ABSTRACT
Introduction: The differential diagnosis of B-cell lymphoproliferative processes remains a challenge for pathologists, dermatologists and oncologists, despite advances in histology, immunohistochemistry and molecular biology. Objective: Evaluate aid and limitations of clonality analysis in the diagnosis of primary cutaneous B-cell lymphomas and B-cell pseudolymphomas. Methods: This study included 29 cases of B-cell lymphoproliferative processes classified as primary cutaneous B-cell lymphomas (13), B-cell pseudolymphomas (6) and inconclusive cases (10) using histology and immunohistochemistry. The clonality analysis was performed by polymerase chain reaction analysis of immunoglobulin light chain and heavy chain rearrangements. Results: DNA quality was shown to be generally poor; eight samples were inadequate for polymerase chain reaction analysis. The results showed monoclonality in eight of the primary cutaneous B-cell lymphomas and polyclonality in four of the B-cell pseudolymphomas. In addition, monoclonality was shown in two of the inconclusive cases by histology and immunohistochemistry, demonstrating the utility of polymerase chain reaction as an ancillary diagnostic tool for primary cutaneous B-cell lymphomas. Discussion: The low quality DNA extracted from these cases demanded the use of an IgH protocol that yielded small fragments and IgK. Both methods used together improved detection. Conclusion: Use of the two protocols, immunoglobulin heavy chain FR3-trad and immunoglobulin light chain-Kappa Biomed protocols for clonality analysis improved diagnostic accuracy.
Subject(s)
Humans , Lymphoma, B-Cell/pathology , Polymerase Chain Reaction/methods , Pseudolymphoma/pathology , Skin Diseases/pathology , Skin Neoplasms/pathology , Diagnosis, Differential , Immunohistochemistry , Immunoglobulin Heavy Chains/genetics , Immunoglobulin kappa-Chains/genetics , Polymerase Chain Reaction/standardsABSTRACT
O mecanismo de interação entre o Mycobacterium leprae e as células neurais não está esclarecido até o momento. Não há interpretação satisfatória do tropismo da bactéria ao sistema nervoso periférico, em particular. O presente estudo é uma revisão da microfisiologia da estrutura do aparelho extracelular, ligado às células de Schwann, assim como a descrição das unidades morfológicas, provavelmente envolvidas no processo de ligação à parede celular da bactéria.
The mechanism of interaction between Mycobacterium leprae and neural cells has not been elucidated so far. No satisfactory interpretation exists as to the bacterium tropism to the peripheral nervous system in particular. The present study is a review of the micro-physiology of the extracellular apparatus attached to Schwann cells, as well as on the description of morphological units probably involved in the process of the binding to the bacterial wall.
Subject(s)
Humans , Leprosy/complications , Leprosy/microbiology , Peripheral Nervous System Diseases/microbiologyABSTRACT
OBJECTIVE: To examine the epidermis in induced phytophotodermatitis using transmission electron microscopy in order to detect histologic changes even before lesions are visible by light microscopy. INTRODUCTION: In the first six hours after the experimental induction of phytophotodermatitis, no changes are detectable by light microscopy. Only after 24 hours can keratinocyte necrosis and epidermal vacuolization be detected histologically, and blisters form by 48 hours. METHODS: The dorsum of four adult rats (Rattus norvegicus) was manually epilated. After painting the right half of the rat with the peel juice of Tahiti lemon, they were exposed to sunlight for eight minutes under general anesthesia. The left side was used as the control and exposed to sunlight only. Biopsies were performed immediately after photoinduction and one and two hours later, and the tissue was analyzed by transmission electron microscopy. RESULTS: No histological changes were seen on the control side. Immediately after induction, vacuolization in keratinocytes was observed. After one hour, desmosomal changes were also observed in addition to vacuolization. Keratin filaments were not attached to the desmosomal plaque. Free desmosomes and membrane ruptures were also seen. At two hours after induction, similar changes were found, and granular degeneration of keratin was also observed. DISCUSSION: The interaction of sunlight and psoralens generates a photoproduct that damages keratinocyte proteins, leading to keratinocyte necrosis and blister formation. CONCLUSIONS: Transmission electron microscopy can detect vacuolization, lesions of the membrane, and desmosomes in the first two hours after experimental induction of phytophotodermatitis.
Subject(s)
Animals , Rats , Dermatitis, Phototoxic/pathology , Desmosomes/ultrastructure , Epidermis/ultrastructure , Microscopy, Electron, Transmission/standards , Blister/chemically induced , Blister/pathology , Citrus , Disease Models, Animal , Erythema/chemically induced , Erythema/pathology , Fruit , Necrosis/chemically induced , Necrosis/pathologyABSTRACT
Malignant fibrous histiocytoma is a rare tumor in children, and its responsible for 2 to 6 percent of pediatric sarcomas. The authors report the case of a child who developed soft tissue malignant fibrous histiocytoma, as well as several fibrous histiocytic skin lesions, following treatment for WilmsÆ tumor patients has been improving very much over the last years because of successful treatment with chemo- and radiotherapy. A small proportion of these cases present a risk of developing a second neoplasm; genetic traits may enhance this risk. The authors discuss in this study those fibrous histiocytic lesions and the use of electron microscopy for definitive diagnosis. The authors conclude that follow-up of these patients treated for WilmsÆ tumor is of great importance for early detection of another neoplasm.
Subject(s)
Humans , Male , Child , Adult , Histiocytoma, Benign Fibrous , Drug Therapy , Histiocytoma, Benign Fibrous , Microscopy, Electron , Radiotherapy , Treatment OutcomeABSTRACT
Os superantígenos säo moléculas de origem microbiana, bacteriana (toxinas) ou viral, que, por meio do complexo maior de histocompatibilidade, estimulam as células T por ligaçäo direta aos receptores de células T (porçäo v-beta). Diferem dos demais antígenos por sua intensa seletividade e capacidade de estimular linfócitos T mediante mecanismos independentes do processamento antigênico intracelular por células apresentadoras de antígenos. Têm sido apontados como fatores de importância na etiopatogenia de enfermidades dematológicas, principalmente as toxinas bacterianas (Staphylococcus e Streptococcus). Os superantígenos podem levar à liberaçäo massiva de linfocinas e chegam a ativar até cerca de 30 porcento dos linfócitos periféricos. Acredita-se que os superantígenos possam exercer papel importante na induçäo e exacerbaçäo das doenças inflamatórias.
Subject(s)
Dermatitis, Atopic/immunology , Major Histocompatibility Complex/immunology , Psoriasis/immunology , Staphylococcus aureus/pathogenicity , Superantigens/immunology , T-Lymphocytes/immunology , Skin Diseases/etiology , Skin Diseases/microbiologyABSTRACT
Sao registrados tres casos de feo-hifomicose subcutanea em transplantados renais provocados pela Exophiala jeanselmei (Langeron) McGinnis et Padhye 1977, fungo demacio capaz, tambem, de produzir raramente eumicetoma de graos pretos. Este fungo, segundo KWON-CHUNG&BENNETT, 1992 e antigenicamente muito heterogeneo, sendo identificados ate o presente momento tres sorotipos com subgrupos dentro de cada um deles....
Subject(s)
Humans , Male , Female , Middle Aged , Dermatomycoses/therapy , Kidney Transplantation , Cyclosporins/therapeutic use , Dermatomycoses/microbiology , Immunosuppression Therapy/adverse effectsABSTRACT
Análise retrospectiva de 58 prontuários de portadores de carcinoma espinocelular do lábio inferior, atendidos no período de janeiro de 1980 a dezembro de 1989, no Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo. Além dos dados demográficos, foram considerados o uso de álcool, fumo e a exposiçäo solar, assim como o estado clínico na época da cirurgia, as características macroscópicas dos tumores, o tipo de tratamento instituído e as observaçöes do seguimento pós-operatório. Os espécimens cirúrgicos foram submetidos a minuciosa revisäo anátomo-patológica com análise do grau de diferenciaçäo histológica, espessura máxima tumoral, elastose solar, invasöes perineural, vascular e muscular, margens cirúrgicas, infiltrado inflamatório peritumoral e acometimento glanglionar, com ou sem rotura capsular. A análise da sobrevida global em 5 anos demonstrou valor prognóstico significativo para as seguintes variáveis: espessura tumoral, tamanho da neoplasia (T) e acometimento ganglionar
Subject(s)
Humans , Carcinoma, Squamous Cell/diagnosis , Lip , Mouth DiseasesSubject(s)
Humans , Male , Entomophthora , Fluconazole/therapeutic use , Mycoses/pathology , Nose Diseases/pathology , Adult , English Abstract , Entomophthora/isolation & purification , Face , Mucormycosis/drug therapy , Mucormycosis/microbiology , Mucormycosis/pathology , Mycoses/drug therapy , Mycoses/microbiology , Nose Diseases/drug therapy , Nose Diseases/microbiologyABSTRACT
Os autores apresentam dois casos de lúpus eritematoso sistêmico bolhoso confirmados clínica e laboratorialmente, juntamente com revisäo de literatura. Discutem a diagnose diferencial das dermatoses bolhosas juncionais associadas ao LES e caracterizam o LES bolhoso como entidade clínico-patológica
Subject(s)
Adolescent , Adult , Humans , Female , Lupus Erythematosus, Systemic/diagnosis , Skin Diseases, Vesiculobullous/diagnosis , Diagnosis, Differential , Lupus Erythematosus, Systemic/pathology , Skin Diseases, Vesiculobullous/pathologyABSTRACT
Os autores relatam 4 casos de tinha favosa por Trichophyton schoenleinii de ocorrência familiar, identificados na cidade de Itapecerica da Serra, município da Grande Säo Paulo. Todos os casos foram tratados com griscofulvina por via oral na dose de 10 mg/kg/dia por no mínimo 3 meses, tendo ocorrido cura clínica e laboratorial em 2 pacientes, e os dois restantes necessitaram de terapêutica mais prolongada
Subject(s)
Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Family Health , Tinea Favosa/epidemiology , Brazil/epidemiology , Griseofulvin/therapeutic use , Pedigree , Tinea Favosa/diagnosis , Tinea Favosa/drug therapy , Trichophyton/isolation & purificationABSTRACT
Registra-se um caso de acremoniose cutânea em paciente do sexo feminino, de 10 anos, procedente do Ceará, com placas eritematodescamativas infiltradas, localizadas predominantemente no flanco esquerdo, na face anterior do tronco e regiäo escapular esquerda. O exame direto das lesöes revelou a presença, várias vezes, de filamentos hialinos septados, com cultivo positivo para fungo, identificado como Acremonium falciforme GAMS, 1971. O exame histopatológico revelou dermatite crônica granulomatosa, com a presença de pequenos filamentos, sem qualquer caráter de especificidade. É discutida a etiopatogenia do processo, bem como a evoluçäo terapêutica e apresentados os resultados de alguns testes laboratoriais de rotina. Casos dessa natureza estäo sendo hoje denominados de hialo-hifomicoses (hifas hialinas), para diferenciar da feo-hifomicose, onde os fungos säo de cor marrom. A microscopia eletrônica da biopsia da pele revelou resposta do tipo macrofágico ao fungo, com características ultra-estruturais semelhantes às já descritas na cromomicose. Estruturas citoplasmáticas da célula hospedeira (macrófago) estavam aprisionadas na intimidade da parede celular do fungo
Subject(s)
Child , Humans , Female , Dermatomycoses/microbiology , Acremonium/isolation & purification , Dermatomycoses/drug therapy , Natamycin/therapeutic useABSTRACT
Os autores apresentam um caso de fibromatose digital infantil estudado pela microscopia eletrônica. Foram encontrados microfilamentos citoplasmáticos que possivelmente seriam os precursores dos corpos de inclusäo característicos desta afecçäo. Trataram o paciente com cirurgia por eletrodessecaçäo, cirurgia incisional e pela criterapia, concluindo ser este último um tratamento promissor nesta doença