Asunto(s)
Carcinoma/cirugía , Enterostomía , Neoplasias del Recto/cirugía , Ureterostomía , Canal Anal , Femenino , Humanos , Persona de Mediana Edad , Proctoscopía , ReoperaciónRESUMEN
Sarcomatoid carcinomas and carcinosarcomas are histologically malignant biphasic neoplasms with an epithelial and a spindle cell component. Both a polyclonal and a monoclonal origin have been postulated for these tumours, but the latter has been favoured. For carcinosarcoma, the stem cell from which the epithelial and mesenchymal components are derived is expected to be more immature than the epithelial stem cell from which different components of sarcomatoid carcinoma originate, since in the latter, immunohistochemical or ultrastructural epithelial characteristics are still detectable. In the present study, comparative genomic hybridization was used to test the hypothesis that both tumour components in sarcomatoid carcinoma have more chromosomal aberrations in common than those in carcinosarcoma. From three sarcomatoid carcinomas originating from the urinary bladder and two carcinosarcomas from the pharynx, the epithelial and spindle cell components were microdissected and analysed for their respective chromosomal aberrations, using comparative genomic hybridization. High-level homology was seen in chromosomal aberrations between the different components in each tumour. This level of homology was even higher in the carcinosarcomas (65 and 91 per cent) than in both sarcomatoid carcinomas (21-51 per cent). The different phenotypic components of both sarcomatoid carcinoma and carcinosarcoma show a large overlap of chromosomal aberrations, strongly suggesting a monoclonal origin for all of these tumours. These findings do not support the hypothesis that the divergence between epithelial and spindle cell components occurs at an earlier stage in carcinosarcomas than in sarcomatoid carcinoma.
Asunto(s)
Carcinoma/genética , Carcinosarcoma/genética , Neoplasias Nasofaríngeas/genética , Sarcoma/genética , Neoplasias de la Vejiga Urinaria/genética , Carcinoma/patología , Carcinosarcoma/patología , Aberraciones Cromosómicas , Células Epiteliales/patología , Humanos , Procesamiento de Imagen Asistido por Computador , Cariotipificación , Neoplasias Nasofaríngeas/patología , Células Madre Neoplásicas/patología , Hibridación de Ácido Nucleico/métodos , Sarcoma/patología , Neoplasias de la Vejiga Urinaria/patologíaRESUMEN
AIMS: Adenocarcinomas may arise primarily from the urinary bladder, but secondary involvement from adenocarcinomas arising in adjacent organs is more common. In the present study we tried to differentiate primary urinary bladder adenocarcinomas from adenocarcinomas arising from the surrounding organs, based on their antigen profiles in routinely processed, paraffin-embedded tissue specimens. We analysed the staining results using stepwise linear discriminant analysis. METHODS AND RESULTS: We investigated the usefulness of a panel of antibodies against cytokeratin 7, E48, cytokeratin 20, PSA, PSAP, CEA, vimentin, OC125 and HER-2/neu, to discriminate primary bladder adenocarcinoma from adenocarcinomas arising from the prostate, urachus, colon, cervix, ovary and endometrium. In the differential diagnosis with urinary bladder adenocarcinoma, an overall correct classification was reached for 77% and 81% of urachal and colonic carcinomas, respectively, using CEA, for 93% of prostatic adenocarcinomas using PSA, for 82% and 70% of cervical and ovarian adenocarcinomas, respectively, using OC125, and for 91% of endometrial adenocarcinomas using vimentin. Adding other antibodies did not improve the classification results for any of these differential diagnoses. CONCLUSIONS: For the surgical pathologist, a panel of antibodies consisting of CEA, PSA, OC125 and vimentin is helpful to differentiate primary urinary bladder adenocarcinomas from adenocarcinomas originating from prostate and endometrium, less helpful in differentiation with urachal carcinoma, and not helpful in differentiation with colonic, cervical and ovarian carcinoma.
Asunto(s)
Adenocarcinoma/patología , Adenocarcinoma/secundario , Anticuerpos Monoclonales/análisis , Carcinoma Papilar/patología , Carcinoma Papilar/secundario , Neoplasias Primarias Desconocidas/patología , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/secundario , Neoplasias Abdominales/química , Neoplasias Abdominales/patología , Fosfatasa Ácida/análisis , Fosfatasa Ácida/inmunología , Adenocarcinoma/química , Anticuerpos Monoclonales/inmunología , Especificidad de Anticuerpos , Antígeno Ca-125/análisis , Antígeno Ca-125/inmunología , Antígeno Carcinoembrionario/análisis , Antígeno Carcinoembrionario/inmunología , Carcinoma Papilar/química , Moléculas de Adhesión Celular/análisis , Moléculas de Adhesión Celular/inmunología , Diagnóstico Diferencial , Neoplasias Endometriales/química , Neoplasias Endometriales/patología , Femenino , Proteínas Ligadas a GPI , Glicoproteínas/análisis , Glicoproteínas/inmunología , Humanos , Inmunohistoquímica , Proteínas de Filamentos Intermediarios/análisis , Proteínas de Filamentos Intermediarios/inmunología , Queratina-20 , Queratina-7 , Queratinas/análisis , Queratinas/inmunología , Masculino , Neoplasias Primarias Desconocidas/química , Neoplasias Ováricas/química , Neoplasias Ováricas/patología , Próstata/química , Próstata/enzimología , Antígeno Prostático Específico/análisis , Antígeno Prostático Específico/inmunología , Receptor ErbB-2/análisis , Receptor ErbB-2/inmunología , Uraco/química , Uraco/patología , Neoplasias de la Vejiga Urinaria/química , Neoplasias del Cuello Uterino/química , Neoplasias del Cuello Uterino/patología , Vimentina/análisis , Vimentina/inmunologíaRESUMEN
1. The Reading model for the egg production of a flock as determined by the intake of a single amino acid is based on the assumption that other amino acid intakes are not limiting egg production. This can result in an overestimation of the optimum intakes of each amino acid considered. 2. In this paper a model is introduced and an optimisation procedure presented that will allow the calculation of the optimal amounts of each of a number of amino acid intakes. 3. The method is illustrated by an example and the sensitivity of the results to different methods of calculation and different values of the parameters investigated. 4. A computer program, available from the authors, calculates optimal amino acid intakes for a flock defined in terms of the distribution of body weight and potential maximum egg production of the birds; the cost of the amino acids and the value of a unit of extra egg production. The program also allows the flock to be divided into 2 sub-flocks according to body weight and optimal diets calculated for each sub-flock.
Asunto(s)
Alimentación Animal , Dieta , Huevos , Oviposición , Animales , Peso Corporal , Pollos , Femenino , Modelos Biológicos , Sensibilidad y Especificidad , Programas InformáticosRESUMEN
Signet-ring cell carcinoma of the urinary bladder is a rare tumour, accounting for approximately 0.24% of all bladder malignancies. In this study, the clinicopathological findings in 13 cases are described. This malignancy is far more common in men than in women (ratio 11:2). The distribution by age and clinical symptoms can not distinguish it from transitional cell carcinoma. The tumour behaves like other high grade malignancies, presenting frequently at an advanced stage, and having an unfavourable clinical outcome. No special therapy seems superior to another.
Asunto(s)
Carcinoma de Células en Anillo de Sello/patología , Neoplasias de la Vejiga Urinaria/patología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma in Situ/patología , Carcinoma de Células Pequeñas/patología , Femenino , Humanos , Inmunohistoquímica , Masculino , Metaplasia/patología , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Sarcomatoid carcinoma is a rare tumor in the urinary bladder and accounts for approximately 0.3% of all bladder malignancies. In this study, the clinicopathologic findings of 18 cases are described. Distribution of sex and age and clinical symptoms are not distinctive from transitional cell carcinoma. The tumor behaves as a high-grade malignancy with advanced initial stage and unfavorable outcome. Surgery is the therapy of choice. Histological differentiation from true sarcoma may be difficult. Recognition rests on the co-existence of an overt carcinomatous component or demonstration of the epithelial nature by immunohistochemistry or electron microscopy.
Asunto(s)
Carcinoma/patología , Neoplasias de la Vejiga Urinaria/patología , Anciano , Anciano de 80 o más Años , Carcinoma/química , Carcinoma/ultraestructura , Femenino , Estudios de Seguimiento , Humanos , Inmunohistoquímica , Queratinas/análisis , Masculino , Glicoproteínas de Membrana/análisis , Microscopía Electrónica , Persona de Mediana Edad , Mucina-1 , Neoplasias de la Vejiga Urinaria/química , Neoplasias de la Vejiga Urinaria/ultraestructura , Vimentina/análisisRESUMEN
Angiotropic intravascular large-cell lymphoma (AILL) is a rare, generally fatal disease characterised by a multifocal proliferation of neoplastic mononuclear cells within small blood vessels. The diagnosis of a patient was made at necropsy. The malignant cells had infiltrated the periventricular areas of the brain.
Asunto(s)
Encefalopatías/patología , Linfoma de Células B Grandes Difuso/patología , Encéfalo/irrigación sanguínea , Encéfalo/patología , Encefalopatías/etiología , Femenino , Humanos , Linfoma de Células B Grandes Difuso/complicaciones , Imagen por Resonancia Magnética , Persona de Mediana EdadRESUMEN
For lengthening of the urethra in female-to-male transsexuals, an anterior vaginal wall flap is used. This flap is separated from the posterior urethral wall down to the attachment at the urethral meatus following a glistening cleavage plane. In this paper we present the anatomic and histologic basis of this flap. Prior to this, the relevant vaginal anatomy will be discussed. The anterior vaginal wall and posterior urethral wall are not indissectible structures; this is true even in the caudal two-thirds of the urethra. A long and narrow flap can be raised, thanks to the abundant vascular supply of the vaginal wall and the musculomucosal quality of the flap. A previously performed anatomic and histologic survey of the anterior vaginal wall has shown that the glistening cleavage plane is not composed solely of fascia, but rather consists of longitudinal strands of muscle, fibrous tissue, and elastin.
Asunto(s)
Colgajos Quirúrgicos , Transexualidad/cirugía , Uretra/cirugía , Vagina/cirugía , Femenino , Humanos , Vagina/anatomía & histologíaRESUMEN
A primary chondrosarcoma arising in the urinary bladder is described in a 73-year-old female, together with a review of the 2 previously reported cases in the literature. The clinical symptoms are similar to transitional cell carcinoma, but chondrosarcoma usually presents at an advanced stage, and the outcome is rather poor. This very rare and commonly poorly differentiated tumor should not be confused with poorly differentiated transitional cell carcinoma. The differential diagnosis from other lesions with chondroid features, such as chondroid metaplasia, osteosarcoma and carcinosarcoma, is discussed. The value of immunohistochemistry and electron microscopy in the differential diagnosis is demonstrated.
Asunto(s)
Condrosarcoma , Neoplasias de la Vejiga Urinaria , Anciano , Condrosarcoma/química , Condrosarcoma/diagnóstico , Condrosarcoma/ultraestructura , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Neoplasias de la Vejiga Urinaria/química , Neoplasias de la Vejiga Urinaria/diagnóstico , Neoplasias de la Vejiga Urinaria/ultraestructuraRESUMEN
AIMS: To investigate the localisation of the E48 epitope and to determine the use of monoclonal antibody E48 for the identification of transitional cell carcinomas (TCC); and to determine if antigenic expression was affected by different standard fixation methods. METHODS: Biopsy specimens were labelled with E48 for immunoelectron microscopy. One hundred and nineteen tissue samples from 47 bladder carcinomas were tested for reactivity with E48, using fresh frozen, sublimate formalin, and formalin fixed tissue. Thirteen undifferentiated bladder tumours and 10 undifferentiated prostatic carcinomas were incubated with E48 and prostate specific antigen. RESULTS: Reactivity to E48 was found in all grade 1 and 2 carcinomas and most (83%) grade 3 tumours. At the ultrastructural level, expression was mainly associated with desmosomes and the cytoplasmic membrane. The reactivity of E48 was generally strong in fresh frozen tissue samples and remained preserved in fixed tissue samples. Ten of the 13 bladder carcinomas expressed E48; all prostatic tumours were totally negative. CONCLUSIONS: E48 is a sensitive marker for transitional cell carcinoma and suitable for differentiation between urothelial and prostatic undifferentiated carcinoma. It can be used in routinely processed, formalin fixed, biopsy specimens.
Asunto(s)
Antígenos de Neoplasias/análisis , Biomarcadores de Tumor/análisis , Carcinoma de Células Transicionales/diagnóstico , Neoplasias de la Vejiga Urinaria/diagnóstico , Animales , Anticuerpos Monoclonales , Especificidad de Anticuerpos , Carcinoma de Células Transicionales/inmunología , Epítopos/análisis , Humanos , Técnicas para Inmunoenzimas , Ratones , Ratones Endogámicos BALB C , Neoplasias de la Vejiga Urinaria/inmunologíaRESUMEN
We report a patient who initially presented with hoarseness and was admitted to our hospital with chest pain, caused by a saccular aneurysm of the thoracic aortic arch. The initial diagnosis was made by cross-sectional echocardiography, the extension and morphology of the saccular aneurysm being detected by transesophageal echocardiography. Magnetic resonance imaging confirmed the measurements of the aneurysm and clearly showed the anatomic relation with surrounding structures and arch vessels. The patient refused operation and died during in-hospital stay. A rupture of the thoracic aneurysm was the cause of death.
Asunto(s)
Aneurisma de la Aorta/diagnóstico , Rotura de la Aorta/etiología , Ecocardiografía/métodos , Esófago/diagnóstico por imagen , Imagen por Resonancia Magnética , Anciano , Aorta Torácica , Aneurisma de la Aorta/complicaciones , Aneurisma de la Aorta/patología , Humanos , MasculinoRESUMEN
Reports of sinonasal non-Hodgkin's lymphomas, analysed with monoclonal antibodies, are scarce, and differentiation of these lymphomas from Wegener's granulomatosis can be difficult. In this study, we investigated histopathologically and immunohistologically 20 cases of non-Hodgkin's lymphoma, primary in the sinonasal region, and sinonasal biopsies from 11 patients with Wegener's granulomatosis. All T-cell lymphomas (n = 7) and plasmacytomas (n = 4) were stage I at clinical presentation, while all B-cell lymphomas (n = 9) presented at higher stages. T-cell lymphomas tended to be more frequent in the nasal cavity and paranasal sinuses; B-cell lymphomas more often presented in the nasopharynx. Remarkably, 1 B-cell lymphoma expressed MT1, and 1 T-cell lymphoma expressed L26 (CD 20). The follow-up of 2 patients with a clinical diagnosis of Wegener's granulomatosis was suggestive of non-Hodgkin's lymphoma. Retrospective immunohistochemical analysis revealed that the original histological diagnosis of non-specific inflammation had to be changed to T-cell lymphoma, pleomorphic small cell type. We conclude that a biopsy from the sinonasal region with a dense inflammatory infiltrate, consisting predominantly of T-lymphocytes, renders a diagnosis of Wegener's granulomatosis unlikely and is at least suspicious of T-cell lymphoma. Immunohistochemical analysis is warranted for this type of biopsy.