RESUMEN

Histológicamente la corteza del cerebelo humano adulto presenta tres capas constitutivas; la capa molecular, la hilera de los cuerpos de las células de Purkinje y la capa granulosa interna. La sustancia cortical del cerebelo de los embriones de mamífero, así como la de los jóvenes, muestran una capa granular externa. Nuestro objetivo es documentar las diferencias morfológicas entre las capas de la corteza cerebelosa adulta y joven. Se realizaron estudios morfométricos microscópicos en 20 cerebelos de autopsias. Los casos se dividieron en dos grupos, adultos y niños menores de 1 año. Se realizaron cortes en parafina, coloreados con hematoxilina y eosina. La corteza del cerebelo adulto presentó diferencias morfológicas con la de los recién nacidos. En el cerebelo adulto presenta tres capas constitutivas, mientras que en el recién nacido presenta una cuarta capa, la granulosa externa...

Histologically, the adult human cerebellar cortex has three constituent layers, the molecular layer, the row of bodies of Purkinje cells and internal granular layer. The cortex of the cerebellum of mammalian embryos, as well as youth, show external granular layer. Our goal is to document morphological differences between the layers of the cerebellar cortex adult and young. Microscopic morphometric studies were performed in 20 cerebellum autopsied. The cases were divided into two groups, adults and children under 1 year. Paraffin sections were performed, stained with hematoxylin and eosin. The cortex of adult cerebellum showed morphological differences of the newborn. In the adult cerebellum has three constituent layers, whereas in the newborn has a fourth layer, the external granular...

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Skin tissue from patients with Psoriasis was analyzed using HROM (High Resolution Optical Microscopy), studying epithelial differentiation and possible structural alterations of the queratinocytes. The samples were taken from 10 patients with histopathologic diagnosis of Psoriasis. This tissue samples where affixed with glutaraldehide buffer-collidine for 48 hours. Later processed with the HROM technique and colored with toluidine blue, metilene blue, basic Fuscine, and silver metenamine. The basal epithelial elements presented ovoid nucleus and most of them had prominent nucleolus. In 7 of the studied cases, the granulose stratus was absent, and thinner in the rest, with nucleus and nucleolus retention. At this level queratinocytes where observed with perinuclear anfofilia, as well as linfocitic and macrophagic infiltrate and union complex where elongated.

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La Psoriais se caracteriza por incremento del ciclo celular a nivel epidérmico, evidenciado a nivel histopatológico por un intensa hiperparaqueratosis, acantosis, papilomatosis e inflamación crónica. Materiales y métodos: Se estudió con microscopia óptica de alta resolución (MOAR), la epidermis de pacientes portadores de Psoriasis, analizando, la diferenciación epitelial y las posibelas alteraciones estructurales de los queratinocitos. Resultados: Los especímenes correspondieron a 10 pacientes con diagnóstico clínico e histopatológico de psoriasis. Las biopsias de piel fueron fijadas en solución de glutaraldehido buffer-collidina durante 48hs, procesados con la técnica para MOAR y coloreados con azul de toluidina, azul de metileno, fuscina básica y metenamina-plata. Los elementos epiteliales basales presentaban núcleos ovoideos, varios de ellos con nucleólos prominentes. En 7 de los casos estudiados el estrato granuloso estuvo ausente y en los 3 casos restantes observamos retención de núcleos y nucleólos. Conclusiones: Seobservaron queratinocitos con anfofilia e infiltrado linfocitario y de macrofagos.

Skin tissue from patients with Psoriasis was analyzed using HROM (High Resolution Optical Microscopy), studying epithelial differentiation and possible structural alterations of the queratinocytes. The samples were taken from 10 patients with histopathologic diagnosis of Psoriasis. This tissue samples where affixed with glutaraldehide buffer-collidine for 48 hours. Later processed with the HROM technique and colored with toluidine blue, metilene blue, basic Fuscine, and silver metenamine. The basal epithelial elements presented ovoid nucleus and most of them had prominent nucleolus. In 7 of the studied cases, the granulose stratus was absent, and thinner in the rest, with nucleus and nucleolus retention. At this level queratinocytes where observed with perinuclear anfofilia, as well as linfocitic and macrophagic infiltrate and union complex where elongated.

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Brown tumor (BT) is an uncommon condition that represents the terminal stage of the cystic osteitis fibrosa and have been increasingly reported in hyperparathyroidism secondary to renal failure, due to the increase of survival in patient with hemodialysis. The fine needle aspiration diagnosis is of great importance in the recognition of the BT, although it can be difficult to distinguish it of lesions as the aneurysmal bone cyst and giant-cell tumor. We describe the case of 20-year-old female with chronic renal failure undergoing hemodialysis during six years. Both x-rays and computer tomography revealed a tumor in head of right humerus and lytic images in scapula of the same side, clavicles and ribs. The patient was subjected to a fine needle aspiration biopsy of the tumor of humerus head and the sample was processed with the habitual technique of inclusion in paraffin and stained with hematoxilina and eosina. Histological preparations showed several multinucleate giant cells and spindly or fibrillary cells, feature that was pointed out as compatible, in a context of secondary hyperparathyroidism to chronic renal failure, with a BT. We consider that the radiological and tomographyc finds, besides the history of chronic renal failure with a long history of hemodialysis, were enough to link, with great approach, the histopathology with the diagnosis of BT.

El tumor pardo (TP) es una condición infrecuente que representa la fase terminal de la osteítis fibrosa quistica, habiéndose incrementado los reportes de tumores pardos en hiperparatiroidismos secundarios a falla renal. debido al aumento de supervivencia en pacientes dializados. El diagnóstico por aspiración con aguja fina es de gran importancia en el reconocimiento del TP. aunque puede ser dificil distinguirlo de lesiones como el quiste óseo aneurismático y el tumor de células gigantes. Presentamos el caso de una mujer de 20 años con insuficiencia renal crónica dializada durante seis años. que mostraba, con la tomografia computada y radiografia, un tumor en cabeza de húmero derecho e imágenes osteolíticas en homóplato homolateral, clavícula y costillas. Se realizó una biopsia por punción de la tumor ación de cabeza de húmero y la muestra fue procesada con la técnica habitual de inclusión en parafina y tinción con hematoxilina y eosina. Los preparados histológicos mostraron tejido constituido por abundantes células fusiformes y numerosas células gigantes multinucleadas, cuadro histopatológico que se señaló como compatible, en un contexto de hiperparatiroidismo secundario a insuficiencia renal crónica, con un TP.

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RESUMEN

Brown tumor (BT) is an uncommon condition that represents the terminal stage of the cystic osteitis fibrosa and have been increasingly reported in hyperparathyroidism secondary to renal failure, due to the increase of survival in patient with hemodialysis. The fine needle aspiration diagnosis is of great importance in the recognition of the BT, although it can be difficult to distinguish it of lesions as the aneurysmal bone cyst and giant-cell tumor. We describe the case of 20-year-old female with chronic renal failure undergoing hemodialysis during six years. Both x-rays and computer tomography revealed a tumor in head of right humerus and lytic images in scapula of the same side, clavicles and ribs. The patient was subjected to a fine needle aspiration biopsy of the tumor of humerus head and the sample was processed with the habitual technique of inclusion in paraffin and stained with hematoxilina and eosina. Histological preparations showed several multinucleate giant cells and spindly or fibrillary cells, feature that was pointed out as compatible, in a context of secondary hyperparathyroidism to chronic renal failure, with a BT. We consider that the radiological and tomographyc finds, besides the history of chronic renal failure with a long history of hemodialysis, were enough to link, with great approach, the histopathology with the diagnosis of BT.(AU)

El tumor pardo (TP) es una condición infrecuente que representa la fase terminal de la osteítis fibrosa quistica, habiéndose incrementado los reportes de tumores pardos en hiperparatiroidismos secundarios a falla renal. debido al aumento de supervivencia en pacientes dializados. El diagnóstico por aspiración con aguja fina es de gran importancia en el reconocimiento del TP. aunque puede ser dificil distinguirlo de lesiones como el quiste óseo aneurismático y el tumor de células gigantes. Presentamos el caso de una mujer de 20 años con insuficiencia renal crónica dializada durante seis años. que mostraba, con la tomografia computada y radiografia, un tumor en cabeza de húmero derecho e imágenes osteolíticas en homóplato homolateral, clavícula y costillas. Se realizó una biopsia por punción de la tumor ación de cabeza de húmero y la muestra fue procesada con la técnica habitual de inclusión en parafina y tinción con hematoxilina y eosina. Los preparados histológicos mostraron tejido constituido por abundantes células fusiformes y numerosas células gigantes multinucleadas, cuadro histopatológico que se señaló como compatible, en un contexto de hiperparatiroidismo secundario a insuficiencia renal crónica, con un TP.(AU)

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Fine needle aspiration (PAAF) of thyroid it has demonstrated to be highly sensitive and specific to establish a diagnosis and to implement the corresponding treatment, these qualities are increased when the guide ecográfica is used: fine needle aspiration of thyroid with ultrasonography guide (PAEAFT). 139 cases of PAEAFT are presented of whose material was carried out extended conventional and thin according to specific technique and they were colored with Haematoxylin and eosin (H & E)--Tint 15 (DIFF-QUIK) and Papanicolaou; analyzing their distribution for sex, age, topography, characteristic of nodules and cytologic diagnoses. The presumptive diagnoses corresponded to: Multinodular Goiter (21.58%)--Hashimoto's thyroiditis (2.87%)--Follicular neoplasm: Under degree (I-II): (57.57%), High degree (III): 2.15%--Hürthle cell tumors (2.87%)--Papilary carcinoma (4.32%). The prevalence corresponded to the female sex (93.52%). The pursuit of the patients was carried out based on the proposed algorithm, modified of that of Gharib, 1997.

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RESUMEN

Fine needle aspiration (PAAF) of thyroid it has demonstrated to be highly sensitive and specific to establish a diagnosis and to implement the corresponding treatment, these qualities are increased when the guide ecográfica is used: fine needle aspiration of thyroid with ultrasonography guide (PAEAFT). 139 cases of PAEAFT are presented of whose material was carried out extended conventional and thin according to specific technique and they were colored with Haematoxylin and eosin (H & E)--Tint 15 (DIFF-QUIK) and Papanicolaou; analyzing their distribution for sex, age, topography, characteristic of nodules and cytologic diagnoses. The presumptive diagnoses corresponded to: Multinodular Goiter (21.58

)--Hashimotos thyroiditis (2.87

)--Follicular neoplasm: Under degree (I-II): (57.57

), High degree (III): 2.15

--H³rthle cell tumors (2.87

)--Papilary carcinoma (4.32

). The prevalence corresponded to the female sex (93.52

). The pursuit of the patients was carried out based on the proposed algorithm, modified of that of Gharib, 1997.

RESUMEN

We describe a case of heterotopic mesenteric ossification presented in a 25 year-old male who underwent laparotomy for a fire-gun injury. Two weeks later he experienced small bowel obstruction and for this reason he has been operated five times with removal of segments of small bowel. Now, nine months later, he needs ileostomy to avoid another obstruction.

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Cartilage is a specialized connective tissue. It contains few cells into an extracell matrix. The matrix mainly constituents are collagen and proteoglycans. Its degradation depends on synoviocytes activity, that secrete metalloproteases, agents to proteoglycans catabolism. There are two types of synoviocytes: macrophagics (type "A:') and fibroblastics (type "B"). The proteoglycan destruction can be LT-dependent or LT-independent. The aim of this work is synoviocytes function ex vívo study, free immune system influence. In order to do it, heparinized synovial fluid samples were obtained from 6 osteoarthritic (OA) and 6 arthritic (RA) both sex untreated patients, diagnosed according ACR criteria, which disease duration was longer than 6 months. Patients average age was 70 +/- 2 years. Control samples were synovial fluid from traumatic arthritis or non inflammatory bone-muscle pathology. Synovial fluid was centifugated at 1500 g for 30 minutes to isolate synoviocytes. Sediment containing cells was 6 hs incubed with Dulbecco-Eagles media, that has HEPES Gibco (26 mM); NaHCO3 (0.5 g/I); glutamine (2 mM), streptomicine (100 mg/l), G-penicillin (1 U/ml); anphotericine B (2.5 mg/l). Cells calification and viability were cytopathologically determined. Before and after incubation, collagenase activity was measured by ELISA-double-sandwich, using 10 micrograms/ml monoclonal anti-MMPs in phosphate-buffer-saline. The antigen-antibody complex production with inespecific proteins was blocked by bovine seric albumine. Streptavidin peroxidase was added and washed with 2,2,azin,di(3-ethyl-benztazoilinsuiphonic) acid to develop color. The link of labeled antibody by absorbance at 410 nm was determined in ELISA-spectrophothometer. RA patients earlier MMPs synoviocytes production was 1373 +/- 115 ng/ml. Then 6 hs incubation 2143 +/- 132 ng/ml was reached. The increase (56%) had high significance (p < 0.0001). OA earlier MMPs cells production was 276 +/- 23 ng/ml, but after incubation it reached 542 +/- 47 ng/ml. (96% increased with highly significativa difference too: p < 0.0001). Microscopic study was carried out before and after incubation, and shows a lot of synoviocytes with plenty of cytopiasme when the collagenase leveis were highest. On the contrary, when low MMPs production by synovial fluid, as no incubated osteoarthritic material, a few cells containing picnotics nucleous were observed. Significant quantitative differences in AR and OA enzymatic secretion were observed. Although in rheumatoid arthritic MMPs leveis synoviocytes production were 4.6 times than OA levels, after 6 hs incubation percentage of increase in OA cells secretion was highest. Described results confirm MMP-1 synthesis by synoviocytes, and these levels correlate with inflammation, more pronounced in acute (RA) than chronic pathology (OA). Synoviocyte incubation let us to test disease changes in synovial fluid according to cells number and phagocytic activity. Authors agree to assert that synovial fluid may reflect what is happening in an articular cartilago, because SF provides markers of joint disease. MMPs are giving information about pathways involved in OA and RA cartilage degradation.

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Cartilage is a specialized connective tissue. It contains few cells into an extracell matrix. The matrix mainly constituents are collagen and proteoglycans. Its degradation depends on synoviocytes activity, that secrete metalloproteases, agents to proteoglycans catabolism. There are two types of synoviocytes: macrophagics (type [quot ]A:) and fibroblastics (type [quot ]B[quot ]). The proteoglycan destruction can be LT-dependent or LT-independent. The aim of this work is synoviocytes function ex vívo study, free immune system influence. In order to do it, heparinized synovial fluid samples were obtained from 6 osteoarthritic (OA) and 6 arthritic (RA) both sex untreated patients, diagnosed according ACR criteria, which disease duration was longer than 6 months. Patients average age was 70 +/- 2 years. Control samples were synovial fluid from traumatic arthritis or non inflammatory bone-muscle pathology. Synovial fluid was centifugated at 1500 g for 30 minutes to isolate synoviocytes. Sediment containing cells was 6 hs incubed with Dulbecco-Eagles media, that has HEPES Gibco (26 mM); NaHCO3 (0.5 g/I); glutamine (2 mM), streptomicine (100 mg/l), G-penicillin (1 U/ml); anphotericine B (2.5 mg/l). Cells calification and viability were cytopathologically determined. Before and after incubation, collagenase activity was measured by ELISA-double-sandwich, using 10 micrograms/ml monoclonal anti-MMPs in phosphate-buffer-saline. The antigen-antibody complex production with inespecific proteins was blocked by bovine seric albumine. Streptavidin peroxidase was added and washed with 2,2,azin,di(3-ethyl-benztazoilinsuiphonic) acid to develop color. The link of labeled antibody by absorbance at 410 nm was determined in ELISA-spectrophothometer. RA patients earlier MMPs synoviocytes production was 1373 +/- 115 ng/ml. Then 6 hs incubation 2143 +/- 132 ng/ml was reached. The increase (56

) had high significance (p < 0.0001). OA earlier MMPs cells production was 276 +/- 23 ng/ml, but after incubation it reached 542 +/- 47 ng/ml. (96

increased with highly significativa difference too: p < 0.0001). Microscopic study was carried out before and after incubation, and shows a lot of synoviocytes with plenty of cytopiasme when the collagenase leveis were highest. On the contrary, when low MMPs production by synovial fluid, as no incubated osteoarthritic material, a few cells containing picnotics nucleous were observed. Significant quantitative differences in AR and OA enzymatic secretion were observed. Although in rheumatoid arthritic MMPs leveis synoviocytes production were 4.6 times than OA levels, after 6 hs incubation percentage of increase in OA cells secretion was highest. Described results confirm MMP-1 synthesis by synoviocytes, and these levels correlate with inflammation, more pronounced in acute (RA) than chronic pathology (OA). Synoviocyte incubation let us to test disease changes in synovial fluid according to cells number and phagocytic activity. Authors agree to assert that synovial fluid may reflect what is happening in an articular cartilago, because SF provides markers of joint disease. MMPs are giving information about pathways involved in OA and RA cartilage degradation.

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Ultrasonography and dynamic tomography are used in the study of acute pancreatitis, thus helping to interpret the diverse anatomophysiopathologic variables. We present 41 patients studied by ultrasonography, on admission and twenty-four hours later or more. After seventy-two hours, a dynamic tomography was performed. We did a clinicotomographic correlation assessing necrosis, and multiple Ranson criteria, being complemented with the anatomopathologic study of specimens both in the complications and in the elective biliary surgery. There were three puncture aspirates for bacteriology. Eight (19.5%) patients developed local complications and four (9.75%) presented organ failure. Ultrasonography showed biliopancreatic hypertension in 45% of cases of biliary pancreatitis and was reversible in nature. Dynamic tomography was important in defining morphology and pancreatic necrotic involvement. There were two patients with intrapancreatic necrosis, six with intra and extrapancreatic necrosis and eleven patients who presents a dissemination of the process into the extrapancreatic tissues. The prevalence of glandular necrosis was 24%. Both, ultrasonography and dynamic tomography allowed to the identify a spectrum of lesions representative of cavitated extrapancreatic necrosis and enzymatic pericholecystitis. Likewise, they contributed to define medical treatment as well as indications, opportunities and approaches in the surgical and/or percutaneous treatment of septic complications.

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Our purpose is to report two cases of fibromatosis in two women of 34 and 48 years old respectively that clinically appeared as a invasive breast carcinoma, particularly for the cutaneous retraction they showed. The histopathological diagnosis was done based on specimens studied with the common technique of paraffin embedding and Hematoxilin & Eosin staining. Both patients had firm poorly demarcated nodules with the histopathological pattern of classic fibromatosis. Mammary fibromatosis is an infrequent relapsing entity, not suspected in differential clinical diagnoses. The pathologist should bear it in mind, especially in frozen biopsies.

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Ultrasonography and dynamic tomography are used in the study of acute pancreatitis, thus helping to interpret the diverse anatomophysiopathologic variables. We present 41 patients studied by ultrasonography, on admission and twenty-four hours later or more. After seventy-two hours, a dynamic tomography was performed. We did a clinicotomographic correlation assessing necrosis, and multiple Ranson criteria, being complemented with the anatomopathologic study of specimens both in the complications and in the elective biliary surgery. There were three puncture aspirates for bacteriology. Eight (19.5

) patients developed local complications and four (9.75

) presented organ failure. Ultrasonography showed biliopancreatic hypertension in 45

of cases of biliary pancreatitis and was reversible in nature. Dynamic tomography was important in defining morphology and pancreatic necrotic involvement. There were two patients with intrapancreatic necrosis, six with intra and extrapancreatic necrosis and eleven patients who presents a dissemination of the process into the extrapancreatic tissues. The prevalence of glandular necrosis was 24

. Both, ultrasonography and dynamic tomography allowed to the identify a spectrum of lesions representative of cavitated extrapancreatic necrosis and enzymatic pericholecystitis. Likewise, they contributed to define medical treatment as well as indications, opportunities and approaches in the surgical and/or percutaneous treatment of septic complications.

RESUMEN

Our purpose is to report two cases of fibromatosis in two women of 34 and 48 years old respectively that clinically appeared as a invasive breast carcinoma, particularly for the cutaneous retraction they showed. The histopathological diagnosis was done based on specimens studied with the common technique of paraffin embedding and Hematoxilin & Eosin staining. Both patients had firm poorly demarcated nodules with the histopathological pattern of classic fibromatosis. Mammary fibromatosis is an infrequent relapsing entity, not suspected in differential clinical diagnoses. The pathologist should bear it in mind, especially in frozen biopsies.

RESUMEN

We present here a case of localised primary amyloidosis of the right inguinal lymph node in a 42 year old female. On gross examination the specimen was 4.0 x 4.0 x 3.2 cm in size with a tan-pink color and two whitish-yellow areas of hard consistency. Histologically the lymph node was replaced by an eosinophilic amorphous material, alkaline Congo red, crystal violet, thioflavine T and sodium sulphate-alcian blue (SAB). We observed areas of mature bone metaplasia alternating with sheets of plasma cells and clusters of foreign body giant cell reaction. Immunohistochemical study showed anti-lambda chain staining within the amorphous material. The negative clinical history, physical examination, normal serum electrophoresis and bone marrow and rectal biopsy allowed us to make the diagnosis of localised primary amyloidosis of lymph node. The patient is alive and without evidence of disease progression to systemic amyloidosis or plasma cell dyscrasia, after clinical follow-up of seven years.

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The microcystic serous cystadenoma of pancreas or glycogen "rich" cystadenoma is a rare entity. We studied five case of this cystadenoma in adult patients ages 47-68 (58 was the mean), four of which were women (80%). The clinical presentation was varied. There was a prevalence of expansive manifestations with epigastric pain in three patients, and extrahepatic bile duct obstruction in other two. A distal tumour was revealed by the diagnostic methodology used (ultrasound and TAC) in three patients, and cephalic tumour in two, with a mean size of 8.8 cm. in diameter. A distal pancreatectomy was performed in two patients, a cephalic pancreatoduodenectomy was performed in one in relation with the presence of extrahepatic bile duct carcinoma, and the other two were treated with a partial cephalic pancreatectomy (enucleation). The nosological diagnose was post-surgical in all case of study. A prognosis for every case was dependent of the associated pathology.

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We present 23 cases of latent thyroid carcinoma which were examined in 356 surgical specimens (incidence: 6.4%), having found a sclerosing variant predominance. Of the total cases that were under study, twenty of them belonged to women (86%), and three to men (14%). Due to the fact that the concepts of latent thyroid carcinoma and occult thyroid carcinoma are often misused as synonyms, regarding both pathologies, we have carefully examined the available literature and therefore, we have made a critic analysis of both entities. We also made a detailed microscopic study of the surgical specimens and included a slice for histopathologic examination, which was evaluated every 5 g of tissue. The purpose of this last study responded to our consideration on the real incidence of latent thyroid carcinoma, which cannot be found in routine studies.

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We report on three patients (28, 55 and 87 years old) with autoimmune granulomatous orchitis (AGO). Of a total of 182 surgical specimens examined, AGO accounted 1.64%. Clinically, it can be misdiagnosed as tuberculosis or tumor of the testis since most patients have a previous history of trauma, respectively. With respect to its pathogenesis, the lipid fraction of spermatozoa may be responsible for its characteristic granulomatous pattern.

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A case is presented of caecal appendix with birdshots, in a 38 years-old male patient, with a clinical picture of biliary pathology. An elongated and "heavy" caecal appendix was palpated during cholecystectomy and removed. The pathological study showed the presence of 99 ammunitions or lead birdshots in the appendicular lumen, with a diameter of 1-5 mm, without histologic evidence of active appendicitis. The patient was fond of hunting wild animals and is used to eat them pickled. Pertinent literature is revised and works are commented in relation to the incidence of different foreign bodies in the appendix lumen, clinical picture and complications.

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We report a case of right-sided parafunicular hemangiopericytoma in a 72-year-old patient with unilateral cryptorchidism. We describe the outstanding histologic features of this uncommon tumor which permit making a differential diagnosis from other neoplasms.

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