Quistes vellosos eruptivos / Eruptive vellus hair cysts

Los quistes vellosos eruptivos se definen por la aparición de numerosas pápulas asintomáticas, que se localizan normalmente en la cara anterior del tórax, el abdomen y las axilas. Se trata de una entidad benigna, que puede aparecer de forma esporádica o heredarse de modo autosómico dominante. El tratamiento constituye todo un reto, con resultados decepcionantes en muchos casos (AU)

Eruptive vellus hair cysts are characterized by numerous symptomatic papules usually located on the anterior chest, abdomen and armpits. It is a benign condition, which may be inherited or acquired in a autosomal dominant manner. The treatment is often challenging with disappointing results manytimes (AU)

Possible prognostic role of p53 expression in laryngeal squamous cell carcinoma of non-smokers, non-alcoholic patients.

CONCLUSIONS: p53 expression seems to negatively influence survival in non-smoking non-alcoholic patients with squamous cell laryngeal carcinoma. p53 might be implicated in the oncogenic pathways leading to neoplastic transformation in this population of patients. OBJECTIVES: The aim of this study was to analyze the prognostic significance of p53 immunohistochemical expression in laryngeal squamous cell carcinoma arising in non-smoking non-alcoholic patients. PATIENTS AND METHODS: We retrospectively reviewed the data from 782 patients diagnosed with laryngeal squamous cell carcinoma in the last 15 years at Mostoles Hospital. From these patients we chose 21 who had never smoked or drunk alcohol and performed immunohistochemical staining for p53 protein in paraffin-embedded archival blocks. RESULTS: We demonstrated immunohistochemical positivity for p53 in the samples from eight patients, most of them with a focal and weak pattern (<25% positivity in six cases). p53 expression did not show any significant prognostic influence on the risk of local or regional recurrence of the tumor, but significantly influenced the risk of death (log-rank test, p=0.03).

Pseudotumor inflamatorio: presentación de dos casos

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Fotoerupción cutánea en infección VIH avanzada / Cutaneous photoeruption in advanced HIV infection

Describimos el caso de una mujer de raza blanca, VIH positiva, que inició erupción cutánea fotosensible coincidiendo con el deterioro de su situación inmune marcada por la disminución de linfocitos CD4 y elevada carga viral. Su evolución clínica fue paralela a la inmunitaria con importante mejoría después de recibir triple tratamiento antiretroviral. Discutimos los aspectos patogénicos de estas fotoerupciones que pueden suponer un marcador clinico de la infección VIH y su progresión. Comentamos la importancia del control de la radiación ultravioleta y puvaterapia en pacientes VIH positivos (AU)

Resultados histológicos en los casos de citología tiroidea sospechosa de malignidad / Histological results in the cases of thyroid cytology suspicious for malignancy

Introducción. La enfermedad nodular tiroidea es un problema clínico frecuente. En la actualidad, la citología tiroidea obtenida por punción-aspiración constituye el elemento básico en la aproximación diagnóstica de la patología nodular tiroidea. Sin embargo, en numerosas ocasiones la información que esta técnica ofrece no es concluyente, como en los casos en los que el estudio citológico es sospechoso de malignidad. Sobre esta base, hemos realizado un estudio para conocer los resultados histológicos en nuestra serie de citologías tiroideas sospechosas de malignidad. Material y métodos. Se han estudiado 133 citologías tiroideas sospechosas de malignidad correspondientes a 115 pacientes (97 mujeres y 18 varones, edad media ñ DE: 46,1 ñ 14,8 años; intervalo: 17-81). Todos los pacientes fueron intervenidos quirúrgicamente obteniéndose un resultado histológico en cada caso. Resultados. De las 133 citologías estudiadas, en 33 de ellas (24,8 por ciento) el resultado histológico fue de malignidad (13 carcinomas foliculares, 10 carcinomas papilares, 6 carcinomas de células de Hürthle y 4 carcinomas medulares); mientras que en 100 casos (75,2 por ciento) fue de benignidad (52 hiperplasias nodulares, 29 adenomas foliculares, 10 tiroiditis de Hashimoto, 8 adenomas de células de Hürthle y un caso de enfermedad de Graves). Conclusiones. Nuestros resultados demuestran que hallazgos citológicos indeterminados o sospechosos de malignidad pueden aparecer en una gran variedad de enfermedades tiroideas. La elevada proporción de carcinomas tiroideos encontrada en nuestra serie (24,8 por ciento) sugiere que la cirugía debe ser considerada como una alternativa terapéutica de primera línea en estos casos (AU)

Cutaneous lymphadenoma: an adnexal neoplasm with intralobular activated lymphoid cells.

Cutaneous lymphadenoma is an uncommon epithelial neoplasm with a controverted adnexal differentiation. We report a typical case of cutaneous lymphadenoma that developed on the left cheek of a 18-year-old woman. Histologically, the neoplasm consisted of lobules of basaloid cells with a peripheral palisading array and filled with a lymphocyte-predmoninant mixed cellular population. Numerous intralobular cells with ample amphopilic cytoplasm, large vesicular nuclei, and prominent nucleoli also were noticed. Immunohistochemical study showed labeling of these Reed-Sternberg-like large cells by antibodies against CD30 antigen. Our findings suggest that cutaneous lymphadenoma is a poorly differentiated adnexal neoplasm, probably trichoblastoma-related, where a singular interaction with several immune cells is established, including activated large lymphocytes analogous to those malignantly proliferating in Hodgkin's disease.

Large-cell lymphoma presenting with hepatic sinusoidal infiltration.

We describe a case of large-cell lymphoma of B-cell phenotype with clinicopathologic features resembling malignant histiocytosis. The clinical presentation was characterized by fever, anemia, thrombocytopenia, coagulopathy, and elevated liver enzyme levels. These features and the finding of a predominantly sinusoidal infiltrate of neoplastic cells on liver biopsy raised the suspicion of malignant histiocytosis. The patient subsequently developed supraclavicular lymphadenopathy, which proved to be due to a diffuse large-cell lymphoma. Immunophenotypic studies performed on the lymph node and the original liver biopsy specimen established the B-cell nature of neoplastic cells at both sites. This case highlights a rare pattern of hepatic involvement by large-cell lymphoma, and contrasts the latter with other hematologic disorders associated with hepatic sinusoidal infiltrates.

Association of a thyrotropin-secreting pituitary adenoma and a thyroid follicular carcinoma.

The different factors involved as etiological agents in thyroid cancer have in common long term thyroid follicle stimulation. On this base, a patient with a TSH-producing pituitary adenoma could be at high risk for developing thyroid cancer. A patient consulting for a single thyroid nodule was studied in our unit. He was diagnosed as having a TSH-producing pituitary adenoma and the Thyroid nodule was shown to be a follicular carcinoma following removed. We speculate that elevated TSH levels could have contributed to neoplastic transformation of the thyroid in this patient.