Pancreatic mucinous lesions: a retrospective analysis with cytohistological correlation

The diagnosis of mucinous pancreatic lesions, which include mucinous noncystic adenocarcinoma, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), and mucinous metaplasia, is critical, given different clinical management and prognosis. This retrospective study is done to assess the cytological features and pitfalls associated with these entities in cytological samples.A search for pancreatic cytology specimens with histological confirmation of the various pancreatic mucinous lesions was done from 1988 to 2005: 9 mucinous adenocarcinoma, 14 IPMN, 11 MCN, and 3 mucinous metaplasia. The majority (35/37) had been endoscopic ultrasound-guided fine-needle aspirations. The cellularity, background extracellular mucin, epithelial architecture, mucinous nature of the epithelium, cell shape, and nuclear features were evaluated on the cytology material. Of the 22 cytological features evaluated, the presence of three-dimensional clusters, micropapillary structures, and nuclear atypia, which includes nuclear crowding, increased N/C ratio, anisonucleosis, nuclear membrane contour irregularity, clumpy chromatin, and prominent nucleoli, was found to be consistently associated with mucinous adenocarcinoma. There were no statistically significant cytological features, which helped in differentiating IPMN, MCN, and mucinous metaplasia. There was a relatively high false-positive rate in the IPMN group (5/14, 36%). Review of the histological specimen showed severe dysplastic epithelial change in these cases. One false-positive case of mucinous metaplasia (1/3, 33%) showed marked intraepithelial acute inflammation.The cytological diagnosis of mucinous pancreatic lesions remains challenging, except for mucinous noncystic adenocarcinoma. The findings were largely nonspecific in the differentiation between IPMN, MCN, mucinous metaplasia, and incidentally sampled gastrointestinal epithelium. False-positive diagnosis of adenocarcinoma occurs not infrequently in the setting of IPMN with severe dysplastic epithelial change and in lesions with associated acute inflammation, and can be a pitfall in the diagnosis of these lesions.     

HLA-DRB1*1602 allele is positively associated with HPV cervical infection in Bolivian Andean women

Incidence of cervical cancer is high among Bolivian Andean women. Human papillomavirus (HPV) infection is known as the major risk factor of cervical cancer. The host immune system plays an important role in the outcome of HPV infection and associated malignancies. In order to study the immunogenetic background of Bolivian Andean women with regard to HPV infection status, we compared HLA class I and class II allele frequencies between 37 HPV positive and 68 HPV negative Bolivian women. Demographic variables, including distribution of Andean ethnicities, were similar in both groups. Comparison of HLA class I allele frequencies between both groups indicated no significant difference. In contrast, HLA class II DRB1*1602 allele, an Amerindian allele, was significantly higher in the HPV positive women compared with HPV negative controls (chi(2) = 5.2, p < 0.05, odds ratio = 3.17; 95% confidence interval = 1.4-8.8). HPV types present in the HPV positive group were HPV-18, -16, -31, -33, and -58. These results suggest that HLA class II DRB1*1602 may confer susceptibility to infection with genetically related HPV types. This is the first report of an HLA class II association with HPV infection in an Andean population.     

Maternal dietary omega fatty acid intake and auditory brainstem-evoked potentials in Mexican infants born at term: cluster analysis

OBJECTIVE: To identify biological and socioeconomic factors associated with the neurological development of Mexican infants born at term, as measured by brainstem auditory-evoked potentials (BAEPs). SUBJECTS AND METHODS: We conducted a cohort study among 76 women with low risk pregnancies recruited in their third trimester of pregnancy and followed their infants until 12 months of age. BAEP tests were conducted on the infants before 3 months of age during physiologic sleep, using 100 msec bipolar clicks. Maternal dietary intake was evaluated by food frequency questionnaire. Two BAEP groups (short latency, long latency) were identified by cluster analysis. The association between BAEP group and maternal PUFAs was estimated using logistic regression models adjusted for socioeconomic and biological factors. RESULTS: Short latency BAEPs were associated with a maternal diet rich in arachidonic acid (OR=3.63, 95% CI 1.23-10.67) after adjusting for age (in days) sex, head circumference and gestational age but was not significantly associated to a maternal diet rich in docosahexaenoic acid (DHA). CONCLUSIONS: Our results suggest the importance of arachidonic acid intake during pregnancy for short latency BAEPs and adequate fetal myelination.     

Myocardial ANP expression in Pompe's disease: An immunohistochemical study

The expression of atrial natriuretic peptide (ANP) was analyzed in the atrial and ventricular myocardium in three cases of Pompe's disease (glycogen storage disease of the myocardium), using an immunoperoxidase technique. The cytoplasm of almost all atrial myocytes and some subendocardial myocytes from the right and left ventricles were ANP-positive, excluding the typical central vacuole, which was occupied by glycogen. Ventricular ANP expression was usually more prominent in left ventricular samples, and its distribution was similar to that described in dilated, hypertrophic, restrictive, or ischemic heart disease; however, the enlargement of the myocytes in Pompe's disease is not caused by hypertrophy. We conclude that the atrial myocytes in Pompe's disease maintain ANP expression, despite severe cytoplasmic vacuolization. These results suggest that ventricular ANP expression may be related to mechanical stimuli, such as the increase in wall stress, and not directly related to myocyte hypertrophy.     

Colobomatous microphthalmia and orbital neuroglial cyst: case report

We present the case of a boy with a congenital right orbital cyst with bilateral colobomatous microphthalmia. Neuroimaging studies excluded communication between the cyst and the eye and between the cyst and the central nervous system. Analysis of cyst fluid obtained by aspiration detected beta 2-transferrin by high resolution immunofixation (IFE). The cyst recurred two months following aspiration. It was then completely excised and histopathologic studies demonstrated a cyst containing neuroglial tissue. No recurrence was observed for 12 months following excision.     

Motor control alteration in posturography in learning-disabled children

BACKGROUND: Some authors have mentioned that intersensory integration is damaged in children with learning disabilities (LDs), and other investigators point to motor control alterations in the same patients. Thus, we decided to study these hypotheses by means of posturographic recordings. METHODS: A highly selected group of 27 children with LDs was compared with 27 children of control group without LDs. Patients and controls were placed on the Equitest equipment platform. Sensory organization tests evaluated different test conditions that systematically vary visual, vestibular, and foot somatosensory cues available to subjects while they attempt to maintain a stable, quiet stance. Movement coordination test involved sudden posterior and anterior translations of the patient support surface. RESULTS: No significant correlations between scholastics and posturographic performance were observed. No difference in the six conditions and in sensory organization ratios or in visual preference between both groups was disclosed. Motor control test on children with LDs showed significant higher values in latencies in averages of large translations. CONCLUSIONS: Our data suggest that vestibular-visual-somatosensory organization for posture control are not abnormal in children with LDs; instead, motor controls show higher latencies with large translation movements, which suggest abnormal rate and timing precision motor coordination.