Análise histopatológica de biópsia prostática guiada pelo ultrassom transretal com 10 e 12 fragmentos: ensaio clínico prospectivo controlado

Pós-graduação em Bases Gerais da Cirurgia - FMB

Metastatic melanoma of the tongue: a case report with immunohistochemical profile

BackgroundMelanoma of the skin is characterised by a high metastatic potential, but reports of metastasis to the tongue are rare. We report a case of skin melanoma with metastasis to the lymph nodes, tongue and brain.ObjectivesThis report highlights the clinical and histological features of oral metastatic melanoma.Case reportA 72-year-old man was seen with a nodule on the tongue. The differential diagnosis included salivary gland tumour, lymphoma and metastatic melanoma. His medical history revealed treatment for melanoma in the periumbilical region and micrometastases in the inguinal lymph nodes. An incisional biopsy was obtained and histological analysis showed the presence of a solid, epithelioid malignant tumour of monotonous appearance infiltrating the skeletal musculature. Immunohistochemistry showed reactivity of neoplastic cells to anti-HMB45, anti-melan A and anti-S100 antibodies and negativity for anti-PAN cytokeratin, confirming the diagnosis of metastatic melanoma.ConclusionThe present findings highlight the importance of a complete medical evaluation of the patient by anamnesis to identify possible oral repercussions of primary diseases in other organs and/or systems.

Diferentes métodos de diagnóstico molecular na diferenciação das espécies de Sarcocystis spp

The Sarcocystis genus includes obligatory two-host life cycle protozoan parasites. It is the most numerous of the six genera of the Sarcocystidae family. The infection caused by parasites of this genus is a zoonotic and cosmopolitan disease known as sarcosistosis or sarcosporidiosis. The sarcositosis though frequently asymptomatic in its definitive hosts can be fatal in its intermediate hosts. The usual diagnoses of sarcosistosis takes place through a histological demonstration of schizonts in blood vessels and organs, and the presence of cysts in muscle tissue by necropsy or biopsy, this second method still more common and based on morphological features of the sarcocyst. However, these methods can be inadequate to a precise identification of the infector species once that, besides the genus being of numerous species, these often present similar morphological features. Another factor that makes the diagnostic more difficult is the non specificity of some Sacocystis species to their hosts. Consequently, molecular diagnostic methods have been used in order to identify the infector species and the parasite specific biological cycles, demonstrating also new species and coevolutive aspects between parasite and host. Among the most employed molecular techniques the Polimerase Chain Reaction (PCR), the nested-PCR and the Restriction Fragment Length Polymorphism (RFLP) stands out

Aspectos clínicos e cirúrgicos do osteossarcoma canino

Osteosarcoma is the primary osseous neoplasia frequently diagnosed in dogs and it’s the main answerable for more than 85% of the neoplasias origened from the skeleton. The average age of onset of the lesion is 7 years, especially in large breeds and giant, with males being more affected than females. In general, 75% of osteosarcomas develop in the appendicular skeleton and 25% in the axial. The forelimbs are more affected than the hindlimbs, since support 60% of body weight. The osteosarcoma diagnosis is made by the analys of the animal’s clinic historic, detailed physique exams, blood exams alkaline phosphatase, xray exams, cytology, biopsy. The treatment of choice is the amputation associated to the chemotherapy. However, in some cases the member is preserved by the allograft technic. The chemotherapy associated to the surgery reduces the total load of the tumor, lengthens the interval of the life and improves the quality of pacient’s life. The most used medicines are cisplatin and doxorubicin. They can be used in separated or associated ways. The prognostic of dogs with osteosarcoma is reserved

Alterações hepáticas em cães intoxicados experimentalmente por sementes de Crotalaria spectabilis

Pós-graduação em Medicina Veterinária - FCAV

Alterações clínicas e laboratoriais de equinos submetidos à biópsia hepática com agulha Tru-cut guiada por ultrassom

Pós-graduação em Medicina Veterinária - FCAV

Resposta endometrial de jumentas (Equus asinus) da raça Pêga ao sêmen fresco, extendido e congelado de jumento

Pós-graduação em Cirurgia Veterinária - FCAV

Gingival squamous cell carcinoma: a case report

Squamous cell carcinoma is a malignant epithelial neoplasm characterized by variable clinical manifestations. When located in the gingiva, this neoplasm may mimic common inflammatory lesions. The aim of this study was to report a case of atypical squamous cell carcinoma, in which the patient had no risk factors for the development of this neoplasm. A 61 year old Caucasian female was seen with a 3 month history of a rapidly growing, painful nodule in the gingiva adjacent to tooth #11. Clinical examination revealed a proliferative lesion in the vestibular marginal gingiva of teeth #11 and #12, presenting with purulent exudation. Thus, in view of the clinical symptoms and differential diagnosis of an infectious granulomatous process and malignant neoplasm, an incisional biopsy was obtained from the lesion. The diagnosis of squamous cell carcinoma was made and fourteen days after incisional biopsy, healing was found to be unsatisfactory. The patient was referred for treatment consisting of surgical excision of the tumour. A removable partial denture was fabricated for rehabilitation, one month after surgery of the maxilla; the patient was submitted to dissection of the regional lymph nodes and radiotherapy for an additional 3 months. Three years after the end of treatment, the patient continues to be followed-up and does not show any sign of recurrence. Gingival squamous cell carcinoma is a condition which chance of cure is higher when carcinomatous lesions are diagnosed and treated early. In this instance dentists play an important role in early detection of gingival squamous cell carcinoma.

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.

Tumor odontogênico queratocístico: relato de caso

Introduction: The odontogenic keratocyst tumor (OKT) derived from dental lamina rests with particularities and specific histological features, with high rates of relapse and aggressive clinical behavior. Presents certain predilection for males, affecting the mandible of 60% to 80% of cases may be related to impacted tooth 25 to 45% of cases. Objective: To highlight the clinical, histopathological and imaging procedures of the OKT, as well as discuss the treatment of this injury. Case Report: To report a case of 10 years of age to look for the orthodontist to correct anterior open bite was observed in panoramic radiography radiolucent area in the region of the body of the mandible associated with pathological inclusion of the lower premolar. It was performed an incisional biopsy of the lesion and the histopathologic diagnosis was odontogenic keratocyst tumor. It was performed a CT scan to assess the extent of the injury and its relation to anatomic structures. How to conduct, we opted for the extraction of the deciduous molar and enucleation of the lesion, preserving the premolar included. The same goes on clinical and radiographic control 18 months, after removal of OKT obtaining the eruption of premolar that was involved in the injury. Final Comments: It is necessary to adopt protocols that include dental care knowledge of oral diagnosis, medical history and careful clinical evaluation without forgetting the need for histopathological confirmation.

Carcinoma de células escamosas de grandes proporções

The oral and oropharyngeal cancer is aggressive and, in Brazil, the incidence is considered one of the world’s tallest, the most common of head and neck. It affects males more intensively and 70% of cases are in adults over 50 years of age. It is located usually on the floor of the mouth and tongue. Therefore, the purpose of this study is to report a case of male patient, 78 years of age, leukoderma who sought hospital care. Reported frequent smoking and alcoholism. On physical examination headgear, there was the presence of lymph node fixed, painless 1.5 to 2 cm in diameter in the submandibular region. Physical examination intraoral ulcer was found at about 5 cm at its greatest extent, localized to the left oral floor region of the oropharynx, reddish, hardened edges, surface and bottom corrugated carton. The differential diagnosis suggested was traumatic ulcer, paracoccidioidomycosis and squamous cell carcinoma. The approach employed was obtained by incisional biopsy and the piece sent to histopathological analysis, confirming the case of squamous cell carcinoma. The treatment consisted in clarifying the patient about the disease and the need to search for an oncology center. It is concluded that the oral clinical examination is accurate in all major injuries to mouth, even if the chief complaint does not focus on this. In individuals at high risk examination should be systematic and individuals with suspicious lesions should be referred to specialist consultation.

Pemphigus vulgaris in adolescence: a case report

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Lymphoepithelial cyst in jugal mucosa

Mouth lymphoepithelial cyst is rare, with few cases reported in literature. The aim of this article is to describe a clinical case, focusing on clinical and diagnostic aspects, treatment and prognosis. The lesion was one year old and had developed as a fibrous nodule in the jugal mucosa of a 71-year-old leucoderma patient. Considering focal inflammatory fibrous hyperplasia, fibroma and mucocele as differential diagnosis, excisional biopsy was carried out. A cystic cavity limited by pseudostratified epithelium without projections into the conjunctive tissue, with lymphoid tissue within, was microscopically identified. Without postoperative adverse events, the one-year clinical followup confirmed the favorable prognosis of this kind of lesion.

CD10 (Neutral Endopeptidase) expression in myoepithelial cells of salivary neoplasms

CD10 is a cell surface peptidase expressed in a wide variety of normal and neoplastic tissues, including breast myoepithelial cells. In salivary glands, expression of CD10 has only been used to identify neoplastic myoepithelial cells of pleomorphic adenomas and myoepithelial carcinomas. However, its accuracy in other salivary tumors with myoepithelial component has yet to be analyzed. We examined 72 salivary tumors with myoepithelial differentiation using immunohistochemical technique to detect CD10. In salivary glands, CD10 expression was not detected in myoepithelial cells. Only fibrocytes within the intralobular stroma were CD10 positive. In neoplastic myoepithelial cells, CD10 expression was found in 25.71% of benign and 32.43% of malignant neoplasms. When the different groups of tumors were compared, epithelial-myoepithelial carcinomas (EMEC) showed a stark contrast with the others (83.3% of cases with CD10 expression). Surprisingly, adenoid cystic carcinomas and basal cell adenomas were negative in 100% of the cases. Myoepitheliomas, pleomorphic adenomas, and myoepithelial carcinomas were positive in 27.7%, 30.0%, and 40% of the cases, respectively. In conclusion, salivary neoplastic myoepithelial cells gain CD10 expression in relation to their normal counterparts. However, the gain of this protein is not a sensitive marker for detecting myoepithelial cells in the majority of the tumors, except for EMEC. The high expression of CD10 by this carcinoma can be a valuable tool to separate EMEC from the tubular variant of adenoid cystic carcinomas in small incisional biopsies, where the precise diagnosis may be impossible.

Actinic Cheilitis: epidemiological study in a riverine population of northern Brazil

AIM: The aim of this survey was to assess the prevalence of AC in riverine population in countryside of Amazonas, northern Brazil. MATERIAL AND METHODS: Patients answered a questionnaire and were examined between January and December of 2008. Data were gathered on the following participant’s characteristics: 1) age group; 2) gender; 3) ethnicity 4) outdoor activities (sunlight exposure); 5) smoking habits; 6) drinking habits; and 7) access to oral health services (the last dental visit). Clinical observation of the lips for determination of AC presence was used. Patients who presented clinical manifestation of moderate and severe AC were submitted to incisional biopsy to confirm the diagnosis. In case of a positive result after histopathological examination, patients were advised and appropriate treatment was offered. All patients received information about AC and its'prevention. RESULTS: Among the 200 participants that were examined, the prevalence of AC was 2% (4 cases). Of all patients surveyed, women were the majority totalizing 124 patients (72.0%). According to age, 48 (24.0%) people were 20g34 yeargold; 42 (21.0%) were 35g44gyeargold; 50 (25.0%) were 45g60gyeargold; and 60 (30.0%) were 61 or older. CONCLUSION: Even though AC was present in a low prevalence rate, an epidemiological variety is expected, once geographic and ethnic differences should be considered.