ABSTRACT
A classificação para linfomas não-Hodgkin (LNH) proposta pela Organização Mundial da Saúde (OMS) enfatiza a importância do imunofenótipo para o diagnóstico. O objetivo deste estudo foi avaliar a utilidade da citologia combinada a citometria de fluxo para o diagnóstico de LNH, utilizando um painel de anticorpos monoclonais e estudo do ciclo celular. O material foi obtido através de aspiração de linfonodos por agulha fina de 78 pacientes. O painel de anticorpos monoclonais para análise em citometria de fluxo foi o seguinte: CD19/CD10, CD20/CD5, CD23, CD38/CD7, CD3/CD4, CD3/CD8, kappa/lambda. O diagnóstico final foi confirmado pela histologia convencional, considerada gold standard. Em 85 por cento dos casos a citologia associada a imunofenotipagem e porcentagem de células em fase S permitiram um diagnóstico correto. Nos demais casos foi possível diferenciar linfomas B ou T e estimar grau de agressividade. O painel, embora pequeno, foi suficiente exceto para os anaplásicos e subclassificação dos linfomas T. Nestes casos, a morfologia foi mais importante que imunofenótipo, sendo este seguro apenas para linfomas linfoblásticos. A fração de fase S mostrou-se importante para diferenciar linfomas indolentes e de alto grau. Concluímos que esta técnica é uma boa alternativa para o diagnóstico de linfomas não-Hodgkin. Permite um diagnóstico rápido, menos invasivo, podendo ser repetida quando necessário, agilizando o tratamento.
Subject(s)
Adolescent , Adult , Middle Aged , Humans , Cell Biology , Flow Cytometry , Immunophenotyping , Lymphoma, Non-Hodgkin/diagnosis , NeoplasmsSubject(s)
Humans , Leukemia , Lymphoma , Hematologic Neoplasms/classification , World Health OrganizationABSTRACT
The involvement of bone marrow in the pathology of experimental P. brasiliensis infection in BALB/c mice was investigated. The histopathological features of bone marrow induced by the fungus were correlated with hematological changes in peripheral blood from 1 to 28 days post-infection. Intense lymphopenia and moderate neutrophilia were detected. The early changes in bone marrow included (i) maturation arrest characterized by an increase immature blood cell precursors, mainly of granulocytic origin, (ii) intense vascular congestion when compared with the vessels of normal marrow, and (iii) an increased number of megakaryocytes. The normal histological pattern of bone marrow was restored by 28 days post-infection. No histologically recognizable lesion, such as granuloma formation or an abnormal cellular infiltrate, which could indicate the presence of the P. brasiliensis in bone marrow, was observed. In addition, special stains were unable to detect the fungus. The mechanisms responsible for the alterations described here are still unclear but are probably related to more general phenomena affecting the host rather than the direct damage of the precursors cells by P. brasiliensis.
Subject(s)
Animals , Mice , Paracoccidioides , Bone Marrow/anatomy & histology , Paracoccidioidomycosis , Bone Marrow/microbiologyABSTRACT
Screening blood donations for anti-HCV antibodies and alanine aminotransferase (ALT) serum levels generally prevents the transmission of hepatitis C virus (HCV) by transfusion. The aim of the present study was to evaluate the efficiency of the enzyme immunoassay (EIA) screening policy in identifying potentially infectious blood donors capable to transmit hepatitis C through blood transfusion. We have used a reverse transcriptase (RT)-nested polymerase chain reaction (PCR) to investigate the presence of HCV-RNA in blood donors. The prevalence of HCV-RNA positive individuals was compared with the recombinant immunoblot assay (RIBA-2) results in order to assess the usefulness of both tests as confirmatory assays. Both tests results were also compared with the EIA-2 OD/C ratio (optical densities of the samples divided by the cut off value). ALT results were expressed as the ALT quotient (qALT), calculated dividing the ALT value of the samples by the maximum normal value (53UI/l) for the method. Donors (n=178) were divided into five groups according to their EIA anti-HCV status and qALT: group A (EIA > or = 3, ALT<1), group B (EIA > or = 3, ALT>1), group C (1<=EIA<3, ALT<1), group D (1<=EIA<3, ALT>1) and group E (EIA<=0.7). HCV sequences were detected by RT-nested PCR, using primers for the most conserved region of viral genome. RIBA-2 was applied to the same samples. In group A (n=6), all samples were positive by RT-nested PCR and RIBA-2. Among 124 samples in group B, 120 (96.8 percent) were RIBA-2 positive and 4 (3.2 percent) were RIBA-2 indeterminate but were seropositive for antigen c22.3. In group B, 109 (87.9 percent) of the RIBA-2 positive samples were also RT-nested PCR positive, as well as were all RIBA-2 indeterminate samples. In group C, all samples (n=9) were RT-nested PCR negative: 4 (44.4 percent) were also RIBA-2 negative, 4 (44.4 percent) were RIBA-2 positive and 1 (11.1 percent) was RIBA-2 indeterminate. HCV-RNA was detected by RT-nested PCR in 3 (37.5 percent) out of 8 samples in group D. Only one of them was also RIBA-2 positive, all the others were RIBA-2 indeterminate. All of the group E samples (controls) were RT- nested PCR and RIBA-2 negative. Our study suggests a strong relation between anti-HCV EIA-2 ratio > or = 3 and detectable HCV-RNA by RT-nested PCR. We have also noted that blood donors with RIBA-2 indeterminate presented a high degree of detectable HCV-RNA using RT-nested PCR...
Subject(s)
Humans , Alanine Transaminase/blood , Hepatitis C/diagnosis , Immunoblotting , Immunoenzyme Techniques , Reverse Transcriptase Polymerase Chain Reaction , Case-Control Studies , Chi-Square Distribution , Hepacivirus/immunology , Hepatitis D , Prevalence , Recombinant Proteins , RNA, Viral/analysisABSTRACT
Este relato apresenta um caso de paciente jovem com linfoma näo Hodgkin refratário que apresentou um edema pulmonar agudo fatal após transplante autólogo de células-tronco periféricas. Embora a causa exata do mecanismo do evento seja desconhecida, o texto discute todas as possibilidades, incluindo anafilaxia ao dimetilsulfoxido e disfunçäo cardíaca ventricular transitória secundária ao regime de condicionamento.
Subject(s)
Humans , Male , Adult , Bone Marrow Transplantation , Lymphoma, Non-Hodgkin/therapy , Postoperative Complications , Pulmonary EdemaABSTRACT
O termo amigdalite crônica foi usado durante muito tempo para afecçöes repetitivas das amígdalas. Os patologistas têm empregado, de modo geral, este termo quando o exame das amígdalas encontram infiltrado linfoplasmocitário. Atualmente chamamos a este achado de reticulaçäo de cripta, sendo sinal de atividade amigdaliana. Os autores fazem estudo comparativo entre a história clínica do paciente e o laudo do exame histopatológico. Verificou-se que, mesmo em paciente sem queixas de amigdalites, o laudo do patologista era de amigdalite crônica. Os autores ainda sugerem uma nova classificaçäo das patologias amigdalianas baseadas nos graus de reticulaçäo, presença de plasmócitos, fases dos centros germinativos e suas quantidades