[Cytomegalovirus encephalitis in an immunocompetent patient: clinical, neuropathological and ultrastructural analysis]. / Encefalitis a citomegalovirus en un paciente inmunocompetente: análisis clinico, neuropatologico y ultraestructural.

Cytomegalovirus encephalitis is rarely diagnosed in immunocompetent patients. It is more frequent among immunocompromised hosts. We present a case of a young male patient without evidence of immunosupression who had a cytomegalovirus encephalitis. The diagnosis was made by detection of viral DNA in cerebral tissue obtained by biopsy. Neuropathologic and ultrastructural changes are described and compared with the descriptions in immunocompromised patients.

Adrenergic innervation in reactive human lymph nodes.

Several experimental models have demonstrated that the central nervous system is functionally linked to the immune system by means of the autonomic nervous system. Samples of 36 lymph nodes of patients whose ages ranged from 16 to 69 y were studied. In order to demonstrate the existence and distribution of sympathetic nerve fibres, a polyclonal antibody antityrosine hydroxylase (TH), with the streptavidin-biotin system of detection, was used. TH-positive nerve fibres appeared in all reactive patterns of the lymph nodes studied. Thin nerve fascicles ramified at the hilar region and also in the connective tissue septae. Adventitial adrenergic nerve fibres were found following afferent, and to a lesser extent, efferent blood vessels. Another source of incoming nerve fibres was found at capsular level, accompanying blood vessels. On the arterial side, the innervation ceased before reaching the follicular arterioles. Our demonstration of innervation in postcapillary venules could support a regulatory role of adrenergic neurotransmitters in lymphocyte traffic. Occasional nerve fibres were also seen in T areas among parenchymatous cells. These findings confirm the existence of sympathetic innervation in human lymph nodes, and provide indirect evidence that the psychoneuroimmune axis could also exist in humans.

Localized myofibroblastic proliferation in the neck of a patient with an IgG myeloma.

We describe a myofibroblastic proliferation in the neck and lower part of the face involving skin and muscle of a 68-year-old female patient with an IgG kappa myeloma. Biopsies showed a fusocellular proliferation with scarce pseudoganglion cells involving the superficial fascia and the cutaneous muscle of the neck. The proliferative cells showed immunohistochemical and ultrastructural features characteristic of myofibrobasts with a proliferating cell nuclear antigen index of 48%; 42% of the cells displayed HLADR-positive membrane staining. Cellular proliferation subsided following the use of immunosuppressive drugs. Eight months after initial consultation, the patient developed polymyositis without a proliferative component and died of aplastic anemia.

[Quantitative evaluation of juxtatrabecular fibrosis in myelodysplastic syndromes]. / Valoración cuantitativa de la fibrosis yuxtatrabecular en los síndromes mielodisplásicos.

PURPOSE: Myelofibrosis is a common, poor-prognosis feature of myelodysplastic syndromes (MDS). The aim of this work was to evaluate quantitatively the extent of the juxtatrabecular fibrosis in primary MDS and in secondary myelodysplasias, along with the presence of immature precursor cells in anomalous position, that is, the displacement of granulopoiesis from the paratrabecular area to central positions. PATIENTS AND METHODS: Twenty-seven bone marrow samples were examined: 9 from primary MDS, 9 from secondary myelodysplasias, and 9 normal. The percentage of myeloblasts and promyelocytes with nucleoli located in the central areas was estimated, in an attempt to correlate such feature with the degree of juxtatrabecular fibrosis. The analysis of data was performed with the Kruskal-Wallis test, values of p < 0.01 being significant. RESULTS: Sectorial juxtatrabecular fibrosis was present in all the myelodysplastic samples, ranging from 6% to 55% of the trabecular surface; the highest values found in the controls were about 3.6% (p < 0.01). Although the juxtatrabecular fibrosis figures are higher in secondary MDS, the difference is not significant with regard to the primary MDS in the number of patients studied here. The count of myeloblasts and promyelocytes with nucleoli present in the MDS was significantly greater than that of the control group. The number of promyelocytes with nucleoli was significantly higher in the primary MDS with respect to the secondary ones, whereas no significant difference was seen between the two types of MDS regarding the myeloblast count. CONCLUSIONS: The increased number of central immature precursor cells in MDS was not directly correlated with the extent of the juxtatrabecular fibrosis. Although the number of cases is small, the fact that the juxtatrabecular fibrosis was higher in the two deceased patients in the series (49% and 56%, respectively) suggests a poor-risk prognosis for such finding.

[Primary small cell carcinoma of the esophagus]. / Carcinoma de células pequeñas primitivo de esófago.

Primary small cell carcinoma of the esophagus, morologically indistinguishable from its counterpart of the lung is a rare tumour with a frequency between 0.05 to 7.6% of all esophageal malignancies. Currently they are divided into oat cell and non oat cell, regarding the presence of neuroendocrine granules. We report 3 cases from our hospital. They were studied clinicopathologically and also examined by electron microscopy.

Carcinoma de células pequeñas primitivo de esófago. / [Primary small cell carcinoma of the esophagus]

Primary small cell carcinoma of the esophagus, morologically indistinguishable from its counterpart of the lung is a rare tumour with a frequency between 0.05 to 7.6

of all esophageal malignancies. Currently they are divided into oat cell and non oat cell, regarding the presence of neuroendocrine granules. We report 3 cases from our hospital. They were studied clinicopathologically and also examined by electron microscopy.

Plasma membrane regionalization and compaction of mouse cleaving embryos: effect of microtubule and microfilament inhibitors.

Two-cell embryos were incubated during 44 h in media containing either microtubule or microfilament inhibitors. The lowest doses that inhibit cleavage were found to be 0.5 micrograms/ml for colchicine and colcemid, 5 micrograms/ml for cytochalasin B and 0.5 micrograms/ml for cytochalasin D. After incubation with the minimal doses of these drugs, embryos were either fixed immediately or transferred to fresh media without drugs and cultured for different times before fixation. Then, embryos were processed for scanning electron microscopy. Following incubation with microtubule inhibitors, less than 10% of the embryos were compacted and about 20% became so in fresh medium. Regionalization was revealed by the cytochemical demonstration of alkaline phosphatase or 5'-nucleotidase on the apposing surfaces of blastomeres in 50% of the embryos, including all those that were compacted. By scanning microscopy microvilli were seen evenly distributed on the embryo surface, as they are observed in normal 2-cell embryos. Following incubation with microfilament inhibitors, few embryos were compacted and about 90% compacted within 4 h in fresh medium. Alkaline phosphatase activity was detected between blastomeres in all compacted embryos and in one half of those still uncompacted. Scanning microscopy showed patches of microvilli on the outer surface which had become otherwise smooth. During incubation in fresh medium, microvilli concentrated in two large patches placed at the antipodes of the embryo. From these results we conclude that cytokineses is not required for cell membrane regionalization, that blastomeres regionalize before they compact, that microtubule and microfilament inhibitors affect differently the array of microvilli on the external surface of arrested embryos.