[Lymphomatoid papulosis evolving into malignant lymphoma. Clinico-pathological and immunohistochemical study of 3 cases]. / Papulosis linfomatoide con evolución a linfoma maligno. Estudio clinicopatológico e inmunohistoquímico de 3 casos.

Lymphomatoid papulosis is a disorder characterized by recurrent skin lesions with histological features suggestive of malignant lymphoma. In most cases the cutaneous lesions heal spontaneously but the course of the disease is long-lasting and an evolution into a Hodgkin's disease and non-Hodgkin lymphomas may be seen. We report herein the clinical, pathological and immunohistochemical study of three patients having a long-standing lymphomatoid papulosis, which turned into Hodgkin's disease, mycosis fungoides and nodular paragranuloma, respectively. Immunohistochemical analysis showed that the immunophenotype of atypical cells in lymphomatoid papulosis was similar to that observed in Reed-Sternberg cells in Hodgkin's disease and the neoplastic cells of mycosis fungoides. However, the immunohistochemical profile of cells in lymphomatoid papulosis differed from those observed in cells of nodular paragranuloma, developed by one of the three patients. The relationship between lymphomatoid papulosis and malignant lymphomas associated to lymphomatoid papulosis is discussed. The results show that no definitive criteria can be infered from an immunohistochemical study in lymphomatoid papulosis, in predicting the clinical evolution of the disease.

[Histopathologic factors with prognostic significance in mesangial proliferative glomerulonephritis]. / Factores histopatológicos de valor pronóstico en glomerulonefritis proliferativa mesangial.

To investigate the histopathological findings with prognostic significance in mesangial proliferative glomerulonephritis (MPGN), 52 patients with this disease were evaluated with sufficient clinical follow-up. A moderate but highly significant correlation was found between the final creatinine levels and the percentage of sclerosed glomeruli and number of atrophic tubuli per 10 high power fields (r = 0.530, p less than 0.001). When the patients with idiopathic MPGN and those with MPGN secondary to systemic or streptococcal disease were separately considered, there was a remarkable increase in the correlation index for the primary cases (r = 0.912, p less than 0.001). It was concluded that the finding with the highest predictive value in idiopathic forms is tubular atrophy. Three levels of disease were proposed, respectively defining patients with preserved renal function, established chronic renal failure and unpredictable outcome of renal function after a follow-up of five years.