[Subcutaneous seeding of hepatocellular carcinoma after fine-needle percutaneous biopsy]. / Implante subcutáneo de un carcinoma hepatocelular tras la punción aspiración con aguja fina.

Subcutaneous tumor seeding after fine-needle percutaneous biopsy for hepatocellular carcinoma is a rarely seen complication. The authors describe a case of subcutaneous neoplastic seeding in a 70-year-old woman with chronic hepatitis C virus complicated by hepatocellular carcinoma. Ultrasonically guided fine-needle aspiration biopsy was performed in segment II of the liver. The neoplastic seeding developed along the needle track used to carry out the fine-needle biopsy. The subcutaneous tumor was excised, and histological examination revealed a well-differentiated hepatocellular carcinoma.

Adenocarcinoma de esófago 36 años después de una estenosis hipertrófica de píloro / Esophageal adenocarcinoma 36 years later of a hypertrophic stenosis of the pylorus

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Implante subcutáneo de un carcinoma hepatocelular tras la punción aspiración con aguja fina / Subcutaneous seeding of hepatocellular carcinoma after fine-needle percutaneous biopsy

Los implantes subcutáneos son una complicación rara tras la punción aspiración con aguja fina de los carcinomas hepatocelulares. Los autores describen un caso de implante subcutáneo neoplásico en una mujer de 70 años con cirrosis hepática por virus C complicada con un carcinoma hepatocelular. Se efectuó una punción aspiración con aguja fina en el segmento II hepático. El implante tumoral se desarrolló en el trayecto de la punción aspiración. La tumoración subcutánea fue extirpada quirúrgicamente y el estudio anatomopatológico confirmó que se trataba de un carcinoma hepatocelular bien diferenciado

Subcutaneous tumor seeding after fine-needle percutaneous biopsy for hepatocellular carcinoma is a rarely seen complication. The authors describe a case of subcutaneous neoplastic seeding in a 70-year-old woman with chronic hepatitis C virus complicated by hepatocellular carcinoma. Ultrasonically guided fine-needle aspiration biopsy was performed in segment II of the liver. The neoplastic seeding developed along the needle track used to carry out the fine-needle biopsy. The subcutaneous tumor was excised, and histological examination revealed a well-differentiated hepatocellular carcinoma

Quiste mesentérico. Experiencia en 4 casos / Mesenteric cyst. Our experience in 4 cases

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Mielopatía recurrente y síndrome de Sjögren: análisis de un caso / Recurring myelopathy and Sjogren´s syndrome: an analysis of one case

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Cerebral solitary Langerhans cell histiocytosis: report of two cases and review of the literature.

Cerebral solitary Langerhans cell histiocytosis (LCH) is a very uncommon condition. We describe two new cases: a 30-year-old man with seizures and a tumour in the left frontal lobe, which was composed of a polymorphic infiltrate with a predominance of histiocytes and eosinophils; and a 65-year-old man with headaches and dysarthria, with a left parietal tumour, which showed a diffuse proliferation of histiocytic cells and areas of necrosis. In both cases, the histiocytes were strongly positive for S-100 and CD1a, and Birbeck's granules were demonstrated by electron microscopy in the first case. Both patients underwent a complete excision of their lesions. The second patient received additional postoperative radiotherapy. They were asymptomatic after 26 and 27 months, respectively. It seems that cerebral solitary LCH is a clinicopathological entity with a good outcome. Only 15 cases of this rare process have been previously reported in the English literature.

[Management of lymphoid hyperplasia of the ocular adnexa]. / Manejo de las hiperplasias linfoides orbitarias.

OBJECTIVE: Lymphoid Hyperplasia (LH) is a benign proliferative lymphocyte-rich process. Histologically, LH may be similar to a lymphoma. Its incidence has decreased because of new sophisticated diagnostic procedures and a better knowledge of lymphomas. Most of the cases are seen in patients between forty and sixty years of age. As there was no consensus about the best treatment, determining this was the objective of our study. METHOD: We describe three patients with a lymphoproliferative process affecting the ocular anexae, in whom histologic, immuno-histochemical and molecular studies were performed. PCR analysis allowed a definitive diagnosis to be made. RESULTS: Histologically, all three cases were diagnosed as LH; immuno-histochemically, one was diagnosed as an idiopathic orbital inflammation, and the other two, as LH. After PCR analysis, one of these latter two cases was definitively diagnosed as B-cell Non-Hodgkin's lymphoma. CONCLUSIONS: Today's molecular techniques allow us to make a definite diagnosis of lymphoma, because sometimes histology and immuno-histochemistry alone can result in a wrong diagnosis being made. LH of the ocular adnexae may be the first stage of a much more serious disease, and a benign hyperplasia at this site must lead to suspicion of lymphoma, which can then be diagnosed or excluded by the improved diagnostic procedures. Therefore, when we make a diagnosis of LH it is necessary to complete a full evaluation and institute a defined follow-up of the patient's clinical condition.

Manejo de las hiperplasias linfoides orbitarias / Management of lymphoid hyperplasia of the ocular adnexa

Objetivo: La hiperplasia linfoide (HL) es una proliferación benigna e hipercelular, rica en linfocitos, que morfológicamente puede simular un linfoma. Su incidencia ha disminuido debido a la sofisticación de las técnicas diagnósticas y mejor conocimiento de los linfomas. Se presenta entre la 4.ª y 6.ª década de la vida y no está determinado un manejo apropiado, objetivo de nuestro trabajo.Método: Se ha estudiado tres pacientes con alteración linfoproliferativa de anexos oculares en los que se aplicó las técnicas de histología, inmunohistoquímica y biología molecular y cuyo diagnostico definitivo se realizó gracias a la reacción en cadena de la polimerasa (PCR).Resultados: Las tres muestras fueron diagnosticadas por histología de HL, con las técnicas inmunohistoquímicas el resultado fue de una inflamación orbitaria idiopática y las otras dos restantes de HL. La PCR diagnosticó un linfoma no-Hodgkiniano tipo B y la otra muestra confirmó una HL.Conclusión: Hoy en día las técnicas de biología molecular son las que permiten definir que es un linfoma, en algunos casos sólo la histología y la inmunohistoquímica pueden inducir a error. Las HL de los anexos pueden suponer un estado inicial de la enfermedad. El hallazgo de una hiperplasia presumiblemente benigna en dicha localización debe hacer sospechar un posible linfoma. El diagnóstico de linfoma está en continuo cambio debido a la sofisticación de las técnicas diagnósticas. Por tanto el diagnóstico de una HL inicialmente benigna, obliga a realizar una exploración sistémica y a un seguimiento de los pacientes estrecho y muy minucioso

Objective: Lymphoid Hyperplasia (LH) is a benign proliferative lymphocyte-rich process. Histologically, LH may be similar to a lymphoma. Its incidence has decreased because of new sophisticated diagnostic procedures and a better knowledge of lymphomas. Most of the cases are seen in patients between forty and sixty years of age. As there was no consensus about the best treatment, determining this was the objective of our study. Method: We describe three patients with a lymphoproliferative process affecting the ocular anexae, in whom histologic, immuno-histochemical and molecular studies were performed. PCR analysis allowed a definitive diagnosis to be made. Results: Histologically, all three cases were diagnosed as LH; immuno-histochemically, one was diagnosed as an idiopathic orbital inflammation, and the other two, as LH. After PCR analysis, one of these latter two cases was definitively diagnosed as B-cell Non-Hodgkin’s lymphoma. Conclusions: Today’s molecular techniques allow us to make a definite diagnosis of lymphoma, because sometimes histology and immuno-histochemistry alone can result in a wrong diagnosis being made. LH of the ocular adnexae may be the first stage of a much more serious disease, and a benign hyperplasia at this site must lead to suspicion of lymphoma, which can then be diagnosed or excluded by the improved diagnostic procedures. Therefore, when we make a diagnosis of LH it is necessary to complete a full evaluation and institute a defined follow-up of the patient’s clinical condition

[Monostotic fibrous dysplasia of the frontal sinus with orbital extension]. / Displasia fibrosa monostótica de seno frontal con extensión orbitaria.

We present the case of a localized monostotic fibrous dysplasia in the frontal sinus with orbital extension and persistency after the first surgery; it had to be operated again with a fronto-orbitary reconstruction. The fibrous dysplasia is a rare bony alteration with transformation of the healthy bony tissue for a disestructuredone. Its etiology is unknown and can be associated to different syndromes, such as Albright's Disease. Its treatment is surgical, but presents a high percentage of recurrence, this is the xenson why it needs a close follow up.

Displasia fibrosa monostótica de seno frontal con extensión orbitaria / Frontal sinus monostotic fibrous dysplasia with orbital extension

Presentamos un caso de displasia fibrosa monostótica localizada en el seno frontal con extensión orbitaria y persistencia tras la primera intervención, siendo operado nuevamente con reconstrucción fronto-orbitaria. La displasia fibrosa es una alteración ósea infrecuente con transformación del tejido óseo sano por otro fibro-óseo desestructurado, es de etiologia desconocida y puede asociarse a varios síndromes, entre ellos el síndrome de Albright (sólo en casos de displasia poliostótica). Su tratamiento es quirúrgico aunque presenta altas tasas de recidiva, por lo que su seguimiento debe ser continuado. (AU)

We present the case of a localized monostotic fibrous dysplasia in the frontal sinus with orbital extension and persistency after the first surgery; it had to be operated again with a fronto-orbitary reconstruction. The fibrous dysplasia is a rare bony alteration with transformation of the healthy bony tissue for a disestructuredone. Its etiology is unknown and can be associated to different syndromes, such as Albright's Disease. Its treatment is surgical, but presents a high percentage of recurrence, this is the xenson why it needs a close follow up (AU)

Analysis of 2 antiapoptotic factors in gliomas: bcl-2 overexpression and p53 mutations.

BACKGROUND: p53 mutations and immunoreactivity have been described in human gliomas. During the past few years, some authors have found bcl-2 overexpression in astrocytomas, although their correlation with histological grade is a matter of disagreement. A relation between bcl-2 overexpression and p53 immunoreactivity has also been suggested. OBJECTIVES: To analyze the frequency of presentation of bcl-2 and p53, their clinicopathologic implications, and their possible coexpression. METHODS: We studied p53 and bcl-2 with immunohistochemical and molecular methods in 61 gliomas (including 21 astrocytomas, 9 anaplastic astrocytomas, 29 glioblastomas, 1 oligodendroglioma, and 1 mixed glioma). RESULTS: We discovered a high level of bcl-2 overexpression (57%). Overexpression of bcl-2 can be an early event in gliomas tumorigenesis, although no correlation was found with any of the clinicopathologic parameters studied. p53 mutations were present in a small proportion of gliomas (17%). p53 immunoreactivity was present in 34 cases (57%), and it was related to histological grade and a supratentorial location. A high percentage of tumors (26 cases, 42%) presented p53 immunoreactivity without p53 mutations. CONCLUSIONS: Since there was no relation between bcl-2 overexpression and p53 mutations or p53 immunoreactivity, both factors may not act together in the genesis and evolution of gliomas.

Assessing microsatellite instability with semiautomated fluorescent technology: application to the analysis of primary brain tumors.

The replication error phenotype, revealed by the observation of widespread microsatellite instability (MIN), has been identified as a new mechanism of cancer susceptibility, and the comparison of the allele sizes of polymorphic microsatellite repeats between normal and tumor DNA is now frequently undertaken in colorectal and other human neoplasias. The lack of precise characterization of the electrophoretic profiles of microsatellites is one of the main sources of discord between the rate of MIN reported for the same type of tumor by different investigators. The recent introduction of fluorescent-based semiautomated microsatellite analysis allows a more accurate size comparison, but one or more artificial peaks, generated during polymerase chain reaction (PCR) and/or electrophoresis, are frequently detected along with the true allele peaks. The aim of this study was to characterize the most frequent artificial extra peaks in the short tandem repeats (STRs) used by us to assess MIN in human cancers. We analyzed eight microsatellite loci in 113 primary brain tumors. HumFibra/FGA exhibited the most frequent extra peak formation. For each microsatellite there is a characteristic pattern of artifact formation which must be recognized to avoid a false-positive diagnosis of MIN.

Value of MIB-1 labelling index (LI) in gliomas and its correlation with other prognostic factors. A clinicopathologic study.

BACKGROUND: In recent years, the monoclonal antibody MIB-1 has become the main factor to measure the proliferative potential of glial tumors. This antibody is equivalent to Ki-67, which is used in frozen sections, and reacts with a nuclear protein that is expressed through the cell cycle. We have investigated the value of MIB-1 Labelling Index (LI) as an independent prognostic factor in gliomas and its relationship with clinical and pathological parameters. METHODS: MIB-1 LI was determined in 139 gliomas by using the Streptavidin-Biotin Complex (SBC) immunohistochemical method. MIB-1 LI immunoreactivity was measured with an automatic cell counting system. Survival was studied by using the Kaplan-Meier bivariant analysis and Cox multivariant regression. RESULTS: In bivariant analysis MIB-1 LI increased with age, histological grade and a supratentorial lateral location. Only size and tumor grade were significant in Cox regression. CONCLUSIONS: Perhaps this proliferation marker is influenced by many factors which reduce its value as an isolated prognostic parameter.

[A fibroepithelial polyp of the ureter. A report of 2 new cases]. / Pólipo fibroepitelial del ureter. Aportación de dos nuevos casos.

Primal neoplasias of the ureter are very rare and account for less than 1% of all genitourinary tumours. Only 20% of them are benign, and the fibroepithelial lineage is the more frequent. We contribute two cases of fibroepithelial polyps of the ureter; a brief comment on the etiology of these lesions, the routine diagnosis procedures and current therapeutical options is presented. Due to breakthroughs in radiologic and endoscopic techniques for the upper urinary tract, a more precise pre-operative diagnosis of these lesions has been achieved as well as a more conservative therapy which avoids incorrect and unnecessary nephroureterectomies, so frequent in past times, considering the benign nature of this unusual pathology.