Linfoma em cão da raça cane corso: relato de caso / Lymphoma in a cane corso dog: case report / Linfoma en un perro cane corso: relato de un caso

Os linfócitos são células de defesa do organismo que funcionam como barreira contra infecções e células cancerígenas, elas circulam pelo sistema linfático e estão presentes por todo o organismo do animal, podem se proliferar de forma maligna, caracterizando o linfoma. Acometem em sua maioria, cães de raças de grande porte, animais de meia idade e idosos. Sendo uma doença de etiologia desconhecida, vários fatores podem contribuir para sua evolução, como deficiências autoimunes, bem como hábitos alimentares ao longo da vida do animal, ou até por predisposição genética. O presente relato de caso, tem o objetivo de mostrar a evolução gradual da doença, quais sinais clínicos o animal poderá apresentar, e como os exames laboratoriais podem nos auxiliar em seu diagnóstico.(AU)

The lymphocytes are defense cells of the body that act as a barrier against infection and cancer cells, they circulate through the lymphatic system and are present throughout the animal's body, and can proliferate in a malignant way, characterizing the lymphoma. They mostly affect large breed dogs, middle-aged and elderly animals. Being a disease of unknown etiology, several factors may contribute to its evolution, such as autoimmune deficiencies, as well as food habits throughout the animal's life, or even genetic predisposition. The present case report has the objective of showing the gradual evolution of the disease, which clinical signs the animal may present, and how laboratory tests can help us in its diagnosis.(AU)

Los linfocitos son células de defensa del organismo que actúan como barrera contra infecciones y células cancerígenas, circulan por el sistema linfático y están presentes en todo el organismo del animal, pudiendo proliferar de forma maligna, caracterizando el linfoma. Afectan sobre todo a perros de razas grandes, animales de mediana edad y ancianos. Siendo una enfermedad de etiología desconocida, varios factores pueden contribuir a su evolución, como deficiencias autoinmunes, así como hábitos alimentarios a lo largo de la vida del animal, o incluso predisposición genética. El presente caso clínico tiene como objetivo mostrar la evolución gradual de la enfermedad, qué signos clínicos puede presentar el animal y cómo las pruebas de laboratorio pueden ayudarnos en su diagnóstico.(AU)

Diferenciación entre linfadenopatía cervical benigna y maligna mediante ecografía en niños / Differentiation of benign from malignant cervical lymphadenopathy by ultrasonography in children

Introducción. Las causas más frecuentes de la linfadenopatía cervical son las afecciones inflamatorias y reactivas; solo unos pocos casos representan una patología seria. El objetivo fue evaluar la relación entre los hallazgos ecográficos y el diagnóstico histopatológico. Población y métodos. Este estudio retrospectivo abarcó la linfadenopatía cervical en los menores de 20 años seguidos en nuestro centro, entre enero de 2007 y diciembre de 2016. Según los informes anatomopatológicos, se dividió a los pacientes en dos grupos: benigno y maligno. Se compararon los resultados anatomopatológicos y los hallazgos ecográficos. Resultados. Después del análisis de los resultados histopatológicos y los hallazgos ecográficos, se incluyó a 107 pacientes con linfadenopatía cervical persistente (44 casos malignos; 63, benignos). La media de edad de los grupos maligno y benigno fue de 14 ± 6,1 años y de 11,9 ± 4,8 años, respectivamente. La presencia de vascularidad hiliar fue estadísticamente significativa (p < 0,0001) en la linfadenopatía benigna, mientras que el flujo periférico y la vascularidad mixta lo fueron (p < 0,05) en la linfadenopatía maligna. No se observó una diferencia significativa en el diámetro máximo (27,3 ± 11,1 mm y 29,8 ± 12,3 mm, respectivamente), pero sí en el diámetro mínimo entre los grupos benigno y maligno (13,7 ± 7,3 mm y 18,7 ± 8,8 mm, respectivamente). Conclusiones. Este estudio sugiere que existe una relación entre los hallazgos ecográficos y de la biopsia para la diferenciación entre la linfadenopatía benigna y maligna, en especial, en el patrón vascular intraganglionar y el hilio ganglionar.

Introduction. The most common causes of cervical lymphadenopathy (LAP) are inflammatory and reactive conditions; only a small proportion have serious pathology, such as malignancy. The objective of this study was to evaluate the relationship between USG findings and histopathological diagnosis of the cervical LAP. Population and Methods. This retrospective study comprised the cases of cervical LAP in patients aged under 20 years old followed in our center between January 2007 to December 2016. Based on pathology reports, we divided the patients into two groups: benign and malignant. Pathology results and USG findings were compared. Results. After the analyze of the histopathological results and USG findings, 107 patients with persistent cervical LAP (44 malignant; 63 benign) were included in the study. Mean age of malignant and benign group were 14 ± 6.1; 11.9 ± 4.8 years, respectively. Hilar vascularity for benign LAP was highly statistically significant (P < 0.0001) and peripheral flow and mixed vascularity for malignant LAP were also statistically significant (p < 0.05). There was not a significant difference in the maximum diameter (27.3 ± 11.1 mm and 29.8 ± 12.3 mm, respectively), however, there was a significant difference in the minimum diameter between benign and malignant groups (13.7 ± 7.3 mm and 18.7 ± 8.8 mm, respectively).Conclusions. The present study suggests that there is a relationship between US and biopsy findings for the differentiation of benign from malignant LAP, especially in terms of nodal hilus and intranodal vascular pattern.

Feline lymphoma in the nervous system: pathological, immunohistochemical, and etiological aspects in 16 cats / Linfoma no sistema nervoso de felinos: aspectos patológicos, imuno-histoquímicos e etiológicos em 16 gatos

The pathological, immunohistochemical (IHC), and etiological features of lymphoma involving the nervous system (NS) in cats were analyzed through a retrospective study (2004-2017) in Rio Grande do Sul State, Brazil. The NS involvement was observed in 16 (12.2%) of 125 felines with lymphoma. Young cats were mainly affected, with a median of 24 months old. Most cases were secondary central NS lymphoma, whereas in three cats, the NS involvement was primary. IHC revealed 14 (87.5%) FeLV-positive, six FIV-positive, and one FeLV/FIV-negative cats. Distribution of feline lymphoma in the NS was 8/16 in the spinal cord, 7/16 in the brain, and 1/16 in the paravertebral nerves and ganglia (neurolymphomatosis). The lymphoma pattern in the spinal cord was exclusively extradural, often focal (6/8), and located in the lumbar (3/6), sacral (1/6), thoracic (1/6), and cervical segments (1/6). Brain neuroanatomical patterns were: leptomeningeal lymphomatosis (4/7), lymphomatous choroiditis (2/7), and intradural lymphoma (1/7). The feline with primary neurolymphomatosis presented a marked thickening of paravertebral nerves and ganglia from the sacral region. B-cell lymphoma (75%) was often diagnosed, and diffuse large B-cell lymphoma (DLBCL) (11/16) was the main subtype. T-cell lymphoma (25%) was less commonly observed and was classified as peripheral T-cell lymphoma (PTCL) (3/16) and T-cell lymphoblastic lymphoma (T-LBL) (1/16).(AU)

Os aspectos patológicos, imuno-histoquímicos (IHQ) e etiológicos do linfoma envolvendo o sistema nervoso de felinos foram analisados através de um estudo retrospectivo (período de 2004-2017) no Estado do Rio Grande do Sul, Brasil. O envolvimento do sistema nervoso foi observado em 16 (12,2%) dos 125 felinos com linfoma desse estudo e afetou principalmente, jovens com idade mediana de 24 meses. A grande maioria dos casos o linfoma era secundário no sistema nervoso central e somente em três gatos o linfoma foi primário do sistema nervoso. Na IHQ, 14 (87,5%) casos foram positivos para FeLV, seis (37,5%) para FIV, e um foi negativo para ambos. A distribuição do linfoma no sistema nervoso foi em 8/16 felinos na medula espinhal, 7/16 no encéfalo e em 1/16 em nervos e gânglios paravertebrais (neurolinfomatose). Na medula espinhal, o padrão do linfoma foi exclusivamente extradural e frequentemente focal (6/8), localizadas nos segmentos lombares (3/6), sacrais (1/6), torácicos (1/6) e cervicais (1/6). No encéfalo, os padrões neuroanatômicos observados foram: linfomatose leptomeningeal (4/7), coroidite linfomatosa (2/7), linfoma intradural (1/7). No felino diagnosticado com neurolinfomatose primária, foi observado acentuado espessamento dos nervos e gânglios paravertebrais da região sacral. Os linfomas de células de células B (75%) foram os mais frequentes e o principal tipo foi o linfoma difuso de grandes células B (11/16). Os linfomas de células T (25%), menos observados, foram classificados como linfomas de células T periférico inespecífico (3/16) e linfoma linfoblástico T (1/16).(AU)

Combinación poco habitual de hepatocarcinoma con síndrome de Sjögren / Uncommon combination of hepatocarcinoma with Sjögren's syndrome

El síndrome de Sjögren es una enfermedad reumática que aumenta el riesgo de padecer enfermedades malignas. Dentro de estas se identifican a los linfomas como las que con mayor frecuencia se presentan. El hepatocarcinoma es una de las enfermedades más agresivas y su incidencia ha ido en aumento asociado al alto consumo de alcohol. Se presenta el caso de una paciente de 56 años de edad con diagnóstico de un síndrome de Sjögren, con manifestaciones clínicas y anátomopatológicas que permiten llegar al diagnóstico de un hepatocarcinoma, asociación muy infrecuente. El hepatocarcinoma provoca un deterioro progresivo del estado de salud de los pacientes. Conocer sus síntomas y signos es de vital importancia con el fin de llegar al diagnóstico precoz de la enfermedad y evitar así las complicaciones que de él se derivan. No se encuentra relación etiopatogénica entre estas dos afecciones(AU)

Sjögren's syndrome is a rheumatic disease that increases the risk of suffering from malignant diseases. Lymphomas are identified among them as most frequent. Hepatocarcinoma is one of the most aggressive conditions and the incidence has been increasing associated with high alcohol consumption. We present the case of a 56-year-old patient with diagnosis of Sjögren's syndrome that presents clinical and anatomo-pathological manifestations allowing the diagnosis of a very rare hepatocarcinoma. This entity causes a progressive deterioration of the patient health status. It is of vital importance knowing the symptoms and signs in order to reach early diagnosis, thus avoid complications. There is no etiopathogenic relationship between these two conditions(AU)

Linfoma primario de ano en un paciente con virus de la inmunodeficiencia humana/sida / Primary lymphoma of anus in a patient with human immunodeficiency virus/AIDS

Se presenta el caso clínico de un paciente de 47 años de edad con seropositividad del virus de inmunodeficiencia humana/sida desde hacía 5 años, quien acudió a la consulta de Cirugía en el Hospital Gubernamental de Mbabane en Suazilandia, por presentar un tumor anal; se diagnosticó hemorroides, pero el tumor continuó aumentando de tamaño, unido a sangrado e intenso dolor. Se realizó una biopsia por incisión que indicó la presencia de un linfoma de alto grado de malignidad. Posteriormente el paciente fue evaluado en la consulta de Oncología, donde se le indicaron los exámenes complementarios necesarios, los que revelaron que la neoplasia se encontraba en estadio IE; de manera que fue remitido a Sudáfrica para recibir quimioterapia combinada, con la cual desapareció la lesión maligna y se controló la enfermedad

The case report of a 47 years patient with the human immunodeficiency virus/AIDS for 5 years is presented. He went to the Surgery Service in the Government Hospital of Mbabane in Swaziland, due to an anus malignancy; hemorrhoids was diagnosed, but its size continued increasing, along with bleeding and acute pain. An incision biopsy that indicated the presence of a high grade lymphoma malignancy was carried out. Later on the patient was evaluated in the Oncology Service, where the necessary complementary exams were indicated, revealing that neoplasm was in IE stage; so he was referred to South Africa to receive combined chemotherapy, with which the malignant lesion disappeared and the disease was controlled

Mucinose folicular primária ­ relato de caso / Primary follicular mucinosis ­ case report

De etiologia desconhecida, a mucinose folicular primária ou idiopática se caracteriza clinicamente como afecção inflamatória, com placas mais ou menos infiltradas e descamativas, com ou sem perda de pelos. Na sua forma secundária, costuma apresentar lesões mais numerosas e difusas, com morfologia variá- vel, desde placas até nódulos ulcerados. É representada por depósitos localizados ou difusos de mucina na pele ou nos folículos pilosos. Objetivo: Apresentar um caso incomum de mucinose folicular primária, de importância da diferenciação com a forma secundária de mucinose folicular, discutir os aspectos clínicos e histopatológicos utilizados no diagnóstico, suas características e classificações, bem como as possíveis escolhas terapêuticas.(AU)

Of unknown etiology, acute follicular mucinosis is clinically characterized as an inflammatory disease coursing with more or less infiltrated and scaly plaques, with or without hair loss. In the chronic form, it usually has more numerous and diffuse lesions with variable morphology, from plaques to ulcerated nodules. It is characterized by localized or diffuse deposits of mucin in the skin or hair follicles. Objective: To present an unusual case of primary follicular mucinosis, the importance of differentiation from the secondary form of follicular mucinosis, to discuss the clinical and histopathological aspects used in the diagnosis, its characteristics and classifications as well as the possible therapeutic choices.(AU)

Epstein-Barr virus load in transplant patients: Early detection of post-transplant lymphoproliferative disorders / Carga de virus Epstein-Barr en pacientes trasplantados: detección temprana de desórdenes linfoproliferativos postrasplante

High levels of circulating EBV load are used as a marker of post-transplant lymphoproliferative disorders (PTLD). There is no consensus regarding the threshold level indicative of an increase in peripheral EBV DNA. The aim of the study was to clinically validate a developed EBV quantification assay for early PTLD detection. Transversal study: paired peripheral blood mononuclear cells (PBMC), plasma and oropharyngeal lymphoid tissue (OLT) from children undergoing a solid organ transplant with (n = 58) and without (n = 47) PTLD. Retrospective follow-up: 71 paired PBMC and plasma from recipients with (n = 6) and without (n = 6) PTLD history. EBV load was determined by real-time PCR. The diagnostic ability to detect all PTLD (categories 1-4), advanced PTLD (categories 2-4) or neoplastic PTLD (categories 3 and 4) was estimated by analyzing the test performance at different cut-off values or with a load variation greater than 0.5 log units. The higher diagnostic performance for identifying all, advanced or neoplastic PTLD, was achieved with cut-off values of 1.08; 1.60 and 2.47 log EBV gEq/10(5) PBMC or 2.30; 2.60; 4.47 log gEq/10(5) OLT cells, respectively. EBV DNA detection in plasma showed high specificity but low (all categories) or high (advanced/neoplastic categories) sensitivity for PTLD identification. Diagnostic performance was greater when: (1) a load variation in PBMC or plasma was identified; (2) combining the measure of EBV load in PBMC and plasma. The best diagnostic ability to identify early PTLD stages was achieved by monitoring EBV load in PBMC and plasma simultaneously; an algorithm was proposed.

La carga alta del virus Epstein-Barr se utiliza como un marcador de desórdenes linfoproliferativos postrasplante (post-transplant lymphoproliferative disorders [PTLD]). El objetivo de este estudio fue validar clínicamente un ensayo de cuantificación del virus Epstein-Barr para la detección temprana de PTLD. Se efectuó un estudio transversal en el que se analizaron muestras pareadas de células mononucleares periféricas (CMP), de plasma y de tejido linfoide orofaríngeo de niños con trasplante de órgano sólido, con PTLD (n = 58) y sin PTLD (n = 47). En el seguimiento retrospectivo se incluyeron 71 muestras pareadas de CMP y de plasma de trasplantados, con PTLD (n = 6) y sin PTLD (n = 6). La carga viral se determinó por PCR en tiempo real. Se estimó la capacidad diagnóstica para detectar PTLD (categorías: todas vs. avanzadas vs. neoplásicas) analizando diferentes valores de corte o una variación de carga mayor de 0,5 logaritmos. El mayor desempeño diagnóstico para identificar todos los PTLD, los avanzados y los neoplásicos, se obtuvo con valores de corte de 1,08; 1,60 y 2,47 log copias/10(5) en CMP y de 2,30; 2,60 y 4,48 log copias/10(5) en células de tejido linfoide orofaríngeo, respectivamente. La detección del ADN del virus Epstein-Barr en el plasma mostró una especificidad alta, pero una sensibilidad baja (todas las categorías) o alta (categorías avanzadas o neoplásicas) para identificar PTLD. Se observó el desempeño diagnóstico más alto en las siguientes condiciones: 1) al identificar una variación de carga en CMP o en plasma; 2) combinando la medición de la carga viral en CMP y en plasma. La mejor capacidad diagnóstica para identificar las etapas tempranas de los PTLD se logró mediante el seguimiento simultáneo de la carga viral en CMP y en plasma; se propone un algoritmo.

Sindrome de inmunodeficiencia adquirida: compromiso del corazón y de los vasos / AIDS: cardiovascular involvement

Las complicaciones cardiovasculares del SIDA, son a menudo asintomáticas, aunque en ocasiones pueden constituir la causa directa de muerte. Puede comprometerse el pericardio, miocardio, endocardio y los vasos, ya sea como manifestación de la enfermedad de base o como resultado de la terapia antirretroviral y su efecto sobre los factores de riesgo, en el contexto de una patología que es actualmente de evolución crónica y con mejores expectativas de sobrevida gracias a las nuevas drogas empleadas para su control y tratamiento. El objetivo de este artículo es presentar una revisión de los aspectos más relevantes del SIDA que comprometen al corazón y los vasos.

The cardiovascular complications of AIDS, are often asymptomatic, although some may be direct cause of death. Pericardium, myocardium, endocardium, and vessels may be involved as a result of illness or the adverse effects of antiretroviral therapy on risk factors, Today has become a chronic condition with improved life expectancy thanks to the development of new drugs for its treatment and control The aim of this article is to present a review of the most relevant aspects of AIDS involving the heart and vessels.

Intestinal and xxtraintestinal neoplasia in patents with inflammatory bowel diisease in a tertiary care hospital

Context The development of neoplasia is an important concern associated with inflammatory bowel disease (IBD), especially colorectal cancer (CRC). Objectives Our aim was to determine the incidence of intestinal and extraintestinal neoplasias among patients with inflammatory bowel disease. Methods There were retrieved information from 1607 patients regarding demographics, disease duration and extent, temporal relationship between IBD diagnosis and neoplasia, clinical outcomes and risk factors for neoplasia. Results Crohn's disease (CD) was more frequent among women (P = 0.0018). The incidence of neoplasia was higher in ulcerative colitis (UC) when compared to CD (P = 0.0003). Eight (0.99%) patients developed neoplasia among 804 with CD: 4 colorectal cancer, 2 lymphomas, 1 appendix carcinoid and 1 breast cancer. Thirty (3.7%) patients developed neoplasia among the 803 UC: 13 CRC, 2 lymphomas and 15 extraintestinal tumors. While CRC incidence was not different among UC and CD (1.7% vs 0.5%; P = 0.2953), the incidence of extraintestinal neoplasias was higher among UC (2.1% vs 0.5%, P = 0.0009). Ten (26.3%) patients out of 38 with neoplasia died. Conclusions CRC incidence was low and similar in both diseases. There was a higher incidence of extraintestinal neoplasia in UC when compared to CD. Neoplasias in IBD developed at a younger age than expected for the general population. Mortality associated with malignancy is significant, affecting 1/4 of the patients with neoplasia. .

Contexto O desenvolvimento de neoplasias se constitui em preocupação constante em pacientes com doenças inflamatórias intestinais (DII), especialmente o câncer colorretal (CCR). Objetivos Determinar a incidência de neoplasias intestinais e extra-intestinais entre pacientes com DII. Métodos Foram obtidas informações de 1607 pacientes, quanto a dados demográficos, duração e extensão da doença, relação temporal entre diagnóstico das DII e neoplasia, evolução clínica e fatores de risco para neoplasia. Resultados Doença de Crohn (DC) foi mais frequente entre as mulheres (P = 0.0018). A incidência de neoplasia foi maior nos doentes com retocolite ulcerativa (RCU) em relação aos com DC (P = 0.0003). Oito (0.99%) pacientes desenvolveram neoplasia entre 804 com DC: quatro tumores colorretais, dois linfomas, um carcinóide de apêndice e um câncer de mama. Trinta (3.7%) pacientes desenvolveram neoplasia entre os 803 RCU: 13 CCR, 2 linfomas e 15 tumores extra-intestinais. Enquanto a incidência de CCR não diferiu entre RCU e DC (1.7% vs 0.5%; P = 0.2953), a incidência de neoplasias extraintestinais foi maior na RCU (2.1% vs 0.5%, P = 0.0009). Dez (26.3%) pacientes de um total de 38 com neoplasia, evoluíram a óbito durante o seguimento. Conclusões A incidência de CCR foi baixa e similar em ambas as doenças inflamatórias. Observou-se incidência maior de neoplasia extra-intestinal na RCU quando comparada à DC. Neoplasias em doenças inflamatórias se desenvolveram em idade mais precoce do que a esperada para a população geral. A mortalidade associada a neoplasias é significativa, afetando 1/4 dos pacientes. .

Differential expression of thymic DNA repair genes in low-dose-rate irradiated AKR/J mice

We previously determined that AKR/J mice housed in a low-dose-rate (LDR) (137Cs, 0.7 mGy/h, 2.1 Gy) gamma-irradiation facility developed less spontaneous thymic lymphoma and survived longer than those receiving sham or high-dose-rate (HDR) (137Cs, 0.8 Gy/min, 4.5 Gy) radiation. Interestingly, histopathological analysis showed a mild lymphomagenesis in the thymus of LDR-irradiated mice. Therefore, in this study, we investigated whether LDR irradiation could trigger the expression of thymic genes involved in the DNA repair process of AKR/J mice. The enrichment analysis of Gene Ontology terms and Kyoto Encyclopedia of Genes and Genomes pathways showed immune response, nucleosome organization, and the peroxisome proliferator-activated receptors signaling pathway in LDR-irradiated mice. Our microarray analysis and quantitative polymerase chain reaction data demonstrated that mRNA levels of Lig4 and RRM2 were specifically elevated in AKR/J mice at 130 days after the start of LDR irradiation. Furthermore, transcriptional levels of H2AX and ATM, proteins known to recruit DNA repair factors, were also shown to be upregulated. These data suggest that LDR irradiation could trigger specific induction of DNA repair-associated genes in an attempt to repair damaged DNA during tumor progression, which in turn contributed to the decreased incidence of lymphoma and increased survival. Overall, we identified specific DNA repair genes in LDR-irradiated AKR/J mice.

Psoriasis, lymphoma and etanercept: is there a correlation? / Psoríase, linfoma e etanercepte: existe correlação?

Psoriasis is a chronic inflammatory disease that can affect skin and joints. Their treatment varies depending on the severity and includes topical and systemic. Among the latter are the immunobiological that target the T cell We report a case that demonstrates the close relationship between psoriasis, lymphoma and biologic therapies.

A psoríase é uma doença inflamatória crônica que pode afetar a pele e as articulações. Seu tratamento varia conforme a gravidade e inclui medicamentos tópicos e sistêmicos. Dentre os últimos estão os imunobiológicos, que têm como alvo a célula T. Relatamos um caso que demonstra a estreita relação entre a psoríase, o linfoma e os imunobiológicos.

Incidência e aspectos de imagem do linfoma pós-transplante hepático em crianças / Incidence and imaging findings of lymphoma after liver transplantation in children

OBJETIVO: Avaliar a incidência e os aspectos de imagem do linfoma pós-transplante hepático em crianças. MATERIAIS E MÉTODOS: Foram revisados os prontuários e exames de imagem de crianças submetidas a transplante hepático entre 2000 e 2008 em uma única instituição. RESULTADOS: De 241 crianças submetidas a transplante hepático, com seguimento médio de 41,4 ± 26,4 meses, 16 (6,6 por cento) tiveram linfoma. A média de idade no transplante hepático das crianças que desenvolveram linfoma foi inferior à das crianças que não desenvolveram (23,9 ± 18,9 vs. 38,0 ± 48,9 meses; p = 0,02). O tempo entre o transplante e o desenvolvimento do linfoma variou de 6 a 103 meses. A apresentação clínica e radiológica foi variável e a localização mais comum do tumor foi no abdome (n = 13; 81,3 por cento), seguida de tórax e cabeça e pescoço (n = 4; 25,0 por cento cada). Os achados de imagem incluíram: linfonodomegalias, massas mediastinais, pulmonares e mesentéricas, espessamento parietal de alças intestinais e nódulos hepáticos e renais. Quatro crianças (25,0 por cento) faleceram devido a complicações do linfoma. CONCLUSÃO: Linfomas são complicações relativamente incomuns e potencialmente fatais que podem acontecer a qualquer momento após o transplante hepático em crianças, e que têm diversas apresentações clínicas e de imagem.

OBJECTIVE: To evaluate the incidence and imaging findings of lymphoma after liver transplantation in children. MATERIALS AND METHODS: The authors reviewed records and imaging studies of children submitted to liver transplantation in the period between 2000 and 2008 in a single institution. RESULTS: Among 241 children submitted to liver transplantation, with a mean follow-up period of 41.4 ± 26.4 months, 16 (6.6 percent) had lymphoma. The mean age of the patients who developed lymphoma at the moment of transplantation was lower than in children who did not develop malignancy (23.9 ± 18.9 versus 38.0 ± 48.9 months; p = 0.02). The time interval between liver transplantation and the diagnosis of lymphoma ranged from 6 to 103 months. Clinical and radiological presentation was variable and the abdomen was the most common location of the tumor (n = 13; 81.3 percent), followed by chest and head and neck (n = 4; 25.0 percent each). Imaging findings included adenopathy, mediastinal, pulmonary and mesenteric masses, bowel wall thickening and hepatic and renal nodules. Four children (25.0 percent) died because of complications of lymphoma. CONCLUSION: Lymphomas are relatively uncommon and potentially fatal complications that may occur any time after pediatric liver transplantation, presenting different clinical and imaging findings.

Compromiso pulmonar en síndrome de Sjõgren: caso clínico: [revisión] / Pulmonary involvement in primary Sjõgren's syndrome: a case report: [review]

Se presenta el caso de una mujer de 53 años con historia de aumento de volumen y dolor articular, pérdida de peso y síntomas sicca. El estudio de laboratorio mostró VHS elevada, anemia, linfopenia, hipocomplementemia y autoanticuerpos contra SSA/Ro y SSB/La, compatibles con un síndrome de Sjõgren (SS). Además, la radiografía de tórax mostró múltiples nódulos pulmonares, lo que fue confirmado por una TAC de tórax. El estudio histológico de los nódulos, plasmocitosis y proliferación linfocitaria atípica no demostró linfoma. Es ampliamente conocido que el SS confiere un mayor riesgo de desarrollar sindromes linfoproliferativos, lo que aumenta cuando hay presencia de vasculitis, hipo-complementemia y linfopenia. En este caso clínico el diagnóstico diferencial de la etiología de los nódulos pulmonares fue particularmente difícil. Dado lo anterior, se discute y revisa la literatura disponible acerca de compromiso pulmonar en SS.

We report the case of a 53-year old woman with a history of joint swelling and pain, weight loss and sicca symptoms. The laboratory showed a high ESR, anemia, lymphopenia, low complements and circulating auto-antibodies against SSA/Ro and SSB/La consistent with Sjõgren´s Syndrome (SS). Interestingly, the chest x-ray revealed multiple nodules in both lungs, which were corroborated by CT scan. The histological study of the pulmonary nodules showed plasmocytosis and atypical lymphocytes, but failed to demonstrate lymphoma. It is widely acknowledged that SS confers a high risk of developing lymphoproliferative syndromes, which is increased when vasculitis, low complements and lymphopenia are present. In this case, it was particularly difficult to elucidate the differential diagnosis of lung nodules. Accordingly, we discuss and review the available literature regarding pulmonary involvement in SS.

Câncer gástrico: experiência de um hospital geral / Gastric cancer: experience of a general hospital

Foram revisados 115 prontuários de pacientes internados no Hospital Nossa Senhora da Conceição, em um período de 2 anos, com diagnóstico de câncer gástrico confirmado histolopatologicamente. A incidência foi maior entre homens (2:1), sendo identificada relação entre câncer gástrico e tabagismo, presente em 58,2% dos pacientes. Não foi possível estabelecer relação etiológica com alcoolismo e com história pessoal ou familiar de outras neoplasias. A apresentação endoscópica mais freqüente foi tumor ulcerado (44,7% dos casos), sendo adenocarcinoma o tipo histopatológico mais prevalente. No estadiamento, 67% dos pacientes que realizaram ecografia ou tomografia abdominal apresentaram alterações que sugeriram a presença do tumor ou sua disseminação e 56,5% dos pacientes apresentavam neoplasia gástrica irressecável no momento do diagnóstico. Novos ensaios clínicos randomizados são necessários para o reconhecimento dos fatores de risco para esta neoplasia e possibilitar o estabelecimento de medidas de prevenção e detecção precoce do câncer gástrico em pacientes de alto risco (AU)

The registers of 115 patients with diagnosis of gastric cancer (histopathologically confirmed) from Hospital Nossa Senhora da Conceição in a 2 year period were studied. The incidence was larger among men (2:1), and a relationship between gastric cancer and tobacco smoking, present in 58,2% of the patients, was identified. It was not possible to establish etiological relationship with alcoholism and personal or family history of another neoplasm. The more frequent endoscopic presentation was ulcerated tumor (44,7% of the cases), being adenocarcinoma the more prevalent histopathologic type. Sixty seven percent of the patients that were submitted to abdominal ecography or tomography presented alterations that suggested the presence of the tumor or its dissemination, and 56,5% of the patients presented irresecable gastric cancer in the moment of the diagnosis. New randomized clinical trials are necessary for the recognition of the risk factors for this neoplasm and then establish prevention measures and early detection of gastric cancer in high risk patients (AU)

Transforming variant of Met receptor confers serum independence and anti-apoptotic property and could be involved in the mouse thymic lymphomagenesis

Met tyrosine kinase receptor, the receptor of hepatocyte growth factor/scatter factor (HGF/SF), is present in mouse tissues as two major isoforms differing by a 47-aminoacid segment in the juxtamembrane domain via alternative splicing of exon 14. We found that the smaller isoform of Met (Sm-Met) was highly transformable in both in vitro and in vivo tumorigenesis assays. In this report, close examination of the transforming activity of the Sm-Met showed that the expression of Sm-Met conferred the cells serum independence and anti- apoptotic property when treated with doxorubicin. These properties of Sm-Met seemed to be originated from its far longer maintenance of tyrosine kinase activity after the binding of HGF/SF. Interestingly, the longer maintenance of activated status was accompanied with more increase of tyrosine phosphorylation of Stat3 protein. Moreover, we have tried to find (an) animal tumorigenesis model(s) showing the increase in the expression of this transforming variant of Met. In gamma-ray-induced mouse thymic lymphoma model, the expression of the mRNAs for Sm-Met was significantly increased as well as those of wild type Met and HGF/SF, suggesting a possible role of the Sm-Met in tumorigenesis in vivo.

Pim-1: A serine/threonine kinase with a role in cell survival, proliferation, differentiation and tumorigenesis

Pim-1 belongs to a family of serine/threonine protein kinases that are highly conserved through evolution in multicellular organisms. Originally identified from moloney murine leukemia virus (MuLV)-induced T-cell lymphomas in mice, Pim-1 kinase is involved in the control of cell growth, differentiation and apoptosis. Expression of Pim-1 kinase can be stimulated by a variety of growth factors and regulated at four different levels: transcriptional, post-transcriptional, translational and post-translational. Several signal transduction pathways may be associated with the regulation of Pim-1's expression; accumulating data support that the expression of Pim-1 protein is mediated through activation of JAK/STATs. Recent studies of Pim family kinases indicate that Pim-1 kinase plays important roles outside of the hematopoietic system as well.

Reordenamiento de inmunoglobulinas en el diagnóstico diferencial del linfoma gástrico primario / Immunoglobulin rearrangement in the differential diagnosis of primary gastric lymphoma

Background: The traditional methods to distinguish Chronic Follicular Gastritis and Primary Gastric Lymphoma do not allow an adequate definitive diagnosis in a significant number of cases. The Molecular Biology diagnostic methods are based on the rearrangement of immunoglobulin genes. The polymerase chain reaction (PCR) specifically amplifies this rearrangement and allows molecular analysis of minimal tissue samples obtained with endoscopical biopsies. Aim: To test the usefulness of this PCR method in the differential diagnosis between Chronic Follicular Gastritis and Primary Gastric Lymphoma. Material and methods: We analyzed the endoscopical biopsies of six Chronic Follicular Gastritis cases and eight surgically treated Primary Gastric Lymphoma cases, six with the correct diagnosis in the endoscopical biopsies and two with a diagnosis of Chronic Follicular Gastritis. Results: A policlonal immunoglobulin rearrangement was found in the six cases with Chronic Follicular Gastritis. A monoclonal arrangement was found in 5 of 6 biopsies with the diagnosis of Primary Gastric Lymphoma. The same monoclonal rearrangement was observed in the two biopsies incorrectly diagnosed as Chronic Follicular Gastritis. Conclusions: PCR analysis of immunoglobulin rearrangement is a useful method in the differential diagnosis between Chronic Follicular Gastritis and Primary Gastric Lymphoma

Linfoma do sistema nervoso central: associaçäo com o vírus de epstein-barr / Central nervous system lymphoma: association with epstein-barr virus

Linfoma maligno do sistema nervoso central (SNC) é patologia rara e representa menos que 2 por cento de todos os tumores primários do SNC. A incidência destes linfomas está aumentando, especialmente na populaçäo de pacientes imunossuprimidos. O vírus de Epstein-Barr (EBV) está imlicado na patogênese do linfoma do SNC em pacientes portadores de imunodeficiência, incluindo SIDA. A associaçäo do EBV em casos de linfoma do SNC em pacientes brasileiros, associada ou näo à imunodeficiência, é desconhecida. No presente estudo, utilizamos técnica de hibridizaçäo in situ para avaliar a associaçäo do EBV em 12 casos de linfomas malignos primários do SNC, em grupo de pacientes brasileiros. Os linfomas foram também classificados morfologicamente e quanto ao seu imunofenótipo. Os resultados evidenciaram que somente 3 casos de linfomas do SNC revelaram positividade para EBV em virtualmente todas as células neoplásicas. Nestes, em 2 casos havia história de imunosspressäo associada a transplante renal e em um caso o paciente era portador de SIDA. Nos 9 casos restantes, EBV foi negativo e näo havia qualquer evidência clínica ou laboratorial de imunodeficiência. Esses resultados indicam que nos pacientes estudados, o EBV parece ter papel importante no desenvolvimento do linfoma do SNC quando a imunossupressäo está presente. Outras etiologias podem ser responsáveis pelo desenvolvimento deste tipo de linfoma em pacientes imunocompetentes