RESUMO
Amyand's hernia is a condition of exceptional presentation in children and is defined by the presence of inflamed appendix inside a inguinal hernia. It may manifest clinically as acute scrotum, inguinal lymphadenitis or strangulated hernia. The treatment is surgical and although several approaches are described, appendectomy with herniotomy by inguinal approach is considered of choice.
Assuntos
Doenças dos Genitais Masculinos/diagnóstico , Hérnia Inguinal/diagnóstico , Escroto , Doença Aguda , Apendicite/complicações , Diagnóstico Diferencial , Hérnia Inguinal/complicações , Humanos , Lactente , MasculinoRESUMO
Papillary squamous craniopharyngioma is an unusual variant of craniopharyngioma that presents almost exclusively in adults. We report a case of a 51-year-old man, who presented with visual and mental symptoms. A CT scan showed a suprasellar and intraventricular, uncalcified mass. After craniotomy a partly solid and cystic mass was resected. Light microscopy examination of the solid part shows a well-differentiated papillary squamous epithelium arranged in anastomosing cords and papillae. Peripheral palisading of cells, "stellate reticulum" and keratoid nodules were not present. No cholesterol clefts or calcifications are seen. The differential diagnosis of this tumor is discussed.
Assuntos
Craniofaringioma/diagnóstico , Neoplasias Hipofisárias/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
Presentation of one case-report of leukaemic infiltration of the prostate. Interestingly, the biopsy was only performed after finding distinctly elevated PSA levels and not because of the clinical findings, whether exploratory or echographic.
Assuntos
Leucemia Linfocítica Crônica de Células B/patologia , Infiltração Leucêmica , Antígeno Prostático Específico/sangue , Próstata/patologia , Neoplasias da Próstata/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Humanos , Leucemia Linfocítica Crônica de Células B/sangue , Masculino , Neoplasias da Próstata/sangueRESUMO
Common variable hypogammaglobulinemia syndrome with lymphoid nodular hyperplasia of the intestine forms part of the so-called hypogammaglobulinemic enteropathies. It is characterized by decreased serum immunoglobulins, recurrent respiratory tract infections and chronic diarrhea. The development of systemic amyloidosis is infrequent, but it can be explained by the multiple infections in this setting. The case of a 47-years old woman with hypogammaglobulinemic enteropathy, who developed systemic amyloidosis is presented. It was manifested as a nephrotic syndrome. The previously published reports include 12 cases of common variable hypogammaglobulinemia with systemic amyloidosis. Half of them presented nephrotic syndrome as a manifestation of their amyloidosis. It is important to keep in mind this complication in these patients' follow-up in order to increase the doses of gammaglobulin. That is the way to compensate their additional losses because of the nephrotic syndrome that they usually develop.
Assuntos
Agamaglobulinemia/complicações , Amiloidose/complicações , Intestinos/patologia , Feminino , Humanos , Hiperplasia/complicações , Hiperplasia/patologia , Pessoa de Meia-IdadeRESUMO
A case where mucoepidermoid and acinic cell carcinoma occurred simultaneously in the left parotid gland of a 67-year-old man is presented. Histologically, the neoplasm contained diagnostic areas of these tumors close to each other within the same tumor mass. A complete immunohistochemical study was performed and confirmed the presence of both components. To the best of our knowledge no similar case has previously been reported.
Assuntos
Carcinoma de Células Acinares/patologia , Carcinoma Mucoepidermoide/patologia , Neoplasias Parotídeas/patologia , Idoso , Anticorpos , Biomarcadores Tumorais/análise , Carcinoma de Células Acinares/cirurgia , Carcinoma Mucoepidermoide/cirurgia , Humanos , Imuno-Histoquímica , Masculino , Neoplasias Parotídeas/cirurgia , Antígeno Nuclear de Célula em Proliferação/análiseRESUMO
Eosinophilic cholecystitis is a rare finding characterized by an inflammatory infiltrate composed primarily of eosinophils. We report a case of eosinophilic cholecystitis associated with hepatic hydatic cyst ruptured into the biliary tract. The release of hydatid cyst content into the biliary tract may have induced a hypersensitivity reaction with numerous eosinophils in the gallbladder wall.
Assuntos
Colecistite/etiologia , Equinococose Hepática/complicações , Eosinófilos , Ductos Biliares Intra-Hepáticos , Colecistectomia , Colecistite/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Ruptura Espontânea , Tomografia Computadorizada por Raios XRESUMO
Solitary angiomyolipoma is a benign tumor that rarely develops in the liver. The preoperative diagnosis of this lesion is of great value because of the therapeutic implications. Radiologic findings are relatively characteristic but not specific. A case of giant angiomyolipoma of the liver is described in which ultrasonography, computed tomography and magnetic resonance imaging were insufficient to establish the diagnosis. Fine needle aspiration biopsy (FNAB) was performed, showing bundles of smooth muscle cells intermingled with fat mature cells, characteristic of this lesion. FNAB may be a valuable method of establishing a definitive diagnosis of hepatic angiomyolipoma.
Assuntos
Angiomiolipoma/diagnóstico , Neoplasias Hepáticas/diagnóstico , Angiomiolipoma/patologia , Biópsia por Agulha , Feminino , Humanos , Neoplasias Hepáticas/patologia , Pessoa de Meia-IdadeRESUMO
In a group of 276 consecutive liver transplants 8 primary graft nonfunctions were identified (2.9%). Recipients showed a progressive elevation of transferases (mean maximum value ALT: 5000 +/- 1892 U/l) and bilirubin (mean maximum value: 20 +/- 11.8 mg/dl) and a decrease in the percent prothrombin time (mean minimum value 26 +/- 13 min.) in the post-implantation survival time of the 8 grafts (range 1-5 days). No statistically significant differences were observed between mean cold and warm-ischemia times for these 8 donor organs and those of a control group of 92 consecutive grafts. All organs except one were ABO isogroup and all except another one displayed negative lymphocytotoxic crossmatch. Predominantly small-droplet hepatocytic vacuolization with no nuclear displacement was observed in plastic-embedded semithin sections of all post-primary nonfunction liver tissues (severe in 4 grafts, centri-mediozonal in 2, and centrolobular in 2). In 3 cases where fresh liver tissue was available the lipidic nature of the vacuoles was confirmed with electron microscopy and with frozen sections stained with Sudan III. Other microscopic lesions were also observed: spotty monocellular coagulative necroses, variable extension of zonal coagulative necroses and hemorrhages, cholestasis and minor mixed inflammatory infiltrate. Comparative microscopic study of these tissues with the protocol biopsy specimens obtained 2-4 hours after reperfusion demonstrated previous liver cell-vacuolization in only 3 cases. In conclusion, an acute progressive microvascular steatosis developed in this primary nonfunction series. No specific etiopathogenic factors were identified.
Assuntos
Transplante de Fígado , Fígado/ultraestrutura , Complicações Pós-Operatórias/patologia , Complicações Pós-Operatórias/fisiopatologia , Adolescente , Adulto , Biópsia , Criança , Pré-Escolar , Fígado Gorduroso/patologia , Feminino , Humanos , Terapia de Imunossupressão , Transplante de Fígado/patologia , Transplante de Fígado/fisiologia , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Preservação de Órgãos/métodos , Vacúolos/ultraestruturaRESUMO
Gastrointestinal stromal tumours (GIST) represent a heterogeneous group whose classification frequently requires ultrastructural and immunohistochemical studies. In a retrospective study of the ultrastructural findings of 24 gastrointestinal stromal tumours, whose light microscopic study has yielded ambiguous results and in which accurate diagnosis had required ultrastructural support, seven were found to have the characteristics of gastrointestinal autonomic nerve (GAN) tumours. In all of them the diagnosis was based on the presence of dendritic processes with dense neuroendocrine granules. Immunohistochemically, the seven tumours were negative for smooth-muscle markers. All stained positively for vimentin. NSE, chromogranin, and synaptophysin were positive in most of them, while S-100 protein was positive only in two cases. We present the ultrastructural and immunohistochemical features of seven GANT against the background of the GISTs of our series. We conclude that GAN tumours cannot be diagnosed by light microscopy alone but this tumour group displays characteristic electron microscopic and immunohistochemical features and appears to represent a distinct type of GIST.
Assuntos
Neoplasias Gastrointestinais/ultraestrutura , Neoplasias de Tecido Nervoso/ultraestrutura , Adulto , Idoso , Citoplasma/ultraestrutura , Grânulos Citoplasmáticos/ultraestrutura , Dendritos/ultraestrutura , Feminino , Neoplasias Gastrointestinais/classificação , Humanos , Imuno-Histoquímica , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Sistemas Neurossecretores/ultraestrutura , Fosfopiruvato Hidratase/análise , Estudos Retrospectivos , Proteínas S100/análise , Células Estromais/ultraestrutura , Sinaptofisina/análise , Vimentina/análiseRESUMO
A 57-year-old man was admitted with complaints of progressive anorexia, weight loss and right flank pain. He had been treated for basal-cell carcinoma of the skin 19 years before. On physical examination, eight moles in the face, back and left thigh were found along with palmar pits. In addition, a painful induration in his right thigh was evident. Biopsy proved that six moles were basal-cell carcinomas and the thigh mass a high-grade leiomyosarcoma. Computed tomographs revealed multiple metastases in the lungs and the liver. The patient was treated with epirubicin, with partial response, and subsequently with ifosfamide. He died 17 months after diagnosis. Whereas the world literature records several cases of soft tissue tumors in patients with nevoid basal-cell carcinoma syndrome, this is the first report of a simultaneous occurrence of leiomyosarcoma and nevoid basal-cell carcinoma syndrome.
Assuntos
Síndrome do Nevo Basocelular/complicações , Leiomiossarcoma/complicações , Neoplasias de Tecidos Moles/complicações , Síndrome do Nevo Basocelular/imunologia , Síndrome do Nevo Basocelular/patologia , Humanos , Leiomiossarcoma/imunologia , Leiomiossarcoma/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias de Tecidos Moles/imunologia , Neoplasias de Tecidos Moles/patologiaRESUMO
We present a patient with human immunodeficiency virus (HIV) infection coincident with diffuse nodular regenerative hyperplasia (DNRH) of the liver and visceral leishmaniasis. This association has not been previously described. Some DNRH cases are secondary to irregular blood flow in the liver. In the presently described case, there exist two possible conditioning factors for heterogeneous distribution of blood flow: 1) the increased blood flow from splenomegaly, and 2) the irregular circulation of blood through sinusoids infiltrated by Leishmania-parasitized hyperplastic macrophages.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/parasitologia , Leishmaniose Visceral/complicações , Fígado/patologia , Infecções Oportunistas Relacionadas com a AIDS/patologia , Adulto , Dependência de Heroína/complicações , Humanos , Hiperplasia/patologia , Leishmaniose Visceral/patologia , Circulação Hepática/fisiologia , Hepatopatias Parasitárias/complicações , Hepatopatias Parasitárias/patologia , MasculinoRESUMO
Granular cell basal cell carcinoma (BCC) is a rare histological variant of BCC. In this, the fifth reported case, a 67-year-old male with BCC located on the nose, light microscopy examination showed a tumour with the classical configuration of nodular BCC, in which most cells had finely granular eosinophilic cytoplasm. Ultrastructural observation showed numerous lysosome-like granules filling the cytoplasm of tumour cells, along with numerous well-formed pentalaminate desmosomes. Immunohistochemical profile (including positivity for keratins C 5.2 and AE 1 and for Leu-M1), together with the presence of cytoplasmic tonofilament bundles and desmosomes, are consistent with the proposed epithelial origin of granular cells in this tumour.