Hiperplasia Endotelial Papilífera Intravascular Oral: relato de dois casos / Oral intravascular papillary endothelial hyperplasia: two cases report

A hiperplasia endotelial papilífera intravascular (HEPI) é uma lesão vascular não neoplásica, benigna e rara, especialmente em cavidade bucal. O presente artigo relata dois casos com diferentes apresentações clínicas de HEPI, envolvendo o lábio inferior. O primeiro caso se refere a um paciente que apresentava nódulo único submucoso, endurecido, arroxeado e assintomático em mucosa labial inferior. E o segundo se reporta a uma paciente que apresentava aumento de volume assintomático em lábio inferior com a mucosa entumecida e arroxeada desde o fundo de sulco. O exame histológico revelou vasos dilatados com proliferação de células endoteliais arredondadas, associadas a estruturas papilares, de tecido conjuntivo projetadas para o lúmen vascular, associadas a um trombo organizado, no primeiro caso, e a um hemangioma, no segundo. A ausência de células inflamatórias, atipia e necrose celular excluíram outras lesões vasculares, sendo o diagnóstico final de HEPI. O prognóstico da HEPI é excelente, uma vez que recidivas são raramente relatadas. A HEPI pode ser incluída no diagnóstico diferencial clínico de lesões labiais únicas, arroxeadas e endurecidas. E por caracterizarse histologicamente por uma proliferação de células endoteliais, é importante estabelecer o diagnóstico diferencial com o angiossarcoma, uma lesão de tratamento mais agressivo e pior prognóstico... (AU)

Intravascular papillary endothelial hyperplasia (IPEH) is a nonneoplastic vascular benign and rare lesion, especially in oral cavity. This article reports two cases of IPEH, with different clinical presentation, involving the inferior lip. The first case refers to a patient presenting a single submucosal indurated purplish and asymptomatic nodule in the lower labial mucosa. And the second, to a patient presenting an asymptomatic increase in the lower lip associated with a swelling and purplish oral mucosa. Histological examination showed dilated vessels with rounded endothelial cells proliferation associated with papillary structures of connective tissue projected to vascular lumen, associated with an organized thrombus in first case and a hemangioma in the second. The absence of inflammatory cells, cytologic atypia and necrosis excluded other vascular lesions, being the final diagnosis of IPEH. The prognosis of IPEH is excellent since recurrences are rarely reported. Isolated purplish and indurated labial lesions can include the IPEH as a possible clinical hypothesis. And, since is histologically characterized by a proliferation of endothelial cells, is crucial the establishment of the histological differential diagnosis with angiosarcoma, which requires a more aggressive treatment and has worse prognosis... (AU)

Freshwater and salt-water influence in human identification by analysis of DNA: an epidemiologic and laboratory study

Aim: To investigate the casuistry of drowning cases by reviewing the records from the Forensic Medicine Institute Nina Rodrigues in the city of Salvador, BA, Brazil, and to verify the potential of DNA recovery in human teeth immersed in water. Methods: An epidemiological survey was conducted followed by a laboratorial phase, in which 40 teeth were immersed in fresh and salt-water, the DNA was extracted by the organic method and amplified by polymerase chain reaction, using the amelogenin as initiator. The electrophoresis initially occurred in agarose gel and later in polyacrylamide gel. Results: In the present survey, 346 deaths from drowning were observed, most of them in salt-water (51.73%), with a predominance of male victims (86.13%) aged from 18 to 35 years-old (37.94%). Dentists identified 14.74% of the victims. DNA was recovered in 37.5% from the samples, most from teeth immersed in freshwater. Polyacrylamide gel analysis in samples that were amplified in agarose gel allowed correct gender identification in 83.3% of the cases. However, allele loss was observed in samples of two victims, jeopardizing gender determination. Conclusions: Dental exposure to water interfered in DNA recovery. The gender investigation using the amelogenin as initiator was effective.