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Biomedical subjects

P González-Peramato

Publications and source records attributed to P González-Peramato.

10 recordsLinked to original sources

Fine needle aspiration cytology of mammary carcinoma with osteoclast-like giant cells.

Carcinoma with osteoclast-like giant cells (OCGC) is an uncommon neoplasm characterized by giant cells, prominent vascularization, haemorrhage and areas of cribriform epithelial growth with moderate atypia. Multinucleated giant cells (MGC) have been described in several other breast lesions raising an interesting differential diagnosis, mainly with benign disorders. Due to its rarity few cases have been described cytologically. We retrospectively reviewed 13 fine needle aspiration samples from nine patients with this variant of carcinoma. Nine corresponded to breast tumours and four to axillary, liver, subcutaneous and mediastinal metastatic lesions. The expression of CD68 by giant cells was evaluated immunocytochemically in six cases. All patients had a complete pathological study of the breast neoplasm. Smears showed a double component of epithelial and giant cells. Epithelial clusters were predominantly of intermediate size with irregular contours. Most were cohesive but others showed cellular dissociation with scarce to moderate cellular pleomorphism. Giant cells had well defined, deeply stained cytoplasm and round to elongated morphology. Two metastatic cases were devoid of them. Haemosiderin-laden macrophages were common in smears from breast tumours. In the six cases tested CD68 was expressed in MGC. Cytological features of mammary carcinoma with OCGC correlate closely with the histological ones. Most cases are clearly recognizable as malignant but in others cytological atypia may be minimal, mimicking a benign lesion. In difficult cases the presence of haemosiderin-laden macrophages and the histiocytic nature of the MGC are helpful diagnostic features.

Adult↗

Fine-needle aspiration cytology of "proximal-type" epithelioid sarcoma.

The cytologic and immunocytologic findings in a case of recurrent "proximal-type" epithelioid sarcoma (ES) of the vulva are presented. This is a recently described neoplasm that differs clinically and morphologically from conventional ES. Cytologic smears showed a dissociated population of large, atypical neoplastic cells with bi- and multinucleated cells, abundant cytoplasm, and rhabdoid-like morphology. Due to its different clinical management it must be differentiated from metastatic carcinoma and melanoma. From a practical perspective, its differentiation from other epithelial-like sarcomas is less important. In conclusion the cytopathologic findings of "proximal-type" ES show a good correlation with histopathology, permitting the diagnosis of recurrences and metastases. When accompanied by adequate clinical information and ancillary studies, a specific preoperative recognition seems possible.

Aged↗

Lipomembranous fat necrosis in three cases of testicular torsion.

AIMS: To describe for the first time a lesion termed lipomembranous fat necrosis (LFN) in three patients with spermatic cord torsion. METHODS AND RESULTS: We reviewed 386 testes and their epididymides and spermatic cords which had been removed for testicular infarction. For the three cases showing LFN, a battery of histochemical tests (including periodic acid-Schiff (PAS), orcein, Sudan black and Perls stains) was applied and clinical histories and laboratory data were also investigated. Findings were similar in the three specimens. The testes showed a central group of necrotic seminiferous tubules which were surrounded by granulation tissue consisting of macrophages, multinucleated giant cells, lymphocytes, plasma cells and fibrous connective tissue at the periphery of the lesion. The spermatic cord showed thrombosed veins surrounded by fat necrosis showing cystic cavities which were bounded by wavy hyaline membranes. These stained with Sudan black, PAS (before and after diastase digestion) and orcein and presented yellowish-green autofluorescence. CONCLUSIONS: Lipomembranous fat necrosis of the spermatic cord is a distinctive entity which seems to be related to spermatic cord torsion and the differential diagnosis of which should be established with regard to the presence of parasites, sclerosing lipogranuloma and granuloma evoked by rupture of a testicular prosthesis.

Adipose Tissue↗

Androgen receptor expression in sertoli cells as a function of seminiferous tubule maturation in the human cryptorchid testis.

Androgen receptor (AR) immunohistochemistry was performed in an archival collection of adult human cryptorchid testes to determine whether AR cellular distribution and intensity of immunostaining were functions of the severity of cellular dysgenesis. The seminiferous tubule histology of cryptorchid testes collected from adults is marked by three specific patterns. 1) Seminiferous tubules are characterized as maintaining focal areas of germinal cell differentiation (albeit incomplete) that are interspersed with 2) tubules composed of Sertoli cells only, these latter cells being principally of the adult type, although dysgenetic and immature Sertoli cells may also be detected. 3) In contrast, there is a class of tubule that is characterized as being composed exclusively of Sertoli cells that are extremely dysgenetic in appearance. The majority of adult-type Sertoli cells found in the first types of tubules exhibited either robust or moderate AR staining intensity. Peritubular cells of these tubules also expressed a similar AR staining intensity. In contrast, in the more dysgenetic and immature type Sertoli cells found in the second type of tubules, the intensity of AR staining was significantly less, if not missing altogether. Finally, in the most dysgenetic tubules, Sertoli cell AR staining was never detected. To our knowledge, this is the first report in the literature that addresses the intensity of AR immunostaining in Sertoli cells of cryptorchid testes. The results presented herein are consistent with the interpretation that the intensity of AR staining in Sertoli cells diminishes as a function of the severity to which the cells are afflicted within a cryptorchid testis and that focal absence of AR expression in Sertoli cells correlates with a lack of local spermatogenesis in the tubules.

Adolescent↗

[Testicular seminoma manifested by carcinomatous neuropathy: an unusual presentation. Review of the literature].

Contribution of one patient with tetraparesic picture originated by a major sensory-motor neuropathy, due to paraneoplastic syndrome produced by a testicular seminoma. The patient underwent inguinal orchiectomy and radiotherapy, with favourable evolution of his neurological symptomatology. Review of the literature and confirmation of the extraordinary rarity of such clinical picture.

Adult↗

[Primary bladder adenocarcinoma: retrospective study of 11 cases and general review].

Eleven cases of primary adenocarcinoma of the bladder are described herein. Eight had a glandular pattern, 1 was papillary and 2 were comprised of signet ring cells (one had areas of colloid carcinoma). One of the cases, originating from the urachus, also showed colloid areas and a glandular pattern. Forty-five percent of the cases were moderately differentiated and the remaining 55% were poorly differentiated. In all cases the tumor had areas of adenocarcinoma in more than 2/3 of its extent. All but two cases revealed muscle layer infiltration at the time of diagnosis. Two patients were submitted to radical cystectomy, lymphadenectomy and Wallace II cutaneous ureteroileostomy, 1 patient underwent partial cystectomy and lymphadenectomy, and 6 were submitted to transurethral resection. Excision of the urachal tumor was by en bloc partial cystectomy. The 5-year survival of patients with infiltrating tumors, excluding the urachal tumor, was 33%, 67% died within the first year of follow-up. The only evaluable case of superficial adenocarcinoma is alive and tumor-free at 94 months. Primary adenocarcinoma of the bladder is an aggressive tumor. Although it may be superficial at the time of diagnosis, it soon develops into an infiltrating tumor if untreated. Treatment and survival depend on tumor stage. Superficial or minimally infiltrating tumors warrant treatment by deep transurethral resection up to the pericystium.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

Secondary testicular tumors.

A review of 3,474 consecutive autopsies on adult men showed that 337 men had died of cancer, and 2 of them presented with testicular metastases from a pancreatic carcinoma and a urinary bladder carcinoma, respectively. In addition, of 32 men with prostatic carcinoma whose testes were removed, 1 man presented with testicular metastases from the tumor, and of 216 patients (children and adults) with neuroblastoma, 2 children showed metastases to the testes.

Adrenal Gland Neoplasms↗

[Necrosis of the bone marrow and cancer].

Bone marrow necrosis (BMN) is a rare complication and is characterized by the presence of an eosinophilic amorphous material in the bone marrow. The clinical, analytical and histological characteristics of 4 patients with BMN associated to a neoplastic process are described. One of them was a gastric cancer but the neoplastic origin could not de determined in the other three cases. Three patients presented bone pain, but in all four patients thrombopenia, anemia, leuko-erythroblastic reaction and elevated LDH was found. A literature review is carried out and the possible physiopathological mechanisms are discussed.

Adult↗

Congenital Leydig cell hyperplasia.

The testes and epididymes collected at autopsy from 21 newborns showed apparent Leydig cell hyperplasia which was studied by light and electron microscopy. Twelve newborns were the sons of diabetic mothers, two had undergone rhesus isoimmunization, two were twins of a non-diabetic mother, three had Beckwitz-Widemann's syndrome, and two had leprechaunism. In the first two groups the placentas were also collected and studied. All the testes showed normal seminiferous tubules and diffuse Leydig cell hyperplasia in the testicular interstitium. In addition one son of a diabetic mother and another with Beckwitz-Widemann's syndrome presented multiple Leydig cell nodules in the mediastinum testis and epididymis. The number of Leydig cells per unit area of the testis was calculated on histological sections stained with the peroxidase-anti-peroxidase method for the detection of testosterone. These numbers varied from 1.4 to 3.2 times those found in age-matched controls, except for the two testes with nodular hyperplasia in which the increase in Leydig cells was even greater. The differential diagnosis between Leydig cell hyperplasia, ectopic adrenal cells and leydig cell tumour is discussed. It is proposed that the cause of congenital Leydig cell hyperplasia might be related to placental secretion of human chorionic gonadotrophin.

Autopsy↗