[Primary non-Hodgkin's lymphoma of the breast. A case report]. / Linfoma no Hodgkin primario de la glándula mamaria. Reporte de un caso.

BACKGROUND: Primary breast lymphomas, a rare subtype of non-Hodgkin's lymphoma, represent 0.04 to 0.5% of all breast cancers, 0.38 to 0.7% of all lymphomas, and 1.7 to 2.2% of extranodal lymphomas. The treatment choice is based on chemotherapy containing anthracycline and rituximab. Surgery is limited to being less invasive and only for diagnostic purposes. Radiotherapy has an important role as consolidation therapy, particularly in patients with negative nodes. CLINICAL CASE: A 70 year old woman with a breast nodule in the left upper outer quadrant, with slow growth, expansive, painless, and accompanied by skin changes, malaise, weight loss, fatigue, chill, and sweating. There was tissue replacement by the mammary gland tumour, skin changes due to invasion, and a 5cm axillary lymphadenopathy. The mammography showed skin thickening and a dense pattern of 80% of breast tissue replacement, and the lymphadenopathy with loss of radiolucent centre and soft tissue invasion. The biopsy confirmed a diffuse high grade large cell lymphoma. She received an Rituximab (R-CHOP) chemotherapy scheme and radiotherapy with tangential and supraclavicular and axillary fields. After completing the chemotherapy, the patient is on follow-up, and at 15 months she is alive without disease activity. CONCLUSIONS: Primary lymphoma of the breast is a rare entity. Multimodal treatment with combined chemo-radiotherapy is the cornerstone. Surgery is reserved only for diagnostic purposes.

[Proctocolectomy with ileoanal anastomoses and desmoid tumor treated with resection. One case of familial adenomatous polyposis]. / Proctocolectomía con anastomosis íleo-anal y resección de tumor desmoide. Un caso de poliposis adenomatosa familiar.

BACKGROUND: Familial adenomatous polyposis (FAP) is a rare disease caused by a mutation in the adenomatous polyposis coli gene (APC). CASE REPORT: We report the case of a 32-year-old woman, with abdominal pain and increased abdominal perimeter, as well as melena and weight loss. She had a tumor of 12 cm in diameter in the right iliac fossa. After the administration of contrast media we found the abdominal tumor compatible with sarcoma versus desmoid tumor. We performed a colonoscopy and we found colorectal polyps. The biopsy reported tubulovillous adenomas. A panendoscopy showed polyps in fundus and body of stomach; the state of the duodenum was normal. Tumor resection was performed with abdominal wall reconstruction with mesh and restorative proctocolectomy with ileoanal reservoir and a temporary ileostomy. The histopathology report demonstrated an abdominal wall desmoid tumor and identified 152 tubulovillous polyps which affected all the portions of colon and rectum. CONCLUSIONS: FAP is an autosomal dominant disease caused by a mutation in the APC gene which results in the development of multiple colorectal polyps. Described in 1991 the APC gene is located at chromosome region 5q21. Without prophylactic surgery, virtually all patients develop colorectal cancer in the third decade of life. Desmoid tumors and duodenal polyps are now the leading cause of death in patients with FAP.

Introducción: la poliposis adenomatosa familiar (PAF) es una rara enfermedad causada por una mutación en el gen de la poliposis adenomatosa coli (APC). Caso clínico: mujer de 32 años, con dolor y aumento del perímetro abdominal además de evacuaciones melénicas y pérdida de peso. La paciente presentó un tumor de 12 cm de diámetro en la fosa iliaca derecha. Tras la administración de medio de contraste, en una tomografía se apreció el tumor abdominal con reforzamiento compatible con sarcoma frente a tumor desmoide. Se realizó colonoscopia, por medio de la que se encontraron pólipos en el recto y el colon. La biopsia reportó adenomas túbulo-vellosos. Una panendoscopía demostró pólipos en fondo y cuerpo gástrico; el duodeno se encontraba en estado normal. Se realizó resección del tumor en pared abdominal y reconstrucción con malla además de proctocolectomía restaurativa con un reservorio íleo-anal con una ileostomía temporal. Se reportó tumor desmoide en la pared abdominal y se identificaron 152 pólipos túbulo-vellosos que afectaban todas las porciones del colon y el recto. Conclusiones: la PAF es una enfermedad autosómica dominante causada por una mutación en el gen APC que da como resultado el desarrollo de múltiples pólipos tanto en el colon como en el recto. Descrito en 1991, el gen APC se localiza en el cromosoma 5q21. Sin cirugía profiláctica, todos los pacientes desarrollarán cáncer colorrectal en la tercera década de la vida. Los tumores desmoides y los pólipos duodenales son ahora la causa de muerte en los pacientes con PAF.

Meduloepitelioma pigmentado maligno intraocular. Presentación de dos casos / Intraocular malignant pigmented medulloepithelioma. A report of two cases

El meduloepitelioma intraocular es una neoplasiaembrionaria poco frecuente desarrollada en el cuerpo ciliar yque ocasionalmente afecta el iris, la retina o el nervio óptico.Presentamos dos casos de meduloepitelioma intraocularmaligno pigmentado, uno teratoide (con componente heterólogo:cartílago hialino) y otro no. Por histoquímica se reconocióla presencia de mucopolisacáridos ácidos y pigmentomelánico. Los estudios de inmunohistoquímica mostraronpositividad para marcadores de distintas líneas de diferenciacióncelular como neuroepitelial (proteína S100, sinaptofisina),glial (proteína ácida gliofibrilar), mesenquimatoso(vimentina, desmina), epitelial (citoqueratina AE1/3, EMA)y melanocítico (HMB-45, Melan-A). El meduloepiteliomaintraocular está compuesto por células multipotenciales conexpresión inmunofenotípica múltiple(AU)

Intraocular medulloepithelioma is a rare embryonaltumour that occurs most often in the ciliary body, but may alsoarise from the iris, retina or optic nerve. We present two casesof pigmented malignant intraocular medulloepithelioma; oneteratoid (with hyaline cartilage as a heterologous element),and one non-teratoid. Histochemistry showed the neoplasticcells synthesizing both an acidic substance that stained positivewith alcian blue and melanin pigment positive for Fontana-Masson stain. Immunohistochemistry showed positive stainingfor markers of several lines of differentiation includingneuroepithelial (S100 protein, synaptophysin), glial (GFAP),mesenchymal/muscle (vimentin, desmin), epithelial (cytokeratinAE1/3, EMA) and melanocytic (HMB-45, Melan-A).Intraocular medulloepithelioma is composed of multipotentialcells capable of polyimmunophenotypic expression(AU)

[Placental histopathological changes in gestational hypertension]. / Alteraciones histopatológicas placentarias en la hipertensión gestacional.

BACKGROUND: Preeclampsia develops after a partial disorder in the process of placental formation, perhaps due to a deficiency of the trophoblast invasion by its spiral arteries and acute aterosis in its miometrial segments. It has not been reported if these changes also appear in placentas of women with gestational hypertension without proteinuria. OBJECTIVE: To describe histopathological changes in the placenta of patients with hypertensive disorders during pregnancy. MATERIAL AND METHODS: Cross-sectional study carried out in 138 patients divided into three groups: 46 with normotensive pregnancy (A group or control), 46 with gestational hypertension (group B), and 46 with preeclampsia (group C). There were registered sociodemographic and clinical variables; and the histopathological study of the placenta was performed. Mean, standard error and percentages were used. We calculated analysis of variance for comparing groups and linear regression for determining correlation between histopathological changes and blood pressure (it was assigned an alpha value of 0.05). RESULTS: There were more histopathological changes in groups of gestational hypertension and preeclampsia compared with controls (p < 0.01). Most frequent changes in all groups were: sincitial hyperplasia and fibrin deposits around the villi. There was correlation between histopathological changes and blood pressure (r= 0.27, p <0.01). CONCLUSION: There are more histopathological changes in placentas of women with hypertensive disease; number of histopathological changes is correlated with the severity of hypertension.

Esporotricosis sistémica mortal / Mortal systemic sporotrichosis

Paciente con esporotricosis sistémica y diabetes mellitus con una historia negativa de evento traumático, previo a la aparición de las lesiones. Estudio histopatológico con una gran cantidad de elementos fúngicos. El paciente empeoró progresivamente hasta su fallecimiento, a pesar de tratamiento con anfotericina-B

Papiloma invertido de vías urinarias en la infancia: informe de un caso / Childhood urinary tract inverted papilloma: report of a case

Se presenta un caso de papiloma invertido vesical en un niño de 11 años de edad, el cuarto notificado en la infancia. Se realiza una breve revisión de la literatura con insistencia especial en las teorías etiológicas, los criterios histopatológicos y el tratamiento de esta enfermedad. PALABRAS CLAVES: Infancia, papiloma invertido, tumor vesical, vejiga urinaria.

Teratoma quístico sacrococcígeo: informe de un caso / Custic sacrococcigeal teratoma: report of a case

Se presenta el caso de una paciente de 14 años de edad con diagnóstico de teratoma quístico mixto del tipo II del cóccix. Se mencionan el protocolo de diagnóstico y la técnica quirúrgica que se recomienda en la actualidad, lo mismo que algunos aspectos de interés para el tratamiento de estos tumores.