[Apoptosis in renal adenocarcinoma. Expression of bcl-2 in locally confined tumors]. / Apoptosis en el adenocarcinoma renal. Expresión de bcl-2 en tumores localmente confinados.

INTRODUCTION AND OBJECTIVE: Bcl-2 is a proto-oncogene known to be a negative regulator of apoptosis, whose expression conferring prolonged cell survival and contributing to tumorigenesis. Inconsistent results concerning bcl-2 expression and the frequency of apoptosis were noted in renal cell carcinoma. To investigate a possible role of bcl-2 protein in renal cell carcinomas, we analyzed its expression and relationship with clinical and pathological parameters, including prognostic impact. METHODS: 58 patients diagnosed of renal cell carcinoma stage pT1, pT2 and pT3a N0 M0 (TNM 1997) were treated by radical or partial nephrectomy. We analyzed clinical and pathological parameters including bcl-2 expression in paraffin-embedded tumor samples using immunohistochemical technique. RESULTS: Bcl-2 immunopositivity was detected in 44/58 of the samples in different grades of intensity. There was no correlation of nuclear grade, tumoral size, stage or recurrency with bcl-2 immunopositivity. Bcl-2 expression was not related to prognosis if we divided all cases into subgroups according of stain intensity. CONCLUSIONS: Bcl-2 expression was not related with any pathological parameters; size, nuclear grade and stage or prognostic.

Apoptosis en el adenocarcinoma renal. Expresión de bcl-2 en tumores localmente confinados / Apoptosis in renal cell carcinoma. BCL-2 expression in locally confined tumors

INTRODUCCIÓN Y OBJETIVO: La expresión del oncogén bcl-2 se relaciona con una resistencia aumentada de las células tumorales a la apoptosis. lo que prolonga su supervivencia y contribuye a su transformación neoplásica. En el adenocarcinoma renal todavía no se ha podido establecer su importancia en cuanto a la evolución de estas neoplasias. Nuestra intención es determinar la expresión de la proteína bcl-2 y su relación con diferentes variables clínicas y anatomopatológicas, estableciendo su valor pronóstico.MÉTODO: 58 adenocarcinomas renales, estadios pT1-T3a NO MO (TNM 1997), tratados mediante nefrectomía radical o parcial con intención curativa. Analizamos diferentes variables clínicas v anatomopatológicas, así como la expresión de bcl-2 en tejido parafinado, mediante técnicas de inmunohisotquímica, obteniendo una tinción citoplasmática que se valoró de forma cualitativa.RESULTADOS: La tinción para bcl-2 fue positiva en 44 de los 58 tumores analizados (62,1 por ciento), en distintos grados de intensidad. En cuanto a la relación de la expresión de bcl-2 con otras variables histopatológicas. no encontramos asociación estadísticamente significativa con el grado nuclear, tamaño, estadio o posibilidad de recidiva tu m oral. Agrupando los tumores según la intensidad de la tinción en dos grupos, tinción negativa y débil positiva, frente a tinción de intensidad moderada e intensa. tampoco obtuvimos relación entre bcl-2 y la supervivencia.CONCLUSIONES: La expresión de bcl-2 no se relacionó con ninguna de las variables histopatológicas analizadas: tamaño, grado y estadio, ni con la supervivencia, por lo que esta proteína no parece relacionarse con la evolución del adenocarcinoma renal (AU)

Aspiration cytology of 147 adnexal cysts with histologic correlation.

OBJECTIVE: To assess the usefulness of cytology in the diagnosis of 147 histologically established adnexal cysts. STUDY DESIGN: Retrospective, macro-microscopic study based on fluid aspirated from 132 ovarian and 15 extraovarian cysts and projected as a cytohistologic correlation. RESULTS: Typical macroscopic features were identified in 76% of endometriotic cysts, in 53% of mucinous neoplasms and in 67% of dermoid cysts. Cytology helped to identify 67% of nonneoplastic and 56% of neoplastic cysts. The lowest diagnostic sensitivities were observed in functional cysts and benign serous neoplasms (50%), while the highest were shown by endometriotic cysts (76%) and malignant epithelial neoplasms (71%). Inadequate samples were obtained from all types of cysts, even malignant ones (two mucinous cystadenocarcinomas). Diagnostic cytology was useless in extraovarian cysts (33% sensitivity). An adult granulosa cell tumor was erroneously diagnosed as a follicular cyst by cytologic examination. CONCLUSION: Examination of the cyst fluids obtained by aspiration demonstrated low sensitivity, with 43% of inadequate samples obtained from all types of cysts. Malignant cystic neoplasms may be overlooked in inadequate samples. Our study also revealed that specificity in this type of analysis is high in inadequate samples, provided that the technique is carried out correctly.

Low expression of Galpha protein subunits in human prostate cancer.

PURPOSE: Because of increasing interest in G protein regulation of cell growth, differentiation and oncogenesis, we studied the functionality and expression of different G protein subunits in human prostate adenocarcinoma. MATERIALS AND METHODS: Surgical prostate specimens from control patients with bladder cancer and patients with prostate cancer were used. The functionality of alphas and alphai G protein subunits was evaluated by studying somatostatin or guanyl-5'-yl-imidotriphosphate regulation of forskolin stimulated adenylyl cyclase activity. The expression of alphas, alphai and beta subunits was studied by reverse transcriptase-polymerase chain reaction and immunoblot analysis. RESULTS: Adenylyl cyclase sensitivity to somatostatin inhibition decreased in prostate cancer. Low guanyl-5'-yl-imidotriphosphate doses inhibited forskolin stimulated adenylyl cyclase, whereas the opposite was true at high concentrations, evidencing the functionality of alphai and alphas, respectively, in normal and cancer tissue samples. Reverse transcriptase-polymerase chain reaction revealed RNA encoding for alphas and alphai1,2,3 subclasses in normal and pathological conditions. However, immunoblot analysis showed that the level of beta subunits was maintained, whereas that of alphas and alphai subunits decreased 30% to 40% after neoplastic transformation. The levels of alphas and alphai1,2 subunits correlated inversely with serum prostate specific antigen in patients with prostate cancer. CONCLUSIONS: The functionality and expression of G protein subunits are selectively modified in human prostate adenocarcinoma. Low alphas and alphai levels in prostate cancer suggest an important regulatory role of G proteins for cell proliferation and neoplastic transformation in the human prostate and they may have prognostic value.

Adenocarcinoma en un pólipo endometrial / Adenocarcinoma in endometrial polyp

No disponible

Ethanol intake, plasma catecholamine levels, and ST-segment changes without myocardial injury in rats with short-term ethanol consumption.

The authors studied the effect of short-term ethanol consumption on the ST-segment and the association between ST-segment changes and the amount of daily ethanol intake and levels of plasma catecholamines. The study used 63 rats (control group n = 20, study group n = 43). The rats in the study group were exposed for 6 days to progressively larger doses of ethanol followed by 15 days of continuous exposure to ethanol. At baseline an electrocardiogram (ECG) was recorded, and on day 25 the ECG was repeated and plasma catecholamine levels were measured. The animals' hearts were removed and processed for histologic study. Repolarization abnormalities were observed in 68% of the ethanol-consuming rats. Two factors differentiated the subgroup of ethanol-consuming rats with ST-segment changes from the subgroup without ST-segment changes: amount of daily ethanol intake (0.0077 +/- 0.02 mL/g/d vs 0.0058 +/- 0.019 mL/g/d) and plasma epinephrine levels (3,881 +/- 733 pg/mL vs 1,478 +/- 406 pg/mL). No myocardial damage was detected. Our results suggest that in ethanol-consuming rats, high-volume daily ethanol intake and increased plasma catecholamines may mediate changes in the ST-segment.

Fine needle aspiration cytology of primary epithelioid sarcoma of the vulva. A case report.

The cytopathologic features of the fine needle aspiration cytology of the local recurrence of a vulvar epithelioid sarcoma were documented. The cytologic findings included round polygonal cells with abundant eosinophilic cytoplasm and an eccentrically located nucleus. Despite their epithelioid aspect, the cells in the smears had a sarcomatous arrangement, consisting of isolated cells and loosely cohesive groups. The cytologic findings correlated well with the histologic features of the tumor, which consisted of nodules of eosinophilic epithelioid cells. We discuss the clinical characteristics and prognostic factors in this unusual, vulvar location of this soft tissue sarcoma.

Reactive oxygen species and platelet-activating factor synthesis in age-related glomerulosclerosis.

This work deals with the hypothesis that an increased synthesis of reactive oxygen species (ROS) or platelet-activating factor (PAF) (or both) may be implied in the genesis of age-related glomerulosclerosis. Plasma concentration and urinary excretion of both thiobarbituric acid-reactive substances (TBARS) and PAF were measured in young and old human beings and rats. Moreover, these same parameters as well as H2O2 synthesis and reduced glutathione (GSH) content were measured in isolated glomeruli of young (3 months) and old (18 months) Wistar rats. H2O2 synthesis and GSH content were also measured in cultured rat mesangial cells from young and old animals. Both human beings and rats showed a decreased glomerular filtration rate and an increased urinary protein excretion with respect to young individuals. Isolated glomeruli from old animals showed a higher protein content and a lower number of cell nuclei than those from young rats. No changes were detected in plasma concentration and urinary excretion of TBARS and PAF in either human beings or rats. Glomeruli from 18-month-old rats exhibited a higher content of TBARS and GSH and an increased synthesis of H2O2 and PAF than did those from 3-month-old rats. GSH content and H2O2 synthesis were higher in cultured cells from old rats than in those from young rats. These results point to the possibility that ROS or PAF could mediate some of the changes that characterize age-related glomerulosclerosis.

Solitary rectal ulcer syndrome in a child.

We describe a 6-year-old boy with solitary rectal ulcer syndrome, and the sigmoidoscopic and histopathologic findings. The evolution of the histologic features and the absence of trauma suggest that the origin of the ulceration is ischemic in nature.

Neurilemoma of the breast in a man. A case report.

A case of neurilemoma of the left breast in an 83-year-old man is presented, including the fine needle aspiration and biopsy diagnosis. A review of the literature did not reveal the existence of such a tumor in a man's breast. The aspirate yielded a cellular smear composed of clusters of spindle-shaped cells showing minimal atypia and Verocay bodies. The final diagnosis was established on the excised mass through histopathologic study.

Cytodiagnosis of gastric ulcer penetration of the liver by examination of endoscopic brushings.

The penetration of a gastric peptic ulcer into the liver was initially diagnosed by the cytologic examination of endoscopic brushings and later confirmed by an endoscopic biopsy of the stomach. One of the smears of the gastric brushing contained sparse groups of liver cells with mild atypia. The endoscopic biopsy specimen included liver parenchyma with signs of peptic hepatitis. The differential diagnostic considerations for a gastric brushing containing hepatoid cells are discussed.

Cystic adenomatoid tumor of the uterus.

We describe a case of cystic adenomatoid tumor of the uterus in a 38-year-old woman. The tumor was a subserosal cystic mass with a maximum diameter of 8 cm and located at the posterior wall of the right cornual region. Histologically, the tumor was composed of multiple cavities lined by flattened cells, lying among thin septa of connective tissue. The neoplasm showed small solid areas with a more typical histologic pattern of adenomatoid tumor. Immunohistochemical techniques showed the cells to be positive for keratins. They showed desmosomes, abundant intracytoplasmic filaments, and microvilli on ultrastructural study. The histologic, immunohistochemical, and ultrastructural characteristics of the present case closely resemble those of benign cystic mesothelioma and strongly support the mesothelial origin of the adenomatoid tumor of the uterus.

Nonimmunologic hydrops fetalis: an etiopathogenetic approach through the postmortem study of 59 patients.

Aiming at increasing our understanding of the various causative factors of nonimmunologic hydrops fetalis (NIHF) and their pathogenetic mechanisms, we have reviewed 59 cases of this condition from a total number of 4,175 pediatric post-mortem studies performed at the Department of Pathology of the Hospital La Paz from 1967 to 1987. We found eight cases (13.5%) without clinical, biochemical, or post-mortem findings justifying the development of hydrops fetalis, seven cases (12%) associated with certain pathologic findings that by themselves do not explain the development of hydrops and, finally, 44 cases (74.5%) in whom pathological findings may explain the development of the condition. Notwithstanding the etiological diversity of this last group, in 31 of these cases (70%), some common pathogenetic features may be recognized, basically a failure of the right ventricle of the heart in the fetus or newborn, due to a primary heart condition, to intracardiac tumors, or to obstructive phenomena at the level of the right venous drainage. In our opinion, whenever NIHF is diagnosed or suspected, causes of right cardiovascular failure should be investigated, since about 50% of all cases seem to be due to this pathogenetic mechanism.

Complete atrioventricular canal. Anatomic study and presentation of a new technique for total correction.

A new surgical technique for total correction of complete common atrioventricular canal was evolved from study of 34 specimens from affected infants who had died in the first year of life. An interventricular patch was fashioned to reconstruct the interventricular septum and the atrioventricular valves. The patch had two distinct components, one superior or atrial and the other inferior or ventricular. The division was made by inserting a lateral support at different levels on either face of the patch, to which the anterior and posterior atrioventricular cusps were sutured. The interatrial defect was closed with a patch that, together with the atrial component of the interventricular patch, produced a foramen ovale type closure mechanism. The authors present the pathologic observations which served as a basis for development of the surgical technique.

[Leukemia and hypercalcemia (author's transl)]. / Leucemia e hipercalcemia.

Two cases of childhood leukemia with hypercalcemia are reported. In the first case who died by acute granulocytic leukemia, autopsy showed a generalized calcinosis. The other case was an acute lymphocitic leukemia with hypercalcemia and destructive lessions of bones with pathologic fractures. Response to chemotherapy was good. Literature about mechanismes which can induce hypercalcemia in malignancy is reviewed.

[Incomplete Digeorge syndrome (author's transl)]. / Síndrome de Di George incompleto

A newborn with multiple malformations, recurrent infections and hypocalcemic tetany is presented. The malformations included: Facial asymmetry, micrognathia, epicantus, low set nose, peculiar ears, club-feet and heart disease. The immunologic work-up disclosed a cellular immunodeficiency, but normal humoral immunity, and a diagnosis of "incomplete DiGeorge syndrome" was made. No thymus, nor parathyroid glands were found at autopsy. The disagreement between the analytical data and the pathological findings of "complete DiGeorge syndrome" are discussed. The existence of vestigial ectopic thymus not found in the dissected organs is considered the most likely hypothesis. Finally some considerations are made about a possible role of the rubeola virus on its etiology and the actual therapeutic possibilities.