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Biomedical subjects

L Requena

Publications and source records attributed to L Requena.

At least 37 records · Page 2Linked to original sources

Clear cell squamous cell carcinoma. A histologic, immunohistologic, and ultrastructural study.

Squamous cell carcinomas (SCCs) usually show a standard histopathologic picture only varying with regard to their degree of differentiation. The authors describe a case of clear cell SCC that was studied by light and electron microscopy. The clear cells showed an empty cytoplasm that was periodic acid-Schiff and alcian blue negative. By electron microscopy these cytoplasms consisted of empty spaces and were not surrounded by membranes, which would be consistent with lipid vacuoles. The differential diagnosis of this uncommon variant of SCC requires consideration of other clear cell tumors.

Adenocarcinoma

Choriocarcinoma of the testis metastatic to the skin.

A case of choriocarcinoma of the testis metastatic to the skin is reported. In this case report the primary tumor was first diagnosed by the histopathologic findings in the cutaneous biopsy of a single nodule that appeared on the chest, with both syncytiotrophoblastic and cytotrophoblastic cells in the metastatic solid tumor islands. Using peroxidase-antiperoxidase techniques, beta-human chorionic gonadotropin (beta-HCG) was positive within the cytoplasm of syncytiotrophoblastic cells. The patient was treated with orchiectomy, chemotherapy, and radiotherapy. With these measures there was a decrease of chorionic gonadotropin serum levels to normal limits and 2 years after this treatment there is no evidence of recurrence.

Adult

Keratoacanthoma within a superficial spreading malignant melanoma in situ.

A case of a keratoacanthoma arising from the center of a superficial spreading malignant melanoma in situ is presented. The keratoacanthoma already showed regressive changes in its central area, and the superficial spreading malignant melanoma had partially disappeared at the site in which the keratoacanthoma had arisen. The possible mechanisms of these interactions are discussed.

Humans

Localized epidermal necrolysis (erythema multiforme-like reaction) following intravenous injection of vinblastine.

We report a case of localized epidermal necrolysis that developed 24 hours after an intravenous injection of vinblastine. Clinically, the lesions consisted of erythematous macules, vesicles, and bullae with a linear arrangement over the injected vein. Histologically, the lesions showed features closely resembling erythema multiforme (epidermal necrolysis). We discuss the pathogenesis of this curious cutaneous drug reaction and review the literature concerning local cutaneous complications associated with intravenously administered chemotherapeutic agents.

Erythema Multiforme

Postlymphography linear dermatitis.

Cutaneous effects secondary to lymphography are rare events. We herein report a patient with Hodgkin's disease who developed a linear dermatitis in both lower limbs 6 days after a pedal lymphography. Histopathologic examination of the lesions demonstrated a subacute dermatitis. Patch tests with the substances used in the lymphography yielded negative results. We discuss the possible pathogenic mechanisms of this striking linear dermatitis.

Adult

Linear pemphigus vulgaris along a surgical scar.

A 64-year-old female had breast carcinoma of the right breast, and a mastectomy was performed. Three years later she developed a vesiculobullous eruption along the surgical scar. Histopathological and direct immunofluorescence findings were consistent with a diagnosis of pemphigus vulgaris. We discuss the possible pathogenesis for this striking linear distribution of the pemphigus vulgaris lesions.

Breast Neoplasms

Erythema elevatum diutinum in a patient with acquired immunodeficiency syndrome. Another clinical simulator of Kaposi's sarcoma.

Several types of vasculitis have been described in patients with human immunodeficiency virus infection. Erythema elevatum diutinum is a rare variant of cutaneous leukocytoclastic vasculitis which, with the exception of the case reported herein, has been described only once in human immunodeficiency virus-infected patients. Our male patient, a longtime intravenous drug abuser, had cutaneous lesions, closely resembling Kaposi's sarcoma, on the extensor surfaces of the lower extremities. Cutaneous biopsy specimens, however, demonstrated leukocytoclastic vasculitis with fibrinoid necrosis of the vessel walls and areas of basophilic degeneration of collagen bundles in early lesions, whereas late lesions showed dense diffuse fibrosis with proliferation of dermal spindle cells and some foci of residual leukocytoclastic vasculitis. Oral therapy with dapsone resulted in marked clearing of the cutaneous lesions within few days. This case raises the necessity of histologic confirmation for all cases of suspected Kaposi's sarcoma in patients with acquired immunodeficiency syndrome. We discuss the possible pathogenesis of leukocytoclastic vasculitis in human immunodeficiency virus-infected patients.

Acquired Immunodeficiency Syndrome

Chemotherapy-induced transverse ridging of the nails.

A case of Beau's lines secondary to combined chemotherapy for Hodgkin's disease is reported. These transverse nail depressions are interpreted as the result of a transient interruption of the nail matrix activity due to antimitotic drugs. Other causes of Beau's lines are reviewed.

Antineoplastic Combined Chemotherapy Protocols

Localized hyperkeratosis lenticularis perstans (Flegel's disease).

A case of hyperkeratosis lenticularis perstans involving only the back of a thirty-nine-year-old woman is reported. Histologic examination showed foci of compact and eosinophilic hyperkeratosis overlying a thinned stratum malpighii. In the underlying papillary dermis there was no evidence of inflammatory infiltrate. This case demonstrates that hyperkeratosis lenticularis perstans may appear as a localized disorder, and that the inflammation is not an essential pathogenic process in this disorder.

Adult

Trichostasis spinulosa within an intradermal melanocytic nevus.

A thirty-six-year-old man presented with a melanocytic nevus on his left shoulder. The lesion was excised and histopathologic examination showed an intradermal nevus with several infundibular cysts among the nevus cells. These cysts showed a cyst wall with epidermoid keratinization and a lumen filled by many cross-sectioned hair shafts. These findings were consistent with a diagnosis of trichostasis spinulosa within an intradermal melanocytic nevus. We note the relationship between these two disorders in the same lesion.

Adult

[Cutaneous epithelial necrosis in coma. Study of 2 cases].

We report two cases of epithelial necrosis in comatous patients. The cutaneous lesions were characterized by erythematous plaques which later evolved to bullous lesions. Histologic examination demonstrated epidermal necrosis with subepidermal blisters, sparse neutrophilic inflammatory infiltrate and, characteristically, eosinophilic necrosis of the eccrine sweat gland coils.

Adult

Vesicular pemphigoid.

A patient with a pruritic vesicular eruption closely resembling dermatitis herpetiformis is described. Histopathologic examination of a biopsy specimen showed a subepidermal blister containing abundant eosinophils and neutrophils, whereas results of direct immunofluorescence studies demonstrated linear and homogeneous deposition of IgG and C3 along the basement membrane zone. Prednisone therapy was necessary to control the clinical symptoms. Similar cases have been described as "vesicular pemphigoid."

Aged

Premalignant changes in nasal and sinus polyps: a retrospective 10 year study (1979-1988).

One hundred and seventy cases of nasal and/or sinus polyps diagnosed in the Pathology Service of the Hospital Militar Central GOMEZ/ULLA of Madrid (Spain) between 1.9.79 and 1.9.88 are reviewed. In two cases areas of 'carcinoma in situ' in the epithelium covering the polyps were demonstrated. The literature is reviewed for reports of malignant transformation and dysplastic changes in nasal and sinusal polyps. We suggest that precancerous changes may occasionally be noted in inflammatory lesions, a fact that pathologists should keep in mind.

Aged

Follicular lymphomatoid papulosis.

A case of follicular lymphomatoid papulosis was studied by light- and electron-microscopic methods. The nature of atypical cells was analyzed with monoclonal antibodies. This case proved to be mainly a type B lymphomatoid papulosis with a predominance of T-helper markers in atypical lymphoid cells. All previously reported cases of this rare variant corresponded to type A lymphomatoid papulosis. Therefore we believe this to be the first case report of type B follicular lymphomatoid papulosis.

Adult