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J J Ríos-Martín

Publications and source records attributed to J J Ríos-Martín.

11 recordsLinked to original sources

Localized Kaposi's sarcoma in a patient with pemphigus vulgaris.

We report the case of a patient with a 13-year history of pemphigus vulgaris (PV) treated with immunosuppressive agents, prednisone and mycophenolate mofetil who had developed lesions of Kaposi's sarcoma (KS) on a sole plaque of PV that had been previously treated with intralesional injections of steroids. The lesions were surgically removed and polymerase chain reaction (PCR) demonstrated human herpesvirus-8 (HHV-8) DNA. There were neither recurrences nor later dissemination of KS following gradual decrease of the immunosuppressive therapy. We suggest that the treatment with intralesional steroids may have influenced the local reactivation of a latent infection of the virus, determining the appearance of this localized KS.

Aged↗

Cutaneous pseudolymphoma in association with molluscum contagiosum in an elderly patient.

BACKGROUND: Molluscum contagiosum (MC) is a common cutaneous infection, which has been reported in association with cutaneous pseudolymphoma in few cases. METHODS: A 72-year-old woman with a nodule arising on the external canthus was reviewed. The lesion was surgically removed, and the histopathological study demonstrated an epidermal invagination filled by molluscum bodies and a diffuse infiltrate comprising atypical lymphocytes. RESULTS: Immunohistochemical stains disclosed predominance of T cells with positive CD30 labeling. Polymerase chain reaction failed to demonstrate clonal rearrangement of the T-cell receptor. CONCLUSION: After ruling out systemic involvement, the patient was followed up for 2 years with no evidence of recurrence. We report this case to the best of our knowledge and discuss the literature about atypical clinical and histological presentations of MC.

Aged↗

P-glycoprotein, metallothionein and NM23 protein expressions in breast carcinoma.

Cellular drug resistance and increased metastatic potential are the major obstacles in the successful treatment of cancer with chemotherapy. The aim of this study was to investigate whether the immunohistochemical expression of two proteins implicated in drug resistance (P-glycoprotein and metallothionein) and the product of the suppressor gene nm23 could be related to prognosis in breast cancer. Seventy-two patients with palpable or occult breast carcinoma, not treated with chemotherapy or endocrine therapy, were examined. Immunohistochemical methods were used to determine the expression of P-glycoprotein (PG), metallothionein (MT), nm23, as well as the estrogen receptor (ER), the p53 status, and the Ki67 index. The results were correlated with clinical and morphological features. Cytoplasmic and membrane-specific immunostainings of PG were seen exclusively in tumor cells and identified in 14 of 72 cases (19.4%). Only a statistically significant association with metastases, (p = 0.06) and recurrences (p = 0.1) was observed. MT-positive reaction was identified in the cytoplasm of the tumor cells in 47 (65.3%) cases. Statistical significance was associated with metastases (p = 0.07), but not with death or recurrences. Specific immunostaining of nm23 protein was seen only in the cytoplasm of tumor cells. A positive reaction was observed in 55 of 72 (89.3%) cases. Although a significant association between nm23 protein expression and other morphologic and immunohistochemical variables did not exist, we observed a higher morbidity in patients with the MT-positive/nm23-negative tumor phenotype. Univariate analysis for survival selected the following variables: histologic grade (p = 0.001), ER (p = 0.002), mitotic index (p = 0.005), Ki 67 index (p = 0.068), MT (p = 0.046) and PG (p = 0.085). The Cox model provided the following independent variables: histologic grade (p = 0.021) and metallothionein (p = 0.03). These data confirm the prognosis observed in patients with PG or metallothionein expression as well as the independence of these two variables. It also suggests that nm23 is not necessarily involved in the development of an invasive phenotype.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Early gastric stump carcinoma with rhabdoid features. Case report.

Among 474 cases of gastric carcinoma studied in gastrectomy specimens from 1990 to 1996, only one (0.21%) showed positivity for vimentin. It was located on a gastric stump and, endoscopically, the tumor was classified as early gastric carcinoma type IIb + IIc. Histologically, tumor cells were extensively round to polygonal and had eosinophilic, or clear cytoplasm; the nuclei were large with conspicuous nucleoli. In some areas, the cytoplasm showed vimentin and(or cytokeratin coexpression by double immunostaining. Our results and the patient's rapid deterioration (death occurred six months after surgery) suggest that this type of tumor, although diagnosed as early carcinoma, behaved like an advanced malignancy.

Biomarkers, Tumor↗

Cutaneous T-cell lymphoma and human immunodeficiency virus infection: 2 cases and a review of the literature.

Cutaneous non-Hodgkin's lymphomas are rare in patients with HIV-1 infection and almost all of the cases reported are of T-cell lineage with histopathological features of mycosis fungoides or Sezary syndrome. We studied 2 cases of mycosis fungoides in HIV-1-positive patients who were intravenous drug abusers and were in stage II and IV C2 (CDC'86), respectively. The first patient (stage II) had multiple, erythematous and infiltrated large plaques on the abdomen, back, arms and legs, whereas the second patient (stage IV) had smaller erythematous, slightly scaly and infiltrated pruritic plaques on the trunk and limbs. Their CD4 lymphocyte counts were 634 and 250 cells/mm3, respectively. Biopsies showed features consistent with mycosis fungoides, with an epidermotropic pattern. The immunohistochemical study revealed a T-cell lineage of this atypical infiltrate. Both patients partially responded to topical steroid ointment, showing moderate improvement. Further biopsies performed 6 months later confirmed the prior diagnosis of mycosis fungoides. No tumour stage was observed during a 2-year follow-up. We conclude that mycosis fungoides is rare in HIV-positive patients, but must be included in the differential diagnosis of erythematous plaques in these patients. In suspected, but non-diagnostic cases of mycosis fungoides in HIV-positive patients, only a close clinical and histopathological follow-up can confirm the diagnosis.

Adult↗

Sarcomatoid carcinoma of the skin: report of a case.

We report the histological, immunohistochemical and ultrastructural findings of an exophytic cutaneous tumor composed of a mixture of typical basal cell carcinoma (BCC) and malignant fibrous histiocytoma. Nine previously reported carcinosarcomas of the skin are reviewed. We prefer the term "sarcomatoid carcinoma" for this rare neoplasm. Only the BCC showed a positive immunoreaction to cytokeratin; the sarcomatous component was negative, but it did express vimentin, and, focally, smooth-muscle-specific actin and KP1 (CD68). Both components showed p53 immunostaining.

Aged↗

Mandibular lymphomas with sclerosis.

Two cases of non-Hodgkin's lymphoma that show a sarcomatoid pattern within the jaw are described. Their primary origin in bone was demonstrated by radiologic studies. In one case, diagnosis was delayed because the clinical picture suggested inflammatory periodontal disease. In both cases, the histologic picture was similar to that of a sarcomatoid neoplasm with intense stromal sclerosis; hemimandibulectomy was performed in one case. The tumor contained cells with large, irregular, sometimes lobulated nuclei and high mitotic activity, and perforated mandibular bone with infiltration into adjacent soft tissues. The lymphoid nature of these neoplasms was demonstrated by immunohistochemical and ultrastructural study.

Humans↗

Nuclear DNA patterns in adrenal cortex proliferative lesions.

In cortical adrenal gland tumours there are discrepancies between morphological criteria for malignancy and biological behaviour. This makes it difficult to select the appropriate treatment. We have studied morphometric and DNA densitometric features of 24 adrenal proliferative lesions (hyperplasia, adenoma, and carcinoma) by means of slide cytometry. All variables have been correlated with pathological diagnosis. The samples were selected from paraffin-embedded tissue, and representative lesions were Feulgen stained. Densitometric study showed aneuploid cell lines in every carcinoma, 5 of 8 adenomas, and 5 of 10 hyperplastic lesions. Both DNA nuclear content (mean ploidy of 2.11 c, 2.41 c, and 3.05 c) mean nuclear area (average of 31.26 microns 2, 35.92 microns 2, and 42.39 microns 2) showed progressive increase from hyperplasia to adenoma, and carcinoma. Mean shape factors were lowest in adenomas (1.69) and highest in carcinomas (1.82). Those karyometric variables which showed statistically significant differences (p < 0.05) among diagnostic groups were included in a stepwise three-way discriminant analysis. Only three parameters, shape factor (p = 0.0008), mean ploidy (p = 0.0012), and adrenal weight (p = 0.0055) persisted as independent predictive factors. Using the three variables selected by discriminant analysis on our cases, 100% of the adenomas were correctly classified, 83% of the carcinomas, and 80% of the hyperplasias. Tumour weight and nuclear shape factor differentiated adrenal cortex adenoma from carcinoma, while mean ploidy distinguished adrenal cortical hyperplasia from carcinoma. Nuclear pleomorphism (shape factor) and DNA-ploidy are the most important nuclear features in predicting the biological course of proliferative adrenal cortex lesions, although by themselves they are not bona-fide discriminators.

Adenoma↗