Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive, malignant neoplasm usually present with the widespread abdominal serosal involvement and affects mainly adolescents and young adults. When presenting within visceral organs, as kidney, the diagnosis of DSRCT imposes significant difficulties. We present a case of primary DSRCT of the kidney in a 10-year-old boy mimicking clinically and pathologically Wilms tumor. The tumor showed morphologic and immunohistochemical features of DSRCT and the presence of the Ewing sarcoma and Wilm tumor 1 fusion transcripts resulting from the t(11;22) (p13;q12) reciprocal translocation. DSRCT should be considered in the differential diagnosis of Wilm tumor and other small blue-round cell tumors of the kidney.
Objective: Systematic review of literature and meta-analysis to evaluate the results of magnetic resonance image 1.5T with endorectal coil in the diagnosis and evaluation of extra-prostatic extension and involvement of seminal vesicles of prostate cancer, compared to the histopathological results of the radical prostatectomy specimen. Materials and Methods: It was conducted a systematic review of literature and meta--analyses of all studies data published after 2008. In those studies, the patients with prostate cancer with indication to radical prostatectomy were submitted to magnetic resonance image (MRI) at pre-operatory period and the results were compared to those of histopathological studies after the surgery. The selected terms for research included prostate cancer, magnetic resonance, radical prostatectomy, and prostate cancer diagnosis, in the databases EMBASE, LILACS, PUBMED/MEDLINE and Cochrane Library. The data were collected using a specific qualitative instrument and the meta-analysis data were presented in the forest plot graphics, homogeneity test and sROC curves and funnel plot. Results: A total of seven studies were included, with a total of 603 patients. Among these studies, six evaluated the value of MRI for the detection of prostate cancer, and the median sensitivity of meta-analysis was 0.6 and specificity 0.58, but with heterogeneity among the studies. Three studies evaluated extra-prostatic extension with a median sensitivity of 0.49, specificity 0.82 and heterogeneity only for sensitivity. Three studies evaluated invasion of seminal vesicles, with median sensitivity of 0.45 and specificity 0.96, with heterogeneity in both analysis. Conclusion: Magnetic resonance of 1.5T with endocoil showed low values of sensitivity and specificity for the diagnosis and staging of prostate cancer. The reviewed studies showed a significant heterogeneity among them. The best observed result was MRI specificity for invasion of seminal vesicles. More studies are necessary to evaluate new techniques and parameters before recommending the routine use of MRI in clinical practice.
OBJECTIVETo evaluate the prevalence of cardiovascular events (CVE) secondary to atherosclerosis in lupus patients and correlate them to the traditional risk factors, disease duration and drug therapy used. METHODSA retrospective study was carried out based on data obtained from patients' charts. Patients included were those who had a lupus diagnosis confirmed at least two years before inclusion in the study and had been followed since 1992. CVE were characterized as MI, angina pectoris and stroke non-related to lupus activity. Risk factors and drugs used for treatment were recorded. RESULTSSeventy-one charts were analyzed. Patients' mean age was 34.2±12.7 years; 68 were women and three were men; 58 were Caucasian (81.6%). Ten (14.08%) presented CVE. Patients in whom CVE were observed were older (42.7 vs. 32.8 years p=0.0021) and presented longer disease duration (10.8 vs. 7.2 years p=0.011). The traditional risk factors, daily and cumulative doses of steroids, immunosuppressive drugs and antimalarial drugs were not significant when patients with and without CVE were compared. CONCLUSIONThe prevalence of CVE secondary to atherosclerosis in systemic lupus erythematosus (SLE) was 14.08%. The traditional risk factors were not associated with the development of CVE in lupus patients. Patients that presented cardiovascular events were older and presented longer disease duration. It is a premature conclusion to establish SLE as an independent risk factor for atherosclerosis development. KEY WORDSSystemic lupus erythematosus, atherosclerosis, cardiovascular disease.
Pulmonary chondroma is a rare neoplasm. (1)(2)(3)(4)(5)(6) It is primarily seen in women and is part of the Carney triad, which consists of pulmonary chondroma, gastric leiomyosarcoma and functioning extraadrenal paraganglioma. (1) In describing this triad, Carney reported four cases involving young women. He suggested that the concomitant development ABSTRACT A 45-year-old man presented with recurrent pulmonary infection for four years, cough, bloody sputum, yellowish excretion and nonpleuritic chest pain. Tomography of the chest revealed a calcified nodule occluding the right lower lobe bronchus. A right lower and middle lobectomy was performed, and the histopathological examination of the bronchi revealed chondroma, a rare pulmonary tumor usually associated with the Carney triad (pulmonary chondroma, gastric leiomyosarcoma and extra-adrenal paraganglioma), being the less common of the three components. In the present case, the other two components of the triad were not observed. Since these components may appear years later, long-term follow-up care is necessary. Case ReportJ Bras Pneumol. 2005;31(4):356-9
UNICAMP), uma das melhores instituições de ensino superior do país e do mundo, pelo grau de qualidade que impõe às suas atribuições assistenciais, de ensino e de pesquisa.Ao Programa de Pós Graduação em Ciências da Cirurgia o qual mantém um Programa de formação de mestres e doutores com alta qualificação científica e intelectual.À Disciplina de Urologia, representada pelo professor Dr. Ubirajara Ferreira, a qual me proporcionou crescimento e amadurecimento profissional por meio de sua Pós Graduação, com a excelência que oferece a seus alunos em todos os âmbitos.À Disciplina de Urologia também pelo fato de ter disponibilizado os dados referentes aos pacientes elencados para este trabalho, dando ampla disponibilidade e acessibilidade ao arquivo estruturado dela Disciplina.Ao meu orientador professor Dr. Wagner José Fávaro, pelos ensinamentos, paciência e acolhimento ao meu trabalho; meu muito obrigado.Ao professor Dr. Athanase Billis pela sua disponibilidade e dedicação em rever toda parte de anatomopatologia do trabalho, disponibilizando seu amplo conhecimento em favorecimento deste estudo.Ao estudante de graduação em medicina Alexandre Forato, bolsista de iniciação científica da FAPESP, pelo auxílio da parte laboratorial in locu ao trabalho.Ao Departamento de Bioestatística da FCM-UNICAMP pelo empenho na realização dos testes estatísticos do trabalho.À FAPESP (processos: 2014/12047-4; 2014/06128-1; 2014/11866-1), CNPq e CAPES pelo suporte financeiro; inquestionavelmente viabilizadores desta tese. Aos meus companheiros de trabalho, Rodrigo de Held Falashi e Carlos EduardoMaluf, os quais entenderam meus momentos de ausência nas atividades de trabalho diárias. Muito obrigado pela compreensão.A todos que de alguma forma, direta ou indiretamente, contribuíram para a realização deste trabalho. EPÍGRAFE"É melhor lançar-se à luta em busca do triunfo, mesmo expondo-se ao insucesso, do que ficar na fila dos pobres de espírito, que nem gozam muito nem sofrem muito, por viverem nessa penumbra cinzenta de não conhecer vitória e nem derrota."Franklin D. Roosevelt RESUMOIntrodução e Objetivos: Ao contrário das células normais, a glicólise é aumentada e a capacidade de fosforilação oxidativa mitocondrial é reduzida em vários tipos de cânceres. Acredita-se que o fenótipo glicolítico no câncer se deve a uma incapacidade permanente da fosforilação oxidativa mitocondrial. Embora a glicólise seja frequentemente encontrada em tumores malignos, a fosforilação oxidativa mitocondrial desempenha um papel importante na produção de energia em alguns tipos de cânceres. Assim, os objetivos desse estudo foram investigar e caracterizar a assinatura bioenergética mitocondrial do câncer de próstata como marcador da classificação de Gleason e o tempo de recidiva bioquímica após a prostatectomia radical (PRR). Também desenvolvemos um índice bioenergético celular (BEC), que pode refletir o prognóstico. Materiais e Métodos: Estudamos amostras de próstata de 4 grupos (10 pacientes em cada grupo): Grupo 1 (Controle): ausência de malignidade; Grupo 2: E...
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