RESUMO
Penicillosis caused by Penicillium marneffei is endemic in Asia and is a highly fatal disease in HIV-AIDS patients. Reports, however; in other immunocompromized diseases are scanty. This report describes the cytological diagnosis of P. marneffei infection from the sputum of a pediatric patient with hypogammaglobulinemia with hyper IgM and severe pneumonia. In this case, rapid, differential identification of the characteristic septated structure of P. marneffei in the macrophages, bronchial epithelium and also extracellularly allowed prompt and proper treatment. In addition, morphometry of P. marneffei obtained from the clinical specimen was reported. This report demonstrated the fungus was not only in the phagocytes, a phenomenon that is well recognized, but also in epithelial cells. Moreover, it also highlights the need for awareness of penicillosis in non-AIDS immunocompromized patients living in, or persons traveling to, P. marneffei-endemic areas.
Assuntos
Itraconazol/uso terapêutico , Micoses/diagnóstico , Penicillium/isolamento & purificação , Pneumonia/diagnóstico , Agamaglobulinemia/complicações , Pré-Escolar , Citodiagnóstico , Humanos , Síndrome de Imunodeficiência com Hiper-IgM/complicações , Hospedeiro Imunocomprometido , Masculino , Micoses/tratamento farmacológico , Penicillium/citologia , Pneumonia/tratamento farmacológico , Escarro , Resultado do TratamentoRESUMO
AIM: To establish and characterize a new cholangiocarcinoma cell line from a patient living in the Opisthorchis viverrini (O. viverrini) endemic area of Northeast Thailand. METHODS: Fresh liver biopsy and bile specimens were obtained from a 65-year-old Thai woman with cholangiocarcinoma of the porta hepatis. After digestion, the cells were cultured in Ham's F12 media. The established cell line was then characterized for growth kinetics, cell morphology, imm-unocytochemistry and cytogenetics. Tumorigenicity of the cell line was determined by heterotransplanting in nude mice. RESULTS: The primary tumor was a poorly differentiated tubular adenocarcinoma. Examination of the bile revealed malignant cells with O. viverrini eggs. The cholangioc-arcinoma cell line KKU-100 was established 4 mo after the primary culture-population doubling time was 72 h. KKU-100 possesses compact and polygonal-shaped epithelial cells. Immunocytochemically, this cell line exhibited cytokeratin, EMA, CEA, and CA125, but not alpha-fetoprotein (AFP), CA19-9, desmin, c-met, or p53. Such protein expressions parallel those of the primary tumor. Cytogenetic analysis identified aneuploidy karyotypes with a modal chromosome number of 78 and marked chromosomal structural changes. Inoculation of KKU-100 cells into nude mice produced a transplantable, poorly differentiated aden-ocarcinoma, similar to the original tumor. CONCLUSION: KKU-100 is the first egg-proven, Opisthorchis-associated cholangiocarcinoma cell line, which should prove useful for further investigations of the tumor biology of this cancer.