunctiva itself causes this conjunctival mass.

Mácula eritematosa dolorosa en el tobillo de una mujer joven / Painful erythematous macular lesion in the ankle of a young woman

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Oclusión coronaria crónica silente como causa de muerte súbita en deportistas / Silent coronary chronic occlusion as a cause of sudden death in athletes

La oclusión completa del tronco es un hallazgo extremadamente raro cuya etiología más frecuente suele ser la ateroesclerosis. El curso clínico de la oclusión aguda asocia muy mal pronóstico mientras que la oclusión crónica puede cursar con síntomas anginosos durante semanas o meses. Las oclusiones completas crónicas de las arterias coronarias no es un proceso incompatible con la vida, siempre que haya una adecuada red de colaterales que garantice la función del miocardio ventricular izquierdo. Presentamos dos deportistas con oclusión crónica total del tronco coronario izquierdo y de la coronaria descendente anterior proximal que sufrieron una muerte súbita cardiaca (AU)

Total occlusion of the left main coronary artery is extremely rare. Most common cause is severe atherosclerosis. Clinical presentation of acute occlusion is usually catastrophic and it has been associated with poor prognosis. Chronic total occlusion presents with anginal syndrome. The duration of angina may vary from weeks to many years. It is important to bare in mind that the chronic occlusion may be compatible with life whenever there is an adequate collateral blood flow that it maintaining left ventricular function. We report two athletes that suffering sudden death in whom chronic total occlusion of the left main coronary artery and proximal anterior descending was found at arteriography or necropsy (AU)

Nasal septal perforation in a patient with subclinical celiac disease: a possible new association.

A female patient presented with nasal septal perforation that did not respond to conventional therapeutic management. Later, because of a malabsorption problem in one of her children, she underwent analytic tests and distal duodenal biopsy, which revealed that she was suffering from subclinical/silent celiac disease. The treatment, a gluten-free diet, unexpectedly resulted in the cessation of the destructive nasal process. Four years later, the patient remains asymptomatic. Nasal septal perforation might constitute a new entity associated with celiac disease hitherto not described in the literature.

[Laryngeal sarcomatoid carcinoma: clinical, histological and immunohistochemical study of four cases]. / Carcinoma sarcomatoide de laringe: estudio clínico, histológico e inmunohistoquímico de cuatro casos.

The purpose of this study was to confirm how the use of immunohistochemical techniques can help to differentiate between tumors with a mixed proliferative pattern (epithelial and mesenchymal). It is fundamental to differentiating tumors of these characteristics in order to determine the prognosis and plan treatment. We used different techniques on tissue samples from four cases diagnosed as laryngeal sarcomatoid carcinoma. The results demonstrated that all four were sarcomatoid carcinomas, which correlated with the patients' favorable clinical evolution. The immunohistochemical study was useful for differentiating tumor type in the case of a biopsy specimen obtained from a mixed-pattern neoplasm.

Mimics of pilomatrixomas in fine-needle aspirates.

This is a review of the fine-needle aspirates (FNAs) of nine pilomatrixomas (PMs) found in a series of 1,500 FNAs performed on skin nodules. The objective is to determine and list the cytologic findings that might mislead the less-experienced cytopathologist and to give him advice on how to avoid such errors. The following recommendations are made: 1) The FNAs should be carried out and the smears interpreted by the same person. 2) Clinical data, particularly age and location, are of paramount importance. 3) Shadow cells are pathognomonic of PMs. 4) Basaloid nuclei with prominent nucleoli should not be overdiagnosed. 5) Use both Papanicolaou and Diff-Quik stains. 6) Think of PM when performing and interpreting aspirations from subcutaneous growths located in the head and neck of young persons.

[Cystic adenoid carcinoma. Review of last five years in our ENT department (1987-1991)]. / Carcinoma adenoide quístico. Revisión de los últimos cinco años en nuestro Servicio de O.R.L. (1987-1991).

We present 4 cases of adenoid cystic carcinoma from different locations (parotid, submaxillary, larynx and auditory duct) and we underline the supraglottic origin of one of them. We point out the good clinical behaviour of this carcinoma, with a long tested survival, more than 5 years, in 2 of our cases. All of them showed morphological features independently of the sitting.

[Nasal angiofibroma in an adult]. / Angiofibroma nasal. A propósito de un caso de presentación en la edad adulta.

We have studied a nasal Angiofibroma in a 71-years-old male, who had not undergone any male-hormonal-therapy. The age of occurrence and the clinical course of this case made the tumor very unlikely to be a silent puberal nasal angiofibroma. After morphologic exam and exclusion of other bleeding entities of the nasal cavity we arrived at the diagnosis of nasal angiofibroma. We believe that this tumor might be arisen "ex novo" and that the nasal angiofibroma of elderly people might be a new entity.

Merkel cell tumor of the eyelid and the cytologic aspect in fine-needle aspirates: report of a case.

We describe one case of Merkel cell tumor (MCT) of the eyelid diagnosed by fine-needle aspiration (FNA). The main cytologic features were: isolated cells, loose cohesive sheets, and rosette-like structures in a hematic background. The cells were round to ovoid and very uniform. Chromatin was finely granular and frequent mitotic figures were observed. Under close scrutiny small faintly stained juxtanuclear "caps" were seen. A strong dot-like positivity for CK22 and NFP was observed in the position corresponding to the "caps." NSE positivity was diffuse, although a weak dot-like positivity was seen in some cells. S-100 was negative. Both the cytologic features and the immunocytologic profile of Merkel cell tumor are very characteristic. FNA enables an early and confident diagnosis of this aggressive tumor and an early planning of surgery.

[Nasosinusal aspergillosis]. / Aspergilosis nasosinusal.

The paper reports about a bilateral maxillary sinusitis and a right pansinusitis of this unusual disease. The allergic polyposis present in the second case is probably due to fungus sensitization (as Katzenstein's case). None of them have had dental problems, not even foreign bodies inside of the sinuses (quoted from other AA.). The diagnosis must be confirmed by both the pathologist and the bacteriologist. The treatment is surgery plus antifungal drugs.

[Laryngeal amyloidosis]. / Amiloidosis laríngea.

Reporting a case localized both on the left ventricular band and on Morgagni's ventricle, which histologic examination resulted luckily in this odd entity. Review of possible anatomopathologic techniques and methods for confirm or reject systemic amyloidosis. Surgery is the treatment of choice (microsurgery or laryngofissure). The lost motility of the larynx was recovered.