Diagnostic value of ascites immunohistochemistry in carcinomatosis of unknown origin.

We present the case of a patient diagnosed with carcinomatosis when admitted urgently for an occlusive condition. It is the immunohistochemistry that clarifies which is the primary tumor. Sigma neoplasia was initially suspected to recur due to operative findings. It was surprising that the primary tumor was of pulmonary origin. It became known thanks to the immunohistochemical cytology of the ascetic fluid.

Association of mammalian target of rapamycin with aggressive type II endometrial carcinomas and poor outcome: a potential target treatment.

The classification of endometrial carcinoma divided into types I and II has shown clinical usefulness. Molecular alterations of PTEN and Wnt/ß-catenin have been identified in this neoplasia. However, the role of mammalian target of rapamycin according to subcellular localization in the pathogenesis of this neoplasia and its prognostic significance are not well defined. We studied the expression of phosphorylated mammalian target of rapamycin, PTEN, and ß-catenin and their relationship with clinicopathologic features, molecular factors (microsatellite instability, mismatch repair, and BRAF genes) and patients' survival in a series of 260 nonconsecutive endometrial carcinomas. Tissue microarrays were manually constructed, and genomic DNA was extracted from paraffin-embedded cylinders (1 mm thick) from preselected tumor areas. The mammalian target of rapamycin in the nuclei (mTORC2; 47%) or cytoplasm (mTORC1; 48%) were seen in type II endometrial carcinoma, the latter also in advanced stages (P ≤ .046). PTEN loss (58%) was detected in type I endometrial carcinoma of grade 1, at early stage, with mismatch repair gene loss (24.4%) and microsatellite instability-positive status (22%; P ≤ .05). Nuclear ß-catenin (16%) was found in type I tumors of younger patients (P ≤ .003). In contrast, BRAF-V600E mutations were not detected (0%). Mammalian target of rapamycin cytoplasmic high expression implied poorer prognosis (P = .02; Kaplan-Meier, log-rank test), but grade 3 tumors, vascular invasion, advanced stage, or PTEN presence correlated independently with a negative impact on survival (all P ≤ .036; Cox analysis). Our results show that mammalian target of rapamycin, PTEN, and ß-catenin are independently involved in different molecular subtypes of endometrial carcinoma with diverse patients' prognosis and support their distinctive treatment based on targeted drugs.

Low activation of Insulin-like Growth Factor 1-Receptor (IGF1R) is associated with local recurrence in early breast carcinoma.

Background The predictive value of IGF1R on local recurrence in invasive breast carcinoma (BC) is not well known. Methods In a series of 197 lymph-node negative BC patients treated with breast-conserving surgery and radiation therapy, we performed immunohistochemistry for alpha-IGF1R, beta-IGF1R (phosphorylated/active form) and Estrogen/Progesterone receptors. We further evaluated the IGF1R mRNA expression by quantitative RT-PCR and IGF1R mutations by direct DNA sequencing (exons 19 and 21) in 85 primary BC (42 control cases, 31 with local recurrence and 12 with distant metastasis) and in 31 local recurrences. Unconditional logistic regression analyses were performed to identify risk factors for recurrence. Results Local recurrences were associated with high-grade tumors, PR-negative and low active-IGF1R, which emerged as independent breast relapse predictors by multivariate analysis. Conclusion Patients with early BC treated with lumpectomy and radiation who have low-grade tumors and favorable markers (increased content of active IGF1R and PR-positive) have a low risk of local recurrence. Therefore, do not benefit from a boost dose on the surgical scar.

Electronic effects in manganite/insulator interfaces: interfacial enhancement of the insulating tunneling barriers.

The transport properties across perovskite oxides heterointerfaces are analyzed. Epitaxial La(2/3)Ca(1/3)MnO3/SrTiO3 (LCMO/STO) heterostructures with different STO insulating-barrier thicknesses are systematically investigated and their behavior compared with LCMO/metal junctions. Atomic force microscopy (AFM) measurements in current-sensing mode show typical features associated with tunneling conduction. Careful analysis of the I-V curves across LCMO/STO heterointerfaces, using the Simmons model in the intermediate voltage range, clearly shows the existence of an interface-induced enhancement of the tunneling barrier of about 1.6 nm on the LCMO side. These results confirm recent theoretical studies predicting electronic phase segregation and the formation of an orbital-ordered insulating phase at the manganite-insulator interface that is a result of the reduction in the number of charge carriers at the interface.

Prognostic implications of HER-2 status in steroid receptor-positive, lymph node-negative breast carcinoma.

Patients with lymph node-negative breast carcinoma (LNNBC) and positive hormone receptor (HR) status during estrogen-based endocrine therapy have different prognoses. The contribution of HER-2 (human epidermal growth factor receptor-2) has not been extensively evaluated. We stained 230 LNNBCs for estrogen and progesterone receptors (ER and PR) and HER-2. HER-2 gene status was studied in 150 randomly selected tumors by chromogenic in situ hybridization and cases with discordant or nondefinitive results by fluorescence in situ hybridization. Patients with ER+ and/or PR+ tumors were treated with tamoxifen. We found positive expression of ER, PR, and HER-2 in 73.7%, 67%, and 27.8%, respectively, and HER-2 amplification in 18.0%. Poorer outcome was seen for patients with ER+ and/or PR+/HER-2 overexpressing tumors and as a trend for patients with HER-2 amplification. ER/PR and HER-2 expression showed an independent prognostic value. In LNNBCs with positive HR status, HER-2 overexpression and/or amplification confer an aggressive tumor phenotype, and this might be related to tamoxifen unresponsiveness.

Nódulos indoloros en los dedos de las manos de un niño de 4 años / Painless nodules on the fingers of a 4-year-old boy

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Tumores neuroendocrinos pulmonares / Neuroendocrine tumors of the lung

Los tumores neuroendocrinos pulmonares constituyen un grupo bien definido dentro de la clasificación de la OMS de 1999. La clasificación de los tumores carcinoides en típicos y atípicos basada en criterios morfológicos permite establecer el pronóstico, con independencia del estadio. La incorporación del carcinoma neuroendocrino de célula grande, más agresivo que los tumores carcinoides atípicos, permite diferenciar estos casos del carcinoma de célula pequeña o del carcinoma de célula grande clásico. En esta revisión, se discuten las categorías diagnósticas, haciéndose referencia a los aspectos clínicos, histológicos, inmunohistoquímicos y moleculares (AU)