Transformación de leucoplasia verrugosa proliferativa en carcinoma oral: diez años de seguimiento

The authors present a case of proliferative verrucous leukoplakia (PVL) in a 78-year-old man. It was initially presented as leukoplakia on the tongue but a microscopic investigation in 1991 revealed it to be a mild epithelial dysplasia. After 5 years of follow-up, the lesion presented changes in size and location, and a recidivant behavior. In 1996, a red granular and indurated area that appeared on the tongue was found to be a microinvasive squamous cell carcinoma when microscopically investigated. After a review of the clinicopathologic behavior of this entity, the authors concluded that it was a typical PVL, whose diagnosis is difficult and retrospective, as indicated by others. The authors emphasize the importance of periodic detailed clinical and histological examination of this type of lesions in order to detect early signs of malignancy.

Quantitative cell-cycle protein expression in oral cancer assessed by computer-assisted system

The knowledge of cell-cycle control has shown that the capacity of malignant growth is acquired by the stepwise accumulation of defects in specific genes regulating cell growth. Histologic diagnosis might be improved by a quantitative evaluation of more specific diagnosis biomarkers, which could help to precisely identify pre-malignant and malignant oral lesions. The aim of the present study is to evaluate whether computer-based quantitative assessment of p53, PCNA and Ki-67 immunohistochemical expression, could be used clinically to foresee the risk of oral malignant transformation. This retrospective study was carried out in ninety-five oral biopsies, 27 were classified as fibrous inflammatory hyperplasia, 40 as leukoplakia and 28 as oral squamous cell carcinoma. Sixteen out of the 40 leukoplakia were diagnosed as non-dysplastic leukoplakia, the other 24 being dysplastic leukoplakia, of which 50.0% were classified as moderate to severe dysplasia. Comparison of the four groups of oral tissues showed significant rises in p53 and Ki-67 positivity index, which increased steadily in the order benign, pre-malignant, and malignant. In contrast, it was not possible to relate higher PCNA levels with pre-malignant and malignant oral lesions. We therefore conclude that PCNA immunohistochemistry expression is probably an inappropriate marker to identify oral carcinogenesis, whereas joint quantitative evaluation of p53 and Ki-67, appears to be useful as a tumor marker, providing a pre-diagnostic estimate of the potential for cell-cycle deregulation of the oral proliferate status.

Retention mucocele on the lower lip associated with inadequate use of pacifier

Mucocele forms because of salivary gland mucous extravasation or retention and is usually related to trauma in the area of the lower lips. Ruptured ducts release the mucous that accumulates into adjacent tissues, leading to swelling. This report describes a large mucocele involving the lower lip, which was produced in a child by incorrect use of a pacifier. A few important concepts are discussed to help clinicians in the diagnosis and treatment of this pathology. © 2010 Dermatology Online Journal.

Aparecimento de psoríase durante o tratamento das doenças inflamatórias intestinais com infliximabe: A terapia biológica deve ser suspensa?

Context - Several paradoxical cases of infliximab-induced or-exacerbated psoriatic lesions have been described in the recent years. There is disagreement regarding the need to discontinue infliximab in order to achieve the resolution of these adverse cutaneous reactions specifically in inflammatory bowel disease (IBD) patients. Objective - To systematically review the literature to collect information on IBD patients that showed this adverse cutaneous reaction, focusing mainly on the therapeutic approach. Methods - A systematic literature review was performed utilizing Medline, Embase, SciELO and Lilacs databases. Published studies were identified, reviewed and the data were extracted. Results - Thirty-four studies (69 IBD patients) met inclusion criteria for review. There was inconsistency in reporting of some clinical and therapeutic aspects. Most patients included had Crohn's disease (89.86%), was female (47.83%), had an average age of 27.11 years, and no reported history of psoriasis (84.05%). The patients developed primarily plaque-type psoriasis (40.58%). There was complete remission of psoriatic lesions in 86.96% of IBD patients, existing differences in the therapeutic approaches; cessation of infliximab therapy led to resolution in 47.83% of cases and 43.48% of patients were able to continue infliximab therapy. Conclusion - As increasing numbers of IBD patients with psoriasis induced or exacerbated by infliximab, physicians should be aware of its clinical manifestations so that appropriate diagnosis and treatment are properly established. The decision whether to continue or discontinue infliximab should be individualized.

Recent mouse and rat methods for the study of experimental oral candidiasis

The Candida genus expresses virulence factors that, when combined with immunosuppression and other risk factors, can cause different manifestations of oral candidiasis. The treatment of mucosal infections caused by Candida and the elucidation of the disease process have proven challenging. Therefore, the study of experimentally induced oral candidiasis in rats and mice is useful to clarify the etiopathology of this condition, improve diagnosis, and search for new therapeutic options because the disease process in these animals is similar to that of human candidiasis lesions. Here, we describe and discuss new studies involving rat and mouse models of oral candidiasis with respect to methods for inducing experimental infection, methods for evaluating the development of experimental candidiasis, and new treatment strategies for oral candidiasis. © 2013 Landes Bioscience.

High fat-induced obesity associated with insulin-resistance increases FGF-2 content and causes stromal hyperplasia in rat ventral prostate

Obesity affects sex hormone secretion, which can negatively influence prostatic structure, homeostasis, and disease. This investigation aimed to evaluate the repercussions of obesity induced by a high-fat diet on the rat prostate, with or without treatment with the aromatase inhibitor, Letrozole. Adult Wistar rats were fed a high-fat diet (20% saturated fat, O) for 15 weeks to induce obesity or received a balanced diet (4% fat, C). Then, a group of C and O rats were daily treated with Letrozole (1 mg/kg b.w. per day) for 2 weeks (CL and OL, respectively). Subsequently, ventral prostate was processed for analysis by transmission electron microscopy, immunohistochemistry, and Western blotting. Obesity decreased 70% of the testosterone plasma level. The prostate showed epithelial atrophy and dilated acini in the intermediate portion and epithelial wrinkling in the distal tips. The relative frequency of smooth muscle alpha-actin in the O group increased by 67%. Ultrastructurally, epithelial cells in obese animals presented altered secretory organelles, lipid droplets, and thicker subjacent fibromuscular layer. Letrozole treatment caused a partial restoration of the prostatic changes caused by obesity. Obesity increased the prostatic content of fibroblast growth factor-2 (FGF-2) by 150%, and Letrozole treatment increased this protein even more in the control and obese groups. This investigation shows that obesity provokes structural and ultrastructural changes in the epithelium of rat prostate; these changes might affect gland homeostasis and physiology. The epithelial and smooth muscle cell hyperplasia and increased FGF-2 expression observed in this experimental model of obesity/insulin-resistance might explain the high frequency of benign prostatic hyperplasia in insulin-resistant men.

Avaliação histológica da próstata de cães adultos sexualmente intactos

Avaliou-se histologicamente a próstata de 30 cães adultos e idosos sexualmente intactos que apresentavam ou não sintomatologia clínica de doença prostática, e verificou-se a incidência de possíveis alterações da glândula. Dentre as alterações encontradas, a hiperplasia prostática benigna constituiu o diagnóstico mais comum, 85,6% (n=24), seguida por prostatite crônica, 64,3% (n=18), displasia do epitélio glandular, 42,8% (n=12), atrofia do epitélio glandular, 39,3% (n=11), infiltrado inflamatório focal, 25% (n=7), dilatação glandular focal, 21,4% (n=6), prostatite aguda, 7,1% (n=2), metaplasia escamosa, 3,6%, (n=1), metástase de neoplasia sistêmica, 3,6% (n=1) e abscesso prostático, 3,6% (n=1). Como em muitos casos os cães são assintomáticos, ressalta-se a importância da realização rotineira de exames clínicos específicos, como o toque retal e a ultrassonografia, para o diagnóstico precoce e o tratamento das afecções prostáticas.

Intra-prostatic injection of botulinum toxin type A in treatment of dogs with spontaneous benign prostatic hyperplasia

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Use of scanning electron microscopy for the evaluation of intestinal epithelium integrity

Propõe-se, neste trabalho, o uso de microscopia eletrônica de varredura para avaliar perda de epitélio intestinal da mucosa intestinal de pintos machos e fêmeas submetidos a prolongado jejum pós-eclosão de água e ração. Dois segmentos do duodeno, jejuno e íleo por ave foram coletados e processados pelo método de rotina para microscopia eletrônica de varredura. Seis diferentes graus de perda de epitélio intestinal foram determinados: grau 0, vilos normais, sem extrusão; grau 1, vilos com pequenos pontos de extrusão; grau 2, vilos com perda de epitélio no ápice; grau 3, vilos com perda de epitélio na região apical; grau 4, vilos com perda de epitélio em sua metade superior; grau 5: vilos sem epitélio; grau 6: vilo quebrado. As três regiões intestinais das fêmeas apresentaram aproximadamente 90% de seus vilos normais (graus 0 e 1), enquanto nos machos ocorreu 38% de vilos normais no duodeno e jejuno e 85% no íleo. Além disso, machos apresentaram graus mais acentuados de perda de epitélio (graus 3, 4, 5 e 6) que as fêmeas (grau 3). Os dados indicaram que a mucosa intestinal de pintos machos é mais sensível a prolongado jejum pós-eclosão que a de pintos fêmeas. A microscopia eletrônica de varredura pode ser usada como um método de rotina seguro para a caracterização e quantificação de perda de epitélio intestinal.

Histopathology of gills of Piaractus mesopotamicus (Holmberg, 1887) and Prochilodus lineatus (Valenciennes, 1836) infested by monogenean and myxosporea, caugth in Aquidauana River, State of Mato Grosso do Sul, Brazil

Realizou-se análise histológica de brânquias de 15 espécimes de Piaractus mesopotamicus e 19 Prochilodus lineatus coletados de abril a novembro de 2004, no Rio Aquidauana, MS, com intuito de contribuir com achados anatomopatológicos em brânquias dessas espécies de peixes de água doce. Amostras de brânquias foram fixadas em formalina 10%, tamponadas e processadas conforme rotina histológica. em P. mesopotamicus observou-se presença de monogênea e cistos de mixosporídio da espécie Henneguya piaractus, com localização intralamelar em vários estágios de desenvolvimento, localizados em todas as regiões (basal, mediana ou distal) das lamelas. Cistos intraepiteliais causaram dilatação e deformação das lamelas vizinhas. em brânquias de P. lineatus, observou-se presença de monogênea. Nas duas espécies de hospedeiro foram registradas hiperplasia do epitélio branquial e desorganização estrutural das lamelas em extensas regiões, alterações que causaram a fusão lamelar. em poucos casos registrou-se presença de células inflamatórias mononucleares e focos hemorrágicos na região distal das lamelas.

Prevalence and histopathology of Neoechinorhynchus curemai Noronha, 1973 (Acanthocephala: Neoechinorhynchidae) in Prochilodus lineatus Valenciennes, 1836 from Volta Grande Reservoir, MG, Brazil

O presente trabalho estudou a prevalência e a histopatologia de Neoechinorhynchus curemai Noronha, 1973 (Acanthocephala: Neoechinorhynchidae) em curimbatá, Prochilodus lineatus Valenciennes, 1836. Dezoito peixes com comprimento total médio de 46,7 + 1,1 cm e peso médio de 1.674,8 + 75,6 g foram coletados com rede, bimestralmente, de dezembro de 1995 a dezembro de 1996 na usina hidrelétrica do Reservatório de Volta Grande (Cemig), Minas Gerais, Brasil. Dos peixes analisados, 15 estavam infectados com acantocéfalos no intestino (prevalência de 83,3%). A maior intensidade média ocorreu em agosto de 1996, com 66,5 (16 a 208) parasitos. A análise histopatológica revelou completa descamação do epitélio intestinal com severa hiperplasia e hipertrofia das células caliciformes. Observou-se, ainda, forte reação inflamatória na submucosa, deslocamento de feixes, associado a edemas, bem como infiltração mononuclear e eosinofílica.

Piscinoodinium pillulare (Schäperclaus, 1954) Lom, 1981 (Dinoflagellida) infection in cultivated freshwater fish from the Northeast region of São Paulo State, Brazil: parasitological and pathological aspects

O Centro de Aqüicultura, Unesp, Jaboticabal, SP, Brasil, recebeu peixes para diagnose, os quais apresentavam aglomeração nas bordas dos viveiros e na entrada da água. Dos 194 casos diagnosticados, 53 apresentavam estruturas brancas circulares ou ovais, imóveis, medindo 162 mm de diâmetro, identificadas como o dinoflagelado Piscinoodinium pillulare. em 34 casos, os parasitos estavam presentes nas brânquias, em 2 casos, no corpo e em 9 casos, em ambos. Dos 53 casos observados, 31 eram o híbrido tambacu; 7, o Piaractus mesopotamicus; 6, o Colossoma macropomum; 5, o Leporinus macrocephalus; 3, o Oreochromis niloticus; e 1, o Prochilodus lineatus. Os peixes apresentaram aumento da produção de muco no corpo e nas brânquias e equimoses no pedúnculo caudal e nos opérculos. As brânquias também apresentaram palidez, congestão e petéquias. A histopatologia revelou a presença de grande número de trofontes situados entre as lamelas secundárias, fixados ou não ao epitélio. As lamelas primárias mostraram hemorragias intersticiais, severa hiperplasia do epitélio e das células caliciformes e infiltrado inflamatório. O presente trabalho é o primeiro relato de P. pillulare no Brasil e enfatiza a importância dos dinoflagelados, que causaram significativas perdas econômicas entre 1995 e 1997.

Ileal mucosal mast cell, eosinophil, and goblet cell populations during Hymenolepis diminuta infection of the rat

The population dynamics in the enteric connective tissues of eosinophils, mucosal mast cells (MMC), and in the mucosal epithelium of goblet cells were examined morphometrically in fixed ileal tissue of outbred Sprague Dawley rats during the first 32 days of infection with the tapeworm Hymenolepis diminuta. MMC and eosinophils were present in the lamina propria and submucosa; however, only eosinophils were also present in the muscularis externa. Eosinophilic infiltrate was first observed in the lamina propria at 15 days postinfection (dpi) and the numbers of eosinophils remained elevated through 32 dpi. Initial mucosal mastocytosis was detected on 6 dpi and MC numbers continued to rise over the study period without reaching a plateau. Goblet cell hyperplasia occurred only at 32 dpi. In contrast to some intestinal nematode infections where these same 3 cell types are associated with the host's expulsion responses, H. diminuta is not lost by a rapid host response in the outbred Sprague Dawley rat strain used in these experiments. We suggest that either the induction of hyperplasia of these host effector cells in ileum tissue during H. diminuta infection is not capable of triggering parasite rejection mechanisms, or the function of the induced hyperplasia is necessary for some as yet unassociated physiological or tissue architecture change in the host's intestine.

Características clínicas e histopatológicas da placa aural em eqüinos das raças Mangalarga e Quarto de Milha

Placa aural é uma variante da papilomatose eqüina. Foram examinados 306 eqüinos da raça Mangalarga e 275 da raça Quarto de Milha, com o objetivo de comparar a ocorrência da placa aural entre os animais destas raças, e caracterizar os achados clínicos e histopatológicos desta enfermidade. A ocorrência da placa aural foi 57% nos eqüinos da raça Mangalarga e 35% nos eqüinos da raça Quarto de Milha. Clinicamente as lesões consistiram de placas aplainadas, descamativas e hipocrômicas, formadas com freqüência pela coalescência de pequenas pápulas. Os principais achados histopatológicos foram hiperplasia epidérmica e hipomelanose levando à alteração abrupta entre o epitélio normal e o epitélio acometido pela placa aural.