ABSTRACT
In the disseminated form of histoplasmosis, isolation and further identification of Histoplasma capsulatum can be performed by several methods, namely, bone marrow aspiration, blood culture, and liver biopsy. Lymph node disease usually is diagnosed by excisional biopsy. Although fungal stains can identify this fungus, detection of specific antigens by immunohistochemistry shows a higher specificity and sensitivity. This approach can use the cell block method when the material is not sent to fungal cultures or fresh staining.
Subject(s)
Biopsy, Fine-Needle , Histoplasmosis/diagnosis , Lymphadenitis/microbiology , Antigens, Fungal/analysis , Histoplasma/immunology , Histoplasmosis/microbiology , Histoplasmosis/pathology , Humans , Immunoenzyme Techniques , Male , Middle Aged , NeckABSTRACT
El aislamiento y la posterior identificación de Histoplasma capsulatum en lahistoplasmosis diseminada puede llevarse a cabo por diversos métodos,como la aspiración de médula ósea, el hemocultivo o la biopsia de hígado.La linfadenopatía es habitualmente diagnosticada por extirpación del ganglioafectado. Aunque la tinción del hongo puede llevar a su identificación,la detección de antígenos específicos mediante procedimientos deinmunohistoquímica muestra una mayor sensibilidad y especificidad.Este método permite la fijación de las células cuando el material no va a serprocesado para cultivo micológico o tinción en fresco(AU)
In the disseminated form of histoplasmosis, isolation and further identificationof Histoplasma capsulatum can be performed by several methods, namely,bone marrow aspiration, blood culture, and liver biopsy. Lymph node diseaseusually is diagnosed by excisional biopsy. Although fungal stains can identifythis fungus, detection of specific antigens by immunohistochemistry shows ahigher specificity and sensitivity. This approach can use the cell block methodwhen the material is not sent to fungal cultures or fresh staining(AU)
Subject(s)
Humans , Histoplasma/isolation & purification , Histoplasmosis/microbiology , Lymphatic Diseases/etiology , Immunohistochemistry/methods , Biopsy, Fine-NeedleABSTRACT
BACKGROUND: Because biological behavior in lung tumors with neuroendocrine differentiation is highly dependent on cell death (apoptosis) and angiogenesis, p21(waf1/cip1) and microvessel density have been targeted as potentially useful tumor markers. We sought to validate the importance of p21(waf1/cip1) and microvessel density and study their interrelationship, analyzing clinical factors, subclassifications, and tumor and stromal markers. METHODS: We examined p21(waf1/cip1) and other markers in tissue from 61 patients with surgically excised large cell carcinomas. The amount of tumor staining for p21(waf1/cip1) and microvessel density was evaluated by immunohistochemistry and morphometry. The study outcome was survival time until death from recurrent lung cancer. RESULTS: Multivariate Cox model analysis demonstrated that after surgical excision, histologic subtypes were significantly related to survival time (p = 0.02), but quantitative staining of the tumor for p21(waf1/cip1) and microvessel density added prognostic information and these variables were more strongly prognostic than histologic subtype (p = 0.00). Cut points at the median staining of 3.5% and 3.0% for p21(waf1/cip1) and microvessel density, respectively, divided patients into two groups with distinctive survival times. Patients with p21(waf1/cip1) staining of more than 3.5% and microvessel density staining of more than 3.0% had a median survival time of 14 months. CONCLUSIONS: Tumor staining for p21(waf1/cip1) and microvessel density in resected large cell carcinomas and certain other types of lung tumors was strongly related to survival. Patients with more than 3.0% staining in their tumors were at high risk of death from lung cancer and may be an appropriate target for prospective studies of adjuvant chemotherapy after surgical resection.
