Whole-slide image analysis identifies a high content of Hodgkin Reed-Sternberg cells and a low content of T lymphocytes in tumor microenvironment as predictors of adverse outcome in patients with classic Hodgkin lymphoma treated with ABVD.

Classic Hodgkin lymphoma (cHL) constitutes the most frequent lymphoma in young adults. Its histopathology is unique as a scattered tumor population, termed Hodgkin Reed-Sternberg (HRS) cells is diluted in a prominent tumor microenvironment (TME) composed of T lymphocytes, B lymphocytes, macrophages, neutrophils, eosinophils and histiocytes. Traditionally, the identification of prognostic biomarkers in the cHL TME has required visual inspection and manual counting by pathologists. The advent of whole-slide imaging (WSI) and digital image analysis methods could significantly contribute to improve this essential objective in cHL research, as a 10-20% of patients are still refractory or relapsed after conventional chemotherapy. In this work, we have digitized a total of 255 diagnostic cHL slides and quantified the proportion of HRS cells (CD30), B cells (CD20) and T cells (CD3) by digital image analysis. Data obtained where then correlated with the overall survival (OS) and progression free survival (PFS) of cHL patients. Quantification of HRS cells, B cells and T cells reflects the biological heterogeneity of the different cHL histological subtypes analyzed. A percentage of 2.00% of HRS cells statistically significantly discriminated between patients achieving a complete metabolic response (CMR) and refractory or relapsed (R/R) patients both for the OS (P=0.001) and PFS (P=0.005). Furthermore, patients with a percentage of T cells below the 26.70% in the TME showed a statistically significantly shorter OS (P=0.019) and PFS (P=0.041) in comparison with patients above this threshold. A subgroup of patients with a low content of T cells and high content of HRS cells exhibited a special aggressive clinical course. Currently, there is the need to implement quantitative and easy scalable methods to enhance clinical translation, as the cHL TME plays a central role in the clinical course of the disease. The results of this study could contribute to the identification of prognostic biomarkers specifically looking at the cHL TME and their inclusion in future clinical trials.

Compositional and structural analysis of engineered stones and inorganic particles in silicotic nodules of exposed workers.

BACKGROUND: Engineered stone silicosis is an emerging disease in many countries worldwide produced by the inhalation of respirable dust of engineered stone. This silicosis has a high incidence among young workers, with a short latency period and greater aggressiveness than silicosis caused by natural materials. Although the silica content is very high and this is the key factor, it has been postulated that other constituents in engineered stones can influence the aggressiveness of the disease. Different samples of engineered stone countertops (fabricated by workers during the years prior to their diagnoses), as well as seven lung samples from exposed patients, were analyzed by multiple techniques. RESULTS: The different countertops were composed of SiO2 in percentages between 87.9 and 99.6%, with variable relationships of quartz and cristobalite depending on the sample. The most abundant metals were Al, Na, Fe, Ca and Ti. The most frequent volatile organic compounds were styrene, toluene and m-xylene, and among the polycyclic aromatic hydrocarbons, phenanthrene and naphthalene were detected in all samples. Patients were all males, between 26 and 46 years-old (average age: 36) at the moment of the diagnosis. They were exposed to the engineered stone an average time of 14 years. At diagnosis, only one patient had progressive massive fibrosis. After a follow-up period of 8 ± 3 years, four patients presented progressive massive fibrosis. Samples obtained from lung biopsies most frequently showed well or ill-defined nodules, composed of histiocytic cells and fibroblasts without central hyalinization. All tissue samples showed high proportion of Si and Al at the center of the nodules, becoming sparser at the periphery. Al to Si content ratios turned out to be higher than 1 in two of the studied cases. Correlation between Si and Al was very high (r = 0.93). CONCLUSION: Some of the volatile organic compounds, polycyclic aromatic hydrocarbons and metals detected in the studied countertop samples have been described as causative of lung inflammation and respiratory disease. Among inorganic constituents, aluminum has been a relevant component within the silicotic nodule, reaching atomic concentrations even higher than silicon in some cases. Such concentrations, both for silicon and aluminum showed a decreasing tendency from the center of the nodule towards its frontier.

[Hodgkin's lymphoma associated with inflammatory bowel disease treated with thiopurines. A case report and review of the literature]. / Linfoma de Hodgkin en enfermedad inflamatoria intestinal tratado con tiopurinas. Presentación de un caso y revisión de la literatura.

The risk of developing a lymphoproliferative disease associated with inflammatory bowel disease (IBD) has been a controversial issue for decades; it is debatable whether the risk is associated with the chronic inflammation of IBD per se or its treatment, especially with thiopurine drugs (azathioprine and mercaptopurine) and anti-TNF-α agents. We present an unusual case of a 35-year-old man who had been diagnosed with Crohn's disease at age 17 and treated with azathioprine, presenting years later with an intestinal Hodgkin's lymphoma.

Schwannoma de mama: a propósito de un caso / Breast schwannoma: Apropos of a case

Los schwannomas o neurilemomas son neoplasias benignas originadas en las células de Schwann de la vaina de los nervios periféricos. Se presentan habitualmente en la cabeza, el cuello, el tronco o en las superficies flexoras de las extremidades, siendo su localización en la mama extremadamente rara. Pueden surgir de forma esporádica, o en el contexto de una neurofibromatosis. Una exhaustiva revisión de la bibliografía ha demostrado un total de 28 casos de schwannomas mamarios documentados en la literatura. En este artículo, presentamos un nuevo caso de schwannoma en la mama de una mujer joven, describiendo los hallazgos mamográficos, ecográficos e histológicos característicos de esta entidad (AU)

Schwannomas or neurilemmomas are benign neoplasms arising in Schwann cells of the peripheral nerve sheath. The most common locations include the head, neck, trunk and flexor surface of the extremities, the breast being a highly unusual location. These tumors may arise sporadically or in the context of neurofibromatosis. An exhaustive review of the literature revealed 28 cases of intramammary schwannomas reported in the English-language literature. We report a new case of Schwannoma of the breast in a young woman and describe its mammographic, ultrasound and histological features (AU)

Endometriosis cutánea: a propósito de un caso / Cutaneous endometriosis: a case report

La endometriosis es una entidad que consiste en la existencia de tejido endometrial fuera de la cavidad uterina. Es una enfermedad relativamente frecuente en mujeres en edad reproductiva. La localización más frecuente es la ovárica, aunque se han descrito en la literatura múltiples sitios, incluyendo la piel. La endometriosis cutánea frecuentemente está en relación con la cirugía previa abdominopélvica y su lugar de aparición suele ser la cicatriz. Ante la existencia de una formación nodular en una cicatriz de cirugía en edad reproductiva, una buena anamnesis dirigida al determinar si presenta dolor e incremento de tamaño cíclico, puede orientarnos al diagnóstico. El tratamiento debe ser siempre su exéresis para diagnóstico de confirmación, que pasa invariablemente por su estudio histopatológico(AU)

Endometriosis consists of the presence of endometrial tissue outside the uterine cavity. This entity is relatively common in women of reproductive age. The most frequent location is the ovary but multiple sites have been described in the literature, including the skin. Cutaneous endometriosis is often related to previous abdominal and pelvic surgery and the site of occurrence is often a surgical scar. In women of reproductive age with a nodule in a surgical scar, a thorough history to determine if there is pain and a cyclical increase in size can guide the diagnosis. Treatment should always be resection for diagnostic confirmation, which is always histopathological(AU)