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Primary thymic carcinoma is a rare and heterogeneous group of tumours of the anterior mediastinum that includes different histological types. Frequently, it first comes to clinical attention through paraneoplastic syndromes such as dermatomyositis. We report the case of a 54-year-old woman with several episodes of fever and chest pain in the previous 5 months. The patient was admitted to the Rheumatology Department with a peri-ungual erythema and papular lesions on both sides of each hand and alteration at biochemistry tests. A left deltoid muscle biopsy specimen showed a histological pattern compatible with the diagnosis of dermatomyositis. A computed tomography of the chest, abdomen and pelvis, showed a solid mass in the upper anterior mediastinal area and a mediastinoscopy with mass-biopsy was performed. Only the immunohistochemical staining technique allowed a definitive histological diagnosis. We report the diagnostic challenge and the therapeutic approach of thymic neoplasia.

Hibernoma is an unusual tumour of brown adipose tissue. Brown adipose tissue is common in mammalian hibernating animals and acts as a thermogenic organ. A first case of hibernoma was reported in 1906 by Merkel. This tumour usually arises in the back, shoulder region, mediastinum, retroperitoneum and in the neck. The neck location of hibernomas is rare and only 18 cases of cervical hibernoma have been reported in the English literature. A 48-year-old male with hoarseness and soft voice, present for 8 months, showed a lesion involving the anterior part of the right vocal fold, with no impaired mobility. This is the first case to be reported of laryngeal hibernoma located in a vocal fold, originating from the white fat tissue of the paraglottic space. Moreover, this report could be evidence of the development of hibernoma from white adipose tissue.

Several prognostic factors like age, gender, histology, stage, type of operation, associated disorders and administration of induction therapy have been evaluated to assess the risk of postoperative complications and outcome in patients with resectable lung cancer. Anemia is a frequent condition in this subset of patients being estimated up to 50%. The aim of this retrospective study was to evaluate the effect of preoperative anemia on early outcome after lung cancer resection.One-hundred thirty nine consecutive patients undergoing surgery for non small cell lung cancer were retrospectively considered. The mean age was 64.8+/-11.6 years. No patient received blood transfusions or administration of erythropoetin preoperatively. Overall, we performed 96 lobectomies, 14 pneumonectomies, 2 bilobectomies and 27 atypical resections. A subset of 27 patients (19.4%) (group I) had a preoperative value of Hb less than 12 g/dl (10.4+/-1.9 g/dL). Seven patients of them were stage IA (26%), 9 stage IB (33.3%), 2 stage IIA (7.4%), 6 stage IIB (22.2%), 2 stage IIIA (7.4%) and 1 stage IIIB (3.7%). Age, gender, stage, type of operation, induction chemotherapy, comorbidities were evaluated by univariate analysis comparing patients with and without preoperative anaemia. The two groups were homogenous regarding demographic characteristics.Three patients (11.1%) in group I and 2 (1.8%) in group II required blood transfusions after surgery (P=0.01); 4 of them received pneumonectomy (P0.0001). The overall morbidity was 17.9% (25/139); the most frequent complication was persistent air leakage, followed by retention of secretions. No statistically significant difference was observed between the 2 groups about early mortality (1 patient-3.7% in group I and 2 patients-1.8% in group II) and postoperative complications (5 patients-18.5% in group I and 20 patients-17.9% in group II).Preoperative anaemia is not a risk factor for an increased rate of postoperative complications and should not be considered a contraindication to surgery.

The aim of this study was to compare the histologic features of the cysts as regards their radiographic and clinical aspects, in order to assess the accuracy of the diagnosis, the appropriateness of the treatment and the reliability of the follow-up.A sample of 173 cysts of the jaws was reviewed in accordance with the 1992 WHO histological classification.Of these cysts, 77.44% were inflammatory, 12.71% follicular and 8.67% keratocysts. The cysts were slightly more frequently located in the mandible (52.60%) than in the maxilla (47.39%) and they affected men more frequently (60.11%) than women (39.88%). However keratocysts and nasopalatine cysts were twice as frequent in women than in men. No recurrence of keratocysts was found, either in those correctly diagnosed at the moment of the first histologic examination, or in those firstly erroneously diagnosed as an other type of cysts.On the basis of the fairly high percentage of non-inflammatory cysts in adult patients, it can be suggested to perform an orthopantomography as a preventive measure, every 5 years, particularly when impaired teeth are present.

To evaluate the effectiveness of extended total laryngectomy for the treatment of recurrences of laryngeal cancer.We conducted a retrospective clinical study of patients who had undergone extended total laryngectomy and were seen over a 15-year period. The follow-up period ranged from 3 to 15 years.Academic tertiary referral medical center.We observed 15 patients who were affected by a recurrence of laryngeal cancer that extended to the overlying soft tissue. All patients were male. The mean age was 61.5 years. Thirteen patients had previously undergone partial laryngeal surgery, and 2 patients had undergone radiation therapy, without success.All patients underwent total laryngectomy extending to the soft tissue, including the overlying skin.Five of the 15 patients died of local recurrence, and 1 patient died of massive postoperative hemorrhaging. An actuarial survival rate of 60% was observed at 5 years.Total laryngectomy extending to the soft tissues seems to be an effective procedure for treating local recurrences of laryngeal cancer after partial laryngectomy or failure of radiation therapy.

The A-Myb transcription factor is structurally related to the c-myb proto-oncogene and is involved in the control of proliferation and/or differentiation of mature B lymphocytes. We have shown previously by PCR analysis that A-myb is preferentially expressed in CD38+CD39−sIgM− mature B cells. We demonstrate here, using in situ hybridization, that A-mybexpression is restricted to the dark zone of human tonsils and lymph nodes. Furthermore, we show that A-Myb expression is cell cycle regulated both in tonsillar B cells and in Burkitt’s lymphoma cell lines, being detectable only in the S and G2/M phases of the cell cycle and not in G0/G1 phase. Strong proliferation of resting human B cells induced in vitro by a variety of physiologic signals, including anti-μ, CD40 ligand, IL-2, IL-4, IL-6, IL-13, IFN-γ, TNF-α, anti-CD19, and anti-CD20, failed to induce A-myb expression, suggesting that proliferation alone is not sufficient for A-myb expression in the absence of induction of a true centroblast phenotype. Finally, we show that differentiation of germinal center B cells in vitro toward either memory or plasma cells is accompanied by rapid down-regulation of A-myb expression. We conclude that A-myb is a marker of centroblasts generated in vivo.