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Siqueira G.G.,Patologia | De Araujo L.C.,University of Brasilia | Rezende G.C.,Cirurgiao Toracico | De Lima N.F.,Hospital Universitario | Marinho L.C.,University of Brasilia
Jornal Brasileiro de Patologia e Medicina Laboratorial | Year: 2012

We present a rare case of thymoma in a 36-year old woman, who was initially diagnosed with severe myasthenia gravis and subsequently undergone surgical resection. During surgery tumor was found at the anterior mediastinum, tightly attached to the phrenic nerve, pleura and pericardium. Histological assessment showed large areas of sclerosis and fibrous collagenous tissue as well as islands of epithelial and lymphoid cells. Sclerosing thymoma, which is a rare subtype of thymoma (< 1%), was diagnosed, thus confirming the first report in Brazil. The patient showed partial improvement of symptoms associated with myasthenia gravis.

Herkenhoff M.E.,Ciencia Animal Genetica | Gaulke R.,Biomedicina | De Souza J.G.,Biologia | Thome N.S.,Farmaceutica | And 2 more authors.
Jornal Brasileiro de Patologia e Medicina Laboratorial | Year: 2012

Introduction: Prothrombin (factor II) is a blood protein synthesized in the liver in the presence of vitamin K. It is a thrombin precursor, which induces fbrin formation. Prothrombin G20210A mutation and high prothrombin levels have been closely associated with thrombophilia. This allelic variant is a single mutation, also denominated single nucleotide polymorphism (SNP), in which guanine is replaced with adenine in the messenger ribonucleic acid (mRNA) cleavage of nucleotide 20210. The replacement is characterized by the presence of allele A and the absence of mutation in allele G. Objective: To quantify the number of individuals homozygous for allele G, allele A and heterozygotes. The samples were collected in Paraná and Santa Catarina from January 1 st, 2009 to October 10th, 2010 and were sent to Genolab Análises Genéticas. Methods: Analysis of single mutation by polymerase chain reaction in real time (RT-PCR). Results: From 243 individuals, 51.03% were from Paraná and 48.97% were from Santa Catarina. 88.89% individuals were homozygous for G genotype, none of them were homozygous for A. Only 11.11% were heterozygotes. Santa Catarina presented a higher frequency in heterozygous genotype in comparison with Paraná. Conclusion: This study showed that patients with suspected thrombophilia should undergo genotype identifcation in both states.

The World Health Organization released the 4th edition of the Classification of Breast Tumors in July 2012. This review summarizes the principal changes that were introduced in the new classification with emphasis on diagnostic and therapeutic implications. The major changes were: (i) the new edition is entirely dedicated to breast tumors; (ii) the epithelial tumors were sorted differently, recognizing nine special types and variants, and eleven rare types of breast tumors apart from invasive ductal carcinoma of no special type. New codes were included for the lobular, medullary, and metaplastic subtypes; (iii) new scores were suggested for the immunohistochemical evaluation of hormone receptor (> 1% positive cells) and human epidermal growth factor receptor 2 (HER2) (> 30% highly positive cells surrounding the whole membrane); (iv) a new approach to molecular and genomic classification of breast cancer was presented including predictive and prognostic tests using gene expression profile; (v) the traditional terminology of intraductal proliferative lesions was maintained and the terminology ductal intraepithelial neoplasia was not recommended; (vi) the prognostic importance of distinguishing atypical lobular hyperplasia and lobular carcinoma in situ (LCIS) within the spectrum of lobular neoplasia was acknowledged; (vii) the columnar cell lesions (columnar cell change and columnar cell hyperplasia without atypia) were excluded from the fiat epithelial atypia group, whose biological behavior is still unknown. It is expected that the widespread use of the new classification by pathologists and oncologists will benefit patients by improving diagnostic and therapeutic decisions.

Cruz-Benitez L.,Servicio de Cirugia Oncologica | Cortes-Cardenas S.A.,Servicio de Cirugia Oncologica | Farias-Alarcon M.A.,Servicios Modulares | Tenorio-Torres J.A.,CMN 20 de Noviembre | And 2 more authors.
Gaceta Mexicana de Oncologia | Year: 2011

Introduction: Myxoid fibrosarcoma or Evans' tumor is an aggressive sarcoma of fibroblastic origin. Histologically, it contains a myxoid matrix. Objective: To report a case of a low-grade myxoid fibrosarcoma and to perform a bibliographic review of the condition. Case Description: A 36 year-old male patient, whose disease started 20 years ago with enlargement of the right lumbosacral region and increased pain with active motion. Computed tomography (CT) showed a 10 x 15 cm right lumbosacral tumor. The patient underwent surgery at some other facility, where wide resection of the tumor was performed and fibromyxoid sarcoma diagnosis was made. The patient was sent to assessment for adjuvant radiotherapy and a 66 Gy total dose radiation therapy was scheduled; however, he did not attend the appointment and was subsequently assessed on November 11 2010 when a 35 x 40 cm, lobulated, exophytic tumor fixed to the lumbar spine was detected in the lumbosacral region. In November 2010, the patient underwent surgery consisting of wide resection of the tumor, facet denervation, and flaps rotation. The pathology report was fibromyxoid sarcoma with surgical margins infiltrated by the tumor. The immunohistochemical report stated the tumor was positive both to vimentin and muscle-specific action. Discussion: Fibromyxoid sarcoma is a rare malignant neoplasm, with less than 150 cases reported worldwide. Hence, the purpose of reviewing this condition as its unusual presentation may lead to diagnostic confusion with other soft tissue sarcomas.

Bernet L.,Patologia | Urruticoechea A.,Onkologikoa | Vicente F.,Cirugia
Revista de Senologia y Patologia Mamaria | Year: 2014

Objectives The importance of obtaining free margins in breast-conserving surgery is well known. However, there are no uniform criteria on when to perform a reexcision. Therefore, the Breast Study Group decided to identify current practice in Spain through a survey. Materials and method An online survey was developed consisting of 28 items divided into the following 4 data sections: General information, perioperative information and decisions, postoperative information and decisions, and other factors. Questionnaires were sent to 87 centers, and responses were obtained from 55 (63.2%). Results Margins were always examined intraoperatively in 60% of the centers and occasionally in 22%. Close margins were defined as those 1 mm away from the margin by 58% of participants. Most centers opted for reexcision when information on involved margins or close margins was obtained intraoperatively. If the information was obtained postoperatively, reexcision was performed in 70-100% of cases of involved margins but in only 18-29% of cases of close margins. In cases of involved margins without reexcision, 50% of respondents increased the radiation dose. Conclusion In Spain, reexcision is usually performed in cases of involved margins. However, there is an appreciable variation in this decision in cases of close margins. © 2014 SESPM. Published by Elsevier España, S.L. All rights reserved.

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