RESUMEN

Hemorrhagic pilocytic astrocytomas (PAs) are rare, accounting for 1.1%-8.0% of all PA cases. They are reported to occur more frequently in older populations, with a male predominance. In this study, we report a case of a 14-year-old boy who presented with a headache, vertigo, and diplopia. As per his brain computed tomography scan, a small hematoma was observed in the left inferior cerebellar peduncle. Follow-up magnetic resonance imaging (MRI) revealed repeated minor bleeding from the lesion and mild expansion, with no neurological deficits. Four years later, the patient developed nausea, vomiting, and left abducens palsy. MRI revealed a mulberry-shaped mass surrounded by a hypointense rim, suggesting a cavernous angioma. The lesion was surgically resected via midline occipital craniotomy with the opening of the cerebellomedullary fissure. Histopathological examination of the lesion revealed PA. Next-generation sequencing analyses revealed that PAs harbored mutations in the ARID1A, ATM, and POLE genes but not in the BRAF gene. To the best of our knowledge, there are yet no reported studies on these mutations in PAs to date. Thus, PA should be considered in the differential diagnosis of cerebellar hemorrhage, especially in young adults and children．.

RESUMEN

BACKGROUND: Although a few cases of accessory breast cancer (ABC) have been reported, most were in the axillary region. We encountered an extremely rare case of ABC in the inframammary region (IMR). CASE PRESENTATION: The patient was a 68-year-old postmenopausal woman who had noticed a congenital accessory nipple in her left IMR with slight, occasional discharge 20 years ago. Recently, she noticed a mass under the accessory nipple and visited a nearby clinic; fine-needle aspiration cytology of the mass revealed that it was malignant. She presented to our department 2 weeks after she had noticed the mass. Physical and imaging examinations showed an irregular tumor mass 1.7 × 1.4 × 1.0 cm in size connected to the accessory nipple beneath the left normal breast. Neither distant metastasis nor lymph node swelling was observed. Ultrasound-guided core needle biopsy revealed the mass to be invasive ductal carcinoma. We diagnosed her tumor as ABC in the left IMR; cT1cN0M0: stage IA. Curative wide resection with sentinel node biopsy was performed. Intraoperative evaluation of the frozen section revealed a hot and green ipsilateral axillary lymph node that was free from carcinoma; therefore, nodal dissection was avoided. Histopathological examination including immunochemical staining revealed that the tumor was invasive ductal carcinoma arising from the accessory breast tissue, scirrhous type, 1.7 × 1.4 × 1.0 cm in size, with a solid intraductal component. There was no lymphovascular infiltration, and the surgical margin was 1.5 cm or more. The tumor was estrogen and progesterone receptor-positive, Her2/neu-negative, and had a Ki-67 labeling index of 20%. There was no involvement of the three hot and/or green nodes. The final classification was pT1cN0(sn)M0: stage IA. Letrozole 2.5 mg/day will be administered for 5 years as adjuvant hormonal therapy. CONCLUSIONS: A cutaneous and/or subcutaneous lesion except for proper breast tissue on the milk line, or mammary ridge from axilla to groin may be an accessory breast tissue. Its serial abnormalities must be worried malignant potential to ductal carcinoma which needs some imaging and pathological examinations for definitive diagnosis and appropriate treatment according to the usual orthotopic breast cancer without delay.

Asunto(s)

Histiocitosis Sinusal , Enfermedades del Mediastino , Biopsia , Histiocitosis Sinusal/diagnóstico por imagen , Humanos , Enfermedades del Mediastino/diagnóstico por imagen

RESUMEN

PURPOSE: Despite improvements in neonatal intensive care, the outcomes of extremely-low-birth-weight infants (ELBWIs) with surgical diseases remain to be improved. We started administering enteral miconazole (MCZ) to ELBWIs from 2002 to prevent fungal infection. Since then, the incidence of intestinal perforation has significantly decreased. We investigated this prophylactic effect of MCZ against necrotizing enterocolitis (NEC) and focal intestinal perforation (FIP) and explored a new prophylactic concept against intestinal perforation. METHODS: We designed a historical cohort study to evaluate the effect of MCZ for intestinal perforation in ELBWIs who underwent treatment in our neonatal intensive-care unit between January 1998 and December 2005. We divided these cases into two groups: the Pre-MCZ group and the Post-MCZ group. We compared the morbidity, clinical outcomes and pathological features of NEC and FIP. RESULTS: The rate of intestinal perforation with NEC was significantly reduced after the introduction of MCZ (p = 0.007, odds ratio; 3.782, 95% confidence interval; 1.368-12.08). The pathological findings of NEC specimens showed that the accumulation of inflammatory cells was significantly reduced in the Post-MCZ group when compared with the Pre-MCZ group (p < 0.05). CONCLUSIONS: The efficacy of the enteral administration of MCZ on intestinal perforation with NEC highlights a new prophylactic concept in the clinical management of ELBWIs.

Asunto(s)

Antifúngicos/administración & dosificación , Enterocolitis Necrotizante/complicaciones , Enterocolitis Necrotizante/prevención & control , Recien Nacido con Peso al Nacer Extremadamente Bajo , Perforación Intestinal/complicaciones , Perforación Intestinal/prevención & control , Miconazol/administración & dosificación , Micosis/prevención & control , Administración Oral , Estudios de Cohortes , Femenino , Humanos , Recién Nacido , Masculino , Micosis/etiología , Factores de Tiempo

RESUMEN

Apocrine papillary lesion (APL) is difficult to diagnose as benign or malignant. We experienced an APL remaining in the body for 22 years. We present a case of a 71-year-old woman who had undergone excisional biopsy 22 years previously at the first hospital that she visited. 1 year previously, she had undergone fine-needle aspiration cytology at a second hospital, and the lesion was diagnosed as potentially malignant. She underwent core-needle biopsy at a third hospital, but whether the lesion was benign or malignant could not be definitively diagnosed. We performed right mastectomy and sentinel lymph-node biopsy, because her tumor was suspected to be malignant based on imaging means, and malignancy could not be ruled out on either biopsy or cytology. The histopathological diagnosis was tiny foci of apocrine proliferative lesion with massive hemorrhagic necrosis and no tumor metastasis in two sentinel lymph nodes. Retrospectively, we compared all of the patient's previous specimens with the present ones, and applied the recent pathological diagnostic criteria. Although the biopsy specimen excised 22 years ago suggested an encapsulated apocrine papillary carcinoma or a papilloma with apocrine ductal carcinoma in situ, neither infiltration nor metastasis has occurred. Furthermore, neither the pathological findings nor the clinical behavior has changed over time.

Asunto(s)

Neoplasias de la Mama/patología , Papiloma/patología , Anciano , Biopsia con Aguja Gruesa , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/cirugía , Carcinoma Ductal de Mama/patología , Carcinoma Papilar/patología , Femenino , Humanos , Papiloma/diagnóstico por imagen , Papiloma/cirugía , Biopsia del Ganglio Linfático Centinela

Asunto(s)

Neoplasias Pulmonares/patología , Blastoma Pulmonar/patología , Humanos , Masculino , Persona de Mediana Edad

RESUMEN

PURPOSE: Intestinal perforation (IP) is a fatal complication in extremely low birth weight infants (ELBWI). We started administrating enteral miconazole (MCZ) to ELBWI in 2002. Since then, the incidence of IP has significantly decreased. The aim of this study was to elucidate the prophylactic effect of MCZ for the treatment of neonatal IP, and to establish a new prophylactic concept for this disease. METHODS: In in vivo experiments, the effects of MCZ were examined histopathologically using a mouse model of intestinal ischemia. In in vitro experiments, the cytoprotective effect of MCZ against hypoxia was evaluated using Caco-2 intestinal cells, and its anti-inflammatory potential using a co-culture model of Caco-2 and HL60 cells. RESULTS: MCZ showed a tissue protective effect against intestinal ischemia. MCZ reduced high mobility group-box 1 (HMGB1) release in Caco-2 cells under hypoxic stress and attenuated the potential to activate co-cultured HL60 leukocytes with Caco-2 cells by suppressing interleukin-8 (IL-8). CONCLUSION: MCZ may have preventive roles in the clinical management of IP in ELBWI by the suppression of IL-8 and HMGB-1.

Asunto(s)

Inhibidores del Citocromo P-450 CYP2C9/uso terapéutico , Perforación Intestinal/prevención & control , Miconazol/uso terapéutico , Animales , Células CACO-2/efectos de los fármacos , Inhibidores del Citocromo P-450 CYP2C9/administración & dosificación , Modelos Animales de Enfermedad , Humanos , Intestinos/efectos de los fármacos , Masculino , Ratones , Ratones Endogámicos BALB C , Miconazol/administración & dosificación , Resultado del Tratamiento

RESUMEN

BACKGROUND: Mammary analogue secretory carcinoma (MASC) with an ETS variant gene 6 (ETV6)-neurotrophic tyrosine kinase receptor type 3 (NTRK3) translocation is a newly described type of salivary gland cancer. It is known that overexpression of signal transducer and activator of transcription 5a (STAT5a) occurs in secretory carcinoma of the breast and MASC, and STAT5a expression may be related to the ETV6-NTRK3 translocation. It was hypothesized that phosphorylated signal transducer and activator of transcription 5 (p-STAT5) might be specifically expressed in MASC of the salivary gland. METHODS: The expression of p-STAT5 and mammaglobin (MMG) was examined with immunohistochemistry (IHC)/immunocytochemistry (ICC) in tissue sections from 58 salivary gland cancers (8 MASCs and 50 other salivary gland cancers) and in cytological smears from 17 salivary gland cancers (7 MASCs with paired histologic samples and 10 other salivary gland cancers). RESULTS: p-STAT5 IHC was clearly increased in MASC versus normal salivary gland tissue and other salivary gland cancers. p-STAT5 expression was found in 7 of 8 MASCs (87.5%) and in none of the 50 other salivary gland cancers (0%) by IHC. On cytology, p-STAT5 expression was found in all cases of MASC (7 of 7 or 100%) but in none of the 10 other salivary gland cancers (0%) by ICC. The expression rate of MMG by histology and cytology was higher than that of p-STAT5 in the other salivary gland cancers. CONCLUSIONS: p-STAT5 might be useful as a detection marker of MASC in the differential diagnosis of salivary gland cancers, and initial screening with p-STAT5 IHC/ICC, combined with auxiliary fluorescence in situ hybridization confirmation, is a reliable, economical approach to identifying MASC of the salivary gland.

Asunto(s)

Biomarcadores de Tumor/metabolismo , Carcinoma de Células Acinares/diagnóstico , Carcinoma Mucoepidermoide/diagnóstico , Carcinoma Secretor Análogo al Mamario/diagnóstico , Factor de Transcripción STAT5/metabolismo , Neoplasias de las Glándulas Salivales/diagnóstico , Proteínas Supresoras de Tumor/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/genética , Carcinoma de Células Acinares/genética , Carcinoma de Células Acinares/metabolismo , Carcinoma Mucoepidermoide/genética , Carcinoma Mucoepidermoide/metabolismo , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Reordenamiento Génico , Humanos , Técnicas para Inmunoenzimas , Hibridación Fluorescente in Situ , Mamoglobina A/metabolismo , Carcinoma Secretor Análogo al Mamario/genética , Carcinoma Secretor Análogo al Mamario/metabolismo , Persona de Mediana Edad , Estadificación de Neoplasias , Proteínas de Fusión Oncogénica/genética , Fosforilación , Pronóstico , Estudios Retrospectivos , Factor de Transcripción STAT5/genética , Neoplasias de las Glándulas Salivales/genética , Neoplasias de las Glándulas Salivales/metabolismo , Translocación Genética/genética , Proteínas Supresoras de Tumor/genética , Adulto Joven

RESUMEN

Folate receptors α (FRα) and ß (FRß) are two isoforms of the cell surface glycoprotein that binds folate. The expression of FRα is rare in normal cells and elevated in cancer cells. Thus, FRα-based tumor-targeted therapy has been a focus area of laboratory research and clinical trials. Recently, it was shown that a significant fraction of tumor-associated macrophages expresses FRß and that these cells can enhance tumor growth. Although FRα and FRß share 70% identity in their deduced amino acid sequence, a monoclonal antibody (MAb) reactive with both receptors has not been developed. A MAb that can target both FRα-expressing cancer cells and FRß-expressing tumor-associated macrophages may provide a more potent therapeutic tool for cancer than individual anti-FRα or anti-FRß MAbs. In this study, we developed a MAb that recognizes both FRα and FRß (anti-FRαß). The anti-FRαß specifically stained trophoblasts and macrophages from human placenta, synovial macrophages from rheumatoid arthritis patient, liver macrophages from cynomolgus monkey and common marmoset, and cancer cells and tumor-associated macrophages from ovary and lung carcinomas. Surface plasmon resonance showed that the anti-FRαß bound to soluble forms of the FRα and FRß proteins with high affinity (KD=6.26×10(-9) M and 4.33×10(-9) M, respectively). In vitro functional analysis of the anti-FRαß showed that this MAb mediates complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity, and antibody-dependent cellular phagocytosis of FRα-expressing and FRß-expressing cell lines. The anti-FRαß MAb is a promising therapeutic candidate for cancers in which macrophages promote tumor progression.

Asunto(s)

Anticuerpos Monoclonales/inmunología , Artritis Reumatoide/diagnóstico , Receptor 1 de Folato/inmunología , Receptor 2 de Folato/inmunología , Neoplasias Pulmonares/diagnóstico , Macrófagos/inmunología , Neoplasias Ováricas/diagnóstico , Trofoblastos/inmunología , Animales , Anticuerpos Monoclonales/biosíntesis , Formación de Anticuerpos , Citotoxicidad Celular Dependiente de Anticuerpos , Artritis Reumatoide/inmunología , Células Cultivadas , Femenino , Citometría de Flujo , Humanos , Técnicas para Inmunoenzimas , Neoplasias Pulmonares/inmunología , Macaca fascicularis , Ratones , Neoplasias Ováricas/inmunología , Placenta/inmunología , Embarazo , Ratas , Ratas Wistar , Resonancia por Plasmón de Superficie , Linfocitos T Citotóxicos/inmunología

RESUMEN

We recognized immunoreactivity for the α subset of inhibin and synaptophysin in synovial sarcomas with granular cell features. Histologic findings of 90 cases of synovial sarcoma were reviewed. Two (2.2%) of the 90 cases had granular cell features, showing sheet or nested proliferation of characteristic epithelioid cells with abundant eosinophilic and granular cytoplasm, in addition to the typical spindle cell component. The 2 cases were both female (aged 86 and 76 years). The tumors were located in the foot and the retroperitoneum and measured 3.5 and 14 cm in maximum diameter. Reverse transcriptase polymerase chain reaction analysis revealed SS18-SSX1 transcripts in both cases. SS18 gene rearrangement was detected in granular cells as well as spindle cells by chromogenic in situ hybridization. Immunohistochemistry found the granular cells to be positive for inhibin-α in both cases and for synaptophysin in 1 case, whereas spindle cells were not. Thirty-six cases (20 monophasic fibrous, 11 biphasic, and 5 poorly differentiated synovial sarcomas) were additionally examined for comparison; they showed no immunoreactivity for inhibin-α or synaptophysin. This is the first report of immunoreactivity for inhibin-α and synaptophysin in synovial sarcoma. These immunohistochemical findings might be characteristic of synovial sarcomas with granular cell features.

Asunto(s)

Inhibinas/biosíntesis , Sarcoma Sinovial/metabolismo , Neoplasias de los Tejidos Blandos/metabolismo , Sinaptofisina/biosíntesis , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/metabolismo , Femenino , Humanos , Inmunohistoquímica , Hibridación in Situ , Microscopía Electrónica de Transmisión , Estudios Retrospectivos , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Sarcoma Sinovial/genética , Sarcoma Sinovial/ultraestructura , Neoplasias de los Tejidos Blandos/genética , Neoplasias de los Tejidos Blandos/ultraestructura

RESUMEN

We report a cased of a 68-year-old man with primary T-cell/histiocyte-rich B-cell lymphoma (T/HRBCL) that arose in the trigeminal ganglion. He had a 30-year history of rheumatoid arthritis and presented with progressive left facial pain that had started 3 weeks earlier. Magnetic resonance imaging (MRI) revealed an enhanced mass in the trigeminal ganglion and swelling of the distal part of the trigeminal root. The tumor, subtotally resected via the left anterior petrosal approach, was composed of proliferating CD30- and CD79-positive atypical large polygonal cells with hyperchromatic single or multiple nuclei. CD3-positive small lymphoid cells and CD68-positive histiocytic cells were intermingled with the neoplastic cells. These findings were compatible with T/HRBCL. After whole-brain radiation, his facial pain improved and he was discharged. Postoperatively, he developed transient left sixth nerve paresis. This is the first report of this rare type of B-cell lymphoma arising from the trigeminal ganglion. We posit that his prolonged immunosuppressive treatment for rheumatoid arthritis contributed to its development.

Asunto(s)

Artritis Reumatoide/complicaciones , Neoplasias de los Nervios Craneales/complicaciones , Neoplasias de los Nervios Craneales/patología , Linfoma de Células B/complicaciones , Linfoma de Células B/patología , Ganglio del Trigémino/patología , Anciano , Histiocitos/patología , Humanos , Masculino , Linfocitos T/patología

Asunto(s)

Quemaduras Químicas/cirugía , Huésped Inmunocomprometido , Síndrome Nefrótico/inmunología , Trasplante de Piel/métodos , Cicatrización de Heridas/fisiología , Adolescente , Quemaduras Químicas/diagnóstico , Quemaduras Químicas/inmunología , Estudios de Seguimiento , Supervivencia de Injerto , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Traumatismo Múltiple , Síndrome Nefrótico/diagnóstico , Medición de Riesgo , Factores de Tiempo , Trasplante Autólogo , Trasplante Homólogo

RESUMEN

Computed tomography (CT), performed in a healthy 28-year-old man after minor head injury, detected a frontal base tumor. Neurological examination revealed left hyposmia. On magnetic resonance imaging scans, there was a heterogeneously enhanced tumor located in the left paramedian frontal base with extension into the left ethmoid sinus. Angiography showed a hypervascular mass in the left anterior cranial fossa; it was mainly fed by the left ethmoidal artery. Positron emission tomography scanning showed moderate accumulation of 11-methylmethionine and low accumulation of 18-fluorodeoxyglucose (FDG) at the tumor site. Bone image CT disclosed compressive, nondestructive deformation of the left frontal base. The preoperative diagnosis was olfactory neuroblastoma or meningioma. The tumor was totally resected via bifrontal craniotomy. The tumor was histologically diagnosed as typical schwannoma; it was positive for S-100 protein. We report a rare subfrontal schwannoma with extension into the nasal cavity that mimicked neuroblastoma. Low FDG accumulation and compressive deformation of the anterior skull base may help in the differential diagnosis of these tumors.

RESUMEN

BACKGROUND: Advanced-stage ovarian cancer patients are generally treated with platinum/taxane-based chemotherapy after primary debulking surgery. However, there is a wide range of outcomes for individual patients. Therefore, the clinicopathological factors alone are insufficient for predicting prognosis. Our aim is to identify a progression-free survival (PFS)-related molecular profile for predicting survival of patients with advanced-stage serous ovarian cancer. METHODOLOGY/PRINCIPAL FINDINGS: Advanced-stage serous ovarian cancer tissues from 110 Japanese patients who underwent primary surgery and platinum/taxane-based chemotherapy were profiled using oligonucleotide microarrays. We selected 88 PFS-related genes by a univariate Cox model (p<0.01) and generated the prognostic index based on 88 PFS-related genes after adjustment of regression coefficients of the respective genes by ridge regression Cox model using 10-fold cross-validation. The prognostic index was independently associated with PFS time compared to other clinical factors in multivariate analysis [hazard ratio (HR), 3.72; 95% confidence interval (CI), 2.66-5.43; p<0.0001]. In an external dataset, multivariate analysis revealed that this prognostic index was significantly correlated with PFS time (HR, 1.54; 95% CI, 1.20-1.98; p = 0.0008). Furthermore, the correlation between the prognostic index and overall survival time was confirmed in the two independent external datasets (log rank test, p = 0.0010 and 0.0008). CONCLUSIONS/SIGNIFICANCE: The prognostic ability of our index based on the 88-gene expression profile in ridge regression Cox hazard model was shown to be independent of other clinical factors in predicting cancer prognosis across two distinct datasets. Further study will be necessary to improve predictive accuracy of the prognostic index toward clinical application for evaluation of the risk of recurrence in patients with advanced-stage serous ovarian cancer.

Asunto(s)

Regulación Neoplásica de la Expresión Génica , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/mortalidad , Adulto , Anciano , Anciano de 80 o más Años , Progresión de la Enfermedad , Supervivencia sin Enfermedad , Femenino , Humanos , Japón , Persona de Mediana Edad , Neoplasias Ováricas/genética , Platino (Metal)/administración & dosificación , Pronóstico , Modelos de Riesgos Proporcionales , Taxoides/administración & dosificación , Resultado del Tratamiento

RESUMEN

To elucidate the mechanisms of rapid progression of serous ovarian cancer, gene expression profiles from 43 ovarian cancer tissues comprising eight early stage and 35 advanced stage tissues were carried out using oligonucleotide microarrays of 18,716 genes. By non-negative matrix factorization analysis using 178 genes, which were extracted as stage-specific genes, 35 advanced stage cases were classified into two subclasses with superior (n = 17) and poor (n = 18) outcome evaluated by progression-free survival (log rank test, P = 0.03). Of the 178 stage-specific genes, 112 genes were identified as showing different expression between the two subclasses. Of the 48 genes selected for biological function by gene ontology analysis or Ingenuity Pathway Analysis, five genes (ZEB2, CDH1, LTBP2, COL16A1, and ACTA2) were extracted as candidates for prognostic factors associated with progression-free survival. The relationship between high ZEB2 or low CDH1 expression and shorter progression-free survival was validated by real-time RT-PCR experiments of 37 independent advanced stage cancer samples. ZEB2 expression was negatively correlated with CDH1 expression in advanced stage samples, whereas ZEB2 knockdown in ovarian adenocarcinoma SKOV3 cells resulted in an increase in CDH1 expression. Multivariate analysis showed that high ZEB2 expression was independently associated with poor prognosis. Furthermore, the prognostic effect of E-cadherin encoded by CDH1 was verified using immunohistochemical analysis of an independent advanced stage cancer samples set (n = 74). These findings suggest that the expression of epithelial-mesenchymal transition-related genes such as ZEB2 and CDH1 may play important roles in the invasion process of advanced stage serous ovarian cancer.

Asunto(s)

Cistadenoma Seroso/clasificación , Perfilación de la Expresión Génica , Proteínas de Homeodominio/genética , Neoplasias Ováricas/genética , Neoplasias Ováricas/patología , Proteínas Represoras/genética , Cistadenoma Seroso/genética , Cistadenoma Seroso/patología , Supervivencia sin Enfermedad , Femenino , Humanos , Estadificación de Neoplasias , Análisis de Secuencia por Matrices de Oligonucleótidos , Neoplasias Ováricas/metabolismo , Pronóstico , Reproducibilidad de los Resultados , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Caja Homeótica 2 de Unión a E-Box con Dedos de Zinc

Asunto(s)

Fluorodesoxiglucosa F18 , Hamartoma/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagen , Mesodermo/patología , Adulto , Hamartoma/patología , Humanos , Neoplasias Hepáticas/patología , Imagen por Resonancia Magnética , Masculino , Mesodermo/diagnóstico por imagen , Tomografía de Emisión de Positrones , Tomografía Computarizada por Rayos X

RESUMEN

AIM: To examine the role of E-cadherin and beta-catenin in carcinogenesis and to assess their prognostic implication in Epstein-Barr virus-associated gastric carcinomas (EBV-GCs). METHODS: We compared the frequency of E-cadherin and beta-catenin expression in 59 EBV-GCs and 120 non-EBV-GCs, and examined the association between patients' prognosis and the expressions of these proteins. RESULTS: Neither the cellular-membranous nor the cytoplasmic E-cadherin expression showed any difference between EBV-GCs and non-EBV-GCs. On the other hand, loss of membranous expression of beta-catenin occurred more frequently in non-EBV-GCs than EBV-GCs [odds ratio = 0.41; 95% confidence interval (CI), 0.19-0.90]. Furthermore, the nuclear and/or cytoplosmic expression of beta-catenin was seen more frequently in EBV-GCs than non-EBV-GCs (odds ratio = 2.23; 95% CI, 0.97-5.09), and was observed in a larger proportion of carcinoma cells of EBV-GCs than non-EBV-GCs (P = 0.024). Survival analysis for non-EBV-GC revealed that lymph node metastasis was significantly associated with poor prognosis (P < 0.001). Among EBV-GCs, the depth of invasion (P = 0.005), lymph node metastasis (P = 0.004) and an intestinal type by Lauren classification (hazard ratio = 9.47; 95% CI, 2.67-33.6) were significantly associated with poor prognosis. On the other hand, nuclear and/or cytoplasmic expression of beta-catenin was associated with a better prognosis in patients with EBV-GC (hazard ratio = 0.32; 95% CI, 0.11-0.93). CONCLUSION: We observed more frequent preservation of beta-catenin in cell membrane and accumulation in nuclei and/or cytoplasm in EBV-GCs than in non-EBV-GCs. Factors involved in the prognosis of EBV-GCs and non-EBV-GCs are different in the two conditions.

Asunto(s)

Cadherinas/biosíntesis , Carcinoma/complicaciones , Carcinoma/virología , Infecciones por Virus de Epstein-Barr/complicaciones , Infecciones por Virus de Epstein-Barr/virología , Regulación Neoplásica de la Expresión Génica , Herpesvirus Humano 4/metabolismo , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/virología , beta Catenina/biosíntesis , Anciano , Estudios de Casos y Controles , Membrana Celular/metabolismo , Núcleo Celular/metabolismo , Citoplasma/metabolismo , Infecciones por Virus de Epstein-Barr/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Neoplasias Gástricas/diagnóstico

RESUMEN

We examined the expression of p16, the CDKN2A gene product, in EBV-associated gastric carcinomas (EBV-GCs). EBV-GCs were identified by detecting EBV-encoded small RNA (EBER) using an in situ hybridization assay of paraffin-embedded tissue. Two non-EBV-GC cases for each EBV-GC case were selected, matched for age, sex, tumor location, and depth of invasion. After excluding cases without sufficient tissue samples for immunohistochemical analysis, 54 EBV-GC and 117 non-EBV-GC cases were available for the present study. The loss of p16 expression was more frequently observed in EBV-GCs (89%) than non-EBV-GC cases (32%; p < 0.001). Among non-EBV-GC cases, the loss of p16 expression was more frequent in female cases (57%) than male cases (29%) (p = 0.042). Expression of p16 was not related to the location of tumor, clinical stage of tumor, age, or prognosis of the patients. In conclusion, the present study suggests that the loss of p16-related cell cycle regulation may be associated with the development of EBV-GC.

Asunto(s)

Carcinoma/virología , Inhibidor p16 de la Quinasa Dependiente de Ciclina/análisis , Infecciones por Virus de Epstein-Barr/complicaciones , Herpesvirus Humano 4/aislamiento & purificación , Neoplasias Gástricas/virología , Infecciones Tumorales por Virus/complicaciones , Anciano , Carcinoma/cirugía , Femenino , Regulación Neoplásica de la Expresión Génica , Herpesvirus Humano 4/genética , Humanos , Inmunohistoquímica , Hibridación in Situ , Masculino , Persona de Mediana Edad , ARN Viral/análisis , Neoplasias Gástricas/cirugía , Análisis de Supervivencia

RESUMEN

We report a case of maternal malignant lymphoma transferred to the fetus during pregnancy. A 29-year-old woman developed lymphoma at 29 weeks' gestation, and her infant developed malignant lymphoma at 8 months. Immunohistochemical examinations revealed lymphoid cells of similar characteristics in the maternal, placental, and infant tissues.

Asunto(s)

Transmisión Vertical de Enfermedad Infecciosa , Linfoma de Células B/etiología , Complicaciones Neoplásicas del Embarazo , Adulto , Resultado Fatal , Femenino , Humanos , Inmunohistoquímica , Hibridación Fluorescente in Situ , Hígado/metabolismo , Linfoma de Células B/inmunología , Placenta/patología , Embarazo , Complicaciones Neoplásicas del Embarazo/inmunología

RESUMEN

INTRODUCTION: Regarding its pathogenesis, discordant development in early gestation, as well as vascular anastomoses between twins are postulated to be required for the establishment of the twin-reversed arterial perfusion (TRAP) sequence. However, first trimester findings associated with this complication have not yet been reported. CASE: A discordant monochorionic twin was revealed upon examination of a 24-year-old primigravida at 11 weeks' gestation. Cystic masses were identified on the back of the smaller twin, later followed by the appearance of skin edema and pericardial effusion, indicating cardiac failure. Subsequently, despite diagnosis of fetal demise at 15 weeks the lower body was shown to have further developed and the heartbeats appeared again, resulting in an acardia anceps or hemicardia. No remarkable change was observed in the larger normal twin. CONCLUSION: This occurrence was considered consistent with the current hypothesis regarding the pathogenesis of the acardiac anomaly. First trimester discordancy in a monochorionic twin gestation is considered to represent an early manifestation of TRAP sequence.

Asunto(s)

Transfusión Feto-Fetal/diagnóstico por imagen , Embarazo Múltiple , Gemelos , Adulto , Preescolar , Femenino , Transfusión Feto-Fetal/patología , Humanos , Masculino , Embarazo , Primer Trimestre del Embarazo , Ultrasonografía