RESUMO
We describe a 65-year-old-man who presented with acute gastrointestinal bleeding secondary to massive submucosal deposits of hyaline material in the small bowel. The histochemical and ultrastructural features of the hyaline substance were typical of lipoid proteinosis, a rare cutaneous disorder in which, to our knowledge, symptomatic compromise of internal organs has not been described previously. The patient was later found to have mild but characteristic mucocutaneous lesions of lipoid proteinosis, as well as asymptomatic deposits in other gastrointestinal sites. Our case documents that severe visceral involvement may occur in lipoid proteinosis, even in previously undiagnosed patients with mild cutaneous manifestations of the disease.
Assuntos
Intestino Delgado , Proteinose Lipoide de Urbach e Wiethe/patologia , Hemorragia/etiologia , Humanos , Hialina/metabolismo , Enteropatias/complicações , Enteropatias/metabolismo , Enteropatias/patologia , Intestino Delgado/metabolismo , Proteinose Lipoide de Urbach e Wiethe/complicações , Proteinose Lipoide de Urbach e Wiethe/metabolismo , Masculino , Pessoa de Meia-IdadeRESUMO
We present the case of a 62-year-old man with a malignant Brenner tumor of the testis and epididymis. The neoplasm showed the distinctive histologic features of Brenner tumors of the ovary, including the presence of nests of transitional epithelium with focal mucinous differentiation, surrounded by septae of dense fibrous tissue. In addition to areas of typical Brenner epithelium, the tumor displayed a component of transitional and squamous carcinoma that invaded the testicular parenchyma, epididymis, and vas deferens, and metastasized to periaortic lymph nodes. To our knowledge, there are only four previously described instances of testicular Brenner tumors. Our case appears to represent the first description of a malignant Brenner tumor of the testis and epididymis.
Assuntos
Tumor de Brenner/patologia , Epididimo , Neoplasias Testiculares/patologia , Tumor de Brenner/metabolismo , Epididimo/metabolismo , Epididimo/patologia , Humanos , Técnicas Imunoenzimáticas , Masculino , Pessoa de Meia-Idade , Neoplasias Testiculares/metabolismo , Testículo/metabolismo , Testículo/patologiaRESUMO
We studied mucin histochemistry in 25 rectosigmoid adenocarcinomas and in the transitional mucosa adjacent to these tumors using standard techniques for the detection of neutral and acid sialomucins and sulfomucins and the paradoxical concanavalin A (Con A) stain. This histochemical procedure selectively detects residues of mannose in glycoproteins exposed to brief steps of oxidation and reduction. Those techniques were also used to study histologically normal mucosa of specimens with carcinoma, normal rectosigmoid mucosa of patients without inflammatory or neoplastic bowel disease, hyperplastic rectal polyps, and rectosigmoid mucosa of human fetuses. Normal mucosa and hyperplastic polyps mainly contained sulfomucins and did not display Con A binding activity with any of the variants of the stain. In contrast, fetal, transitional, and malignant mucosa predominantly showed sialomucins and although not reactive with the standard Con A sequence, displayed binding activity for the lectin after short oxidative-reductive steps. These results provide further evidence that transitional and malignant mucosa produce markedly abnormal mucins whose histochemical patterns represent a re-emergence of the fetal type found during development. The principles of the paradoxic Con A reaction may be applied to unmask lectin binding activity in apparently unreactive sites.