Treatment and prognosis of primary ocular adnexal extranodal marginal zone mucosa-associated lymphoid tissue lymphoma: a report from a single center / 中华血液学杂志

Objective: This study aimed to see how different initial treatment regimens affected the long-term prognosis of patients with extranodal marginal zone mucosa-associated lymphoid tissue lymphoma confining to the ocular adnexal (OAML) . Methods: Between April 2008 and April 2019, 109 patients with initial mucosa-associated lymphoid tissue confining to ocular adnexal were evaluated and followed-up, and the prognosis of various initial treatment regimens were examined. Results: A total of 36 patients underwent complete surgical resection of the lesions, and 73 patients had residual lesions after surgery, of which 37 patients chose watchful waiting, and 36 patients chose treatment. The treatment regimen included local radiotherapy and systemic treatment (chemotherapy, immunochemotherapy, the combination of radiotherapy and chemotherapy, etc.) , and no serious toxic and side effects were observed in patients receiving systemic treatment. The median follow-up time was 61 (10-142) months. The 5-year and 10-year progression-free survival (PFS) of monocular involvement patients were 78.2% and 76.0% . The 5-year and 10-year PFS rates of patients with binocular involvement were 64.4% and 23.5%. There was significant diference in PFS between patients with monocular and binocular involvement (P=0.010) . Patients who received additional treatment had higher PFS than those patients in the watchful waiting group (P=0.046) . The 5-year PFS was 71.4% and 90.1% among patients in the watchful waiting group and those who received additional treatment, whereas the 10-year PFS was 63.5% and 75.1% , respectively. Patients with OAML were still a risk of disease progression after 5 years. Conclusions: Patients with binocular involvement OAML at the start of the disease had a poor prognosis, but treatment could reduce the risk of recurrence/progression. Systemic therapy is one of the first-line treatment options for patients with OAML, who require long-term monitoring.

Metástasis solitaria intraparenquimatosa del bazo estudios clínicos patológicos e inmunohistoquímico / Intraparenchymal solitary spleen metastasis pathological and immunohistochemical clinical studies

Las metástasis esplénicas intra-parenquimatosas de tumores sólidos son tumores muy raros, y si se trata de nódulos únicos, son excepcionales. Presentamos dos casos de metástasis intra-parenquimatosas. El primer caso se trató de una mujer de 66 años con antecedentes de un adenocarcinoma endometrial. El segundo caso se trató de un paciente de sexo masculino con antecedente de un adenocarcinoma prostático, quien se presentó con un adenocarcinoma mucinoso en el bazo, como segunda neoplasia. También realizamos una revisión de los registros de biopsias de 14 años, del servicio de anatomía patológica del instituto(AU)

The spleen parenchymal metastasis of the solid tumors, are very rare, but the isolated metastasis to the spleen are considered exceptional. We herein present two cases of the isolated splenic metastases. The first case was a female a 66 year old female with a diagnosis endometrial adenocarcinoma. The second cases was a 71 years old male, with a history of a prostatic adenocarcinoma, and a spleen metastasis of a ucinous adenocarcinoma, as a second malignancy. We also made a review of 14 years, biopsies records from the pathology service, of the institute(AU)

Tratamento intralesional de malformações linfáticas com ênfase na escleroterapia com picibanil (OK-432): revisão sistemática / Intralesional treatment of lymphatic malformations with emphasis on Picibanil (OK-432) sclerotherapy: a systematic review

INTRODUÇÃO: Conduziu-se revisão sistemática retrospectiva da literatura incluindo estudos relatando o uso de picibanil para tratar malformações linfáticas (ML). MÉTODOS: A pesquisa foi realizada com estudos publicados no PubMed de janeiro de 1990 a 14 de abril de 2013. Na estratégia de busca, usou-se os descritores "OK-432" ou "Picibanil" e "lymphatic malformation". Os seguintes elementos foram comparados aos de outras modalidades relatadas e, então, compilados: mecanismo de ação, indicações, contraindicações, eficácia, administração, efeitos colaterais, complicações, vantagens e desvantagens. RESULTADOS: Foram encontrados 44 estudos, 27 dos quais atenderam aos critérios de inclusão. O picibanil é uma preparação liofilizada de uma cepa de baixa virulência de Streptococcus pyogenes inativada pela penicilina G. Seu mecanismo de ação ainda não definido claramente, mas especula-se que provoque uma resposta inflamatória controlada com adesão das paredes dos cistos. O picibanil é indicado quase que unanimemente para o tratamento da ML macrocística, cuja resposta é mais efetiva do que em lesões microcísticas ou mistas. Em geral, o picibanil é administrado por meio de punção com visualização direta ou guiada por ultrassonografia, com o paciente sob anestesia geral. A preparação comumente utilizada consiste em 0,1 mg de picibanil em 10 ml de soro fisiológico. Os efeitos colaterais são, em geral, leves; sendo dor, inchaço e febre os mais frequentemente relatados. CONCLUSÃO: Os estudos apresentam pouca evidência científica. A revisão sistemática identificou que o picibanil é útil no tratamento da ML de qualquer tipo, mas tem resultados melhores em lesões macrocísticas. A eficácia foi comparável à de outras terapias. Não foi apresentada nenhuma contraindicação específica. Embora o mecanismo de ação ainda não tenha sido determinado, o picibanil trata-se de opção de tratamento.

INTRODUCTION: We performed a retrospective systematic review of studies reporting the use of Picibanil for treatment of lymphatic malformations (LMs). METHODS: We searched the PubMed database for available studies, including those published between January 1990 and April 14, 2013. The search strategy involved the use of the keywords "OK-432" or "Picibanil" and "lymphatic malformation." Information was compiled regarding the reported mechanism of action, indications, contraindications, efficacy, administration, side effects, complications, and advantages and disadvantages compared to those of other modalities. RESULTS: Forty-four studies were found, of which 27 fulfilled the inclusion criteria. Picibanil is a lyophilized preparation of a low-virulence strain of Streptococcus pyogenes inactivated with penicillin G. Its mechanism of action is unclear, but it has been speculated that it causes a controlled inflammatory response with adhesion of cyst walls. Picibanil is almost unanimously indicated for the treatment of macrocystic LMs, which show a greater effectiveness response compared to that shown by microcystic or mixed LMs. Picibanil is usually administered by puncturing, either with direct visualization or guided by ultrasound, with the patient under general anesthesia. The most widely used preparation comprises 0.1 mg of Picibanil in 10 mL of saline. Side effects are mostly mild, with pain, swelling, and fever being the most frequently reported. CONCLUSION: The studies had low scientific evidence. A systematic review found that Picibanil is useful against any LM, with better results in macrocystic lesions. Efficacy was comparable to that of other therapies. No specific contraindication was presented. Although the mechanism of action has not been established, the inclusion of Picibanil as a treatment option is warranted.

Scrapie diagnosis in a goat and four Santa Inês sheep from the same herd in Brazil / Diagnóstico de scrapie em um caprino e quatro ovinos Santa Inês de um mesmo rebanho no Brasil

Scrapie is a fatal and progressive transmissible spongiform encephalopathy (TSE) of natural occurrence in sheep and goats. The suspicion of scrapie may be based on clinical signs; however, the detection of pathological features of the prionic protein (PrP) in target tissues is necessary to diagnose the disease. The presence of an abnormal protein form (PrPSc) in lymphoreticular and nervous tissues is an important characteristic in diagnosis. This paper reports a case of scrapie in a flock of 55 Suffolk crossbred sheep, 19 Santa Inês sheep and 21 goats in the Mato Grosso state, midwestern Brazil. The animals were euthanized after the confirmation of a scrapie case with clinical signs in a Suffolk sheep in the same farm...

Scrapie é uma encefalopatia espongiforme transmissível (EET) progressiva e fatal de ocorrência natural em ovinos e caprinos. A suspeita de scrapie é baseada nos sinais clínicos, porém a manifestação patológica da proteína priônica (PrP) nos tecidos-alvo é necessária para a confirmação da doença. A presença de uma forma anormal da proteína (PrPSc) em tecido linforreticular e tecido nervoso constitui uma característica importante para o diagnóstico. Este trabalho é o relato de um foco de scrapie ocorrido em rebanho com 55 ovinos mistos Suffolk, 21 caprinos e 19 ovinos Santa Inês, na região Centro-Oeste do Brasil. Os animais foram eutanasiados após a confirmação de um caso de scrapie com sinais clínicos em um ovino Suffolk nessa propriedade...

Caracterización clínico-epidemiológica de los linfomas en un período de cinco años en Villa Clara / Clinical and epidemiological characterization of lymphomas in a five year-period in Villa Clara

INTRODUCCIÓN: Los linfomas de Hodgkin y no Hodgkin son neoplasias malignas derivadas de los componentes celulares del sistema inmune, en particular, de los linfocitos y de sus precursores. Constituyen un grupo muy heterogéneo con amplias diferencias clinicobiológicas, pronósticas y terapéuticas. OBJETIVO: Caracterizar algunas variables clínico - epidemiológicas en los linfomas. MÉTODOS: Se realizó un estudio descriptivo y longitudinal entre enero de 2006 y diciembre de 2010 que incluyó a todos los pacientes adultos atendidos en los hospitales Celestino Hernández Robau y Arnaldo Milián Castro, en Santa Clara, Villa Clara. RESULTADOS: Se evaluaron 388 pacientes, con un predominio de edades mayores de 40 años, del sexo masculino y color de la piel blanca. El linfoma no Hodgkin tuvo mayor frecuencia; los factores de riesgo que predominaron fueron pertenecer al sexo masculino y la presencia del virus de Epstein-Barr. En las tres cuartas partes de los pacientes, la localización principal fue ganglionar. De las variedades histológicas del linfoma de Hodgkin la más frecuente fue la esclerosis nodular, mientras que para los linfomas no Hodgkin, fue el folicular. El estadio con mayor número de pacientes fue el III-b para ambos tipos de linfomas. La tercera parte de los pacientes fallecieron; el mayor número correspondió a los linfomas no Hodgkin. CONCLUSIÓN: Los linfomas tienen una alta morbilidad y mortalidad en los adultos de la provincia de Villa Clara.

IINTRODUCTION: Hodgkin and non-Hodgkin lymphomas are considered malignant neoplasms derived from cellular components of the immune system, in particular, of the lymphocytes and their precursors. They constitute a very heterogeneous group with broad clinical and biological, prognostic and therapeutic differences. OBJECTIVE: To characterize some clinical and epidemiological variables in lymphomas. METHODS: A descriptive and longitudinal study was carried out from January, 2006 to December, 2010, which included all adult patients who were attended at «Dr. Celestino Hernández Robau¼ and «Arnaldo Milián Castro¼ Hospitals, in Santa Clara, Villa Clara. RESULTS: A number of 388 patients were evaluated, with a predominance of white male, aged over 40. Non-Hodgkin lymphoma was the most frequent; male sex and the presence of Epstein-Barr virus were identified as predominant risk factors. The main localization of lymphomas was ganglionated in the three- quarter parts of patients. Nodular sclerosing was the most frequent histological variety of Hodgkin lymphomas, while for non-Hodgkin lymphomas it was follicular. The higher number of patients had III-b stage for both types of lymphomas. The third part of patients died; the higher number corresponded to non-Hodgkin lymphomas. CONCLUSION: Lymphomas has a high morbidity and mortality in adults from Villa Clara province.

Lymphoepithelial Cyst of the Pancreas / 대한소화기학회지

No abstract available.

Alterações venosas e linfáticas em mulheres com linfedema após linfadenectomia axilar no tratamento do câncer de mama / Venous and lymphatic alterations in women with lymphedema after axillary lymphadenectomy in breast cancer treatment

OBJETIVO: Avaliar as alterações do sistema venoso axilo-subclávio e do sistema linfático em mulheres com linfedema após linfadenectomia axilar para o tratamento do câncer de mama. MÉTODOS: Trata-se de um estudo de série de casos, envolvendo 11 mulheres com linfedema unilateral de membro superior após linfadenectomia axilar para o tratamento do câncer de mama. O estudo foi realizado em hospital universitário do Brasil Central no período compreendido entre os meses de março de 2010 e março de 2011. Avaliou-se a presença de alterações venosas nas veias subclávia e axilar, por meio do exame de ultrassonografia com dopplervelocimetria, e de alterações linfáticas, pela linfocintilografia, em ambos os membros superiores. O teste Exato de Fisher foi utilizado na comparação entre os membros. RESULTADOS: No membro superior com linfedema, detectou-se diferença significativa na veia subclávia, em relação ao membro contralateral, quanto ao volume do fluxo (p<0,001), sendo que 54,6% das mulheres apresentaram fluxo aumentado. Já, na veia axilar, 45,4% apresentaram fluxo aumentado e 45,4% reduzido, com diferença significante (p<0,01) na comparação entre os membros. Também foram observadas alterações linfáticas significativas (p<0,05), em relação ao membro contralateral, representadas pelo trajeto do vaso (não visibilizado), número de vasos linfáticos (nenhum), linfonodos axilares (ausentes) e refluxo dérmico (presente). No membro superior contralateral sem linfedema, não foram encontradas alterações venosas ou linfáticas. CONCLUSÃO: As mulheres submetidas à linfadenectomia axilar para o tratamento do câncer de mama apresentam tanto alterações venosas quanto linfáticas no membro superior com linfedema.

PURPOSE: To evaluate changes in the venous axillary-subclavian and lymphatic systems of women with lymphedema after axillary lymphadenectomy for breast cancer treatment. METHODS: This was a case series involving 11 women with unilateral upper limb lymphedema after axillary lymphedenectomy for the treatment of breast cancer. The study was carried out in the Mastology Program of the Clinical Hospital of the Federal University of Goiás, Goiânia, GO, during the period between March 2010 and March 2011. Doppler velocimetry ultrasonography was used to detect the presence of venous changes in the subclavian and axillary veins. Lymphatic changes were evaluated by lymphoscintigraphy in both upper limbs. Fisher's exact test was used for the comparison between limbs. RESULTS: Subclavian vein flow volume in the upper limb with lymphedema was significantly different from that in the contralateral limb (p<0.001), 54.6% of the women had increased flow. In the axillary vein, 45.4% had increased flow and 45.4% had decreased flow, with a statistically significant difference (p<0.01) between limbs. Compared to the contralateral limb, significant lymphatic changes (p<0.05) were also found in the vessel route (not visualized), number of lymphatic vessels (none), axillary lymph nodes (absent) and dermal reflux (present). In the contralateral upper limb without lymphedema, no venous or lymphatic alterations were encountered. CONCLUSION: The women subjected to axillary lymphadenectomy for the treatment of breast cancer presented both venous and lymphatic changes in the upper limb with lymphedema.

Primary Endobronchial Marginal Zone B-Cell Lymphoma of Bronchus-Associated Lymphoid Tissue: CT Findings in 7 Patients

OBJECTIVE: To investigate CT and 18F-flurodeoxyglucose (18F-FDG) positron-emission tomography/CT findings of primary endobronchial marginal zone B-cell lymphoma of the bronchus-associated lymphoid tissue (BALT). MATERIALS AND METHODS: From June 2006 through April 2012, seven patients (six female, one male; age range, 21-61 years; mean age, 49 years) were examined who were pathologically diagnosed with the primary endobronchial marginal zone B-cell lymphoma of BALT. We evaluated the locations and characteristics of the lesions on CT and 18F-FDG-PET/CT scans. The lesions were classified into the following three patterns: 1) solitary intraluminal nodule; 2) several tiny nodular protrusions; and 3) diffuse wall thickening. RESULTS: A solitary intraluminal nodule was observed in four patients (57.1%), several tiny nodular protrusion in two patients (28.6%), and diffuse wall thickening in one patient (14.3%). The lesions were categorized into 3 major locations: confined to the trachea (n = 3), confined to the lobar bronchus (n = 2), and diffuse involvement of the trachea and both main bronchi (n = 2). All lesions demonstrated homogeneous iso-attenuation as compared with muscle on pre- and post-enhancement scans. Secondary findings in the lungs (n = 3; 42.9%) included postobstructive lobar atelectasis (n = 1), air trapping (n = 1), and pneumonia (n = 1). On 18F-FDG-PET/CT (n = 5), 4 lesions showed homogeneous uptake with maximum standardized uptake values (mSUV), ranging 2.3-5.7 (mean mSUV: 3.3). One lesion showed little FDG uptake. CONCLUSION: Primary endobronchial marginal zone B-cell lymphoma of the BALT manifests as three distinct patterns on CT, with the solitary intraluminal nodule presenting as the main pattern. Most lesions demonstrate homogeneous but weak FDG uptake on 18F-FDG-PET/CT.

A Case of Ileal Mucosa-associated Lymphoid Tissue Lymphoma Accompanied by Luminal Stricture and Arterial Spurting / 대한소화기학회지

Primary small intestinal lymphoma is relatively uncommon. Small bowel tumors are difficult to diagnose, because they are usually asymptomatic in the initial phase, and they are not easily detected by traditional methods of investigating the small intestine. This case shows a successfully detected and treated gastrointestinal bleeding from rare ileal mucosa-associated lymphoid tissue lymphoma, using double balloon endoscopy.

Prevalence of upper digestive endoscopy and gastric histopathology findings in morbidly obese patients / Prevalência de achados gástricos endoscópicos e histopatológicos em pacientes obesos

CONTEXT: The prevalence of obesity has been increasing in modern society. Roux-en-y gastric bypass is a bariatric surgery that involves the exclusion of significant part of the stomach. Atrophy, intestinal metaplasia and gastric cancer have been associated with infection by Helicobacter pylori. OBJECTIVES: To evaluate the presence of endoscopy findings and histological changes in morbid obese patients for the presence of inflammatory cells, inflammatory activity, lymphoid hyperplasia, H. pylori infection, atrophy and intestinal metaplasia in the gastric mucosa. METHODS: Upper digestive endoscopy and gastric histopathological were studied in 126 obese patients in the preoperative evaluation for bariatric surgery. RESULTS: Upper digestive endoscopy abnormalities were diagnosed in 73/126 (57.9%) patients. In three patients (2.4%) the upper gastrointestinal endoscopy diagnosed gastric ulcer and one patient (0.8%) had duodenal ulcer. The histopathological from gastric biopsies of these obese patients showed 65.1% of mucosa inflammation, inflammatory activity in 50.0%, infection by H. pylori in 53.2%, lymphoid hyperplasia in 50.0% and atrophy and/or intestinal metaplasia in 16.7%. CONCLUSIONS: In present study, with routine preoperative upper gastrointestinal endoscopy and histopathological examination, were detected 57.9% patients with endoscopy abnormalities, high prevalence of infection by H. pylori (53%) and 16.7% of gastric atrophy and/or intestinal metaplasia.

CONTEXT: A prevalência de obesidade tem aumentado significativamente nos últimos anos. Bypass gástrico em Y-de-Roux, uma das técnicas cirúrgicas realizadas no tratamento da obesidade, envolve exclusão de parte do estômago. Atrofia, metaplasia intestinal e câncer gástrico têm sido associados com infecção pelo Helicobacter pylori. OBJETIVOS: Avaliar a prevalência de achados endoscópicos e alterações histopatológicas em pacientes obesos mórbidos em relação à presença de células inflamatórias, atividade inflamatória, hiperplasia linfóide, infecção pelo H. pylori, atrofia e metaplasia intestinal na mucosa gástrica. MÉTODOS: Achados na endoscopia digestiva alta e histopatologia gástrica foram analisados em 126 pacientes obesos na avaliação pré-operatória de cirurgia bariátrica. RESULTADOS: Anormalidades endoscópicas do trato digestivo superior foram diagnosticadas em 73/126 pacientes, com três pacientes (2,4%) apresentando úlcera gástrica e um paciente (0,8%) com úlcera duodenal. A histopatologia das biopsias gástricas dos obesos estudados revelou 65,1% de processo inflamatório na mucosa, atividade inflamatória em 50,0%; infecção pelo H. pylori em 53,2%, hiperplasia linfóide em 50,0%, atrofia e/ou metaplasia intestinal em 16,7%. CONCLUSÕES: No presente estudo, através de endoscopia digestiva alta e histopatologia de biopsias gástricas, foram detectados 57,9% de pacientes com anormalidades endoscópicas, prevalência de infecção pelo H. pylori em 53% e atrofia e/ou metaplasia intestinal em 16,7%.

The response of bronchial associated lymphoid tissue to intratracheal administration of peste des petit ruminants virus and its Co-Infection with mannheimia hemolytica in goats / Respuesta del tejido linfoide asociado con bronquios a la administración intratraqueal del virus peste de pequeños rumiantes y su coinfección con Mannheimia hemolytica en cabras

The morphometry of bronchial associated lymphoid tissue (BALT) and its possible exploration as to the control of common viral and bacterial pneumonia and their co-infection in Sub-Saharan goats is scanty in literatures. This investigation utilizes archival tissues from study that involved 35 apparently healthy West Africa Dwarf goats which were divided into groups PPRV and PPRV+MH with 15 goats each while 5 goats served as control. PPRV goats were infected intratracheally with 1ml of pure cultured 106.5 TCID50 PPR Pestes des petit Ruminant virus (PPRV) grown in baby hamster kidney cell lines and PPRV+MH with 1 ml of PPRV and a week later 1ml of MH (Mannheimia hemolytica) A2. The BALT number, type and cellularity were determined using standard methods with the use of an image analyzer. Student t-test was used to test for significant differences. The results showed that the average number of BALT was significantly more in PPRV+MH infection than that of PPRV infection i.e. 6.20+/-3.63 for PPRV+MH and 4.11+/-2.92 for PPRV with more nodular types of BALT (8.01+/-1.83) than the aggregates type (4.3+/-1.50) while the average number of lymphocytes in the nodular, aggregate BALT significantly increased with 82.25+/-15.95, 56.00+/-7.28 in PPRV to 103.33+/-44.10, 66.00+/-7.93 in PPRV+MH respectively. There was an irregular pattern in the surface Area (SA) and Perimeter (P) of BALT following infections. The increase in average number of BALT and lymphocytes in PPRV+MH infection than that of PPRV infection showed that the development of BALT and the number of lymphocytes in BALT could be used to assess the mucosal immunity following intratracheal administration of PPRV and MH in goats. This is however the first study that described the morphometry of bronchial associated lymphoid tissue in experimental PPRV and PPRV+MH infection in Sub-Saharan goats.

Es escaso en la literatuta el conocimiento de la morfometría del tejido linfoide asociado a bronquios (BALT) y su posible exploración para el control de la neumonía viral común, pneumonia bacteriana y su co-infección en el ganado caprino subsahariano. Esta investigación utilizó tejidos archivados pertenecientes a 35 cabras enanas del oeste africano aparentemente sanas, que fueron divididas en grupos PPRV y PPRV+MH con 15 cabras cada uno, mientras que 5 cabras sirvieron como control. Las cabras PPRV fueron infectadas por vía intratraqueal con 1 ml de cultivo puro 106,5 TCID50 PPR virus Peste de Pequeños Rumiantes (PPRV) cultivados en líneas celulares renales de hámsters recien nacidos y PPRV+MH con 1 ml de PPRV y una semana después de 1 ml de MH (Mannheimia haemolytica) A2. El número de BALT, tipo y la celularidad se determinaron utilizando métodos estándar con el uso de un analizador de imágenes. Se utilizó la prueba t de Student para probar las diferencias significativas. Los resultados mostraron que el número promedio de BALT fue significativamente mayor en la infección PPRV+MH que la infección PPRV, es decir, 6,20+/-3,63 para PPRV+MH y 4,11+/-2,92 para PPRV con un BALT principalmente de tipo nodular (8,01+/-1,83) que de tipo agregado (4,3+/-1,50), mientras que el número promedio de linfocitos en el BALT nodular y agregado aumentó significativamente con 82,25+/-15,95 y 56,00+/-7,28 en PPRV y, 103,33+/-44,10 y 66,00+/-7,93 en PPRV+MH respectivamente. No hubo un patrón irregular en el área de superficie y perímetro del BALT después de las infecciones. El aumento en el número promedio de BALT y linfocitos en la infección PPRV+MH comparado con la de infección PPRV mostró que el desarrollo de BALT y el número de linfocitos en BALT podría ser utilizado para evaluar la inmunidad de la mucosa después de la administración intratraqueal de PPRV+MH en cabras. Este es el primer estudio que describe la morfometría del tejido linfoide asociado a bronquios en la...

Benign hyperplasia of duct-associated lymphoid tissue: Report of a case and review of literature.

Focal lymphoid tissue is ubiquitously present in the oral mucosa and serves as a barrier for entrapment of antigens. The mucosa-associated lymphoid tissue is generally dispersed and sometimes associated with the ducts of the minor salivary glands. Proliferation of the duct-associated lymphoid tissue (DALT) is rarely reported, though probably of common occurrence. We report a case of benign hyperplasia of DALT in the buccal mucosa of a 58-year-old male. The histogenesis and pathological implications of this tissue are discussed and the need for recognition of this entity is stressed.

Mucosa-associated lymphoid tissue in individuals with AIDS / Tecido linfoide associado à mucosa em indivíduos com AIDS

Vestibular folds (VF) protect upper airways, but contain fewer immune cells in AIDS patients, which affects the structure of lymphoid follicles (LF). OBJECTIVE: To characterize fibrosis and immunoglobulin production in vestibular fold lymphoid tissues of AIDS patients with or with no infection and malnutrition. MATERIALS AND METHODS: A retrospective study of 71 adult vestibular fold autopsy specimens. The morphological analysis was done using the picrosirius staining method. Immunohistochemical methods consisted of anti-IgA, anti IgG, and anti IgM antibodies. RESULTS: Fibrosis was less intense in AIDS patients compared to subjects without AIDS; the same applied to patients with infection or malnutrition. IgA and IgG titers were higher in AIDS patients; IgM titers were higher in cases with infection. CONCLUSION: This study helps understand variations in lymphoid follicle components of AIDS patients; it also shows the influence of architectural changes and the effect of associated respiratory infection and malnutrition on lymphoid follicle function.

Pregas vestibulares (PV) são responsáveis pela proteção das vias aéreas superiores e, nos indivíduos com AIDS, apresenta diminuição das células imunes, o que influencia na estrutura dos folículos linfoides (FL). OBJETIVO: Caracterizar a fibrose e a produção de imunoglobulinas nos FL das PV nos indivíduos com AIDS, com e sem infecções e subnutrição associadas. MATERIAIS E MÉTODOS: Foi realizado um estudo retrospectivo transversal em 71 PV de adultos autopsiados. Para a análise morfológica foi usada a coloração picro-sirius. A imuno-histoquímica foi realizada com os anticorpos: anti-IgA, anti-IgG, anti-IgM. RESULTADOS: Nos pacientes com AIDS, a quantidade de fibrose foi menor quando comparados com aqueles que não possuíam AIDS, o mesmo sendo encontrado nos pacientes com infecções ou subnutrição. As quantidades de IgA e IgG foram maiores nos indivíduos com AIDS, e os valores de IgM foram maiores nos casos com infecção. CONCLUSÃO: Este estudo contribui para o melhor conhecimento da variação dos constituintes dos FL das PV nos indivíduos com AIDS, bem como da influência de modificações arquiteturais, e da associação de outras entidades, como infecções respiratórias e a subnutrição, sobre a função destes FL.

Lymphoepithelial cyst in jugal mucosa / Quiste linfoepitelial en la mucosa yugal

Mouth lymphoepithelial cyst is rare, with few cases reported in literature. The aim of this article is to describe a clinical case, focusing on clinical and diagnostic aspects, treatment and prognosis. The lesion was one year old and had developed as a fibrous nodule in the jugal mucosa of a 71-year-old leucoderma patient. Considering focal inflammatory fibrous hyperplasia, fibroma and mucocele as differential diagnosis, excisional biopsy was carried out. A cystic cavity limited by pseudostratified epithelium without projections into the conjunctive tissue, with lymphoid tissue within, was microscopically identified. Without postoperative adverse events, the one-year clinical followup confirmed the favorable prognosis of this kind of lesion.

Un quiste linfoepitelial bucal es raro, con pocos casos reportados en la literatura. El objetivo de este artículo es describir un caso clínico, centrándose en los aspectos clínicos y diagnósticos, tratamiento y pronóstico. La lesión tuvo un año de evolución, y se había desarrollado como un nódulo fibroso en la mucosa yugal de un paciente de 71 años de edad con leucoderma. Teniendo en cuenta la hiperplasia fibrosa inflamatoria, fibroma y mucocele como diagnósticos diferenciales, se llevó a cabo una biopsia por escisión. Una cavidad quística limitada por epitelio pseudoestratificado sin proyecciones en el tejido conjuntivo, con tejido linfoide en el interior fue identificado microscópicamente. No se observaron eventos adversos postoperatorios, y el seguimiento clínico al año confirmó el pronóstico favorable de este tipo de lesión.

A Case of Ocular Benign Lymphoid Hyperplasia Treated with Bevacizumab Injection

We report the first case of ocular benign lymphoid hyperplasia (BLH) treated with subconjunctival injection of bevacizumab (Avastin). A 27-year-old man presented to our clinic with conjunctival masses and limbal neovascularization. An incisional biopsy yielded the diagnosis of BLH. The patient was subsequently given a subconjunctival injection of bevacizumab (1.25 mg / 0.1 mL). The patient did not experience recurrence or malignant metaplasia during the one-year follow-up period. In patients with conjunctival BLH, subconjunctival injection of bevacizumab can be a useful treatment option in patients unable to undergo a surgical procedure due to limbal neovascularization.

Omental and pleural milky spots: different reactivity patterns in mice infected with Schistosoma mansoni reveals coelomic compartmentalisation

In vertebrate animals, pleural and peritoneal cavities are repositories of milky spots (MS), which constitute an organised coelom-associated lymphomyeloid tissue that is intensively activated by Schistosoma mansoni infection. This study compared the reactive patterns of peritoneal MS to pleural MS and concluded from histological analysis that they represent independent responsive compartments. Whole omentum, lungs and the entire mediastinum of 54 S. mansoni-infected mice were studied morphologically. The omental MS of infected animals were highly activated, modulating from myeloid-lymphocytic (60 days of infection) to lymphomyeloid (90 days of infection) and lymphocytic or lymphoplasmacytic (160 days of infection) types. The non-lymphoid component predominated in the acute phase of infection and was expressed by monocytopoietic, eosinopoietic and neutropoietic foci, with isolated megakaryocytes and small foci of late normoblasts and mast cells. Nevertheless, pleural or thoracic MS of infected mice were monotonous, consisting of small and medium lymphocytes with few mast and plasma cells and no myeloid component. Our data indicate that compartmentalisation of the MS response is dependent on the lymphatic vascularisation of each coelomic cavity, limiting the effects or consequences of any stimulating or aggressive agents, as is the case with S. mansoni infection.

O papel da expressão de Bcl-2 em material obtido por PAAF no diagnóstico de doenças linfoproliferativas B / The role of Bcl-2 expression in fine needle aspiration specimens for the diagnostic accuracy in lymphoproliferative diseases

INTRODUÇÃO: O diagnóstico das doenças linfoproliferativas (DLP) tradicionalmente baseia-se no estudo histológico dos linfonodos (LN) acrescido de imuno-histoquímica. A imunofenotipagem (IFT) pela citometria de fluxo (CF) é uma ferramenta sensível e rápida, que pode ser aplicada nas DLP, em material obtido por punção aspirativa por agulha fina (PAAF) de LN. O Bcl-2 é um proto-oncogene que se expressa em várias DLP, porém em níveis especialmente elevados no linfoma folicular (LF). OBJETIVOS: Diagnosticar DLP, através de morfologia e imunofenotipagem por CF, em amostras obtidas por PAAF de LN. MATERIAL e MÉTODO: Amostras de 25 pacientes com adenopatias e de duas tonsilas reacionais foram analisadas pela morfologia e IFT, utilizando um painel inicial de AcMo (CD3, CD4, CD8, CD19, anti-kappa; e anti-lambda;), ampliado conforme a necessidade (CD5, CD10, CD11c, CD23, CD79b, sIgM, FMC-7 e Bcl-2). Os resultados foram comparados com a histologia. RESULTADOS:Dos 25 casos, quatro foram classificados como reacionais e 21 como DLP-B, havendo concordância com resultados histológicos em todos os casos. A intensidade média de fluorescência (IMF) da Bcl-2 no LF (19,92) foi maior que em outras DLP-B (11,93) e que nos controles (3,49) (p = 0,032). CONCLUSÃO:A PAAF de LN combinada com a citomorfologia e a IFT por CF permite uma rápida diferenciação entre os processos reacionais e linfoproliferativos B. A elevada expressão da Bcl-2 nos LFs pela citometria mostra sua utilidade no diagnóstico do tipo mais freqüente das DLP-B. A obtenção de células por PAAF requer treinamento e recomendamos mais de uma punção.

BACKGROUND: The diagnosis of lymphoproliferative disorders (LPD) is routinely made through histological and immunohistochemical analysis of lymph nodes. Immunophenotyping by flow cytometry (FC) is a sensitive and fast tool, which may be applied in samples obtained through fine needle aspiration for the diagnosis of LPD. Bcl-2 is a proto-oncogene that appears in several LPD and it has a significantly high expression in follicular lymphomas. OBJECTIVES: to diagnose LPD in FNA samples through morphology and flow cytometry immunophenotyping. MATERIAL AND METHODS: Samples from 25 patients with lymphadenopathies and 2 reactive tonsils were studied through morphology and immunophenotyping. The antigens expressions were evaluated by using a screening panel of monoclonal antibodies (CD3, CD4, CD8, CD19, light chains kappa; and lambda), followed by CD5, CD10, CD11c, CD23, CD79b, sIgM, FMC-7 and Bcl-2 when required. The results were compared with histology. RESULTS:Four out of 25 samples were reactive processes and 21were B-LPD. In all cases there was consistency with histological results. The mean fluorescence intensity of Bcl-2 in Follicular Lymphoma (19.92) was higher compared with other lymphoproliferative diseases (11.93) and controls (3.49) (p = 0.032). CONCLUSION: Fine needle aspiration of lymph nodes associated with cytomorphology and flow cytometry immunophenotyping allows a fast differentiation between reactive processes and B lymphoproliferative cases. The high expression of Bcl-2 by cytometry shows its usefulness in the diagnosis of the most frequent type of B-LPD. Fine needle aspiration sampling requires training and more than one aspiration is recommended.

Apoptose, proliferação e histomorfometria do baço de ratas adultas com hipofunção tireoidiana e ovariana / Apoptosis, proliferation and spleen histomorphometry of adult female rats with thyroid and ovarian hypofunction

Apoptose, proliferação e histomorfometria do baço foram investigados em ratas Wistar adultas ovariectomizadas e não-ovariectomizadas, mantidas em hipotireoidismo induzido pela administração diária de propiltiouracil (PTU) por 120 dias. Dois grupos eutireóideos ovariectomizados e não-ovariectomizados serviram como controle. Foi colhido o plasma para dosagem de T4 livre e o baço para análise da histomorfometria, do índice apoptótico e da expressão imunohistoquímica de caspase 3 e CDC47. Valores de T4 livre foram menores nas ratas tratadas com PTU (p < 0,05). Nos grupos hipotireóideos houve redução do peso do baço, do número e do tamanho dos folículos linfóides e aumento do índice apoptótico e da expressão de caspase 3 (p < 0,05). Porém, o baço de ratas hipotireóideas ovariectomizadas apresentou aumento menos acentuado do índice apoptótico e da expressão de caspase 3 do que o baço de ratas hipotireóideas não-ovariectomizadas (p < 0,05). O grupo eutireóideo ovariectomizado apresentou hiperplasia da polpa branca em relação ao grupo eutireóideo não-ovariectomizado. Não houve diferença na expressão de CDC47 entre os grupos. Conclui-se que a hipofunção tireoidiana e gonadal apresentam efeitos distintos no baço e que na associação hipotireoidismo-hipogonadismo há aumento menos acentuado do índice apoptótico e da expressão de caspase-3 esplênica do que no hipotireoidismo isolado.

Apoptosis, proliferation and histomorphometry of spleen were investigated in ovariectomized and non-ovariectomized adult Wistar rats maintained in hypothyroidism induced by daily administration of propylthiouracil (PTU) during 120 days. Two groups ovariectomized euthyroid and non-ovariectomized euthyroid were used as controls. Plasma was collected for free T4 dosage and the spleen for histomorphometry analysis, apoptosis index and the immunohistochemistry expression of caspase 3 and CDC47. Values of free T4 were lower in rats treated with PTU (p<0.05). In the hypothyroid groups there was some decrease in the spleen weight as well as the number and size of lymphoid follicles and there was some increase in the apoptotic index and the caspase 3 expression (p<0.05). However, the increase in the apoptosis index and the expression of caspase 3 in ovariectomized hypothyroid rats spleen was less accentuated than non-ovariectomized hypothyroid ones (p<0.05). The ovariectomized euthyroid group presented white pulp hyperplasia in comparison to the non-ovariectomized euthyroid group. There was no difference in the CDC47 expression between groups. It was concluded that the thyroid and ovarian hypofunction have distinct effects on the spleen and that in the hypothyroidism-hypogonadism association, the increase in the apoptosis index and in the expression of splenic caspase 3 is not as much as in isolated hypothyroidism.

Avaliação imunológica nas pregas vestibulares de pacientes autopsiados com a Síndrome da Imunodeficiência Adquirida / Immunological evaluation of vestibular folds in autopsies of patients with the Acquired Immunodeficiency Syndrome

Em pacientes com Síndrome da Imunodeficiência Adquirida há uma diminuição das células envolvidas na resposta imune, o que influencia na população celular dos folículos linfóides encontrados nas pregas vestibulares, favorecendo o aparecimento de infecções nas vias aéreas destes pacientes. Estas infecções são a principal causa de mortalidade e morbidade nestes pacientes. OBJETIVO: Caracterizar a população de células nos folículos linfóides localizados nas pregas vestibulares de adultos autopsiados com Síndrome da Imunodeficiência Adquirida, com e sem infecções respiratórias associadas. MATERIAIS E MÉTODOS: Foi realizado um estudo retrospectivo transversal em 64 laringes de adultos coletadas na rotina das autopsias. Para a imunohistoquímica foram utilizados os anticorpos: Anti-B cells, Anti-CD3, Anti-CD68 e Anti-follicular dendritic cells. RESULTADOS: 46 (71,87 por cento) dos pacientes estudados tinham diagnóstico de Síndrome da Imunodeficiência Adquirida. Nestes pacientes, a celularidade dos folículos linfóides foi estatisticamente menor em relação ao grupo controle em todos os fenótipos estudados. Nos pacientes imunodeprimidos com infecção respiratória associada, o número de células estava diminuído, sendo significante no caso dos linfócitos T (p=0,024). CONCLUSÃO: Em nosso estudo demonstramos que os folículos linfóides das pregas vestibulares são afetados pela infecção viral e representam com fidedignidade o estado imunológico de imunodepressão destes pacientes.

Immune response cells are decreased in patients with the Acquired Immunodeficiency Syndrome. This alters the cell population in vestibular fold lymphoid follicles, leading to respiratory infections in these patients. Such infections are the main cause of mortality and morbidity in these patients. AIM: to characterize lymphoid follicle cell populations in the vestibular folds of adults with the Acquired Immunodeficiency Syndrome and associated or not respiratory infection. MATERIALS AND METHODS: A retrospective study was made of 64 adult larynges harvested during routine autopsies. Anti-B cell, Anti-CD3, Anti-CD68 and Anti-follicular dendritic cell antibodies were used for immunological testing. RESULTS: 46 (71.87 percent) of the sample patients had the Acquired Immunodeficiency Syndrome. In these patients, lymphoid follicle cellularity was lower compared to the control group. The cell number was decreased in patients with the Acquired Immunodefficiency Syndrome and associated respiratory tract infection. CONCLUSION: We demonstrated in this study that vestibular fold lymphoid follicles were affected by viral infections, and may be considered as a reliable marker of immunodepression in these patients.