Código numérico 1720Palabras clave Melanoma; Ganglio centinela
Código numérico 1720El ganglio centinela ha sido recientemente aceptado como uno de los factores pronósticos más importantes en el melanoma maligno según la AJCC (American Joint Committee on Cancer), a pesar de que su uso sistemático no está aún extendido a todas la unidades de melanoma y su empleo no está exento de controversias. Entre otros aspectos, se discute si la realización de la ampliación de márgenes debe ser realizada en el mismo tiempo quirúrgico que el ganglio centinela para la eficacia del mismo. Se realiza un estudio retrospectivo sobre 78 pacientes intervenidos de ganglio centinela por melanoma entre Mayo 99 y Enero 04, todos ellos remitidos por Dermatología con diagnóstico de melanoma maligno >1mm de espesor de Breslow y adenopatías no palpables (estadio I y II de la AJCC). De ellos, 42 son mujeres y 36 varones, con una edad media de 53.5 años. El espesor de Breslow medio es de 2.78mm. La ampliación de márgenes se hizo en un tiempo quirúrgico anterior por parte de Dermatología en 59 casos (76.62%), mientras que en 18 se realizó en el mismo tiempo que el ganglio centinela. La demora media entre la ampliación de márgenes y la realización del ganglio centinela fue de 5.87 meses. En el 19.23% (15 pacientes) no se observó captación gamagráfica, por lo que el estudio del ganglio centinela no pudo llevarse a cabo. De ellos, en 12, la ampliación de márgenes había sido anterior al tiempo del ganglio centinela, con una demora media de 5.06meses.El 50% (39) de los ganglios enviados a Anatomía Patológica fueron negativos para células malignas. El 25.74% (20pacientes) fueron positivos. El seguimiento medio es de 23.12 meses; 18 pacientes presentan en la actualidad metástasis o han fallecido; 47 casos (60%) se encuentran libres de tumor. Según la experiencia recogida en nuestro Servicio durante este tiempo, se corrobora que el ganglio centinela es una técnica sencilla, de baja morbilidad, con una importante función de estadiaje para el tratamiento del melanoma maligno. No se observa ninguna diferencia entre el grupo de casos con ampliación de márgenes en el tiempo del ganglio centinela y aquellos con ampliación previa.El ganglio centinela en el melanoma: nuestra experiencia
Resumen AbstractThe sentinel lymph node biopsy for melanoma: our experience The sentinel lymph node biopsy (SLNB) has recently been accepted as one of the most important prognostic factors of the cutaneous primary melanoma by the AJCC (American Joint Committee on Cancer), even its overall use is still not extended to all the melanoma units and there are many controversies about its use. Among other aspects, there is no consensus about if the previous wide local excision can alter the results of the biopsy. This is a retrospective study done over 78 consecutive cases of SLNB for melanoma between May´99 and Jan´04. All of them were remitted from Dermatology with the diagnose of melanoma, tumor thickness >1.0mm and no clinical nodes (AJCC est. I and II). Out of the 78 cases, 42 wer...
An adult male Australian parakeet (Melopsittacus undulatus) presented a firm nodular lesion in the lateral metacarpal region of the right wing. Microscopically, there were neoplastic cells, round and polyhedral in shape, with abundant, slightly eosinophilic granular cytoplasm; they were strongly periodic-acid Schiff-positive and resistant to diastase digestion. Some groups of neoplastic cells were immunopositive for smooth muscle actin and desmin. There was no immunopositivity for S-100 protein, CD68 and cytokeratin. Ultrastructurally, the neoplastic cells were round and polygonal in shape, and they were characterized by abundant cytoplasm with numerous homogeneous osmophilic bodies covered by an electron-dense membrane (lysosomes). The histopathologic, immunohistochemical and ultrastructural features of the neoplastic tissue are consistent with a granular cell tumour, which has been described in different animal species and anatomic locations; however, this seems to be an infrequent neoplasm in Australian parakeets. The immunopositivity of the neoplastic cells for smooth muscle actin and desmin, as well as slight positivity for muscle with Masson's trichrome, suggest that this is a tumour of myogenic origin.
We report on pathologic examination of three autopsied newborns with Jarcho-Levin syndrome. The most important abnormalities noted were multiple extraskeletical defects such as cardiovascular, urogenital, respiratory, and central nervous system malformations. These cases add new information to the multiple vertebral segmentation defects found in this syndrome.
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