Screening a Solitary Dilated Duct in the Breast: A Pictorial Essay.

A solitary dilated duct visualized by mammography is a rare event. According to the latest edition of BI-RADS® it is classified as category 4. This series of cases shows complementary ultrasound of a solitary dilated duct can reduce false-positive results on mammography.

Silicone-Induced Granuloma of Breast Implant Capsule (SIGBIC): Histopathology and Radiological Correlation.

Currently, attention has been given to complications related to breast implants, especially due to the presence of anaplastic large cell lymphoma (ALCL) related to silicone implants. Many manuscripts attempt to associate silicone presence with clinical complaints reported by patients, while others try to demonstrate the mechanisms of silicone bleeding by permeability loss of breast implant surfaces. There also are reports of foreign body type reactions from implant fibrous capsule to silicone corpuscles. However, there seems to be no study that correlates the clinical, radiological, and histological correlations of these lesions. The objective of this review is to correlate radiological findings of silicone-induced granuloma of breast implant capsule (SIGBIC) from breast MRI (BMRI) scans and complementary findings of ultrasound (US) and positron emission tomography (PET) scan, and its histology originated from surgical breast implant capsulectomy. To make this correlation possible, we divided SIGBIC into three radiological findings: (1) intracapsular SIGBIC, (2) SIGBIC with extracapsular extension, and (3) mixed SIGBIC associated with seroma. Our experience demonstrates histological-radiological correlation in SIGBIC diagnosis. Knowledge of these findings may demonstrate its real importance in terms of public health and patient management. We believe that SIGBIC is currently underdiagnosed by lack of training, guidance, and management in our clinical practice.

Lipophyllodes of the breast. A reappraisal of fat-rich tumors of the breast based on 22 cases integrated by immunohistochemical study, molecular pathology insights, and clinical follow-up.

We have studied 22 cases of mammary lipophyllodes tumors (LPT), analyzing their clinicopathologic features along with available follow-up. All cases were tested for cytokeratins, S100 protein, and MDM2, and in selected cases for estrogen receptor, smooth muscle actin, bcl2, desmin, and myogenin. Patients were women aged 21 to 69 years (average, 45 years), and LPT size ranged from 1.6 to 30 cm (average, 9.7 cm). Microscopically, LPT segregated as follows: atypical lipoma-like tumor/well-differentiated liposarcoma (ALT/WDL), 8 cases; myxoid, 6; and pleomorphic/poorly differentiated/round cell, 8, including a case of dedifferentiated liposarcoma. Immunohistochemistry studies showed focal positive staining for S100 and CD34 in most ALT/WDL, and desmin and myogenin in 2 cases with evidence of rhabdomyoblastic differentiation. MDM2 positivity was focally seen in 1 case. Follow-up was available in 8 cases. Multiple recurrent tumors were seen in 2 patients, and metastatic disease to the lung was seen in 2 patients. In 4 patients with a follow-up between 2 and 15 years there was no evidence of recurrent or metastatic disease. Patients with ALT/WDL (2/2) were alive with no evidence of disease; 2 of 4 patients with myxoid liposarcoma component experienced tumor recurrence, whereas pleomorphic liposarcoma LPT pursued a less favorable course although only 1 patient died of the condition. Absence of MDM2 reactivity in most cases seems not as meaningful as in fatty tumors of somatic soft parts.

Follicular lymphoma in young adults: a clinicopathological and molecular study of 200 patients.

Follicular lymphoma is clinically heterogenous, and therefore necessitates the identification of prognostic markers to stratify risk groups and optimize clinical management. It is relatively rare in patients younger than 40 years, and the clinicopathologic characteristics and biological behavior in this age group are poorly understood. In the current study, samples from a cohort of 200 patients between 19 and 40 years were evaluated retrospectively with respect to clinical, histologic, and genetic features. These were then correlated with clinical outcome. The median age at presentation was 35 years with a slight female prepoderance (56%). Most of the cases are presented with nodal disease (90%). Concomitant follicular lymphoma and diffuse large B-cell lymphoma were observed in 7 (4%) patients. Immunohistologic studies showed the expression of CD10 (91%), BCL6 (97%), BCL2 (95%), MUM1/IRF4 (12%), MDM2 (17%), and CD23 (25%). BCL2 rearrangement was present in 74%, and BCL6 in 20%. The estimated overall survival of patients was 13 years (mean). The presence of anemia, elevated lactose dehydrogenase, bone marrow involvement, and high-risk follicular lymphoma international prognostic index correlated with adverse overall survival. Our findings revealed that follicular lymphoma in young adults demonstrate similarities with that of older adults, including the frequency of presentation at various anatomic sites, grade, and adverse prognostic factors.

Metastatic melanoma presenting as an isolated breast tumor: a study of 20 cases with emphasis on several primary mimickers.

CONTEXT: The mammary gland can be a site of metastasis in patients with malignant melanoma, which is easily recognized microscopically if clinical information is available. Nonetheless, metastatic melanoma presenting as an isolated mammary tumor can be more challenging to diagnose because it can simulate a primary breast carcinoma clinically and morphologically. OBJECTIVE: To review metastatic melanoma to the breast, presenting as primary breast carcinomas clinically and morphologically. DESIGN: The authors report 20 cases of metastatic melanoma clinically presenting as breast tumors. Cases with widespread metastatic presentation were excluded. RESULTS: Epithelioid and spindle cell tumors predominated, suggesting mammary ductal, papillary, or sarcomatoid carcinoma. Most cases (16 of 20) were submitted for consultation or second opinion owing to their unusual presentation in the breast, or to perform predictive/prognostic immunohistochemical assays. Seven cases had a remarkable phenotypic spectrum expanding the differential diagnosis to large cell lymphoma, leiomyosarcoma, medullary carcinoma, malignant schwannoma, and liposarcoma. Tumor cells were negative for cytokeratin stains and positive for S100 protein, HMB-45, and Melan-A. Negative staining was also observed for epithelial membrane antigen, CD45, desmin, estrogen and progesterone receptors, and human epidermal growth factor receptor 2. CONCLUSIONS: Metastatic melanoma may simulate a broad spectrum of primary breast malignancies. Although the application of a simple panel of antibodies assists in rendering the correct interpretation, lesions presenting as isolated breast tumors may introduce a significant diagnostic difficulty, especially when there is inadequate patient history and/or limited biopsy material. Further challenges are introduced by the extraordinary phenotypic plasticity of metastatic melanoma. Awareness of this pattern variance is essential to avoid inappropriate treatment, especially in cases simulating a "triple negative," poorly differentiated carcinoma of the breast.

Immunohistochemistry applied to the differential diagnosis between ductal and lobular carcinoma of the breast.

The distinction between classic lobular and ductal carcinoma, both in situ and invasive, has important therapeutic and management implications. Most ductal and lobular carcinomas are distinguished readily on hematoxylin-eosin-stained sections because of distinct histomorphologic features. In cases with ambiguous morphologic features, however, categorization in one or another type can be a challenge. Several immunohistochemical markers, including epithelial cadherin, p120, ß-catenin, and low-molecular-weight and high-molecular-weight cytokeratins among others, have been introduced to help better discriminate between lobular neoplasia and ductal carcinoma. In this critical review of the literature, we comment about the usefulness and the limitations of these markers to improve the accuracy in the differential diagnosis of breast pathology.

Estrogen and progesterone receptor testing in breast carcinoma: concordance of results between local and reference laboratories in Brazil.

CONTEXT AND OBJECTIVE: Breast cancer accounts for approximately one quarter of all cancers in females. Estrogen and progesterone receptor testing has become an essential part of the clinical evaluation of breast carcinoma patients, and accurate results are critical in identifying patients who may benefit from hormone therapy. The present study had the aim of investigating the concordance of the results from hormone receptor tests between a reference laboratory and local (or community) laboratories in Brazil. DESIGN AND SETTING: Retrospective study at a reference pathology laboratory. METHODS: The concordance in the results from hormone receptor tests between a reference laboratory and 146 local laboratories in Brazil was compared in relation to 500 invasive breast carcinoma cases, using immunohistochemistry. RESULTS: There was concordance in 89.4% (447/500 cases) and 85.0% (425/500 cases) of the results from estrogen (κ = 0.744, P < 0.001) and progesterone (κ = 0.688, P < 0.001) receptor tests, respectively, between local and reference laboratories. This was similar to findings in other countries. The false negative rates from estrogen and progesterone receptor tests in local laboratories were 8.7% and 14.4%, respectively. The false positive rates from estrogen and progesterone receptor tests in local laboratories were 15.5% and 16.0%, respectively. CONCLUSION: Technical and result interpretation issues may explain most of the discordances in hormone receptor testing in local laboratories. Validation of estrogen and progesterone receptor tests at local laboratories, with rigorous quality control measures, is strongly recommended in order to avoid erroneous treatment of breast cancer patients.

Ileal perineurioma as a cause of intussusception.

CONTEXT: Perineuriomas are rare tumors composed of cells resembling those of the normal perineurium. It usually occurs in subcutaneous, soft-tissue or intraneural locations. Very few reports in the literature have described perineuriomas in the gastrointestinal tract, including the stomach, colon and jejunum. CASE REPORT: We report the clinicopathological and immunohistochemical features of a case of ileal perineurioma that was manifested clinically as intestinal obstruction due to intussusception. Ileal perineurioma has not previously been reported at this anatomical location.

Ileal perineurioma as a cause of intussusception / Perineurioma ileal como uma causa de intussuscepção

CONTEXT: Perineuriomas are rare tumors composed of cells resembling those of the normal perineurium. It usually occurs in subcutaneous, soft-tissue or intraneural locations. Very few reports in the literature have described perineuriomas in the gastrointestinal tract, including the stomach, colon and jejunum. CASE REPORT: We report the clinicopathological and immunohistochemical features of a case of ileal perineurioma that was manifested clinically as intestinal obstruction due to intussusception. Ileal perineurioma has not previously been reported at this anatomical location.

CONTEXTO: Perineurioma é uma rara neoplasia composta de células que lembram aquelas do perineuro normal e geralmente ocorre no subcutâneo, tecidos moles ou em localização intraneural. Poucos relatos na literatura descrevem perineuriomas no trato gastrointestinal incluindo estômago, cólon e jejuno. RELATO DE CASO: Os autores apresentam as características clinicopatológicas e imunoistoquímicas de um caso de perineurioma ileal apresentando-se clinicamente por obstrução intestinal decorrente de intussuscepção. Perineurioma ileal não havia sido descrito até o momento nessa localização anatômica.

HER2 testing in breast carcinoma: very low concordance rate between reference and local laboratories in Brazil.

Breast cancer accounts for approximately one quarter of all cancers in females. HER2 gene amplification or HER2 protein overexpression, detected in about 20% of breast carcinomas, predicts a more aggressive clinical course and determines eligibility for targeted therapy with trastuzumab. HER2 testing has become an essential part of the clinical evaluation of all breast carcinoma patients, and accurate HER2 results are critical in identifying patients who may be benefited from targeted therapy. This study investigated the concordance in the results of HER2 immunohistochemistry assays performed in 500 invasive breast carcinomas between a reference laboratory and 149 local laboratories from all geographic regions of Brazil. Our results showed an overall poor concordance (171 of 500 cases, 34.2%) regarding HER2 results between local and reference laboratories, which may be related to the low-volume load of HER2 assays, inexperience with HER2 scoring system, and/or technical issues related to immunohistochemistry in local laboratories. Standardization of HER2 testing with rigorous quality control measures by local laboratories is highly recommended to avoid erroneous treatment of breast cancer patients.

Estrogen and progesterone receptor testing in breast carcinoma: concordance of results between local and reference laboratories in Brazil / Teste de receptores de estrógeno e progesterona em carcinoma de mama: concordância dos resultados entre laboratórios locais e de referência no Brasil

CONTEXT AND OBJECTIVE: Breast cancer accounts for approximately one quarter of all cancers in females. Estrogen and progesterone receptor testing has become an essential part of the clinical evaluation of breast carcinoma patients, and accurate results are critical in identifying patients who may benefit from hormone therapy. The present study had the aim of investigating the concordance of the results from hormone receptor tests between a reference laboratory and local (or community) laboratories in Brazil. DESIGN AND SETTING: Retrospective study at a reference pathology laboratory. METHODS: The concordance in the results from hormone receptor tests between a reference laboratory and 146 local laboratories in Brazil was compared in relation to 500 invasive breast carcinoma cases, using immunohistochemistry. RESULTS: There was concordance in 89.4 percent (447/500 cases) and 85.0 percent (425/500 cases) of the results from estrogen (κ = 0.744, P < 0.001) and progesterone (κ = 0.688, P < 0.001) receptor tests, respectively, between local and reference laboratories. This was similar to findings in other countries. The false negative rates from estrogen and progesterone receptor tests in local laboratories were 8.7 percent and 14.4 percent, respectively. The false positive rates from estrogen and progesterone receptor tests in local laboratories were 15.5 percent and 16.0 percent, respectively. CONCLUSION: Technical and result interpretation issues may explain most of the discordances in hormone receptor testing in local laboratories. Validation of estrogen and progesterone receptor tests at local laboratories, with rigorous quality control measures, is strongly recommended in order to avoid erroneous treatment of breast cancer patients.

CONTEXTO E OBJETIVO: O carcinoma de mama é responsável por cerca de um quarto de todos os cânceres em mulheres. O teste de receptores de estrógeno e progesterona se tornou parte essencial da avaliação clínica de pacientes com carcinoma de mama; assim, resultados precisos são fundamentais para identificação de pacientes que podem se beneficiar da terapia hormonal. O presente estudo tem por objetivo investigar a concordância nos resultados do teste de receptores hormonais entre um laboratório referência e laboratórios locais (ou comunitários) do Brasil. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo em laboratório referência em patologia no Brasil. MÉTODOS: A concordância nos resultados dos testes de receptores hormonais entre um laboratório referência e 146 diferentes laboratórios locais brasileiros foi comparada em 500 casos de carcinoma invasivo de mama através da imunoistoquímica. RESULTADOS: Houve concordância de 89,4 por cento (447/500 casos) e 85,0 por cento (425/500 casos) nos resultados dos testes de receptores de estrógeno (κ = 0,744, P < 0,001) e progesterona (κ = 0,688, P < 0,001), respectivamente, entre laboratórios locais e referência, similar à descrita em outros países. A taxa de resultados falso-negativos nos testes de receptores de estrógeno e progesterona em laboratórios locais foi de 8,7 por cento e 14,4 por cento, respectivamente. A taxa de resultados falso-positivos nos testes de receptores de estrógeno e progesterona em laboratórios locais foi de 15,5 por cento e 16,0 por cento, respectivamente. CONCLUSÃO: Questões técnicas e de interpretação dos resultados podem explicar a maior parte das discordâncias nos testes de receptores hormonais em laboratórios locais. A validação dos testes de receptores de estrógeno e progesterona pelos laboratórios locais com medidas de controle de qualidade rigorosas é fortemente recomendada de modo a evitar o tratamento errôneo de pacientes com carcinoma de mama.

Primary central nervous system peripheral T-cell lymphoma in a child.

A 10-year-old Caucasian boy was admitted to the hospital with a 3-month history of headache, vomiting, ataxia, and right amaurosis. A magnetic resonance imaging (MRI) showed a solid, expansive, parasagittal mass in the right parietal hemisphere that extended sagitally to include the optical chiasm. The lesion was considered unresectable. Histology and immunophenotyping of biopsy tissue revealed characteristics of peripheral T-cell lymphoma. No other anatomical region, including bone marrow, was compromised. Primary T-cell lymphomas of the central nervous system are rare, especially in childhood. Here, we describe the rapidly deteriorating and fatal clinical course of a boy with a primary T-cell lymphoma in the central nervous system.

Extraocular muscle fixation to porous polyethylene orbital implants using 2-octyl-cyanoacrylate.

PURPOSE: To evaluate the efficacy of bioadhesive in attaching the extraocular muscles to porous polyethylene spheres in rabbit enucleated cavities. METHODS: A prospective, experimental study was performed. Eight adult New Zealand white rabbits underwent right enucleation with insertion of an unwrapped 12 mm porous polyethylene sphere. The superior and inferior rectus muscles were attached to the implant with 2-octyl cyanoacrylate placed to the underside of the muscles and application of pressure for 5 seconds. Ninety days after surgery, the orbits were exenterated and four animals underwent histologic evaluation and the other four animals tensile strength testing of the muscle-sphere attachment. RESULTS: There were no exposures or infections of the implants and the muscles remained attached in all cases. Histologic examination showed fibrous tissue reaction at the muscle-sphere attachment with minimal inflammation of the surrounding tissues; a pseudocapsule formation around the spheres and full vascularization of the implant was also observed. There was no evidence of residual glue on histologic examination. Tensile strength testing showed that rupture force was similar between bonded muscle and the porous polyethylene sphere. CONCLUSIONS: The 2-octyl-cyanoacrylate did not cause deleterious effects in orbital tissues and provided strong adhesion between muscles and spheres. Bioadhesive may be an option for attaching the extraocular muscles to orbital implants in anophthalmic cavity reconstruction.

High concordance of SP3 rabbit monoclonal antibody with FISH to evaluate HER2 in breast carcinoma.

HER2 gene amplification or HER2 protein overexpression predicts a more aggressive clinical course in breast cancer, with a worse response to hormonal therapy, and determines eligibility for the use of the anti-HER2 antibody trastuzumab. For these reasons, the diagnostic assays that determine HER2 status in breast carcinoma have become increasingly important. Our goal was to evaluate the concordance, sensitivity, and specificity of a rabbit monoclonal antibody directed to the extracellular domain of the HER2 receptor (SP3) and compare it with fluorescence in situ hybridization and HercepTest in 179 invasive breast carcinomas. We found that SP3 was in agreement with fluorescence in situ hybridization results in 94.6% of cases. HercepTest and fluorescence in situ hybridization results were in agreement in 95.1% of the cases. Only 4.3% (4/93) of the cases that scored 0/1+ by SP3 were amplified by fluorescence in situ hybridization, and 8.3% (3/36) of cases that scored 3+ were not amplified by fluorescence in situ hybridization. Comparing SP3 with HercepTest, we observed that HercepTest demonstrated higher sensitivity (100.0% vs. 89.0%) but SP3 demonstrated higher specificity (97.0% vs. 89.0%). An important advantage of SP3 (in comparison with HercepTest) is its higher discrimination power (72.1% vs. 34.1%). For these reasons, this antibody could be helpful in the determination of HER2 status in a routine basis.

[2-octyl-cyanoacrylate in rabbit anophthalmic cavity reconstruction]. / Uso de 2-octil-cianoacrilato na reconstrução da cavidade anoftálmica de coelhos.

PURPOSE: To evaluate fixation by a bioadhesive of the external ocular muscles to the porous polyethylene spheres. METHODS: An experimental study was performed using eight white rabbits that underwent right eye enucleation with placement of 12 mm spheres of porous polyethylene. The rectus muscles (superior and inferior) were attached to the implant with a bioadhesive (2-octyl-cyanoacrylate) applied to the inferior side of the external muscles. Ninety days after surgery the orbital content was removed and 4 animals were submitted to a tensile strength test of the muscle-sphere attachment and the other 4 to histological evaluation. RESULTS: The tensile strength test showed that the rupture force was similar between the muscle and porous polyethylene sphere bond attachment and normal external ocular muscles. The histologic evaluation showed fibrous tissue reaction and muscle-sphere attachment with no deleterious effects to the tissues; a capsule formation around the spheres and new vessels inside the implant were also observed. CONCLUSION: 2-octyl-cyanoacrylate provides strength adhesion between muscles and spheres, with surgery time reduction and does not provoke deleterious effects on the orbital tissues. Thus, the bioadhesive might be a good choice for use in the anophthalmic cavity reconstruction.

Uso de 2-octil-cianoacrilato na reconstrução da cavidade anoftálmica de coelhos / 2-octyl-cyanoacrylate in rabbit anophthalmic cavity reconstruction

OBJETIVO: Avaliar a ligação entre músculos oculares extrínsecos e esferas de polietileno poroso usando um bioadesivo. MÉTODOS: Estudo experimental envolvendo 8 coelhos albinos submetidos a enucleação do olho direto com colocação de implante esférico de polietileno poroso de 12 mm de diâmetro unido aos músculos oculares extrínsecos por meio do bioadesivo 2-octil-cianoacrilato. Noventa dias após a cirurgia os animais foram sacrificados e o conteúdo orbitário removido. Em 4 animais foi realizado estudo biomecânico, avaliando-se a força de ruptura entre a musculatura e a esfera (grupo implante) e entre a musculatura e a esclera nos olhos contralaterais (grupo controle). Nos outros 4 animais foi realizada análise histológica. RESULTADO: A avaliação biomecânica revelou que a força de ruptura entre esfera-músculo e esclera-músculo foram semelhantes quando se usa o adesivo de cianoacrilato. O exame histológico mostrou reação fibrovascular no local da adesão entre a musculatura e a esfera, sem efeitos deletérios aos tecidos. Ao redor dos implantes foi possível observar pseudocápsula e no interior, neovasos e tecido fibrovascular preenchendo os espaços entre os grânulos do polietileno. CONCLUSÃO: O adesivo 2-octil-cianoacrilato mantém boa força de adesão na união entre os músculos e as esferas de polietileno poroso, com redução do tempo cirúrgico e sem efeitos deletérios aos tecidos orbitais. Desta forma, deve-se considerar o uso do bioadesivo na reconstrução da cavidade anoftálmica.

PURPOSE: To evaluate fixation by a bioadhesive of the external ocular muscles to the porous polyethylene spheres. METHODS: An experimental study was performed using eight white rabbits that underwent right eye enucleation with placement of 12 mm spheres of porous polyethylene. The rectus muscles (superior and inferior) were attached to the implant with a bioadhesive (2-octyl-cyanoacrylate) applied to the inferior side of the external muscles. Ninety days after surgery the orbital content was removed and 4 animals were submitted to a tensile strength test of the muscle-sphere attachment and the other 4 to histological evaluation. RESULTS: The tensile strength test showed that the rupture force was similar between the muscle and porous polyethylene sphere bond attachment and normal external ocular muscles. The histologic evaluation showed fibrous tissue reaction and muscle-sphere attachment with no deleterious effects to the tissues; a capsule formation around the spheres and new vessels inside the implant were also observed. CONCLUSION: 2-octyl-cyanoacrylate provides strength adhesion between muscles and spheres, with surgery time reduction and does not provoke deleterious effects on the orbital tissues. Thus, the bioadhesive might be a good choice for use in the anophthalmic cavity reconstruction.

Leydig cell tumor of the testis with histological and immunohistochemical features of malignancy in a 1-year-old boy with isosexual pseudoprecocity.

The article reports the clinical, histopathological, and immunohistochemical findings of a 1-year-old boy presenting with isosexual pseudoprecocity attributable to a functioning Leydig cell tumor of the testis. The case appears to represent the youngest patient ever recognized with this well-known syndrome. Malignancy features were also for the first time initially assessed using criteria, retrospectively developed from the literature, for metastasizing Leydig cell tumor. All the following were found: infiltrative borders, cellular pleomorphism, high mitotic index (12-14/high-power field), high MIB-1 index (40%), P53 positivity in 50% of the cells, and bcl-2 positivity in 15% of the cells. Immunohistochemistry proved the cells of the tumor to be positive for inhibin, Melan-A, synaptophysin, cytokeratin, and calretinin and negative for S-100 and chromogranin A. Notably, lipochrome and crystals of Reinke were not found in the tumor cells. Although the neoplasm fulfilled the criteria for a potentially metastasizing Leydig cell tumor, there was no evidence of that event having occurred, perhaps as a result of early treatment or as indication that criteria developed for Leydig cell tumor of adults may not apply to children.

[Gel and porous polyethylene implants in the rabbit anophthalmic cavity]. / Implantes de polietileno gel e poroso em cavidade anoftálmica de coelhos.

PURPOSE: To evaluate porous polyethylene implants as compared to solid and gel spheres in anophthalmic cavities. METHODS: Thirty-six white rabbits underwent a right eye enucleation with placement of 12 mm of porous (18 animals) or gel (18 animals) polyethylene spheres. The animals were submitted to weekly clinical evaluation. Ultrasound examinations were done 30, 60 and 90 days after surgery and the animals were sacrificed on the day 90th. Then, the orbit content was removed and submitted to light microscopy. RESULTS: Five animals (27.2%) which received porous polyethylene spheres presented sphere extrusion. With the gel polyethylene spheres, the extrusions happened in 94.4% of the animals and it was observed that the expelled gel spheres had higher diameter then the implanted ones. Ultrasound evaluation showed that the porous polyethylene implant becomes vascularized but the gel not, as confirmed by histological examination. CONCLUSION: Spheres of material in the gel state hydrate and increase in volume making it necessary to know the final size before the implantation. Ultrasound examination allows the evaluation of the implant-tissue integration.

Implantes de polietileno gel e poroso em cavidade anoftálmica de coelhos / Gel and porous polyethylene implants in the rabbit anophthalmic cavity

OBJETIVO: Comparar implantes de polietileno poroso no estado sólido e gel em cavidades enucleadas. MÉTODOS: Trinta e seis coelhos albinos foram submetidos à enucleação do olho direito, recebendo esferas de polietileno poroso (18 animais) ou gel (18 animais), de 12 mm de diâmetro. Os animais foram avaliados semanalmente por exame clínico e mensalmente por ultra-sonografia modo B, realizada 30, 60 e 90 dias após a cirurgia, tendo sido os animais sacrificados aos 90 dias. Após o sacrifício, o conteúdo orbitário foi removido e examinado histologicamente. RESULTADOS: Cinco animais (27,2 por cento) que receberam os implantes de polietileno poroso tiveram extrusão do implante. Houve extrusão em 94,4 por cento dos animais que receberam a esfera de polietileno gel, tendo-se observado que o diâmetro das esferas gel extruídas encontrava-se aumentado em relação ao diâmetro da esfera implantada. A ultra-sonografia mostrou que o implante de polietileno poroso se vascularizou e que o gel não, o que foi confirmado pelo exame histológico. CONCLUSÃO: Esferas de polietileno no estado gel sofrem hidratação e aumentam de volume, sendo necessário conhecer o seu tamanho final antes da implantação. A ultra-sonografia permite conhecer a vascularização do implante, podendo ser usada na avaliação da integração esfera-hospedeiro.

Coristoma ósseo episcleral: relato de caso / Episcleral osseous choristoma: case report

Os autores apresentam um caso de coristoma ósseo episcleral (COE), cujo diagnóstico foi dado pelo exame histopatológico. O coristoma ósseo episcleral é tipo raro de coristoma, em geral localizado no quadrante temporal superior, sendo formado por tecido ósseo maduro.