RESUMEN
INTRODUÇÃO: o câncer de ovário é o nono tipo mais incidente entre as mulheres no mundo, correspondendo a 3,6% de todos os cânceres femininos em 2020. No Brasil, o número estimado de novos casos de câncer de ovário, para cada ano do triênio de 2023 a 2025, é de 7.310 casos, correspondendo a um risco estimado de 6,62 casos novos a cada 100 mil mulheres. Os genes BRCA1 e BRCA2 estão entre os genes mais frequentemente mutados no carcinoma seroso ovariano de alto grau, responsável pela grande maioria das mortes por câncer de ovário. Aproximadamente 25% das mulheres diagnosticadas com carcinoma seroso de alto grau apresentam mutações germinativas deletérias em BRCA1 ou BRCA2. Os inibidores da enzima poli-ADP-ribose polimerase (iPARP) têm sido estudados pela sua atividade em pacientes com câncer de ovário, principalmente naquelas com mutação em BRCA1 e 2. No Brasil, apenas olaparibe e niraparibe possuem registro na Agência Nacional de Vigilância Sanitária (Anvisa). Até a chegada destes medicamentos, o tratamento das pacientes se baseava em quimioterapia com derivados de platina, seguido por vigilância ativa. PERGUNTA: olaparibe é seguro e eficaz para o tratamento de pacientes adultas com carcinoma de ovário (incluindo trompa de
Asunto(s)
Humanos , Neoplasias Ováricas/tratamiento farmacológico , Platino (Metal)/farmacología , Poli Adenosina Difosfato Ribosa/uso terapéutico , Genes BRCA1 , Genes BRCA2 , Trompas Uterinas/patología , Sistema Único de Salud , Brasil , Eficacia , Análisis Costo-Beneficio/economíaRESUMEN
La hernia inguinal supone la patología de pared abdominal más frecuente hoy en día. En el saco herniario podemos encontrar diferentes estructuras, como grasa preperitoneal, intestino delgado, colon o incluso la vejiga, resultando inusual la presencia de la trompa de Falopio y el ovario. El contenido tubo-ovárico supone un hallazgo frecuente en población pediátrica, mientras que resulta un hecho extremadamente raro en mujeres en edad reproductiva o menopáusica, siendo imprescindible su tratamiento con el fin de evitar complicaciones relacionadas con la fertilidad y la viabilidad de los anejos. Con el objetivo de revisar la bibliografía descrita al respecto dado la infrecuencia que supone este hallazgo en mujeres adultas, se presenta el siguiente caso clínico de forma resumida, con la consiguiente revisión de la literatura disponible. Se trata de una paciente mujer de 50 años, con antecedentes de mioma uterino, intervenida de forma programada de hernioplastia inguinal derecha, observando contenido tubo-ovárico en el saco herniario, en la cual se realiza hernioplastia inguinal según la técnica de Lichtenstein con preservación de anejos sin complicaciones postoperatorias. Como conclusiones finales, consideramos que los hallazgos intraoperatorios de contenido tubo-ovárico en la cirugía de hernia inguinal en mujeres adultas supone un hecho infrecuente, cuyo conocimiento y manejo resulta necesario para el cirujano general, precisando de un índice de alta sospecha con el fin de evitar complicaciones y otorgar el tratamiento quirúrgico más óptimo para el bienestar de los pacientes.
Inguinal hernia represents the most common pathology of the abdominal wall currently. In the hernia sac, various structures can be found, such as preperitonealphat, smallbowel, colon, oreventhe bladder, but the presence of the fall opiantube and ovaryisun common. Tubo-ovarian content is a frequent finding in pediatric population, while infection is extremely rare in women of reproductive or menopausal age, requiring essential treatment to prevent complications related to fertility and adnexal viability. In order to review the literature described in this regard, given the infrequency of this finding in adult women, we present the following clinical case, along with a review of the available literature. The patient is a 50-year-old woman with a history of uterine fibroids, who underwent surgery of a right inguinal hernioplasty, revealing tube-ovarian content in the hernia sac. Inguinal hernioplasty was performed using the Lichtenstein technique with preservation of adnexa, and there were no postoperative complications. In final conclusions, we consider that intraoperative finding of tube-ovarian content in inguinal hernia surgery in adult women are uncommon, and knowledge and management of this condition are necessary for the general surgeon. A high index of suspicion is required to avoid complications and provide the most optimal surgical treatment for the well-being of patients.
A hérnia inguinal representa uma patologia comum da parede abdominal nos dias seguintes. No saco herniário, podem ser encontradas diferentes estruturas, como gordura pré-peritoneal, intestino delgado, cólon propriamente dito com a bexiga, sendoincomum com presença da trompa de Falópio e do ovário. O conteúdo trompa-ovariano é muito comum em populações pediátricas, mas é extremamente raro em mulheres em saúde reprodutiva ou na menopausa, sendo essencial ou seutratamento para evitar complicações relacionadas à fertilidade e à viabilidade dos dois anexos. Com o objetivo de revisar a bibliografia descrita a esse respeito, dado pouco discutido em mulheres adultas, o seguinte caso clínico é apresentado de forma resumida, juntamente com uma revisão da literatura disponível. Trata-se de paciente do sexo feminino, 50 anos, com história de mioma uterino, submetida a hernioplastia inguinal direta programada, observando-se conteúdo da tuba ovariana e saco herniário. A hernioplastia inguinal foi realizada segundo a técnica de Lichtenstein, comprimindo dois anexos e sem complicações operatórias. Como conclusões finais, consideramos que a redução intraoperatória do conteúdo tubo-ovariano na cirurgia de hérnia inguinal em mulheres adultas é incomum, e o conhecimento e o manejo dos procedimentos necessários à cirurgia geral requerem um alto índice de suspeita para evitar complicações e proporcionar tratamento cirúrgico . maisadequado para ou bem-est dois pacientes.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Ovario/cirugía , Trompas Uterinas/cirugía , Hernia Inguinal/cirugía , Hernia Inguinal/complicaciones , Ovario/patología , Perimenopausia , Trompas Uterinas/patología , HerniorrafiaAsunto(s)
Actinomicosis/diagnóstico , Cuello del Útero/patología , Trompas Uterinas/patología , Actinomyces/aislamiento & purificación , Actinomicosis/tratamiento farmacológico , Actinomicosis/patología , Adulto , Ampicilina/administración & dosificación , Antibacterianos/administración & dosificación , Cuello del Útero/diagnóstico por imagen , Diagnóstico Diferencial , Doxiciclina/administración & dosificación , Trompas Uterinas/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Neoplasias Ováricas/diagnóstico , Sulbactam/administración & dosificación , Tomografía Computarizada por Rayos X , Neoplasias del Cuello Uterino/diagnósticoRESUMEN
Infertility has been a common postoperative problem caused by peritoneal adhesions. Since several prophylactic agents have recently shown promising preliminary results, more complete studies comparing their real efficacy and safety are needed urgently. The aim of this study was to investigate and describe practical considerations of a porcine model that can be used to assess such prophylactic agents. First, 10 healthy 5½ months old female pigs (24.3-31.3 Kg) underwent a standardized laparoscopy to provoke peritubal adhesion formation without prophylactic agents. After 30 days, a second-look laparoscopy was performed to evaluate adhesions and perform adnexectomy for histopathological evaluation. Adhesions at different sites were classified by grade, for which the scores range from 0 (no adhesion) to 3 (very strong vascularized adhesions), and also by area, with scores ranging from 0 (no adhesion) to 4 (>75% of the injured area). The histopathological evaluation of the distal uterine horns, oviducts and ovaries were compared withthose from a control group of six healthy pigs with no previous surgery. Biological samples were collected to assess vitality, inflammation and renal, hepatic and hematopoietic systems. There were small (but significant) changes in serum albumin (P = 0.07), globulin (P = 0.07), C-reactive protein (P = 0.011), fibrinogen (P = 0.023) and bilirubin (P<0.01) after 30 days, but all values were within the normal range. No inflammation or abscess formation was observed, but different degrees of adhesion were identified. The estimated occurrence of adhesion (scores >0) and of strong / very strong adhesion (scores >1) was 75% (95% CI: 55-94.9) and 65% (95% CI: 45-85), respectively. The porcine model represents a useful animal platform that can be used to test the efficacy and safety of candidate prophylactic agents intended to prevent postoperative peritubal adhesions formation. We present several practical considerations and measures that can help to minimize animal suffering and avoid problems during such experiments.
Asunto(s)
Trompas Uterinas , Laparoscopía , Ovario , Complicaciones Posoperatorias , Adherencias Tisulares , Animales , Femenino , Bilirrubina/sangre , Biomarcadores/sangre , Proteína C-Reactiva/metabolismo , Modelos Animales de Enfermedad , Trompas Uterinas/metabolismo , Trompas Uterinas/patología , Fibrinógeno/metabolismo , Laparoscopía/efectos adversos , Ovario/metabolismo , Ovario/patología , Complicaciones Posoperatorias/sangre , Complicaciones Posoperatorias/patología , Albúmina Sérica/metabolismo , Índice de Severidad de la Enfermedad , Porcinos , Adherencias Tisulares/sangre , Adherencias Tisulares/etiología , Adherencias Tisulares/patologíaRESUMEN
The murine infection with Taenia crassiceps WFU (T. crassiceps WFU) cysticerci has been widely used as an experimental model to better understand human cysticercosis. Several reports have established that the host hormonal environment determines the susceptibility and severity of many parasite infections. Female mice are more susceptible to infection with T. crassiceps cysticerci suggesting that a rich estrogen environment facilitates their reproduction. Ovarian androgens and estrogens are synthesized by key enzymes as P450-aromatase and 17α-hydroxilase/17, 20 lyase (P450C17). The aim of this study was to determine the effect of chronic intraperitoneal infection of T. crassiceps WFU cysticerci on mice ovarian follicular development, ovulation, the expression of ovarian P450-aromatase and P450C17, and serum 17ß-estradiol, key enzymes of the ovarian steroidogenic pathway. To perform this study ovaries and serum were obtained at two, four and six months from T. crassiceps WFU cysticerci infected mice, and compared to those of healthy animals. The ovaries were fixed and processed for histology or lysed in RIPA buffer for Western blot using specific antibodies for P450C17 and P450-aromatase. 17ß-estradiol serum concentration was measured by ELISA. The results showed that the infection with T. crassiceps WFU cysticerci significantly reduced the number of primordial and primary follicles after two months of infection. Through the course of the study, the corpus luteum number began to decrease, whereas atretic follicles increased. The expression of ovarian P450C17 and P450-aromatase as well as serum E2 concentration were significantly increased in the infected group compared to control. These findings show that chronic infection with Taenia crassiceps WFU may alter the reproductive functions of the female mice host.
Asunto(s)
Estradiol/sangre , Folículo Ovárico/fisiología , Ovario/enzimología , Teniasis/fisiopatología , Análisis de Varianza , Animales , Western Blotting , Peso Corporal , Cuerpo Lúteo/patología , Densitometría , Ensayo de Inmunoadsorción Enzimática , Trompas Uterinas/patología , Femenino , Ratones , Ratones Endogámicos BALB C , Ovario/anatomía & histología , Distribución Aleatoria , Esteroide 17-alfa-Hidroxilasa/metabolismo , Teniasis/sangre , Teniasis/enzimología , Útero/anatomía & histologíaRESUMEN
Femoral hernias comprise a small proportion of all groin hernias. They are more common in women and have a high rate of incarceration and strangulation, leading to emergency repair. A 61-year-old female patient was admitted to the emergency department complaining of a 2-day painful lump in the right groin, that had become more intense in the last 24 hours. Physical examination suggested the presence of a strangulated femoral hernia, and the patient underwent emergency surgical repair. Intraoperatively, the right fallopian tube was observed in the hernia sac. Since there were no signs of ischemia, the tube was reduced back into the pelvic cavity and the hernia was repaired. The postoperative period was uneventful, and the patient was discharged without complications, 3 days after surgery.
As hérnias femorais representam uma pequena fração de todas as hérnia da região inguinal. Elas são mais comuns entre as mulheres e estão associadas a elevadas taxas de complicações, como encarceramento e estrangulamento, com necessidade de cirurgia urgente. Uma paciente do sexo feminino, de 61 anos, recorreu ao serviço de emergência por quadro de dor e tumefação da região inguinal direita com 2 dias de evolução e agravamento nas últimas 24 horas. O exame objetivo sugeria a presença de uma hérnia femoral encarcerada, e a paciente foi submetida a cirurgia urgente. Intraoperatoriamente, confirmou-se o diagnóstico de hérnia femoral encarcerada, que continha a trompa de falópio direita no interior do saco herniário. Uma vez que a que a trompa não apresentava sinais de isquemia, o conteúdo da hérnia foi reduzido, e procedeu-se à sua reparação. O período pós-operatório decorreu sem intercorrências, e a paciente teve alta no 3° dia após a cirurgia.
Asunto(s)
Trompas Uterinas , Hernia Femoral , Trompas Uterinas/patología , Trompas Uterinas/fisiopatología , Trompas Uterinas/cirugía , Femenino , Ingle/cirugía , Hernia Femoral/diagnóstico , Hernia Femoral/patología , Hernia Femoral/fisiopatología , Hernia Femoral/cirugía , Humanos , Persona de Mediana EdadRESUMEN
Abstract Femoral hernias comprise a small proportion of all groin hernias. They are more common in women and have a high rate of incarceration and strangulation, leading to emergency repair. A 61-year-old female patient was admitted to the emergency department complaining of a 2-day painful lump in the right groin, that had become more intense in the last 24 hours. Physical examination suggested the presence of a strangulated femoral hernia, and the patient underwent emergency surgical repair. Intraoperatively, the right fallopian tube was observed in the hernia sac. Since there were no signs of ischemia, the tube was reduced back into the pelvic cavity and the hernia was repaired. The postoperative period was uneventful, and the patient was discharged without complications, 3 days after surgery.
Resumo As hérnias femorais representamuma pequena fração de todas as hérnia da região inguinal. Elas são mais comuns entre as mulheres e estão associadas a elevadas taxas de complicações, como encarceramento e estrangulamento, com necessidade de cirurgia urgente. Uma paciente do sexo feminino, de 61 anos, recorreu ao serviço de emergência por quadro de dor e tumefação da região inguinal direita com 2 dias de evolução e agravamento nas últimas 24 horas. O exame objetivo sugeria a presença de uma hérnia femoral encarcerada, e a paciente foi submetida a cirurgia urgente. Intraoperatoriamente, confirmou-se o diagnóstico de hérnia femoral encarcerada, que continha a trompa de falópio direita no interior do saco herniário. Uma vez que a que a trompa não apresentava sinais de isquemia, o conteúdo da hérnia foi reduzido, e procedeu-se à sua reparação. O período pós-operatório decorreu sem intercorrências, e a paciente teve alta no 3° dia após a cirurgia.
Asunto(s)
Humanos , Femenino , Trompas Uterinas/cirugía , Trompas Uterinas/fisiopatología , Trompas Uterinas/patología , Hernia Femoral/cirugía , Hernia Femoral/diagnóstico , Hernia Femoral/fisiopatología , Hernia Femoral/patología , Ingle/cirugía , Persona de Mediana EdadRESUMEN
AIMS: The incidence of intraepithelial neoplasia in the fallopian tubes of women over 40 years of age who had undergone elective hysterectomy was assessed at the Aguascalientes Women's Hospital. METHODS: An observational, prospective, descriptive study was carried out at the Aguascalientes Women's Hospital on female patients over 40 years of age who underwent elective hysterectomy between July and October 2017. In these 4 months, 85 patients underwent elective hysterectomy. RESULTS: In this study, 85 patients who received a hysterectomy for non-oncological reasons were analyzed. Salpinx alterations compatible with intraepithelial neoplasia in the Fallopian tubes were found in 2.4% of the patients studied. CONCLUSIONS: The incidence of intraepithelial neoplasia in the fallopian tubes of high-risk patients at the Aguascalientes Women's Hospital is 2.4%. Prophylactic salpingectomy is a simple procedure and has the potential to decrease the risk of high-grade ovarian cancer. In premenopausal patients, total abdominal hysterectomy with bilateral salpingectomy should be the procedure most often performed.
Asunto(s)
Carcinoma in Situ/epidemiología , Neoplasias de las Trompas Uterinas/epidemiología , Histerectomía/estadística & datos numéricos , Adulto , Anciano , Carcinoma in Situ/patología , Carcinoma in Situ/cirugía , Neoplasias de las Trompas Uterinas/patología , Neoplasias de las Trompas Uterinas/cirugía , Trompas Uterinas/patología , Femenino , Humanos , Incidencia , México/epidemiología , Persona de Mediana Edad , Neoplasias Ováricas/prevención & control , Premenopausia , Procedimientos Quirúrgicos Profilácticos , Estudios Prospectivos , SalpingectomíaRESUMEN
Objective: The aim of this study was to provide a three-dimensional (3D) microscopic reconstruction of morphological modifications of the fallopian tube (FT) following surgical sterilization (including tuboperitoneal fistula) and ectopic pregnancy (EP) using confocal microtomography (micro-CT). Methods: Six specimens of FT from elective and emergency surgeries were selected: three remnants of the FT (RFT) from surgical sterilization, including one presenting tuboperitoneal fistula, and three FTs with EP. The specimens were fixed in formalin and stained with Lugol solution. Micro-CT studies were conducted on the specimens using protocols adapted from biological studies. Results: Three RFTs from surgical sterilization and three FTs affected by EPs were successfully scanned using micro-CT. There was good contrast impregnation, allowing tissue segmentation and analysis of different sections of the FTs. Three FT specimens from EP exhibited considerable distortion of the tubal anatomy, mainly from the blood clot in the tubal abortion. Three RFT specimens exhibited some features observed in traditional microscopy, such as tubal distension and loss of normal anatomical characteristics of a normal FT, and indicated the presence of a tuboperitoneal fistula in one of the three specimens. Conclusion: Micro-CT can identify morphological characteristics of FT pathologies previously described in a microscopic scale, with tissue contrast and the possibility of 3D reconstruction. Micro-CT is also useful in guiding traditional sectioning of specimens for histopathological studies.
Asunto(s)
Trompas Uterinas/patología , Imagenología Tridimensional/métodos , Microtomografía por Rayos X/métodos , Trompas Uterinas/diagnóstico por imagen , Femenino , Fístula/diagnóstico por imagen , Fístula/patología , Humanos , Enfermedades Peritoneales/diagnóstico por imagen , Enfermedades Peritoneales/patología , Embarazo , Embarazo Tubario/diagnóstico por imagen , Embarazo Tubario/patología , UltrasonografíaRESUMEN
Anabolic androgenic steroids (AAS) are recommended for therapeutic clinic, but their use has increased in recent decades for aesthetic reasons. No study has evaluated the impact of AAS in the fallopian tube, after treatment and recovery periods. Herein, the aim of study was to investigate the effects of Nandrolone Decanoate (ND), administered in different doses (1.87; 3.75; 7.5 and 15â¯mg/kg) on the ampulla of the fallopian tube in rats, following post-treatment (PT; 15 consecutive days) and post-recovery (PR; 30 consecutive days) periods. The control group received mineral oil. Estrous cycle was monitored daily during both periods and in sequence the rats (nâ¯=â¯8/group/period) were killed. All ND-treated animals showed estral acyclicity during the PT and PR periods, but the histomorphometric changes in the fallopian tube varied according to the ND dose level. The expression of AR, ERα and ERß varied in the nucleus and cytoplasm of epithelial cells. No AR expression was observed in the stroma. The muscle cells exhibited variation in immunostaining. In conclusion, ND promoted histomorphometric and immunohistochemical changes in the ampullary portion of the fallopian tube after treatment and recovery periods in a dose-independent manner.
Asunto(s)
Anabolizantes/administración & dosificación , Trompas Uterinas/efectos de los fármacos , Hormonas Esteroides Gonadales/administración & dosificación , Nandrolona/análogos & derivados , Anabolizantes/efectos adversos , Animales , Relación Dosis-Respuesta a Droga , Receptor alfa de Estrógeno/genética , Receptor beta de Estrógeno/genética , Ciclo Estral/efectos de los fármacos , Trompas Uterinas/patología , Femenino , Regulación de la Expresión Génica/efectos de los fármacos , Hormonas Esteroides Gonadales/efectos adversos , Nandrolona/administración & dosificación , Nandrolona/efectos adversos , Nandrolona Decanoato , Tamaño de los Órganos/efectos de los fármacos , Ratas , Receptores Androgénicos/genéticaRESUMEN
Background:Neisseria gonorrhoeae (Ngo) is the etiological agent of gonorrhea, a sexually transmitted infection that initially infects the female lower genital tract. In untreated women, the bacteria can ascend to the upper genital reproductive tract and infect the fallopian tube (FTs), which is associated with salpingitis and can lead to impaired FT function and infertility. The extracellular matrix (ECM) plays an important role in cell migration and differentiation in the female genital tract, and some pathogens modify the ECM to establish successful infections. The ECM is regulated by matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs), their endogenous inhibitors; MMP deregulation causes pathological conditions in a variety of tissues. Results: The aim of this work was to analyze the expression and localization of MMP-3, MMP-8, MMP-9, and TIMP-1 in FT explants during Ngo infection using real-time PCR, immunohistochemistry, zymography and ELISA. No significant variations in MMP-3, MMP-9, and TIMP-1 transcript levels were observed. In contrast, a significant increase (p < 0.05) was observed for MMP-8 expression and was accompanied by stromal immunoreactivity in infected explants. ELISA results supported these findings and showed that MMP-8 release increased upon gonococcal infection. Conclusions: Our results indicate that gonococcal infection induces increased MMP-8 expression, which might contribute to FT damage during infection.
Asunto(s)
Trompas Uterinas/metabolismo , Gonorrea/inmunología , Metaloproteinasa 8 de la Matriz/metabolismo , Neisseria gonorrhoeae/patogenicidad , Adulto , Trompas Uterinas/citología , Trompas Uterinas/microbiología , Trompas Uterinas/patología , Femenino , Humanos , Inmunohistoquímica , Metaloproteinasa 3 de la Matriz/metabolismo , Metaloproteinasa 9 de la Matriz/metabolismo , Persona de Mediana Edad , Técnicas de Cultivo de Órganos , ARN Mensajero/análisis , Inhibidor Tisular de Metaloproteinasa-1/metabolismoRESUMEN
OBJECTIVE: To evaluate the association between the depth of trophoblastic infiltration and serum vascular endothelial growth factorconcentration in patients with an ampullary pregnancy. METHODS: This prospective cross-sectionalstudy involved 34 patients with an ampullary ectopic pregnancy who underwent salpingectomy between 2012 and 2013. Maternal serum vascular endothelial growth factor concentrations were measured using Luminex technology. Trophoblastic invasion was classified histologically as follows: stage I, limited to the tubal mucosa; stage II, reaching the muscle layer; and stage III,involving the full thickness. The qualitative data were compared using Fisher's exact test. The nonparametric Kruskal-Wallis and Mann-Whitney tests were used to evaluate differences in serum vascular endothelial growth factor among the degrees of trophoblastic invasion. ROC curves were constructed to determine vascular endothelial growth factor cut-off values that predict the degree of tubal invasion based on the best sensitivity and specificity. RESULTS: Eight patients had stage I trophoblastic invasion, seven had stage II, and 19 had stage III. The median serum vascular endothelial growth factorconcentration was 69.88 pg/mL for stage I, 14.53 pg/mL for stage II and 9.08 pg/mL for stage III, with a significant difference between stages I and III. Based on the ROC curve, a serum vascular endothelial growth factor concentration of 25.9 pg/mL best differentiated stage I from stages II and III with asensitivity of 75.0%, specificity of 76.9%, and area under the curve of 0.798. CONCLUSIONS: The depth of trophoblastic penetration into the tubal wall isassociated with serum vascular endothelial growth factor concentration in ampullary pregnancies.
Asunto(s)
Humanos , Femenino , Embarazo , Niño , Adolescente , Adulto , Adulto Joven , Trompas Uterinas/patología , Embarazo Tubario/sangre , Embarazo Tubario/patología , Trofoblastos/patología , Factor A de Crecimiento Endotelial Vascular/sangre , Estudios Transversales , Edad Gestacional , Valor Predictivo de las Pruebas , Estudios Prospectivos , Curva ROC , Estadísticas no ParamétricasRESUMEN
An adenoma of the uterine tube in a 14-year-old, mixed breed, female dog with history of abdominal distention is described. Ultrasonographic examination revealed a 15 x 20 cm anechoic mass in the left caudal region of the abdominal cavity. Laparotomy was performed and the mass, within the left ovarian bursa, was surgically excised by ovariohysterectomy. Grossly, the left ovarian bursa was markedly increased in size (7 x 15 x 20 cm) and contained approximately 300ml of serosanguineous fluid that surrounded a 5 x 13 x 17 cm in diameter, red, papilliform, and soft mass. Histologically, the mass was characterized as an epithelial neoplastic proliferation arranged in a papilliform pattern. The numerous papillae were lined by a single layer of well-differentiated columnar ciliated cells, with occasional cuboidal cells, and supported by a dense fibrovascular stroma. Columnar cells contained abundant, slightly vacuolated and granular cytoplasm. The granules were located predominantly in the apical surface and were Alcian blue and periodic acid-Schiff positive. Nuclei were round and polarized in the apical surface of the cell. Neoplastic cells were positive for pan-cytokeratin and vimentin. The diagnosis of adenoma of uterine tube was based on the anatomic location, and histological, immunohistochemical and ultrastructural findings.
Asunto(s)
Femenino , Animales , Perros , Adenoma/diagnóstico , Adenoma/veterinaria , Trompas Uterinas/patología , Neoplasias de las Trompas Uterinas/veterinariaRESUMEN
An adenoma of the uterine tube in a 14-year-old, mixed breed, female dog with history of abdominal distention is described. Ultrasonographic examination revealed a 15 x 20 cm anechoic mass in the left caudal region of the abdominal cavity. Laparotomy was performed and the mass, within the left ovarian bursa, was surgically excised by ovariohysterectomy. Grossly, the left ovarian bursa was markedly increased in size (7 x 15 x 20 cm) and contained approximately 300ml of serosanguineous fluid that surrounded a 5 x 13 x 17 cm in diameter, red, papilliform, and soft mass. Histologically, the mass was characterized as an epithelial neoplastic proliferation arranged in a papilliform pattern. The numerous papillae were lined by a single layer of well-differentiated columnar ciliated cells, with occasional cuboidal cells, and supported by a dense fibrovascular stroma. Columnar cells contained abundant, slightly vacuolated and granular cytoplasm. The granules were located predominantly in the apical surface and were Alcian blue and periodic acid-Schiff positive. Nuclei were round and polarized in the apical surface of the cell. Neoplastic cells were positive for pan-cytokeratin and vimentin. The diagnosis of adenoma of uterine tube was based on the anatomic location, and histological, immunohistochemical and ultrastructural findings.(AU)
Asunto(s)
Animales , Femenino , Perros , Adenoma/veterinaria , Adenoma/diagnóstico , Trompas Uterinas/patología , Neoplasias de las Trompas Uterinas/veterinariaRESUMEN
OBJECTIVE:: To evaluate the association between the depth of trophoblastic infiltration and serum vascular endothelial growth factorconcentration in patients with an ampullary pregnancy. METHODS:: This prospective cross-sectionalstudy involved 34 patients with an ampullary ectopic pregnancy who underwent salpingectomy between 2012 and 2013. Maternal serum vascular endothelial growth factor concentrations were measured using Luminex technology. Trophoblastic invasion was classified histologically as follows: stage I, limited to the tubal mucosa; stage II, reaching the muscle layer; and stage III,involving the full thickness. The qualitative data were compared using Fisher's exact test. The nonparametric Kruskal-Wallis and Mann-Whitney tests were used to evaluate differences in serum vascular endothelial growth factor among the degrees of trophoblastic invasion. ROC curves were constructed to determine vascular endothelial growth factor cut-off values that predict the degree of tubal invasion based on the best sensitivity and specificity. RESULTS:: Eight patients had stage I trophoblastic invasion, seven had stage II, and 19 had stage III. The median serum vascular endothelial growth factorconcentration was 69.88 pg/mL for stage I, 14.53 pg/mL for stage II and 9.08 pg/mL for stage III, with a significant difference between stages I and III. Based on the ROC curve, a serum vascular endothelial growth factor concentration of 25.9 pg/mL best differentiated stage I from stages II and III with asensitivity of 75.0%, specificity of 76.9%, and area under the curve of 0.798. CONCLUSIONS:: The depth of trophoblastic penetration into the tubal wall isassociated with serum vascular endothelial growth factor concentration in ampullary pregnancies.
Asunto(s)
Trompas Uterinas/patología , Embarazo Tubario/sangre , Embarazo Tubario/patología , Trofoblastos/patología , Factor A de Crecimiento Endotelial Vascular/sangre , Adolescente , Adulto , Niño , Estudios Transversales , Femenino , Edad Gestacional , Humanos , Valor Predictivo de las Pruebas , Embarazo , Estudios Prospectivos , Curva ROC , Estadísticas no Paramétricas , Adulto JovenRESUMEN
Cáncer epitelial de ovario es una enfermedad altamente letal. Constituye la quinta causa de muerte por cáncer en mujeres a nivel mundial. El subtipo histológico más frecuente es el carcinoma seroso de alto grado. Este es el responsable de la alta letalidad de la enfermedad. Se presenta evidencia que respalda el origen tubario de este tipo histológico desde lesiones precursoras. A partir de estos datos se ha establecido que el cáncer tradicionalmente conocido como cáncer ovárico seroso de alto grado, el cáncer de trompa de Falopio y el carcinoma peritoneal primario, corresponden a una misma entidad nosológica: cáncer seroso pélvico de alto grado. Se revisa además la evidencia disponible para establecer que la salpingectomía podría constituir una medida de prevención para este tipo de cáncer.
Epithelial ovarian cancer is a highly lethal disease. It is the 5th cause of cancer death in women worldwide. The most common histologic subtype is the high-grade serous carcinoma. This is the responsible for the high lethality of the disease. Evidence supporting the tubal origin of this histological type from precursor lesions is presented. From these data it has been established that cancer traditionally known as serous high-grade ovarian cancer, cancer of the fallopian tube and primary peritoneal carcinoma, correspond to a single disease entity: pelvic serous high-grade cancer. We also check the available evidence to establish that the salpingectomy could be a preventive measure for this type of cancer.
Asunto(s)
Humanos , Femenino , Neoplasias Ováricas/etiología , Neoplasias Ováricas/patología , Trompas Uterinas/patología , Carcinoma Epitelial de Ovario/etiología , Carcinoma Epitelial de Ovario/patología , Neoplasias Ováricas/genética , Neoplasias Ováricas/prevención & control , Proteína p53 Supresora de Tumor , Trompas Uterinas/cirugía , Salpingectomía , Clasificación del Tumor , Carcinogénesis , Carcinoma Epitelial de Ovario/genética , Carcinoma Epitelial de Ovario/prevención & controlRESUMEN
Elafin is a natural antimicrobial molecule member of the antileukoproteinase (Trappin) family that is normally expressed in the mucosa of human fallopian tubes and neutrophils. Ectopic pregnancy is a condition in which neutrophil influx is present. Current data on elafin expression on fallopian tubes with ectopic pregnancy do not differentiate the expression of elafin in these 2 compartments. The objective of this study was to analyze the protein expression of elafin on epithelial mucosa of fallopian tubes with and without ectopic pregnancy using immunohistochemical analysis. Tissue sections of ectopic pregnancies (n=10) and normal tubes (n=10) were analyzed for the intensity of the staining with 3,3'-diaminobenzidine using ImageJ software. Statistical analysis was performed using unpaired t test and analysis of covariance. Elafin expression (mean ± SD) in the mucosa of fallopian tubes was 73.3 ± 19.7 (control) versus 48.9 ± 17.8 (ectopic pregnancy) (P=0.009). The immunoexpression of elafin is reduced in tubal epithelium of ectopic pregnancies, compared with nonectopic pregnancy tubes.
Asunto(s)
Elafina/genética , Trompas Uterinas/metabolismo , Membrana Mucosa/metabolismo , Embarazo Tubario/diagnóstico , Embarazo Tubario/genética , Programas Informáticos , 3,3'-Diaminobencidina , Adulto , Animales , Trompas Uterinas/patología , Femenino , Expresión Génica , Humanos , Procesamiento de Imagen Asistido por Computador , Inmunohistoquímica/estadística & datos numéricos , Persona de Mediana Edad , Membrana Mucosa/patología , Neutrófilos/metabolismo , Embarazo , Embarazo Tubario/patologíaRESUMEN
Elafin is a natural antimicrobial molecule and a member of the antileukoproteinase (Trappin) family. It is normally expressed in the mucosae of fallopian tubes. Hydrosalpinx is a chronic inflammatory process of the fallopian tubes. The objective of this study is to compare the localization of elafin protein and levels of elafin messenger RNA (mRNA) in the mucosa of oviducts with and without hydrosalpinx. Immunohistochemical analysis was performed on tissue sections of hydrosalpinx (n = 10) and normal tubes (n = 22) from paraffin-embedded blocks, obtained from patients who underwent salpingectomy for benign conditions. The main outcome measure was the intensity of staining with 3,3'-diaminobenzidine calculated by ImageJ software and mRNA expression by real-time polymerase chain reaction. The mean intensity of elafin (mean ± standard deviation) in mucosae of the fallopian tubes was 69.68 ± 24.55 in controls and 32.03±18.16 in patients with hydrosalpinx (P < .0001). Elafin mRNA levels were reduced in hydrosalpinx, although not significantly (P = .05, n = 9 from each group). Therefore, tubal epithelium of women with hydrosalpinx seems to have a lower expression of elafin, an elastase inhibitor and a natural antimicrobial molecule, compared to normal tubes.
Asunto(s)
Elafina/biosíntesis , Trompas Uterinas/metabolismo , Trompas Uterinas/patología , Salpingitis/metabolismo , Salpingitis/patología , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Persona de Mediana Edad , Membrana Mucosa/metabolismo , Membrana Mucosa/patologíaRESUMEN
Pathogenic microorganisms, such as Neisseria gonorrhoeae, have developed mechanisms to alter epithelial barriers in order to reach subepithelial tissues for host colonization. The aim of this study was to examine the effects of gonococci on cell junction complexes of genital epithelial cells of women. Polarized Ishikawa cells, a cell line derived from endometrial epithelium, were used for experimental infection. Infected cells displayed a spindle-like shape with an irregular distribution, indicating potential alteration of cell-cell contacts. Accordingly, analysis by confocal microscopy and cellular fractionation revealed that gonococci induced redistribution of the adherens junction proteins E-cadherin and its adapter protein ß-catenin from the membrane to a cytoplasmic pool, with no significant differences in protein levels. In contrast, gonococcal infection did not induce modification of either expression or distribution of the tight junction proteins Occludin and ZO-1. Similar results were observed for Fallopian tube epithelia. Interestingly, infected Ishikawa cells also showed an altered pattern of actin cytoskeleton, observed in the form of stress fibers across the cytoplasm, which in turn matched a strong alteration on the expression of fibronectin, an adhesive glycoprotein component of extracellular matrix. Interestingly, using western blotting, activation of the ERK pathway was detected after gonococcal infection while p38 pathway was not activated. All effects were pili and Opa independent. Altogether, results indicated that gonococcus, as a mechanism of pathogenesis, induced disruption of junction complexes with early detaching of E-cadherin and ß-catenin from the adherens junction complex, followed by a redistribution and reorganization of actin cytoskeleton and fibronectin within the extracellular matrix.