Transumbilical laparoscopic treatment of Congenital Infantile Fibrosarcoma of the Ileum.

Congenital-Infantile Fibrosarcoma (CIF) is a malignant mesenchymal tumor representing 10-20% of soft-tissue tumors. Complete surgical resection is generally the treatment of choice. The most recurrent cytogenetic abnormality was identified as the traslocation t(12;15)(p13:q25), which bears the fusion of Tel gene EVT6 with TrkC gene. This study describes a case of infantile fibrosarcoma of the ileum in a female newborn examined for intestinal occlusion and its laparoscopic treatment.

Oncocytic papillary renal cell carcinoma: potential pitfall in small enucleation.

OBJECTIVE: We describe an emerging entity, recently recognized as a pitfall in the diagnostic practice among eosinophilic renal cell tumours. METHODS: A 60-year-old male underwent enucleation of a 1.2 cm nodule. Immunohistochemistry and FISH analysis were performed. RESULTS: Histology revealed a neoplasm composed of large cells with eosinophilic cytoplasm, Fuhrman grade 3, arranged in papillae. At the immunohistochemical level, cells showed positivity for AMACR and CD10. Fluorescence in situ hybridization (FISH) demonstrated gains of chromosomes 7 and 17 and loss of Y. A diagnosis of oncocytic papillary renal cell carcinoma was made. CONCLUSIONS: The distinction between renal oncocytoma and oncocytic papillary renal cell carcinoma is of substantial importance because of their different behaviour and prognosis, since the latter has malignant potential. Although the available evidence supporting tumour enucleation as the surgical treatment for renal cortical tumours < or = 4 cm, due to aforementioned clinicopathological features such tumours need to be evaluated using appropriate immunophenotypical and cytogenetic analyses.

Cathepsin-K immunoreactivity distinguishes MiTF/TFE family renal translocation carcinomas from other renal carcinomas.

The microphthalmia transcription factor/transcription factor E (TFE)-family translocation renal cell carcinomas bear specific translocations that result in overexpression of TFE3 or TFEB. TFE3 fusion gene product overexpression occurs as consequence of different translocations involving chromosome Xp11.2, whereas TFEB overexpression is the result of the specific translocation t(6;11)(p21;q12), which fuses the Alpha gene to TFEB. Both TFE3 and TFEB are closely related members of the microphthalmia transcription factor/TFE-family, which also includes TFEC and microphthalmia transcription factor. These transcription factors have overlapping transcriptional targets. Overexpression of microphthalmia transcription factor has been shown to mediate the expression of cathepsin-K in osteoclasts. We hypothesize that the overexpression of the related TFE3 fusion proteins and TFEB in translocation renal cell carcinomas may have the same effect. We studied cathepsin-K in 17 cytogenetically confirmed microphthalmia transcription factor/TFE-family translocation renal cell carcinomas. Seven cases showed a t(6;11)(p21;q12), ten cases showed translocations involving Xp11.2; five cases t(X;1)(p11;q21) resulting in a PRCC-TFE3 gene fusion; three cases t(X;1)(p11;p34) resulting in a PSF-TFE3 gene fusion, one t(X;17)(p11;q25) resulting in an ASPL-TFE3 gene fusion, and one t(X;3)(p11;q23) with an unknown TFE3 gene fusion. As control we analyzed cathepsin-K in 210 clear cell, 40 papillary, 25 chromophobe renal cell carcinomas and 30 oncocytomas. All seven TFEB translocation renal cell carcinomas were labeled for cathepsin-K. Among the cytogenetically confirmed TFE3 translocation renal cell carcinomas, 6 out of 10 were positive. None of the other renal neoplasms expressed cathepsin-K. We conclude the following: (1) cathepsin-K is consistently and strongly expressed in TFEB translocation renal cell carcinomas and in 6 of 10 TFE3 translocation renal cell carcinomas. (2) Cathepsin-K immunolabeling in both TFE3 and TFEB translocation renal cell carcinomas distinguishes these neoplasms from the more common adult renal cell carcinomas, and may be a specific marker of these neoplasms. (3) These results further support the concept that the overexpression of TFE3 or TFEB in these neoplasms activates the expression of genes normally regulated by microphthalmia transcription factor in other cell types.

Detection of parvovirus B19 and Chlamydophila pneumoniae in a patient with atypical sarcoidosis.

We present an elderly female patient with fever, aplastic anemia, arthralgic symptoms and atypical pneumonia. Serological and clinical findings suggested Parvovirus B19 and Chlamydophila pneumoniae infection. These supposed infections delayed the recognition of underlying sarcoidosis which definitive diagnosis was reached through a lung biopsy and histological demonstration of nonnecrotizing granulomas containing giant cells and noncaseating epithelioid cells. The present case highlights the potential difficulty to diagnose sarcoidosis in the presence of unusual infections which may complicate the course of this disease.

Self-starting mode locking of a cw Nd:YAG laser using cascaded second-order nonlinearities.

The nonlinear mode variations induced by the equivalent third-order susceptibility resulting from cascaded secondorder nonlinearities in an intracavity lithium triborate crystal are exploited for mode locking of a cw Nd:YAG laser. The loss modulations are provided by a slit, as in the Kerr-lens mode-locking scheme. The mode-locking process is self-starting and produces nearly transform-limited pulses of 14-ps duration with 0.5-W average power.

Nonlinear mirror mode locking of a cw Nd:YLF laser.

Passive mode locking of a cw lamp-pumped Nd:YLF laser with the nonlinear mirror technique is reported. Nearly transform-limited pulses of 13-ps duration and 1.5-W average power at 1.047 microm have been obtained. The nonlinear mirror consists of a lithium triborate frequency-doubling crystal and a dichroic mirror with high reflectivity for the second harmonic and lower reflectivity for the fundamental frequency. The mode-locking process is self-starting, with pulse duration and stability strongly dependent on the cavity parameters.