Actualización del diagnóstico histopatológico de las enfermedades intersticiales difusas del pulmón / Current histopathologic diagnosis of the pulmonary diffuse interstitial diseases

Las enfermedades pulmonares intersticiales difusas (EDIP) son un grupo de procesos caracterizados por tener un patrón radiológico pulmonar difuso, asociado a un déficit fisiológico, cuya lesión histológica puede ser inflamatoria, fibrosante o ambas, dañando fundamentalemtne el intersticio pulmonar de forma multifocal o difusa. Se describen siete “patrones histológicos”: neumonía intersticial usual, neumonía intersticial no específiva, neumonía organizada, daño alveolar difuso, bronquiolitis respiratoria, neumonía intersticial descamativa y neumonía intersticial linfocítica. Se presenta un problema importante para el diagnóstico de las biopsias transbronquiales o quirúrgicas, debido a sus consecuencias pronósticas, fundamentalmente. Se discute la validez de la toma de biopsias múltiples, teniendo en cuenta la variabilidad de los cuadros morfológicos

The pulmonary diffuses interstitial diseases (EDIP) are a cluster of processes characterized by a pulmonary diffuse radiological pattern associated to an organic physiological deficit, whose histological lesion is an inflammatory one, fibrous or both, damaging the pulmonary interstice mainly in a multifocal or diffuse way. Seven “histological patterns” are described: usual interstitial pneumonia, non specific interstitial pneumonia, organized pneumonia, diffuse alveolar damage, respiratory bronchiolitis, interstitial desquamative pneumonia and lymphocytes interstitial pneumonia. An important difficult is shown at diagnosis in the cronchial biopsies as much as the surgical ones, mainly due to its prognostic consequences. The validity of multiple biopsy takes is discussed, considering the morphological variation

[Scrotal leiomyosarcoma with bone metastasis]. / Leiomiosarcoma escrotal con metástasis óseas.

A case of scrotum leiomyosarcoma is presented in a 87 year-old patient. It debuts as a painless lesion in left hemiescrotum, of one year of evolution. Bony metastasis were observed in the moment of the diagnosis. We carried out a literature revision proving the rarity of this lesion type (only 27 cases have been described), and that, contrary to another leiomiosarcomas type, their aggressive evolution is not habitual in this localization.

Leiomiosarcoma escrotal con metástasis óseas / Scrotal leiomyosarcoma with bone metastasis

Se presenta un caso de leiomiosarcoma de escroto en un paciente de 87 años que debuta como una lesión en hemiescroto izquierdo indolora, y de un año de evolución. En el momento del diagnóstico se observa la presencia de metástasis óseas. Se realiza una revisión de la literatura comprobándose la rareza de este tipo de lesión (sólo se han descrito 27 casos), y que a diferencia de otro tipo de leiomiosarcomas, su evolución agresiva no es habitual en esta localización

A case of scrotum leiomyosarcoma is presented in a 87 year-old patient. It debuts as a painless lesion in left hemiescrotum, of one year of evolution. Bony metástasis were observed in the moment of the diagnosis. We carried out a literature revision proving the rarity of this lesion type (only 27 cases have been described), and that, contrary to another leiomiosarcomas type, their aggressive evolution is not habitual in this localization

Generation and characterization of recombinant human antibodies specific for native laminin epitopes: potential application in cancer therapy.

Laminins are specific cellular regulators that directly and indirectly control activities such as cell attachment and migration, differentiation and polarity, proliferation and apoptosis, and protease expression. Considering the centrality of these issues to tumor progression, the generation of human-derived antibody fragments able to modulate laminin-regulated biological functions would allow the development of new strategies to improve treatment of cancer patients. In this report, we explore the use of phage display technology to isolate human anti-laminin antibody fragments. A library of single chain antibodies was selected using intact mouse laminin, and five different clones were identified. All the antibodies were specific for their cognate antigen, as revealed by lack of cross-reactivity with other components of the basement membranes. A more extensive characterization of the panel indicated that these antibodies recognize the native protein through conformational epitopes. All of them reduced tumor cell attachment to laminin, suggesting that domains of the laminin molecule that are recognized by these antibodies likely bind to cell-surface receptors. The antibody fragments bind to mouse, rat and human laminin. and show strong immunohistochemical reactivity with basement membranes in human and murine tissue sections. Their properties make them ideal candidates for in vivo applications.

[Pleural effusion with diffuse lung involvement and single subcutaneous nodule as first manifestation of atypical bronchial carcinoid tumor]. / Derrame pleural con afectación difusa pulmonar y nódulo único subcutáneo como primera manifestación de un tumor carcinoide atípico bronquial.

Patient with atypical carcinoid with pleural effusion, diffuse pulmonary involvement and subcutaneous nodule, bone metastases and mediastinal metastases as the first presentation of the carcinoid. Atypical carcinoid is defined as a higher incidence of metastases, and a worse prognosis.

[Pulmonary mucormycosis: a case report and review of the literature]. / Mucormicosis pulmonar: presentación de un caso y revisión bibliográfica.

Mucormycosis is an opportunistic mycotic infection, the frequency of pulmonary infection is 22% and the associated mortality rates were 83% for pulmonary. We present a case of pulmonary mucormycosis survived after the therapy with amphotericin B and surgery.

[Peritoneal mesothelioma: long-course ascites as the only clinical manifestation]. / Mesotelioma peritoneal: ascitis de larga evolución como única manifestación clínca.

The mesothelioma is a rare tumor, especially in its peritoneal location (20%). Most of these cases are related to an exposition to asbestos long time age. We present a patient with long-evolution ascites and without any other clinical manifestations. The study of the ascitic fluid, the imaging techniques and the peritoneoscopy did not allow the diagnosis in the first place. Only after one year of follow-up and when the patient recalled, in a directed interrogation, her occupational contact with asbestos thirty years age, the diagnosis could be established.