Evaluation of density of Langerhans cells in human cervical intraepithelial neoplasia.

OBJECTIVE: To compare the number of Langerhans cells in areas of CIN 3 and in areas without histopathological alteration adjacent to CIN 3 with those found in histologically normal control cases. MATERIAL AND METHODS: Specimens were obtained from 46 normal cervixes from women undergoing hysterectomies due to uterine leiomyomata and 71 from conization specimens for CIN 3. The identification of the Langerhans cells was performed by immunohistochemical analysis, using antibodies to S-100 protein. The number of intraepithelial Langerhans cells was counted at a 400x magnification under light microscope and a 10 field count was performed in areas of epithelium of the normal cervix (group A), areas of CIN 3 in the conization specimens (group B), and areas of epithelium without histopathologic alteration adjacent to CIN 3 (group C). Results were expressed as number of cells per square millimeter of epithelium. RESULTS: Comparing groups A and B, we observed that the number of Langerhans cells was significantly higher in the latter group; between groups A and C, the number of cells was significantly lower in the second group. The number of Langerhans cells was also compared between groups B and C and it was significantly lower in the latter, independent of smoking habits. CONCLUSIONS: We theorize that the increase in the population of Langerhans cells in areas of CIN 3 could be explained by migration of these cells from adjacent areas without histopathologic alterations in order to act in the restraint of the development of neoplasia; cigarette smoking did not influence this migration.

Primary hypothyroidism presenting as ovarian tumor and precocious puberty in a prepubertal girl.

We report a case of a prepubertal girl with juvenile primary hypothyroidism presenting as ovarian cysts and precocious puberty. The 7-year-old female was referred to our clinic because of a pelvic/abdominal mass and vaginal bleeding. Besides these findings, on physical examination we noticed the thyroid gland globally increased and the presence of secondary sexual characteristics. Based upon the clinical profile and investigations, the patient was diagnosed with juvenile primary hypothyroidism due to autoimmune thyroiditis. The cysts and precocious puberty resolved spontaneously after the simple replacement of thyroid hormone. It is important to bear in mind hypothyroidism in cases of girls presenting ovarian cysts and precocious puberty in order to avoid unnecessary surgery on the ovaries.