Francisco Tresserra

A 22-year-old woman patient, diagnosed with an inclusion cyst of the conjunctiva in the nasal sector of the left eye, who after 2 shot/needle injections in the lesion came to our clinic with a dense subconjunctival hemorrhage in four quadrants and with severe pain. After excision biopsy, a capillary hemangioma of the conjunctiva was diagnosed. Conjunctival capillary hemangioma is mainly a benign lesion, asymptomatic and mostly congenital in origin, its progression or de novo growth is rare in adulthood.

Peripheral benzodiazepine receptors have been evidenced in human normal prostate and prostatic nodular hyperplasia using [3H]Ro 5-4864 and [3H]PK 11195. Binding of both radioligands was found to be saturable. In normal and pathologic tissues, Scatchard analysis revealed a single population of binding sites. KD values of [3H]PK 11195 in normal and hyperplastic prostates were 14.6 +/- 5.6 and 12 +/- 2.42 nmol/l with Bmax of 12,155 +/- 1,328 and 13,924 +/- 2,454 fmol/mg protein, respectively. Using [3H]Ro 5-4864, the value of Bmax was similar (13,630 +/- 1,878 fmol/mg protein), but its affinity was 15 times lower when compared to [3H]PK 11195. Human prostatic nodular hyperplasia is not associated with a change in the density of peripheral benzodiazepine receptors.

To study the ocular surface changes following laser assisted in situ keratomileusis (LASIK). Prospective study of pre and post-LASIK impression cytology in two sites of the conjunctival epithelium of 12 eyes from 6 patients. The samples were studied for changes in cellularity, cell size, nucleus size, nucleus-cytoplasm ratio, number of goblet cells, PAS positivity and number of inflammatory cells. All the samples except two, showed pathological changes like a decrease in nuclear size, increase in cytoplasm, change in nucleus-cytoplasm ratio, a significant decrease in goblet cell density and certain degree of squamous metaplasia. One month following LASIK we observed histopathologic changes in the perilimbal conjunctiva, mainly a decrease in the number of goblet cells and different grades of squamous metaplasia.

Tumors of the parotid are the most frequently encountered salivary gland tumors. Knowledge of the histology and anatomy of the salivary gland is important when considering the histiogenesis of salivary gland tumors, requiring close cooperation between the pathologist and the surgeon. Most tumors are benign epithelial formations. Pleomorphous adenomas predominate. Superficial lobectomy is adequate treatment. When the tumor involves a deep lobe, total parotidectomy is indicated. Treatment of malignant tumors depends on the histology, its TNM stage and other factors. Total parotidectomy with lymphadectomy and radiotherapy are needed in case of high grade malignancy. In children, vascular neoplasias are the most frequent, followed by malignant tumors. Their histological features and treatment are the same as for adults.

Recent trials have shown that duodenal ulcers treated by H2-blockers heal faster if Helicobacter pylori is eradicated concurrently. To evaluate the efficacy of a short treatment regimen in H. pylori eradication and ulcer healing and to assess the impact of colloidal bismuth subnitrate (CBS) in H. pylori eradication rate. Sixty-one patients with H. pylori-associated duodenal ulcer were randomized in two short treatment groups. Group A patients (31) were given omeprazole 20 mg b.i.d. x 8 days. Clarithromycin (500 mg, b.i.d.) and CBS (120 mg, q.i.d.) were added 24 h after starting omeprazole and were given for 7 days. Group B patients (30) were treated as group A patients but without CBS. Endoscopies were performed at entry and 4 wk after the end of treatment. Presence of H. pylori was assessed at each endoscopy by urease test, and biopsy specimens were examined for histological evidence of gastritis and by Gram stain and culture for H. pylori infection. No patient received follow-up t...

Three to five percent of patients treated with injectable collagen implants have adverse local reactions. Systemic signs or symptoms are infrequent. We describe the case of a 53-year-old woman who developed local and general complaints 2 months after receiving two collagen injections in both nasolabial folds. She presented asthenia, malaise, polyarthralgia and inflammatory nodular panniculitis in the places of injection as well as on the forearms and lower extremities. Skin testing was compatible with hypersensitivity to collagen. This case raises the question as to whether the injection of animal-derived collagen induces manifestations similar to those observed in connective autoimmune diseases or human adjuvant disease.

To establish the ultrasonographic (US) characteristics of benign versus metastatic lymph nodes. One hundred fifty-eight axillary lymph nodes in 40 patients (age range, 31-73 years) surgically treated for breast cancer have been studied in vitro with a 7.5-MHz US probe in a water bath. The long-to-short axis ratio and the hilar and cortical characteristics were evaluated; the US findings were correlated with the histopathologic findings. To estimate the long-to-short axis ratio, all lymph nodes were measured. Of the 158 lymph nodes, 45 showed histopathologic evidence of metastasis; 38 of the 45 revealed US signs of malignancy. The signs that caused malignancy to be suspected were a long-to-short axis ratio of less than 1.5, absence of a hilus, and disruption of the cortical zone. The most specific sign for the diagnosis of metastasis was absence of the hilus. The increase in the long-to-short axis ratio was the finding that caused the most false-negative interpretations. Signs of mal...

Extrabronchial small cell carcinoma (ESCC) is an infrequent tumor with controversial histogenesis, clinical evolution and therapeutic strategy. The aim of this study was to know the immunohistochemical features and the clinical evolution of patients diagnosed of ESCC during a 10 year period. All the diagnoses of small cell carcinoma (bronchial and extrabronchial) carried out by the Unit of Pathology between 1980-1989 were reviewed. In all the ESCC an immunohistochemical study was performed with three neuroendocrine markers, chromogranin, neurospecific enolase and synaptophysin. The clinical evolution of the patients is described. The 6 patients with ESCC represented 4.7% of all the small cell carcinomas. The primary localization was: parotid, urinary bladder, the skin, maxillary sinus and esophagus (2 patients). In five cases positivity was observed for one or more of the neuroendocrine markers. In two cases the ESCC was associated with differentiated cell populations (squamous carc...

ABSTRACT IntroductionDiffuse uterine leiomyomatosis is a rare entity that increases uterine size.Cases descriptionThe clinicopathologic features of five cases are reviewed. The most frequent symptom was uterine bleeding. Three of the patients had children and two of them had a past history of abortion. In three patients, subtotal hysterectomy was performed. In the remaining two, partial resection was carried out as the patients wished to preserve fertility.Conclusion Diffuse uterine leiomyomatosis is a benign lesion that can affect patients’ fertility or complicate delivery.

Accurate presurgical assessment of tumor size in breast cancer is important for choosing appropriate treatment. We retrospectively compared presurgical sonographic measurements of tumor size with postsurgical measurements of size and other variables. In 174 cases, tumor size was measured by sonography before surgery, and those measurements were compared with values obtained by histopathologic examination of the specimens. The histologic type and grade, the number of lesions, and the presence of an extensive intraductal component also were considered in the intramodal correlations of tumor size. Sonographic measurements of tumor size correlated well with size measured after surgery (r = 0.72; 95% confidence interval, 0.64-0.78). The correlation was higher for lesions of 20 mm or less in their longest diameter than for larger lesions. The intramodal size correlation was lower for tumors with an extensive intraductal component than for tumors without an extensive intraductal component. The sonographic versus pathologic correlation of tumor size was less accurate when several lesions were present. Sonography is useful for presurgical assessment of tumor size in patients with breast cancer, especially for single lesions of 20 mm or less and without an extensive intraductal component.