Oral syphilis: report of three cases and characterization of the inflammatory cells

Syphilis is a sexually transmitted infectious disease caused by Treponema pallidum. This study reports 3 cases of syphilis and highlights the importance of identifying oral lesions for its final diagnosis. Case 1: a 48-year-old male patient presented with a bleeding ulcer in the lower lip. Overall clinical examination revealed patchy alopecia and skin target lesions. Case 2: a 61-year-old male patient presented with white spots on the lateral tongue and nodules on the dorsum of the tongue. Overall clinical examination showed erythematous target lesions on the abdomen, forearm, palms of the hand, and soles of the feet. Case 3: a 17-year-old male patient presented with an ulcerated lesion on the tongue and lymph node involvement. The following serologic tests were requested: Venereal Disease Research Laboratory, fluorescent treponemal antibody-absorption, anti-HIV-1 and anti-HIV-2, and anti-hepatitis C virus. An incisional biopsy revealed epithelial hyperplasia associated with intense and diffuse mononuclear inflammatory cell infiltration consisting mainly of plasma cells, in a perivascular and perineural distribution. The final diagnosis in the 3 patients was syphilis. Treatment consisted of 1 weekly dose of penicillin (2.4 million units, intramuscular) for 2 or 3 weeks. Immunohistochemical reactions for XIIIa, CD3, CD20, CD68, CD163, S100, CD1a, CD11c, CD83, CD138, and CD208 were performed. Clinicians should be familiarized with oral syphilis lesions in order to be able to diagnose this emerging infectious disease of variable clinical presentation.

Determinação da expressão da molécula de adesão CD56 em plasmócitos no mieloma múltiplo através de estudo imuno-histoquímico

O papel das moléculas de adesão celular, na fisiopatologia do mieloma múltiplo (MM), tem sido alvo de vários estudos nos últimos anos. A expressão de CD56 pelos plasmócitos tumorais está associada a comportamento clínico menos agressivo da doença, e sua perda tem sido descrita na fase de leucemização plasmocitária. A determinação da expressão da molécula CD56 pelos plasmócitos tumorais pode ser obtida através de citometria em fluxo, revelando positividade em 55% a 78% dos casos. No presente estudo, objetivamos verificar a expressão da molécula CD56 por plasmócitos tumorais na medula óssea de portadores de MM, utilizando o estudo imuno-histoquímico das amostras histológicas obtidas ao diagnóstico. Analisamos as amostras de medula óssea de vinte portadores de MM, e realizamos o estudo imuno-histoquímico para determinação da expressão das cadeias leves kappa e lambda e da molécula CD56 pelos plasmócitos tumorais. A expressão da molécula CD56 foi importante em três casos, moderada em seis, discreta em quatro e negativa em sete. O estudo imuno-histoquímico mostrou-se válido para determinação da expressão de CD56 por plasmócitos tumorais em portadores de MM, fornecendo resultados semelhantes aos descritos para os obtidos por citometria em fluxo. Através do estudo imuno-histoquímico, foi possível observar variações da expressão da molécula CD56.

Microalterations in the third eyelid gland of dogs with keratoconjunctivits sicca secondary to distemper

Analisaram-se, à microscopia óptica, 28 glândulas da terceira pálpebra de cães, que morreram com cinomose. O diagnóstico de ceratoconjuntivite seca baseou-se nas alterações da superfície ocular e no teste da lágrima de Schirmer. À histologia, visibilizaram-se atrofia tubuloacina, espessamento do tecido conjuntivo e exudação inflamatória de leve a intensa com presença de plasmócitos, de histiócitos e por hipertrofia compensatória de algumas glândulas. O lume das glândulas encontrava-se hipertrofiado contendo células epiteliais descamadas, polimorfonucleares e hemácias, além de muco.

SINUS HISTIOCYTOSIS WITH MASSIVE LYMPHADENOPATHY (ROSAI-DORFMAN DISEASE) - CYTOMORPHOLOGIC ANALYSIS ON FINE-NEEDLE ASPIRATES

Cytomorphologic characteristics of smears from fine-needle aspirates (FNA) of three cases of sinus histiocytosis with massive lymphadenopathy (SHML) (Rosai-Dorfman disease) are described. All aspirates showed mature lymphocytes, plasma cells, and large pale histiocytes with well-preserved lymphocytes within the cytoplasm (lymphocytophagocytosis). The cases were confirmed by surgical biopsy, and the immunohistochemical findings suggested a macrophage origin for this lesion. The value of FNA analysis as an aid to diagnosis of SHML is discussed.

Detection of cytokines and nitric oxide synthase in skin lesions of Jorge Lobo's disease patients

Studies investigating the immunopathological aspects of Jorge Lobo's disease have shown that the inflammatory infiltrate consists mainly of histiocytes and multinucleated giant cells involving numerous yeast-like cells of Lacazia loboi, with the T lymphocytes more common than B lymphocytes and plasma cells. The quantification of cytokines in peripheral blood mononuclear cells culture supernatant has revealed alterations in the cytokines profile, characterized by predominance of a Th2 profile. In view of these findings and of the role of cytokines in cell interactions, the objective of the present study was to investigate the presence of the cytokines IL-10, TGF-ss 1 and TNF-alpha, as well as iNOS enzyme in granulomas induced by L. loboi. Histological sections obtained from skin lesions of 16 patients were analyzed by immunohistochemistry for the presence of these cytokines and iNOS. The results showed that TGF-ss 1 was the cytokine most frequently expressed by cells present in the inflammatory infiltrate, followed by IL-10. There was a minimum to discrete positivity of cells expressing TNF-alpha and iNOS. The results suggest that the presence of immunosuppressive cytokines in skin lesions of patients with the mycosis might be responsible for the lack of containment of the pathogen as demonstrated by the presence of numerous fungi in the granuloma.

Pediatric Chronic Sclerosing Sialadenitis: Kuttner Tumor

Chronic sclerosing sialadenitis is an uncommon cause of salivary gland enlargement mainly occurring in the fifth and seventh decade of life. In the Western population, chronic sclerosing sialadenitis has been characterized as an IgG4-related disease. Although rare, this lesion occurs in children. To increase awareness about this entity in the pediatric age group, we report the case of an 11-year-old boy with a hard, 4.0-cm circumscribed mass in the right submandibular gland. Histologically there was marked distortion of the gland architecture by a dense lymphocytic infiltrate and extensive fibrosis with septa that crossed and distorted the gland, leaving atrophic acini and dilated, irregular ducts. The lymphoid infiltrate formed multiple follicles with active germinal centers, numerous plasma cells, and areas with diffuse arrangement. Immunophenotyping showed abundant CD20- and CD3-positive lymphocytes; cytokeratin AE1/AE3 highlighted the distorted architectural pattern; IgG staining showed large numbers of positive cells infiltrating the interstitium and surrounding the atrophic acini and ducts. IgG4 staining revealed a large proportion of positive infiltrating elements. Kuttner tumor belongs to the group of IgG4-related sclerosing diseases. The differential diagnosis includes pleomorphic adenoma and other salivary gland neoplasms. Its recognition in children is important clinically because this entity is amenable to steroid treatment, and additional work up and follow up is warranted to stave off other IgG4-related diseases/complications.

Skin and pulmonary models using coated bentonite particles for the study of the inflammation evoked by Paracoccidioides brasiliensis antigens in previously immunized mice

Bentonite particles coated with polysaccharide antigen or crude soluble antigen of Paracoccidioides brasiliensis were injected intradermally or intravenously in mice. In control animals that were not pre-immunized with P. brasiliensis antigens, coated and uncoated bentonite caused minimal and nonspecific inflammation around the cutaneous injection site or around the bentonite thrombi in small lung vessels after intravenous injection. However, in mice previously immunized with P. brasiliensis antigens, the coated bentonite particles boosted the humoral and cellular immune responses to P. brasiliensis and evoked intense inflammatory reactions. Twelve days after intradermal injection, the inflammatory reaction around the bentonite was rich in neutrophils, macrophages, lymphocytes and plasma cells associated with young granulation tissue. In intravenously injected mice, the pulmonary inflammation was maximal at day 2, and was characterized by a florid neutrophilic and macrophagic cellular infiltration around bentonite thrombi; in some foci, there was incipient organization to mature granuloma. However, in both models, there was no formation of epithelioid granulomata, demonstrating that in paracoccidioidomycosis cellular immunity alone, without the presence of intact micro-organisms, may not be enough for the development of this type of granuloma.

Alterações clínicas, protéicas do humor aquoso, sorológicas e histopatológicas em olhos de cães (Canis familiaris) (Linnaeus, 1758), infectados experimentalmente, por via conjuntival, com Leishmania (Leishmania) chagasi (Cunha & Chagas, 1937)

Pós-graduação em Cirurgia Veterinária - FCAV

Apoptose em linfonodos de cães com Leishmaniose Visceral

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Análise da expressão de MMP-2 e MMP-9 na pele de cães com Leishmaniose visceral

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

Avaliação do processo inflamatório e da imunomarcação de formas amastigotas de Leishmania infantum na superfície do olho de cães infectados experimentalmente pela via ocular tópica

Pós-graduação em Medicina Veterinária - FCAV

Fenotipagem das populações celulares e detecção in situ de citocinas em biópsias de pacientes com paracoccidioidomicose

Pós-graduação em Patologia - FMB

Resposta imune na medula óssea e perfil hematológico de cães com Leishmaniose visceral

Pós-graduação em Medicina Veterinária - FCAV

Morphological changes and parasite load of the adrenal from dogs with visceral leishmaniasis

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

Infecção por strigea falconis em buteo magnirostris no Brasil

Background: Buteo magnirostris, popularly known as roadside hawk belongs to the family Accipitridae, Ciconiiformes. The specimen is common throughout Brazil inhabiting open areas, tolerating disturbed areas very well, but avoiding dense forests. The trematodes are common parasites in the intestines of birds of prey, with scant notice of pathogenic infections. However, severe infections of trematodes Strigeidae family have been previously reported as a cause of anemia, diarrhea, enteritis, weight loss and death. This paper aims to report the occurrence of infection in S. Falconis in B. magnirostris diagnosed by post mortem examination. Case: The specimen of B. magnirostris, male, young was sent for necropsy at the Laboratory of Veterinary Pathology, Federal Rural University of Semi-Arid (UFERSA), Mossoró-RN, Brazil. With a history of apathy, anorexia, diarrhea and death in one course of 24 h. The free bird life and even puppy had been captured for training and practice of falconry shortly before the clinical manifestation of infection (time of captivity uninformed). On physical examination ruffled feathers, cachexia and pallor of skeletal muscle was observed. At necropsy there was severe enteritis with petechiae and accumulation of liquid contents into the duodenum. Fifty-two trematodes were found set in duodenal mucosa. The other organs and structures showed no changes. Fragments of all organs were harvested, fixed in 10% formalin buffered, routinely processed for histopathology and stained with hematoxylin and eosin (HE). Parasites were carefully collected, washed in saline, fixed, processed and identified according to the morphology and taxonomy. Histologically, the lesions were restricted to the duodenum and were characterized by melting, severe atrophy and necrosis of the epithelial cells of the intestinal villi; inflammatory infiltrate (consisting of lymphocytes, plasma cells and eosinophils) in the lamina propria, in addition to trematodes infiltrated the mucosa and lamina propria. These were 60-80 mm in diameter, consisted of parenchymal body enclosed by the integument. In some cross sections of the parasite was possible to observe the presence of cecum, testis and uterus, with some variations between sections; there were also yellowish eggs and coated with a delicate membrane. The trematodes contain approximately 1 mm in length and used as morphology and taxonomy has been identified as S. Falconis. Discussion: S. Falconis is a trematode intestinal parasite of birds of prey, with reports of its occurrence in Europe, North America and Central. In neotropical regions is described the occurrence of the subspecies S. Falconis brasiliana. Although the absence of clinical signs is a common pattern, parasitism by trematodes may become evident, common to captivity stress conditions, and thus infections, even for low pathogenic parasites can cause diarrhea, anorexia, weight loss and death, as reported in this paper. A factor that possibly contributed to the scant notice is its small size, which makes the observation of this parasite in analysis of necropsy in non-pathological conditions and also not familiar with the technical laboratories in the morphological shape of the eggs, which creates difficulty in finding the parasite in parasitological analysis in captive animals. Despite being considered poorly pathogenic trematodes, epidemiologically, the presence of the parasite should be considered a health risk to free-living predators, newly captive in parks, zoos, veterinary hospitals, triage center for wildlife and creators, as they may express pathogenicity in immunosuppressed animals. This work contributes to recording the presence S. falconis parasitizing the duodenal mucosa of B. magnirostris in Brazil.