ABSTRACT
INTRODUCTION: Frequent histologic changes (90%) in the pancreas suggesting protein-energy malnutrition were found in a previous necropsy study of pancreas morphology in patients with AIDS. However, additional studies were required to clarify subcellular changes. AIM: To ultrastructurally analyze pancreas changes in AIDS patients through transmission electron microscopy. METHODOLOGY AND RESULTS: Pancreas specimens for necropsy were obtained from nine consecutive AIDS patients and four normal controls. A semiquantitative histologic and ultrastructural analysis of exocrine pancreas was carried out with the following findings: preserved pancreas structure with little autolysis, marked decrease in zymogen granules (100%), increased lipofuscin pigment (80%), augmented and dilated rough endoplasmic reticulum (100%), and increased number and size of mitochondria. The Golgi complex could be identified only in two cases. In all cases, acinar nuclei were decreased in size, with peripherally condensed chromatin and undulated membrane suggesting early apoptosis. In addition, immunohistochemical evaluation of the pancreas was carried out to detect opportunistic agents. CONCLUSION: Decreased zymogen granules, acinar atrophy, increased lipofuscin pigment, and rarefying Golgi complex represent the morphologic substrate of protein-energy malnutrition in AIDS patients. The combination of rough endoplasmic reticulum and mitochondria changes could be due to the need for supplying vital plasma proteins rather than exportation protein synthesis associated, or not, with the deleterious effects of inflammatory cytokines and/or therapy for disease.
Subject(s)
Acquired Immunodeficiency Syndrome , Pancreas/ultrastructure , Adult , Autopsy , Female , Humans , Male , Microscopy, Electron , Pancreas/pathologyABSTRACT
The involvement of the gastrointestinal tract in the co-infection of HIV and Leishmania is rarely reported. We report the case of an HIV-infected adult man co-infected with a disseminated form of leishmaniasis involving the liver, lymph nodes, spleen and, as a feature reported for the first time in the English literature, the pancreas. Light microscopy showed amastigote forms of Leishmania in pancreatic macrophages and immunohistochemical staining revealed antigens for Leishmania and also for HIV p24. Microscopic and ultrastructural analysis revealed severe acinar atrophy, decreased zymogen granules in the acinar cytoplasm and also nuclear abnormalities such as pyknosis, hyperchromatism and thickened chromatin. These findings might correspond to the histologic pattern of protein-energy malnutrition in the pancreas as shown in our previous study in pancreas with AIDS and no Leishmania. In this particular case, the protein-energy malnutrition may be due to cirrhosis, or, Leishmania or HIV infection or all mixed. We believe that this case represents the morphologic substratum of the protein energy malnutrition in pancreas induced by the HIV infection. Further studies are needed to elucidate these issues
Subject(s)
Humans , Male , Adult , AIDS-Related Opportunistic Infections/complications , HIV Infections/complications , Leishmaniasis, Visceral/complications , Pancreas/ultrastructure , Protein-Energy Malnutrition/etiology , AIDS-Related Opportunistic Infections/pathology , HIV Infections/pathology , Leishmaniasis, Visceral/pathologyABSTRACT
Os tumores do tronco cerebral säo raros e geralmente tratados sem diagnóstico histopatológico. Sua incidência varia na literatura entre 1,09% e 17,5% dos tumores cerebrais. O objetivo do trabalho foi relatar a casuística desses tumores em 285000 necrópsias realizadas de 1952 a 1985 no Departamento de Anatomia Patológica da Santa Casa de Säo Paulo. Enfatizamos os aspectos neuropatológicos, comparamos nossos casos com os de outras séries e salientamos os tumores mais observados nessa regiäo, com a finalidade de procurar contribuir para melhor abordagem terapêutica. Utilizamos alguns dados clínicos e, através do exame anatompatológico, localizamos o tumor cerebral sendo o diagnóstico microscópico estabelecido segundo os critérios da Organizaçäo Mundial da Saúde. Dos 428 tumores intracranianos observados, 35 estavam localizados no tronco cerebral. Foram aqui incluídos os tumores próprios do tronco cerebral e as metástases e excluídos os tumores que infiltravam o tronco. A maior incidência ocorreu na primeira década e a causa de óbito predominante foi edema cerebral. A localizaçäo preferencial foi a ponte e o tumor mais freqüente foi o glioblastomma multiforme (19 casos. As metástases ficaram em segundo lugar na freqüência (9 casos), na maioria dos casos de origem pulmonar. Apesar de alguns autores se posicionarem contra a biópsia de tumor nessa regiäo, baseando-se no alto risco cirúrgic, discordamos dessa opiniäo, pois acreditamos que, frente ao diagnóstico de glioma, será importante a caracterizaçäo ou näo de malignidade. Ainda, näo devemos deixar de considerar os diagnósticos diferenciais de processo expansivo no tronco. Enfim, com o diagnóstico anatompatológico de glioma ou de uma das possibilidades aventadas, o procedimento terapêutico poderá ser mais adequado
Subject(s)
Child, Preschool , Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Astrocytoma/pathology , Brain Neoplasms/pathology , Brain Stem , Glioblastoma/pathology , Brain Neoplasms/secondaryABSTRACT
Estudos morfológicos de microscopia óptica e eletrônica foram realizados em tumores crescidos em ratos nude atímicos, pós-transplantes de linhagem celular tumoral humana de carcinoma epidermóide de boca (KB), desde a 1ª inoculaçäo realizada, até a 8ª passagem seriada do tumor nesses animais. Os autores descrevem o aumento do volume celular e nuclear, bem como a elevaçäo do número de mitoses e uma maior velocidade de crescimento da massa tumoral, à medida que as passagens seriadas do tumor se sucedem. Também foi observado que, com o progredir dessas passagens, a reaçäo inflamatória por parte do hospedeiro aumenta
Subject(s)
Animals , Rats , Rats, Nude , Neoplasm Transplantation , Neoplasms, Experimental , KB Cells/pathologyABSTRACT
Os autores relatam o comportamento biológico de tumores crescidos em ratos nude, pós-transplante de oito passagens sucessivas de linhagem celular tumoral humana (KB), enfatizando a possibilidade de utilizaçäo desse modelo experimental em estudos biológicos, fisiológicos e terapêuticos dos tumores assim gerados
