[A fibrolamellar variety of hepatocarcinoma in a young woman 17 years old]

We report here the case of a 17-year-old female with typical fibrolamellar hepatocellular carcinoma, no hepatitis B or C viral infection and a normal, non-cirrhotic liver. Computed tomography and magnetic resonance imaging revealed a solid tumor with a central fibrous scar. A fibrolamellar hepatocellular carcinoma is an uncommon malignancy of unknown etiology, without cirrhosis, usually without an increase in tumor markers, and rarely associated with hepatitis B virus. It occurs mainly in young patients. This tumor presents a high resectability rate (48-100%), a good prognosis and a mean survival of 68 months. This tumor is an important differential diagnosis of space occupying lesions in younger adults.

[Testicular lymphoma in two patients with AIDS and two without AIDS]

OBJECTIVE

To describe the clinical, morphological and inmunophenotypic characteristics and followup of testicular non Hodgkin lymphomas seen in a referral center.

METHODS

We reviewed the cases of testicular lymphoma seen from 1987 to 1997. We obtained data of laboratory tests, radiological findings, clinical course, treatment and new immunohistochemical studies (CD45, CD20, CD43, Epstein-Barr virus latent membrane protein and antibodies UCHL-1). We performed a blind analysis to identify the morphological variables associated to the clinical course. The Fisher exact test was used for statistical significance identification.

RESULTS

53 patients with testicular tumors were seen. Four of them were lymphomas (7.5%) with a mean age of 47 years (range 33-73) and two of the four had AIDS. A comparative analysis showed major local invasion of surgical margins and systemic progression in the AIDS cases. Immunohystochemical testing showed that the neoplasia was formed by B cells negative for Epstein-Barr virus latent membrane protein. The two patients without AIDS showed no evidence of the disease after 64 and 144 months of followup. The AIDS cases died one and three months after the diagnosis of testicular lymphoma was made.

CONCLUSIONS

The four cases of testicular lymphoma were of B cell lineage without immunohystochemical expression for Epstein-Barr virus latent membrane protein. There was a more aggressive clinical course in the cases associated with AIDS.

[Giant acinic cell parotid gland adenocarcinoma of the papillary- cystic type]

A case of a 38-year-old male having an acinic cell adenocarcinoma of the parotid gland is reported. The tumor measured 22 cm and histologically it was of the papillary-cystic type. The following features were of interest: 1) the tumor size surpassed the size of previous reported acinic cell adenocarcinomas by 9 cm; and 2) the rarity of its histological variety (cystic papillary) demanded immunohistochemical and electron microscopic studies to confirm the diagnosis.