Could We Consider Ultrasound-Guided Minimally Invasive Autopsy as a Part of POCUS?

We present a 3-patient case series that support the use of ultrasound guided minimally invasive autopsy (MIA). This technique has a high diagnostic accuracy in specific clinical settings. It makes easier to diagnose pathologies once the patient has died, avoiding body deformation, with a notable reduction in sample processing time compared to the open autopsy study and, therefore, a shorter overall diagnostic response time. MIA shows some similarities with point of care ultrasound (POCUS), like examination protocols or that they can be performed at the bedside.

[Mucinous tubular and spindle cell renal cell carcinoma: two novel cases and a literature review.] / Carcinoma mucinoso tubular y de células fusiformes renal: aportación de 2 nuevos casos y revisión de la literatura.

INTRODUCTION: Mucinous tubularand spindle cell carcinomas (MTSC) are a relativelyrare subtype of renal cell carcinoma (RCC) . Thesetumors are composed by tubular and spindle cellareas within a mucinous stroma. They are generallylow-grade nuclei tumors and limited to the kidney, sothey usually have a favorable prognosis. We report twonew cases of MTSC treated at our institution. MATERIALS AND METHODS: We reviewed therenal tumors surgery database of our hospital from2008 to 2019, selecting patients diagnosed with CMTF.We evaluated clinicopathological data and evolution ofthe patients. We also reviewed the published literatureto compare it with our findings. RESULTS: Two patients were included in the study,a 50-year-old male (case 1) and a 55-year-old female(case 2). The diagnosis was made by ultrasound asan incidental fi nding in case 1 and during the studyof fl ank pain in case 2. Treatment was surgical withpartial and radical nephrectomy respectively. After amean follow-up of 70 months, both patients are aliveand disease-free. CONCLUSION: Mucinous tubular and spindle cellcarcinomas (MTSC) is a rare renal tumor, approximatelytwo hundred cases have been published. Thereare questions yet to be answered about their diagnosisand behaviour so it is of utmost importance to reportnew cases in order to increase our knowledge and improvepatient care.

INTRODUCCIÓN: Los carcinomasmucinosos tubulares y de células fusiformes (CMTF)son un subtipo relativamente infrecuente de carcinomarenal (CCR). Están compuestos por célulastubulares y fusiformes con un estroma mucinoso.Generalmente son tumores de bajo grado y estánlimitados al riñón, por lo que habitualmente tienenbuen pronóstico. Reportamos dos nuevos casos deCMTF tratados en nuestra institución. MATERIAL Y MÉTODOS: Se realizó una revisiónde todos los tumores renales intervenidos en nuestrohospital desde el año 2008 has ta el año 2019, seleccionandolos pacientes diagnosticados de CMTF.Se evaluaron las características clinicopatológicasy la evolución de los pacientes. Así mismo, se realizóuna revisión exhaustiva de la literatura publicadapara comparar los hallazgos descritos con los denuestros casos. RESULTADOS: Dos pacientes fueron incluidos enel estudio, un varón de 50 años ( caso 1) y una mujer de55 años ( caso 2). El diagnóstico fue ecográfico, de forma incidental en el caso 1 y a partir del estudio de undolor en flanco, en el caso 2. El tratamiento fue quirúrgicomediante nefrectomía parcial y radical respectivamente.Tras un seguimiento medio de 70 meses ambospacientes están vivos y libres de enfermedad. CONCLUSIÓN: El carcinoma mucinoso tubular yde células fusiformes (CMTF) es un tumor renal infrecuente,habiéndose publicado aproximadamente doscentenares de casos. Aún hay incógnitas que resolversobre su diagnóstico y comportamiento, de ahí la importanciade reportar nuevos casos que nos permitanaumentar su conocimiento y mejorar el manejo denuestros pacientes.

Carcinoma mucinoso tubular y de células fusiformes renal: aportación de 2 nuevos casos y revisión de la literatura / Mucinous tubular and renal spindle cell carcinoma: contribution of 2 new cases and review of the literature

INTRODUCCIÓN: Los carcinomasmucinosos tubulares y de células fusiformes (CMTF)son un subtipo relativamente infrecuente de carcinoma renal (CCR). Están compuestos por célulastubulares y fusiformes con un estroma mucinoso.Generalmente son tumores de bajo grado y estánlimitados al riñón, por lo que habitualmente tienenbuen pronóstico. Reportamos dos nuevos casos deCMTF tratados en nuestra institución.MATERIAL Y MÉTODOS: Se realizó una revisiónde todos los tumores renales intervenidos en nuestro hospital desde el año 2008 hasta el año 2019, seleccionando los pacientes diagnosticados de CMTF.Se evaluaron las características clinicopatológicasy la evolución de los pacientes. Así mismo, se realizó una revisión exhaustiva de la literatura publicada para comparar los hallazgos descritos con los denuestros casos.RESULTADOS: Dos pacientes fueron incluidos enel estudio, un varón de 50 años ( caso 1) y una mujer de55 años ( caso 2). El diagnóstico fue ecográfico, de forma incidental en el caso 1 y a partir del estudio de undolor en flanco, en el caso 2. El tratamiento fue quirúrgico mediante nefrectomía parcial y radical respectivamente. Tras un seguimiento medio de 70 meses ambos pacientes están vivos y libres de enfermedad.CONCLUSIÓN: El carcinoma mucinoso tubular yde células fusiformes (CMTF) es un tumor renal infrecuente, habiéndose publicado aproximadamente doscentenares de casos. Aún hay incógnitas que resolversobre su diagnóstico y comportamiento, de ahí la importancia de reportar nuevos casos que nos permitanaumentar su conocimiento y mejorar el manejo denuestros pacientes.

INTRODUCTION: Mucinous tubularand spindle cell carcinomas (MTSC) are a relativelyrare subtype of renal cell carcinoma (RCC) . These tumors are composed by tubular and spindle cellareas within a mucinous stroma. They are generallylow-grade nuclei tumors and limited to the kidney, sothey usually have a favorable prognosis. We report twonew cases of MTSC treated at our institution.MATERIALS AND METHODS: We reviewed therenal tumors surgery database of our hospital from2008 to 2019, selecting patients diagnosed with CMTF.We evaluated clinicopathological data and evolution ofthe patients. We also reviewed the published literatureto compare it with our findings. RESULTS: Two patients were included in the study,a 50-year-old male (case 1) and a 55-year-old female (case 2). The diagnosis was made by ultrasound asan incidental fi nding in case 1 and during the studyof fl ank pain in case 2. Treatment was surgical withpartial and radical nephrectomy respectively. After amean follow-up of 70 months, both patients are aliveand disease-free.CONCLUSION: Mucinous tubular and spindle cellcarcinomas (MTSC) is a rare renal tumor, approximately two hundred cases have been published. Thereare questions yet to be answered about their diagnosisand behaviour so it is of utmost importance to reportnew cases in order to increase our knowledge and improve patient care.

Carcinoma verrucoso esofágico: una rara entidad de difícil diagnóstico / Verrucous carcinoma of the esophagus: A rare entity with a difficult diagnosis

No disponible

Adenocarcinoma intestinal secundario de vejiga que simula clínicamente neoplasia primaria. Dos patrones clinicopatológicos diferenciados / Secondary adenocarcinoma of the bladder. Two differentiated clinicopathological patterns

Los adenocarcinomas secundarios de vejiga urinaria son tumores infrecuentes, y representan menos del 2% de todas las neoplasias malignas de vejiga. El origen colorrectal es el más habitual. La infiltración vesical secundaria puede suceder por extensión directa o por metástasis a distancia. Desde el punto de vista clínico, suelen manifestarse como los tumores vesicales primarios, y en el estudio histológico inicial plantean un desafío morfológico con los adenocarcinomas primitivos de vejiga urinaria. El presente estudio analiza las características clinicopatológicas de estas 2 formas de afectación vesical secundaria, y propone el uso de un panel inmunohistoquímico básico para el diagnóstico diferencial de estos adenocarcinomas. El diagnóstico específico de adenocarcinoma primario frente a infiltración vesical secundaria (invasión directa o metastásica) tiene relevantes connotaciones pronósticas y es decisivo en la toma de decisiones terapéuticas (AU)

Secondary adenocarcinoma of the urinary bladder is rare, representing less than 2% of all malignant bladder neoplasms. The most common origin of the primary tumour is colorectal. The bladder may be affected either by direct invasion or metastases. Secondary tumours present in the same way as primary bladder neoplasms and the initial histopathological diagnosis can prove challenging. The present study analyzes the clinicopathological features of both types of secondary bladder involvement and proposes the use of a basic immunohistochemical panel for their differential diagnosis. A correct differential diagnosis between primary adenocarcinoma of the bladder and secondary infiltration by either direct invasion or metastasis is important for both prognosis and therapy (AU)

Fine-needle aspiration cytology of mammary myofibroblastoma: a report of six cases.

OBJECTIVE: To evaluate cytologic features of mammary myofibroblastoma in order to establish the possibility of precise preoperative recognition. STUDY DESIGN: This was a multi-institutional study of 6 patients with myofibroblastoma (5 men and 1 woman) in which preoperatively fine-needle aspiration cytology was performed. Four cases showed classical histologic features, 1 corresponded to the cellular variant and the remaining 1 to the fibrous form. RESULTS: Except for 1 case, smears were cellular and distributed as irregular aggregates and single cells. Most groups showed a small amount of metachromatic stroma and capillaries. Cells retained cytoplasm and showed a spindle-to-plump oval morphology with moderate pleomorphism. Nuclear pleomorphism was present and was relevant in 1 case. Intranuclear pseudoinclusions and mast cells were present in 3 cases. No epithelial clusters were seen. Due to hypercellularity and pleomorphism 1 case was considered as suspicious for malignancy. The remaining 5 were diagnosed as low-grade mesenchymal lesions, and myofibroblastoma was suggested in 3. CONCLUSION: Cytologic features of myofibroblastoma reflect what is seen on histology. When such findings are correlated with image studies, preoperative recognition can be possible. This is especially true for male patients in whom the tumor is relatively frequent.

Linfadenitis cervical aislada por leishmaniasis con patrón «Piringer-Kuchinka-like» en un paciente inmunocompetente / Isolated cervical "Piringer-Kuchinka-like" lymphadenitis due to leishmaniasis in an immunocompetent patient

La linfadenitis cervical aislada por leishmaniasis es una forma de presentación peculiar que clínicamente simula una enfermedad maligna, fundamentalmente linfoma. Los criterios citológicos de la linfadenitis por leishmanias son característicos, y los cuerpos de Leishman-Donovan son la clave diagnóstica de esta entidad, con rasgos citológicos e histológicos similares a los descritos como linfadenitis de Piringer- Kuchinka. Presentamos este caso por tratarse de una presentación clinicopatológica inusual en una paciente inmunocompetente(AU)

Isolated cervical lymphadenitis due to leishmaniasis is rare and clinically may resemble malignant disease. The characteristic cytology with the presence of Leishman-Donovan bodies provides the most important diagnostic clue. Microscopically, it has similar features to toxoplasmosis (Piringer-Kuchinka) lymphadenitis. We present a case of leishmaniasis in an immunocompetent patient with an unusual clinicopathological presentation(AU)

Metástasis retroperitoneal de liposarcoma mixoide/células redondas: patrón metastásico peculiar / Retroperitoneal metastases of myxoid/round cell liposarcoma: a peculiar metastatic pattern

El liposarcoma mixoide aparece en extremidades depacientes jóvenes, y muestra una apariencia mixoide, y unascaracterísticas citogenéticas determinantes.Presentamos el caso de un varón de 37 años con un grantumor retroperitoneal, que había sido diagnosticado previamentede un tumor de muslo. El tumor se caracterizaba porpresentar una red vascular capilar plexiforme con célulasfusiformes monomorfas y células redondas atípicas. Mostrabauna translocación (12;16). Planteó el diagnostico diferencialcon liposarcoma desdiferenciado con áreas de tipomixofibrosarcoma.El liposarcoma mixoide en retroperitoneo es más probablede origen secundario, por la peculiar propensión del LPSmixoide de extremidad a dar metástasis en tejidos blandosextrapulmonares, sobre todo retroperitoneo (AU)

Myxoid liposarcoma usually ocurs in extremities inyounger patients, showing a myxoid appearance and distinctivecytogenetic features.We report a huge retroperitoneal myxoid tumor, with ina patient that initially presented a liposarcoma of the thigh.The tumour showed a fine plexiform capillary network withmonomorphic spindle-cell and atypical round cells. FISHshowed a translocation t(12;16). This retroperitonealmyxoid tumor may be confused with dedifferentiated liposarcomawith myxofibrosarcoma-like areas.The retroperitoneal myxoid liposarcoma is more likelyto be secondary. Retroperitoneum is the most common siteof extrapulmonary metastatic myxoid liposarcoma (AU)

[Paratesticular liposarcoma. Clinical and pathological study of three cases and review of the literature]. / Liposarcomas paratesticulares. Estudio clinicopatológico de tres casos y revisión de la literatura.

OBJECTIVES: Paratesticular liposarcomas are rare; most published cases are single cases. We report the clinical, histological and immunohistochemical characteristics of three cases of paratesticular liposarcomas. METHODS: We performed clinical, histological and immunohistochemical studies with expression of ki 67 and p 53 markers in three cases of tumors of the spermatic cord. RESULTS: Patient age ranged from 36 to 67 years, with a mean of 54 years. All tumors were big, multinodular and predominant histological type was well-differentiated (2/3), being one case undifferentiated (1/3). All cases were treated by surgical excision; one of them had a relapse five years later (33%) as a low-grade undifferentiated liposarcoma. None of the patients have developed metastases after a long follow-up (10, 7, and 5 yr.). CONCLUSIONS: Paratesticular liposarcomas have favourable prognostic markers (histological type, low proliferation index Ki 67 and p 53). The evaluation of this masses should be based on imaging tests, but a biopsy is necessary to determine their nature both in the case of primary tumors and recurrences. Surgical treatment should include complete excision with free margins to avoid recurrences.

Liposarcomas paratesticulares. Estudio clinicopatológico de tres casos y revisión de la literatura / Paratesticular liposarcoma. Clinical and pathological study of three cases and bibliographic review

OBJETIVO: Los liposarcomas paratesticulares son poco frecuentes y la mayoría de los casos publicados son casos únicos. Presentamos las características clínicas histológicas e inmunohistoquímicas de 3 casos de LPS paratesticulares, exclusivamente dependientes de cordón espermático. MÉTODOS: Hemos realizado estudio clínico, histológico e inmunohistoquímico con la expresión de marcadores Ki 67 y p53 de 3 casos. RESULTADOS: La edad oscila entre 36 y 67 años, con una media de 54 años, y todos ellos son tumores de gran tamaño, con arquitectura multinodular, y predominio del tipo histológico bien diferenciado (2/3), siendo un caso LPS desdiferenciado (1/3). El tratamiento en todos ellos fue la resección quirúrgica completa, y uno presentó recidiva a los 5 años (33%), en forma de LPS desdiferenciado de bajo grado. Con un largo tiempo de seguimiento en los tres tumores (10, 7 y 5 años), no se han desarrollado metástasis en ninguno de ellos. CONCLUSIONES: Los LPS paratesticulares tienen marcadores pronósticos favorables (tipo histológico, bajo índice de proliferación Ki67 y p53). La evaluación de estas masas indeterminadas debe apoyarse en técnicas de imagen y la biopsia es necesaria para determinar la naturaleza de las mismas, tanto en caso de ser un tumor primario, como en caso de recidivas. El tratamiento quirúrgico debe ser excisión quirúrgica completa con márgenes libres para evitar recidivas

OBJECTIVES: Paratesticular liposarcomas are rare; most published cases are single cases. We report the clinical, histological and immunohistochemical characteristics of three cases of paratesticular liposarcomas. METHODS: We performed clinical, histological and immunohistochemical studies with expression of ki 67 and p 53 markers in three cases of tumors of the spermatic cord. RESULTS: Patient age ranged from 36 to 67 years, with a mean of 54 years. All tumors were big, multinodular and predominant histological type was well-differentiated (2/3), being one case undifferentiated (1/3). All cases were treated by surgical excision; one of them had a relapse five years later (33%) as a low-grade undifferentiated liposarcoma. None of the patients have developed metastases after a long follow-up (10, 7, and 5 yr.). CONCLUSIONS: Paratesticular liposarcomas have favourable prognostic markers (histological type, low proliferation index Ki 67 and p 53). The evaluation of this masses should be based on imaging tests, but a biopsy is necessary to determine their nature both in the case of primary tumors and recurrences. Surgical treatment should include complete excision with free margins to avoid recurrences