Castleman's disease mimetizing pancreatic tumor.

CONTEXT: Angiofollicular lymph node hyperplasia or Castleman's disease is a rare clinical condition. Knowledge about etiology and physiopathology; and treatment management as well are yet to be defined. Unicentric presentation of this disease affecting single lymph nodes in the mediastinum seems to be the most common presentation. Castleman's disease localized in the pancreas topographic area that mimics a pancreatic neoplasm is an even more uncommon event, with available published data of less than 15 cases until now. CASE REPORT: We present a 64-year-old male patient with a six-month past history of asthenia, adynamia, and lack of general clinical conditions. Imaging studies showed a nodular hypoechoic mass in the pancreatic head. Enucleation of the lesion was performed. Histopathological study revealed unicentric form of Castleman's Disease. CONCLUSIONS: Castleman's disease mimetizing pancreatic tumor is uncommon and it also curses with a difficult preoperative diagnosis. Surgery seems to be the best therapeutic alternative for this disease.

Development of intraepithelial cells in the porcine small intestine.

The number, phenotype, localisation and development of intraepithelial lymphocytes (IEL) from duodenum (Du) and ileum (Il) were studied by immunohistochemistry (IHC) and light and electron microscopy in unweaned (0-7 weeks old) and six months-old pigs. Developmental changes at birth showed that 38% of the total lymphocytes in the villi were IEL, mainly of the CD2+CD4-CD8- double negative (DN) phenotype. That proportion rose to over 50% at week 5 after birth, resembling adult proportion, although still with fewer cells than in adult pigs. CD4+ cells appeared relatively early in life although they were confined to the lamina propria (LP) and CD8+ cells were found only in low numbers. In the villi of adult animals, almost half of the total number of lymphocytes were IEL (49% Du, 52% Il). Over half of these IEL (52% Du, 53% Il) showed the CD2+CD4-CD8+ phenotype and were localized at the epithelium's basement membrane. Numerous (43% Du, 42% Il) DN IEL were found grouped at the enterocyte nucleus level and relatively few (5% in Du and Il) granular IEL were found apically in the epithelium. These proportions were homogeneously maintained along the villi's tip, middle and bottom, suggesting that the IEL may have their origin in the LP. Therefore, the IEL compartment in the porcine intestine develops slowly with age and is actually composed by a heterogeneous population of cells (null, DN and CD8+). These results may explain the increased susceptibility of young animals to disease during the lactation period and should be taken into account when functional studies are carried out with IEL. The quantitative results of this paper established a model for studies on the effect of age, diet, normal flora, infection and oral immunization on the IEL of the gut.

Lymphocyte subsets in experimental hemochromatosis.

The distribution of lymphocyte subsets in blood, thymus, spleen, mesenteric lymph nodes, Peyer's patches and bone marrow was evaluated in an experimental model of secondary hemochromatosis in rats. The values of CD2, CD4, CD8, B and NK cells in these different lymphoid compartments did not differ between the control group and the experimental group. These results suggest that the abnormalities of lymphocyte subsets previously reported in patients with secondary hemochromatosis may be due to factors other than iron overload.

Quantitation of soluble E-receptor of T lymphocytes in serum from HIV-1 positive patients.

Human T lymphocytes carry a membrane receptor for sheep erythrocytes (E) related to the CD2 molecule. The E-receptor is found in a soluble from (Rs) in serum and can be quantitated by "rocket electrophoresis" using an anti-Rs serum obtained by immunizing sheep with autologous erythrocytes coated with Rs. Increased serum levels of Rs are found in patients with diseases associated with immunodepression. In the present study, 14 asymptomatic HIV-1 seropositive individuals were investigated regarding their Rs levels and delayed hypersensitivity skin tests every 3 months for a period of 35 months. All these patients progressed to AIDS in this period. Rs serum levels have also been quantitated in 14 normal individuals. The mean Rs values in normal individuals, asymptomatic, and AIDS patients were, respectively: 4.8 +/- 1.5 mm (SD), 9.6 +/- 1.9 mm (SD) and 11.3 +/- 2.4 mm (SD). An increase of Rs serum levels was observed when we compared normal individuals with CDC-II and CDC-IV clinical stage patients (P < 0.05, Mann-Whitney test) and CDC-II and CDC-IV patients, (P < 0.05, Wilcoxon test). We have observed a depressed delayed hypersensitivity response to ubiquitous antigens in CDC-IV patients. Our results indicate that Rs serum levels can be used as a progression marker in HIV infected patients.

Phenotypic analysis of intestinal non-inflamed mucosa in Crohn's disease: evidence of mononuclear cell depletion in lamina propria.

OBJECTIVE: The objective of this study was to examine mononuclear cell subpopulations and evidence of cellular activation in unaffected jejunal mucosa in Crohn's disease. DESIGN: A cross-sectional study was performed in patients with Crohn's disease from the ambulatory unity of the University Hospital, UFRJ. METHODS: Mucosal samples from 20 patients with Crohn's colitis or ileitis were obtained by peroral jejunal biopsy. Patients with jejunal involvement or pregnant women were excluded from the study. Specimens were analysed histologically and by indirect immunoperoxidase method using anti-monoclonal antibodies to CD2, CD4, CD8, CD25, CD45RO, RFDR1, RFD1 and RFD7 by two 'blind' observers. Seven patients with non-inflammatory bowel disorders and two healthy volunteers were studied as controls. RESULTS: Lamina propria CD2-positive (CD2+) cells were reduced in Crohn's disease (P < 0.004) whether clinically active (P < 0.02) or clinically inactive (P < 0.008). CD4+ and CD8+ cells were also reduced in Crohn's disease (P < 0.003), whereas the CD4:CD8 ratio did not differ from that in controls. CD25+, CD45RO+ and HLA-DR+ cells were not significantly increased in patients with Crohn's disease. RFD7+ cells were decreased in Crohn's disease (P < 0.02), whereas RFD1+ cells were not significantly different from the control group. CONCLUSION: No evidence of cellular activation was found in the unaffected mucosa of Crohn's disease. The reduction in T-cell and macrophage-like cell numbers may result from cell migration to inflamed areas. It is also possible that this finding represents a primary defect which may have a role in the pathogenesis of Crohn's disease.

Effect of early weaning on the development of immune cells in the pig small intestine.

The controlled effects of age and weaning on the numbers of CD2+ T cells, subsets (CD4+, CD8+), accessory cells (macrophage/granulocyte) and cells expressing MHC class II (DQw) and IL-2R in the piglet intestine was investigated. At birth low numbers of CD2+CD4-CD8- cells were the only demonstrable T cells in the intestine. Monocyte/granulocyte and MHC class II+ cells were also detected in low numbers and IL-2R+ cells were proportionally quite numerous. All those cell populations, except the IL-2R+ cells, increased thereafter and peaked at Week 7 when the numbers of cells were comparable with those of adult animals. CD4+ cells increased dramatically after Week 1. In contrast, CD8+ remained scarce until after 5-7 weeks of age in unweaned animals. Four days after weaning at 3 weeks old, there were increases in CD2+ (P < 0.001) and macrophage/granulocyte (P < 0.01) cells in proximal small intestinal villi and in CD2+ cells only (P < 0.01) in crypts. No significant changes in cell numbers were demonstrated in the distal small intestine.