RESUMO
This report describes the case of an 8 year old boy who developed ileocecal B cell lymphoma after liver transplantation. The patient underwent orthotopic liver transplantation for biliary atresia and had been given immunosuppressive drugs--cyclosporin A and tacrolimus hydrate. Six years after the liver transplantation, the patient had a sudden onset of fever and abdominal pain. Necropsy revealed an ileocecal mass that was a B cell lymphoma. Epstein-Barr virus (EBV) encoded RNA 1 was demonstrated in lymphoma cells and hyperplastic follicular germinal centre cells in various tissues. Although monoclonal immunoglobulin gene rearrangement was detected in the liver, EBV episomes were of polyclonal origin and lytic forms of EBV were also demonstrated by Southern blotting. Immunohistochemically, lymphoma cells were positive for p53 but negative for latent membrane protein 1 and EBV nuclear antigen 2. These findings suggested that this B cell lymphoma might have occurred sporadically, regardless of EBV infection.
Assuntos
Neoplasias do Ceco/patologia , Neoplasias do Íleo/patologia , Neoplasias Hepáticas/patologia , Transplante de Fígado , Linfoma de Células B/patologia , Complicações Pós-Operatórias/patologia , Atresia Biliar/genética , Atresia Biliar/patologia , Atresia Biliar/cirurgia , Neoplasias do Ceco/genética , Criança , Evolução Fatal , Rearranjo Gênico do Linfócito B , Genes de Imunoglobulinas , Herpesvirus Humano 4/genética , Humanos , Neoplasias do Íleo/genética , Imuno-Histoquímica , Neoplasias Hepáticas/genética , Linfoma de Células B/genética , Masculino , Reação em Cadeia da Polimerase , RNA Viral/análise , Proteína Supressora de Tumor p53/análiseRESUMO
Elongated epididymis is an abnormality encountered most frequently in patients who have an undescended testis (or testes). To clarify the implication of this anomaly in testicular descent, the anatomic configuration of paratesticular structures, especially the site of cranial attachment of the gubernaculum in relation to the configuration of the vas deferens, was evaluated in 54 undescended testes of 44 patients. Undescended testes were associated with an elongated epididymis in 42.5% of cases. Of these, the cranial gubernaculum was attached solely to the vas deferens in 73.9%. In this group, the cranial gubernaculum was attached to the most descended part of the loop of the vas deferens. No patient with a nonelongated epididymis had a gubernaculum attached solely to the vas deferens. These results suggest that the abnormal attachment of the cranial gubernaculum in the embryological stage might affect the mode of descent of adjacent paratesticular structures.
Assuntos
Criptorquidismo/patologia , Epididimo/anormalidades , Criança , Pré-Escolar , Criptorquidismo/cirurgia , Epididimo/patologia , Epididimo/cirurgia , Humanos , Lactente , Masculino , Ducto Deferente/anormalidades , Ducto Deferente/patologia , Ducto Deferente/cirurgiaRESUMO
An investigation was carried out on the productivity of cytokines and active-oxygen by peripheral blood cells during the pre- and post-operative periods. While the preoperative production of tumor necrosis factor (TNF) and interleukin-1 alpha (IL-1 alpha) was elevated, that of lymphotoxin (LT) and interferon-gamma (IFN-gamma) were slightly suppressed. In the postoperative period the peak TNF and IL-1 alpha and active-oxygen productivity was elevated, while LT and IFN-gamma productivity was suppressed in patients with an intraoperative bleeding volume of more than 1,000 ml compared to those with that of less than 1,000 ml. Thus, stress stimulates the TNF and IL-1 alpha and active-oxygen producing system, that is, the macrophage-neutrophil system, and suppresses the LT and IFN-gamma system, being, the inflammatory helper T cell system, in the early postoperative period.
