The role of immunohistochemistry in the diagnosis of neoplastic pleural effusions.

Identification of the origin of neoplastic pleural effusion is a major concern in lung pathology. This study followed the diagnostic role of a panel of antibodies that included calretinin, HBME1, D2-40, Ber-EP4, CK5/6, CEA and TTF1, in a total of 37 cases of pleural and lung cancer with tumor-type cytology, later confirmed by histopathology. For mesothelioma, positive staining for calretinin, D2-40 and CK5/6 and negative for CEA and TTF1 were characteristic. For lung adenocarcinomas, we found Ber-EP4, CEA and TTF1 positivity, and calretinin, D2-40 and CK5/6 negativity. Squamous lung carcinomas were positive for Ber-EP4, CK5/6 and CEA and negative for HBME1, D2-40 and TTF1. The panel of antibodies used in this study provides a differential diagnosis between mesotheliomas and lung carcinomas as well as between lung adenocarcinomas and squamous carcinomas.

The role of cytology in the diagnosis of fluid collection syndromes associated with liver cirrhosis. Clinical, epidemiological, cytological and biochemical study of pleural effusion.

Cirrhosis, end-stage of many liver diseases, presents many complications during its evolution. One of these is the presence of pleural fluid collection syndrome. This may be a direct consequence of liver disease (hepatic hydrothorax) or may be a random association. A formidable complication due to its consequences is spontaneous pleural empyema. The present study aimed to assess the incidence, the factors that influence its occurrence, and the frequency of the infectious complication.

Intestinal pseudo-obstruction--a rare condition with heterogeneous etiology and unpredictable outcome. A case report.

Intestinal pseudo-obstruction (IPO), either acute or chronic, is a condition including features of intestinal ileus in the absence of mechanical obstruction. We present such a rare case of idiopathic IPO in a 53-year old male patient in whom recurrent episodes of pseudo-obstruction were successfully resolved by anticholinesterase agents, motilin agonists or colonic decompression. However, subsequently total colectomy was required. Huge colonic dilatation was identified intraoperatively, while histology evidenced a neuropathic variant of chronic intestinal pseudoobstruction. IPO is a condition in which conservative treatment usually fails. Total colectomy with ileoanal pouch was the solution in our patient.

Erythrokeratodermia variabilis - variant with circumscribed variable erythema and periorificial fixed Bazex Dupré erythema.

Erythrokeratodermia represents a group of rare genetic diseases characterized through disorders of keratinization. Clinically, they are presenting themselves with erythematous and hyperkeratosic lesions that can be persistent or variable as to their aspect and localization. They were classified in erythrokeratodermia variabilis (EKV) and erythrokeratodermia symmetric progressive (EKSP). We are presenting the case of a 9-years-old child which presents from birth facial and perioral erythema; erythematous and hyperkeratosic lesions with circinate character, extremely variable, localized especially on the anterior thorax (on the chest and in the axillar and inguinal folds). The neonatal debut, the clinical and histological aspect are suggestive elements for the EKV. In addition, the child has a plan frontal angioma and a congenital horizontal nistagmus. We realized a review of a literature data being different clinical variants of presentation of EKV and the eventual possible associations. It is considered the fact that the clinical presentation in the presented case corresponds to the variant of EKV with variable circinate erythema described by Bazex and Dupré. The case is also particular through the association of a plan frontal angioma, particularly of a congenital horizontal nistagmus, associations that we could not find in the literature.

Bone abnormalities occurring in the follow-up of the patients with neurofibromatosis type 1.

Neurofibromatosis type 1 (NF1), also called von Recklinghausen disease or peripheral neurofibromatosis, is a common autosomal dominant disorder characterized by multiple neurofibromas, "café au lait" spots and Lisch nodules of the iris with a variable clinical expression. Osseous anomalies appeared in the patients with NF1 including dysplasia, scoliosis and pseudoarthrosis. We propose a research of the osseous involvement at 11 patients, seven female and four male with ages from 9 to 60 at which the cutaneous aspect has the complete form, hyperpigmented spots and cutaneous neurofibromas and only more than six "café au lait" spots. All the patients suffered radiological exams, CT- and MRI-scan. The results were different from case to case from the extreme severe deformations, especially at the children, to clinical unapparent osseous involvement, incidental found or with occasion of our investigation. CONCLUSIONS. The patients with NF1 has osseous abnormalities specific of the disease, like dysplasia, scoliosis, pseudoarthrosis, often gentle but sometimes extremely severe. The most severe osseous involvement are presented in the cases when these development early in the childhood. Other times the osseous abnormalities are clinical asymptomatic, their finding been clinical incidental. We want to have a separate mention for the maxillary and mandible involvement, which according to our information is not a rare form.

Kaposi's sarcoma associated with AIDS.

In 1872, Moritz Kaposi, first described "Idiopathisches multiples Pigmentsarkom der Haut", which has become known as Kaposi sarcoma (KS). In the present KS is considerate an opportunistic neoplasm rather than a genuine cancer. It is a disease with clinical aspects extremely different, associate with some immunological deficits. The discovering in 1994 of a new type of human herpes virus called human herpes virus type 8 (HHV8) in the KS lesions sustains also a viral etiology. Four forms of Kaposi's sarcoma are recognized: classical, endemic (associated with AIDS), epidemic and iatrogenic (usually after transplant). All these forms have the same histopathologic aspects and are associated with HHV. However, these differ in prognosis and treatment. The authors present a KS case associated with AIDS occurring at a patient in the childhood. The particularities of the case are the presence of only two cutaneous lesions, from which one giant tumor, and the other nodular in aspect and the appearance of an infection HIV in the childhood with involvement of others risk factors except homosexuality. It is important, on one side the importance of the histopathologic exam of an angiomatous tumor for the establishing the diagnosis of KS even when is solitaire and appear in the child, and the other side the absolute necessity to search an eventual concomitant infection with HIV in the presence of a KS.