Expression of p53, Ki-67, and CD31 in the vaginal margins of radical hysterectomy in patients with stage IB carcinoma of the cervix.

OBJECTIVES: This study was undertaken to evaluate the expression of p53, Ki-67, and CD31 both in the tumor and in the vaginal margins of radical hysterectomy in patients with stage IB squamous cell carcinoma of the cervix, as an attempt to use these proteins as possible markers for residual tumor in cervical cancer. METHODS: Thirty patients with stage IB squamous cell carcinoma of the cervix were submitted to radical hysterectomy (study group), and thirty patients with uterine myoma were submitted to vaginal hysterectomy (control group) and were prospectively studied from November 2001 to September 2002. Tissue samples were taken from the tumor or cervix, anterior vaginal margin (AVM), and posterior vaginal margin (PVM) and were immunohistochemically evaluated by monoclonal antibodies for p53, Ki-67, and CD31. Vaginal samples in which the histological examination showed tumor involvement were excluded from the study. RESULTS: Patient's mean age was 48.7 +/- 10.4 years (27-73 years). The clinical stage was IB1 in 22 patients (73.3%) and IB2 in eight patients (26.7%). The expressions of p53, Ki-67, and CD31 were significantly higher in the tumor than in the benign cervix (P < 0.001). Higher expressions of these markers were noted in the vaginal margins of radical hysterectomy in patients with cervical carcinoma compared to the vaginal margins of control patients. This association was demonstrated for p53 in the AVM proximal (P = 0.045), for Ki-67 in AVM proximal (P < 0.001), AVM distal (P < 0.001), PVM proximal (P = 0.009), and PVM distal (P < 0.001), and for CD31 in AVM proximal (P = 0.003) and AVM distal (P = 0.018). There was no difference in p53, Ki-67, and CD31 expression between the proximal and distal regions of the vaginal margins in patients with carcinoma of the cervix. CONCLUSION: The expressions of p53, Ki-67, and CD31 were significantly higher in both the histologically positive (cervical tumor) and negative (vaginal margins) tissues of patients who had undergone radical hysterectomy for cervical cancer compared to the benign control tissues.

Orbital solitary fibrous tumor: report of two cases and literature review.

BACKGROUND: Solitary fibrous tumor (SFT) is a rare, benign, and very uncommon lesion in the orbit. Because of its complex and variable clinical and histological appearance the SFT is often misdiagnosed. CASES: Two new cases of orbital SFT are reported, one in a man and the other in a woman, both unilateral and in the superomedial orbit. OBSERVATIONS: Clinical and tomographical evaluations were conducted and the lesions were excised. The histological evaluation showed the tumors were composed of spindle-shaped cells within collagen bundles and vascular channels. Immunohistochemical staining was positive for CD 34 and negative for S-100 protein. CONCLUSION: Immunohistochemical study is an important adjuvant in determining the SFT diagnosis. Long-term follow-up is necessary because of the possibility of SFT recurrence after excision.

Hodgkin disease in adult and juvenile groups from two different geographic regions in Brazil: characterization of clinicopathologic aspects and relationship with Epstein-Barr virus infection.

We analyzed clinicopathologic data, immunophenotype, and Epstein-Barr virus (EBV) status in 96 cases of Hodgkin disease (HD) in juveniles (younger than 20 years) and adults (20 years or older) from 2 distinctive states in Brazil. We studied 34 juvenile (group 1) and 16 adult (group 2) cases from Ceara and 31 juvenile (group 3) and 15 adult (group 4) cases from São Paulo. Ceara has a socioeconomic profile similar to a developing country; São Paulo is in better economic condition. Mixed cellularity (MC) was the major histologic subtype among groups 1 (22 [65%]), 3 (21 [68%]), and 4 (7 [47%]); nodular sclerosis (NS) was more frequent in group 2 (8 [50%]). EBV infection was observed in 61 cases (64%), including the following (among others): group 1, MC, 22 (65%) and NS, 4 (12%); group 2, NS, 3 (19%) and MC, 2 (12%); group 3, MC, 16 (52%) and NS, 1 (3%); and group 4, MC, 7 (47%). There was predominance of EBV+ HD cases in group 1 compared with group 3. HD in Brazilian patients is highly associated with EBV infection, but geographic differences reflect histologic subtypes and age distribution.

Preditores clínicos e histopatológicos de tumor trofoblástico gestacional pós-mola hidatiforme completa / Clinical and histopathological predictors of gestacional trophoblastic tumor +after complete hydatidiform mole

Objetivo: definir os preditores clínicos e histopatológicos mais eficientes da evolução da mola hidatiforme completa (MHC) Para tumor trofoblástico gestacional (TTG). Métodos: estudo prospectivo clínico e histopatológico de todas as portadoras de MHC, atendidas entre 1990 e 1998 no Hospital das Clínicas de Botucatu - UNESP. A avaliação clínica pré-esvaziamento molar classificou a gravidez molar em: MHC de alto risco e MHC de baixo risco. Foram analisados os preditores clínicos para TTG, estabelecidos por Goldstein et al. e por outros autores. A avaliação histopatológica incluiu a determinação do diagnóstico de MHC, segundo os critérios de Szulman e Surti, e o reconhecimento dos fatores de risco para TTG, de Ayhan et al.. Os preditores clínicos e histopatológicos foram correlacionados com o desenvolvimento de TTG pós-molar. Resultados: em 65 portadoras de MHC, cistos do ovário maiores que 6 cm e tamanho uterino maior que 16 cm foram os preditores clínicos mais eficientes de TTG. A proliferação trofoblástica, a atipia nuclear, a necrose/hemorragia, a maturação trofoblástica e a relação cito/ sinciciotrofoblasto não foram preditores significativos para TTG. A correlação entre preditor clínico e histopatológico para o desenvolvimento de TTG não foi possível porque nenhum parâmetro histopatológico foi significativo. Conclusões: mais estudos são necessários para avaliar possíveis preditores de persistência (TTG) a sua aplicação no contexto clínico das MHC. Enquanto isso, a determinação seriada de hCG serico permanece o único indicador prognóstico seguro para TTG pós-MHC

Morte súbita: definiçöes, significado clínico e patogênese - o papel dos Serviços de verificaçäo de óbito / Sudden death: definitions, clinical implications and pathogenesis - the role of the coroner's autopsy

O patologista e os serviços de verificaçäo de óbito (SV) têm papel de destaque no correto diagnóstico de morte súbita. A menor incidência no ambiente hospitalar, o caráter inesperado e os mecanismos fisiopatológicos peculiares fazem com que os conceitos a respeito de morte súbita sejam menos conhecidos pelos médicos. Diante disso, os autores fazem uma revisäo dos critérios, dos mecanismos e das repercussöes clínico-epidemiológicas do diagnóstico de morte súbita, apresentando também a casuística do serviço de Verificaçäo de óbito do Departamento de Patologia da Universidade Estadual Paulista (UNESP) - Botucatu-SP

Doença de Hodgkin infarto-juvenil no estado do Ceará e sua relaçäo com vírus de Epstein-Barr: parâmetros clínicos e análise morfológica, imuno-histoquímica e por hibridizaçäo in situ / Hodgkin's disease in chidhood and adolescence in the state of Ceará and its relationship to Epstein-Barr virus: clinical profile, morphological, immunohistochemical and in situ hybridization analysis

O vírus de Epstein-Barr (EBV) tem sido implicado numa série de neoplasias, das quais se destacam o carcinoma nasofaríngeo, o linfoma de Burkitt e a Doença de Hodgkin (DH). Ýs evidências clínico-epidemiológicas de sua participaçäo na DH juntou-se a demonstraçäo direta do EBV na célula de Reed-Sternberg, através de técnicas de biologia molecular, hibridizaçäo in situ (HIS) e imuno-histoquímica (IHQ). O papel do EBV parece mais importante no subtipo celularidade mista (DHCM), nos casos infantis e nos países de 3o. mundo. Com o objetivo de avaliar o perfil da DH infanto-juvenil no estado do Ceará e sua possível associaçäo com o EBV,34 casos de DH de pacientes desta regiäo, menores de 18 anos, foram selecionados. Foi realizada revisäo histológica dos linfonodos, IHQ com marcadores linfóides e LMP (latent membrane protein viral), e HIS para a detecçäo do genoma viral nas células RS. Conclui-se que no grupo infanto-juvenil do estado do Ceará há grande incidência da DH em crianças abaixo de 10 anos e acometimento mais frequente de linfonodos cervicais, sendo o subtipo mais comum a DHCM (64,7 por cento). Além disso, a DH infanto-juvenil no estado do Ceará está fortemente associada ao EBV, principalmente na sua forma DHCM (EBV foi detectado em 100 por cento dos casos de DHCM). HIS e IHQ säo técnicas de boa qualidade e adequadas para a pesquisa do EBV em nosso meio