Tumor do estroma gastrintestinal (GIST): relato de caso / Gastrintestinal stromal tumor (GIST): case report

The authors report a case of a male patient in his forties with progressive abdominal pain associated with weight loss, dyspnea, and edema of the inferior limbs, culminating in a surgical acute abdomen. A segmental enterectomy containing a lesion of about 10cm in diameter was performed. It was later confirmed, by means of immuno-hystochemistry, as being a Gastrointestinal Stromal Tumor of high biological aggressiveness. Etiology, diagnosis, classification, prognosis and therapeutic with Imatinib Mesylate - STI-571 (Glivec® - Novartis) are hence discussed.

Caso para diagnóstico / Case for diagnosis

Esteatocistoma múltiplo é um raro transtorno genético autossômico dominante que se caracteriza por múltiplos cistos dérmicos de tamanho variável e assintomáticos. Descreve-se o caso de um paciente do sexo masculino, de 23 anos, com quadro clínico e evolutivo típicos dessa desordem.

Steatocystoma multiplex is a rare genetic disorder, autosomal dominant, that is characterized by multiple asymptomatic dermal cysts which vary in size. It is described here the case of a 23 year-old male patient with a typical clinical and evolutional progression of this disease.

Ileal perineurioma as a cause of intussusception / Perineurioma ileal como uma causa de intussuscepção

CONTEXT: Perineuriomas are rare tumors composed of cells resembling those of the normal perineurium. It usually occurs in subcutaneous, soft-tissue or intraneural locations. Very few reports in the literature have described perineuriomas in the gastrointestinal tract, including the stomach, colon and jejunum. CASE REPORT: We report the clinicopathological and immunohistochemical features of a case of ileal perineurioma that was manifested clinically as intestinal obstruction due to intussusception. Ileal perineurioma has not previously been reported at this anatomical location.

CONTEXTO: Perineurioma é uma rara neoplasia composta de células que lembram aquelas do perineuro normal e geralmente ocorre no subcutâneo, tecidos moles ou em localização intraneural. Poucos relatos na literatura descrevem perineuriomas no trato gastrointestinal incluindo estômago, cólon e jejuno. RELATO DE CASO: Os autores apresentam as características clinicopatológicas e imunoistoquímicas de um caso de perineurioma ileal apresentando-se clinicamente por obstrução intestinal decorrente de intussuscepção. Perineurioma ileal não havia sido descrito até o momento nessa localização anatômica.

Histopathologic evaluation of the peritoneum exposed to heat shock: experimental study in rats

PURPOSE: To evaluate histopathologic alterations of the peritoneum exposed to heat shock. METHODS: Sixty rats were randomly distributed into 6 groups: Heat Shock (HS), High Temperature (HT), Body Temperature (BT), Temperature 0oC (TZ), Sham (SH) and Control (CG) with 10 animals each. The peritoneal cavity of animals from groups HS, HT, BT and TZ was irrigated with NaCl solution 0.9 percent at temperatures 50°C, 0°C, 50°C, 37°C and 0°C, respectively. For animals from group SH, the procedures were simulated and those from group CG, laparotomy and biopsies were conducted. Twenty-four hours later, biopsies of the peritoneum for exams under light and electronic microscopy were performed. RESULTS: Edema was found in groups HS 80 percent, HT 60 percent, BT 30 percent TZ 70 percent, SH 40 percent and CG 30 percent. Vascular congestion was found in groups HS 20 percent, HT 30 percent, BT 10 percent and TZ 20 percent. Erythrocyte extravasation was found in groups HT 60 percent and SH 10 percent. Mesothelium destruction was found in 100 percent of specimens from groups HS, HT, BT, TZ, SH and CG 90 percent. Necrosis was found in groups HS 30 percent, HT 20 percent and BT 10 percent. The mean peritoneal thickness ranged from 42.26 μm (TZ) to 26.42 μm (CG). CONCLUSION: The heat shock caused no deaths, but promoted significant peritoneal edema without affecting the other histopathologic indicatives.

OBJETIVO: Avaliar alterações histopatológicas do peritônio exposto a choque térmico. MÉTODOS: Sessenta ratos foram distribuídos aleatoriamente em seis grupos: Choque Térmico (CT), Temperatura Elevada (TE), Temperatura 0°C (TZ) Sham (SH) e Controle (GC) com 10 animais. A cavidade peritoneal dos animais dos grupos CT, TE, TC e TZ foi irrigada com solução de NaCl 0,9 por cento nas temperaturas, 50°C e 0°C, 50°C, 37°C e 0°C, respectivamente. Nos animais do grupo SH foram simulados os procedimentos e nos do GC laparotomia e biópsias. Depois de 24 horas foram realizadas biópsias do peritônio para exames sob microscopia de luz e eletrônica. RESULTADOS: Edema foi encontrado nos grupos CT 80 por cento, TE 60 por cento, TC 30 por cento, TZ 70 por cento, SH 40 por cento e GC 30 por cento. Congestão vascular foi encontrada nos grupos CT 20 por cento, TE 30 por cento, TC 10 por cento e TZ 20 por cento. Extravasamento de hemácias foi encontrado nos grupos TE 60 por cento e SH 10 por cento. Destruição de mesotélio foi encontrada em 100 por cento dos espécimes dos grupos CT, TE, TC, TZ, SH e no grupo GC 90 por cento. Necrose foi encontrada nos grupos CT 30 por cento, TE 20 por cento e TC 10 por cento. A espessura média do peritônio variou de 42,26 μm (TZ) a 26,42 μm (GC). CONCLUSÃO: O choque térmico não causou óbitos, mas promoveu edema peritoneal significante sem alterar os demais indicadores histopatológicos.

Six-year follow-up survey of sexually transmitted diseases in Brasilia, the Capital of Brazil

The notification of sexually transmitted diseases (STD) is a prime component of well-designed public health policy. However, peculiar aspects of STD must be taken into account for the correct management of surveillance activities. Here, we describe the distribution of the most common sexually transmitted diseases among patients attended by the gynecological clinics of the principal public hospitals of Brasilia and the Federal District, Brazilian capital, during six years. A total of 142,158 patients had their cervicovaginal samples collected for Papanicolaou preparations and eventual biopsies. Diagnosis was made according to cytological and histological alterations, distinguishing among vaginal infections, and pre-cancerous and cancerous cervical lesions. We also looked at the annual prevalence of the various types of infections and alterations. There was a high prevalence of bacterial vaginosis, trichomoniasis and candidiasis, with suggestive changes over the years. Pre-cancerous and cancerous lesions increased 2.2 fold during the six years. A large proportion of the cases involved late stages of cervical cancer, indicating the necessity of prompt attendance of the population in a routine gynecological prevention program.

Linfadenite necrosante sem infiltraçäo granulocítica (doença de Kikuchi): apresentaçäo de um caso / Necrotising lymphadenitis without granulocytic infiltration (kikuchi's disease): a case report

É descrito um caso de linfadenite necrosante sem infiltraçäo granulocítica (doença de Kikuchi). Aspectos clínicos e laboratoriais da doença säo discutidos, assim como seu diagnóstico diferencial com outras linfadenopatias

Balanite xerótica obliterante / Balanitis xerotina obliterants

Descreve-se um caso de balanite xerótica obliterante em menino de 11 anos. Discutem a etiologia da doença, bem como sua rara ocorrência na infância