Lesiones apocrinas de la mama / Apocrine lesions of the breast

El cambio apocrino del epitelio mamario es una alteraciónfrecuente habitualmente conocida como metaplasia apocrina. Aunque comúnmente se observa en el epitelio de revestimiento de quistes mamarios, existen otras lesiones, histológicamente más complejas, desde las hiperplasias de diverso grado, la adenosis esclerosante, al carcinoma in situ o invasor, también con citología apocrina. Su particular morfología se acompaña, además, de un perfil de marcadores inmunohistoquímicos distinto al de las lesiones ductales comunes similares: se caracterizan por la expresión de GCDFP, pero, además por la negatividad para receptores de estrógenos, progesterona y bcl-2, y positividad para receptores de andrógenos. El significado biológico de las lesiones apocrinas benignas, en cuanto a riesgo de carcinoma posterior, es controvertido, al igual que su posible carácter preneoplásico

Apocrine change of breast epithelium is a frequent lesion usually known as apocrine metaplasia. It is commonly observed on the lining epithelium of breast cysts, but there are also another histologycally more complex lesions, from hyperplasias or sclerosing adenosis to in situ or infiltrating carcinoma, with apocrine cytology. Besides its special morphology, apocrine metaplasia shows a distinctive immunohistochemical profile, different from similar usual ductal lesions: positivity for GCDFP and androgens receptors and negativity for oestrogen and progesterone receptors and for bcl-2. The risk of subsequent carcinoma in patients with benign apocrine lesions and its possible precancerous condition are controversial subjects

[Paratesticular solitary fibrous tumor]. / Tumor fibroso solitario paratesticular.

OBJECTIVE: To describe an additional case of paratesticular solitary fibrous tumor. METHODS/RESULTS: A 67-year-old man presented a paratesticular mass lasting for one year. Histological examination showed a well-circumscribed lesion comprised of spindle cells proliferation without atypia, arranged in a fascicular pattern, intimately intertwining with thick collagen fibers. Tumor cells were strongly positive for vimentine and CD-34. Diagnostic criteria, clinical features and treatment of this condition are discussed. CONCLUSION: Solitary fibrous tumors are spindle cell neoplasm originally described in the pleura, but may occur in many different sites. Intrascrotal solitary fibrous tumors are uncommon and few cases have been reported.

[Synchronous prostatic carcinosarcoma: report of 2 cases and review of the literature]. / Carcinosarcoma prostático sincrónico: presentación de dos casos y revisión de la literatura.

OBJECTIVE: Carcinosarcoma of the prostate is a biphasic tumor containing adenocarcinoma and recognisable sarcomatous components. It is a rare neoplasm with less than 40 reported cases. We describe two additional examples showing carcinosarcoma in the initial pathologic material (synchronous presentation). METHODS AND RESULTS: The patients were 71 and 78 year-old, respectively. The primary prostatic tumour in case one was composed of adenocarcinoma admixed with a neoplastic mesenchymal component that displayed foci of chondrosarcoma, rhabdomyosarcoma and angiosarcoma. The adenocarcinoma in the second case was admixed with spindle cell sarcoma and chondrosarcoma. Both patients died of disease after surgery, 3 and 9 months respectively. CONCLUSION: Synchronous carcinosarcoma of the prostate is a highly malignant neoplasm that may need an aggressive therapy.

Carcinosarcoma prostático sincrónico: presentación de dos casos y revisión de la literatura / Synchronous carcinosarcoma of the prostate: report of two cases and review of the literature

OBJETIVO: El carcinosarcoma prostático es un tumor bifásico que contiene adenocarcinoma y componentes sarcomatosos reconocibles. Es una neoplasia muy poco frecuente, de la que se han comunicado menos de 40 casos. Describimos dos ejemplos adicionales que muestran carcinosarcoma en el primer material anatomopatológico (presentación sincrónica). MÉTODOS Y RESULTADOS: Los pacientes tenían edades de 71 y 78 años. El tumor prostático primario en el Caso 1 estaba constituido por adenocarcinoma mezclado con un componente mesenqui-mal que mostraba focos de condrosarcoma, rabdomiosarcoma y angiosarcoma. El adenocarcinoma en el Caso 2 estaba mezclado con sarcoma fusocelular y condrosarcoma. Ambos pacientes murieron a causa de la enfermedad, tras cirugía, a los 3 y 9 meses respectivamente. CONCLUSIÓN: El carcinosarcoma prostático sincrónico es una neoplasia altamente maligna que puede precisar una terapia agresiva (AU)

Colon cancer: p53 expression and DNA ploidy. Their relation to proximal or distal tumor site.

Overexpression of nuclear p53 and DNA ploidy were analyzed in a series of 65 colorectal adenocarcinomas and correlated with standard clinical and pathological variables (Dukes stage, tumor site, histological grade and type, and nature of the tumor margins). Immunohistochemical tests were done with the DO-7 monoclonal antibody, using formalin-fixed tissue samples and an antigen retrieval solution. Levels of p53 expression were evaluated using a semiquantitative grading system (CAS 200, BD). Nuclear staining of more than 15% of neoplastic cells was observed in 35 samples (53.8%), which were classified as p53-positive. DNA content was measured by flow cytometry in samples of fresh tissue. Tumor site had a significant direct relationship with DNA ploidy (p < 0.01) and p53 expression (p < 0.001). Proximal tumors were more frequently diploid than were distal tumors (78.6% vs 32%). Moreover, distal neoplasms showed more p53 expression than proximal tumors (64.6% vs 14.3%). However, there was no correlation between the other clinical or pathological variables and the pathological parameter p53 expression and DNA ploidy. Our data support the hypothesis that mechanisms of colorectal carcinogenesis may differ in proximal and distal neoplasms.

[Value of Markovian nuclear texture to predict progression in surface transitional cell carcinoma of the bladder]. / Utilidad de las texturas nucleares Markovianas en la predicción de la progresión en los CCT superficiales de vejiga.

The aim of this work has been to determine if the DNA and nuclear Markovian textures of tissue sections evaluated by image cytometry correlate with the histologic grade and the progression probability of superficial transitional carcinoma of the bladder. In our study, DNA ploidy is related to histologic grade in that aneuploidy frequency increases with a higher grade of malignancy. Image analyses of superficial TCC tissue sections of the bladder, has allowed us to identify "sub-visual parameters" as well as nuclear textures that according to our results can be useful in clarifying the evolutive behaviour of these tumours. Two Markovian textures that identify entropy (TXI) and mean internal contrast (TXB) allow to discriminate between histologic grades as well as progression or non-progression. In conclusion, image analysis cytometry of paraffin embedded tissue sections of TCC of the bladder supplies densitometric parameters related to grade and provides valuable information for the prediction of progression. Quantification of chromatin pattern description in Feulgen-stained nuclei using the Markovian method can be useful in this context.

Sarcomatoid transitional cell carcinoma of the renal pelvis. A report of five cases with clinical, pathological, immunohistochemical and DNA ploidy analysis.

Sarcomatoid transitional cell carcinoma of the renal pelvis is a rare neoplasm with only 7 well illustrated examples reported. These tumours can assume a partial or complete spindle cell pattern of growth, leading to the erroneous classification as sarcomas. We describe the clinic-pathologic features of five additional examples of sarcomatoid carcinoma of the renal pelvis observed in three males and two females. The age ranged from 65-to-82 years-old (mean 71.6). All these patients were treated by nephrectomy and died of disease between 6 and 20 months (mean 11.2) after the onset of symptoms. An immunohistochemical study demonstrated coexpression of keratins, epithelial membrane antigen and vimentin. The image DNA ploidy of all the tumours showed an aneuploid pattern.

Human papillomavirus infection and transitional cell carcinoma of the bladder. Immunohistochemistry and in situ hybridization.

The aim of the present research was to investigate human papillomavirus (HPV) infection by means of immunohistochemistry and in situ hybridization in 76 bladder cancer specimens. A biotinylated DNA probe that recognizes HPV 6/11, HPV 16/18 and HPV 31/33/35 was used for in situ hybridization. A polyclonal antibody recognizing HPV capsid antigen (HPVcAg) was used for immunohistochemistry. In situ hybridization and immunohistochemistry were developed by alkaline phosphatase and immunogold-silver techniques respectively. Our results showed that 25 (32.8%) out of 76 bladder carcinoma specimens reacted with HPVcAg. Twelve (15.7%) out of 76 cases were positive for HPV 16/18-DNA using non-isotopic in situ hybridization. Sixteen cases had koilocytosis. No positive signals were found for HPV 6/11 or 31/33/35-DNA probes.

[Primary amyloidosis localized in the bladder]. / Amiloidosis primaria localizada de vejiga urinaria.

OBJECTIVE: We report a case of localized amyloidosis of the urinary bladder in an 80-year-old female whose main presenting symptom was massive hematuria. METHODS: Cystoscopic examination revealed a tumor on the trigone and bladder neck. A transurethral resection of the tumor was performed and the fragments were processed for histopathological study with hematoxylin-eosin and Congo red staining and ultrastructural study. RESULTS: The histopathological analyses disclosed large eosinophilic deposits in the submucosa with birefringence under polarized light in Congo red staining. Electron microscopy revealed a meshwork of filaments typical of amyloid. The patient had no symptoms or signs of systemic disease and remains symptom-free four years later. CONCLUSIONS: Primary localized amyloidosis of the urinary bladder is a rare condition that can be successfully treated surgically and has an excellent prognosis.