Chromophobe renal cell carcinoma (CRCC) may be grossly and microscopically confused with oncocytoma. It is now believed that many, if not all, of the so-called malignant oncocytomas or oncocytomas with metastases reported in the literature were indeed chromophobe renal cell carcinomas. CRCC is characteristically positive for colloidal iron and shows cytoplasmic microvesicles in electron microscopy. This study of CRCC is thought to be the first one done in Latin America. Of a total of 106 renal epithelial neoplasms, 7 (6.6%) fulfilled the criteria for chromophobe renal cell carcinoma. This frequency in Brazil is similar to that in other parts of the world. There was no difference in age, sex, and race distribution of CRCC compared to usual renal epithelial tumors. Grossly, the CRCC ranged in size from 3.5 to 20 cm (average: 10.2 cm) in greatest dimension. Most frequently, the tumor was brown on the cut surface. The growth pattern showed compact areas in all tumors and, in most of the cases, both clear and eosinophilic cellular subtypes were seen. The electron microscopic findings favor an origin of the microvesicles from outpouchings of the outer membrane of mitochondria. The strong positivity for colloidal iron in spite of the destruction of the cytoplasmic vesicles in paraffin-embedded specimens seems to indicate that the acid mucopolysaccharides are not located inside the microvesicles. By the time of diagnosis, only one case had regional lymph node metastases and this particular case was the only one mixed (associated with the usual renal cell carcinoma). The follow-up examination after nephrectomy showed that prognosis seems to be favorable in CRCC, except when the tumor coexists with the usual renal cell carcinoma.
Endomyocardiofibrosis is a restrictive cardiomyopathy characterized by fibrotic involvement of the endocardium and adjacent myocardium, and by diastolic dysfunction caused by changes in distensibility making ventricular filling inadequate while preserving the systolic function. Clinically, it appears as heart failure, but etiological symptomatic discernment, suspicion and a clinical examination would be necessary in order to make a correct etiological diagnosis. The case of a patient with biventricular endomyocardial fibrosis associated with renal amyloidosis is presented.
Os lipossarcomas, tumores originários da célula mesenquimal primitiva, representam 15% de todos os sarcomas de partes moles 1. São tumores raros que ocorrem, geralmente, em pessoas idosas e que aparecem, quase sempre, em locais onde existe acúmulo de tecido adiposo 2,3. Esses tumores atingem com maior freqüência os membros inferiores e superiores, o tronco e o abdômen, sendo excepcional sua localização na região vulvar, onde representam apenas 1 a 2% das neoplasias malignas 4. A revisão da literatura confirma a raridade deste tipo de localização quando se verifica o pequeno número de casos publicados 5. Na maioria das vezes o lipossarcoma da região vulvar apresenta-se como lesão única, de pequeno ou médio porte, e sua aparência macroscópica circunscrita leva, freqüentemente, ao diagnóstico errôneo de doença benigna 3,5. Este retardo no diagnóstico faz com que um número não desprezível de doentes procure atendimento
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