BAP1 Immunostain Status in Intraocular Biopsy Specimens for Uveal Melanoma Highly Correlates with Other Prognostic Markers.

Introduction: Loss of BAP1 protein expression emerged as a negative prognostic marker in uveal melanoma (UM) and has primarily been studied in enucleations. Intraocular biopsy is frequently performed prior to UM globe-conserving therapy. Methods: We retrospectively evaluated BAP1 immunostaining of UM in 16 biopsies and 8 subsequent enucleations, and results were correlated with the UM-specific gene expression profile (GEP; n = 11), chromosome 3 status by FISH and/or chromosomal microarray (n = 12; 9 also had GEP), and clinical outcomes. Results: UM involved the choroid in 15 (of 16) cases. Biopsy was performed for prognostication (n = 12) or diagnosis (n = 4). Treatment included brachytherapy (n = 13; 5 followed by enucleation) or enucleation only (n = 3). BAP1 nuclear immunostaining was positive in 9, negative in 4, and equivocal in 3 biopsies. For the 3 equivocal biopsies, BAP1 immunostaining was positive in 2 (of 3) subsequent enucleations. BAP1 immunostaining was concordant between all 5 remaining biopsies and enucleations. BAP1-positive biopsies had disomy 3 (n = 6) or 3p loss (n = 1) and class 1 GEP (n = 6). BAP1-negative biopsies had monosomy 3 (n = 3) and class 2 GEP (n = 2). Median follow-up was 62.5 months (range, 17-150). For BAP1-positive UM patients, 8 were alive (7 without metastatic disease) and 3 had died (1 melanoma-related death). Among BAP1-negative UM patients, 2 were alive (1 with metastatic disease) and 3 had melanoma-related deaths. Conclusion: BAP1 immunostaining in biopsies highly correlates with results in subsequent enucleations and with well-established UM prognostic markers, representing a potential additional prognostic tool for UM biopsies.

Carcinoma brônquio associado a tuberculose pulmonar: relato de um caso / Bronchogenil carcinoma associated with pulonary tuberculosis: a report of case

Paciente do sexo masculino, 63 anos, fumante, portador de DPOC com relato de imagem radiológica de tuberculose pulmonar residual no ápice direito, que evoluiu com alargamento hilar ipsilateral. O diagnóstico inicial de neoplasia maligna pulmonar foi confirmado pela citologia do broncoaspirado: carcinoma epidermóide. Indicada pneumectomía direita; o exame histopatológico da peça demonstrou associaçäo do carcinoma brônquico e tuberculose gânglio-pulmonar. Administrado esquema tríplice (rifampicina, isoniazida e pirazinamida). A evoluçäo clínica foi favorável

Carcinoma cloacogênico transicional / Transitional cloacogenic carcinoma

Apresentam-se três casos de tumor cloacogênico do canal anal, relatando aspectos relacionados com diagnóstico, tratamento e prognóstico. Discute-se sobre a importância de diagnóstico precoce dado comportamento biológico do tumor, que invade precocemente a musculatura. Elege-se a amputaçäo abdômino-perineal do reto associado à radioterapia como a forma mais efetiva do tratamento