Immunoexpression of cleaved caspase-3 shows lower apoptotic area indices in lip carcinomas than in intraoral cancer.

OBJECTIVE: This study aimed to evaluate apoptosis by assessing cleaved caspase-3 immunoexpression in hyperplastic, potentially malignant disorder (PMD), and malignant tumors in intraoral and lower lip sites. MATERIAL AND METHODS: A retrospective study using paraffin blocks with tissues from patients with inflammatory fibrous hyperplasia (IFH), actinic cheilitis, oral leukoplakia, lower lip and intraoral squamous cell carcinoma (SCC) was performed. The tissues were evaluated by immunohistochemical analysis with anti-cleaved caspase-3 antibody. Apoptotic area index was then correlated with lesion type. RESULTS: From 120 lesions assessed, 55 (46%) were cleaved caspase-3-positive. The SCC samples (n=40) had the highest apoptotic area indices (n=35; 87.5%). Significant differences were detected between SCCs and PMDs (p=0.0003), as well as SCCs and IFHs (p=0.001), regarding caspase-3 immunopositivity. Carcinomas of the lower lip had lower apoptotic area indices than intraoral cancer (p=0.0015). CONCLUSIONS: Cleaved caspase-3 immunoexpression showed differences in oral SCCs and PMDs and demonstrated a distinct role of apoptosis in carcinogenesis of intraoral and lower lip cancer. In future, the expression of cleaved caspase-3 with other target molecules in oral cancer may be helpful in delineating the prognosis and treatment of these tumors.

Immunoexpression of cleaved caspase-3 shows lower apoptotic area indices in lip carcinomas than in intraoral cancer

ABSTRACT Objective This study aimed to evaluate apoptosis by assessing cleaved caspase-3 immunoexpression in hyperplastic, potentially malignant disorder (PMD), and malignant tumors in intraoral and lower lip sites. Material and Methods A retrospective study using paraffin blocks with tissues from patients with inflammatory fibrous hyperplasia (IFH), actinic cheilitis, oral leukoplakia, lower lip and intraoral squamous cell carcinoma (SCC) was performed. The tissues were evaluated by immunohistochemical analysis with anti-cleaved caspase-3 antibody. Apoptotic area index was then correlated with lesion type. Results From 120 lesions assessed, 55 (46%) were cleaved caspase-3-positive. The SCC samples (n=40) had the highest apoptotic area indices (n=35; 87.5%). Significant differences were detected between SCCs and PMDs (p=0.0003), as well as SCCs and IFHs (p=0.001), regarding caspase-3 immunopositivity. Carcinomas of the lower lip had lower apoptotic area indices than intraoral cancer (p=0.0015). Conclusions Cleaved caspase-3 immunoexpression showed differences in oral SCCs and PMDs and demonstrated a distinct role of apoptosis in carcinogenesis of intraoral and lower lip cancer. In future, the expression of cleaved caspase-3 with other target molecules in oral cancer may be helpful in delineating the prognosis and treatment of these tumors.

Anatomopathological characterization of placentas from HIV+ patients associated with p24 expression / Caracterização anatomopatológica da placenta de pacientes HIV+ associada à expressão do p24

INTRODUCTION: The study of placentas from pregnant human immunodeficiency virus (HIV) positive women has become the subject of numerous studies in the literature. Morphological, viral, immune and inflammatory placental aspects have been analyzed in order to grasp the vertical transmission of the virus. OBJECTIVE: To identify the most frequent findings in the placentas by associating them with a viral antigen and correlating them with the infection of newborns. MATERIAL AND METHODS: Thirty-five placentas from HIV- positive pregnant women were pathologically and immunohistochemically analyzed with the use of p24 antibody in the period from 1992 to1997 in accordance with the routine laboratory testing from the Anatomopathological Department - Hospital Universitário Antônio Pedro - Universidade Federal Fluminense (APD/HUAP/UFF). RESULTS: The microscopic alterations detected in all cases, including those with vertical transmission, were arteriopathy in the fetal blood circulation, chorioamnionitis, perivillous fibrin deposition, syncytial knotting, villous edema and villous immaturity. No specific macroscopic or histopathological changes were found in these placentas. The neonatal infection was observed in five cases. Vertical transmission was identified in two out of five placentas that had low weight for the respective stage of pregnancy. Immunohistochemical analysis revealed 14 positive cases, two of which showed vertical transmission. The viral protein was not identified in 10 out of 14 placentas from patients who had been medicated with zidovudine (AZT). CONCLUSION: Our study has contributed to the anatomopathological investigation into placentas from HIV-positive patients, although p24 expression per se did not allow a definite and early diagnosis of the vertical transmission.

INTRODUÇÃO: A importância do estudo da placenta de gestantes com o vírus da imunodeficiência humana (HIV) soropositivas tornou-se alvo de inúmeros trabalhos na literatura. Aspectos morfológicos, virais, imunes e inflamatórios intrínsecos ao tecido placentário foram analisados para o entendimento da transmissão vertical do vírus. OBJETIVO: Identificar as lesões mais frequentes nas placentas, associando-as ao antígeno viral e correlacionando-as com a infecção dos recém-nascidos. MATERIAL E MÉTODOS: Trinta e cinco placentas de gestantes HIV soropositivas foram analisadas por estudo anatomopatológico e imuno-histoquímico, utilizando o anticorpo p24, no período de 1992 a 1997, segundo a rotina do laboratório do Serviço Anatomia Patológica/Hospital Universitário Antônio Pedro/Universidade Federal Fluminense (SAP/HUAP/UFF). RESULTADOS: As alterações microscópicas registradas em todos os casos, inclusive nos de transmissão vertical, foram arteriopatia no circuito vascular fetal, corionamnionite, depósito fibrinoide perivilositário, excesso de nós sinciciais, edema do estroma viloso e dismaturidade vilosa. Nenhuma alteração microscópica ou macroscópica específica do HIV foi encontrada nas placentas. A infecção neonatal pôde ser constatada em cinco casos. A transmissão vertical foi identificada em duas placentas entre cinco que tinham baixo peso para a idade gestacional. Análise da imuno-histoquímica do p24 mostrou 14 casos positivos, dois dos quais apresentaram transmissão vertical. A proteína viral não foi identificada em 10 das 14 placentas cujas pacientes foram medicadas com zidovudina (AZT). CONCLUSÃO: Nosso estudo contribuiu para o estudo anatomopatológico da placenta de pacientes soropositivas para o HIV, porém a expressão do p24 por si só não permitiu um diagnóstico definitivo e precoce da transmissão vertical.

[Mycosis fungoides in children and adolescents: a report of six cases with predominantly hypopigmentation, along with a literature review]. / Micose fungóide em crianças e adolescentes: Relato de seis casos com predomínio da forma hipocromiante e revisão da literatura.

UNLABELLED: Mycosis fungoides (MF), the most common form of cutaneous T cell lymphoma (CTCL), is mainly manifested in the elderly. However, it has been described in children and teenagers. OBJECTIVES: To report six patients with mycosis fungoides diagnosed in patients under 20 years of age. Our focus is on epidemiologic data, clinical features, histopathological aspects, and immunophenotypical findings. METHODS: The files of all patients diagnosed with CTCL at Hospital Universitário Antônio Pedro (HUAP) / Universidade Federal Fluminense (UFF), Niterói, Brazil, from 2007 to 2010 were searched to identify patients under 20 years of age. Slides were reviewed with routine methods (H&E) and immunohistochemical stains by two dermatopathologists and one surgical pathologist. RESULTS: Among a total of 66 patients with MF, six were children and adolescents between five and nineteen years of age. Most of them had dark skin and presented with the hypopigmented variant of MF; some expressed the T cell CD8+ phenotype, although the prognosis remains the same as for classical CTCL. The main histopathological findings were basilar lymphocytes, Pautrier microabscesses, eccrine infiltration, and dermal fibrosis. One patient had shown pityriasis lichenoides chronica for 10 years before the diagnosis of MF. CONCLUSIONS: The incidence of juvenile mycosis fungoides has increased, corresponding to 9.1 percent of patients diagnosed with MF in our institution in four years. In this sample, 83.3 percent of the patients had the hypopigmented variant and 50 percent of them showed the CD3+/CD8+ T cells phenotype. We emphasize the occurrence of pityriasis lichenoides chronica before the onset of MF in one of our cases. This association, although rare, must be considered in cases of atypical evolution of PLC. The diagnosis of hypopigmented MF should also be considered in patients when hypochromic patches are persistent. We would like to highlight the importance of Pautrier microabscesses, basilar distribution, and eccrine involvement by neoplastic lymphocytes as histopathological diagnostic criteria for this variant of MF.

Evaluation of mast cells in periapical cysts, dentigerous cysts, and keratocystic odontogenic tumors.

BACKGROUND: Several cell types are associated with the development of cystic and tumoral odontogenic lesions. Among inflammatory cells, mast cells can be associated with their pathogenesis. The aim of this study was to analyze mast cells in periapical cysts, dentigerous cysts, and keratocystic odontogenic tumors. METHODS: Tissue sections were submitted to toluidine blue staining and immunohistochemistry with antibody anti-tryptase (clone G3). Mast cells were quantitated using Image-Pro Plus software to obtain the mean number of mast cells in three regions: epithelial, superficial portion of the fibrous wall and deep portion of the fibrous wall from 20 periapical cysts, 20 dentigerous cysts (six non-inflamed and 14 inflamed) and 20 keratocystic odontogenic tumors (four non-inflamed and 16 inflamed). RESULTS: The mean number of mast cells detected per lesion by immunohistochemistry (4.1) was higher than by histochemistry (1.5) (P<0.0001). Inflamed dentigerous cysts and keratocystic odontogenic tumors showed a higher mean number of mast cells than non-inflamed lesions in all regions. The deep region from all cysts showed the highest mean number of degranulated mast cells, except for non-inflamed keratocystic odontogenic tumors analyzed by immunohistochemistry. CONCLUSIONS: Immunohistochemical staining detected higher number of mast cells than histochemistry. The higher number of mast cells observed in inflamed lesions could indicate the participation of these cells in the inflammatory response in odontogenic lesions. The prevalence of degranulated mast cells in the deep region suggests intense activity of these cells, possibly related to growth of cystic lesions.

Investigação da LMP1 do EBV e a coinfeçcão do HPV em lesões genitais de pacientes infectados ou não pelo HIV / Investigation of the LMP1 EBV and co-infection by HPV in genital lesions of patients infected or not by HIV

INTRODUÇÃO: Vários estudos têm demonstrado associação do vírus Epstein-Barr (EBV) com neoplasias malignas, inclusive genitais, em que o papilomavírus humano (HPV) é o principal vírus associado às neoplasias epiteliais benignas e malignas. OBJETIVO: Investigar a presença do EBV e do HPV em lesões genitais de ambos os sexos, em pacientes soropositivos (grupo A) ou não (grupo B) para o vírus da imunodeficiência humana (HIV). MATERIAL E MÉTODO: Selecionados 126 pacientes e 135 lesões anogenitais, sendo 67 pacientes (53 por cento) e 75 lesões (56 por cento) no grupo A e 59 pacientes (47 por cento) e 60 lesões (44 por cento) no grupo B, para análise imuno-histoquímica (IHQ) por meio dos anticorpos monoclonais antiproteína latente de membrana 1 (LMP1) e HPV (DAKO®). RESULTADOS: A análise mostrou que o número total de lesões com imunopositividade para o HPV e para a LMP1 foi maior no grupo A (32 e 35, respectivamente) quando comparado ao B (16 e seis, respectivamente). A análise estatística (nível de significância de 5 por cento) mostrou que as proporções para o HPV não são estatisticamente significativas (z = 1,93; valor p = 0,053). Entretanto, para a LMP1, a diferença (47 por cento no grupo A e 10 por cento no B) é significativa (z = 4,60; valor p = 4,2×10-6). Do mesmo modo, a associação HPV-LMP1 (21 por cento no grupo A e 7 por cento no B) também mostrou diferença estatisticamente significativa (z = 2,38; valor p = 0,017). CONCLUSÃO: Esses resultados indicam a possibilidade de sinergismo da infecção pelo EBV e a coinfecção EBV-HPV em lesões epiteliais genitais, particularmente em pacientes soropositivos para o HIV. Entretanto, investigações com metodologia de maior especificidade e sensibilidade são necessárias para a verificação da real participação do EBV na patogênese de lesões epiteliais genitais.

INTRODUCTION: Several studies have demonstrated the association between Epstein-Barr virus (EBV) and malignant neoplasias, including genital lesions, in which the human papillomavirus (HPV) is the main virus associated with both benign and malignant epithelial neoplasias. OBJECTIVE: Investigate the presence of EBV and HPV in genital lesions in HIV-infected patients (group A) or HIV non-infected patients (group B) from both genders. MATERIAL AND METHOD: We selected 126 patients and 135 anogenital lesions, comprising 67 patients (53 percent) and 75 lesions (56 percent) from group A and 59 patients (47 percent) and 60 lesions (44 percent) from group B, to histopathological and immunohistochemical analyses through latent membrane protein 1 (LMP1) monoclonal antibodies and HPV (DAKO®). RESULTS: The analysis showed that the total number of lesions with immunopositivity for HPV and for LMP1 was higher in group A (32 and 35 respectively) in comparison with B (16 and six respectively). Statistical analysis (significance level of 5 percent) showed that the proportions for HPV are not statistically significant (z = 1.93; value p = 0.053). However, the difference (47 percent in group A and 10 percent in B) is significant for LMP1 (z = 4.60; value p = 4.2×10-6). Similarly, the association of HPV and LMP1 (21 percent in group A and 7 percent in B) also showed a significant statistical difference (z = 2.38; value p = 0.017). CONCLUSION: The results demonstrated the possibility of synergism between EBV infection and EBV-HPV co-infection in genital epithelial lesions, mainly among HIV-infected patients. However, further investigations with a more specific and sensitive methodology are required in order to assess the real influence of EBV on the pathogenesis of genital epithelial lesions.

Análise comparativa da imunoexpressão da proteína p53 (clones DO-7 e PAb-240) em carcinomas de células escamosas intrabucais e labiais / Comparative analysis of p53 protein immunostaining (antibodies DO-7 and PAb-240) in oral cavity and lip squamous cell carcinomas

INTRODUÇÃO: A carcinogênese caracteriza-se como um processo multifatorial, e a inativação da proteína p53 é uma alteração genética comumente observada nos carcinomas de células escamosas de boca (CCEB). OBJETIVO: Analisar e comparar a imunoexpressão da proteína p53, por meio dos clones DO-7 e PAb-240, em CCEB com localização intrabucal e em lábio inferior. MATERIAL E MÉTODOS: Foram selecionados 40 casos de CCEB, sendo 20 de localização intrabucal e 20 em lábio inferior. Foi realizado um estudo imuno-histoquímico utilizando os anticorpos anti-p53 clone DO-7 e PAb-240. A imunoquantificação foi realizada por meio de análise digital de imagem, e os resultados, submetidos a tratamentos estatísticos. RESULTADOS: A imunoexpressão da proteína p53 foi verificada com o anticorpo DO-7 em 13 casos (65 por cento) de carcinoma intrabucal e em 19 (95 por cento) de carcinoma de lábio inferior. Imunorreatividade para o anticorpo PAb-240 foi observada em 9 casos (45 por cento) de lesões intrabucais e em 15 (75 por cento) localizados em lábio inferior. Não foram observadas, segundo o teste de Mann-Whitney, diferenças estatisticamente significativas (p > 0,05) na expressão da proteína p53 entre as duas localizações estudadas, independentemente do anticorpo avaliado. Foram identificadas, pelo teste de Wilcoxon, diferenças estatisticamente significativas entre a expressão dos clones DO-7 e PAb-240 em cada um dos grupos analisados (valor p = 0,013 - lábio inferior; valor p = 0,016 - intrabucal). CONCLUSÕES: A expressão da proteína p53 observada nos CCEB, com localizações intrabucais e labiais, sugere a ocorrência de mutações no gene TP53. As diferenças quantitativas obtidas entre os anticorpos estudados, independentemente da localização das lesões, refletem uma especificidade distinta entre os clones DO-7 e PAb-240. O desenvolvimento de mais estudos será fundamental para estabelecer o anticorpo mais adequado para proteína p53 em CCEB.

BACKGROUND: Carcinogenesis is a multifactorial process and inactivation of p53 protein is a genetic change commonly observed in oral squamous cell carcinomas (OSCC). OBJECTIVES: To analyze and compare the expression of p53 protein through antibodies DO-7 and PAb-240 in OSCC samples located in the oral cavity and lower lip. MATERIAL AND METHODS: Forty cases of OSCC were selected and divided into oral cavity and lower lip groups (20 cases each). Immunohistochemical technique was performed using antibodies DO-7 and PAb-240. Quantification of the cases was performed through digital image analysis and underwent specific statistical treatments. RESULTS: Expression of p53 protein was verified with DO-7 antibody in 13 cases (65 percent) of oral cavity carcinomas and in 19 cases (95 percent) of lower lip carcinoma. PAb-240 positivity was detected in 9 cases (45 percent) of oral cavity lesions and in 15 cases (75 percent) located in the lower lip. According to Mann-Whitney test, there were no statistically significant differences between the expressions of p53 protein in both groups, regardless of the antibody used. According to Wilcoxon test, there were statistically significant differences between the expression of DO-7 antibody and PAb-240 in each of the analyzed groups (p-value = 0.013; lower lip p-value = 0.016 - oral cavity). CONCLUSIONS: The expression of p53 protein was observed both in the oral cavity and lip OSCC, which suggests the occurrence of mutations in TP53 gene. The quantitative differences between the antibodies studied, regardless of the site of the lesions, reflect different specificity between clones DO-7 and PAb-240. Further studies are required to establish the best antibody for p53 protein in oral squamous cell carcinomas.

Expression of Bcl-2 family proteins and associated clinicopathologic factors predict survival outcome in patients with oral squamous cell carcinoma.

The aims of this study were to assess the expression levels of three proteins involved in apoptosis--Bcl-2, Bcl-X, and Bax--and evaluate their relationship with clinicopathologic features and survival in oral squamous cell carcinoma (OSCC). Immunohistochemistry was used to evaluate protein expression in 53 primary OSCCs treated by radical surgery with free margins at a single institution in 1999. Histologic specimens were graded and analyzed for perineural invasion, lymphocytic infiltrate, and pattern of invasion. Digital image analysis was performed to quantify immunostaining. Survival was analyzed using the Kaplan-Meier method and Cox's proportional hazard model. Cancer-specific 5-year survival (CSS) was 61% (56% overall survival (OS), and 51% disease-free interval (DFI)). Kaplan-Meier analysis identified pathologic stage (p=0.0007, log-rank test, OS), negative nodes status (pN) (p<0.0001, log-rank test, OS), presence of lymphocytic infiltrate (p=0.0084, log-rank test, OS), and high Bax expression (p=0.025, log-rank test, OS) to each be associated with both better OS and CSS. Tongue tumors (p=0.0179, log-rank test), worst pattern of invasion (p=0.0293, log-rank test), lack of lymphocytic infiltrate (p=0.0328, log-rank test), perineural invasion (p=0.0448, log-rank test), poorly differentiated tumors (p=0.0318, log-rank test), and low Bcl-X expression (p=0.044, log-rank test) were all associated with a low DFI. Cox regression found pN, lymphocytic infiltrate, and Bax expression to be independent prognostic factors for OS and CSS, whereas lymphocytic response and tongue tumors were predictors of DFI. Bcl-2 expression emerged as an independent marker of favorable CSS. Lymphocytic infiltrate was the most meaningful histopathologic parameter in survival analysis, whereas expression of Bcl-2 family members seems to be an important marker of a favorable prognosis in OSCC.

Identification of growth hormone receptor in plexiform neurofibromas of patients with neurofibromatosis type 1.

OBJECTIVE: The aim of this study was to investigate the presence of growth hormone receptor in plexiform neurofibromas of neurofibromatosis type 1 patients. INTRODUCTION: The development of multiple neurofibromas is one of the major features of neurofibromatosis type 1. Since neurofibromas commonly grow during periods of hormonal change, especially during puberty and pregnancy, it has been suggested that hormones may influence neurofibromatosis type 1 neurofibromas. A recent study showed that the majority of localized neurofibromas from neurofibromatosis type 1 patients have growth hormone receptor. METHODS: Growth hormone receptor expression was investigated in 5 plexiform neurofibromas using immunohistochemistry. RESULTS: Four of the 5 plexiform neurofibromas were immunopositive for growth hormone receptor. CONCLUSION: This study suggests that growth hormone may influence the development of plexiform neurofibromas in patients with neurofibromatosis type 1.

Identification of growth hormone receptor in plexiform neurofibromas of patients with neurofibromatosis type 1

OBJECTIVE: The aim of this study was to investigate the presence of growth hormone receptor in plexiform neurofibromas of neurofibromatosis type 1 patients. INTRODUCTION: The development of multiple neurofibromas is one of the major features of neurofibromatosis type 1. Since neurofibromas commonly grow during periods of hormonal change, especially during puberty and pregnancy, it has been suggested that hormones may influence neurofibromatosis type 1 neurofibromas. A recent study showed that the majority of localized neurofibromas from neurofibromatosis type 1 patients have growth hormone receptor. METHODS: Growth hormone receptor expression was investigated in 5 plexiform neurofibromas using immunohistochemistry. RESULTS: Four of the 5 plexiform neurofibromas were immunopositive for growth hormone receptor. CONCLUSION: This study suggests that growth hormone may influence the development of plexiform neurofibromas in patients with neurofibromatosis type 1.

Erythrovirus B19 infection in acquired immunodeficiency syndrome: screening by histopathology, immunohistochemistry, and in situ hybridization.

Erythrovirus B19 infects erythrocytic progenitors, transiently interrupting erythropoiesis. In AIDS patients it causes chronic anemia amenable to treatment. We looked for evidences of B19 infection in stored bone marrow material from patients with acquired immunodeficiency syndrome. Histological sections were made from stored paraffin blocks from 33 autopsies (39 blocks) and 35 biopsies (45 blocks, 30 patients) performed from 1988 to 2002. They were examined after hematoxylin-eosin (HE) staining, immunohistochemical (IHC), and in situ hybridization. HE revealed intra-nuclear inclusion bodies ("lantern cells") suggesting B19 infection in 19 sections corresponding to 19 of 63 patients examined with this test. Seven of 78 sections subjected to immunohistochemistry were positive, corresponding to 7 of 58 patients examined with this test. Fourteen sections corresponding to 13 of the 20 HE and/or IHC positive patients were subjected to in situ hybridization, with six positives results. Among the 13 patients subjected to the three techniques, only one gave unequivocal positive results in all and was considered a true positive. The frequency of B19 infection (1/63 patients) in the material examined can be deemed low.

Erythrovirus B19 infection in acquired immunodeficiency syndrome: screening by histopathology, immunohistochemistry, and in situ hybridization

Erythrovirus B19 infects erythrocytic progenitors, transiently interrupting erythropoiesis. In AIDS patients it causes chronic anemia amenable to treatment. We looked for evidences of B19 infection in stored bone marrow material from patients with acquired immunodeficiency syndrome. Histological sections were made from stored paraffin blocks from 33 autopsies (39 blocks) and 35 biopsies (45 blocks, 30 patients) performed from 1988 to 2002. They were examined after hematoxylin-eosin (HE) staining, immunohistochemical (IHC), and in situ hybridization. HE revealed intra-nuclear inclusion bodies ("lantern cells") suggesting B19 infection in 19 sections corresponding to 19 of 63 patients examined with this test. Seven of 78 sections subjected to immunohistochemistry were positive, corresponding to 7 of 58 patients examined with this test. Fourteen sections corresponding to 13 of the 20 HE and/or IHC positive patients were subjected to in situ hybridization, with six positives results. Among the 13 patients subjected to the three techniques, only one gave unequivocal positive results in all and was considered a true positive. The frequency of B19 infection (1/63 patients) in the material examined can be deemed low.

Identification of Helicobacter sp. in gastric mucosa from captive marmosets (Callithrix sp.; callitrichidae, primates).

The aim of this study was to identify the presence of Helicobacter sp. in the gastric mucosa of captive marmosets (Callithrix sp.). Histologic specimens from the fundic, corpus, and antral gastric regions of six Callithrix jacchus, 12 C. kuhli, and 12 C. geoffroyi specimens were evaluated. The sections were stained with hematoxylin-eosin (H&E) and the Warthin-Starry silver impregnation method, and immunostained with rabbit anti-H. pylori polyclonal antibody. Helicobacter-like organisms (HLOs) and coccoid forms were present in silver-stained sections from 29 stomachs, whereas immunohistochemistry (IHC) tests revealed bacterial aggregates in 15 stomachs. No statistical difference relative to the presence of Helicobacter sp. was found among the gastric regions or marmoset species. Gastric lesions were found in the groups of marmosets that had positive and negative IHC results, but no correlation between inflammation and Helicobacter sp. infection was established. These findings demonstrate that marmosets are susceptible to naturally-occurring Helicobacter sp. infection, and open the way to the development of comparative studies on Helicobacter sp. infection in humans.

Análise histopatológica comparativa entre líquen plano oral e cutâneo / Comparative histopathological analysis between oral and cutaneous lichen planus

Introdução: Líquen plano é uma doença inflamatória crônica relativamente comum que acomete pele e membranas mucosas, separadamente ou em combinação. Freqüentemente envolve a cavidade oral, com ou sem compromentimento cutâneo concomitante. Microscopicamente, enquanto a pele apresenta aspectos bastantes característicos, a mucosa oral pode apresentar variações relacionadas às características locais da mucosa na cavidade oral. Objetivos: Comparar as alterações histopatológicas do líquen plano oral (LPO) com as do líquen plano cutâneo (LPC), estudando os componentes do infiltrado inflamatório. Material e métodos: 59 biópsias (29 de LPO e 30 de LPC) fixadas em formol e incluídas em blocos de parafina. Foi realizada análise semiquantitativa das alterações epidérmicas e dérmicas utilizandoðse as colorações de hematoxilina-eosina e ácido periódico Schiff. Resultados: No LPC foram observados os aspectos clássicos de ortoceratose, hipergranulose em cunha e acantose em dente de serra. Tais aspectos diferem do LPO, no qual ortoceratose e camada granulosa espessada ocorrem com menos freqüência, observando-se aquisição destas camadas nos locais onde estão normalmente ausentes. Vacuolização e apagamento do limite epitélio-conjuntivo predominaram nas duas localizações (pele e mucosa oral), e linfócitos e histiócitos foram as células inflamatórias presentes em todos os casos. Conclusões: O conjunto de alterações clássicas como ortoceratose compacta, hipergranulose em cunha, acantose em dente de serra e vacuolização da basal, associadas a linfócitos em faixa superficial é diagnóstico de LPC. Para o LPO, no entanto, devem ser consideradas as características próprias da mucosa no local biopsiado, devendo ser valorizadas alterações mais sutis da camada córnea - leve ortoceratose - e aparecimento da camada granulosa em locais onde normalmente é ausente. Aspecto em cunha da hipergranulose é de ocorrência rara no LPO. Acantose em dente de serra é achado pouco freqüente no LPO, porém vacuolização basal está presente associada a infiltrado linfocitário em faixa, plasmócitos podem acompanhar linfócitos no LPO, mas estão ausentes do LPC.

Ceratoacantoma: aspectos imuno-histoquímicos diferenciais do Carcinoma de Células escamosas

O ceratoacantoma é um tumor cutâneo de crescimento rápido, composto de células escamosas ceratinizadas que apresenta achados clínicos e histopatógicos em comum com o carcinoma de células escamosas (CCE) cutâneo, tornando, às vezes, difícil o diagnóstico diferencial para o patologista. Relatos de lesões de aspecto clássico, clíncia e histopatologicamente, exibindo comportamento biológico agressivo, com invasão tumoral e metástases, têm sugerido que a ceratoacantoma pode ser considerado um tipo de CCE. O objetivo foi analisar as diferenças imuno-histoquímicas entre o ceratoacantoma e o CCE cutâneo. Foram estudados 14 casos de ceratoacantoma e 12 casos de CCE. Foram realizadas técnicas imuno-histoquímicas, utilizando anticorpos monoclonais para PCNA, p53 e Bcl-2. Dentre os casos de ceratoacantoma, 13 (92 por cento) mostratam positividade maior para PCNA na região da camada basal ou periférica de massas tumorais, enquanto no CCE foi encontrada positividade variável entre a camada basal e o interior dos ninhos, sugerindo diferenças no modelo de expressão do PCNA entre esses tumores. Todos os casos avaliados demonstraram imunorreação negativa para o proto-oncogenese Bcl-2. De forma semelhante ao PCNA, a marcação para p53(gene supressor tumoral) também se mostrou maior na camada basal do que no interior do tumor, na maioria dos casos de ceratoacantoma, diferentemente dos casos de CCE, onde a mairoria apresentou positividade semelhante entre a área periférica e o interior da neoplasia. A análise dos resultados sugere que a positividade para PCNA e p53 maior no interior da massa tumoral do que na periferia invadida o dignóstico de ceratoacantoma. A positividade para p53 e PCNA se mostrou de forma semelhante entre o ceratoacantoma e o CCE bem diferenciado, apontando para uma aproximação do comportamento biológico desses tumores

Leucoplasia pilosa oral: aspectos histopatológicos da fase subclínica / Oral hairy leukoplakia: histopathologic features of the subclinical stage

A leucoplasia pilosa oral (LPO) é uma das manifestaçöes orais mais comuns na AIDS, com valor diagnóstico e prognóstico. A LPO está relacionada ao Epstein-Barr vírus (EBV), com características clínicas e histopatológicas definidas. Já existem relatos de uma fase subclínica da LPO, porém sem caracterizaçäo histopatológica. O presente trabalho teve por objetivo descrever os aspectos histopatológicos desta fase, bem como realizar uma análise comparativa entre a LPO subclínica e clínica, com a finalidade de verificar a suficiência diagnóstica dos critérios histopatológicos. Trata-se de uma estudo retrospectivo de 11 casos, obtidos a partir de cinco biópsias realizadas em pacientes com lesäo e da borda de seis línguas sem lesäo macroscopicamente detectável, provenientes de necropsias. Foram utilizados os seguintes métodos: histopatologia, imuno-histoquímica e hibridizaçäo in situ. Os aspectos histopatológicos que caracterizaram a fase subclínica da LPO foram: ausência de paraceratose e papilomatose, acantose leve, presença de células claras e alteraçöes nucleares (inclusäo tipo Cowdry A, núcleo em "vidro fosco" e núcleo "em colar"). Houve identificaçäo do EBV através da hibridizaçäo in situ e da imuno-histoquímica nas alteraçöes nucleares observadas na histopatologia. Concluiu-se, com fundamentos na identificaçäo do EBV nas alteraçöes nucleares, que a LPO em sua fase subclínica, da mesma forma que na lesäo clínica, apresenta características histopatológicas específicas específicas e suficientes para um diagnóstico definitivo, independentemente da identificaçäo do EBV

Patologia da língua: estudo prospectivo em 100 necropsias / Pathology of the tongue: a prospective study of 100 necropsies

A língua é a localizaçäo anatômica preferencial de diversas patologias. O objetivo deste estudo foi identificar as lesöes mais prevalentes na borda da língua em pacientes necropsiados, correlacioná-las com a causa do óbito e com a doença principal e investigar o diagnóstico in vivo das principais afecçöes identificadas. Foram examinadas 100 línguas de pacientes submetidos à necropsia. Das línguas examinadas, 33 näo apresentavam alteraçöes patológicas. A candidose foi diagnosticada em 23 casos; a glossite inespecífica, em 15; a necrose epitelial focal e a pseudoleucoplasia pilosa, em oito cada; a leucoplasia pilosa subclínica e o herpes, em cinco cada; e o líquen plano, em quatro casos. De relevância, identificaram-se a associaçäo da candidose e do herpes simples com pacientes imunocomprometidos, e a associaçäo do líquen plano com o diabetes mellitus. Concluímos que as lesöes de maior prevalência foram a candidose e a glossite inespecífica. Ressaltamos a importância de um exame bucal mais detalhado, que possibilite a identificaçäo de lesöes em pacientes internados

AIDS – Alterações renais em crianças HIV+. Material de necrópsia. Estudo histopatológico e clínico

The nephropathy associated with the AIDS virus (N-AIDS) has been described in 30% of the HIV+ children who have the perinatal infection. This contrasts with the low number found in the pediatric population infected with HIV by blood transfusions and breastfeeding. Its pathogenesis is unclear. Recent studies demonstrating the presence of HIV suggest that this virus directly affects the kidney parenchima. HIV-associated nephropathy is clinically characterized by nephrotic proteinuria, occasionally hematuria and by the frequent progression to renal failure. Morphologically, HIV associated nephropathy (N-AIDS) is characterized by focal segmental glomerulosclerosis, diffuse mesangial hyperplasia, tubular microcystic dilation, celular infiltration, interstitial edema and fibrosis. This project aims at the identification of the AIDS nephropathy in pediatric autopsies from 1993 to 1998. Specifically, to describe the clinical and hystopathological findings in the kidneys of children with AIDS who died from the disease; also, to record the most frequent ultra-estructural abnormalities; furthermore, to investigate the presence of viral particles through immunohystochemistry and detect the antigen gp41 in kidney cells. The selection of cases was made after checking patients’ data and those considered HIV+, according to CDC criteria, were studied. Later on, autopsy results were revised. Also, there was a retrospective study of the optic and electronic microscopy. The gp41 protein of the immunodeficiency human virus is part of the gp 41/ gp 120 glicoproteic complex and plays an important role in the viral infection. The HIV investigation in the kidney parenchima will still be made, through detection of the 41-glicoprotein by means of the immunohystochemistry technique using the antibody anti-gp 41. Through this research we intend not only to call attention to kidney damages among HIV+ pediatric population, but also to contribute to the thorough understanding of the pathogenesis of HIV-associated nefropathy, which remains unclear and can be the early symptom of the disease