Lesiones apocrinas de la mama / Apocrine lesions of the breast

El cambio apocrino del epitelio mamario es una alteraciónfrecuente habitualmente conocida como metaplasia apocrina. Aunque comúnmente se observa en el epitelio de revestimiento de quistes mamarios, existen otras lesiones, histológicamente más complejas, desde las hiperplasias de diverso grado, la adenosis esclerosante, al carcinoma in situ o invasor, también con citología apocrina. Su particular morfología se acompaña, además, de un perfil de marcadores inmunohistoquímicos distinto al de las lesiones ductales comunes similares: se caracterizan por la expresión de GCDFP, pero, además por la negatividad para receptores de estrógenos, progesterona y bcl-2, y positividad para receptores de andrógenos. El significado biológico de las lesiones apocrinas benignas, en cuanto a riesgo de carcinoma posterior, es controvertido, al igual que su posible carácter preneoplásico

Apocrine change of breast epithelium is a frequent lesion usually known as apocrine metaplasia. It is commonly observed on the lining epithelium of breast cysts, but there are also another histologycally more complex lesions, from hyperplasias or sclerosing adenosis to in situ or infiltrating carcinoma, with apocrine cytology. Besides its special morphology, apocrine metaplasia shows a distinctive immunohistochemical profile, different from similar usual ductal lesions: positivity for GCDFP and androgens receptors and negativity for oestrogen and progesterone receptors and for bcl-2. The risk of subsequent carcinoma in patients with benign apocrine lesions and its possible precancerous condition are controversial subjects

[Multiple bladder inverted papillomas]. / Papilomas invertidos vesicales múltiples.

OBJECTIVE: To describe the clinical and histological findings of the unusual involvement of the urinary bladder by multiple inverted papillomas of transitional cells. METHODS/RESULTS: A 53-year-old male presented with obstructive symptoms and gross hematuria lasting for one year. Ultrasound examination of the urinary bladder demonstrated two polypoid masses. Transurethral resection was performed and histopathological examination of specimens showed a subepithelial, non-atypical cell proliferation arranged in a trabecular pattern. DNA-ploidy showed diploid population and ki-67 determination revealed a low proliferation index. CONCLUSIONS: Multiple inverted papillomas of the urinary bladder are very rare. Histological examination is essential for the definitive diagnosis. Determination of DNA-ploidy and proliferative index may be useful for appropriate management of this disease.

[Paratesticular solitary fibrous tumor]. / Tumor fibroso solitario paratesticular.

OBJECTIVE: To describe an additional case of paratesticular solitary fibrous tumor. METHODS/RESULTS: A 67-year-old man presented a paratesticular mass lasting for one year. Histological examination showed a well-circumscribed lesion comprised of spindle cells proliferation without atypia, arranged in a fascicular pattern, intimately intertwining with thick collagen fibers. Tumor cells were strongly positive for vimentine and CD-34. Diagnostic criteria, clinical features and treatment of this condition are discussed. CONCLUSION: Solitary fibrous tumors are spindle cell neoplasm originally described in the pleura, but may occur in many different sites. Intrascrotal solitary fibrous tumors are uncommon and few cases have been reported.

Colon cancer: p53 expression and DNA ploidy. Their relation to proximal or distal tumor site.

Overexpression of nuclear p53 and DNA ploidy were analyzed in a series of 65 colorectal adenocarcinomas and correlated with standard clinical and pathological variables (Dukes stage, tumor site, histological grade and type, and nature of the tumor margins). Immunohistochemical tests were done with the DO-7 monoclonal antibody, using formalin-fixed tissue samples and an antigen retrieval solution. Levels of p53 expression were evaluated using a semiquantitative grading system (CAS 200, BD). Nuclear staining of more than 15% of neoplastic cells was observed in 35 samples (53.8%), which were classified as p53-positive. DNA content was measured by flow cytometry in samples of fresh tissue. Tumor site had a significant direct relationship with DNA ploidy (p < 0.01) and p53 expression (p < 0.001). Proximal tumors were more frequently diploid than were distal tumors (78.6% vs 32%). Moreover, distal neoplasms showed more p53 expression than proximal tumors (64.6% vs 14.3%). However, there was no correlation between the other clinical or pathological variables and the pathological parameter p53 expression and DNA ploidy. Our data support the hypothesis that mechanisms of colorectal carcinogenesis may differ in proximal and distal neoplasms.

[Bladder transitional cell carcinoma rating, systematization of grading and value of DNA ploidy]. / Contribución a la categorización de los CCT de vejiga, sistemátización de la gradación y utilidad de la ploidía de ADN.

UNLABELLED: TCCs are an heterogenous group of tumors with an uncertain biologic behaviour, especially intermediate grade (G2). Histologic grade and pathologic stage have revealed only partially useful on predicting the outcome. OBJECTIVE: Search and statement of objective and cuantitative parameters able to define prognostic subgroups to TCCs. MATERIAL AND METHOD: We studied consecutive 106 patients with TCC in order to: 1) Identify every variable with independent predictive value in classifying cases of TCC in a three (1,2,3) or two (high/low) grades systems. 2) Make a correlation between DNA ploidy obtained by image analysis and DNA ploidy and S-phase obtained by flow cytometry. RESULTS: Every variable used to define the histologic grade showed significative correlation with both gradation systems. In multivariate analysis, the presence of superficial cells and the mitotic counts revealed us the most valuable variables in predicting the histologic grade. DNA-ploidy (both obtained by static an flow cytometry) correlated well with grade, stage, growth pattern and necrosis, whereas S-phase did so with grade, mitotic index and DNA ploidy. Image cytometry showed similars results to those of flow cytometry and also was able to detect aneuploidy when an situ carcinoma or dysplasia were present in the adyacent mucosa.

[Value of Markovian nuclear texture to predict progression in surface transitional cell carcinoma of the bladder]. / Utilidad de las texturas nucleares Markovianas en la predicción de la progresión en los CCT superficiales de vejiga.

The aim of this work has been to determine if the DNA and nuclear Markovian textures of tissue sections evaluated by image cytometry correlate with the histologic grade and the progression probability of superficial transitional carcinoma of the bladder. In our study, DNA ploidy is related to histologic grade in that aneuploidy frequency increases with a higher grade of malignancy. Image analyses of superficial TCC tissue sections of the bladder, has allowed us to identify "sub-visual parameters" as well as nuclear textures that according to our results can be useful in clarifying the evolutive behaviour of these tumours. Two Markovian textures that identify entropy (TXI) and mean internal contrast (TXB) allow to discriminate between histologic grades as well as progression or non-progression. In conclusion, image analysis cytometry of paraffin embedded tissue sections of TCC of the bladder supplies densitometric parameters related to grade and provides valuable information for the prediction of progression. Quantification of chromatin pattern description in Feulgen-stained nuclei using the Markovian method can be useful in this context.