ASSOCIATION AMONG HISTOLOGICAL FINDINGS SUGGESTIVE OF PAPILLOMA VIRUS ON HEMORRHOIDECTOMY SPECIMENS / ASSOCIAÇÃO ENTRE ACHADOS HISTOLÓGICOS SUGESTIVOS DE LESÕES POR PAPILOMAVÍRUS HUMANO EM ESPÉCIMES DE HEMORROIDECTOMIAS

Background: Many researchers studied human Papillomavirus infection in the anal area supposing it represents a risk factor for precursor lesions of anal cancer. Aim: To study the association between histological findings suggestive of injury by the virus in hemorrhoidectomy specimens. Method: Prevalence study was carried out based on histopathological analysis of hemorrhoidectomy specimens to find viral cytopathic effects. These findings were compared with anal condyloma acuminata that had no relationship with hemorrhoidectomy for microscopic comparison. Results: Of the 91 hemorroidectomies analyzed, eight had findings suggestive of viral cytopathic effects, with the presence of irregular acanthosis in 63%, koilocytes in 50% and other indirect viral cytopathic effects, such as hyperkeratosis (38%), parakeratosis (25% ) and papillomatosis (13%). Conclusion: This study was unable to conclude that there is an association between these two pathologic entities.

Racional : Muitas pesquisas foram direcionados ao estudo da infecção do papilomavírus humano em região anal após a constatação de que é fator de risco para lesões precursoras e câncer anal. Objetivo : Estudar a associação existente entre achados histológicos sugestivos de lesões pelo vírus em espécimes de hemorroidectomias. Métodos : Foi realizado estudo de prevalência baseado em análise de laudos histopatológicos de hemorroidectomias com microscopia relatada para encontrar efeitos citopatológicos virais. Esses achados foram comparados aos laudos de condiloma acuminado anais que não possuíam relação com peças de hemorroidectomias para comparação de microscopia. Resultados : Dos 91 laudos de hemorroidectomias analisados, oito apresentaram achados sugestivos de efeitos citopatológicos virais, com presença de acantose irregular em 63%, coilócitos em 50% e os demais mostravam efeitos citopatológicos virais indiretos, como a hiperceratose (38%), paraqueratose (25%) e papipomatose (13%). Conclusão : Este estudo não pôde concluir ou inferir que exista associação entre essas duas entidades patológicas.

ASSOCIATION AMONG HISTOLOGICAL FINDINGS SUGGESTIVE OF PAPILLOMA VIRUS ON HEMORRHOIDECTOMY SPECIMENS.

BACKGROUND: Many researchers studied human Papillomavirus infection in the anal area supposing it represents a risk factor for precursor lesions of anal cancer. AIM: To study the association between histological findings suggestive of injury by the virus in hemorrhoidectomy specimens. METHOD: Prevalence study was carried out based on histopathological analysis of hemorrhoidectomy specimens to find viral cytopathic effects. These findings were compared with anal condyloma acuminata that had no relationship with hemorrhoidectomy for microscopic comparison. RESULTS: Of the 91 hemorroidectomies analyzed, eight had findings suggestive of viral cytopathic effects, with the presence of irregular acanthosis in 63%, koilocytes in 50% and other indirect viral cytopathic effects, such as hyperkeratosis (38%), parakeratosis (25% ) and papillomatosis (13%). CONCLUSION: This study was unable to conclude that there is an association between these two pathologic entities.

High-resolution anoscopy in the diagnosis of anal cancer precursor lesions in renal graft recipients.

BACKGROUND: Renal graft recipients are one of the population groups known to be at high risk of developing anal cancer. This study investigated the presence of subclinical anal squamous intraepithelial lesions and the diagnostic ability of high-resolution anoscopy in detecting these lesions in renal graft recipients followed-up in Manaus. METHODS: In a cross-sectional study, 50 renal graft recipients were interviewed and submitted to high-resolution anoscopy with biopsies of acetowhite lesions or of the anal transition zone mucosa when acetowhitening was absent. Considering the histopathological reports of the examined anal specimens as the gold standard, the diagnostic validation and precision measures of high-resolution anoscopy were calculated as well as the prevalence of anal squamous intraepithelial lesions in the studied population. RESULTS: In 42 renal graft recipients with satisfactory histopathological readings, prevalence of anal squamous intraepithelial lesions or condyloma acuminatum (ASIL-ACU) was 23.81%. Sensitivity of high-resolution anoscopy was 100%; specificity, 65.63%; positive predictive value, 47.62%; negative predictive value, 100%; and kappa coefficient, 0.48. CONCLUSIONS: With a prevalence of 23.81% of subclinical ASIL-ACU lesions, the studied renal graft recipients had all these lesions detected by high-resolution anoscopy, notwithstanding most anal transition zone acetowhitened biopsied areas did not reveal histopathological aspects of anal cancer precursor lesions or condyloma acuminatum. Therefore, greater experience with the diagnostic tool was felt necessary to enhance its positive predictive value, specificity and diagnostic precision.

Avaliação das alterações pleuropulmonares após a injeção de óleo de resina de copaíba, extrato aquoso de crajiru e polivinilpirrolidona iodado (PVPI) na pleura e parênquima pulmonar de ratos / Evaluation of the pleuropulmonary alterations after injection of copaiba oil, aqueous extract of crajiru and iodine PVP in the pleural space of mice

OBJETIVO: Avaliar as alterações anatomopatológicas e histopatológicas da pleura e do parênquima pulmonar após a injeção de óleo de copaíba, extrato aquoso de crajiru e polivinilpirrolidona iodado (PVPI) no espaço pleural de ratos. MÉTODO: Foram utilizados 128 Rattus norvegicus var. Wistar, machos, com peso médio 198,9g (± 24,9g), randomizados em quatro grupos: copaíba, PVPI, crajiru e simulação. As substâncias foram injetadas no espaço pleural direito dos animais, os quais foram mortos em 24 h, 48 h, 72 h e 504 h, para análise macro e microscópica da pleura visceral e pulmão direito. RESULTADOS: Macroscopicamente, observou-se intensa reação pleuro-pulmonar no grupo copaíba com significância estatística (p= 0,001) em relação aos outros grupos e entre os diferentes momentos. Microscopicamente, a espessura pleural apresentou maior aumento no grupo copaíba com significância estatística nos tempos 72 h e 504 h. O PVPI provocou reação inflamatória aguda em 24 h e 48 h com melhora em 72 h, porém, na última observação, evidenciou-se lesão crônica pulmonar. O crajiru apresentou-se pouco irritativo e sem significância em relação aos demais. CONCLUSÃO: A copaíba mostrou-se muito irritante; o PVPI, moderadamente irritante, e o extrato aquoso de crajiru apresentou pouca reação inflamatória na pleura e parênquima pulmonar dos animais de experimentação.

BACKGROUND: Copaiba oil and crajiru are Amazon phytotherapics which have anti-inflammatory and cicatrisation properties. There are no descriptions about their effects in the pleural space. Therefore, the purpose of this study is to evaluate macro and microscopic pleuropulmonary alterations after injection of copaiba's oil, aqueous extract of crajiru and iodine PVP in the pleural space of mice. METHODS: 128 Rattus norvegicus var. Wistar, male, with average weight of 198.9g (± 24.9g), were used and assigned for four groups: copaíba, PVPI, crajiru and control. These substances were injected in the right pleural space of the animals, which were killed in 24h, 48h, 72h and 504h. They were submitted to macroscopical and microscopical analysis of the lung and right visceral pleura. RESULTS: Macroscopic evaluation showed intense pleuropulmonary reaction in the copaiba's group with statistical significance (p=0.001) in opposite to the other groups and the different studied moments (24h, 48h, 72h and 504h). Microscopically, the pleural thickness had greater increase in the copaiba's group with statistical significance at the moments 72h and 504h. The PVPI caused an acute inflammatory reaction in the beginning of the experiment (24h and 48h) with improvement in 72h, however, in the last observation, chronic injury was shown The crajiru's group presented little damage and without significance in relation to the other groups. CONCLUSION: Copaíba revealed to be greatly irritating; the PVPI was moderately irritating and the watery extract of crajiru presented little inflammatory reaction for the pleura and lung of rats.

[Anal cytology as a screening method for early detection of anal cancer: are hydrophilic cotton smears really unsatisfactory?]. / Citologia anal como método de rastreamento para a detecção precoce do cancer anal: esfregaços com algodão hidrófilo são mesmo insatisfatórios?

PURPOSE: To test the ability of analpaps performed with cotton swab smears to produce satisfactory cytologic readings as compared to traditional sampling materials. METHODS: 318 consecutive patients were examined at the Ambulatório Araújo Lima of Hospital Universitario Getúlio Vargas in the Anal Cancer Prevention Week and were sampled for the performance of analpap. 180 of these patients were randomly sorted to be sampled by either one of the following materials: cytologic brush, dacron swab or cotton swab. The ability of cotton in producing satisfactory anal cytologic readings as compared to dacron and cytologic brush was analised. RESULTS: There was no statistical difference among the materials employed in the ability to produce satisfactory citological readings in analpaps. (p > 0.05) CONCLUSION: Our results showed that cotton swabs were as efficient as dacron swabs or cytologic brushes in the ability to produce satisfactory analpap readings.

Citologia anal como método de rastreamento para a detecção precoce do câncer anal: esfregaços com algodão hidrófilo são mesmo insatisfatórios? / Anal cytology as a screening method for early detection of anal cancer: are hydrophilic cotton smears really unsatisfactory?

OBJETIVO: Testar se swabs de algodão hidrófilo são capazes de produzir esfregaços de secreção anal que permitam leituras citológicas satisfatórias ao Pap-a em comparação a métodos tradicionais de coleta. MÉTODOS: 318 pacientes sofreram coleta de material anal para a realização do Pap-a. 180 deles realizaram a captura de células anais com material sorteado (escova citológica, swab de poliéster ou cotonete de algodão). Foram comparados entre si os materiais usados para a coleta de secreção anal segundo a capacidade de produção de leitura citológica satisfatória. RESULTADOS: Não houve diferença estatística entre o algodão hidrófilo, o poliéster e a escova na capacidade de produzir leituras citológicas satisfatórias (p>0,05). CONCLUSAO: No material estudado, o algodão hidrófilo foi tão bom quanto o poliéster ou a escova citológica na produção de leituras citológicas adequadas no Pap-a.

Intradiaphragmatic bronchogenic cyst

The bronchogenic cyst is a common congenital malformation, generally located in the mediastinum; however, it can develop in other areas, such as the diaphragm. A rare case of intradiaphragmatic bronchogenic cyst is described here, discovered in a 32 year-old patient, who experienced thoracic pain and dyspnea following thoracic trauma. The pre-operative exams were compatible with left diaphragmatic hernia. The patient was submitted to a left post-lateral thoracotomy with the operative discovery of a cystic lesion enveloped by the diaphragm with mucinous content, and a partial resection of the diaphragm was performed. The histological findings of the operated portion revealed ciliated cylindrical epithelium, compatible with bronchogenic cysts. The post-operative outcome was excellent.