Our results indicate that the freezing of sputum samples at different stages of processing does not alter sputum morphology to an extent that affects the results of differential cell counts.
Lichen sclerosus (LSc) with penile cancer is found in about two thirds of specimens. It has been hypothesized that LSc represents a precancerous condition. To qualify as such, in addition to cytological atypia and similarity with the invasive tumor, a spatial correlation between LSc and neoplastic lesions needs to be demonstrated. The purpose of this study was to evaluate such a spatial relationship. Circumcision (28 cases) and penectomy (81 cases) specimens were evaluated. All cases had LSc, penile intraepithelial neoplasia (PeIN), and/or invasive squamous cell carcinomas. We examined LSc in relation to invasive carcinoma, PeIN, and normal epithelia. Invasive squamous cell carcinomas, classified according to the World Health Organization criteria as non–human papillomavirus (HPV)-related and HPV-related PeIN, were present in 100 cases. Non-HPV-related (differentiated) PeIN was the most common subtype associated with LSc (89%). There were 5 spatial patterns identified: (1) LSc adjacent to PeIN (23%), (2) LSc adjacent and comprising PeIN (42%), (3) LSc next to and within invasive carcinomas (8%), (4) LSc throughout the sequence PeIN-invasive carcinoma (24%), and (5) LSc was separate (with normal tissue between the lesions) from PeIN and/or invasive carcinomas in a minority of cases (3%). LSc within the cancer was not previously described. In this series, we found 35 cases with LSc within invasive carcinomas. The striking continuous spatial relationship among LSc, PeIN, and/or invasive carcinoma as shown in this study may be a necessary (but not sufficient) condition for the hypothesis postulating LSc as a penile precancerous lesion.
Since the seminal study of Hart and Helwig in 1975, there are few detailed pathological studies of lichen sclerosus (LS). The aims of this study were to provide a detailed histopathological description of penile LS, as well as to explore its relationship with penile intraepithelial neoplasia (PeIN) or invasive carcinoma. We evaluated 200 patients and designed a topographical approach for the histological evaluation focusing in alterations of the following anatomical layers: squamous epithelium, lamina propria, dartos, and corpus spongiosum. We documented the quantity and topographical location of stromal lymphocytes. The prevalent lesions found were epithelial hyperplasia, atrophy, PeIN, basal cell vacuolization, lamina propria sclerosis, and variable patterns of lymphocytic infiltration. Various unique patterns of stromal sclerosis were described: perivascular, globular, linear, and solid fibrosis/hyalinization; any of them were found to be diagnostic for LS. The variation in the topography and density of lymphocytes was determinant for the identification of LS morphological variants: lichenoid, band-like, lymphocytic depleted, and mixed. A major finding was the identification of the variant designated as lymphocytic depleted LS, which we considered as the morphological prototype of LS associated with penile neoplasia. The detailed description of this complex lesion presented in this study may help pathologists in practice to identify and better define LS. The identification of the special variants suggests a role of the stromal lymphocytes in the process of carcinogenesis. Confirmation of the observations with more studies is necessary to determine the significance of these findings.
El Quiste Odontogénico Calcificante forma parte del grupo de Quistes Odontógenicos y No Odontogénicos del Desarrollo, según la Clasificación de Quistes Maxilares de la Organización Mundial de la Salud, 2017. Es una patología poco común sin predilección por el género, afectando tanto a la población joven como adulta involucrando por igual a mandíbula y maxilar y es frecuentemente encontrado en asociación con piezas dentarias incluidas. El objetivo de esta presentación fue diagnosticar y desarrollar un plan de tratamiento quirúrgico, acorde al caso clínico. Se reporta un caso clínico de paciente de género masculino de 15 años de edad, con presencia de una lesión quística de 5 meses de evolución en zona anterior del maxilar superior izquierdo. El diagnóstico histopatológico previa biopsia incisional se correlacionó con los hallazgos clínicos y radiográficos, lo cual revela en el estudio histopatológico la presencia de Quiste Odontogenico Epitelial Calcificante asociado a Quiste Dentigero. El tratamiento consistió en la remoción quirúrgica del quiste bajo anestesia general. Posterior a la enucleación se hicieron los controles postoperatorios y el seguimiento del paciente por un periodo de 2 años. La realización de una historia clínica exhaustiva, confirmación diagnóstica mediante biopsia y técnica quirúrgica correcta en la eliminación del quiste nos permitió obtener un resultado favorable.
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