Orbital soft tissue composite lymphoma presenting as recurrence of a nodal lymphoma with mantle and follicular cell components: a case report, literature review and guideline for the treatment of patients / Linfoma compuesto de tejidos blandos orbitario presentándose como recurrencia de un linfoma ganglionar con componentes del manto y folicular: descripción de un caso, revisión de la literatura y guía para el tratamiento de los pacientes

Composite lymphoma with mantle and follicular cell components is a challenging diagnosis. Flow cytometry, immunohistochemistry and molecular genetics are required to distinguish the two components, as often the more aggressive one is predominant and masks the other. A 58-year-old man with history of nodal composite lymphoma presented with right exophthalmos and diplopia. A head CT scan showed an orbital tumor. A biopsy of the tumor revealed a mantle cell lymphoma predominating over a follicular lymphoma. Immunoglobulin heavy chain and light chain rearrangements analysis by PCR proved that both components of the orbital tumor were recurrences of the same nodal composite lymphoma diagnosed two years earlier. The nodal lymphoma was composed of a follicular lymphoma and an in situ mantle cell neoplasia. Consensus view is that dominant lymphoma should be treated when needed but taking into account if the mantle cell lymphoma is an in situ neoplasia and if it expresses CD5 and SOX11

El diagnóstico de linfoma compuesto con componentes del manto y folicular es desafiante y requiere de técnicas como citometría de flujo, inmunohistoquímica y genética molecular, porque a menudo el componente linfoide más agresivo predomina sobre el otro, enmascarándolo. Un varón de 58 años con historia de linfoma compuesto ganglionar presentó exoftalmos derecho y diplopia. La TAC de cabeza mostró un tumor orbitario. Una biopsia del tumor reveló un linfoma del manto predominando sobre un linfoma folicular. El reordenamiento genético mediante PCR de la cadena pesada y cadenas ligeras de inmunoglobulina demostró que ambos componentes del tumor orbitario eran recurrentes del mismo linfoma compuesto ganglionar diagnosticado 2 años antes. El linfoma ganglionar estaba compuesto por linfoma folicular y neoplasia del manto in situ. El consenso es que el linfoma dominante debe ser tratado cuando sea necesario considerando si el linfoma del manto es in situ y si expresa CD5 y SOX11

Orbital soft tissue composite lymphoma presenting as recurrence of a nodal lymphoma with mantle and follicular cell components: A case report, literature review and guideline for the treatment of patients.

Composite lymphoma with mantle and follicular cell components is a challenging diagnosis. Flow cytometry, immunohistochemistry and molecular genetics are required to distinguish the two components, as often the more aggressive one is predominant and masks the other. A 58-year-old man with history of nodal composite lymphoma presented with right exophthalmos and diplopia. A head CT scan showed an orbital tumor. A biopsy of the tumor revealed a mantle cell lymphoma predominating over a follicular lymphoma. Immunoglobulin heavy chain and light chain rearrangements analysis by PCR proved that both components of the orbital tumor were recurrences of the same nodal composite lymphoma diagnosed two years earlier. The nodal lymphoma was composed of a follicular lymphoma and an in situ mantle cell neoplasia. Consensus view is that dominant lymphoma should be treated when needed but taking into account if the mantle cell lymphoma is an in situ neoplasia and if it expresses CD5 and SOX11.

Iodine-125 seeds in prostatic transurethral resection: Differential diagnosis with schistosome eggs / Presencia de I-125 semillas en material de resección transuretral. Diagnóstico diferencial con huevos de esquistosoma

The presence of foreign bodies in a prostate transurethral resection may pose a histopathological challenge. A 65-year-old white man with urinary obstructive symptoms was subjected to a transurethral resection. Histopathology showed a squamous cell carcinoma affecting prostatic ducts and multiple foreign bodies; their differential diagnosis was between iodine-125 seeds and Schistosoma sp. eggs, as both can show oval morphology and terminal spines. The seeds are irregular, homogeneous and solid, unlike Schistosoma eggs that are heterogeneous, with a lytic appearance and some embryonated or calcified. The seeds are located in prostatic ducts inducing periductal fibrosis whereas the Schistosoma sp. eggs are found in the stroma inducing desmoplasia and granulomas. The seeds are associated with a lymphoplasmacytic infiltrate while the eggs are surrounded by eosinophils

La presencia de cuerpos extraños en una resección transuretral de próstata puede suponer un desafío histopatológico. Un varón de 65 años con síntomas de obstrucción urinaria fue sometido a una resección transuretral. El estudio histopatológico demostró un carcinoma de células escamosas de conductos prostáticos y múltiples cuerpos extraños planteando el diagnóstico diferencial entre semillas de iodo-125 y huevos de esquistosoma. Ambos pueden tener morfología oval y espinas terminales. Las semillas son irregulares, homogéneas y sólidas, a diferencia de los huevos de esquistosoma que son heterogéneos, de apariencia lítica, y otros embrionados o calcificados. Las semillas se localizan en los ductos prostáticos induciendo fibrosis periductal mientras que los huevos están en el estroma induciendo desmoplasia y granulomas. Las semillas se asocian a infiltrado linfoplasmocítico mientras que los huevos están rodeados por eosinófilos

[Differential diagnosis and management of intramuscular myxomas: A review of our experience]. / Diagnóstico diferencial y manejo de mixomas intramusculares: revisión de nuestra experiencia.

BACKGROUND: Intramuscular myxoma is a rare benign soft tissue tumour of mesenchymal origin, which appears as a painless mass of slow growth. Early diagnosis is important in order to differentiate it from other entities, especially soft tissue sarcoma. CLINICAL CASES: Two cases, both women with a mean age of 52.5 years (range 40-65) are presented. The first was seen due to growth of a gluteal mass, and the second by coccydynia. Computed tomography and nuclear magnetic resonance were the diagnostic tests of choice. In one case, where there was a single but large lesion, radical extirpation of the gluteal muscle was chosen. In the other case, in which the lesions were multiple, individualised excision of cysts was performed. Postoperative functional limitation was low in both types of surgery, with good oncological results being obtained. CONCLUSION: Intramuscular myxomas are benign lesions. There are no cases of malignancy or recurrence due to incomplete resection. It has to be determined whether they are single or multiple, since in the latter case, they could be due to syndromes such as Mazabraud syndrome, which is associated with bone fibrous dysplasia, or Albright syndrome that is also associated with pigmented skin spots.

Seudotumor inflamatorio de amígdala / Inflammatory pseudotumor of the tonsil

El seudotumor inflamatorio es una neoformación benigna infrecuente potencialmente invasiva. En cabeza y cuello afecta principalmente a órbita y senos paranasales. Presentamos un caso de afectación amigdalar y cervical, con biopsia diagnóstica obtenida mediante amigdalectomía. Tras amigdalectomía y corticoterapia, no se ha detectado recurrencia a los 2 años (AU)

Inflammatory pseudotumor is an unusual benign but potentially invasive lesion. In the head and neck area, it mainly involves the orbit and paranasal sinuses. We present a case in tonsil and neck. After tonsillectomy and steroid therapy, there has been no recurrence (AU)

Amigdalitis por Yersinia enterocolitica / Yersinia enterocolitica tonsillitis

Presentamos los casos de cinco pacientes con infección amigdalar debida a Yersinia enterocolitica. Fue común la ausencia de respuesta a antibióticos de empleo habitual y el contacto habitual con suidos. El diagnóstico definitivo se estableció por aislamientos microbiológicos de muestras histológicas amigdalares (AU)

We present five cases of tonsillitis secondary to Yersinia enterocolitica. No response to commonly-used antibiotics and continuous professional contact with pigs were common. The definitive diagnosis was established by bacteriological isolation on tonsil tissue samples (AU)

[Yersinia enterocolitica tonsillitis]. / Amigdalitis por Yersinia enterocolitica.

We present five cases of tonsillitis secondary to Yersinia enterocolitica. No response to commonly-used antibiotics and continuous professional contact with pigs were common. The definitive diagnosis was established by bacteriological isolation on tonsil tissue samples.