Assuntos
Neoplasias Colorretais Hereditárias sem Polipose/genética , Neoplasias Colorretais Hereditárias sem Polipose/patologia , Leiomiossarcoma/genética , Leiomiossarcoma/patologia , Neoplasias Musculares/genética , Neoplasias Musculares/patologia , Neoplasias Primárias Múltiplas/genética , Neoplasias Primárias Múltiplas/patologia , Adulto , Colonoscopia , Evolução Fatal , Feminino , Humanos , Estadiamento de Neoplasias , Linhagem , Medição de RiscoRESUMO
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Assuntos
Idoso , Masculino , Humanos , Microscopia/métodos , Imuno-Histoquímica/métodos , Técnicas Imunoenzimáticas , alfa-Fetoproteínas/administração & dosagem , alfa-Fetoproteínas , Cirrose Hepática/diagnóstico , Cirrose Hepática/patologia , Úlcera Duodenal/complicações , Úlcera Duodenal/diagnóstico , Úlcera Duodenal/patologia , Hemorragia Gastrointestinal/complicações , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/mortalidade , Hemorragia Gastrointestinal/patologia , Carcinoma/diagnóstico , Carcinoma/patologia , Carcinoma/complicações , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/complicações , Pólipos Intestinais/diagnóstico , Pólipos Intestinais/complicações , Pólipos Intestinais/patologia , Metástase Neoplásica/patologia , Neoplasias Primárias Desconhecidas/diagnóstico , Neoplasias Primárias Desconhecidas/patologia , Neoplasias Intestinais/diagnóstico , Neoplasias Intestinais/patologia , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/patologia , Mucosa Gástrica/patologia , Mucosa Gástrica/ultraestrutura , Fígado/patologia , Carcinoma Hepatocelular/secundário , Pólipos Intestinais/secundárioRESUMO
Only a few reports of primary cutaneous rhabdoid tumors have been published. We describe the case of a 3-month-old female patient who developed a rhabdoid type cutaneous sarcomatoid neoplasm in her upper back, close to a benign myofibromatous proliferation of infancy. The lesion was studied both by light microscopy and immunohistochemically. Flow cytometry was performed showing a DNA diploid profile of the malignant tumor. The pathological findings suggest a mesenchymal origin (hemangiopericytic or myofibroblastic type) for both tumors. The patient was surgically treated, but she died nine months later.
Assuntos
Mesenquimoma/patologia , Neoplasias Primárias Múltiplas/patologia , Tumor Rabdoide/patologia , Neoplasias Cutâneas/patologia , Biomarcadores Tumorais/análise , Separação Celular , DNA de Neoplasias/análise , Evolução Fatal , Feminino , Citometria de Fluxo , Humanos , Técnicas Imunoenzimáticas , Lactente , Mesenquimoma/química , Mesenquimoma/genética , Mesenquimoma/cirurgia , Neoplasias Primárias Múltiplas/química , Neoplasias Primárias Múltiplas/genética , Neoplasias Primárias Múltiplas/cirurgia , Ploidias , Tumor Rabdoide/química , Tumor Rabdoide/genética , Tumor Rabdoide/cirurgia , Neoplasias Cutâneas/química , Neoplasias Cutâneas/genética , Neoplasias Cutâneas/cirurgiaRESUMO
AIM: To determine the clinical and prognostic value of serum laminin in chronic alcoholic liver disease and to discern whether laminin, alone or in combination with serum N-terminal type III collagen propeptide, and/or biochemical parameters, is useful in estimating the histomorphometrically determined amount of fibrosis. STUDY DESIGN: Prospective. PATIENTS: 121 (80 of them cirrhotics), 107 followed up for a variable periods ranging from 1 to 1440 days. RESULTS: Serum laminin was higher in cirrhotic patients belonging to Child's C group and, in cirrhotic patients, it significantly correlated with Pugh's score (r = 0.32, p < 0.01), prothrombin activity (r = 0.23, p < 0.05), serum albumin (r = -0.35, p < 0.001) and bilirubin (r = 0.30, p < 0.01), and also with the degree of fibrosis (r = 0.49, p < 0.001). Serum laminin over 3.5 U/ml were associated to higher mortality rates in the total population (Log rank test = 4.9, p = 0.022), but not in cirrhotics. Stepwise multiple regression analysis showed that laminin is useless in the estimation of liver fibrosis in cirrhotics, although in non-cirrhotic alcoholics, serum laminin together with alkaline phosphatase and GGT roughly estimates the amount of liver fibrosis (r = 0.72, p < 0.001, standard error = 7.29). CONCLUSIONS: Laminin is not useful in estimating the total amount of fibrosis neither in prognostic assessment of cirrhotics. However, serum laminin-values over 3.5 U/ml were associated with higher mortality rates in patients with chronic alcoholic liver disease, and serum laminin together with alkaline phosphatase and GGT correlated with the amount of fibrosis in the non-cirrhotic subgroup.
Assuntos
Laminina/sangue , Cirrose Hepática/sangue , Hepatopatias Alcoólicas/sangue , Adulto , Fosfatase Alcalina/sangue , Bilirrubina/sangue , Doença Crônica , Ensaios Enzimáticos Clínicos , Colágeno/sangue , Seguimentos , Humanos , Cirrose Hepática/diagnóstico , Hepatopatias Alcoólicas/diagnóstico , Hepatopatias Alcoólicas/mortalidade , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Protrombina/análise , Análise de Regressão , Albumina Sérica/análise , Fatores de Tempo , gama-Glutamiltransferase/sangueRESUMO
A 27 year old male patient was referred to our clinical unit because of marked elevation of serum bilirubin (up to 15.3 mg/dl), ASAT (563 U/l) and ALAT (845 U/l) were detected after institution of therapy with alpha interferon. The patient had been previously treated because of persistent slight elevation of serum transaminases, serological markers of hepatitis B virus and hepatitis C virus being both negative. Liver histology was consistent with chronic active hepatitis. Antinuclear, anti smooth muscle and antimitochondrial autoantibodies were all negative, although anti smooth muscle antibodies became positive (1/40) after interferon therapy. The drug was withdrawn, prednisone was instituted, and transaminases and bilirubin values returned to normality.
Assuntos
Hepatite Crônica/patologia , Hepatite/tratamento farmacológico , Interferon-alfa/efeitos adversos , Adulto , Anti-Inflamatórios/uso terapêutico , Bilirrubina/sangue , Biópsia , Doença Crônica , Hepatite/complicações , Hepatite/diagnóstico , Hepatite Crônica/diagnóstico , Humanos , Fígado/patologia , Masculino , Prednisona/uso terapêutico , Transaminases/sangueRESUMO
We have analyzed 245 transplant aspirative cytologies (TACs) from 96 renal allograft patients. TACs were divided in two chronological groups: Early (TACs performed during the first 3-mo posttransplantation) and late (TACs performed after the third month post-transplantation), in order to assess the effect of allograft tolerance on TAC features. Both morphological and immunocytochemical aspects were evaluated, including CD4, CD8, IL2-R, and HLA-DR immunolabeling. A final diagnosis for each case of allograft dysfunction was achieved by other independent diagnostic means. Four diagnostic groups were considered in the present study: acute rejection (AR), chronic rejection (CR), acute tubular necrosis (ATN), and Cyclosporin A toxicity (CsA-T). In addition, a control group (C) was established from patients with stable allograft function. We found that immunocytochemical analysis of TACs is particularly helpful in the diagnosis of late allograft dysfunction, a time period when the simple cytological study of renal infiltrate is not informative enough to help take therapeutic decisions.
Assuntos
Transplante de Rim/patologia , Técnicas Citológicas , Diagnóstico Diferencial , Seguimentos , Rejeição de Enxerto/patologia , Humanos , Imuno-Histoquímica , Sucção , Fatores de Tempo , Transplante HomólogoRESUMO
In vitro studies have shown that growth factors may mediate the growth stimulatory effect of estrogen in hormone-dependent human breast carcinomas while the constitutive expression of same growth factors might by-pass the need for estrogenic stimulus in hormone-independent neoplasms. We have performed immunocytochemical analysis of the expression of epidermal growth factor receptor (EGF-R or proto-oncogen c-erbB-1) and estrogen receptor (ER) in 70 cases of human breast carcinoma. We found an inverse relationship between the expression of EGF-R and ER (Kendall's tau b = -0.1997, P < 0.03), which prompts us to conclude that ER(-) breast carcinomas may grow in a hormone-independent manner through the over-expression of the proto-oncogene c-erbB-1, which is the receptor for epidermal (EGF) and alpha transforming (TGFalfa) growth factors.
Assuntos
Neoplasias da Mama/genética , Receptores ErbB/genética , Regulação Neoplásica da Expressão Gênica/fisiologia , Neoplasias Hormônio-Dependentes/genética , Proteínas Proto-Oncogênicas/genética , Receptores de Estrogênio/genética , Idoso , Mama/patologia , Neoplasias da Mama/patologia , Feminino , Humanos , Técnicas Imunoenzimáticas , Pessoa de Meia-Idade , Neoplasias Hormônio-Dependentes/patologia , Prognóstico , Proto-Oncogene MasAssuntos
Rejeição de Enxerto , Transplante de Rim/patologia , Biomarcadores , Biópsia por Agulha/métodos , Relação CD4-CD8 , Ciclosporina/efeitos adversos , Ciclosporina/uso terapêutico , Humanos , Transplante de Rim/imunologia , Receptores de Interleucina-2/análise , Estudos Retrospectivos , Transplante HomólogoRESUMO
To evaluate changes in T-lymphocyte subsets and DR expression on tubular cells, 74 fine-needle allograft aspirates (FNAB) were evaluated in 31 patients with cadaver kidney transplants. Monoclonal antibodies against T helper CD4+, cytotoxic/suppressor CD8+, and HLA-DR were used with an indirect alkaline-phosphatase-staining technique. Cases with acute rejection (n = 11) showed a significant increase of CD8+: CD4+ ratio versus those with stable function (n = 21), acute tubular necrosis (n = 10) or CsA toxicity (n = 7) (ANOVA F = 10; P less than 0.01). Cases with chronic rejection or CMV infection showed no differences in the CD8+: CD4+ ratio with the other groups. DR expression on tubular cells was frequently found in cases of acute rejection, chronic rejection and CMV (73%, 66%, and 43% respectively), occasionally found in CsA toxicity (14%), but never seen in controls or ATN. Both tests, the CD8+: CD4+ ratio and the DR expression on tubular cells, had a high sensitivity and specificity in differentiating acute rejection versus controls, acute tubular necrosis, and CsA toxicity. When both tests are taken together no case without rejection showed a CD8+:CD4+ ratio greater than 1.6 and DR expression on tubular cells. Cases with acute rejection who lost the graft (n = 6) had a CD8+:CD4+ ratio significantly greater than those who responded to antirejection therapy (n = 5) (t = 2.9; P less than 0.05).