ABSTRACT
In patients with Chronic Rheumatic Carditis, active carditis is an often underdiagnosed condition. Rheumatic attacks promote the aggravation of existing lesions, leading to a deterioration of the patient's clinical condition. Thus, reducing the morbidity and mortality of the disease depends, in part, on controlling relapses through secondary prophylaxis. Underdiagnosis is due in part to the occurrence of subclinical rheumatic attacks. This study was carried out with data from patients who were diagnosed with Chronic Rheumatic Carditis and who underwent cardiac surgery for valve replacement or repair, without clinical or laboratory evidence of rheumatic outbreak. A fragment of myocardium was sent for histopathological analysis. Data on the frequency of histopathological alterations compatible with a rheumatic outbreak were analyzed. After analysis, 80% of patients showed changes compatible with inflammatory activity. Of these, 87.5% had lymphocytic infiltrate; 25% had Aschoff's nodules. The most frequent histopathological findings of chronic disease were myocardial hypertrophy in 56.7% of patients and fibrosis in 53.3% (AU).
Nos pacientes com Cardite Reumática Crônica, a cardite em atividade é uma condição frequentemente subdiagnos-ticada. Os surtos reumáticos promovem o agravamento das lesões já existentes, levando a uma deterioração da condição clínica do paciente. Dessa forma a redução da morbimortalidade da doença depende, em parte, do contro-le de recidivas a partir da profilaxia secundária. O subdiagnóstico deve-se em parte a ocorrência de surtos reumáti-cos subclínicos. Este estudo foi realizado com dados dos pacientes que tiveram o diagnóstico de Cardite Reumática Crônica e foram submetidos à cirurgia cardíaca para troca ou plastia valvar, sem evidência clínica ou laboratorial de surto reumático. Um fragmento de miocárdio foi enviado para análise histopatológica. Foram analisados os dados de frequência de alterações histopatológicas compatíveis com surto reumático. Após análises, 80% dos pacientes apresentaram alterações compatíveis com atividade inflamatória. Desses, 87,5% apresentavam infiltrado linfocitá-rio; 25% apresentavam nódulos de Aschoff. Os achados histopatológicos de doença crônica mais frequentes foram hipertrofia miocárdica em 56,7% pacientes e fibrose em 53,3% (AU).
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Rheumatic Fever , MyocarditisABSTRACT
CD10 is a cell surface peptidase expressed in a wide variety of normal and neoplastic tissues, including breast myoepithelial cells. In salivary glands, expression of CD10 has only been used to identify neoplastic myoepithelial cells of pleomorphic adenomas and myoepithelial carcinomas. However, its accuracy in other salivary tumors with myoepithelial component has yet to be analyzed. We examined 72 salivary tumors with myoepithelial differentiation using immunohistochemical technique to detect CD10. In salivary glands, CD10 expression was not detected in myoepithelial cells. Only fibrocytes within the intralobular stroma were CD10 positive. In neoplastic myoepithelial cells, CD10 expression was found in 25.71% of benign and 32.43% of malignant neoplasms. When the different groups of tumors were compared, epithelial-myoepithelial carcinomas (EMEC) showed a stark contrast with the others (83.3% of cases with CD10 expression). Surprisingly, adenoid cystic carcinomas and basal cell adenomas were negative in 100% of the cases. Myoepitheliomas, pleomorphic adenomas, and myoepithelial carcinomas were positive in 27.7%, 30.0%, and 40% of the cases, respectively. In conclusion, salivary neoplastic myoepithelial cells gain CD10 expression in relation to their normal counterparts. However, the gain of this protein is not a sensitive marker for detecting myoepithelial cells in the majority of the tumors, except for EMEC. The high expression of CD10 by this carcinoma can be a valuable tool to separate EMEC from the tubular variant of adenoid cystic carcinomas in small incisional biopsies, where the precise diagnosis may be impossible.
Subject(s)
Epithelial Cells/metabolism , Myocytes, Smooth Muscle/metabolism , Myoepithelioma/diagnosis , Neprilysin/metabolism , Salivary Gland Neoplasms/diagnosis , Actins/metabolism , Aged , Biomarkers, Tumor/metabolism , Cell Differentiation , Cell Transformation, Neoplastic , Diagnosis, Differential , Disease Progression , Epithelial Cells/pathology , Female , Humans , Immunohistochemistry , Male , Middle Aged , Myocytes, Smooth Muscle/pathology , Myoepithelioma/enzymology , Myoepithelioma/pathology , Salivary Gland Neoplasms/enzymology , Salivary Gland Neoplasms/pathologyABSTRACT
CD10 e Podoplanina (D2-40), além de expressos nas células mioepiteliais, estão envolvidos na progressão tumoral e podem ser utilizados como marcadores prognósticos. Em 79 neoplasias salivares com diferenciação mioepitelial (44 malignas e 35 benignas), analisamos a expressão dessas proteínas nas células neoplásicas, na reação desmoplásica tumoral e, nos carcinomas adenóides císticos (CAC), verificamos possível correlação com fatores prognósticos. CD10 foi negativo nas células epiteliais em 100 por cento dos casos. Nas mioepiteliais, foi positivo em 25,71 por cento das lesões benignas e em 27,27 por cento das malignas, sendo esses resultados significantemente inferiores àqueles da a-SMA (60 por cento e 88,64 por cento, respectivamente). CD10 foi positivo em 83,33 por cento, 30 por cento, 27,7 por cento e 40 por cento dos carcinomas epiteliais-mioepiteliais (CEME), adenomas pleomórficos, mioepiteliomas e carcinomas mioepiteliais, respectivamente, e negativo em 100 por cento dos CAC, adenocarcinomas polimórficos de baixo grau (APBG) e adenomas de células basais. No estroma tumoral, a expressão do CD10 (38,64 por cento) foi significantemente...
CD10 and Podoplanin (D2-40) are expressed in myoepithelial cells and, in addition, are involved in tumoral progression and can be utilized as prognostic markers. In a series of 79 salivary neoplasias with myoepithelial differentiation (44 malignant and 35 benign), the expression of these proteins was analyzed in tumor cells as well as in tumor-associated stromal cells and it was correlated with prognostic factors in a select group of lesions (adenoid cystic carcinomas). In epithelial cells, CD10 was negative in 100 per cent of the cases. In myoepithelial cells, CD10 was positive in 25.71 per cent of the benign neoplasias and in 27.27 per cent of the malignant ones and this expressions was significantly lower in comparison to that of a-smooth muscle actin (a-SMA) (60 per cent and 88.64 per cent, respectively). In neoplasias classified according to histological subtype, CD10 was positive in 83.33 per cent, 30 per cent, 27.27 per cent and 40 per cent of epithelial-myoepithelial carcinomas (EMC), pleomorphic adenomas, myoepitheliomas and myoepithelial carcinomas, respectively...
