ABSTRACT
BACKGROUND: Breast carcinoma with osteoclast-like giant cells (OGCs) is infrequent, being most reported cased described as ductal invasive carcinomas. Invasive pleomorphic lobular carcinoma (PLC) is a distinct morphological variant of invasive lobular carcinoma characterized by higher nuclear atypia and pleomorphism than the classical type. In the best of our knowledge, a PLC with OGCs has not been previously reported. CASE PRESENTATION: We report the case of a 72-year-old woman presenting with a pleomorphic tumor of the left breast with a dense infiltration by OGCs and T lymphocytes with a 10:1 predominance of CD8+ over CD4+ cells. The diagnosis of a lymphoid or mesenchymal neoplasia was excluded after demonstrating keratin expression by the neoplastic cells. The absence of E-cadherin expression and the morphological features were consistent with the diagnosis PLC with OGCs. In addition, we demonstrated the deleterious mutation C.del866C in CDH1gene, but no mutations in any of the other 33 genes analyzed by next generation sequencing. CONCLUSIONS: Breast carcinoma with stromal osteoclast-like giant cells is a very rare tumor, for that reason, the use of the cytologic features and growth patterns in combination with immunohistochemically studies is mandatory for a correct diagnosis of lobular carcinoma. In addition, further studies are necessary to clarify the influence of OGCs in the prognosis of these patients.
Subject(s)
Breast Neoplasms/pathology , Carcinoma, Lobular/pathology , Giant Cells/pathology , Osteoclasts/pathology , Aged , Antigens, CD/analysis , Antigens, CD/genetics , Biomarkers, Tumor/analysis , Biomarkers, Tumor/genetics , Breast Neoplasms/chemistry , Breast Neoplasms/genetics , Breast Neoplasms/therapy , Cadherins/analysis , Cadherins/genetics , Carcinoma, Lobular/chemistry , Carcinoma, Lobular/genetics , Carcinoma, Lobular/therapy , Chemotherapy, Adjuvant , DNA Mutational Analysis , Female , Giant Cells/chemistry , Humans , Immunohistochemistry , Keratins/analysis , Lymphocytes, Tumor-Infiltrating/chemistry , Lymphocytes, Tumor-Infiltrating/pathology , Mastectomy , Mutation , Osteoclasts/chemistry , T-Lymphocytes/chemistry , T-Lymphocytes/pathology , Treatment OutcomeABSTRACT
Lymphomatoid papulosis type E (LyP) is a recently described subtype of LyP characterized by an angioinvasive infiltrate of atypical lymphocytes expressing CD30. We present a case of type E LyP with extensive cutaneous necrosis in the histopathological evaluation which was misdiagnosed as an ulcerative form of bacterial skin infection. The remarkable cutaneous necrosis showed in our case might be related to the angiodestructive infiltrate that was present in this circumstance.
Subject(s)
Lymphomatoid Papulosis/diagnosis , Lymphomatoid Papulosis/drug therapy , Methylprednisolone/administration & dosage , Skin Neoplasms/diagnosis , Skin Neoplasms/drug therapy , Aged , Anti-Inflammatory Agents/administration & dosage , Humans , Male , NecrosisABSTRACT
Objetivos:a)Determinar el grado de contaminación por monóxido de carbono en corredores aficionados de áreas urbanas y su variación al correr en horarios de alto y bajo tránsito vehicular, b)Definir periodos del día en los que se puede realizar ejercicio en áreas con tránsito vehicular. Materiales y Métodos: Once corredores aficionados de 23 a 41 años de edad no fumadores, sin historia de cardiopatía ni enfermedades respiratorias; corrieron alrededor del Club "El Golf" en el distrito de San Isidro. Se determinó la concentración sanguínea de carboxihemoglobina de cada corredor antes y después de correr durante 45 minutos en horarios de alto y bajo tránsito vehicular. Simultáneamente se midió la concentración de monóxido de carbono en el aire mediante un analizador portátil en el recorrido. Resultados: En el horario de alto tránsito vehicular se encontró una variación de Carboxihemoglobina estadísticamente significativa (de 0,44 por ciento a 0,54 por ciento, p=0,039). En el horario de bajo tránsito vehicular no se encontró variación de Carboxihemoglobina estadísticamente significativa (de 0,45 por ciento a 0,43 por ciento, p=0,722). Al comparar la variación de Carboxihemoglobina de ambos horarios, la diferencia no fue estadísticamente significativa (p=0,219). La medición de monóxido de carbono en el aire no mostró concentraciones constantes. Conclusiones: Este estudio demuestra un aumento en los niveles de Carboxihemoglobina durante el horario de alto tránsito vehicular, sin embargo los valores de Carboxihemoglobina permanecieron dentro de valores normales. En esta zona urbana se puede realizar ejercicio físico al aire libre en cualquiera de los dos horarios, sin riesgo de contaminación por monóxido de carbono.
