pCLE can identify changes to the elastin composition of the airways and alveoli in lung cancer. These changes correlate with histopathology and may help indicate the presence of malignant changes in vivo.

No abstract

INTRODUÇÃOA neoplasia de esôfago é doença muito comum em regiões com populações de baixa renda e naquelas habituadas à ingestão de álcool e abuso de tabaco 15,19 . Quase sempre o diagnóstico dessa afecção é tardio, pois a disfagia -principal sintoma da neoplasia de esôfago -, ocorre somente quando mais de 2/3 da luz esofágica esta preenchida por lesão tumoral. O diagnóstico retardado, perda de peso excessiva consequente à disfagia e associação de doenças cardiopulmonares decorrente do abuso de tabaco, tornam o portador dessa neoplasia paciente de difícil controle clínico, tendo o médico que o assiste poucas possibilidades terapêuticas. Este fato é muito comum, uma vez que em vários centros de tratamento da neoplasia esofágica, principalmente no mundo ocidental, apenas cerca de 20-30% dos pacientes conseguem realizar tratamento cirúrgico radical 15,17,18 .Dessa forma, muitas vezes o tratamento para essa afecção torna-se paliativo, sendo que o ideal seriam procedimentos que restaurassem satisfatoriamente a deglutição, sem a necessidade de novas internações hospitalares, com menores índices de complicações e que proporcionassem qualidade de vida mais adequada9. Assim, com o evoluir da técnica cirúrgica, passou-se procurar alternativas que atingissem essas finalidades, sendo o tubo gástrico isoperistáltico de grande curvatura um dos métodos de eleição 18,20 .Entretanto, o grande óbice deste procedimento é a deiscência da anastomose do tubo gástrico com o esôfago cervical, retardando a deglutição normal e, consequentemente, comprometendo em demasia a qualidade de vida do paciente que já se apresenta com condições nutricionais bem comprometidas devido ao caráter avançado da doença 7,9,18 . Estudo anterior em 53 pacientes com câncer de esôfago irressecável no qual estes autores utilizaram tubo gástrico isoperistaltico paliativo, a anastomose esofagogástrica cervical foi confeccionada com sutura manual, com deiscência anastomótica em 29,5%, o que comprometeu muito a qualidade de vida destes pacientes, impedindo que eles pudessem deglutir por via oral em média por um mês 4 .Com o advento da sutura mecânica, divulgada a partir da década de 60, tornou-se possível desenvolver nos dias atuais

Background Morphological evaluation of tumor-infiltrating lymphocytes (TILs) in breast cancer is gaining momentum as an immunological biomarker. This experiment evaluates the role of TILs in distant tumors as a measure of abscopal effect from cryoablation of breast cancer. Methods BALB/c mice underwent bilateral orthotopic transplant with 4T1-12B (triple-negative) cells. At 2 weeks, left tumors were treated by either resection (standard of care group) or cryoablation (intervention group) followed by resection of the distant right tumors 1 week posttreatment. TIL scores were calculated from hematoxylin and eosin-stained sections and phenotyped for cytotoxic T-lymphocyte (CTL) markers by immunofluorescence. Primarily resected tumors served as baseline (Tbaseline), whereas resected distant right-sided served as the readout for abscopal effect (AbsRes or AbsCryo). Mice were monitored for tumor recurrence and metastasis. Results The AbsCryo had a significant mean (SD) increase in stromal (2.8 [1.1]%; p = 0.015) and invasive margin TILs (50 [12]%; p = 0.02) compared with TBaseline (1.0 [0]% and 31 [4.9]%, respectively). CTL phenotyping revealed a significant increase in mean (SD) CD8+ T cells (15.7 [12.1]; p = 0.02) and granzyme B (4.8 [3.6]; p = 0.048) for the AbsCryo compared with TBaseline (5.2 [4.7] and 2.4 [0.9], respectively). Posttreatment, the cryoablation group had no recurrence or metastasis, whereas the resected group showed local recurrence and lung metastasis in 40% of the mice. Postprocedure increase in TIL score of distant tumors was associated with decrease in tumor relapse (p = 0.02). Conclusions Cryoablation induced a robust tumor-specific TIL response compared with resection, suggesting an abscopal effect leading to the prevention of cancer recurrence and metastasis.

No abstract

The authors describe a case of yellow nail syndrome in a 44-year-old male patient, with a clinical picture characterized by hand and foot onychodystrophy, lymphedema in the legs and recurrent pleural and pericardial effusions. They indicate subxiphoid pericardiostomy and pleural drainage as the rational surgical procedure for the treatment of this particular associated pathology.

No abstract

Primary pancreatic lymphoma (PPL) is an extremely rare form of extranodal malignant lymphoma. The most common histological subtype of PPL is diffuse large B-cell lymphoma (DLBCL). Clinical and imaging features of PPL may often overlap with pancreatic adenocarcinoma. Therefore, it is very important to obtain a preoperative cytohistology diagnosis of pancreatic tumors to avoid unnecessary surgeries in cases with a diagnosis of PPL. Herein, we report a 71-year-old male who was admitted to our hospital with a diagnosis of acute pancreatitis after he presented with complaints of nausea, vomiting, and epigastric abdominal pain. MRI of the abdomen revealed a pancreatic head mass, and histopathology and immunohistochemical assessment of the pancreatic lesion established the diagnosis of DLBCL. The patient achieved remission after six cycles of rituximab-cyclophosphamide, doxorubicin (hydroxydaunomycin), vincristine (oncovin), prednisolone (R-CHOP) chemotherapy.