Ultrastructural study of the neovagina following the utilization of human amniotic membrane for treatment of congenital absence of the vagina

We present an ultrastructural study of the utilization of human amniotic membrane in the treatment of congenital abscence of the vagina in 10 patients. All patients were surgically treated with application of an amniotic membrane graft using the modifified McIndoe and Bannister technique. Sixty days after surgery, samples of the vaginal neoepithelium were collected for transmission electron microscopy analysis. The ultrastructural findings consisted of a lining of mature squamous epithelium indicating the occurrence of metaplasia of the amniotic epithelium into the vaginal epithelium. The cells were arranged in layers as in the normal vaginal epithelium, i.e., superficial, intermediate and deep layers. There were desmosomes and cytoplasmic intermediate cytokeratin filaments, as well as some remnant features of the previous amniotic epithelium. These findings suggest that human amniotic membrane is able to complete metaplasia into squamous cells but the mechanism of this cellular transformation is unknown.

Apresentacao incomum do carcinoma indiferenciado da glandula tiroide. / An unusual presentation of unspecified carcinoma of the thyroid gland

O carcinoma indiferenciado da tiroide e raro e geralmente ocorre em pacientes na 7a. e 8a. decada da vida. Ha uma discreta predilecao pelo sexo feminino. O sintoma clinico mais frequente e um aumento de volume da glandula tiroide. Manifestacoes clinicas relacionadas com a invasao dos tecidos adjacentes e metastases a distancia sao frequentes. Foi relatado um caso de uma paciente de 39 anos de idade que apresentou um quadro clinico de aumento doloroso de lobo direito da tiroide e presenca de calor e rubor da regiao cervical anterior. Febre e leucocitose importante com neutrofilia e desvio nuclear a esquerda acompanhavam o quadro clinico. A puncao da tiroide revelou a presenca de um abscesso asseptico. Com a recidiva dos sintomas no pos-operatorio imediato, realizou-se uma exploracao da tiroide e constatou-se a presenca de um carcinoma indiferenciado da tiroide com invasao dos tecidos subjacentes