Endobronchial leiomyoma: an unusual non-defining neoplasm in a patient with AIDS

Smooth muscle neoplasms are more frequent in human immunodeficiency infected children than in HIV seropositive adults. Endobronchial leiomyoma is a rare benign tumor in HIV infected adult patients. Epstein-Barr virus (EBV) has been implicated in the pathogenesis of these tumors. Here we describe an adult patient with HIV infection with atelectasis of the left upper pulmonary lobe as the first clinical expression of an intrabronchial leiomyoma. In this case, we can not show the association with EBV. Our report suggests that smooth muscle tumors as leiomyoma should be included in the differential diagnosis of endobronchial masses in AIDS patients.

Computed tomography-guided percutaneous trephine removal of the nidus in osteoid osteoma patients: experience of a single center in Brazil

AbstractObjective:To report the results of computed tomography (CT)-guided percutaneous resection of the nidus in 18 cases of osteoid osteoma.Materials and Methods:The medical records of 18 cases of osteoid osteoma in children, adolescents and young adults, who underwent CT-guided removal of the nidus between November, 2004 and March, 2009 were reviewed retrospectively for demographic data, lesion site, clinical outcome and complications after procedure.Results:Clinical follow-up was available for all cases at a median of 29 months (range 6–60 months). No persistence of pre-procedural pain was noted on 17 patients. Only one patient experienced recurrence of symptoms 12 months after percutaneous resection, and was successfully retreated by the same technique, resulting in a secondary success rate of 18/18 (100%).Conclusion:CT-guided removal or destruction of the nidus is a safe and effective alternative to surgical resection of the osteoid osteoma nidus.

Adenoma viloso da ampola de Vater

The aim of this paper is to present a case of a 37-year-old female patient with a benign tumor of the Ampulla of Vater and a brief review of the literature. The patient presented with progressive obstructive jaundice and weigth loss due to the presence of two adenomas of the second portion of duodenum. Laboratory tests confirmed the presence of obstruction of the biliary tree. Ultrasound and CT scan of the abdomen revealed bile duct dilatation. ERCP showed a tumor at the site of the Ampulla of Vater. The biopsies revealed tubular adenoma. She was submitted to local resection of the tumors and sphincteroplasty, since the frozen biopsy at the time of surgery showed no malignancy. During the post-operative follow-up she presented recurrence of symptoms. An upper GI endoscopy revealed a tumor at the Ampulla of Vater. She was then submitted to Whipple procedure with an uneventful recovery.

Linfangioma cístico do fígado

Hepatic lymphangioma developed from a malformation that blocks the lymphatic system of a given area of the liver is a rare benign tumor observed most often in children and adolescents. The authors report and discuss a case of cystic lymphangioma of the liver in a 65 years old female patient, from a region where hydatid disease is endemic, with a complaint of epigastric pain, nausea, and vomiting. The patient presented a non-pulsatile mass, with severe pain at palpation in the epigastric region, The diagnostic investigation revealed a large cystic lesion in the left lobe of the liver; and she was submitted to bisegmentectomy II and III, which showed a hepatic lymphangioma. Considering the progressive character of this lesion, it should be carefully evaluated, since the removal of the lymphangioma is a safe, curative procedure.

Timolipoma simulando cardiomegalia

Thymolipoma is a rare benign tumor of the thymus. Because of its large size and pliability the mass usually drapes itself around the heart, conforming to its borders and producing a large radiographic shadow easily mistaken as cardiomegaly. This report describes a 48-year-old man with a chest radiograph strongly suggestive of cardiomegaly. Careful radiological study showed the existence of a large mass in the anterior mediastinum, simulating cardiomegaly. A thymolipoma weighing 2500g was resected through an esternotomy.

Tratamento cirúrgico do schwannoma traqueal

Schwannoma is a rare benign tumor of the proximal tracheobronchial tree. The aim of the present study is to report a case of tracheal schwannoma causing airway obstruction. A 16-year-old woman complained of cough, wheezing and dyspneia. Bronchoscopy and computerized tomography showed a polypoide intratracheal mass obstructing approximately 80% of the lumen. The treatment consisted of tracheal resection and primary anastomosis. Histological analysis revealed a tracheal schwannoma. The postoperative course was uneventful and the patient remains well twelve months after surgery.

Paraganglioma gangliocítico duodenal

We present a case of a 42-year-old man with abdominal pain, obstructive jaundice and a mass in the second portion of the duodenum, near the papillary region. The patient was operated and the histological study of the specimen returned duodenal gangliocytic paraganglioma (a rare submucosal benign tumor of the duodenum). We also describe, after revision of the literature, the pathology, the diagnosis and its treatment.

Pseudoaneurisma de artéria poplítea secundário a osteocondroma femoral: relato de caso

Osteochondromas are the most common benign tumor of the bone. They are sometimes responsible for vascular complications involving either veins or arteries, principally around the knee. Pseudoaneurysms are considered a rare condition. The authors describe the occurrence of a pseudoaneurysm of the popliteal artery in association with a femoral osteochondroma in a 30-years-old man.

Spontaneous rupture of renal angiomyolipoma during pregnancy

Renal angiomyolipoma is a benign tumor, composed of adipocytes, smooth muscle cells and blood vessels. The association with pregnancy is rare and related with an increased risk of complications, including rupture with massive retroperitoneal hemorrhage. The follow-up is controversial because of the lack of known cases, but the priorities are: timely diagnosis in urgent cases and a conservative treatment when possible. The mode of delivery is not consensual and should be individualized to each case. We report a case of a pregnant woman with 18 weeks of gestation admitted in the emergency room with an acute right low back pain with no other symptoms. The diagnosis of rupture of renal angiomyolipoma was established by ultrasound and, due to hemodinamically stability, conservative treatment with imaging and clinical monitoring was chosen. At 35 weeks of gestation, it was performed elective cesarean section without complications for both mother and fetus.

Retrospective canine skin peripheral nerve sheath tumors data with emphasis on histologic, immunohistochemical and prognostic factors

Abstract: In this retrospective study was determined the frequency of canine skin peripheral nerve sheath tumors (PNST) in cases diagnosed by the Setor de Patologia Veterinária of the Universidade Federal do Rio Grande do Sul (SPV-UFRGS), Brazil, between the years 2000 and 2012. The canine profiles, as well as histological, immunohistochemical and prognostic aspects of the tumors were based on 70 samples, comprising 40 females, 29 males and one unspecified sample. Between 2000 and 2012, 2,984 skin tumors of dogs were diagnosed in the SPV-UFRGS, totaling 2.34% of skin neoplasms in dogs. Animals that comprised the largest amount of samples (43%) were those with no breed (SRD), followed by German Shepherds (10%). Females were more affected than males (40/70 - 57% and 29/70 - 41% respectively). Skin PNST of this research showed predominant localization on the limbs (40% in the forelimbs and 29% in the hindlimbs); affecting adult dogs, mostly aged between 8 and 11 years (54%). The samples were routinely processed for hematoxylin and eosin, and were also evaluated by toluidine blue and Masson's trichrome staining, and immunohistochemistry (IHC) anti-vimentin, -S-100, -GFAP, -actin, von Willebrand factor and neurofilament. Anisocytosis and anisokaryosis, mitotic index, intratumoral necrosis, invasion of adjacent tissues, tumor location, local recurrence and metastasis were related to the diagnosis of benign (49/70) or malignant tumor (21/70). The Antoni A histological pattern was observed more frequently in benign tumors. The immunohistochemistry helped to diagnose PNST, and anti-vimentin and anti-protein S-100 showed the highest rates of immunostaining. Throughout statistical analysis of animals with tumor recurrence, it was found that the chance of an animal with a malignant peripheral nerve sheath tumor to develop recurrence is 4.61 times higher than in an animal that had a benign tumor.

Dirofilariasis involving the oral cavity: report of the first case from South America

Oral dirofilariasis is very rare with non-specific clinical manifestations. Here, we report the case of a 65-year-old South American woman with a submucosal nodule on her right buccal mucosa. The nodule was slightly tender and painful. Differential diagnoses included mesenchymal (lipoma or fibrolipoma, solitary fibrous tumor, and neurofibroma) or glandular benign tumors (pleomorphic adenoma) with secondary infections. We performed excisional biopsy. A histopathological examination revealed a dense fibrous capsule and a single female filarial worm showing double uterus appearance, neural plaque, well-developed musculature and intestinal apparatus. Dirofilariasis was diagnosed, and the patient was followed-up for 12 months without recurrence.

Correlação entre a classificação clínica TNM e as características histológicas de malignidade do carcinoma epidermóide oral

A gradação histológica das margens mais profundas do carcinoma epidermóide oral influencia diretamente na sobrevida do paciente, já que células neoplásicas nesse local mostram-se indiferenciadas e de grande valor prognóstico. OBJETIVO: A proposta desse estudo é correlacionar a classificação clínica TNM com as características histopatológicas (grau de queratinização, pleomorfismo nuclear, padrão de invasão e infiltrado linfoplasmocitário) e os escores histológicos de malignidade de 38 casos de carcinoma epidermóide oral nas áreas mais profundas da lesão. FORMA DE ESTUDO: Estudo clínico retrospectivo. MATERIAL E MÉTODO: O estudo foi baseado em uma revisão retrospectiva incluindo a observação histológica de 38 casos de carcinoma epidermóide oral dos arquivos do Hospital Dr. Luis Antônio, Natal-RN, Brasil. Com a análise dos prontuários médicos, foram obtidos os dados referentes à classificação clínica TNM. A gradação histológica de malignidade foi realizada na área invasiva do tumor por dois patologistas em secções histológicas de 3 µm de espessura coradas pela hematoxilina e eosina. Para as análises estatísticas foram aplicados os testes paramétricos (ANOVA) e não-paramétricos (Tukey; Pearson; Qui²). RESULTADOS: Foi encontrada correlação estatisticamente significante do estadiamento clínico TNM com os escores histológicos de malignidade (p= 0,001) e com os parâmetros histológicos isolados tais como: pleomorfismo nuclear (p= 0,016) e grau de queratinização (p= 0,025). Além disso, houve também uma correlação estatisticamente significante entre infiltrado linfoplasmocitário (p= 0,016) e pleomorfismo nuclear (p= 0,004) com a classificação clínica TNM quando agrupada em duas séries: TNM-I/II e III/IV. CONCLUSÕES: A classificação clínica TNM teve uma correlação estatisticamente significante com grau de queratinização, pleomorfismo nuclear e infiltrado linfoplasmocitário, assim como com os escores médios de malignidade. Esses resultados altamente significantes indicam que as áreas invasivas podem ser primariamente responsáveis pelo comportamento clinico do tumor e isso pode ser imprescindível para a escolha da terapia para o carcinoma epidermóide oral.

Role of ACTH receptor in adrenocortical tumor formation

Adrenocorticotrophin (ACTH) is the major regulatory hormone of steroid synthesis and secretion by adrenocortical cells. The actions of ACTH are mediated by its specific membrane receptor (ACTH-R). The human ACTH-R gene was recently cloned, allowing systematic determination of its sequence, expression and function in adrenal tumorigenesis. The presence of oncogenic mutations of the ACTH-R gene in adrenocortical tumors has been reported. Direct sequencing of the entire coding region of the ACTH-R gene of sporadic adrenocortical adenomas and carcinomas did not reveal constitutive activating mutations, indicating that this mechanism is not frequent in human adrenocortical tumorigenesis. Recent studies demonstrated allelic loss of the ACTH-R gene in a subset of sporadic adrenocortical tumors using a PstI polymorphism located in the promoter region of the ACTH-R gene. Loss of heterozygosity of the ACTH-R was analyzed in 20 informative patients with a variety of benign and malignant adrenocortical tumors. Three of them showed loss of heterozygosity of the ACTH-R gene. In addition, Northern blot experiments demonstrated reduced expression of ACTH-R mRNA in these three tumors with loss of heterozygosity, suggesting the functional significance of this finding at the transcriptional level. Deletion of the ACTH-R gene seems to be involved in a subset of human adrenocortical tumors, contributing to cellular dedifferentiation.

Cytotoxic activity of the dichloromethane fraction from Vernonia scorpioides (Lam.) Pers. (Asteraceae) against Ehrlich's tumor cells in mice

Vernonia scorpioides has been widely used in Brazil to treat skin problems and chronic wounds, such as ulcers of the lower limbs and diabetic lesions. In the present study, we investigated the effect of a dichloromethane (DCM) fraction of V. scorpioides leaf extract on Ehrlich ascitic and solid tumor-bearing mice. The animals were treated once a day with the DCM fraction at a concentration of 5 mg/kg, administered ip during and after the development of the tumor. The lifespan, weight, number and type of leukocytes, number of tumor cells, volume of solid and ascitic tumors were measured. The development of the tumor with pre-treated tumor cells in vitro with the DCM fraction (5 mg/kg) was analyzed and the animals were sacrificed after 7 days. The DCM fraction (5 mg/kg) totally inhibited tumor development when in direct contact with tumor cells, and also ascitic tumor development with in vitro treatment or when administered ip, in loco (after 7 days). Animals treated with the DCM fraction increased their lifespan ca. 2 weeks and maintained their body weight for 30 days. When applied immediately after the inoculation of the tumor cells in vivo, it totally abolished tumor development, with tumor development only decreasing when treatment was started 3 days after the tumor challenge. These data suggest an antineoplastic activity of the fraction. Oral or ip administration of DCM fraction (5 mg/kg) for 7 days did not reduce the solid tumor volume. The cytotoxic activity described here differs from the conventional immune suppressing profile of standard chemotherapy because it increases neutrophil influx to the peritoneal cavity. These results show that, besides exhibiting a tumoricidal activity, the DCM fraction also exhibits inflammatory activity.

Abundant immunohistochemical expression of dopamine D2 receptor and p53 protein in meningiomas: follow-up, relation to gender, age, tumor grade, and recurrence

Meningiomas are common, usually benign tumors, with a high postoperative recurrence rate. However, the genesis and development of these tumors remain controversial. We aimed to investigate the presence and implications of a mutated p53 protein and dopamine D2 receptor in a representative series of meningiomas and to correlate these findings with age, gender, tumor grade, and recurrence. Tumor tissue samples of 157 patients diagnosed with meningioma (37 males and 120 females, mean age 53.6±14.3 years) who underwent surgical resection between 2003 and 2012 at our institution were immunohistochemically evaluated for the presence of p53 protein and dopamine D2 receptor and were followed-up to analyze tumor recurrence or regrowth. Tumors were classified as grades I (n=141, 89.8%), II (n=13, 8.3%), or grade III (n=3, 1.9%). Dopamine D2 receptor and p53 protein expression were positive in 93.6% and 49.7% of the cases, respectively. Neither of the markers showed significant expression differences among different tumor grades or recurrence or regrowth statuses. Our findings highlight the potential role of p53 protein in meningioma development and/or progression. The high positivity of dopamine D2 receptor observed in this study warrants further investigation of the therapeutic potential of dopamine agonists in the evolution of meningiomas.