Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas diagnosed by endoscopic ultrasound guided biopsy.

Undifferentiated pancreatic carcinoma with osteoclast-like giant cells is a rare tumour that has been published under a wide variety of names, including pleomorphic carcinoma, giant cell carcinoma, sarcomatoid carcinoma and carcinosarcoma, among others. For these reasons and its low frequency, the reports of these tumours are scarce and frequently lead to confusion with other entities which present with giant cells. We present the case of a patient with obstructive jaundice and a mixed cystic and solid pancreatic mass, accompanied by multiple hepatic lesions. The histological study of the material obtained by endoscopic ultrasound guided biopsy demonstrated a proliferation of atypical epithelioid cells, accompanied by a spindle cell component with marked pleomorphism and numerous osteoclast-like giant cells. The epithelioid component showed positive immunostaining with cytokeratin cocktail and cytokeratin 7. The spindle cell component showed coexpression of cytokeratins and vimentin. The osteoclast-like giant cells were positive for CD68. Protein p53 was overexpressed in both epithelial and spindle cell neoplastic components, and was negative in the giant cells. These findings permitted the diagnosis of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells. This case outlines the effectiveness of endoscopic ultrasound-guided biopsy and the importance of morphological and immunohistochemical examination in the diagnosis of different types of pancreatic tumours, especially when they are in advanced stages and are not suitable for surgical treatment.

[Prevalence of hypertension in an Indian community in the North of Argentina]. / Prevalencia de hipertension arterial en una comunidad aborigen del norte argentino.

The prevalence of hypertension among adults of both sexes was assessed as part of a primary medical attention program in an Indian Wichi-Chorote community in Santa Victoria Este, province of Salta, Argentina. Arterial blood pressure was measured after a five minutes rest in a sitting position in adults (over 18 years old) of both sexes with a calibrated sphygmomanometer. A total of 522 adults (318 women and 204 men) were evaluated with median age of 43.5 +/- 16.3. The mean systolic blood pressure (SBP) was 125.2 +/- 22.7 mm Hg, and the mean dyastolic blood pressure (DBP) was 76.3 +/- 12.8 mm Hg. Thirty five percent of the people evaluated had normal pressure values (SBP<80 and DBP<120), 37% prehypertensive (SBP 120-139 or DBP 80-89) and 28% hypertensive (SBP > or = 140 or DBP > or = 90). Thirty one percent of the men (mean age: 43.93 +/- 17.11, mean SBP: 126.81 +/- 22.61 and mean DBP: 77.80 +/- 13.33) and 27% of the women studied (mean age: 42.93 +/- 16.3, mean SBP: 124.92 +/- 24.02 and mean DBP: 75.28 +/- 12.57) were hypertense. Fifty nine percent of the people over 65 years of age (n:58) (mean age: 73.15 +/- 6.36, mean SBP: 144.81 +/- 28.72 and mean DBP: 79.68 +/- 13.17) had blood pressure values in the hypertense range. The prevalence of hypertension in the evaluated rural population, suffering extreme demographic and sanitary conditions, is similar to that reported for urbanized societies in the USA but lower than the one reported for other rural areas of our country.

Prevalencia de hipertension arterial en una comunidad aborigen del norte argentino. / [Prevalence of hypertension in an Indian community in the North of Argentina]

The prevalence of hypertension among adults of both sexes was assessed as part of a primary medical attention program in an Indian Wichi-Chorote community in Santa Victoria Este, province of Salta, Argentina. Arterial blood pressure was measured after a five minutes rest in a sitting position in adults (over 18 years old) of both sexes with a calibrated sphygmomanometer. A total of 522 adults (318 women and 204 men) were evaluated with median age of 43.5 +/- 16.3. The mean systolic blood pressure (SBP) was 125.2 +/- 22.7 mm Hg, and the mean dyastolic blood pressure (DBP) was 76.3 +/- 12.8 mm Hg. Thirty five percent of the people evaluated had normal pressure values (SBP<80 and DBP<120), 37

prehypertensive (SBP 120-139 or DBP 80-89) and 28

hypertensive (SBP > or = 140 or DBP > or = 90). Thirty one percent of the men (mean age: 43.93 +/- 17.11, mean SBP: 126.81 +/- 22.61 and mean DBP: 77.80 +/- 13.33) and 27

of the women studied (mean age: 42.93 +/- 16.3, mean SBP: 124.92 +/- 24.02 and mean DBP: 75.28 +/- 12.57) were hypertense. Fifty nine percent of the people over 65 years of age (n:58) (mean age: 73.15 +/- 6.36, mean SBP: 144.81 +/- 28.72 and mean DBP: 79.68 +/- 13.17) had blood pressure values in the hypertense range. The prevalence of hypertension in the evaluated rural population, suffering extreme demographic and sanitary conditions, is similar to that reported for urbanized societies in the USA but lower than the one reported for other rural areas of our country.