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O tumor sólido pseudopapilar de pâncreas (TSPP) é uma neoplasia maligna de baixo grau, que acomete predominantemente mulheres jovens e corresponde a um processo tumoral ovoide pardo-avermelhado e de crescimento lento. Os autores relatam um caso incidental de TSPP, e discutem os achados anatomopatológicos e clínicos desta rara neoplasia. Paciente feminino, 45 anos, obesa mórbida, sem outras queixas clínicas, em avaliação para procedimento de cirurgia bariátrica, apresentou, nos exames de ultrassonografia e tomografia computadorizada do abdome, lesão tumoral sólido-cística na cauda do pâncreas, que mediu 7,1 cm no maior eixo. A paciente foi submetida à ressecção do processo. Aos cortes, foi identificada uma lesão tumoral ovoide, pardo-avermelhada, predominantemente sólida, circunscrita, que mediu 7,4 x 6,0 x 5,3 cm. Ao exame microscópico, identificou-se uma neoplasia de cé- lulas epitelioides monomórficas de tamanho intermediário, com citoplasma exibindo pequenos glóbulos hialinos, dispostas em áreas sólidas e císticas. O processo exibiu imunoexpressão positiva para pancitoqueratina, betacatenina, sinaptofisina, cromogranina A, CD56 e receptores de progesterona, e imunoexpressão negativa para E-caderina, CDX-2 e TTF-1. O diagnóstico de Tumor Sólido Pseudopapilar do Pâncreas foi então estabelecido. Após um seguimento de quatro meses, não foram encontradas evidências clínicas ou radiológicas de recidiva tumoral(AU)

The solid pseudopapillary tumor of the pancreas (SPTP) is a malignant neoplasm of low degree, which predominantly affects young women and corresponds to an ovoid reddish-brown tumor process of slow growth. The authors report an incidental case of SPTP and discuss the clinical and pathological findings of this rare neoplasm. A female patient, 45 years old, morbidly obese, with no other clinical complaints, in evaluation for bariatric surgery procedure, presented, in ultrasound examination and computed tomography of the abdomen, a solid-cystic tumor lesion in the pancreas tail, which measured 7.1 cm in the major axis. The patient underwent resection process. The cuts showed an ovoid reddish-brown tumor lesion predominantly solid, circumscribed, which measured 7.4 x 6.0 x 5.3 cm. Microscopic examination identified a tumor of monomorphic epithelioid cells of intermediate size, with cytoplasm exhibiting small hyaline globules arranged in solid and cystic areas. The process showed positive immunoreactivity for pancytokeratin, beta-catenin, synaptophysin, chromogranin A, CD56 and progesterone receptors, and negative immunoreactivity for E-cadherin, CDX-2 and TTF-1. The diagnosis of solid pseudopapillary tumor of the pancreas was then established. At a four-month follow-up, there was no clinical or radiological evidence of tumor recurrence(AU)

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PURPOSE: To evaluated the effects of L-arginine (a NO donor) and L-NAME (Nw-nitro-L-arginine methyl ester - a NOS inhibitor) on ischemia-reperfusion in rat livers. METHODS: One hundred fifty two male Wistar rats were divided into four groups: control (simulated surgery); hepatic IR; pretreatment with L-arginine plus hepatic IR; and L-NAME plus hepatic IR. The hepatocellular damage was evaluated at the first, third and seventh days after the procedures through the alanine-aminotransferase (ALT) and aspartate-aminotransaminase (AST) levels, as well as histopathological features: vascular congestion (VC); steatosis (STE); necrosis (NEC); and inflammatory infiltration (INF). The mortality rate was also evaluated. RESULTS: The pretreatment with L-NAME significantly worsened the AST levels after hepatic IR (p<0.05) at first day and L-arginine demonstrated an attenuating effect on ALT levels at seventh day (p<0.05). Furthermore, the administration of L-arginine was able to reduce the VC and STE in the seventh day after hepatic IR (p<0.05). The analysis of the mortality rates did not demonstrate any difference between the groups. Nevertheless, there was not effect of L-arginine and L-NAME on the mortality of the animals. CONCLUSION: L-arginine/NO pathway has a role in the hepatic IR because the pretreatment with L-arginine partially had attenuated the hepatocellular damage induced by hepatic IR in rats.

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PURPOSE: To evaluated the effects of L-arginine (a NO donor) and L-NAME (Nw-nitro-L-arginine methyl ester - a NOS inhibitor) on ischemia-reperfusion in rat livers. METHODS: One hundred fifty two male Wistar rats were divided into four groups: control (simulated surgery); hepatic IR; pretreatment with L-arginine plus hepatic IR; and L-NAME plus hepatic IR. The hepatocellular damage was evaluated at the first, third and seventh days after the procedures through the alanine-aminotransferase (ALT) and aspartate-aminotransaminase (AST) levels, as well as histopathological features: vascular congestion (VC); steatosis (STE); necrosis (NEC); and inflammatory infiltration (INF). The mortality rate was also evaluated. RESULTS: The pretreatment with L-NAME significantly worsened the AST levels after hepatic IR (p<0.05) at first day and L-arginine demonstrated an attenuating effect on ALT levels at seventh day (p<0.05). Furthermore, the administration of L-arginine was able to reduce the VC and STE in the seventh day after hepatic IR (p<0.05). The analysis of the mortality rates did not demonstrate any difference between the groups. Nevertheless, there was not effect of L-arginine and L-NAME on the mortality of the animals. CONCLUSION: L-arginine/NO pathway has a role in the hepatic IR because the pretreatment with L-arginine partially had attenuated the hepatocellular damage induced by hepatic IR in rats. .

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PURPOSE: To evaluated the effects of L-arginine (a NO donor) and L-NAME (Nw-nitro-L-arginine methyl ester - a NOS inhibitor) on ischemia-reperfusion in rat livers.METHODS: One hundred fifty two male Wistar rats were divided into four groups: control (simulated surgery); hepatic IR; pretreatment with L-arginine plus hepatic IR; and L-NAME plus hepatic IR. The hepatocellular damage was evaluated at the first, third and seventh days after the procedures through the alanine-aminotransferase (ALT) and aspartate-aminotransaminase (AST) levels, as well as histopathological features: vascular congestion (VC); steatosis (STE); necrosis (NEC); and inflammatory infiltration (INF). The mortality rate was also evaluated.RESULTS: The pretreatment with L-NAME significantly worsened the AST levels after hepatic IR (p 0.05) at first day and L-arginine demonstrated an attenuating effect on ALT levels at seventh day (p 0.05). Furthermore, the administration of L-arginine was able to reduce the VC and STE in the seventh day after hepatic IR (p 0.05). The analysis of the mortality rates did not demonstrate any difference between the groups. Nevertheless, there was not effect of L-arginine and L-NAME on the mortality of the animals.CONCLUSION: L-arginine/NO pathway has a role in the hepatic IR because the pretreatment with L-arginine partially had attenuated the hepatocellular damage induced by hepatic IR in rats.(AU)

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BACKGROUND: Gastric adenocarcinoma is more often found in men over 50 years in the form of an antral lesion. The tumor has heterogeneous histopathologic features and a poor prognosis (median survival of 15% in five years). AIM: To estimate the relationship between the presence of nodal metastasis and other prognostic factors in sporadic gastric adenocarcinoma. METHOD: Were evaluated 164 consecutive cases of gastric adenocarcinoma previously undergone gastrectomy (partial or total), without clinical evidence of distant metastasis, and determined the following variables: topography of the lesion, tumor size, Borrmann macroscopic configuration, histological grade, early or advanced lesions, Lauren histological subtype, presence of signet ring cell, degree of invasion, perigastric lymph node status, angiolymphatic/perineural invasion, and staging. RESULTS: Were found 21 early lesions (12.8%) and 143 advanced lesions (87.2%), with a predominance of lesions classified as T3 (n=99/60, 4%) and N1 (n=62/37, 8%). The nodal status was associated with depth of invasion (p<0.001) and tumor size (p<0.001). The staging was related to age (p=0.048), histological grade (p=0.003), and presence of signet ring cells (p = 0.007), angiolymphatic invasion (p = 0.001), and perineural invasion (p=0.003). CONCLUSION: In gastric cancer, lymph node involvement, tumor size and depth of invasion are histopathological data associated with the pattern of growth/tumor spread, suggesting that a wide dissection of perigastric lymph nodes is a fundamental step in the surgical treatment of these patients.

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Background: Gastric adenocarcinoma is more often found in men over 50 years in the form of an antral lesion. The tumor has heterogeneous histopathologic features and a poor prognosis (median survival of 15% in five years). Aim: To estimate the relationship between the presence of nodal metastasis and other prognostic factors in sporadic gastric adenocarcinoma. Method: Were evaluated 164 consecutive cases of gastric adenocarcinoma previously undergone gastrectomy (partial or total), without clinical evidence of distant metastasis, and determined the following variables: topography of the lesion, tumor size, Borrmann macroscopic configuration, histological grade, early or advanced lesions, Lauren histological subtype, presence of signet ring cell, degree of invasion, perigastric lymph node status, angiolymphatic/perineural invasion, and staging. Results: Were found 21 early lesions (12.8%) and 143 advanced lesions (87.2%), with a predominance of lesions classified as T3 (n=99/60, 4%) and N1 (n=62/37, 8%). The nodal status was associated with depth of invasion (p<0.001) and tumor size (p<0.001). The staging was related to age (p=0.048), histological grade (p=0.003), and presence of signet ring cells (p = 0.007), angiolymphatic invasion (p = 0.001), and perineural invasion (p=0.003). Conclusion: In gastric cancer, lymph node involvement, tumor size and depth of invasion are histopathological data associated with the pattern of growth/tumor spread, suggesting that a wide dissection of perigastric lymph nodes is a fundamental step in the surgical treatment of these patients. .

Racional: O adenocarcinoma gástrico é encontrado mais frequentemente em homens acima de 50 anos sob a forma de lesão antral. A neoplasia apresenta características histopatológicas heterogêneas e prognóstico ruim (sobrevida média de 15% em cinco anos). Objetivo: Estimar a relação entre a presença de metástases nodais e demais fatores prognósticos no adenocarcinoma gástrico esporádico. Método: Foram avaliados 164 casos consecutivos de adenocarcinoma gástrico previamente submetidos à gastrectomia (parcial ou total), sem evidências clínicas de metástase à distância, sendo determinadas as seguintes variáveis: topografia da lesão, tamanho tumoral, configuração macroscópica segundo Borrmann, grau histológico, lesão precoce ou avançada, subtipo histológico segundo Lauren, presença de células em anel de sinete, grau de invasão, status dos linfonodos perigástricos, invasão angiolinfática/perineural e estadiamento. Resultados: Foram encontradas 21 lesões precoces (12,8%) e 143 avançadas (87,2%) com predomínio de lesões T3 (n=99/60,4%) e N1 (n=62/37,8%). O status nodal esteve associado à profundidade de invasão (p<0,001) e tamanho tumoral (p<0,001). O estadiamento esteve relacionado à idade (p=0,048), grau histológico (p=0,003) e presença de células em anel de sinete (p=0,007), invasão angiolinfática (p=0,001) e invasão perineural (p=0,003). Conclusão: No adenocarcinoma gástrico, o envolvimento linfonodal, o tamanho tumoral e a profundidade de invasão são dados histopatológicos associados ao padrão de crescimento/disseminação neoplásico, sugerindo que a dissecção ampla de linfonodos perigástricos seja etapa fundamental ...

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Introdução: As lesões expansivas do sistema nervoso central constituem um grupo diversificado de condições neoplásicas e não neoplásicas que podem ocorrer em virtualmente qualquer região anatômica e em pacientes de qualquer idade. A biópsia estereotáxica cerebral (BEC) é um procedimento seguro que pode ser usado na determinação do diagnóstico histopatológico desses processos. O objetivo deste estudo foi avaliar a acurácia da técnica de BEC na determinação do diagnóstico de processos expansivos intraparenquimatosos cerebrais. Métodos: Foram avaliadas 114 amostras distintas de BEC, através da técnica de hematoxilina-eosina, com o intuito de estabelecer o diagnóstico histológico de cada caso. As neoplasias secundárias foram avaliadas pela técnica de imunoistoquímica para estabelecer o sítio primário destas lesões. Resultados: Foi encontrada um média de idade igual a 52.92 anos (±8,125), com uma idade mediana de 51,0 anos. O grupo de pacientes incluiu 64 homens (56%). O número de fragmentos analisados em cada caso era igual a 12. Os fragmentos mediam em média 8,0 milímetros de largura e 1,0 mm de comprimento. O diagnóstico histológico de neoplasia foi estabelecido em 95 casos (83,3%), sendo o astrocitoma difuso (24,5%) e o glioblastoma (22,8%) os tipos histológicos mais frequentes. Foram encontrados 10 casos de envolvimento cerebral por neoplasias secundárias, sendo o linfoma não-hodgkiniano difuso de células B e o adenocarcinoma (80% em conjunto) os tipos predominantes. As lesões não neoplásicas corresponderam a 19 casos (16,7%) da amostra. Conclusão: A acurácia da BEC corresponde cerca de 92%, favorecendo seu emprego principalmente na investigação clínica de processos neoplásicos

Introduction: Expansive brain lesions of the central nervous system are a diverse group of neoplastic and non-neoplastic conditions that may occur in virtually any anatomical region and in patients of all ages. Stereotactic brain biopsy (SBB) is a safe procedure that can be used to determine the histopathologic diagnosis of these processes. The aim of this study was to evaluate the accuracy of SBB in determining the diagnosis of expansive intraparenchymal brain processes. Methods: We evaluated 114 different samples of SBB through the hematoxylin-eosin technique in order to establish the histologic diagnosis of each case. Secondary neoplasms were evaluated by immunohistochemistry to determine the primary site of these lesions. Results: Patient mean age was 52.92 years (± 8.125), with a median of 51.0 years. The group of patients included 64 men (56%). Twelve fragments were analyzed in each case. On average, fragments were 8.0 mm wide and 1.0 mm long. The histological diagnosis of cancer was established in 95 cases (83.3%). Diffuse astrocytoma (24.5%) and glioblastoma (22.8%) were the most frequent histological types. There were 10 cases of cerebral involvement by secondary neoplasms, and diffuse non-Hodgkin B-cell lymphoma and adenocarcinoma (80% combined) were the predominant types. There were 19 cases of non-neoplastic lesions (16.7%) in this sample. Conclusion: The accuracy of SBB was 92%, which favors its use in clinical research of neoplastic processes

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A hemocromatose caracteriza-se pelo acúmulo excessivo de ferro no organismo, que é depositado redominantemente no fígado, e resulta ou de um defeito genético determinando uma absorção excessiva de ferro ou da administração parenteral deste íon. O ferro em excesso determina alterações celulares através da peroxidação lipídica, estímulo da deposição de colágeno e interação com o oxigênio reativo e DNA. Os autores relatam um caso de hemocromatose em paciente portador de cirrose hepática associada ao desenvolvimento de hepatocarcinoma, hemangioma hepático, adenocarcinoma prostático e carcinoma renal, e apresentam uma discussão geral deste processo, frequentemente associado ao desenvolvimento de neoplasias.

Hemochromatosis is characterized by excessive accumulation of iron in the body, which is deposited primarily in the liver. It results either from a genetic defect determining an excessive absorption of iron or from parenteral administration of this ion. The excess iron determines cellular changes through lipid peroxidation, stimulation of collagen deposition, and interaction with reactive oxygen and DNA. The authors report a case of hemochromatosis in a patient with liver cirrhosis associated with development of hepatocellular carcinoma, hepatic hemangioma, prostate adenocarcinoma and renal cell carcinoma, and provide a general discussion of this process often associated with the development of neoplasias.

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PURPOSE: To investigate the degree of placental permeability in dyslipidemic rabbits and the consequent vascular dysfunction in fetuses of female rabbits with high lipoprotein levels. METHODS: Fifteen adult females New Zealand White rabbits were divided into two groups. Group 1(n=5) - hypercholesterolemic diet with 0.5 percent cholesterol, and Group 2 (n=10) - control. On day 30, the levels of plasma lipoproteins and triglycerides were analyzed in the mothers, and the presence of collagen was analyzed in the placenta as well as in fetal coronary and aorta. Statistical analyses used the Student's t and the Mann-Whitney tests. RESULTS: Lipoprotein levels were significantly different (p=0.02 to p<0.001) in experimental and control groups. In the hypercholesterolemic group, total cholesterol levels were in average 793mg/dl; triglycerides were in average 257mg/dl; HDL-C was 48mg/dl, and LDL-C was in average 692mg/dl. The amount of collagen per micrometers square (mµ²) in samples from hypercholesterolemic animals was significantly higher than in the control group. CONCLUSIONS: The study confirmed placental permeability to lipoproteins, shown by increased amounts of collagen in fetal tissues. This alteration results in increased susceptibility to atherosclerosis in adult life, representing a risk factor for the early development of disease, which may appear even in the prenatal period.

OBJETIVO: Investigar a permeabilidade placentária em coelhos adultos fêmeas dislipidêmicas e a consequente disfunção vascular em seus fetos. MÉTODOS: Quinze coelhos adultos fêmeas Nova Zelândia Brancas foram distribuídas em grupo dislipidêmico e grupo controle. No trigésimo dia de gestação foram medidos os triglicerídeos e as lipoproteínas nas coelhas e verificada a presença de colágeno na placenta e coronárias fetais. Análise estatística foi feita com teste t de Student´s e Mann-Whitney. RESULTADOS: Os níveis de lipoproteínas foram diferentes estatisticamente entre os grupos (p=0,02 a p<0,001). A quantidade de colágeno por micrômetro quadrado foi significantemente maior no grupo hipercolesterolêmico em comparação ao grupo controle. CONCLUSÕES: O estudo confirmou a permeabilidade placentária para lipoproteínas demonstrando aumento de colágeno nos tecidos fetais. Esta alteração induz ao aumento da suscetibilidade para aterosclerose na vida adulta, representando um fator de risco para desenvolvimento precoce da doença aterosclerótica a qual pode estar presente mesmo no período pré-natal.

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PURPOSE: To investigate the degree of placental permeability in dyslipidemic rabbits and the consequent vascular dysfunction in fetuses of female rabbits with high lipoprotein levels. METHODS: Fifteen adult females New Zealand White rabbits were divided into two groups. Group 1(n=5) - hypercholesterolemic diet with 0.5 percent cholesterol, and Group 2 (n=10) - control. On day 30, the levels of plasma lipoproteins and triglycerides were analyzed in the mothers, and the presence of collagen was analyzed in the placenta as well as in fetal coronary and aorta. Statistical analyses used the Student's t and the Mann-Whitney tests. RESULTS: Lipoprotein levels were significantly different (p=0.02 to p<0.001) in experimental and control groups. In the hypercholesterolemic group, total cholesterol levels were in average 793mg/dl; triglycerides were in average 257mg/dl; HDL-C was 48mg/dl, and LDL-C was in average 692mg/dl. The amount of collagen per micrometers square (mµ²) in samples from hypercholesterolemic animals was significantly higher than in the control group. CONCLUSIONS: The study confirmed placental permeability to lipoproteins, shown by increased amounts of collagen in fetal tissues. This alteration results in increased susceptibility to atherosclerosis in adult life, representing a risk factor for the early development of disease, which may appear even in the prenatal period.(AU)

OBJETIVO: Investigar a permeabilidade placentária em coelhos adultos fêmeas dislipidêmicas e a consequente disfunção vascular em seus fetos. MÉTODOS: Quinze coelhos adultos fêmeas Nova Zelândia Brancas foram distribuídas em grupo dislipidêmico e grupo controle. No trigésimo dia de gestação foram medidos os triglicerídeos e as lipoproteínas nas coelhas e verificada a presença de colágeno na placenta e coronárias fetais. Análise estatística foi feita com teste t de Studentïs e Mann-Whitney. RESULTADOS: Os níveis de lipoproteínas foram diferentes estatisticamente entre os grupos (p=0,02 a p<0,001). A quantidade de colágeno por micrômetro quadrado foi significantemente maior no grupo hipercolesterolêmico em comparação ao grupo controle. CONCLUSÕES: O estudo confirmou a permeabilidade placentária para lipoproteínas demonstrando aumento de colágeno nos tecidos fetais. Esta alteração induz ao aumento da suscetibilidade para aterosclerose na vida adulta, representando um fator de risco para desenvolvimento precoce da doença aterosclerótica a qual pode estar presente mesmo no período pré-natal.(AU)

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