Reproducibility of histopathologic diagnosis and classification of non-melanocytic skin cancer: a panel exercise in the framework of the multicenter southern European study HELIOS.

AIMS AND BACKGROUND: The reproducibility of histologic diagnoses, and in particular of the distinction between basal and squamous cell forms, has been evaluated in the framework of a multicenter case-control study (in Italy, France, Spain and Switzerland) aimed to assess the causes of non-melanocytic skin cancers. METHODS: A panel composed of 10 pathologists from the collaborating centers was appointed. A total of 1,774 slides of routine diagnoses were blindly reviewed by a second panelist; discordant diagnoses underwent a third examination. Controversial and interesting cases were discussed during general sessions. RESULTS: The results showed a high degree of concordance (99.5%), with a Cohen's kappa of 0.85 (95% CI, 0.77-0.94) in the assessment of malignancy of lesions. The concordance in the distinction between large morphologic groups, basal cell carcinoma and squamous cell carcinoma was also high (Cohen's kappa = 0.85; 95% CI, 0.82-0.89). The assessment of histologic subtypes, degree of invasion and differentiation showed a lower degree of concordance, presumably as a consequence of a weaker consistency in the relevant classifications. CONCLUSIONS: The reproducibility study has therefore validated the epidemiologic study and in particular allowed to correct some misclassifications that could have lessened the analysis of the case-control study. In general, because of its characteristics (number of pathologists and variety of their origins, the large number of cases examined, blind examination of histologic slides), the conclusions of the study may show a certain degree of generalization, at least with regard to the countries represented. Routine histologic diagnoses of cutaneous carcinoma showed a high degree of reliability with reference to the assessment of malignancy and the distinction between basal and squamous cell carcinoma morphotypes.

Hemoptisis de repetición en enfermo hipertensocon infiltrados nodulares, dolor torácico y hemorragia pulmonar fatal / Repeat hemoptysis in a hypertensive patient with nodular infiltrates thoracic pain and fatal pulmonary hemorrahage

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Microscopic rice bodies in rheumatoid synovial fluid sediments.

To determine the clinical significance of the microscopic study of the synovial fluid (SF) sediment, 306 sediments were examined from 216 patients with the most frequently occurring acute and chronic arthropathies. The SF was obtained using a fine gauge needle. Microscopic rice bodies were seen in 53 (17.3%) of the samples studied. Forty-five (84.9%) of the samples in which rice bodies were observed were from patients with rheumatoid arthritis (RA) (p < 0.001); 34.9% of the 129 RA samples were found to contain rice bodies. The specificity of finding rice bodies in RA was 95.5%. Most rice bodies were composed of partly or totally hyalinized fibrinous material; in their interior, mononuclear cells were predominantly observed--most of them macrophagic in appearance. With less frequency the rice bodies exhibited central areas of fibrosis. Our results suggest that microscopic rice bodies are fibrinous particles derived from the entrapping of cells in the dense fibrin network present in inflammatory SF.

[Cholelithiasis and cancer: a study using precursor changes in a population with low incidence of cholelithiasis]. / Colelitiasis y cáncer: estudio mediante las alteraciones precursoras en una población de baja incidencia de colelitiasis.

In order to assess the role of cholelithiasis in the pathogenesis of gallbladder carcinoma in a low-risk population for cholelithiasis and gallbladder cancer, we have studied the relationship between cholelithiasis and cancer. Our findings suggest that, both the relationship between cancer and cholelithiasis, and the frequency of precursors lesions, are very similar to those obtained in surveys carried out in high-risk populations for both conditions. Our findings bear out our hypothesis that cholelithiasis plays a main role in the pathogenesis of gallbladder carcinoma.

[Cholelithiasis in the region of Cartagena: an approximation to its real incidence based on the study of its symptomatic group]. / Colelitiasis en la comarca de Cartagena: una aproximación a su incidencia real a partir del estudio de su grupo sintomático.

We have studied the frequency of cholelithiasis in a group of patients who complained of clinical symptoms of cholelithiasis and lived in the region of Cartagena. This group of patients accounts for 40% of all the patients suffering from cholelithiasis this would account for 0.5% of the whole population and 1% of the exposed population over 30 year-of-age. Our results suggest that the population living in the region of Cartagena has a low-risk for cholelithiasis.

[The so-called appendiceal mucocele versus mucinous cystadenoma]. / Sobre el llamado mucocele apendicular versus cistoadenoma mucinoso.

In a review of 3,573 appendectomies, three diagnoses of mucinous cystadenoma of the cecal appendix and eleven cases of appendicular mucocele were encountered. Once the new divisions were made and the pictures were reclassified, we found simple mucocele on only 3 occasions, the other 8 corresponding to mucinous cystadenomas. Appendicular mucocele requires serial microscopic study in which the papillary proliferative or mucosecretory lesions, although minimal, are evaluated as cystadenoma lesions. The diagnostic importance of appendicular cystadenoma lies in its association with other colorectal or ovarian neoplasms.