[Heterotopic sebaceous glands in the esophagus: case report with review of the literature]. / Talgdrüsenheterotopie im Ösophagus: Fallbericht in Zusammenschau mit der Literatur.

Heterotopia of sebaceous glands is a very rare endoscopically indistinct benign finding in the esophagus. To date only 30 cases have been reported in the literature. The lesions exhibit a considerable variation in number and size. No malignant transformation has yet been reported. From the pathologists' point of view an inflammatory or neoplastic process has to be excluded as the cause of the non-distinctive endoscopic findings.

Differential expression of microRNA-675, microRNA-139-3p and microRNA-335 in benign and malignant adrenocortical tumours.

BACKGROUND: For the clinical management of adrenocortical neoplasms it is crucial to correctly distinguish between benign and malignant tumours. Even histomorphologically based scoring systems do not allow precise separation in single lesions, thus novel parameters are desired which offer a more accurate differentiation. The tremendous potential of microRNAs (miRNAs) as diagnostic biomarkers in surgical pathology has recently been shown in a broad variety of tumours. METHODS: In order to elucidate the diagnostic impact of miRNA expression in adrenocortical neoplasms, a cohort of 20 adrenocortical specimens including normal adrenal tissue (n=4), adrenocortical adenomas (ACAs) (n=9), adrenocortical carcinomas (ACCs) (n=4) and metastases (n=3) was analysed using TaqMan low density arrays to identify specific miRNA profiles in order to distinguish between benign and malignant adrenocortical lesions. Results were validated in a validation cohort (n=16). RESULTS: Concerning the differential diagnosis of ACAs and ACCs, 159 out of 667 miRNAs were up- and 89 were down-regulated in ACAs. Using real-time PCR analysis of three of the most significantly expressed single key miRNAs allowed separation of ACAs from ACCs. ACCs exhibited significantly lower levels of miR-139-3p (up to 8.49-fold, p<0.001), miR-675 (up to 23.25-fold, p<0.001) and miR-335 (up to 5.25-fold, p<0.001). A validation cohort of 16 specimen with known Weiss score showed up-regulation of miR-335 and miR-675 in the majority of cases with probable malignant course, although overlapping values exist. CONCLUSION: miRNA profiling of miR-675 and miR-335 helps in discriminating ACCs from ACAs. miRNA analysis may indicate malignant behaviour in cases with indeterminate malignant potential.

[Cytomegalovirus colitis in an elderly polytraumatised patient]. / Cytomegalievirus-Kolitis bei einer polytraumatisierten älteren Patientin.

HISTORY AND CLINICAL FINDINGS: During a long-term stay on a intensive-care unit a polytraumatised elderly patient developed hematochezia, which was refractory to blood transfusion. INVESTIGATIONS AND DIAGNOSIS: During colonoscopy, multiple ulcers were found in the right colon and rectum, and right hemicolectomy was performed after another massive anal blood loss. Histological findings showed characteristic intranuclear inclusions, positive Cytomegalovirus (CMV)-IgM titer and positive polymerase chain reaction (PCR) in blood. TREATMENT AND COURSE: After hemicolectomy, antiviral therapy with ganciclovir was initiated for two weeks intravenously, and no more gastrointestinal symptoms occurred. In the following days, enteral alimentation was continued without problems. CONCLUSIONS: CMV colitis should be considered in immunoincompetent patients after more common etiologies for severe diarrhea have been excluded. Timely diagnosis is essential to improve the outcome for elderly patients or patients with severe co-morbidities.