Lymphomas affecting the submandibular glands.

BACKGROUND: Lymphomas affecting the submandibular glands are very uncommon and few reports are currently available in the literature. Therefore, the aim of the current study is to describe the clinical and microscopic features of an original series of lymphomas affecting the submandibular glands. MATERIAL AND METHODS: The pathology files of two institutions were searched for lymphoma cases affecting the submandibular glands. The original hematoxylin and eosin, and immunohistochemical slides were revised by a pathologist for diagnosis confirmation following the revised 4th edition of the World Health Organization classification of tumours of haematopoietic and lymphoid tissues. Clinical data regarding age, sex, clinical manifestation, treatment, follow-up and status at last appointment were retrieved from the patients' medical charts. RESULTS: During the period investigated, 16 cases were included in the study. Females predominated (10:6) with a mean age of 57.8 years-old. Tumors usually presented as asymptomatic swellings. MALT lymphoma represented the most common subtype, followed by diffuse large B cell lymphoma and follicular lymphoma. Three patients died, one of them affected by plasmablastic lymphoma, one by DLBCL and one by MALT lymphoma. CONCLUSIONS: Low-grade B cell lymphomas predominate in the submandibular glands, but DLBCL and other subtypes may also be rarely diagnosed in this salivary gland.

Immunoexpression of REGγ and apoptosis-related proteins in oral tongue squamous cell carcinoma.

The aim of this study was to investigate the immunohistochemical expression of REGγ, p53, MDM-2, Bcl-2, and Bax in oral tongue squamous cell carcinoma (OTSCC), and to correlate the findings with clinicopathological parameters. Fifty-eight OTSCC cases were selected for the study. The percentages of nuclear (REGγ, p53, and MDM-2) and cytoplasmic (Bcl-2 and Bax) staining in epithelial cells were determined and correlated with clinicopathological parameters (regional lymph node metastasis, clinical stage, clinical outcome, and histopathological grade of malignancy). Expression of REGγ was observed in all cases studied. Significantly lower percentages were observed in tumours with lymph node metastasis (P = 0.036) and in high-grade tumours (P = 0.013). No significant differences in p53, MDM-2, or Bax expression were observed according to the clinicopathological parameters. Lower percentages of Bcl-2 staining were found in high-grade OTSCC (P = 0.040) and in cases of disease-related death (P = 0.032). The expression of REGγ showed a weak positive correlation with the expression of MDM-2 (P = 0.001) and Bcl-2 (P = 0.014). The results of this study suggest that lower expression of REGγ may contribute to the progression of OTSCC. The role of REGγ in the development of OTSCC does not appear to be primarily related to the modulation of apoptosis in neoplastic cells.

Prognostic and diagnostic implications of MMP-2, MMP-9, and VEGF-α expressions in colorectal cancer.

PURPOSE: Angiogenesis and tumor invasion are complex processes that are mediated by various proteins, such as vascular endothelial growth factor (VEGF-α) and the matrix-degrading enzymes metalloproteinase-2 and -9 (MMP-2, MMP-9). The aim of this study was to determine what roles MMP-2, MMP-9, and VEGF-α play in colorectal cancer (CRC) by correlating their expression levels with the cancer TNM stage, modified Dukes criteria, degree of cell differentiation, and long-term patient survival. METHODS: The present series consisted of tissue samples obtained from 180 patients who had undergone large bowel resection during 1995 and 2005 at the Luis Antonio Hospital. Archival paraffin-embedded CRC tissue samples were used to generate tissue microarray blocks, which were immunohistochemically stained for MMP-2, MMP-9, and VEGF-α. Three different grading systems were applied to evaluate staining intensity. Chi-squared Person test and Kaplan-Meier survival curves were used, and values of p<0.05 were considered statistically significant. RESULTS: MMP-2 expression showed a significant association with more invasive cancer stages (p<0.001) and death (p<0.041). VEGF-α expression correlated with a high TNM stage (p<0.009), the degree of cell differentiation (p<0.025) and patient death as a result of disease (p<0.035). The Kaplan-Meier survival estimated that patients with strong staining for MMP-2 (log-rank x(2)=34.09; p<0.0001), MMP-9 (log-rank x(2)=12.83; p<0.0003) and VEGF (log-rank x(2)=33.9; p<0.0001) showed a greater tendency towards death during 60 months of follow up. CONCLUSIONS: The quantification of VEGF-α, MMP-2 and MMP-9 expression in colorectal cancer may be related to survival. These data add to the growing epidemiological and experimental evidence that VEGF-α, MMP-2 and MMP-9 may play a role in colorectal tumorigenesis.

Squamous and/or glandular differentiation in urothelial carcinoma: prevalence and significance in transurethral resections of the bladder.

BACKGROUND: It is controversial if urothelial carcinoma of the bladder with squamous and/or glandular differentiation is a more aggressive neoplasm than conventional urothelial carcinoma. DESIGN: A total of 165 transurethral resections of the bladder were reviewed. A group with squamous and/or glandular differentiation was compared to a group without this finding. The chi-square test was used to assess the association of the groups with stage (TNM, 1997). RESULTS: Of the total of 165 transurethral resections of the bladder, 153 (92.72%) were conventional urothelial carcinomas and 12 (7.27%) showed squamous and/or glandular differentiation. The distribution according to stage was 84 (54.9%), 35 (22.9%) and 34 (22.2%) for the group without differentiation and 0 (0%), 3 (25%) and 9 (75%) for the group with squamous and/or glandular differentiation, respectively for stages pTa, pT1 and pT2. Tumors with squamous and/or glandular differentiation showed a significant statistical correlation to higher stage at clinical presentation (p < 0.0001). There was no significant statistical relation according to age (p = 0.8433), sex (p = 0.5672) or race (p = 0.3137). CONCLUSIONS: The results suggest that urothelial bladder carcinomas with squamous and/or glandular differentiation are more aggressive neoplasms. There was a significant statistical correlation between tumors with this differentiation and higher stage at clinical presentation.

Dengue epidemic in the State of Rio Grande do Norte, Brazil, in 1997.

During 1997 a large dengue epidemic occurred in Rio Grande do Norte, a State in north-east Brazil. The co-circulation of dengue virus type 1 and dengue virus type 2 was demonstrated by virus isolation in Aedes albopictus clone C6/36 cell-line and by reverse transcriptase-polymerase chain reaction (RT-PCR). IgM capture enzyme-linked immunosorbent assay confirmed 52.3% of the 8105 studied cases and dengue antigen was demonstrated by immunohistochemical reaction on hepatocytes from 2 out of 5 fatal cases studied. Individual risk factors for development of dengue haemorrhagic fever/dengue shock syndrome, such as hypertension, diabetes mellitus and bronchial asthma, are discussed.

A simple method for detecting subcutaneous phaeohyphomycosis with light-colored fungi. A study of eight cases.

Eight cases of subcutaneous phaeohyphomycosis are presented. A lack or scarcity of fungal pigmentation was seen in six of these cases. The simple act of lowering the microscope condenser makes these uncolored fungi easily visible. The thick hyaline capsule becomes refringent, presenting single oval or round cells and septated hyphae, which can be short or elongated, branched or unbranched, and irregularly swollen. The dematiacious character of the fungi is confirmed by using the Fontana-Masson stain. The fungi are not visible under polarized light. Our studies point to the probability of subcutaneous phaeohyphomycosis being a widespread tropical disease in Brazil. However, it is rarely diagnosed because of the common practice of fixing tissue specimens without prior culturing and the difficulties of detecting the fungal forms using customary microscopic procedures, especially when the fungi have a lack of pigment and are hard to detect by hematoxylin and eosin stain.

[Fatal visceral leishmaniasis associated with acquired immunodeficiency syndrome: report of a case with necropsy findings and immunohistochemical study]. / Leishmaniose visceral fatal associada à síndrome de imunodeficiência adquirida: relato de caso com achados necroscópicos e estudo imuno-histoquímico.

A case of fatal visceral leishmaniasis associated with immunodeficiency syndrome in a 32 year-old male patient is reported. The protozoonosis was responsible for the patient's death. Visceral leishmaniasis showed itself in an atypical form, at necropsy, with an intense parasitation of the mononuclear phagocitic system and damaging organs not usually affected by the disease, such as the adrenals, the kidneys, the lungs and the brain. Parasitised cells were observed within small vessels in several tissues. An immunohistochemical study was done on samples from the spleen, lymph nodes and brain, showing strong reactivity with antibody directed against leishmania.

Tuberculose de osso temporal: estado atual e apresentaçäo de 2 casos / Temporal bone tuberculosis: current status and serie report of 2 cases

Säo apresentados dois casos de otite tuberculosa em criança com cerca de um ano de idade, que foram diagnosticados no ano de 1986 na clínica otorrinolaringológica do nosso hospital. É feita uma revisäo bibliográfica dos principais aspectos desta doença: o contato inicial com o bacilo de Koch costuma ocorrer na infância, tendo os pulmöes como porta de entrada por onde a infecçäo pode se disseminar para qualquer órgäo do corpo. Recentemente tem se tornado mais comum a descriçäo na literatura de casos de tuberculose. primária do ouvido. Acreditamos que a incidência de otite tuberculosa em nosso meio seja muito superior a 0,1% das otites médias crônicas, como relatado por Maitre. Assim, a pesquisa de tuberculose. deveria ser rotineira em crianças com otites médias crônicas resistentes aos tratamentos habituais. Os achados clínicos mais importantes säo: - presença de tecido de granulaçäo abundante - hipoacusia intensa - paralisia facial - linfadenite regional - história familiar de tuberculose. A comprovaçäo diagnóstica normalmente é muito difícil e o exame anatomopatológico é fundamental. Com o tratamento quimioterápico e, se necessário, também cirúrgico, conseguimos bom resultado quanto à erradicaçäo da infecçäo. Para um bom resultado funcional é fundamantal o diagnóstico precoce

Noncongenital dominant universal alopecia in a family.

An apparently hitherto undescribed noncongenital universal alopecia, due to an autosomal dominant gene with variable expressivity, is described.

Pseudotumorous form of ascariasis. Report of a case.

Pathologic study of an abdominal mass removed from a 16-month-old girl revealed a marked granulomatous and fibroblastic reaction surrounding eggs and adults of Ascaris lumbricoides. As often occurs in such cases, there was an increased eosinophilia in the lesion and in the peripheral leukocytes. Both the clinical and gross aspects of the lesion simulated a benign neoplasm; this similarity justifies the designation "pseudotumorous form of ascariasis".