Airway segmentation and analysis for the study of mouse models of lung disease using micro-CT.

Animal models of lung disease are gaining importance in understanding the underlying mechanisms of diseases such as emphysema and lung cancer. Micro-CT allows in vivo imaging of these models, thus permitting the study of the progression of the disease or the effect of therapeutic drugs in longitudinal studies. Automated analysis of micro-CT images can be helpful to understand the physiology of diseased lungs, especially when combined with measurements of respiratory system input impedance. In this work, we present a fast and robust murine airway segmentation and reconstruction algorithm. The algorithm is based on a propagating fast marching wavefront that, as it grows, divides the tree into segments. We devised a number of specific rules to guarantee that the front propagates only inside the airways and to avoid leaking into the parenchyma. The algorithm was tested on normal mice, a mouse model of chronic inflammation and a mouse model of emphysema. A comparison with manual segmentations of two independent observers shows that the specificity and sensitivity values of our method are comparable to the inter-observer variability, and radius measurements of the mainstem bronchi reveal significant differences between healthy and diseased mice. Combining measurements of the automatically segmented airways with the parameters of the constant phase model provides extra information on how disease affects lung function.

Goblet Cell Carcinoid of the appendix. A 52 years old male with acute appendicitis

El carcinoide de células globoides, también denominadoadenocarcinoide, carcinoma mucinoso, ycarcinoma de células de la cripta, es una rara neoplasiacon características específicas clínicas y patológicas.Revisamos el manejo del carcinoide decélulas globoides del apéndice aprovechando la presentaciónde un caso clínico ilustrativo

Goblet cell carcinoid, also variably known asadenocarcinoid, mucinous carcinoid, and crypt cellcarcinoma, is a rare neoplasm with distincthistological and clinical features. We review themanagement of goblet cell carcinoid of theappendix using an illustrative case report

[Atypical stromal hyperplasia of the prostate (stromal proliferation of uncertain malignant potential)]. / Hiperplasia estromal atípica de próstata (proliferación estromal de potencial maligno incierto).

OBJECTIVE: To describe a case of atypical stromal hyperplasia of the prostate. METHODS: A 62-year-old patient presented with prostatic syndrome. Physical examination disclosed an indurated prostate and PSA determination showed increased levels. A prostate biopsy was performed. RESULTS: The histological analysis showed atypical stromal proliferation with elongated nuclei and immunohistochemical expression for vimentine, smooth muscle actin and CD34 with glandular hyperplasia. The diagnosis was that of atypical stromal hyperplasia of the prostate (prostatic stromal proliferation of uncertain malignant potential). CONCLUSIONS: A careful histological study is necessary to make the correct diagnosis of prostatic stromal proliferation of uncertain malignant potential. CD34 expression is a characteristic finding. As its name indicates, its evolution is uncertain.

[Pacinian neurofibroma of the vulva]. / Neurofibroma pacciniano de la vulva.

OBJECTIVE: To report on a rare case of Pacinian neurofibroma of the vulva. METHODS: A 27-year-old patient who presented with a vulvar tumor is described. Patient evaluation showed no other remarkable findings. RESULTS: The nodule was resected without difficulty. The histopathological analysis-demonstrated Pacinian neurofibroma with abundant concentric laminar structures. The immunohistochemical (CD34+), ultrastructural and histological analyses showed perineural cells. No signs of neurofibromatosis were found. CONCLUSIONS: Pacinian neurofibroma may present in the vulva and could probably arise from the so-called perineural fibroblasts.

[Pigmented renal carcinoma, rich in hemosiderin]. / Carcinoma renal pigmentado, rico en hemosiderina.

OBJECTIVE: To report a case of hemosiderin-rich, pigmented renal cell carcinoma. METHODS: A 70-year-old patient referred several episodes of gross hematuria during the last few weeks, without any other symptoms. CT demonstrated a renal mass compatible with carcinoma. A right renal nephrectomy was performed. RESULTS: Anatomopathological analysis revealed a hemosiderin-rich, pigmented, papillary renal cell carcinoma localized to the renal capsule that stained blue with the iron staining method. The postoperative period was unremarkable and the patient is asymptomatic one year postoperatively. CONCLUSION: Papillary renal cell carcinoma can present as a pigmented lesion due to the accumulation of iron in the cytoplasm. This peculiar form must be distinguished from neuromelanin-pigmented lesions.

Metástasis ósea, primera manifestación de un hepatocarcinoma / Hepatocellular carcinoma presenting as osseus metastases

No disponible

[Intrascrotal malignant fibrous histiocytoma]. / Histiocitoma fibroso maligno intraescrotal.

OBJECTIVE: To describe a rare case of intrascrotal malignant fibrous histiocytoma. METHODS: A 90-year-old man presented with a scrotal mass which he had noted during the past few months. A scrotal tumor, 8 cm in diameter, was detected on physical evaluation. Tumor resection was decided due to the patient's good general condition despite his age. RESULTS: The histological analysis confirmed a sarcomatoid neoplasm with pleomorphism. The immunohistochemical analysis demonstrated strong overexpression of vimentin, alpha-1-antichymotrypsin, CD68 (Kpl), p53 oncoprotein and elevated Ki67. The ultrastructural study showed undifferentiated mesenchymal cells. The diagnosis of intrascrotal malignant fibrous histiocytoma was made based on the foregoing findings. CONCLUSIONS: Malignant fibrous histicytoma should be included in the differential diagnosis of intrascrotal tumors. Histological, immunohistochemical and ultrastructural studies are very important to distinguish the different paratesticular sarcomas. The strong overexpression of the p53 oncoprotein may be involved in the pathogenesis of this tumor type.

[Granular cell tumor of the scrotum with high pseudoepitheliomatous hyperplasia]. / Tumor de células granulares del escroto con intensa hiperplasia pseudoepiteliomatosa.

OBJECTIVE: To report a rare case of scrotal granular cell tumor. METHODS: A 19-year-old man presented with a nodule on the scrotum, 2 cm in diameter. It had been present for months and was covered with ulcerated epidermis. The tumor was resected. RESULTS: The histological study disclosed a neoplasm composed of polygonal cells with cytoplasmic granules and pseudoepitheliomatous hyperplasia of the overlying skin. Immunohistochemically, the cells showed a strong positivity for S100 protein and vimentin. The proliferation index (ki 67) was low in its cells, but high in the overlying hyperplasic epidermal cells. CONCLUSIONS: To our knowledge, this is the second case of scrotal granular cell tumor reported. The case described herein has the unique feature of severe overlying pseudoepitheliomatous hyperplasia. S100 positivity supports a neurogenic differentiation.