Expression of blood group-related antigens in neoplastic uterine cervix

Expression of blood group antigens in normal, displastic and tumoral uterine cervix from 35 hysterectomised women with carcinoma of the cervix was investigated; the results were correlated with patients' ABH phenotype and secretor status. We used an indirect immunoperoxidase technique and a panel of monoclonal antibodies and lectins directed against different antigenic specificities. Anomalous expression of blood group antigens in premalignant lesions from cervix was found. Partial loos of expression of blood group antigens and some lectins in different grades of cervical intraepithelial neoplasia, and a total loss of expression in CIN III and in infiltrating carcinoma of the cervix from secretor patients was revealed. The findings herein described confirm the importance of these antigens as tumour markers and they might be useful for the study of cervical carcinogenesis (AU)

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Bronquiolitis respiratoria como causa de fibrosis pulmonar (BR-FP): estudio histopatológico y ultraestructural de tres casos / Respiratory bronchiolitis with cause of pulmonary fibrosis (BR-FP): study histopathologic and structure of three cases

La bronquiolitis respiratoria es una lesión que se desarrolla en los pulmones de pacientes fumadores. Recientemente ha sido señalado que esta enfermedad puede evolucionar hacia la fibrosis pulmonar y se denomina Bronquiolitis Respiratoria-Fibrosis pulmonar. Histologicamente: La lesión se caracteriza por fibrosis peribronquiolar con macrófagos alveolares con un pigmento citoplasmático, finamente granular PAS positivo y Azul de Prusia débilmente positivo localizados en los espacios bronquiolares y alveolares, enfisema centrolobulillar e hiperplasia de neumocitos tipo II. A la ultraestrctura se observa en el citoplasma de los macrófagos alveolares intraluminales, fagolisosomas complejos que contienen un material amorfó electro-denso y particulas electrón lúcidas en forma de agujas conocidas como "inclusiones del fumador". Estudiamos tres (3) biopsias pulmonares con diagnóstico clínico de Enfermedad Pulmonar Intersticial. A través del estudio morfológico correlacionado con la clínica y la radiología concluimos que se trataba de una BR-FP. Enfatizamos la importancia de los criterios diagnósticos morfológicos y el diagnóstico diferencial de esta entidad, ya que se describe que tiene buena respuesta a la terapia con esteroides y al cese del hábito de fumar, por lo cual se considera de mejor pronóstico que otras enfermedades pulmonares intersticiales

Melatonin treatment enhances the efficiency of mice immunization with Venezuelan equine encephalomyelitis virus TC-83.

To determine whether treatment with melatonin (MLT) improves the efficiency of immunization against Venezuelan equine encephalomyelitis (VEE) virus, mice were vaccinated with TC-83 VEE virus and treated daily with MLT (1 or 5 mg/kg) starting 3 days before immunization, until 10 days after. IgM antibody titers were determined at days 7, 14, and 21 post-immunization. IL-10 levels were assayed at day 14 postvaccination. Treatment with MLT increased antibody titers 14 days after the immunization. IL-10 levels also increased with MLT treatment (1 and 5 mg/kg). Mice were challenged with live VEE virus at day 21 postimmunization, and viral titers were plaque assayed in chicken embryo fibroblasts 4 days after the infection. Following this challenge brain virus levels were significantly reduced. The results suggest that MLT treatment enhances the efficiency of mice immunization against VEE virus.

Melatonin prolongs survival of immunodepressed mice infected with the Venezuelan equine encephalomyelitis virus.

Male albino mice immunodepressed after the injection of dexamethasone (DEX) were inoculated intraperitoneally with the Guajira strain of Venezuelan equine encephalomyelitis (VEE) virus. Melatonin (MLT) was administered daily, at a dose of 500 micrograms/kg bodyweight, for 3 days before virus inoculation and 10 days after. Serum levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-2 (IL-2) were determined in all the experimental groups (control, DEX, DEX + MLT, DEX + VEE, DEX + VEE + MLT, VEE and MLT). At day 6 after the virus inoculation, the survival rate was significantly increased from 0% in group DEX + VEE to 32.5% in the group of immunodepressed infected mice treated with MLT (DEX + VEE + MLT). By day 10 a survival rate of 10% was found in group DEX + VEE + MLT and 0% in group VEE. No alterations in IL-2 serum levels were observed. MLT increased GM-CSF in control and in DEX-treated mice. In the VEE virus-infected mice treated with DEX, serum levels of GM-CSF increased progressively from day 1 to 5 postinoculation. In contrast, the levels of GM-CSF in infected immunodepressed mice treated with MLT decreased significantly from day 1 to 5 postinoculation. At day 5 after viral inoculation, no differences were detected in the cerebral viral titres in groups VEE, DEX + VEE and DEX + MLT + VEE. These results show that MLT does not inhibit VEE viral replication in the brain of immunodepressed mice.

Ovarian ependymoma. A case report.

We present the case of a 30-year-old woman who was referred to our institution with an erroneous diagnosis of poorly differentiated carcinoma of the ovary. The patient presented pelvic pain for one year prior to surgery. A second laparotomy revealed a bilateral pure ovarian ependymoma that infiltrated the uterus and presented implants on the omentum. Differential diagnosis included mainly endometrioid and small cell carcinoma of the ovary. Presence of typical ependymal rosettes and positivity to GFAP confirmed the diagnosis of ependymoma. Other teratomatous elements were not observed. Ovarian ependymomas are rare tumors; only eight cases, to our knowledge, have been reported in the literature. They have a favorable prognosis; patients with advanced stage disease are reported alive and well after treatment with surgery and chemotherapy.

Cotyledonoid dissecting leiomyoma (Sternberg tumor): an unusual form of leiomyoma.

Smooth muscle tumors are the most common neoplasms of the female genital tract. While most are usually easy to diagnose, several variants pose considerable diagnostic difficulties. Recently, a new form of uterine smooth muscle tumor was described that has an infiltrative character, which was named "cotyledonoid dissecting leiomyoma" or "Sternberg tumor" due to its macroscopic similarity to the gross architecture of the placental cotyledon. This report, the second such of this tumor, describes the macroscopic, microscopic, immunohistochemical and ultrastructural features of one of these unusual cases.

[Morphometric analysis of nuclear variations in normal and neoplastic mammary ductal cells]. / Análisis morfométrico de variables en núcleos de células ductales normales y neoplásicas de la glándula mamaria. Informe preliminar.

Morphometry is a method to detect changes in a variety of tissues through quantitative elements. The purpose of this study was to examine several nuclear morphologic characteristics in normal and neoplastic mammary ductal cells using a multivariable method and expression of estrogen receptors by immunohistochemical techniques. A total of 1879 nuclei were examined by a computerized program, following the detection of estrogen receptors. Nuclear area, perimeter, diameter, maximal and minimal radio were obtained in 439 normal ductal nuclei. The mean nuclear area was 14.45 with a range between 10.88 and 17.90. Variables showed adequate statistical correlation (r > 0.5). A total of 1440 neoplastic nuclei were classified as grades I, II and III, and a statistical significative difference was found between these three groups. We conclude that the nuclear area is a reliable variable for statistical correlation being the ductal nuclei anisotropic objects.

[Ultrastructural aspects of lesions caused by Mycobacterium spp in AIDS]. / Aspectos ultraestructurales de las lesiones producidas por Mycobacterium spp en el SIDA.

Samples from necrotizing lesions in eight autopsy cases of AIDS were examined with transmission electron microscopy. They were selected among 35 autopsies of Mycobacterium spp infection and AIDS, and were part of a series of 230 autopsy cases of AIDS performed from 1984 to 1995 in the Anatomopathologic Institute at Central University of Venezuela. Ultrastructural aspects of micobacteriae, their relationship with macrophages and tissue alterations are discussed and related to the immune defcit observed in AIDS patients.

[An ultrastructural evaluation of Pneumocystis carinii]. / Evaluación ultraestructural del Pneumocystis carinii.

The pneumocystis carinii (PNC) is a challenge, because its taxonomy has not been completely explained. PNC seems to be a chimera with fungal and parasitic characteristics. The objective of the present study is to analyze the different stages observed in PNC using transmission electron microscopy in order to correlate them with bibliographic reports regarding a possible taxonomic classification. The trophic stage was the form most frequently encountered in alveolar spaces and their organisms varying in size and shape from 6 to 20 microns. Cyst were round or oval, with diameters ranging between 4 and 12 microns, showing four intracystic bodies were individually limited by a membrane. Connections between the membrane of intracystic bodies and junctions between them and the inner cell membrane of the cyst wall were also observed. Our ultrastructural findings appear to be in agreement with several reports which considered PNC among the fungi, most likely related them to the non-gemating Ascomycetes.

Paracoccidioidomicosis del cuello uterino: presentación de un caso / Paracoccidioidomycosis of uterine cervix: reported a case

Se presenta un caso de paracoccidioidomicosis de cuelo uterino; el primer caso descrito en nuestro medio, tal vez el segundo caso publicado a nivel mundial. Se hacen comentarios desde el punto de vista clínico, de microscopia de luz y de microscopia electrónica de transmisión

[Importance of transmission electron microscopy in the diagnosis of a Venezuelan equine encephalitis outbreak in 1995 in the Venezuelan Guajira]. / Importancia de la microscopía electrónica de transmisión en el diagnóstico de la epidemia de encefalitis equina venezolana de 1995 en la Guajira Venezolana.

Transmission electron microscopy of the brain in 25 newborn mice was performed. Mice were intracerebrally inoculated with cultured VERO cells infected with VEE to be used as positive control, with samples of serum of cerebrospinal fluid from patients with clinical symptoms and signs of encephalitis, with serum from healthy patients or with serum from sick equines. Borate bovine albumin serum was also inoculated in some mice to be used as negative control. All samples were obtained during the epizootic and epidemic outbreak in the Venezuelan Guajira area, northern of Zulia State during October 1995. The ultrastructural study was blindly performed, however the presence of Togavirus particles were detected in 100% of the virologically positive cases. The usefulness, accuracy and speed of the employed methodology is stressed.

[Pulmonary alveolar proteinosis: ultrastructural study of 4 cases]. / Proteinosis alveolar pulmonar: estudio ultraestructural de cuatro casos.

Pulmonary Alveolar Proteinosis (PAP) is a rare and diffuse lung disease characterized by the abnormal deposition of PAS positive, lipoproteinaceous material in the alveolar spaces. It has been related, mainly, to alterations in the immune state and to secondary infections. We studied four cases of PAP diagnosed by light microscopy. In two cases we were able to demonstrate disseminated Histoplasmosis related to immunodeficiency states (AIDS and malnutrition), one case with Pneumocystis carinii infection and AIDS, and one case with no related pathology. Granular and electron dense material, concentric myelin figures, and variable-sized osmiophilic bodies were observed by electron microscopy. We found yeast-like structures, trophozoites and cysts in the alveolar spaces, in the Histoplasmosis and Pneumocystic carinii infection cases, respectively. In one of our cases, the circulating neutrophils showed crystalloid inclusions in the nucleus. PAP should be considered in the differential diagnoses of patients with pulmonary infiltrates.

[Application of electron microscopy and immunohistochemistry to the study of malignant tumors: a review of their diagnostic importance]. / Aplicación de la microscopía electrónica y de la inmunohistoquímica a1 estudio de los tumores malignos: una revisión de su importancia diagnóstica.

The results of examining in the course of the past twenty years a considerable number of malignant tumors with transmission electron microscopy and immunohistochemistry are discussed. The neoplasms were divided into epithelial tumors, tumors of fusiform cells, malignant round cell tumors and tumors of endocrine nature. The main ultrastructural findings and the results of immunohistochemical studies were pointed out regarding their contributory role in the diagnosis as well as for the prognosis and treatment of patients with cancer.

Superficial bladder cancer: study of the proliferative nuclear fraction as a prognostic factor.

The expression of the anti-proliferating cell nuclear antigen (PCNA) was examined in bladder specimens from 48 patients with superficial transitional carcinoma, with the use of the PC10 monoclonal antibody. In vesical tumours with good clinical behaviour, we found a median PCNA positivity of 7.1% with a range of 5-25%. In vesical tumours with high incidence of recurrence, the median was 36.6% with a range of 15-80%. In vesical tumours with a strong tendency to invasion, the median positivity for PCNA staining was 68% with a range of 40-92%. In conclusion, we believe that using PC10 immunostaining to determine a nuclear proliferative fraction is a quick and simple method of studying the prognosis of patients who have vesical tumours of low grade and low stage.

Prognostic significance of high expression of proliferating cell nuclear antigen in patients with intestinal metaplasia.

Although some types of intestinal metaplasia are considered to be potentially pre-malignant lesions leading to gastric carcinoma, their high frequency and variability limit their usefulness as early markers of malignant progression. The present study was carried out to search for parameters which could be used in conjunction with histological diagnosis to identify groups of patients with a high risk for developing gastric neoplasia. The expression of proliferating cell nuclear antigen (PCNA), as revealed by immunohistochemical staining of anti-PCNA monoclonal antibody (PC10) in 82 endoscopic biopsy specimens, was compared with the histological classification of intestinal metaplasia, the biochemical composition of gastric mucins and the expression of blood group Lewis antigens. Statistically significant (p 0.001) correlation between the PCNA labelling index (the percentage of positive cells in more than 700 tumor cells per sample) and the histological type of intestinal metaplasia, the presence of sulphomucins, and the presence of anomalous Lewis a antigen was found. We conclude that a high PCNA-labelling index in the gastric mucosa, with a histological diagnosis of incomplete intestinal metaplasia, could constitute a good prognostic marker of the severity of the histologic lesion. These parameters, together with others such as the presence of sulphomucins and of cells expressing anomalous Lewis a antigen, may be used to define patients with a high risk of developing a gastric neoplasia.

Granulomatous amebic encephalitis: a review and report of a spontaneous case from Venezuela.

Granulomatous amebic encephalitis (GAE), or meningoencephalitis due to Acanthamoeba spp. and leptomyxid ameba are uncommon CNS infections that generally occur in immunocompromised hosts. We describe a case of GAE caused by Balamuthia mandrillaris previously designated as a leptomyxid ameba, in an apparently healthy 14-year-old Venezuelan boy. This case was characterized by sudden onset of seizures, focal neurologic signs and by a prolonged clinical course (from November 1992 to March 1993). Neuroimaging studies showed cerebral hypodense lesions in cerebral hemispheres, brain stem and cerebellum. Microscopically, we found a chronic granulomatous inflammatory reaction with necrotizing angiitis, large numbers of amebic trophozoites and few cysts in perivascular spaces and within necrotic CNS tissue. The amebas were identified as B. mandrillaris based on their immunofluorescence reactivity with the anti-B. mandrillaris serum. So far, 30 cases of GAE due to B. mandrillaris have been recognized in humans, two in AIDS patients. No visceral involvement by free-living amebas or any other significant abnormality was observed. This patient developed "spontaneous" GAE, but it remains possible that an undiagnosed abnormality in cell-mediated immunity or a deficient humoral immune response may explain the susceptibility of this patient to this opportunistic infection.

[Clinical and anatomo-pathologic findings in a case of Cronkhite-Canada syndrome]. / Hallazgos clínicos y anatomopatológicos en un caso de síndrome de Cronkhite--Canadá.

We present a case of Cronkhite-Canada Syndrome with gastrointestinal polyposis, which is the first one to be reported in this country. We make a review of the literature and compare the clinical and anatomopathological finding in this case with others described.

[Sickle-cell anemia. The liver lesions. A clinical, morphological and ultrastructural study of 21 cases]. / Anemia drepanocítica. Lesiones hepáticas. Estudio clínico, morfológico y ultraestructural de 21 casos.

Liver changes in patients with sickle cell anemia, for some authors, is a common finding and is hot in relation with the severity of the anemia. The grade of liner disfunction or malfunction is related with ischemia and, there exists probable, slowing of intrahepatic circulation secondary to sinusoidal obstruction due to masses of sickle cells and to the hypertrophy of Kupffer cells. In this paper, clinical morphologic and ultrastructural findings of 21 cases of SS and SA, hemoglobinopathies are presented. Sixty percent were females and forty percent were males with ages between 18 and 46 years. The most frequent microscopic findings were sinusoid distention followed by hypertrophy of Kupffer cells and inflammation. Areas of necrosis, fatty changes and iron deposits were also seen.

[A morphological study of the liver in the acquired immunodeficiency syndrome. An analysis of 69 cases]. / Estudio morfológico del hígado en el síndrome de inmunodeficiencia adquirida. Análisis de 69 casos.

The morphologic findings in the liver of 69 autopsy cases with had died of AIDS are presented. The morphologic changes were represented by the presence of opportunistic germs (Histoplasma capsulatum, Mycobacteria, Cryptococcus neoformans and CMV). Other alterations found were fatty changes, portal fibrosis, dilated and congested sinusoids. We did not find Kaposi's sarcoma in the liver and only one case of lymphoblastic lymphoma was seen observed.