Cytomegalovirus infection amplifies class I major histocompatibility complex expression on cultured human endothelial cells.

Cytomegalovirus infection, a common complication in immunosuppressed graft recipients, bears an adverse impact on graft survival. Cytomegalovirus enhances the expression of the monotypic determinants of the class I major histocompatibility complex molecule by the endothelium, possibly rendering the endothelial cells more immunogenic and prone to attack by the allogeneic lymphocytes. In the present study, we focused on the effect of cytomegalovirus on the endothelial cell expression of different class I genes, on the relation between the extent of endothelial cell infection and the class I effect, and on the time course of the class I changes induced by the cytomegalovirus infection. Cytomegalovirus infection of primary cultures of human umbilical vein endothelial cells augmented the expression of the A2, A3, and B7 class I major histocompatibility complex genes when compared with uninfected cells. beta 2 microglobulin upregulation by the infected cells paralleled the changes in specific class I expression; this effect was significant only after 7 days after infection. Double immunocytochemical staining and fluorescence-activated cell sorter analysis revealed that the class I enhancement was uniform throughout the umbilical vein endothelial cell monolayer and not restricted to the cells that expressed cytomegalovirus early or late antigens. Ultraviolet-inactivated supernatants from infected umbilical vein endothelial cell did not increase class I expression on uninfected cells. In conclusion, cytomegalovirus might affect graft survival by amplifying the changes in class I expression beyond the sites of viral replication.

Vulvar destruction by malignant lymphoma.

Two cases of vulvar and perineal destruction by malignant lymphoma are described. The first case was of an untreated 4-year-long vulvar destruction due to a kappa-positive lymphoplasmacytic lymphoma that ultimately resulted in the death of the patient. The second patient had involvement of the vulva and perineum by an angiocentric small and large mixed-cell lymphoma. Aggressive chemotherapy induced regression and healing of the lesions in the second case. Delayed diagnosis and inappropriate management of lymphomas in the vulva may lead to widely destructive disease of the lower female genital tract.

Sindrome da imunodeficiencia adquirida: descricao anatomo-patologica de dois casos de necropsia. / Acquired immunodeficiency syndrome: anatomopathological report of 2 necropsy cases

Os Autores apresentam dois casos de Sindrome de Imunodeficiencia Adquirida com enfase aos achados de necropsia. A criptococose generalizada de padrao miliar, infrequente, e a pneumocistose foram infeccoes oportunisticas de curso fatal pela destruicao parenquimatosa de orgaos vitais que acarretaram. E destacado o papel etiopatogenico do citomegalovirus, pela concomitancia de infeccao em ambos os casos e associacao aos orgaos mais afetados. Extensa necrose de supra-renal foi constatada, possivelmente secundaria a destruicao celular viral pelo CMV