An integrated analysis of the structural changes and gene expression of spleen in human visceral leishmaniasis with and without HIV coinfection.

The spleen plays a pivotal role in the pathogenesis of visceral leishmaniasis. In severe forms of the disease, the spleen undergoes changes that can compromise its function in surveilling blood-circulating pathogens. In this study, we present an integrated analysis of the structural and gene expression alterations in the spleens of three patients with relapsing visceral leishmaniasis, two of whom were coinfected with HIV. Our findings reveal that the IL6 signaling pathway plays a significant role in the disorganization of the white pulp, while BCL10 and ICOSLG are associated with spleen organization. Patients coinfected with HIV and visceral leishmaniasis exhibited lower splenic CD4+ cell density and reduced expression of genes such as IL15. These effects may contribute to a compromised immune response against L. infantum in coinfected individuals, further impacting the structural organization of the spleen.

Breast cancer in very young women: Clinicopathological study of 149 patients ≤25 years old.

BACKGROUND: Breast cancer in young women has different clinical and pathologic features and a more aggressive biological behavior when compared to breast cancers in older women. However, information is limited to the group of very young women (≤25 years). OBJECTIVES: The aim of the present study was to investigate the pathological characteristics of breast cancer in 149 Brazilian women who were ≤25 years old at the time of breast cancer diagnosis. MATERIALS AND METHODS: Tumor samples diagnosed between 2003 and 2009 were analyzed from the archives of the Bacchi Laboratory. RESULTS: In our series of 149 Brazilian women ≤25 years, 8.7% presented with in situ disease only. Of 136 invasive carcinomas, 91.9% were of the ductal type and 45.6% were of histological grade III. Overall, estrogen receptor (ER) was positive in 59.6% cases, and HER2 overexpression was detected in 32.8%. We also found a low prevalence of Luminal A cases and a high prevalence of Triple Negative cases. Statistical analysis showed that HER2 and basal-like groups had a lower overall survival expectation. Follow-up data showed high frequencies of regional lymph node metastasis, distant metastasis, and tumor-related deaths. CONCLUSION: The present study represents the largest series of breast cancer arising in women ≤25 years and establishes the main clinical, pathological, immunohistochemical and follow-up features of this population.

Immunohistochemistry applied to the differential diagnosis between ductal and lobular carcinoma of the breast.

The distinction between classic lobular and ductal carcinoma, both in situ and invasive, has important therapeutic and management implications. Most ductal and lobular carcinomas are distinguished readily on hematoxylin-eosin-stained sections because of distinct histomorphologic features. In cases with ambiguous morphologic features, however, categorization in one or another type can be a challenge. Several immunohistochemical markers, including epithelial cadherin, p120, ß-catenin, and low-molecular-weight and high-molecular-weight cytokeratins among others, have been introduced to help better discriminate between lobular neoplasia and ductal carcinoma. In this critical review of the literature, we comment about the usefulness and the limitations of these markers to improve the accuracy in the differential diagnosis of breast pathology.