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We studied 44 cases of small cell bladder carcinoma (SCBC) and 2 cases of large cell neuroendocrine bladder carcinoma (LCNBC) to determine the immunohistochemical profile and biologic behavior. Thyroid transcription factor (TTF)-1, cytokeratin (CK)20, chromogranin A (CgA), synaptophysin, neuron-specific enolase (NSE), and Leu-7 studies were performed. TTF-1+ cases were stained for surfactant protein A (SP-A). The immunohistochemical profile for 44 SCBC cases was as follows: TTF-1+, 11 (25%); CK20+, 3 (7%); CgA+, 13 (30%); synaptophysin+, 22 (50%); NSE+, 35 (80%); and Leu-7+, 30 (68%), and for 2 LCNBC cases was as follows: TTF-1+, 2 (100%); CgA+, (50%); synaptophysin+, 1 (50%); NSE+, 2 (100%); and Leu- 7+, 2 (100%). All cases with TTF-1 expression were negative for SP-A, except 1 case. This case was a mixed SCBC with TTF-1 expression in the urothelial component, which also expressed SP-A. Immunohistochemical markers were not associated with survival. The prognosis of SCBC is relatively better than its pulmonary counterpart. LCNBC seems to be a rarely recognized entity. TTF-1 expression is not limited to small cell lung carcinoma.

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The aim of the present study was to evaluate the expression of blood group antigens in squamous bronchial metaplasia in order to determine whether this factor could identify patients at risk of lung cancer.In total, 100 bronchial biopsies were included in the present study. The cases were classified according to the World Health Organization grading system. Immunohistochemical stains for histo-blood groups A and B, and reactivity tests to p53 and the cellular proliferation index were performed.A total of 56 (56%) patients belonged to blood group A. Among them, six (10.7%) patients who did not express antigen in squamous metaplasia, showed carcinoma at the moment of the biopsy (n53) or developed synchronous lung carcinoma (n53). A total of nine (9%) patients belonged to blood group B. Loss of antigenic expression was observed in five cases. All of them developed synchronous lung carcinoma. The patients with low-and high-grade dysplasia developed lung cancer in 71 and 100% of the cases, respectively.In conclusion, the findings of the present study suggest that the loss of histo-blood antigens expression is an event in the carcinogenesis of bronchial mucosa and it is usually associated with high-grade lesions and hyperproliferative activity.

Individuals with schizophrenia and other chronic mental illnesses present a series of risk factors, that predispose them to extensive medical comorbidity. The aim of this study was to determine the risk factors for respiratory disease in chronic psychiatric inpatients. Methods: All patients at a long-term mental institution were invited to participate in this study. Socio-demographic data, tobacco and alcohol consumption, respiratory symptoms and chest x-rays were collected from 154 patients. Sputum microscopy and cultures for M. tuberculosis were done in specific cases. Results:The symptoms reported were cough (58%); expectoration (44.2%); dyspnea (28.6%); hemoptysis (9.7%), and chest pain (20.1%). There were chest x-ray changes in 57.1% of patients. These were suggestive of chronic obstructive pulmonary disease (COPD) in 31.2% and an interstitial pattern in 19.1%. The prevalence of tuberculosis in this sample was 4.5%. Schizophrenia was the most common mental illness (43.5%), followed by an organic mental disorder (32.5%). We found a positive relationship between schizophrenia and cigarette smoking (odds ratio 2.30, 95% CI 1.11 to 4.76), and schizophrenia and x-ray changes (odds ratio 2.35, 95% CI 1.15 to 4.83). There was no significant relationship with other psychiatric disorders. Conclusions: The high prevalence of respiratory morbidity in patients with chronic mental illness hospitalized in long-term care facilities, is probably due to factors such as extreme poverty, tobacco consumption, overcrowding, and nutritional deficit.

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