BCG diseminada tipo miliar. Hallazgo de autopsia y diagnostico por PCR / Miliary BCG. Autopsy finding and PCR diagnosis

La diseminacion del BCG es una complicacion conocida en pacientes inmunodeficientes en quienes produce lesiones cutaneas oseas y viscerales, con extenso daño tisular. Menos frecuentemente se la ha mencionado en pacientes inmunocompetentes; en estos ultimos produce lesiones locales, diseminacion cutanea y osea, y una forma de diseminacion miliar visceral principalmente pulmonar y hepatica(cinco casos publicados previamente)

Sindrome de mobius por lesiones de tronco cerebral en un lactante con defectos congénitos multiples. Hallazgos neuropatológicos / Mobius syndrome due to brain stem damage in a milk-fed baby with multiple congenital defects. Neuropathological findings

Se presenta un caso de síndrome de mobius caracterizado clínicamente por parálisis facial y paresia del velo del paladar y cuerdas vocales del lado derecho, congénitos, asociados a hipoplasia ósea de la hemicara derecha y trastornos de conducción cardíacos (bloqueo de rama derecha y hemibloqueo anterior izquierdo). El estudio neuropatológico reveló una hipoplasia del hemibulbo y hemiprotuberancia derechos con ausencia de los núcleos del facial y del núcleo ambiguo. Se halló además ausencia del 1er. par, hipoplasia del núcleo del 6to. derecho y ausencia del núcleo del fasículo solitario. En el corazón se encontró una comunicación tipo ostium primun y anormalidades microscópicas del haz de his y sus ramas. El conjunto malformativo sugiere el efecto de una noxa que actuó entre la 5ta. y 6ta. semanas de edad gestacional (aproximadamente día 38 de la gestación), indicando una patogenia disruptiva para este caso. La revisión de la literatura reveló que si bien el síndrome de mobius puede tener además otras etiologías (genética esporádica, genética familiar, hipóxica periparto) su estudio neuroanatómico no es un hecho muy frecuente. (AU)

Hallazgos patológicos en la intoxicación por dietilenglicol. / [Pathologic findings in diethylene glycol poisoning]

We are reporting the necropsy findings of 7 patients poisoned with diethylene glycol-contaminated propolis (a rubbery substance produced by bees from vegetal resins). Besides the well-known features of hydropic necrosis of centrolobular areas in the liver and renal tubules we found acute pancreatitis with diffuse enzymatic fat necrosis which in two of the cases was considered the secondary cause of death, and acute demyelinating lesions in the central and peripheral nervous system. Six out of the 7 cases showed glomerular PAS-positive arteriolar hyalinosis at the vascular pole, in two of them widely disseminated. Differing from the findings reported in ethylene glycol poisoning we could not find calcium oxalate crystals in any of the cases. The pancreatic, central and peripheral nervous system lesions as well as the glomerular arteriolar hyalinosis have not been previously described in the literature in relation with diethylene glycol poisoning.

Atrofia focal con [quot ]cicatrices estrelladas[quot ] en niños con gastritis crónica asociada con Helicobacter pylori. Gastritis atrófica inicial? / [Focal atrophy with stellate scars in children with chronic gastritis associated to Helicobacter pylori. Is this early atrophic gastritis?]

BACKGROUND: Atrophic gastritis has not been described in children in the setting of Helicobacter Pylori infection. METHODS: Gastric biopsies of six children (7 to 11 years old) with history of HpCG and recent therapeutic eradication of H. Pylori, were reviewed. In the 6 H. Pylori was documented with histology, culture, direct visualization and/or serology before treatment. Cases were compared with five biopsies of age-matched patients showing none of the above-mentioned clinical data. All the biopsies were formalin-fixed, paraffin embedded and stained with hematoxilin-eosin, Masson trichrome and reticulin stain. RESULTS: The biopsies of the six treated patients showed variable-in-size stellate-shaped spots of glandular loss replaced by dense connective tissue with few inflammatory cells. The fibrous tissue showed a central area of scarring and radially oriented spikes extending to adjacent interglandular tissue, more evident with the Masson trichrome stain. Density of inflammatory cells in the lamina propria was variable. H. Pylori organisms were consistently absent. On the reticulin stain the atrophic areas showed coarser and compacted reticulin. Stellate scars were not present in the five controls. CONCLUSIONS: Small foci with fibrous scars may be found in children with long standing HpCG, perhaps as an early sequel of it. We hypothesize that if the chronic gastritis-gastric atrophy process is a continuum, these stellate scars may be representing the very beginning of the multifocal atrophic gastritis usually seen in adult patients.