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OBJECTIVES: Currently, two premalignant lesions have been recognized: prostatic intraepithelial neoplasia (PIN) and atypical adenomatous hyperplasia (AAH). Due to the possible clinical implications of these lesions, we attempted to determine their incidence in specimens of benign prostatic hyperplasia (BPH), the most frequent pathology of the prostate. METHODS: A pathological and immunohistochemical study using several markers was performed to detect premalignant lesions in 156 specimens obtained by adenomectomy and TUR from 1990 to 1992. RESULTS: 20 PIN and 8 AAH (20.6%) were found. There were other equivocal prostatic lesions, not only with respect to premalignant lesions but prostatic carcinoma as well. CONCLUSIONS: Premalignant lesions within BPH nodules are frequent (20.6%). Furthermore, other lesions were also found that caused difficulty in making the differential diagnosis.

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We present an endometrial Müllerian adenosarcoma in which the sarcomatous component showed prominent nests of foamy cells that accounted for 50% of the neoplastic mesenchyma. Such foamy cells showed occasional cytological atypias and immunohistochemical features of histiocytic (macrophagic differentiation in the absence of changes that could substantiate the presence of an inflammatory infiltration of foamy histiocytes. These facts suggest histiocytic differentiation from neoplastic mesenchymal cells. Such differentiation has been reported in association with malignant mixed mesodermal tumor, but not in Müllerian adenosarcoma.

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Renal Acquired Cystic Disease (RACD) is a frequent entity in patients with a long standing renal failure under hemodialysis treatment. Incidence of a tumor pathology is higher in those patients than in the general population. A new case is presented and some possible etiopathologenical factors of RACD and neoplasias on such pathology are established.

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We present a case of pure testicle choriocarcinoma in a 13-year-old male. Its first clinical manifestation consisted in a pattern of acute dyspnea caused by multiple pulmonary metastases. Alphafetoprotein investigation in serum and tissue proved negative. We carry out an immunohistochemical study of the case and discuss its histogenesis current classification and prognostic significance.

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The immunohistochemical determination of immunoglobulins IgA, IgG and IgM in axillary lymph nodes from 50 unselected breast ductal carcinomas disclosed that lymph nodes with IgG-positive lymphoid follicles and/or metastasized lymph nodes with IgM-positive lymphoid cells are statistically related to breast tumors with a high histologic grade and more than 3 lymph node metastases.

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In fifty non selected ductal carcinomas of the breast we found that a marked tumoral inflammatory infiltrate (P less than 0.025), perinodal tumoral infiltrate (P less than 0.01), sinus catarrh (P less than 0.05), follicular hyperplasia (P less than 0.025), mixed pattern in lymph nodes (P less than 0.01) and with 54 years of age or younger (P less than 0.01) correlated significantly with lymph node metastases and/or high histologic grade. On the contrary, elastosis (P less than 0.05), scanty or absent inflammatory infiltrate (P less than 0.01), sinus histiocytosis (P less than 0.001) and endothelial hyperplasia were statistically related to low histologic grade and/or lack of metastases. Elastosis is considered a defensive host response. Groups of lymphocytes in the perinodal fat is usually found in metastasized lymph nodes and may indicate metastasis should be sought in a lymph node which otherwise seems to be tumor-free.

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Human yolk sac carcinomas have been studied only twice with the electron microscope, and have never been compared at this level with normal human yolk sac. In the present study, the ultrastructural features of three primary ovarian yolk sac carcinomas, omental metastases from one of these, and a primary retroperitoneal yolk sac carcinoma in a male are reported, as are the ultrastructural findings in human yolk sac from normal 7- and 12-week gestations. The most prominent feature of the tumors is the presence of voluminous basement membrane material (the nature of which is confirmed by indirect enzyme-labeled antibody technique in one case) in both intra-and extracellular location, corresponding to the PAS-positive hyaline globules seen in these tumors by light microscopy. The tumor cells are also demonstrated to produce this material in tussue culture. Although basement membrane has not been described previously in normal human yolk sac at 8 and 10 weeks' gestation, it was present in the 7-week specimen which we studied, suggesting that its production may be a feature of only very young sac. Other ultrastructural findings are also similar in human yolk sac carcinoma, normal human yolk sac, and rodent yolk sac and yolk sac carcinomas. Thus, these studies confirm the suggested germ cell-derived yolk sac origin of the human tumor.

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