Could the truncated variant of ERBB2 be present in the squamous carcinomas of the cervix?

ERBB2, a ligand-less membrane receptor, is frequently overexpressed in a number of human tumors, contributing to uncontrolled cell proliferation. In some cases, gene amplification correlates with protein overexpression and predicts response to trastuzumab. We analyzed the expression of ERBB2 in a group of 40 patients diagnosed with infiltrating squamous cervical carcinomas (ISCC) using a microarray. Immunochemistry was performed using two different antibodies, one against the extramembrane domain and the other one for the intramembrane domain. Ten of the 40 cases included in the study could not be evaluated. Of the 30 remaining biopsies, 13 (42%) showed immunoreactivity only with the antibody against the intramembrane domain. In 5 (16.12%), both intramembrane and extramembrane immunoreactivity was observed, and 12 (40%) were negative for both antibodies. Looking at our results, we propose that, in some ISCC, there is a rupture of the ERBB2 receptor, and this event, with slight genetic amplification, could explain the unfavorable response to trastuzumab observed in some ISCC descript for some authors.

Radiologic evaluation of breast disorders related to pregnancy and lactation.

During pregnancy and lactation, the breast can be affected by a variety of specific and unique disorders, including benign disorders closely related to physiologic changes, inflammatory and infectious diseases, juvenile papillomatosis, and benign and malignant tumors. Patients with pregnancy-associated breast carcinoma tend to have more advanced neoplasms at diagnosis and a poorer prognosis due to delayed diagnosis and a more aggressive biologic pattern. Pregnancy-related Burkitt lymphoma characteristically manifests with bilateral and diffuse involvement of the breasts. Fibroadenoma may manifest with growth, infarction, large cysts, prominent ducts, and secretory hyperplasia during pregnancy and lactation. Galactocele is the breast lesion most commonly found during lactation and manifests as either pseudolipoma, a cystic mass with a fat-fluid level, or pseudohamartoma. Tumors and diseases affecting the breasts during pregnancy and lactation are basically the same as those observed in nonpregnant women but may have a different appearance. The sensitivity of mammography in pregnant and lactating women is decreased due to increased parenchymal density. Instead, ultrasonography is the most appropriate radiologic method for evaluating breast masses in this setting and is particularly useful in the diagnosis and treatment of abscesses. Knowledge of the unique entities that are specifically related to pregnancy and lactation and of their radiologic-pathologic appearances can help the radiologist make the correct diagnosis.

Radiologic evaluation of uncommon inflammatory and reactive breast disorders.

The radiologic features of breast lesions caused by immunologic, reactive, and noncurrent infectious diseases often mimic those of malignancy, frequently constituting a diagnostic challenge even if the underlying disease is known. Churg-Strauss syndrome mimics carcinomatous mastitis. Amyloidosis usually manifests as a suspicious mass, often accompanied by microcalcifications. Wegener granulomatosis and sarcoidosis often manifest as irregular masses, although sarcoidosis can also manifest as round, well-defined masses reflecting intramammary node involvement. Diabetic mastopathy is a rare but well-known entity in patients with long-standing insulin-dependent diabetes. Breast involvement by necrobiotic xanthogranulomatosis is rare and manifests as multiple bilateral asymmetric lesions. Multiple clustered hypoechoic tubular structures in a large hypoechoic mass seen after pregnancy can be suggestive of granulomatous mastitis. Mammary tuberculosis can manifest with a nodular, diffuse, or sclerosing pattern. A granulomatous inflammatory reaction must be carefully evaluated because it constitutes the major feature of a diverse group of diseases that includes vasculitis, granulomatous mastitis, tuberculosis, and carcinoma-associated sarcoidlike reactions. Core biopsy can play a major role in developing a differential diagnosis for these rare immunologic, inflammatory, or infectious disorders affecting the breast, and knowledge of these entities can, in the appropriate clinical setting, help the radiologist narrow the differential diagnosis, although cancer must be excluded definitively.

La broncoscopía en la neoplasia pulmonar periférica: resultados de una pauta diagnóstica / Bronchoscopy in peripheral lung neoplasia: results of a diagnostic guideline

La neoplasia pulmonar periférica, supone un reto diagnóstico para el neumólogo. Para su estudio dentro del campo endoscópico, existe una variedad de pruebas diagnósticas. Es importante pues, escoger un conjunto de técnicas que ofrezcan una buena relación costo-beneficio-riesgo. Presentamos los resultados obtenidos con una pauta diagnóstica consistente en la realización de una broncoscopía con control radioscópico, intento de cepillado de la lesión y posterior punción de la lesión si se establece un buen contacto. Broncoaspirado sistemático. El tiempo de radioscopía fue siempre inferior a 4 minutos. Este método se realizó en 84 casos de neoplasia pulmonar periférica, 38 con un diámetro inferior a 3 cm. El broncoaspirado fue positivo en el 54 porciento de los casos; el cepillado en el 51 porciento, de las 71 ocasiones en que el instrumento contactó con la lesión; la punción fue positiva en el 69 porciento de los 45 casos en que se realizó. En conjunto la broncoscopía fue diagnóstica en 58 casos (69 porciento). No se presentaron complicaciones. El cepillado bronquial, fue útil para conocer en un mínimo de tiempo, qué bronquio conduce a la lesión. La punción, cuando se pudo realizar satisfactoriamente, resultó ser la técnica más sensible. El broncoaspirado no incrementó la complejidad ni la duración de la exploración y ofreció un aceptable rendimiento diagnóstico. Estos resultados sugieren que dicha pauta endoscópica, obtiene un rendimiento diagnóstico satisfactorio, con una breve exposición radioscópica y una escasa morbilidad