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Biomedical subjects

N Flores

Publications and source records attributed to N Flores.

At least 37 records · Page 2Linked to original sources
PubMed1994

Small cell carcinoma of the urinary bladder. A clinicopathological study of six cases.

OBJECTIVE: To study the clinical, histological, and immunohistochemical findings of small cell carcinoma (SCC) of the urinary bladder, and also to delineate its behaviour in comparison with transitional cell carcinomas of the bladder. MATERIALS AND METHODS: A retrospective review of 552 patients with bladder cancer yielded six cases (1%) of small cell carcinoma which were histologically identical to pulmonary small cell anaplastic carcinoma. Clinical data and follow-up were collected. Aside from the conventional histological parameters, an immunohistochemical study with AE1-AE3 and Cam 5.2 keratins, epithelial membrane antigen, neuron-specific enolase, chromogranin, synaptophysin, ACTH, calcitonin, and prostatic specific antigen was performed. RESULTS: The clinical presentation did not differ from conventional transitional cell carcinoma, haematuria being the most frequent complaint (four cases). All the cases presented as flat tumours. On light microscopy, there were oat cell (four cases), intermediate (one case) and mixed oat-cell/intermediate (one case) variants. Three cases were associated with transitional cell carcinoma. Dysplastic changes were observed in the adjacent urothelium in one case only. At the time of diagnosis, all tumours were deeply invasive (pT3). Three cases were Stage III and three Stage IV, with involvement of regional lymph nodes and metastases to the liver (two cases) and lung (one case). Immunohistochemically, epithelial markers were variably expressed as AE1-AE3 keratin (5/6), Cam 5.2 keratin (2/6) and epithelial membrane antigen (3/6). Neuron specific enolase was demonstrated in every case. Chromogranin, however, was expressed in only one case. Synaptophysin, ACTH, calcitonin, and prostatic specific antigen all gave negative results. All the patients died of the disease and the overall length of survival was very poor (range 5-25 months, mean 13.3). CONCLUSION: Small cell carcinomas show the same histological patterns as their pulmonary counterpart. Immunohistochemistry reveals a wide spectrum of activity, enolase and keratins being the most constant. The present study confirms that the overall prognosis of this tumour is very poor.

Aged↗
PubMed1994

Extrarenal retroperitoneal angiomyolipoma.

The clinical and pathological findings in a patient with extrarenal angiomyolipoma arising in the perinephric space are presented. This location has been reported only rarely and sets forth some diagnostic and therapeutic difficulties that are also discussed.

Angiomyolipoma↗
PubMed1994

Lethal cytomegalovirus adrenalitis in a case of AIDS.

The clinico-pathologic report of a case of cytomegalovirus (CMV) necrotizing adrenalitis arising in an intravenous drug-abuser and HIV-infected young is presented. CMV urinary tract infection, genital Kaposi's, and demyelinating changes in central nervous system were associated findings.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Lateral cysts of the prostate].

Description and differential diagnosis of lateral cysts of the prostate gland which during their growth may invade its central section. Most cases, sized below 0.8 cm, are diagnosed by accident. A symptomatic prostate cyst is, in fact, a very uncommon condition. Presentation of one case of prostate cystadenoma which presented as a low urinary obstruction in a middle-age adult subject.

Adult↗
PubMed1993

Urinoma formation secondary to ureteral obstruction by metastatic squamous cell carcinoma of the appendix. Case report.

We report a case of secondary squamous cell carcinoma of the appendix causing spontaneous extravasation of urine and urinoma formation. On the basis of clinical findings, we interpret this rare lesion as metastatic from a cervical carcinoma surgically resected 8 years earlier. Ureteral continuity was restored by retrograde catheterization and the urinoma was drained percutaneously. The final diagnosis was made at laparotomy.

Aged↗
PubMed1993

Cavitation of lung metastases from bladder cancer. Report of two cases.

We describe 2 cases of cavitary lung metastasis from bladder cancer and retrospectively analyze the frequency of such an event in our environment. Although rare, this finding is not exceptional and should be taken into account when clinicians and oncologists face the differential diagnosis of pulmonary cavitation. Moreover, a cavitary pulmonary nodule may also be the presenting sign of bladder cancer.

Aged↗
PubMed1993

The value of tumour spread, grading and growth pattern as morphological predictive parameters in bladder carcinoma. A critical revision of the 1987 TNM classification.

A group of 343 patients with bladder carcinomas was uniformly staged, both clinico-radiologically and pathologically. In accordance with pathological staging, they were treated from 1983 to 1990 and follow-up was closed on January 1992. No systemic chemotherapy regime was used. The present study was designed to assess the value of classical morphological parameters (tumour extension, histological subtype, grade and growth pattern) in the prediction of prognosis, and also to evaluate the adequacy of the current TNM classification (4th edition, 1987) of bladder cancer. The initial tumour stage appears the most useful criterion in the prediction of prognosis. Nevertheless, survival analysis confirms the necessity to modify the present TNM classification for routine clinical practice. In fact, stage III proves to be heterogeneous, and the difference in survival between categories pT3a and pT3b is even more statistically significant (log-rank P < 0.01) than the difference between pT2 and pT3 as a whole (log-rank P < 0.02). Consequently, invasion of the muscular layer should be reclassified into a common stage II, equivalent to the B category in the ABCD system. Moreover, stage IV is also heterogeneous in terms of survival. Despite the overall life-expectancy being rather poor for a patient with bladder carcinoma, three subsets with different prognosis (log-rank P < 0.001) can be identified: pT4N0M0; pTxN1-3M0; pTxNyM1, where x and y represent any number. Therefore, we believe that various subgroups should be distinguished in a future edition of the TNM classification. Current treatment modalities, involving the role of systemic chemotherapy and aimed at bladder preservation, make such innovations even more convenient for a new edition of the TNM classification of bladder cancer. Apart from tumour staging, several microscopic morphological parameters are valuable in distinguishing patients with different prognosis. Pure transitional-cell histology, papillar growth, and low grade, are favourable data. In fact, tumour grade, although somewhat subjective, is a factor of major prognostic importance. Pauwels' distinction of intermedium grade 2 into 2A and 2B is also helpful in the assessment of a population of "intermediate" prognosis. Similarly, with regard to superficial tumours, the division of infiltration levels of subepithelial connective tissue into "superficial" or "deep into the muscularis mucosae", is also relevant, even after stratification by grade.

Adenocarcinoma↗
PubMed1993

[Bladder carcinoma: I. Epidemiologic considerations in the Basque country].

Review of several facts of epidemiological nature, from a study on bladder urothelial carcinoma cases detected over the period 1983-1990 in our centre, a reference hospital serving the Bilbao area. Certain data recently published by the Euskadi Cancer Register allowed us to establish some considerations related to the presence of this entity in our setting. Its incidence nears the highest rates in industrial countries. Age distribution, but no the men/female ratio, is similar to that in other settings. Overall, no difference was detected in sex-related survival. But, we corroborate that the youngest groups have the best prognosis. Also, an analysis is made of the association between age at diagnosis and several clinical and histopathological parameters.

Adolescent↗
PubMed1993

[Primary bladder carcinoma on diverticulum. Clinico-pathologic study of 5 cases].

This paper reviews our experience with the vesical cancer which develops on the diverticulum, a situation occurring in 1.5% of all vesical tumours in our setting. The condition's clinical features (diagnostic and therapeutic), usually detected in advanced stages, are emphasized. From a morphological point of view, histology of over half these tumours differs from the pure transitional one. There were two cases of pure transitional carcinoma, one small cells cancer, one squamous cells cancer and one with adenocarcinoma differentiating foci. Several sets of data, which include histological variability as well as presence of congenital diverticulum and urethral tumours, have led us to suspect the existence of morpho-genetical factors in the development of these neoplasias. However, the widely accepted carcinogenetic theory continues to be the most likely.

Aged↗
PubMed1993

Urologic malignancies and progressive systemic sclerosis.

We present two cases of urologic malignancies, transitional cell carcinoma of the bladder and renal cell carcinoma respectively, closely associated to progressive systemic sclerosis. The relationship between such neoplasms and immune disorders is thereof reviewed. Cancer may develop in a context of diminished immunological surveillance. Conversely, autoimmunity can also be secondary to neoplasia and somehow understood as paraneoplastic. Anyway, the cases here reported could be regarded as unusual associations that may reproduce the still unclear connections between immunity and neoplasia.

Aged↗
PubMed1993

[Conceptual review of oncocytic lesions].

Updating of a series of entities which significance is not always pathological, or it is poorly known, and which are related to oxyphilic transformation of epithelial cells. Review of concepts such as "oncocytosis", "oncocytic hyperplasia" and "oncocytoma", establishing a hypothetical continuum of damage which could actually be contemplated within the evolution spectrum of hyperplasia-adenoma-carcinoma. Also, both the changes occurring at subcellular level and the hypothesis considered to explain them are commented.

Adenoma↗
PubMed1993

[Ultrastructural study of the stromal component in urethral caruncle].

The stromal component of the urethral caruncle (UC) comprises a mixture of inflammatory, vascular, and fibrotic phenomena. Although mastocytes are cell elements known to appear in relation with chronic inflammation, there is no data in the literature explaining their significance in UCs or their ultrastructure relation with fibroblasts. We postulate that this special form of intercellular attachment could play a role in this condition's pathogenesis.

Female↗
PubMed1993

[Acute focal bacterial nephritis in a case of AIDS].

Presentation of one case of bacterial acute focal nephritis (acute lobe nephrosis) in a parenterally drug-abuser, HIV-infected male. From the clinical point of view, the picture was interpreted as acute hepatitis, and the lesion was detected by ultrasound techniques. A right side location, relative lack of urological symptoms and coexistence of a chronic liver disease contributed to the diagnostic error. Failure of initial response to therapy with antibiotics coincided with the lesion migration. Eventually, the case evolved favourable with conservative treatment.

AIDS-Related Opportunistic Infections↗
PubMed1993

[Adrenal pseudocyst: clinicopathologic study of a case].

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.

Adenocarcinoma↗