RESUMO

ABSTRACT Purpose The present study aimed to determine whether sarcopenia after radical cystectomy (RC) could predict overall survival (OS) in patients with urothelial bladder cancer (UBC). Materials and Methods The lumbar skeletal muscle index (SMI) of 80 patients was measured before and 1 year after RC. The prognostic significance of sarcopenia and SMI decrease after RC were evaluated using Kaplan-Meier analysis and a multivariable Cox regression model. Results Of 80 patients, 26 (32.5%) experienced sarcopenia before RC, whereas 40 (50.0%) experienced sarcopenia after RC. The median SMI change was -2.2 cm2/m2. Patients with sarcopenia after RC had a higher pathological T stage and tumor grade than patients without sarcopenia. Furthermore, the overall mortality rate was significantly higher in patients with sarcopenia than in those without sarcopenia 1 year after RC. The median follow-up time was 46.2 months, during which 22 patients died. Kaplan-Meier estimates showed a significant difference in OS rates based on sarcopenia (P=0.012) and SMI decrease (P=0.025). Multivariable Cox regression analysis showed that SMI decrease (≥2.2 cm2/m2) was an independent predictor of OS (hazard ratio: 2.68, confidence interval: 1.007-7.719, P = 0.048). Conclusions The decrease in SMI after surgery might be a negative prognostic factor for OS in patients who underwent RC to treat UBC.

Assuntos

Humanos , Masculino , Feminino , Idoso , Neoplasias da Bexiga Urinária/cirurgia , Carcinoma in Situ/cirurgia , Cistectomia/efeitos adversos , Sarcopenia/etiologia , Fatores de Tempo , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/fisiopatologia , Neoplasias da Bexiga Urinária/mortalidade , Carcinoma in Situ/complicações , Carcinoma in Situ/mortalidade , Índice de Massa Corporal , Cistectomia/métodos , Cistectomia/mortalidade , Modelos de Riscos Proporcionais , Análise Multivariada , Estudos Retrospectivos , Músculo Esquelético/fisiopatologia , Estimativa de Kaplan-Meier , Sarcopenia/fisiopatologia

RESUMO

PURPOSE: The present study aimed to determine whether sarcopenia after radical cystectomy (RC) could predict overall survival (OS) in patients with urothelial bladder cancer (UBC). MATERIALS AND METHODS: The lumbar skeletal muscle index (SMI) of 80 patients was measured before and 1 year after RC. The prognostic signifi cance of sarcopenia and SMI decrease after RC were evaluated using Kaplan-Meier analysis and a multivariable Cox regression model. RESULTS: Of 80 patients, 26 (32.5%) experienced sarcopenia before RC, whereas 40 (50.0%) experienced sarcopenia after RC. The median SMI change was -2.2 cm2/m2. Patients with sarcopenia after RC had a higher pathological T stage and tumor grade than patients without sarcopenia. Furthermore, the overall mortality rate was signifi - cantly higher in patients with sarcopenia than in those without sarcopenia 1 year after RC. The median follow-up time was 46.2 months, during which 22 patients died. Kaplan-Meier estimates showed a signifi cant difference in OS rates based on sarcopenia (P=0.012) and SMI decrease (P=0.025). Multivariable Cox regression analysis showed that SMI decrease (≥2.2 cm2/m2) was an independent predictor of OS (hazard ratio: 2.68, confi dence interval: 1.007-7.719, P = 0.048). CONCLUSIONS: The decrease in SMI after surgery might be a negative prognostic factor for OS in patients who underwent RC to treat UBC.

Assuntos

Carcinoma in Situ/cirurgia , Cistectomia/efeitos adversos , Sarcopenia/etiologia , Neoplasias da Bexiga Urinária/cirurgia , Idoso , Índice de Massa Corporal , Carcinoma in Situ/complicações , Carcinoma in Situ/mortalidade , Cistectomia/métodos , Cistectomia/mortalidade , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Análise Multivariada , Músculo Esquelético/fisiopatologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Sarcopenia/fisiopatologia , Fatores de Tempo , Neoplasias da Bexiga Urinária/complicações , Neoplasias da Bexiga Urinária/mortalidade , Neoplasias da Bexiga Urinária/fisiopatologia

RESUMO

Mucinous cystic neoplasm of the liver (MCN-L) and intraductal papillary mucinous neoplasm of the bile duct (IPMN-B) are diagnoses that were classified by the World Health Organization in 2010 as mucin-producing bile duct tumors of the hepatobiliary system. The preoperative differential diagnosis between these two entities is difficult; the presence of a communication with the bile duct is usually considered as a typical sign of IPMN-B. However, the presence of an ovarian-like stroma (OLS) has been established to define the diagnosis of MCN-L. We present the case of a 33-year-old woman with a rapid progression of a cystic tumor of the liver. In 2 years, the lesion increased from 27 to 64 mm and a dilation of the left hepatic duct appeared. Percutaneous transhepatic drainage with a biopsy was performed. No malignant cells were found on biopsy. Because of the rapid progression of the cystic tumor and unclear malignant potential, left hemihepatectomy was performed. Even though tumor masses were present in the biliary duct, on the basis of the presence of OLS, histology finally confirmed MCN-L with intermediate-grade intraepithelial dysplasia to high-grade intraepithelial dysplasia. The patient is currently under oncologic follow-up with no signs of recurrence of the disease. We present a rare case where MCN-L caused a dilation of the left hepatic duct, a sign that is usually a characteristic of IPMN-B.

Assuntos

Neoplasias dos Ductos Biliares/diagnóstico , Ducto Hepático Comum/patologia , Neoplasias Hepáticas/diagnóstico , Neoplasias Císticas, Mucinosas e Serosas/diagnóstico , Adulto , Neoplasias dos Ductos Biliares/patologia , Biópsia , Carcinoma in Situ/complicações , Carcinoma in Situ/diagnóstico , Carcinoma in Situ/patologia , Carcinoma in Situ/cirurgia , Colangiografia , Diagnóstico Diferencial , Dilatação Patológica , Progressão da Doença , Feminino , Hepatectomia , Humanos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/cirurgia , Imageamento por Ressonância Magnética , Neoplasias Císticas, Mucinosas e Serosas/complicações , Neoplasias Císticas, Mucinosas e Serosas/patologia , Neoplasias Císticas, Mucinosas e Serosas/cirurgia , Valor Preditivo dos Testes , Tomografia Computadorizada por Raios X , Carga Tumoral

RESUMO

PURPOSE: To assess the role of E-cadherin as prognostic biomarker in upper tract urothelial carcinoma (UTUC) in a large multi-institutional cohort of patients. METHODS: Immunohistochemistry technique was used to evaluate E-cadherin expression in 678 patients with unilateral, sporadic UTUC treated with RNU. E-cadherin expression was considered decreased if 10 % or more cells had decreased expression (<90 %). RESULTS: Decreased E-cadherin expression was observed in 353 patients (52.1 %) and was associated with advanced pathological stage (P < 0.001), higher grade (P < 0.001), lymph node metastasis (P = 0.006), lymphovascular invasion (P < 0.001), concomitant carcinoma in situ (P < 0.001), multifocality (P = 0.004), tumor necrosis (P = 0.020) and sessile architecture (P < 0.001). Within a median follow-up of 30 months (interquartile range 15-57), 171 patients (25.4 %) experienced disease recurrence and 150 (21.9 %) died from UTUC. In univariable analyses, decreased E-cadherin expression was significantly associated with worse recurrence-free survival (P < 0.001) and cancer-specific survival CSS (P = 0.006); however, in multivariable analyses, it was not (P = 0.74 and 0.84, respectively). The lack of independent prognostic value of E-cadherin remained true in all subgroup analyses. CONCLUSION: In UTUC patients treated with RNU, decreased E-cadherin expression is associated with features of biologically and clinically aggressive disease and worse outcome in univariable, but not multivariable, analyses. If E-cadherin's association with factors of advanced disease is confirmed on UTUC biopsy specimens, it could be used to help in the clinical decision-making regarding kidney-sparing approaches and/or neo-adjuvant chemotherapy.

Assuntos

Caderinas/metabolismo , Carcinoma in Situ/metabolismo , Carcinoma de Células de Transição/metabolismo , Neoplasias Renais/metabolismo , Neoplasias Primárias Múltiplas/metabolismo , Neoplasias Ureterais/metabolismo , Idoso , Antígenos CD , Carcinoma in Situ/complicações , Carcinoma in Situ/patologia , Carcinoma de Células de Transição/mortalidade , Carcinoma de Células de Transição/patologia , Intervalo Livre de Doença , Feminino , Humanos , Imuno-Histoquímica , Neoplasias Renais/mortalidade , Neoplasias Renais/patologia , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Gradação de Tumores , Estadiamento de Neoplasias , Neoplasias Primárias Múltiplas/mortalidade , Neoplasias Primárias Múltiplas/patologia , Prognóstico , Estudos Retrospectivos , Neoplasias Ureterais/mortalidade , Neoplasias Ureterais/patologia

RESUMO

Anal intraepithelial neoplasia (AIN) is associated with HPV infection and can be detected by cytological screening. While conventional exfoliative cytology (CC) is a low-cost and nonaggressive method, liquid-based cytology (LBC) tends to give clearer readings. Although studies of the efficacy of anal cancer screening methods would be of great importance for groups at high risk for AIN, few such studies have been conducted. The aim of the present study was to assess the concordance of CC and LBC in diagnosing anal pre-neoplastic lesions, and to compare cytological results with anoscopy, histopathological, and molecular biology findings. Comparative study involving 33 HIV-positive patients, who underwent anoscopy and biopsy of suspected lesions. Concordance between the two cytology methods was calculated, as were the associations between cytology results and findings from other screening methods. A total of 54.5% of cases were considered AIN-negative by CC and LBC, and concordance between the two methods was statistically significant (P < 0.05). Anoscopy was negative in 15 of the 18 CC- and LBC-negative cases. CC identified 75% of patients with positive biopsy, while LBC identified 85.71% of these patients. Molecular biology results showed that patients with LSIL tested positive for the highest number of HPV subtypes. The associations between positive biopsy and high grade HPV, HPV 16, and multiple HPV infections were not statistically significant. Conventional and liquid-based cytology are equally effective in screening for anal preneoplastic lesions.

Assuntos

Neoplasias do Ânus/diagnóstico , Carcinoma in Situ/diagnóstico , Soropositividade para HIV/complicações , Teste de Papanicolaou/métodos , Adolescente , Adulto , Neoplasias do Ânus/complicações , Neoplasias do Ânus/patologia , Carcinoma in Situ/complicações , Carcinoma in Situ/patologia , Feminino , Humanos , Masculino

RESUMO

BACKGROUND: The aim of this study was to investigate the frequency of gonadal tumors among patients with Turner syndrome (TS) carrying Y-derivative sequences in their chromosomal constitution. METHODS: Six out of 260 patients with TS were selected based on mosaicism of the entire Y chromosome; 10 were included because Y-derivative sequences have been detected by PCR with specific oligonucleotides (sex-determining region on the Y, testis specific-protein, Y and DYZ3) and further confirmed by FISH. The 16 patients were subjected to bilateral gonadectomy at ages varying from 8.7 to 18.2 years. Both histopathological investigation with hematoxylin and eosin (H&E) and immunohistochemical analysis with anti-octamer-binding transcription factor 4 (OCT4) antibody were performed. RESULTS: Gonadal neoplasia was not detected in any of the 32 gonads evaluated by H&E; however, four gonads (12%) from three patients (19%) had positive OCT4 staining in 50-80% of nuclei, suggesting the existence of germ cell tumors (gonadoblastoma or in situ carcinoma). CONCLUSIONS: Evaluation of the real risk of development of gonadal tumors in TS patients with Y-derivative sequences in their chromosomal constitution may require a specific histopathological study, such as immunohistochemistry with OCT4.

Assuntos

Carcinoma in Situ/genética , Cromossomos Humanos Y/química , Gonadoblastoma/genética , Fator 3 de Transcrição de Octâmero/metabolismo , Síndrome de Turner/genética , Adolescente , Carcinoma in Situ/complicações , Carcinoma in Situ/patologia , Criança , Cromossomos Humanos Y/genética , Feminino , Gonadoblastoma/complicações , Gonadoblastoma/patologia , Humanos , Imuno-Histoquímica , Medição de Risco , Síndrome de Turner/complicações , Síndrome de Turner/patologia

Assuntos

Carcinoma in Situ/complicações , Córnea/patologia , Doenças da Córnea/complicações , Neoplasias Oculares/complicações , Carcinoma in Situ/diagnóstico , Doenças da Córnea/diagnóstico , Neoplasias Oculares/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade

RESUMO

BACKGROUND: An association between human papilloma virus (HPV) infection and progression to anal intraepithelial neoplasia (AIN) and epidermoid cancer has been established. OBJECTIVE: To know the prevalence of low and high grade AIN, as well as HPV infection in an anoreceptive patients group, infected or not, by human immunodeficiency virus (HIV). MATERIAL AND METHODS: All patients with anoreceptive sexual relations were considered in this study. Patients who accepted anal citology and high definition anoscopy and biopsies with a follow-up not minor of 3 months were included. RESULTS: Forty-four patients were included: 40 male (90.9%) with average age of 31 years. Anal cytology showed inflammatory alterations in 21 patients (28%), low grade intraepithelial lesion in 23 (52%); there were not patients with high grade epithelial lesion. According to the high definition anoscopy, there were low grade intraepithelial lesion in 42 patients (95%) and high grade in 2 (5%). Biopsy showed low grade intraepithelial in 26 patients (59%), high grade in 4 (9%) and inflammatory alterations in 14 (32%). The prevalence of AIN and HPV infection was 68% in both diseases. The HIV infection was associated with the presence of high grade AIN (p=0.002, OR 47.7) CONCLUSIONS: There is a high prevalence of AIN and HPV infection between patients with anoreceptive sexual relations. The HIV infection is a risk factor for the development of high grade AIN.

Assuntos

Neoplasias do Ânus/complicações , Carcinoma in Situ/complicações , Infecções por Papillomavirus/complicações , Comportamento Sexual/estatística & dados numéricos , Adolescente , Adulto , Canal Anal/patologia , Neoplasias do Ânus/patologia , Biópsia , Carcinoma in Situ/patologia , Progressão da Doença , Feminino , Infecções por HIV/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Papillomavirus/patologia , Fatores de Risco , Adulto Jovem

RESUMO

Vaginal adenosis is an uncommon pathology, characterized by the presence of cylindrical epithelium in the vagina. This pathology is considered rare if not found in women exposed in utero to diethylstilbestrol (dietilestilbestrol). Vaginal intraepithelial neoplasia (VAIN) is another uncommon condition in women who have not been hysterectomized to treat cervical intraepithelial neoplasia (CIN), with an incidence of 0.3 per 100,000 women. On the other hand 0.9% of the patients who have been poshysterectomized to treat CIN develop VAIN. This paper aims at reviewing the literature on vaginal adenosis, vaginal intraepithelial neoplasia and their possible treatments. In addition, the paper reports on a case of vaginal adenosis in a young female patient with concomitant VAIN 2, the CO2 laser ablation performed, and the short-term results obtained.

Assuntos

Carcinoma in Situ/complicações , Doenças Vaginais/complicações , Neoplasias Vaginais/complicações , Adulto , Carcinoma in Situ/patologia , Carcinoma in Situ/cirurgia , Feminino , Humanos , Doenças Vaginais/patologia , Doenças Vaginais/cirurgia , Neoplasias Vaginais/patologia , Neoplasias Vaginais/cirurgia

RESUMO

Carcinoma ductal in situ é extremamente raro, com incidência aproximada de 7% de todos os carcinomas de mama, no sexo masculino. Nas mulheres, ao contrário, a freqüência do carcinoma ductal in situ ocorre em 20% a 25% de todos os casos de câncer de mama feminino. Em comparação com o carcinoma invasivo da mama, o prognóstico associado com o carcinoma in situ, em homem, é bastante favorável, não obstante a apresentação clínica ser variável. Os autores relatam um caso de carcinoma ductal in situ associado a ginecomastia em paciente de 48 anos, sem outros fatores de risco. Submetido a uma adenomastectomia à esquerda, o exame histopatológico revelou carcinoma ductal in situ, com provável infiltração incipiente. Posteriormente submeteu-se a mastectomia mais linfadenectomia axilar. O exame anatomopatológico, seguido de painel de imunoistoquímica da peça, mostrou tratar-se de ginecomastia associada a carcinoma ductal micropapilar in situ, sem comprometimento axilar.

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Ductal carcinoma in situ, an extremely rare occurrence in male patients, accounts for approximately 7% of all breast carcinomas. In contrast, in women ductal carcinoma in situ occurs in 20% to 25% of all cases of female breast cancer. Compared to invasive breast carcinoma, the prognosis associated with carcinoma in situ in men is relatively favorable, in spite of variations in clinical presentation. The authors report a case of histopathologically confirmed ductal carcinoma ductal in situ, with early signs of infiltration, associated with gynecomastia in a otherwise healthy 48-year-old patient submitted to a left-sided adenomastectomy. The patient was subsequently submitted to mastectomy and lymphadenectomy of the axilla. An anatomic pathology examination followed by an immunoshistochemical panel revealed gynecomastia associated with micropapillary ductal carcinoma in situ without involvement of the axilla.

Assuntos

Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma in Situ/cirurgia , Carcinoma in Situ/complicações , Ginecomastia/cirurgia , Ginecomastia/complicações , Mastectomia Simples , Neoplasias da Mama Masculina/cirurgia , Neoplasias da Mama Masculina/complicações

Assuntos

Humanos , Masculino , Feminino , Neoplasias do Ânus/fisiopatologia , Neoplasias do Ânus/epidemiologia , Neoplasias do Ânus/diagnóstico , Neoplasias do Ânus/etiologia , Neoplasias do Ânus/mortalidade , Neoplasias do Ânus/terapia , Carcinoma in Situ/diagnóstico , Carcinoma in Situ/complicações , Carcinoma in Situ/epidemiologia , Técnicas Citológicas/estatística & dados numéricos , Carcinoma de Células Escamosas/epidemiologia , Displasia do Colo do Útero/complicações , Papillomavirus Humano , Sondas de DNA de HPV/diagnóstico , Fatores de Risco , Tabagismo/efeitos adversos , Terapia de Imunossupressão/efeitos adversos , Condiloma Acuminado/complicações

RESUMO

PURPOSE: The incidence of anogenital squamous-cell carcinoma was observed to have increased since the beginning of the human immunodeficiency virus infection epidemic among male homosexuals, both with acquired immunodeficiency syndrome and without acquired immunodeficiency syndrome. It seems that immunosuppression is the most important risk factor for the progression of anogenital lesions, recurrences of anal condyloma, and development of anal carcinoma, in particular in acquired immunodeficiency syndrome. High-grade anal intraepithelial neoplasia was predominantly observed in the human immunodeficiency virus-positive men. We have also observed a high rate of recurrences of anal lesions in cases of high-grade anal intraepithelial neoplasia. However, there are many cases of recurrences of low-grade anal intraepithelial neoplasia that cannot be predicted by routine histologic studies. By using immunohistochemical methods, we studied the expression of Ki-67 in epithelial cells of low-grade anal intraepithelial neoplasia of patients with acquired immunodeficiency syndrome to try to predict recurrence of these lesions. METHODS: Anal biopsies of 38 patients were studied retrospectively. Of these patients, 14 had no recurrences (Group 1), and 24 patients had recurrence of the anal lesions before one year of follow-up (Group 2). RESULTS: The median percentage of Ki-67-positive cells in Group 1 was 6.3 +/- 7.03 and in Group 2 was 24.1 +/- 16.72. The difference between Groups 1 and 2 was statistically significant (P < 0.001). CONCLUSIONS: Our results showed a high correlation between the percentage of Ki-67-positive cells and recurrences. We concluded that Ki-67 counting in low-grade anal intraepithelial neoplasia can aid in predicting recurrences and therefore aid in the follow-up of these patients.

Assuntos

Síndrome da Imunodeficiência Adquirida/complicações , Neoplasias do Ânus/complicações , Neoplasias do Ânus/metabolismo , Carcinoma in Situ/complicações , Carcinoma in Situ/metabolismo , Condiloma Acuminado/complicações , Condiloma Acuminado/metabolismo , Antígeno Ki-67/metabolismo , Adulto , Neoplasias do Ânus/patologia , Carcinoma in Situ/patologia , Condiloma Acuminado/patologia , Humanos , Imuno-Histoquímica , Masculino , Recidiva Local de Neoplasia , Estudos Retrospectivos

RESUMO

Antecedentes. la litiasis es uno de los mayores factores de riesgo para cambios inflamatorios, metaplásicos, displásicos y neoplásicos de vesícula biliar, con frecuencia variable en diferenes poblaciones. Objetivo. determinar la frecuencia de asociación de los principales procesos patológicos y datos clínicos con litiasis vesicular. Material y métodos. estudio transveral, descriptivo de 1,367 piezas de colecistectomía, con (1,096) y sin (271) litiasis fue la siguiente: metaplasia psudopilórica 50 por ciento y 25 por ciento; metaplasia intestinal 16 por ciento y 2 por ciento; displasia de bajo grado 40 por ciento y 17 por ciento; displasia de alto grado 16 por ciento y 2 por ciento; carcinoma in situ 1.5 por ciento y 0 por ciento y carcinoma invasor 2.6 por ciento y 0 por ciento. El 80 por ciento de los casos con litiasis, el 65 por ciento de los casos de carcinoma in situ y el 90 por ciento de los casos de carcinoma invasor correspondieron a mujeres. La edad media de los pacientes con displasia de bajo y alto grado, carcinoma in situ y carcinoma invasor fue de 42, 48, 53 y 61 años, en ese orden. Conclusiones. la frecuencia de procesos inflamatorios agudos, colecititis crónica xantogranulomatosa, adenomiomatosis, metaplasia pseudopilórica e intestinal, pólipos hiperplásicos, displasia de bajo y alto grado, adenomas tubulares, carcinoma in situ y carcinoma invasor fue mayor en vesículas con litiasis que en vesículas sin litiasis (p<.05)

Assuntos

Humanos , Masculino , Feminino , Pré-Escolar , Adolescente , Adulto , Pessoa de Meia-Idade , Adenocarcinoma/complicações , Adenocarcinoma/patologia , Adenoma/complicações , Adenoma/patologia , Carcinoma in Situ/complicações , Carcinoma in Situ/patologia , Carcinoma/complicações , Carcinoma/patologia , Colecistite/patologia , Colelitíase/complicações , Colelitíase/patologia , Neoplasias da Vesícula Biliar/complicações , Neoplasias da Vesícula Biliar/patologia , Metaplasia/patologia , Lesões Pré-Cancerosas/complicações , Lesões Pré-Cancerosas/patologia , Fatores de Risco , Vesícula Biliar/patologia , Doença Aguda

RESUMO

BACKGROUND: A strong association has been reported between gallbladder carcinoma, premalignant epithelial or metaplasic inflammatory lesions and cholelithiasis, varying the incidence among different ethnic groups. PURPOSE: To determine the frequency of association between such lesions and gallbladder lithiasis. MATERIAL AND METHODS: We examined histopathologic changes in 1,367 cholecystectomy specimens with (1,096) or without (271) lithiasis and established its frequency of association, correlating with main clinical data. RESULTS: Overall, 80% had lithiasis. In this group, pseudopyloric metaplasia (50%), intestinal metaplasia (16%), low grade dysplasia (40%), high grade dysplasia (16%), carcinoma in situ (1.5%) and invasive carcinoma (2.6%) were observed compared to 25%, 2%, 17%, 2%, 0%, and 0% in the control group. The findings of 80% with lithiasis, 65% with carcinoma in situ and 90% of invasive carcinoma, all were in women. Median age of patients with low and high grade dysplasia, carcinoma in situ and invasive carcinoma was 42, 48, 53 and 61 years, respectively. CONCLUSIONS: Acute and xanthogranulomatous cholecystitis, adenomyomatosis, pseudopyloric and intestinal metaplasia, hyperplastic polyps, low and high grade dysplasia, tubular adenomas, carcinoma in situ and invasive carcinoma were more frequent when cholelithiasis was present (p < .05) than in cases without lithiasis.

Assuntos

Adenoma/complicações , Carcinoma in Situ/complicações , Carcinoma/complicações , Colelitíase/complicações , Neoplasias da Vesícula Biliar/complicações , Vesícula Biliar/patologia , Lesões Pré-Cancerosas/complicações , Doença Aguda , Adenocarcinoma/complicações , Adenocarcinoma/patologia , Adenoma/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/patologia , Carcinoma in Situ/patologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Colecistite/patologia , Colelitíase/patologia , Feminino , Neoplasias da Vesícula Biliar/patologia , Humanos , Masculino , Metaplasia/patologia , Pessoa de Meia-Idade , Pólipos/patologia , Lesões Pré-Cancerosas/patologia , Fatores de Risco

RESUMO

El cáncer de testículo es una enfermedad importante debido a las características de la población afectada y a las elevadas posibilidades de curación con los recursos terapéuticos actuales. El carcinoma in situ (CIS) de testículo es un reconocido precursor del tumor invasivo. Investigamos la incidencia de cis en grupo de riesgo para esta condición en nuestra población; no hubo ningún caso de CIS en 20 gónadas estudiadas

Assuntos

Humanos , Masculino , Adulto , Carcinoma in Situ/epidemiologia , Neoplasias Testiculares/epidemiologia , Carcinoma in Situ/complicações , Criptorquidismo/complicações , Fatores de Risco

RESUMO

The diagnosis of early gallbladder carcinoma is almost impossible before surgery; in many cases the tumors are grossly inapparent. The usefulness of imprint cytology in detecting early carcinoma of the gallbladder mucosa was assessed. Eight macroscopically inapparent carcinomas were diagnosed, and nine grossly evident carcinomas were confirmed by imprint cytology in 120 cholecystectomies. The sensitivity of cytologic diagnosis of macroscopically inapparent carcinoma was 80%, specificity and predictive value were 100%, and efficiency was 97.7%. If overt carcinomas are included, both the sensitivity and efficiency increase, to 89.6% and 98%, respectively. For the diagnosis of dysplasia the sensitivity and predictive value was 84%, specificity 97.6% and efficiency 95.8%. Because of the simplicity and rapidity of imprint cytology of gallbladder mucosa, coupled with its high sensitivity and reliability, it is recommended for the detection of inapparent carcinoma during cholecystectomy in patients at high risk of cancer.

Assuntos

Neoplasias da Vesícula Biliar/patologia , Vesícula Biliar/patologia , Doença Aguda , Idoso , Carcinoma in Situ/complicações , Carcinoma in Situ/diagnóstico , Carcinoma in Situ/patologia , Colecistectomia , Colecistite/complicações , Colecistite/cirurgia , Colelitíase/complicações , Colelitíase/cirurgia , Colestase Extra-Hepática/complicações , Colestase Extra-Hepática/cirurgia , Feminino , Neoplasias da Vesícula Biliar/complicações , Neoplasias da Vesícula Biliar/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa/patologia , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Sensibilidade e Especificidade

Assuntos

Humanos , Feminino , Carcinoma in Situ/complicações , Displasia do Colo do Útero/complicações , Neoplasias do Colo do Útero/complicações

RESUMO

É relatado um caso de endometrite e cercicite tuberculosa associadas a carcinoma in situ do colo uterino numa mulher na pós-menopausa. A paciente havia se submetido a uma amputaçäo de colo uterino por carcinoma in situ e durante o seguimento foi observada recidiva do processo, após um ano da cirurgia. Foi entäo realizada uma histerctomia total com anexectomia bilateral, cujo resultado histopatológico revelou a associaçäo de endometrite e cervicite tuberculosa com carcinoma in situ do colo uterino. As trompas e os ovários näo estavam afetados pelo processo tuberculoso. É ressaltada a raridade do caso, e feita uma revisäo da literatura sobre o assunto

Assuntos

Pessoa de Meia-Idade , Humanos , Feminino , Carcinoma in Situ/complicações , Endometrite/complicações , Tuberculose dos Genitais Femininos/complicações , Neoplasias do Colo do Útero/complicações , Cervicite Uterina/complicações , Menopausa , Recidiva

RESUMO

No período de 1976 a 1987 foram estudadas 50 mulheres portadoras de neoplasia maligna da vulva, na Clínica da FMUSP. A idade variou de 31 a 92 anos, média de 64,37 anos. Foram realizados os seguintes tipos de tratamentos: vulvectomia radical em 29(58%), vulvectomia simples em 12(24%), radioterapia exclusiva em 3(6%), quimioterapia exclusiva em 2(4%). Em 4(8%) casos nenhum tratamento foi realizado (recuso ou abandono). O objetivo do presente estudo foi o de verificar as possíveis associaçöes entre câncer vulvar, neoplasia vulvar intra-epitelial (VIN) e distrofias vulvares crônicas (DVC). Os resultados mostraram as seguintes associaçöes: carcinoma vulvar invasor e DVC em 12(29%), correspondendo a seis casos de líquen escleroso, cinco de distrofia hiperplásica e um caso de distrofia mista; carcinoma vulvar invasor e VIN em 2(4%) dos casos, VIN I e VIN II, respectivamente. Houve associaçäo de Ca in situ (VIN III) e DVC em 3(50%) casos, correspondendo estes à distrofia hiperplásica. Concluem os autores que a DVC está associada ao carcinoma vulvar invasor em níveis superioras quando comparados ao VIN. As portadoras de DVC, apesar de considerada afecçäo benigna, deveräo ser acompanhadas periodicamente, no sentido de se detectar quaisquer lesöes atípicas precocemente

Assuntos

Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Carcinoma de Células Escamosas/complicações , Carcinoma in Situ/complicações , Melanoma/complicações , Doença de Paget Extramamária/complicações , Neoplasias Vulvares/complicações , Estudos Retrospectivos

RESUMO

Se presentan dos pacientes del sexo masculino de 76 y 72 años de edad, que consultan por queratosis seborreicas de 5 y 10 años de evolución respectivamente. Ambos habían sufrido cambios clínicos en los últimos meses. Una de las lesiones se ubicaba en pabellón auricular y la otra en área cubierta (cara interna de brazo). El estudio histológico demostró la presencia de un epitelioma espinocelular in situ y la queratosis seborreica en los dos casos. Destacamos la rareza del hallazgo confirmado y la posibilidad de reconocer signos clínicos de alarma en las queratosis seborreicas

Assuntos

Idoso , Humanos , Masculino , Carcinoma in Situ/complicações , Ceratose/complicações , Neoplasias Cutâneas/complicações , Ceratose/patologia