Carlos Alberto Fontes de Souza

Chromophobe renal cell carcinoma: clinicopathological study of 7 cases.

Chromophobe renal cell carcinoma (CRCC) may be grossly and microscopically confused with oncocytoma. It is now believed that many, if not all, of the so-called malignant oncocytomas or oncocytomas with metastases reported in the literature were indeed chromophobe renal cell carcinomas. CRCC is characteristically positive for colloidal iron and shows cytoplasmic microvesicles in electron microscopy. This study of CRCC is thought to be the first one done in Latin America. Of a total of 106 renal epithelial neoplasms, 7 (6.6%) fulfilled the criteria for chromophobe renal cell carcinoma. This frequency in Brazil is similar to that in other parts of the world. There was no difference in age, sex, and race distribution of CRCC compared to usual renal epithelial tumors. Grossly, the CRCC ranged in size from 3.5 to 20 cm (average: 10.2 cm) in greatest dimension. Most frequently, the tumor was brown on the cut surface. The growth pattern showed compact areas in all tumors and, in most of the cases, both clear and eosinophilic cellular subtypes were seen. The electron microscopic findings favor an origin of the microvesicles from outpouchings of the outer membrane of mitochondria. The strong positivity for colloidal iron in spite of the destruction of the cytoplasmic vesicles in paraffin-embedded specimens seems to indicate that the acid mucopolysaccharides are not located inside the microvesicles. By the time of diagnosis, only one case had regional lymph node metastases and this particular case was the only one mixed (associated with the usual renal cell carcinoma). The follow-up examination after nephrectomy showed that prognosis seems to be favorable in CRCC, except when the tumor coexists with the usual renal cell carcinoma.

Desmoid tumor of the abdominal wall during pregnancy: a case report

Desmoid tumors are neoplasms of the conjunctive tissue that are characterized by exclusive locoregional growth, frequent recurrence and minimal metastatic potential. They mainly affect individuals with familial adenomatous polyposis of the colon, and rarely occur isolated. The single form of this neoplasm most frequently appears in women of reproductive age, and during pregnancy. A case of a desmoid tumor of large proportions located in the abdominal wall is described. It appeared at the 17th week of pregnancy in a woman without any history of familial adenomatous polyposis. The neoplasm was totally extirpated, with the use of a polypropylene prosthesis for reconstitution of the abdominal wall. One year after the surgery, the patient continues to be well, while using non-steroidal anti-inflammatory drugs for the prevention of relapses.

Pseudolipomatose do cólon: relato de caso

Pseudolipomatosis of the colon is a rarely described benign condition that is characterized histologically by the presence of multiple vesicles containing air, in the wall of the large intestine. It is believed that this disease has iatrogenic origin, caused by air infiltration through the colon mucosa during endoscopic procedures. The objective of the present report was to present a case of pseudolipomatosis of the colon that was confirmed by histopathological studies. Case report: A 74-year-old woman underwent colonoscopy to investigate anemia. She had been complaining about cyclical rectal bleeding during evacuations, weight loss and anemia. The endoscopic examination did not show any abnormalities in the colon and only showed the presence of a single hemorrhoid, which at the time of examination presented signs of recent bleeding. Three weeks after this examination, she underwent elastic ligation of the hemorrhoid. While carrying out this procedure, a whitish yellow raised area was found in the intestinal mucosa. It was approximately 4 cm in diameter and was located on the posterior wall of the rectum at a distance of 13 cm from the anal margin. It had not existed at the time of performing the colonoscopy. The altered region of the mucosa and the elastic ligation of the hemorrhoid were biopsied. Histopathological examination showed the presence of large numbers of vacuoles of varying diameters and sometimes confluent, located in the intestinal wall layer itself. The appearance mimicked adipose tissue. The presence of a longitudinal connection allowing communication between the vacuolized region and the surface of the colon mucosa was noted. Histochemical and immunohistochemical techniques for detecting fat inside the vesicles gave negative results, thus allowing the diagnosis of pseudolipomatosis of the colon. After the elastic rubber band ligation, the patient did not present any further rectal bleeding and recovered from the anemia. Conclusion: Although pseudolipomatosis of the colon is rare, it is a condition that may be found after performing endoscopic procedures in the colon.

Endomiocardiofibrose biventricular associada à amiloidose renal

Endomyocardiofibrosis is a restrictive cardiomyopathy characterized by fibrotic involvement of the endocardium and adjacent myocardium, and by diastolic dysfunction caused by changes in distensibility making ventricular filling inadequate while preserving the systolic function. Clinically, it appears as heart failure, but etiological symptomatic discernment, suspicion and a clinical examination would be necessary in order to make a correct etiological diagnosis. The case of a patient with biventricular endomyocardial fibrosis associated with renal amyloidosis is presented.