Mucoepidermoid tumors of the bronchus. Ultrastructural and immunohistochemical study. Histiogenic correlations.

UNLABELLED: Bronchial mucoepidermoid tumors are uncommon neoplasms, morphologically similar to their salivary gland counterpart. The histogenesis is controversial. The aim of this study is to identify myoepithelial cells and speculate on their role in the origin of these tumors. METHODS AND RESULTS: Sixteen bronchial mucoepidermoid tumor surgical specimens were formalin-fixed, paraffin-embedded and studied using a panel of nine antibodies in order to identify a myoepithelial differentiation. Additional antigens against several cytokeratins were performed in four cases and five of the biopies were studied using the electron microscopy. The different types of cells of the primary bronchial mucoepidermoid tumor (mucous luminal, intermediate and squamous) reacted strongly against AE1, CK7, 34bE12 and weakly with AE3, CK18 and CK8/18/19. S-100, alpha-smooth muscle actin, muscle actin HHF35 and alpha-actinin were consistently negative in all cell types. CD10 was positive in very few cells in just one case. CONCLUSION: The immunohistochemical and the ultrastructural study of bronchial mucoepidermiod tumors support a ductal unit origin, without a myoepithelial participation.

[Clinicopathological features of solitary fibrous tumors of the pleura: a case series and literature review]. / Tumor fibroso solitario pleural: características clinicopatológicas de una serie de casos y revisión de la bibliografía.

We assessed the clinicopathological features of solitary fibrous tumors of the pleura in a case series comprising 30 patients (20 women, 66.6%) with a mean age of 58.39 years. Forty-five percent of the cases were asymptomatic. In 70% of the cases the tumors arose in the visceral pleura. Twenty percent presented multiple tumors, a finding that was associated with intrapulmonary localization and malignant behavior (P<.0001) Histology revealed low cell density in 15% of the cases, moderate density in 50%, and high density in 35%; further findings showed atypia in 45% of the cases, necrosis in 25%, and hemorrhage in 15%. More than 4 mitoses per 10 high-power fields were noted in 30% of the cases. Immunohistochemistry results were positive for vimentin in all cases; cells were CD34+ in 85% of the cases, BCL2+ in 65%, and CD99+ in 40%. Findings for keratin and protein S100 were negative in all cases. Malignant biological behavior (local recurrence and metastasis) was observed in 4 cases, 2 of which were CD34-. Solitary fibrous tumors of the pleura are uncommon neoplasms with unpredictable biological behavior; follow-up should therefore be based on early detection of recurrence or metastasis.

Tumor fibroso solitario pleural: características clinicopatológicas de una serie de casos y revisión de la bibliografía / Clinicopathological features of solitary fibrous tumors of the pleura: a case series and literature review

Hemos evaluado las características clinicopatológicas del tumor fibroso solitario pleural en una serie de 30 casos. El 70% de los pacientes eran mujeres. El promedio de edad fue de 58,39 años. El 45% de los casos fueron asintomáticos. La localización más frecuente fue la pleura visceral (70%). En el 20% de los casos se observaron tumoraciones múltiples y se asociaron a localización intrapulmonar (p < 0,0001). Histológicamente mostraron densidad celular escasa en el 15% de los casos, moderada en el 50% e intensa en el 35%; atipia en el 45%; necrosis en el 25%; hemorragia en el 15%, y mitosis mayor de 4 por 10 campos en el 30%. La inmuhistoquímica mostró positividad para vimentina (100%), CD34 (85%), BCL2 (65%) y CD99 (40%), y negatividad en el 100% de los casos para queratinas y la proteína S100. Cuatro pacientes presentaron un comportamiento biológico maligno (recurrencia local y metástasis); en 2 de ellos el CD34 había sido negativo. El tumor fibroso solitario pleural es una neoplasia poco común de comportamiento biológico impredecible, por lo que el seguimiento debe centrarse en la detección precoz de la recurrencia o de metástasis

We assessed the clinicopathological features of solitary fibrous tumors of the pleura in a case series comprising 30 patients (20 women, 66.6%) with a mean age of 58.39 years. Forty-five percent of the cases were asymptomatic. In 70% of the cases the tumors arose in the visceral pleura. Twenty percent presented multiple tumors, a finding that was associated with intrapulmonary localization and malignant behavior (P<.0001) Histology revealed low cell density in 15% of the cases, moderate density in 50%, and high density in 35%; further findings showed atypia in 45% of the cases, necrosis in 25%, and hemorrhage in 15%. More than 4 mitoses per 10 high-power fields were noted in 30% of the cases. Immunohistochemistry results were positive for vimentin in all cases; cells were CD34+ in 85% of the cases, BCL2+ in 65%, and CD99+ in 40%. Findings for keratin and protein S100 were negative in all cases. Malignant biological behavior (local recurrence and metastasis) was observed in 4 cases, 2 of which were CD34­. Solitary fibrous tumors of the pleura are uncommon neoplasms with unpredictable biological behavior; follow-up should therefore be based on early detection of recurrence or metastasis

Leiomiosarcoma primario cutáneo / Primary cutaneos leiomyosarcoma

Los leiomiosarcomas localizados en las partes blandas superficiales son neoplasias muy raras o infrecuentes, tanto en las formas primarias como en el caso de las formas secundarias o metastásicas. Presentamos el caso de un leiomiosarcoma cutáneo primario en una mujer de 42 años de edad y realizamos una revisión de sus características clínicas y diagnóstico, así como de las diferencias pronóstico-evolutivas según las distintas localizaciones de esta afección. Por último, debe señalarse que el tratamiento es fundamentalmente quirúrgico, con escisión con márgenes de seguridad, ya que no existe una respuesta satisfactoria o significativa al tratamiento radio y/o quimioterápico, siendo imprescindible y obligado efectuar un seguimiento periódico de los enfermos debido a la tasa de recurrencia local y la posibilidad de metastatizar según la localización histológica del tumor (AU)

[Breast metastases from embryonal rhabdomyosarcoma: apropos 2 cases and a review of the literature]. / Metástasis mamarias de rabdomiosarcoma embrionario: a propósito de dos casos y revisión de la literatura.

The presence of breast metastases is uncommon in oncology. In children and young adults, the most common type of primary tumour is rhabdomyosarcoma, and primary breast rhabdomyosarcomas are exceptional. Two cases are reported of breast metastatic rhabdomyosarcoma in two adolescents with several atypical characteristics in their presentation forms: the embryonal variety and the primary location at maxillary sinus. The cases reported in the literature up to now were reviewed, with a special emphasis on epidemiologic, clinical, diagnostic, and therapeutic data of this rare entity.

Metástasis mamarias de rabdomiosarcoma embrionario: a propósito de dos casos y revisión de la literatura / Metastases to the breast of embryonal rhabdomyosarcoma: report of two cases and review of the literature

La presencia de metástasis mamarias es un hecho poco frecuente en Oncología. En los niños y adultos jóvenes el tumor primario más frecuente es el rabdomiosarcoma, siendo los rabdomiosarcomas primarios de mama excepcionales. Se describen dos casos de rabdomiosarcoma metastásico en mama en dos adolescentes con varias características atípicas en su presentación: la variedad embrionaria y la localización primaria en seno maxilar. Se analizan los casos descritos en la literatura hasta la actualidad, estudiando los datos epidemiológicos, clínicos, diagnósticos y terapéuticos de esta rara entidad (AU)

[Renal oncocytoma in acquired cystic diseases]. / Oncocitoma renal en enfermedad quística adquirida.

The authors report a case of renal oncocytoma associated with acquired renal cystic disease and we comment on its pathogenesis and course. This case responds a patient with chronic end renal insufficiency, included in a maintenance hemodialysis program for the two previous years nefrectomy. The association of oncocytoma with acquired renal cystic disease has been previously described only twice; both patients have been hemodialyzed for a long time.

Depressed adenoma of the stomach. Conceptual review and study of five cases.

Depressed gastric adenoma is a recently featured lesion, distinguished by a depression in the gastric mucosa, with histologic changes of conventional adenomatous polyp. We observed five cases of depressed gastric adenoma, one of them associated with a peptic ulcer, another with a gastric stump, and yet another with an early gastric carcinoma. None of the cases was detected clinically by radiology or endoscopic study. Endoscopically, this lesion stimulates a peptic ulcer at a re-epithelialization stage or an early carcinoma of the depressed type. Histologically, all the cases showed dysplastic changes of varying degrees, with a relevant risk of malignancy. A similarity is shown to other lesions described in the gastric mucosa.

[Solitary gastric ulcer due to cytomegalovirus: a cause of acute digestive hemorrhage]. / Ulcera gástrica solitaria por citomegalovirus: una causa de hemorragia digestiva aguda.

A 29-year-old homosexual man, with acquired immune deficiency syndrome was admitted to the hospital for evaluation of severe and recurrent epigastric pain, and important weight loss of 3-5 month duration. An upper gastrointestinal GI hemorrhage required an endoscopic examination which demonstrated a larger ulcer of the gastric antrum interpreted as suspicious of malignancy. Gastric cytomegalovirus (CMV) inclusion bodies, indicating CMV infection, were detected in the biopsy tissue from the edge of the gastric ulcer.

Expression of blood group antigens by normal bronchopulmonary tissues and common forms of pulmonary carcinomas.

The expression of ABH and Lewis antigens has been studied in a series of pulmonary carcinomas, in areas of squamous metaplasia, and in normal adjacent bronchopulmonary tissues by means of a panel of lectins and monoclonal antibodies. All respiratory epithelial cells can express antigens, with the exception of glandular serous cells. The expression of AB antigens is rather homogeneous, while Lewis antigens are expressed in a more irregular pattern, alternating positively stained cells with negatively stained cells in the same microscopic field. The expression of blood group antigens allows the identification of residual pneumocytes inside the tumor and the proper classification of some neoplasms. Metaplastic areas show a variation in the staining profile when compared with normal tissues and pulmonary carcinomas. The most significant findings are the deletion of A antigen and the strong expression of Le antigen. Pulmonary carcinomas are composed by a heterogeneous population and tend to express antigens in the more differentiated cases or areas. The most important findings are the deletion of AB antigens and the strong expression of Le(y) antigen.

[Area of high incidence of gastric cancer in Burgos]. / Area de alta incidencia de cáncer gástrico en Burgos.

This is an statistical of the incidence of gastric cancer in the province of Burgos during the period of 1981-1985. The incidence of the disease in this area was the highest in Europe according to world Registries. We observed a high risk area which comprised the regions of Páramo, Bureda and Sierra and Burgos city. The incidence was 65.3 males and 33.4 females per 100,000 inhabitants/year. This values are two times higher than those observed in neighbouring areas and were only surpassed by areas of Costa Rica and Japan.

Lectin histochemistry of normal bronchopulmonary tissues and common forms of bronchogenic carcinoma.

Normal bronchopulmonary tissues, areas of basal cell hyperplasia and of squamous metaplasia, and 26 pulmonary carcinomas, including the three major types (squamous cell carcinoma, adenocarcinoma, and oat cell carcinoma), were studied with 12 biotinylated plant lectins. The study demonstrated a rather characteristic lectin-binding profile for most normal epithelial cell types, while pulmonary tumors showed a variation in the lectin reactivity when compared with the whole spectrum of normal cells, with binding of some lectins that were not reactive with normal tissues and a loss of reactivity with others that bound to normal tissues. Adenocarcinomas showed the highest density of reacting sites, while undifferentiated carcinomas were the less-reacting variant. Areas of metaplasia and hyperplasia showed some variation in the lectin-binding profile with normal tissues, but as a whole, there was a much smaller number of reacting sites than tumors.

Sclerosing hemangioma of the lung. An immunohistochemical study of intermediate filaments and endothelial markers.

Three cases of so-called pulmonary sclerosing hemangioma have been studied for endothelial markers (alkaline phosphatase, adenosine triphosphatase, factor VIII-related antigen, and Ulex europaeus I lectin), for intermediate filaments (keratin, vimentin), and for carcinoembryonic and epithelial membrane antigen. Not one of the neoplasms expressed endothelial markers, carcinoembryonic antigen, or keratin reactivity. The tumor cells showed a positive reaction for epithelial membrane antigen and vimentin. The findings exclude an endothelial origin for this group of tumors and favored an epithelial origin as the probable genesis of the neoplastic proliferation.

Bronchial granular cell tumor. Presentation of three cases with tissue culture and ultrastructural study.

Three granular cell tumors, two arising from the bronchi and one from the trachea, are described. Two of the cases were studied by tissue culture and electron microscopy of the original tumor tissue and the cultivated cells. The granular cells grew actively in culture and showed a specific pattern in vitro different from tumors of fibrohistiocytic and schwannian origin. Ultrastructural examination of the newly grown cells allowed follow-up of the progressive cytoplasmic granulation of cells, with a transition from elements with an ultrastructural morphology consistent with the "early granular cells" described in tumor tissue in previous studies to fully developed mature granular cells.