Pleomorphic malignant fibrous histiocytoma in bladder diverticulum.

The Malignant Fibrous Histiocytoma is a very rare cancer and rather exceptional when located in bladder diverticulum. it occurs in men in their sixties, manifests itself through haematuria and/or irritative micturition. There is not a causal association. An immunohistochemical analysis is necessary to establish a differential diagnosis. It is aggressive, with a high rate of local recurrence and remote progression, thereby requiring early treatment that consists of radical cystectomy with pelvic lymph node dissection followed by adjuvant therapy, predominantly radiotherapy on the surgical wound. Close follow-up is crucially important. Poor survival rate even when patients undergo multimodal therapy.

Análisis integrado clínico, molecular e histopatológico de la médula ósea en las neoplasias mieloproliferativas crónicas / Comprehensive clinical, molecular and histopathological analysis of bone marrow in chronic myeloproliferative neoplasia

OBJETIVOS: Análisis de las posibles correlaciones entre las alteraciones moleculares en los genes JAK2, MPL y CALR, el patrón morfológico de la médula ósea y el perfil clínico-hematológico de los pacientes. PACIENTES Y MÉTODOS: Se trata de un estudio retrospectivo que incluye 140 pacientes con diagnóstico de neoplasias mieloproliferativas Filadelfia negativas (NMP Fi−) de un único centro. RESULTADOS: En la TE, los pacientes con la mutación el JAK2 V617F, presentaron un mayor número de leucocitos y neutrófilos que aquellos que presentaron la mutación en CALR. Los CALR mutados obtuvieron un mayor número de plaquetas y mayor necesidad de tratamiento citorreductor. Estos hallazgos apoyan el hecho de que el estado mutacional en la TE parece definir subtipos de pacientes con un curso clínico y pronóstico substancialmente diferentes. En la MF el estado mutacional parece influir en los cambios histopatológicos encontrados en la BMO, lo que no ocurrió en PV y TE

OBJECTIVES: To analyse the possible correlation between molecular changes in the JAK2, MPL and CALR genes, the morphological pattern of bone marrow and the clinical-haematologic profile of patients. PATIENTS AND METHODS: We conducted a retrospective study that included 140 patients diagnosed with Philadelphia-negative myeloproliferative neoplasia (Ph-MPN) in a single centre. RESULTS: In essential thrombocythaemia (ET), the patients with the JAK2 V617F mutation presented more leucocytes and neutrophils than patients who presented the CALR mutation, who had more platelets and a greater need for cytoreductive therapy. These findings support the fact that the mutational state in ET appears to define subtypes of patients with substantially different clinical courses and prognoses. In myelofibrosis, the mutational state appears to influence the histopathological changes found in the bone marrow biopsy, which did not occur in polycythaemia vera or ET

Multimodal therapy in urachal carcinoma with oligometastatic bone disease.

A 35-year-old male patient was admitted to our hospital for urachal carcinoma with oligometastatic bone disease. He received a surgical resection through the umbilical area, urachal ligament and bladder dome (partial cystectomy) and adjuvant chemotherapy based on cisplatin-gemcitabine regimens together zoledronic acid with a good tolerance, no toxicity. Nine months after surgery, our patient presented no symptoms and the metastasis had been brought under control with no apparent signs of recurrence as assessed in a follow-up CT. To our knowledge, is the first case report of a urachal carcinoma with oligometastatic bone disease who received multimodal therapy, including surgery resection.

Comprehensive clinical, molecular and histopathological analysis of bone marrow in chronic myeloproliferative neoplasia. / Análisis integrado clínico, molecular e histopatológico de la médula ósea en las neoplasias mieloproliferativas crónicas.

OBJECTIVES: To analyse the possible correlation between molecular changes in the JAK2, MPL and CALR genes, the morphological pattern of bone marrow and the clinical-haematologic profile of patients. PATIENTS AND METHODS: We conducted a retrospective study that included 140 patients diagnosed with Philadelphia-negative myeloproliferative neoplasia (Ph-MPN) in a single centre. RESULTS: In essential thrombocythaemia (ET), the patients with the JAK2 V617F mutation presented more leucocytes and neutrophils than patients who presented the CALR mutation, who had more platelets and a greater need for cytoreductive therapy. These findings support the fact that the mutational state in ET appears to define subtypes of patients with substantially different clinical courses and prognoses. In myelofibrosis, the mutational state appears to influence the histopathological changes found in the bone marrow biopsy, which did not occur in polycythaemia vera or ET.

Chondroma of the Bladder: An Atypical Localization.

Chondroma is a benign tumour of mesenchymal origin that is composed of cartilage and rarely located in soft tissues, being described so far only in four cases, as located in the bladder, according to our knowledge. We describe the fifth case of a 67-year-old woman who consulted for microscopic haematuria, with an endoscopic finding of submucosal nodular image in the anterior wall of the bladder, which after resection and the histologic study shows cartilage and fibroconnective tissue, in part hyalinised, and positive immunohistochemical staining of cells with vimentin and S-100; this fact can support the diagnosis of bladder chondroma.

Ovarian Leydig cells (OLC): A histomorphological and immunohistochemical study.

Testicular Leydig cells (LC) regulate the proper development of male individuals, both during fetal life (fetal LC) and puberty (adult LC). In the ovaries of adult women, there are cells that are very similar to Leydig cells, the ovarian hilus cells (OHC), which also produce testosterone. The origin of these cells, in both sexes, remains unknown and is still a matter of debate. We have studied the location, characteristics and relationships of the OHC in 90 patients. The indications for oophorectomy were: metrorrhagia (n=9), prolapse (n=8), endometrial hyperplasia (n=14), cancer (endometrial, myometrial, or cervical) (n=35), uterine leiomyomata (n=14), and various ovarian tumors (cysts and benign tumors, borderline and malignant) (n=10). In addition to the hilus, occasionally the nodules, nests and clusters of OHC were located in the mesovarium, the mesosalpinx, and in the medullar and cortical regions of the ovaries. The morphological (including crystalloids of Reinke) and immunohistochemical (positivity for calretinin and alpha-inhibin) findings were similar to those described for testicular LC. Therefore, OHC can be considered ovarian Leydig cells (OLC). LC are usually found in small numbers in the ovaries, but if one looks for them intentionally, one always finds them. Close relationships were observed between the OLC with nerves and vessels. Moreover, an intraneural location of the OLC was demonstrated in all cases, and these intraneural cells showed similar characteristics to extraneural OLC, suggesting that they derive from endoneural cells which are present in the vegetative nerves of the ovaries.

[Usefulness of urine cytology for bladder carcinoma diagnosis: comparative study with biopsy]. / Utilidad de la citología de orina para el diagnóstico del carcinoma vesical: estudio comparativo con biopsia.

OBJECTIVES: Traditionally, urine cytology has been considered as the gold standard for bladder cancer screening. However, new methods are playing new roles in these cases. In order to assess the value of cytology of voided urine we performed one comparative study between cytology and biopsy. METHODS: We retrospectively analyzed the results of urine cytology and biopsy follow-up in 109 patients. All cytologies were from voided urine. They were cytocentrifuged and stained with Papanicolaou stain. RESULTS: We found 70 true positive cases and 24 true negative cases. Sensitivity was calculated to be 97% and specifity 96-100%. 12 cases had the first cystoscopy test and biopsy negative, as the cancer was diagnosed in the second biopsy. CONCLUSIONS: Patients with clearly positive urine cytology, which was not confirmed in a first cystoscopic study, should be carefully followed up to identify a possible bladder or upper urinary tract cancer. The urine cytology still has a significant role as the gold standard for bladder cancer screening.

Utilidad de la citología de orina para el diagnóstico del carcinoma vesical: estudio comparativo con biopsia / Usefulness of urine cytology for bladder carcinoma diagnosis: comparative study with biopsy

Objetivo: La citología de orina se ha considerado la técnica de elección para el cribado de carcinoma vesical. La existencia de otros métodos diagnósticos adicionales, han puesto en duda su utilidad. Aportamos un estudio comparativo cito-histológico para comprobar su valor. Método: Hemos realizado un estudio retrospectivo de 109 biopsias vesicales en relación con los diagnósticos citológicos previos. Todas las citologías eran de micción espontánea, procesadas por citocentrifugación y teñidas con Papanicolaou. Resultados: Encontramos 70 casos verdaderos positivos, y 24 casos verdaderos negativos, consiguiendo una sensibilidad del 97% y una especificidad del 96-100%. Destacando que 12 casos positivos tenían la primera cistoscopia y biopsia negativa, diagnosticándose la neoplasia en la segunda biopsia. Conclusiones: Los pacientes con citologías de orina claramente positivas, que no se confirman en una primer estudio citoscópico, deben ser seguidos, para identificar una posible neoplasia vesical o de vías urinarias altas. La citología de orina puede seguir considerándose como una técnica de elección para el cribado y control de neoplasia vesical (AU)

Objectives: Traditionally, urine cytology has been considered as the gold standard for bladder cancer screening. However, new methods are playing new roles in these cases. In order to assess the value of cytology of voided urine we performed one comparative study between cytology and biopsy. Methods: We retrospectively analyzed the results of urine cytology and biopsy follow-up in 109 patients. All cytologies were from voided urine. They were cytocentrifuged and stained with Papanicolaou stain. Results: We found 70 true positive cases and 24 true negative cases. Sensitivity was calculated to be 97% and specifity 96-100%. 12 cases had the first cystoscopy test and biopsy negative, as the cancer was diagnosed in the second biopsy. Conclusions: Patients with clearly positive urine cytology, which was not confirmed in a first cystoscopic study, should be carefully followed up to identify a possible bladder or upper urinary tract cancer. The urine cytology still has a significant role as the gold standard for bladder cancer screening (AU)

[Indurated erythema as the presenting form of a case of chronic myelomonocytic leukemia]. / Eritema indurado como forma de presentación de un caso de leucemia mielomonocítica crónica.

Chronic myelomonocytic leukemia (CMML) is an oncohematologic disease with a mixed nature, myeloproliferative and myelodysplastic, and presenting features are usually the consequence of peripheral blood cytopenias (anemic syndrome, infections or bleeding). Specific or non-specific cutaneous involvement in patients with myelodysplastic syndromes or chronic leukemias is exceptional, and it takes place often in advanced stages of the disease, as a preample of a transformation from chronic illness to acute leukemia. Recognition and early diagnosis of the skin lesion by cutaneous biopsy, in every patient with myelodysplastic or myeloproliferative disease, have therapeutic and prognostic significance. We describe a patient who presented with a non-especific cutaneous lesion, Bazin's erhythema induratum, as initial manifestation of chronic myelomonocytic leukemia; we also comment diagnostic, therapeutic and clinical evolution aspects.

Eritema indurado como forma de presentación de un caso de leucemia mielomonocítica crónica / Erythema induratum as presenting form in a case of chronic myelomonocytic leukemia

La leucemia mielomonocítica crónica (LMMC) constituye un proceso oncohematológico de naturaleza mixta, mieloproliferativa y mielodisplásica, siendo su forma habitual de presentación consecuencia, generalmente, de las citopenias en sangre periférica (síndrome anémico, infecciones o diátesis hemorrágica). La afectación cutánea en pacientes con síndromes mielodisplásicos o leucemias crónicas, ya bien sea específica o inespecífica, es una circunstancia excepcional, teniendo lugar más frecuentemente en estadios avanzados de la enfermedad como preámbulo a una transformación del proceso crónico en leucemia aguda. El reconocimiento y el diagnóstico precoces del tipo de afectación cutánea en cualquier paciente con síndrome mielodisplásico o mieloproliferativo crónico, obtenido dicho diagnóstico mediante biopsia de la lesión, resulta de gran importancia, pues conlleva un claro significado pronóstico y terapéutico. Describimos a continuación el caso de un paciente que presentó una lesión cutánea inespecífica, un eritema indurado de Bazin, como manifestación inicial de una LMMC; se comentan aspectos diagnósticos, terapéuticos y evolutivos del mismo (AU)

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[Transitional cells carcinoma of the prostate. Contribution of 1 case]. / Carcinoma de celulas transicionales de la próstata aportación de un caso.

The revision of one case of transitional cell carcinoma of the prostate, studied by the Department of Pathology of the Hospital General y Clínico de Tenerife, comparing the results with those in the foreign bibliography. The authors discussed the possibility that the tumoration had it's origin in the periurethral ducts at the expense of the "basal" or "reserve" cells. Therefore the symptomatology is inespecific, for which we have-special emphasis in the histologic study of the lesion as diagnostic means. The transurethral resection (TUR) is suitable for the diagnosis and estrogenic therapy doesn't seem to give good results.