Biomedical subjects
Publications and source records attributed to J M Elizalde.
A typical case of gliosarcoma in a 74 year-old woman is reported. The exact origin of sarcomatous areas of this tumor has been a matter of debate. Our immunohistochemical findings, using a panel of antibodies (GFAP), vimentin, keratins, F-VIII related antigen, muscle specific actin, KP-1 and HMB-45), support its undifferentiated nature. The literature concerning this topic is reviewed and briefly discussed.
Two extraskeletal myxoid chondrosarcomas arising on the left lower extremity of two women, aged 48 and 72 years, respectively, are reported. One case mimicked clinically an organized hematoma. By light microscopy, they showed a lobular architecture. Anastomosing cords of cells lying in a myxoid background were the histologic hallmark. Based on conventional criteria, they were classified as neoplasms of low (G1) and intermediate (G2) grade malignancy. Both cases were strongly positive for S-100 protein and vimentin. Follow-up confirmed the low aggressiveness of this entity.
A case of central mucoepidermoid carcinoma (CMEC) occurring in a 68-year-old woman is reported. The tumor clinically appeared as a long-standing cortical swelling in the left angle of her mandible. As an intrabony lesion was radiologically evidenced, an odontogenic cyst was preoperatively diagnosed. Surgical curettage demonstrated a solid tumor the histological study of which allowed the final diagnosis. Immunohistochemical profile accorded with the patterns previously observed in salivary gland counterparts. Adjuvant radiotherapy was performed. Neither local recurrences nor metastases have been observed to date.
The light microscopy and immunohistochemical findings of a jugulo-tympanic paraganglioma occurring in a 29-year-old man are reported. Diagnostic difficulties from frozen sections are stressed and selected literature is briefly commented upon.
A case of Whipple's disease occurring in a 63-year-old woman is reported. Cervical lymphadenopathy and vague constitutional symptoms were soon followed by diarrhea and weight loss. Supraclavicular lymph node exeresis suggested the initial diagnosis, which was confirmed by intestinal biopsy. The concurrence of cystic spaces, PAS-positive foamy histiocytes and epithelioid granulomas is considered by the authors to provide a useful histological clue in the diagnosis of lymph node involvement in Whipple's disease. Pathologists must be aware of such an un-conventional presentation of this rare entity and therefore include it within the differential diagnosis of cervical and/or axillary lymphadenopathies.
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Cytologic findings of two cases of infiltrating papillary carcinoma of the breast are presented. Both cases showed highly cellular smears, prominent papillary configuration, and cohesive groups of polygonal cells with bland nuclei and scarce mitoses. Bipolar cells were not observed. A clean background with hemorrhage, lymphocytes and hemosiderin-laden macrophages was also found. Histologic sections confirmed the initial diagnosis and proved their infiltrating nature. Literature concerning its cytologic differential diagnosis is briefly reviewed and commented.
Herein we describe a case of a hemorrhagic adrenal pseudocyst that had been initially suspected as being a renal adenocarcinoma. The intraoperative anatomopathological study of the specimen permitted performing conservative surgery. The diagnosis and pathogenesis of this uncommon disease entity are discussed.
A case of pigmented dermatofibrosarcoma protuberans in a 37-year-old man is reported. The tumour presented as a nodular lesion located in the left scapular area. Surgical resection with wide margins was performed. No recurrences have appeared to date. The presumptive origin of this entity is briefly discussed.
A perineurioma with prominent myxoid changes is presented. The patient, a 41 year-old woman, presented with a small skin nodule on her back. Light microscopy revealed subtle cellular whorls within a myxoid background. Immunohistochemistry showed epithelial membrane antigen positivity. In contrast, S-100 protein, common leukocyte antigen, vimentin and AE1-AE3 cytokeratin were negative.
The clinicopathologic features of a hibernoma occurring in a 26 year-old female are reported. The tumor was located in the interscapular region and eventually became painful. Surgical excision was performed and to date, no recurrences have been detected.
The simultaneous presence of xanthogranulomatous cholecystitis and adenocarcinoma of the gallbladder has rarely been reported. A review of 53 cases of gallbladder adenocarcinoma in a 15-year period revealed 5 cases in which a concomitant diffuse xanthogranulomatous disease was observed. Clinical and pathologic features of these cases are commented and the diagnostic importance stressed. Both inflammatory and neoplastic components were closely mixed in 3 cases, thus making a prompt diagnosis difficult. Etiologic factors implicated in the development of both entities are considered.
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Eight patients with typical Prinzmetal's angina and angiography proven coronary artery spasm are reviewed. In all cases the angina pain appeared at rest and was accompanied by a simultaneous ST-segment elevation. The coronary angiography results varied from severe multivessel disease (3 cases) to single vessel disease (3 cases), and normal coronary arteries (2 cases). In all patients a coronary spasm was documented, in five cases induced by ergonovine and in three spontaneously; in all patients but in one, the localization of the spasm was concordant with the ST-segment elevation localization. One case with a severe proximal left anterior descending stenosis was grafted; however the pain was not relieved despite treatment with large amounts of propranolol. This patient died after an episode of severe chest pain. Treatment with nifedipine was given to six patients, with excellent results in four cases, and regular response in two. The main physiopathologic diagnostic and therapeutic aspects of the variant angina syndrome are reviewed.