Esophageal GIST: therapeutic implications of an uncommon presentation of a rare tumor.

Gastrointestinal stromal tumors (GISTs) are rarely reported in the esophagus. The authors report a patient with an esophageal GIST, incidentally found after an echocardiogram. CT scan and endoscopic ultrasonography showed the tumor in the dependence of the muscularis propria of the esophageal wall. An Ivor-Lewis esophagectomy was performed. The tumor was well-circumscribed involving the submucosal and the muscular layers of the esophagus, measuring 13.5 x 8.5 x 7.6 cm, without involving the surgical margins. Histologically, the tumor consisted of spindle cells, with low mitotic index (2/50 HPF), that were immunoreactive for KIT (CD117) and CD34, consistent with GIST of high risk of aggressive behavior. No adjuvant therapy was given to the patient, who is alive and without evidence of disease 1 year after surgery. Since esophageal GISTs are rarely reported in the literature and usually have a poor prognosis, the diagnostic differentiation of these tumors from other more common mesenchymal neoplasms is essential, both for therapeutic and prognostic reasons.

[Lymnic snails from the microregion of Belo Horizonte, Minas Gerais, Brazil with an emphasis on parasite disease vectors]. / Moluscos límnicos da microrregião de Belo Horizonte, MG, com ênfase nos vetores de parasitoses.

A malacological survey to detect foci of transmission of schistosomiasis and other parasitic diseases was undertaken into water-courses from 13 municipalities of microregion of Belo Horizonte, MG, Brazil. From 1990 to 1996, 22,066 snails were collected. From those, 378 (1.7%) were found infected by trematodes: Biomphalaria glabrata (7,920), infected by Schistosoma mansoni (1.9%), Echinostomatidae (1.2%), Strigeidae (0.6%), Cercaria minense (0.1%) and Derogenidae (-0.1%); B. straminea (4,093) infected by Strigeidae (0.6%), Echinostomatidae (0.2%), Clinostomatidae (-0.1%) and two unidentified cercariae; B. tenagophila (1,338), infected by Strigeidae (0.1%) and Physa marmorata (1,776) by Echinostomatidae (1.6%). The snails Biomphalaria peregrina, B. occidentalis, B. schrammi, Drepanotrema depressissimum, D. lucidum, D. cimex, Physa cubensis, Lymnaea columella, Melania tuberculata, Idiopyrgus souleyetianus, Pomacea sp, Anodontites sp and Ancylidae were found noninfected. Snails from 9 municipalities were infected by S. mansoni and from 11 by other trematodes.

Moluscos límnicos da microrregião de Belo Horizonte, MG, com ênfase nos vetores de parasitoses / Lymnic snails from the microregion of Belo Horizonte, Minas Gerais, Brazil with an emphasis on parasite disease vectors

A malacological survey to detect foci of transmission of schistosomiasis and other parasitic diseases was undertaken into water-courses from 13 municipalities of microregion of Belo Horizonte, MG, Brazil. From 1990 to 1996, 22,066 snails were collected. From those, 378 (1.7%) were found infected by trematodes: Biomphalaria glabrata (7,920), infected by Schistosoma mansoni (1.9%), Echinostomatidae (1.2%), Strigeidae (0.6%), Cercaria minense (0.1%) and Derogenidae (-0.1%); B. straminea (4,093) infected by Strigeidae (0.6%), Echinostomatidae (0.2%), Clinostomatidae (-0.1%) and two unidentified cercariae; B. tenagophila (1,338), infected by Strigeidae (0.1%) and Physa marmorata (1,776) by Echinostomatidae (1.6%). The snails Biomphalaria peregrina, B. occidentalis, B. schrammi, Drepanotrema depressissimum, D. lucidum, D. cimex, Physa cubensis, Lymnaea columella, Melania tuberculata, Idiopyrgus souleyetianus, Pomacea sp, Anodontites sp and Ancylidae were found noninfected. Snails from 9 municipalities were infected by S. mansoni and from 11 by other trematodes.

Um levantamento malacológico em coleções hídricas de 13 municípios da microrregião de Belo Horizonte, MG, Brasil, foi efetuado para detectar focos de transmissão de esquistossomose e outras parasitoses. De 1990 a 1996 foram coletados 22.066 moluscos dos quais 378 (1,7%) estavam infectados com trematódeos: Biomphalaria glabrata (7.920), com Schistosoma mansoni (1,9%), com Echinostomatidae (1,2%), com Strigeidae (0,6%), com Cercaria minense (0,1%) e Derogenidae (-0,1%); B. straminea (4.093), com Strigeidae (0,6%), com Echinostomatidae (0,2%), com Clinostomatidae (-0,1%) e duas cercárias desconhecidas; B. tenagophila (1.338), com Strigeidae (0,1%); Physa marmorata (1.776), com Echinostomatidae (1,6%). Os moluscos Biomphalaria peregrina, B. occidentalis, B. schrammi, Drepanotrema depressissimum, D. lucidum, D. cimex, Physa cubensis, Lymnaea columella, Melania tuberculata, Idiopyrgus souleyetianus, Pomacea sp, Anodontites sp e Ancylidae não estavam infectados. Moluscos de 9 municípios estavam infectados com S. mansoni e de 11 com outros trematódeos.

Schistosoma mansoni: the sex ratios of worms in animals infected with cercariae from three species of Biomphalaria.

The ratios of male to female worms of Schistosoma mansoni were determined in mice infected with cercariae from LE, SJ and AL strains shed by mollusc hosts of the parasite in Brazil. The sex ratios of worms in the animals were similar with cercariae from Biomphalaria glabrata and B. tenagophila varying from 1.1:1 to 1.6:1 with LE and AL strains and 1:1.1 with SJ. In the animals infected with cercariae from B. straminea the ratio of male to female worms was similar to those obtained using cercariae shed from the other two species of molluscs, 1.5:1 with LE strain. Inoculations by AL and SJ cercariae resulted in sex ratios of 3.1:1 and 6:1 respectively. The normal sex ratios of worms established in Brazil in animals inoculated with cercariae from B. glabrata and B. tenagophila is from 1:1 to 2:1. The higher number of male worms that developed from cercariae of the AL and SJ strains obtained from B. straminea indicate a lower compatibility of the snail concerning these strains of S. mansoni.

Influence of temperature on development of Schistosoma mansoni female cercariae in Biomphalaria glabrata.

In these experiments the ratio of male to female S. mansoni larvae in B. glabrata from Belo Horizonte and Ribeirão das Neves Minas Gerais, Brazil, either reared in laboratory or collected in the field, varied from 1:1 to 1:1.3 or 1.4:1. Cercariae of LE strain of Schistosoma mansoni, shed by 39 snails maintained at 25 +/- 0.5 degrees C were used to infect mice on a weekly basis. Subsequent perfusion resulted in 76.6% male and 23.4% female worms. The cercariae produced by 32 infected snails maintained at 27 +/- 0.5 degrees C were inoculated into mice and produced 43.4% male and 56.6% female worms (p < 0.05). Cercariae eliminated by snails collected in Barreiro and Ressaca, Belo Horizonte, during hot months, produced 45.7 to 47.7% male and 52.3 to 54.3% female worms. A lower number of cercariae shed by snails collected in Gorduras, Belo Horizonte, at 20 +/- 3.0 degrees C, produced 51.6% male and 48.4% female worms. Thus, in this region the infection of vertebrate hosts with S. mansoni cercariae would be more severe in the summer due to the higher level of parasites and the number of eggs.