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The terminal illness and cause of death of prominent persons are an important part of the history of medicine. The various afflictions and autopsies of Napoleon, Lenin, and Einstein among others have been the subject of an abundant literature. In México, for the most part this information has been relegated to the mass media and is therefore mostly erroneous and incomplete. In the case of Octavio Paz, a "bone cancer" is mentioned as his terminal illness, an imprecise term that does not identify any clinical pathological illness. In the case of Lázaro Cárdenas his illness is attributed to an "hepatic disease" and a "blood cancer". In both cases we have sufficient information to document precisely their primary disease and cause of death. Octavio Paz died in 1998 due to a recidivist renal carcinoma of the clear cells that was removed in 1977. Lázaro Cárdenas died due to a cutaneous melanoma that spread first to the cervical lymphatic ganglia and then to the liver, spleen, and the thoracic and abdominal ganglia. If we believe that medicine is also an important part of our culture, this knowledge is relevant. [ABSTRACT FROM AUTHOR]

Introduction: Most prostatic biopsies do not represent a diagnostic problem. 11 owe ver, there is a subgroup oteases of difficult interpretation that frequently are consulted for a second opinion. The analysis of these cases allows although in an indirect manner which are the lesions that most often are difficult to diagnose, and eventually cause false positive or false negative results. Material and methods: Prospectively, 142 prostatic biopsies were seen in consultation during the period of January 2012 to June 2013. Noted were age, level of specific prostatic antigen, the original pathological diagnosis and the type of biopsy (needle, transurethral resection or prostatectomy). Conventional sections stained with hematoxylin and eosin were reviewed as well as the immunohistochemical studies in case they were submitted. In some biopsies additional immunohistochemical studies were performed in our laboratory and/or additional sections were made when they were considered necessary and ease the diagnostic interpretation. The employed antibodies included high molecular weight keratins, P63 protein and less frequently alpha meti-lacyl coenzyme A racemase. Results: The average age was 68 years. PSA levels varied from 3.5 to 67 ng/ml (median 12.2 ng/ml). Needle biopsies were I 15, 22 products of transurethral resections and 5 prostatectomies. Focal carcinoma and some varieties of prostatic carcinoma different of conventional acinar carcinoma, (pseudohyperplastic, xanthomatous or atrophic carcinoma) were frequently sent for consultation as glandular proliferations of uncertain significance. In the group of benign lesions there was a predominance of atypical basal cell hyperplasia and different types of atrophic lesions (partial atrophy, post-atrophic hyperplasia and sclerosing atrophy). The diagnostic concordance between the original diagnosis and the diagnosis established at our institution was 64%. Conclusions: The diagnostic discordance of 36% found in this series suggests that some of the biopsies reviewed it could have been interpreted erroneously during the original study. The above benign and malignant lesions noted above are probably the prostatic lesions that represent a common diagnostic problem in our population. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Gastritis, intestinal metaplasia, atrophy, and dysplasia are disorders that frequently precede the full development of gastric adenocarcinoma. On the other hand, primary gastric lymphomas seem to arise from mucosa-associated lymphoid tissue. It is well accepted that these histological changes are caused by Helicobacter pylori infection. The objective of this study is to determine the frequency and characteristics of epithelial and lymphoid tissue disorders of the gastric mucosa surrounding primary carcinomas and lymphomas. METHODS: We studied 111 gastrectomies from patients harboring primary adenocarcinomas (30 intestinal and 30 diffuse type) and 51 gastric lymphomas. For comparative purposes, we analized 86 stomachs from patients who died of diseases other than gastric malignancies. Histopathological disorders of the gastric mucosa adjacent to primary neoplasms such as atrophy, intestinal metaplasia, and dysplasia were recorded. Lymphoid follicles were classified in two groups, with or without expansion. Expansion was characterized by increased size, irregular borders, enlarged marginal zone, and expanded germinal centers. Differences were statistically evaluated with χ² and Fisher exact tests, odds ratio, and relative risk, with 95% CI. p values <0.05 were considered statistically significant. RESULTS: Most intestinal-type adenocarcinomas showed atrophy (76.6%) and intestinal metaplasia (86.6%) and less frequently, dysplasia (23.3%), in the surrounding gastric mucosa. Expansive lymphoid follicles were more frequent among lymphomas than in adenocarcinomas (56.8% vs 25%); however, a high percentage of lymphomas were also associated with atrophy (50.9%). intestinal metaplasia (62.7%), and rarely dysplasia (11.8%). On the contrary, diffuse-type adenocarcinoma displayed less frequently atrophy (33%). intestinal metaplasia (50%), and dysplasia (3%). Gastric mucosa from patients without any gastric neoplasia was almost normal (84%), whereas the remaining 16% showed, both or alone, atrophy and intestinal metaplasia. CONCLUSION: Histopathological disorders of the gastric mucosa are not specific for any neoplasm, but intestinal-type adenocarcinomas frequently showed atrophy, intestinal metaplasia, and not uncommonly, dysplasia of the surrounding non-neoplastic gastric mucosa. Diffuse-type adenocarcinomas did not frequently show such lesions. Primary lymphomas displayed expansive lymphoid follicles and also a high percentage of atrophy and intestinal metaplasia of the surrounding gastric mucosa. The presence of intestinal metaplasia, atrophy, and lymphoid follicles with expansion in endoscopic biopsies could suggest a higher suceptibility for the development of gastric intestinal-type adenocarcinoma or gastric lymphoma. Patients harboring such histopathological changes must receive eradication therapy against H. pylori and probably closer follow-up. [ABSTRACT FROM AUTHOR]

Background: High-grade intraepithelial neoplasia (HGPIN) is the only lesion regarded as precursor of prostatic carcinoma, though its frequency is unknown in many countries. Here we studied the frequency of HGPIN in a population with high grade frequency of prostatic carcinoma., Material and Methods: A total of 486 cases of sextant prostatic biopsies performed from January 2001 to January 2006 were reviewed. These included 280 biopsies from patients belonging to an urban population, with medium or high socioeconomic status, from two hospitals in Mexico City. For comparison, 206 cases from the Regional Hospital of Tabasco located in the tropical zone of the country were included. This hospital receives patients from a rural population with low income and socioeconomic status., Results: Of the total 486 cases, 162 (33.33%) cases were diagnosed as prostatic carcinoma and 319 (65.64%) as benign conditions. Only in five (1.03%) biopsies was HGPIN found. Three of these patients were from Mexico City, and two from the Regional Hospital of Tabasco., Conclusions: Even when our results were obtained only in three hospitals, they suggest that a low frequency of HGPIN on needle prostate biopsies does not necessarily mean a low frequency of prostatic carcinoma in the same population. The reason for such a disparity could be related to a reduced extension of HGPIN areas in the prostate gland. In populations with low frequency of HGPIN and high incidence of prostatic carcinoma, perhaps more biopsy cores should be obtained in order to minimize false negative results for premalignant lesions or early adenocarcinoma.

Introduction: Detailed revision of prostate biopsies with benign alterations may show potentially malignant lesions limited to isolated fields, which may be overviewed in routine analysis., Aim: To exam the morphological alterations in patients with suspicious of prostatic carcinoma and benign diagnosis in needle biopsies., Materials and Methods: During 2000-2001, one hundred consecutive patients with first prostate biopsy diagnosed as benign were included. Biopsies were performed by sextants or modified sextants technique. Slides were reviewed by two observers with knowledge of original diagnosis and this was accepted or modified in accordance to the findings found during the review., Results: Patients age ranged between 57 and 79 years old. Nine per cent of biopsies originally diagnosed as benign revealed different potentially malignant lesions, which should be noted due to possible association with carcinoma. In this group, there were five biopsies with atypical small acinar proliferation, three with few isolated glands with xanthomatous cytoplasm, and one with scarce atypical cells in the prostatic stroma. In contrast with Caucasian and Afro-American population, frequency of high grade intraepithelial neoplasia in needle biopsy seems to be very low and this lesion was not found in any of the 100 biopsies reviewed. Some lesions that simulate carcinoma, as atypical basal cell hyperplasia, post-atrophic hyperplasia, and adenosis were diagnosed as benign, and there was none false positive result., Conclusions: A small but significant group of the biopsies originally diagnosed as benign lesions, showed atypical lesions in isolated fields that were overlooked in the routine analysis. It is necessary the urologist to ask for a directed review of the biopsies if clinical and laboratory data strongly suggest prostatic carcinoma. Additional histological cuts, immunohistochemical studies and more than one observer may increase the frequency of detection of potentially malignant lesions.

Objective: To present a case of adult intussusception with uncommon etiology., Background: Intussusception is a relatively common cause of intestinal obstruction in children, but is a rare clinical entity in adults, representing less than one per cent of intestinal obstruction in this patient population., Method: We report on 72-year old female patient with intestinal obstruction due to ileocolic intussusception related to leiomyosarcoma of the terminal ileum. A synchronic adenocarcinoma in the cecum was identified. The patient underwent right hemicolectomy and terminal ileum resection with primary anastomosis. Her postoperative course was uneventful. The patient is free of all evidence of disease at 2 year of follow-up. A thorough review of the literature of adult intussusception was carried out., Conclusion: From this review, the recommendation is to resect all cases of adult intussusception, different from the recommended approach in pediatric population.

Objective: To analyze pathologic and clinical features in patients with primary gastric lymphoma (PGL) in a reference hospital in Mexico City, and to evaluate the variety of treatments chosen., Methods: Patients with primary gastric lymphoma between 1975 and 2000. Those with histological diagnosis of primary gastric lymphoma confirmed by endoscopic biopsy or gastrectomies were eligible for inclusion in the study. The study was retrolective., Results: Forty-two patients (21 M, and 21 F) with an average age of 57 years (between 20 and 80 years). The major clinical findings were no weight loss in 31 patients (73%), abdominal pain in 24 patients (57%), gastrointestinal pair in 19 patients (45%), and early satiety in 15 patients (36%). The endoscopic findings were gastric folds in 21 (50%), thickening of gastrics folds in 13 (31%) and tumor in eight patients (19%). We found H pylori in 14 of 16 endoscopic biopsies (87%). High grade lymphomas were found in 29 patients (69%) and low grade lymphoma in 13 (31%). The clinical stage according to the Staging Classification from the Fifth International Conference on Malignant Lymphoma (1993) was 15 patients in stage I (36%), 14 patients in stage II1 (33%). Five patients in stage IV (12%), six patients in stage IIE (14) and one patient in stages II and II2 (2%). The treatment chosen before 1990 was surgery with or without chemotherapy no matter the grade of malignancy, in contrast with the later decade in which solely eradication of H pylori was successfully to cure the disease. In high grade lymphomas, treatment was surgery and chemotherapy for reviewing the study, most patients were alive and without disease., Conclusions: In the study, most lymphomas were localized in the stomach of perigastric lymph nodes. The most frequent clinical stages were stages I and II1 (36 and 33%, respectively), and their response was successful to all treatments even though most patients were high graded and treated differently.