Spindle epithelial tumor with thymus-like elements is a rare thyroid lesion of children and young adults thought to be derived from branchial pouch remnants or foci of ectopic thymus. The lesion is poorly understood, and although it was originally believed to follow an indolent clinical course, its potential for late metastasis is becoming generally acknowledged. We have recently seen a unique case of this rare tumor in an 11-year-old boy, in which an unexpected and salient feature is the presence of a micrometastasis in a single lymph node at presentation. With the exception of 1 case with extensively infiltrative tumor and metastatic disease at the time of onset, in all other cases dissemination occurred years after surgical resection of the primary lesion. We review all previously reported cases and provide a detailed study of the histologic and ultrastructural appearances of this lesion.

The distinctive patterns of elastic fibers, best shown by the elastin immunostain, were helpful in evaluating melanomas associated with melanocytic nevi.

To measure discrepancies in diagnoses and recommendations impacting management of proliferative lesions of the breast, a questionnaire of five problem scenarios was distributed among over 300 practicing pathologists. Of the 230 respondents, 56.5% considered a partial cribriform proliferation within a duct adjacent to unequivocal ductal carcinoma in situ (DCIS) as atypical ductal hyperplasia (ADH), 37.7% of whom recommended reexcision if it were at a resection margin. Of the 43.5% who diagnosed the partially involved duct as DCIS, 28.0% would not recommend reexcision if the lesion were at a margin. When only five ducts had a partial cribriform proliferation, 35.7% considered it as DCIS, while if ≥20 ducts were so involved, this figure rose to 60.4%. When one duct with a complete cribriform pattern measured 0.5, 1.5, or 4 mm, a diagnosis of DCIS was made by 22.6, 31.3, and 94.8%, respectively. When multiple ducts with flat epithelial atypia were at a margin, 20.9% recommended reexcision. Much of these discrepancies arise from the artificial separation of ADH and low-grade DCIS and emphasize the need for combining these two under the umbrella designation of ductal intraepithelial neoplasia grade 1 (DIN 1) to diminish the impact of different terminologies applied to biologically similar lesions.

Primary epithelial tumors of the pancreas are extremely uncommon in children, and among these, acinar cell carcinoma (ACC) is the most rare. Here we describe our recent observations in the case of a 10-year-old boy with one of these exceptional examples. The histologic diagnosis of ACC was supported by both immunohistochemistry and electron microscopy. Despite its rarity, ACC should be kept in the differential diagnosis of pediatric pancreatic exocrine tumors. We also provide a comparison with an example of solid pseudopapillary tumor, another relatively infrequent epithelial tumor of the pancreas in the young. We review the relevant literature addressing the clinical and pathologic features of ACC and its distinction from other pancreatic neoplasms.

Introduction: COVID-19 in chronic kidney disease (CKD) in renal replacement therapy (RRT), hemodialysis (HD), peritoneal dialysis (DP), and kidney transplant (Tx), has high mortality, with clinical and epidemiological data in Latin America still limited. Methods: National observational, multicenter study, with data obtained by the Task Force against COVID-19 in Chile (FUTAC Renal), evaluating epidemiology and major clinical results of CKD patients in RRT,

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Actualmente no hay evidencia clínica que permita recomendar un tratamiento específico de la infección causada por SARS-CoV-2 en pacientes con sospecha o confirmación. Sin embargo, con los conocimientos actuales se pueden hacer ciertas recomendaciones para su manejo 1 como se muestra en la Tabla 1. TRATAMIENTO SINTOMÁTICO Se administra en pacientes confirmados con cuadro clínico leve o en pacientes sospechosos; se recomienda aislamiento social durante 14 días. 2 Respecto al uso de paracetamol e ibuprofeno, la OMS y algunas autoridades reguladoras, como la AEM, el NHS y la AEMPS, han manifestado que actualmente no existe evidencia que permita afirmar un agravamiento de la infección por COVID-19 con el uso de ibuprofeno u otros fármacos antiinflamatorios no esteroideos (AINEs). Hasta que se generen evidencias adicionales, consideraremos adecuada la aproximación sugerida por el NHS, que, reconociendo la falta de evidencia, no aconseja suspender tratamientos con este medicamento,