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1.
Parasite Immunol ; 41(5): e12623, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30870579

RESUMO

Phenotypic and functional aspects of monocytes from Localized Cutaneous Leishmaniasis (LCL) patients were evaluated. The frequencies of monocyte subsets and TLR2/TLR4 expression were evaluated in fresh peripheral blood whereas cytokine production was evaluated in whole blood cell cultures stimulated with TLR agonists or Leishmania braziliensis antigen (Ag). CD16+ monocytes frequency was increased in patients compared with controls. A TLR4 agonist (LPS) induced expression of TNF and IL-10 in monocyte subsets of patients and controls. The CD14+ CD16+ monocytes expressed higher levels of these cytokines than CD14+ CD16- cells. The levels of secreted TNF were higher in whole blood cell cultures from patients than controls after LPS/TLR4 or Ag stimulation. Whereas in controls there was a positive correlation between TNF and IL-10 levels, this was not observed in stimulated cell cultures from patients. The high levels of LPS-induced TNF were associated with the number of lesions and the percentages of CD14hi CD16+ monocytes. The levels of TLR2-induced TNF were also associated with number of lesions. All monocyte subsets from patients expressed higher levels of TLR2 and TLR4 than controls. Data suggest that systemically activated monocytes contribute for an imbalance in pro- and anti-inflammatory cytokine production during LCL, participating in the immunopathogenesis of the disease.


Assuntos
Leishmaniose Cutânea/imunologia , Adulto , Idoso , Citocinas/imunologia , Feminino , Humanos , Interleucina-10/imunologia , Leishmaniose Cutânea/parasitologia , Masculino , Pessoa de Meia-Idade , Monócitos/imunologia , Adulto Jovem
2.
Am J Trop Med Hyg ; 99(5): 1165-1169, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30203744

RESUMO

The disseminated form of leishmaniasis is a serious and rare disease, being diagnosed in 2% of the cutaneous cases registered per year in Brazil. The main characteristic is the appearance of multiple pleomorphic lesions on the cutaneous surface. A 68-year-old male from the rural area of Tocantins, Brazil, presented atypical disseminated cutaneous leishmaniasis (ACL). The clinical course and histopathological and immunological findings presented a mixed pattern that hindered diagnosis and therapeutic management. Molecular typing revealed a mixed infection with Leishmania (V.) guyanensis and Leishmania (L.) amazonensis. Molecular identification of the agents responsible for ACL is important for adequate therapeutic planning, minimizing the possibility of sequellae that impact the quality of life of the patient.


Assuntos
Coinfecção/diagnóstico , Coinfecção/parasitologia , Leishmania guyanensis/genética , Leishmania mexicana/genética , Leishmaniose Cutânea/diagnóstico , Idoso , Anfotericina B/uso terapêutico , Antiprotozoários/uso terapêutico , Brasil , DNA de Protozoário/genética , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Leishmania guyanensis/isolamento & purificação , Leishmania mexicana/isolamento & purificação , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/parasitologia , Masculino , Tipagem Molecular , População Rural , Pele/parasitologia , Pele/patologia
3.
Infect Immun ; 86(5)2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29483288

RESUMO

Visceral leishmaniasis (VL) is a chronic parasitic disease caused by Leishmania infantum in the Americas. During VL, several proinflammatory cytokines are produced in spleen, liver, and bone marrow. However, the role of interleukin-32 (IL-32) has not been explored in this disease. IL-32 can induce production of proinflammatory cytokines in innate immune cells and polarize the adaptive immune response. Herein, we discovered that L. infantum antigens induced expression of mRNA mainly for the IL-32γ isoform but also induced low levels of the IL-32ß transcript in human peripheral blood mononuclear cells. Furthermore, infection of human IL-32γ transgenic mice (IL-32γTg mice) with L. infantum promastigote forms increased IL-32γ expression in the spleen and liver. Interestingly, IL-32γTg mice harbored less parasitism in the spleen and liver than wild-type (WT) mice. In addition, IL-32γTg mice showed increased granuloma formation in the liver compared to WT mice. The protection against VL was associated with increased production of nitric oxide (NO), interferon gamma (IFN-γ), IL-17A, and tumor necrosis factor alpha by splenic cells restimulated ex vivo with L. infantum antigens. In parallel, there was an increase in the number of Th1 and Th17 T cells in the spleens of IL-32γTg mice infected with L. infantum IL-32γ induction of IFN-γ and IL-17A expression was found to be essential for NO production by splenic cells of infected animals. These data indicate that IL-32γ potentiates the Th1/Th17 immune response during experimental VL, thus contributing to the control of L. infantum infection.


Assuntos
Imunidade Inata/imunologia , Imunidade Inata/fisiologia , Interleucinas/imunologia , Interleucinas/fisiologia , Leishmania infantum/imunologia , Leishmaniose Visceral/imunologia , Fatores de Proteção , Animais , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Transgênicos , Modelos Animais
6.
Rev. bras. mastologia ; 27(1)jan.-mar. 2017.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-832170

RESUMO

This article has presented a rare case of multiple fibroadenomas of the breasts and axillary accessory breast. In the light of current knowledge, the most proper management is discussed. A 37-year-old woman was referred to our Breast Service due to complaint of a right axillary accessory breast nodule. On physical examination, there were no palpable breast nodules. Bilateral axillary accessory breast was observed with a right breast nodule and no alterations in the left breast. Mammography and ultrasonography demonstrated multiple bilateral breast nodules with benign characteristics and a possible malignancy in the right axillary nodule. The patient underwent a fine needle aspiration biopsy guided by ultrasonography of the largest nodule in each breast and of the nodule in the right axillary accessory breast. Cytologically, all nodules had benign characteristics. A diagnostic hypothesis of fibroadenoma was formulated. The patient underwent surgical removal of the right axillary nodule. The histopathological examination demonstrated fibroadenoma. Conservative management was chosen for the axillary accessory breasts and multiple breast fibroadenomas. At 11-month follow-up, there was neither recurrence of the right axillary nodule nor changes in the fibroadenomas. Conservative management of axillary accessory breast is possible. However, axillary accessory breast tissue may be affected by neoplasia. In cases of possible malignancy, the investigation should be carried out through the same clinical work-up used for normally-positioned breasts. In the presence of multiple bilateral fibroadenomas in the breasts, conservative management can be safely adopted.


Apresentamos um caso raro de múltiplos fibroadenomas envolvendo as mamas e a mama acessória axilar. À luz do conhecimento atual, a conduta mais adequada é discutida. Uma mulher de 37 anos foi encaminhada ao Serviço de Mastologia em função da queixa de nódulo em mama acessória axilar direita. No exame físico, não havia nódulos palpáveis nas mamas. Observou-se mama acessória axilar bilateral com nódulo à direita e sem alterações à esquerda. Mamografia e ultrassonografia demonstraram múltiplos nódulos de mama bilateral com características benignas e um nódulo suspeito de malignidade na axila direita. A paciente submeteu-se à punção aspirativa com agulha fina guiada por ultrassonografia do maior nódulo de cada mama e do nódulo na mama acessória axilar direita. Citologicamente, todos os nódulos apresentaram características benignas. Formulou-se a hipótese diagnóstica de fibroadenoma. Paciente submeteu-se à remoção cirúrgica do nódulo na axila direita. O exame histopatológico demonstrou fibroadenoma. Decidiu-se por uma conduta conservadora para as mamas acessórias axilares e múltiplos fibroadenomas mamários. Após 11 meses de seguimento, não houve recidiva do nódulo na axila direita nem alterações dos fibroadenomas. A conduta conservadora na mama acessória axilar é possível, porém o tecido mamário acessório pode ser afetado por neoplasia. Nos casos suspeitos de malignidade, a investigação deve ser conduzida com os mesmos recursos propedêuticos utilizados nas mamas normalmente posicionadas. Na presença de múltiplos fibroadenomas nas mamas, a conduta conservadora pode ser adotada com segurança.

7.
Rev. Assoc. Med. Bras. (1992) ; 61(6): 497-499, Nov.-Dec. 2015. graf
Artigo em Inglês | LILACS | ID: lil-771992

RESUMO

SUMMARY Primary osteosarcoma of the breast (POB) is an extremely rare and aggressive tumor. Differential diagnosis of POB includes osteosarcoma of the chest wall and metaplastic breast carcinoma. Imaging tests that exclude the existence of a direct connection between the tumor and chest wall, as well as histopathological and immunohistochemical studies that rule out the presence of an epithelial component are required for the diagnosis of POB. We report a case of a 69-year old woman with POB. Imaging and pathological findings are presented. Therapeutic approach is discussed in the light of current knowledge, including potential complications.


RESUMO O osteossarcoma primário da mama (OPM) é um tumor extremamente raro e agressivo. O diagnóstico diferencial do OPM inclui o osteossarcoma da parede torácica e o carcinoma metaplásico da mama. Exames de imagem que excluam a existência de uma conexão direta entre o tumor e a parede torácica, e estudos histopatológico e imuno-histoquímico que descartem a presença de um componente epitelial são necessários para o diagnóstico de OPM. Relatamos um caso de OPM em uma mulher de 69 anos de idade. Os achados de imagem e patológicos são apresentados. A abordagem terapêutica é discutida à luz do conhecimento atual, incluindo potenciais complicações.


Assuntos
Idoso , Feminino , Humanos , Neoplasias da Mama/patologia , Osteossarcoma , Neoplasias da Mama , Neoplasias da Mama , Diagnóstico Diferencial , Evolução Fatal , Linfonodos/patologia , Mamografia , Mastectomia Simples , Mesenquimoma/patologia , Osteossarcoma , Osteoblastos/patologia
8.
Biomed Res Int ; 2015: 350764, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26583102

RESUMO

The aim of this study was to characterize clinical field isolates of Leishmania spp. obtained from patients with American Tegumentary Leishmaniasis (ATL) who live in Goiás state, Brazil. The presumed areas of infection were in Goiás, Tocantins, and Pará states. Three isolates of parasites were identified as L. (Viannia) braziliensis and one as L. (V.) guyanensis. The in vitro growth profiles were found to be similar for all parasites. Nevertheless, in C57BL/6 mice, L. (V.) guyanensis infection was better controlled than L. (V.) braziliensis. Yet in C57BL/6 mice deficient in interferon gamma, L. (V.) guyanensis lesions developed faster than those caused by L. (V.) braziliensis isolates. In BALB/c mice, the development of lesions was similar for isolates from both species; however, on the 11th week of infection, amastigotes could not be observed in macrophages from L. (V.) guyanensis-infected mice. Thus, L. (V.) guyanensis can be circulating in Goiás, a state where autochthonous cases of this species had not yet been reported. Considering the difficulties to differentiate L. (V.) guyanensis from L. (V.) braziliensis at the molecular, morphological, and clinical (human and murine models) levels, the presence of L. (V.) guyanensis infections is possibly underestimated in several regions of Brazil.


Assuntos
Leishmania braziliensis/patogenicidade , Leishmania guyanensis/patogenicidade , Leishmaniose Cutânea/parasitologia , Animais , Brasil , Humanos , Leishmania braziliensis/isolamento & purificação , Leishmania guyanensis/isolamento & purificação , Leishmaniose Cutânea/patologia , Camundongos
9.
Rev Assoc Med Bras (1992) ; 61(6): 497-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26841158

RESUMO

Primary osteosarcoma of the breast (POB) is an extremely rare and aggressive tumor. Differential diagnosis of POB includes osteosarcoma of the chest wall and metaplastic breast carcinoma. Imaging tests that exclude the existence of a direct connection between the tumor and chest wall, as well as histopathological and immunohistochemical studies that rule out the presence of an epithelial component are required for the diagnosis of POB. We report a case of a 69-year old woman with POB. Imaging and pathological findings are presented. Therapeutic approach is discussed in the light of current knowledge, including potential complications.


Assuntos
Neoplasias da Mama/patologia , Osteossarcoma/patologia , Idoso , Neoplasias da Mama/diagnóstico por imagem , Diagnóstico Diferencial , Evolução Fatal , Feminino , Humanos , Linfonodos/patologia , Mamografia , Mastectomia Simples , Mesenquimoma/patologia , Osteoblastos/patologia , Osteossarcoma/diagnóstico por imagem , Ultrassonografia
10.
BMC Infect Dis ; 14: 249, 2014 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-24884781

RESUMO

BACKGROUND: The interleukin 32 (IL-32) is a proinflammatory cytokine produced by immune and non-immune cells. It can be induced during bacterial and viral infections, but its production was never investigated in protozoan infections. American Tegumentary Leishmaniasis (ATL) is caused by Leishmania protozoan leading to cutaneous, nasal or oral lesions. The aim of this study was to evaluate the expression of IL-32 in cutaneous and mucosal lesions as well as in peripheral blood mononuclear cells (PBMC) exposed to Leishmania (Viannia) braziliensis. METHODS: IL-32, tumour necrosis factor (TNF) and IL-10 protein expression was evaluated by immunohistochemistry in cutaneous, mucosal lesions and compared to healthy specimens. The isoforms of IL-32α, ß, δ, γ mRNA, TNF mRNA and IL-10 mRNA were assessed by qPCR in tissue biopsies of lesions and healthy skin and mucosa. In addition, PBMC from healthy donors were cultured with amastigotes of L. (V.) braziliensis. In lesions, the parasite subgenus was identified by PCR-RFLP. RESULTS: We showed that the mRNA expression of IL-32, in particular IL-32γ was similarly up-regulated in lesions of cutaneous (CL) or mucosal (ML) leishmaniasis patients. IL-32 protein was produced by epithelial, endothelial, mononuclear cells and giant cells. The IL-32 protein expression was associated with TNF in ML but not in CL. IL-32 was not associated with IL-10 in both CL and ML. Expression of TNF mRNA was higher in ML than in CL lesions, however levels of IL-10 mRNA were similar in both clinical forms. In all lesions in which the parasite was detected, L. (Viannia) subgenus was identified. Interestingly, L. (V.) braziliensis induced only IL-32γ mRNA expression in PBMC from healthy individuals. CONCLUSIONS: These data suggest that IL-32 plays a major role in the inflammatory process caused by L. (Viannia) sp or that IL-32 is crucial for controlling the L. (Viannia) sp infection.


Assuntos
Interleucina-10/biossíntese , Interleucinas/biossíntese , Leishmania braziliensis/imunologia , Leishmaniose Cutânea/metabolismo , Fator de Necrose Tumoral alfa/biossíntese , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Interleucinas/genética , Leishmaniose Cutânea/imunologia , Leucócitos Mononucleares/metabolismo , Masculino , Pessoa de Meia-Idade , Membrana Mucosa/metabolismo , Pele/metabolismo , Regulação para Cima , Adulto Jovem
11.
An Bras Dermatol ; 89(2): 353-5, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24770522

RESUMO

A 6 year-old patient began to experience localized hairloss in the right temporal region three years ago. During the first appointment, diagnoses of alopecia areata and congenital triangular alopecia were made. After one year, there was no change. Upon dermatological examination, non-scarring alopecia was noted in the right temporal region, revealing extremely fine and fair hair follicles. A dermoscopy revealed only thin vellus-type hairs. Congenital triangular alopecia is a condition commonly confused with alopecia areata and is thus underdiagnosed. However, well-established clinical parameters and dermoscopic criteria can be used to distinguish skin diseases that affect hair and define the diagnosis.


Assuntos
Alopecia em Áreas/diagnóstico , Alopecia/diagnóstico , Dermoscopia/métodos , Doenças Genéticas Ligadas ao Cromossomo X/diagnóstico , Criança , Diagnóstico Diferencial , Humanos , Masculino
12.
Case Rep Infect Dis ; 2014: 930459, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24707416

RESUMO

Esophagitis caused by herpes simplex virus (HSV) is often documented during periods of immunosuppression in patients infected with human immunodeficiency virus (HIV); it is rare in immunocompetent diagnosed patients. Case reports of herpetic esophagitis in students of health sciences are extremely rare. The disease presents with a clinical picture characterized by acute odynophagia and retrosternal pain without obvious causes and ulcers, evidenced endoscopically in the middistal esophagus. Diagnosis depends on endoscopy, biopsies for pathology studies, and immunohistochemistry techniques. The disease course is often benign; however, treatment with acyclovir speeds the disappearance of symptoms and limits the severity of infection. In this report, we present a case of herpetic esophagitis in an immunocompetent medical student, with reference to its clinical features, diagnosis, and treatment. The disease may have manifested as a result of emotional stress experienced by the patient.

13.
J. coloproctol. (Rio J., Impr.) ; 34(2): 104-108, Apr-Jun/2014. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: lil-714703

RESUMO

OBJECTIVE: to report clinical and pathological features of patients with colorectal cancer diagnosed during emergency abdominal surgery. METHODS: records of 107 patients operated between 2006 and 2010 were reviewed. RESULTS: there were 58 women and 49 men with mean age of 59.8 years. The most frequent symptoms were: abdominal pain (97.2%), no bowel movements (81.3%), vomiting (76.6%), and anorexia (40.2%). Patients were divided into five groups: obstructive acute abdomen (n = 68), obstructive acute perforation (n = 21), obstructive acute inflammation (n = 13), abdominal sepsis (n = 3), and severe gastrointestinal bleeding (n = 2). Tumors were located in the rectosigmoid (51.4%), transverse colon (19.6%), ascendent colon (12.1%), descendent colon (11.2%), and 5.6% of the cases presented association of two colon tumors (synchronic tumors). The surgical treatment was: tumor resection with colostomy (85%), tumor resection with primary anastomosis (10.3%), and colostomy without tumor resection (4.7%). Immediate mortality occurred in 33.4% of the patients. Bivariate analysis of sex, tumor location and stage showed no relation to death (p > 0.05%). CONCLUSIONS: colorectal cancer may be the cause of colon obstruction or perfuration in patients with nonspecific colonic complaints. Despite the high mortality rate, resection of tumor is feasible in most patients. .


OBJETIVO: analisar os aspectos clinicos e patológicos de pacientes operados de cancer colorretal diagnosticados durante operações abdominais de urgencia. MÉTODOS: foram estudados os prontuários de 107 pacientes operados entre 2006 e 2010. Resultados: Foram incluidos 58 mulheres e 49 homens com idade media de 59,8 anos. Os sintomas mais frequentes foram: dor abdominal (97,2%), parade de eliminação de gases e fezes (81,3%), vomitos (76,6%) e anorexia (40,2%). Os pacientes foram divididos em cinco grupos: abdomen agudo obstrutivo (68), abdomen agudo perfurativo (21), abdomen agudo inflamatorio (13), sepsis abdominal (3) e hemorragia digestive baixa (2). Os tumores localizavam-se no rectossigmoide (51,4%), colon transverso (19,6%), colon ascendente (12,1%), colon descendente (11,2%) e 5,6% dos pacientes apresentavam tumors sincronicos. O tratamento cirurgico foi: colectomia com colostomy (85%), colectomia com anastomose primaria (10,3%) e colostomia sem ressecçao do tumor (4,7%). Mortalidade immediate ocorreu em 33,4% dos pacientes. Analise bivariate de sexo, localização do tumor e estadio não foi relacionada a mortalidade (P>0,05%). CONCLUSÕES: o cancer colorretal pode ser a causa de obstrução colonica ou perfuração in pacientes com queixas inespecificas. A despeito da alta taxa de mortalidade, a ressecção do tumor pode ser realizada na maioria dos pacientes. .

14.
An. bras. dermatol ; 89(2): 353-355, Mar-Apr/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-706992

RESUMO

A 6 year-old patient began to experience localized hairloss in the right temporal region three years ago. During the first appointment, diagnoses of alopecia areata and congenital triangular alopecia were made. After one year, there was no change. Upon dermatological examination, non-scarring alopecia was noted in the right temporal region, revealing extremely fine and fair hair follicles. A dermoscopy revealed only thin vellus-type hairs. Congenital triangular alopecia is a condition commonly confused with alopecia areata and is thus underdiagnosed. However, well-established clinical parameters and dermoscopic criteria can be used to distinguish skin diseases that affect hair and define the diagnosis.


Assuntos
Humanos , Masculino , Criança , Doenças Genéticas Ligadas ao Cromossomo X/diagnóstico , Dermoscopia/métodos , Alopecia/diagnóstico , Alopecia em Áreas/diagnóstico , Diagnóstico Diferencial
15.
J Bras Pneumol ; 38(4): 445-51, 2012.
Artigo em Inglês, Português | MEDLINE | ID: mdl-22964928

RESUMO

OBJECTIVE: To compile fiberoptic bronchoscopy findings in patients diagnosed with lung cancer and to correlate those with histopathological findings. METHODS: This was a retrospective study involving 212 patients with a confirmed diagnosis of lung cancer by cytological evaluation of BAL specimens or by histopathological evaluation of endobronchial or transbronchial biopsy specimens. The data were collected at the Respiratory Endoscopy Sector of Hospital São Salvador, located in the city of Goiânia, Brazil, between 2005 and 2010. The endoscopic findings were classified as endoscopically visible tumor, endoscopically invisible tumor, mucosal injury, as well as being classified by the presence/type of secretion. The visible tumors were also classified according to their location in the tracheobronchial tree. RESULTS: Endobronchial mass (64%) and mucosal infiltration (35%) were the main endoscopic findings. The histological type was determined in 199 cases, the most prevalent types being squamous carcinoma, in 78 (39%), adenocarcinoma, in 42 (21%) small cell carcinoma, in 24 (12%), and large cell carcinoma, in 2 (1%). More than 45% of the visible tumors were at the upper bronchi. Squamous carcinoma (n = 78) was most commonly visualized as an endobronchial mass (in 74%), mucosal infiltration (in 36%), luminal narrowing (in 10%), or external compression (in 6%). CONCLUSIONS: Our results show that the endobronchial mass is the most common bronchoscopic finding that is suggestive of malignancy. Proportionally, mucosal infiltration is the most common finding in small cell carcinoma. In adenocarcinoma, luminal narrowing, external compression, mucosal injury, and endobronchial secretion prevail.


Assuntos
Broncoscopia/métodos , Carcinoma/patologia , Neoplasias Pulmonares/patologia , Adenocarcinoma/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia , Carcinoma/classificação , Carcinoma de Células Grandes/patologia , Carcinoma de Células Pequenas/patologia , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Pulmão/patologia , Neoplasias Pulmonares/classificação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
16.
J. bras. pneumol ; 38(4): 445-451, jul.-ago. 2012. ilus, tab
Artigo em Português | LILACS | ID: lil-647810

RESUMO

OBJETIVO: Catalogar alterações encontradas em imagens obtidas por fibrobroncoscopia em pacientes com diagnóstico de neoplasia pulmonar e correlacionar esses achados com achados histopatológicos. MÉTODOS: Estudo retrospectivo envolvendo 212 pacientes com diagnóstico de câncer de pulmão confirmado por citologia obtida por lavado broncoalveolar e/ou histopatologia de biópsia endobrônquica ou transbrônquica. Os dados foram obtidos no Serviço de Endoscopia Respiratória do Hospital São Salvador (Goiânia-GO), entre 2005 e 2010. Os achados endoscópicos foram classificados como tumor endoscopicamente visível, tumor endoscopicamente não visível e lesão na mucosa, assim com quanto à pr sença/tipo de secreção. Os tumores visíveis também foram classificados de acordo com sua localização na árvore traqueobrônquica. RESULTADOS: O principal achado endoscópico foi a presença de massa endobrônquica (64%), seguido por infiltração da mucosa (35%). Quanto aos tipos histológicos (n = 199), os mais prevalentes foram carcinoma escamoso (39%), adenocarcinoma (21%), carcinoma de pequenas células (12%) e carcinoma de grandes células (1%). Mais de 45% dos tumores visíveis estavam localizados nos brônquios superiores. O carcinoma escamoso (n = 78) apresentou-se mais frequentemente como massa tumoral endobrônquica (74%), infiltração da mucosa (36%), estreitamento do lúmen (10%) e compressão extrínseca (6%). CONCLUSÕES: Nossos resultados indicam que a massa tumoral endobrônquica é o achado endoscópico que mais sugere malignidade. Proporcionalmente, infiltração da mucosa é mais comumente achada em carcinoma de pequenas células. Estreitamento do lúmen, compressão extrínseca, lesão na mucosa e secreção endobrônquica prevalecem no adenocarcinoma.


OBJECTIVE: To compile fiberoptic bronchoscopy findings in patients diagnosed with lung cancer and to correlate those with histopathological findings. METHODS: This was a retrospective study involving 212 patients with a confirmed diagnosis of lung cancer by cytological evaluation of BAL specimens or by histopathological evaluation of endobronchial or transbronchial biopsy specimens. The data were collected at the Respiratory Endoscopy Sector of Hospital São Salvador, located in the city of Goiânia, Brazil, between 2005 and 2010. The endoscopic findings were classified as endoscopically visible tumor, endoscopically invisible tumor, mucosal injury, as well as being classified by the presence/type of secretion. The visible tumors were also classified according to their location in the tracheobronchial tree. RESULTS: Endobronchial mass (64%) and mucosal infiltration (35%) were the main endoscopic findings. The histological type was determined in 199 cases, the most prevalent types being squamous carcinoma, in 78 (39%), adenocarcinoma, in 42 (21%) small cell carcinoma, in 24 (12%), and large cell carcinoma, in 2 (1%). More than 45% of the visible tumors were at the upper bronchi. Squamous carcinoma (n = 78) was most commonly visualized as an endobronchial mass (in 74%), mucosal infiltration (in 36%), luminal narrowing (in 10%), or external compression (in 6%). CONCLUSIONS: Our results show that the endobronchial mass is the most common bronchoscopic finding that is suggestive of malignancy. Proportionally, mucosal infiltration is the most common finding in small cell carcinoma. In adenocarcinoma, luminal narrowing, external compression, mucosal injury, and endobronchial secretion prevail.


Assuntos
Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Broncoscopia/métodos , Carcinoma/patologia , Neoplasias Pulmonares/patologia , Adenocarcinoma/patologia , Biópsia , Carcinoma de Células Grandes/patologia , Carcinoma de Células Pequenas/patologia , Carcinoma de Células Escamosas/patologia , Carcinoma/classificação , Neoplasias Pulmonares/classificação , Pulmão/patologia , Estudos Retrospectivos
17.
Arq. bras. oftalmol ; 73(6): 539-540, nov.-dez. 2010. ilus
Artigo em Português | LILACS | ID: lil-572222

RESUMO

O caso em relato aborda uma etiologia rara para necrose de canto medial da pálpebra com comprometimento do sistema canalicular em uma paciente em tratamento para hanseníase virchowiana. O exame histopatológico da lesão necrótica evidenciou reação inflamatória granulomatosa com acúmulo de histiócitos e presença de bacilos álcool-ácido resistentes. Após tratamento medicamentoso a paciente apresentou uma evolução favorável com recuperação espontânea da arquitetura do canto medial, porém com destruição total do sistema canalicular.


In the present case we deal with a medial eyelid necrosis and injury of the canalicular system in a patient in treatment for lepromatous leprosy. Histology of the necrotic lesion showed granulomatous inflammatory reaction with accumulation of histiocytes and presence of alcohol-acid resistant bacilli. After medical treatment, the patient had a spontaneous recovery of the medial canthus architecture but with complete destruction of the canalicular system.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Doenças Palpebrais/etiologia , Hanseníase Virchowiana/complicações , Doenças Palpebrais/patologia , Necrose
18.
J Bras Pneumol ; 36(5): 657-61, 2010.
Artigo em Inglês, Português | MEDLINE | ID: mdl-21085832

RESUMO

Lipoid pneumonia is an underdiagnosed disease that is caused by the aspiration of lipid particles into the lungs. Although most of the reported cases have been associated with the use of mineral oil as a laxative, other lipid substances can also cause the disease. We report the case of a 50-year-old female patient with a complaint of productive cough who was initially diagnosed with bronchial hyperresponsiveness and gastroesophageal reflux disease (GERD). The patient was treated for GERD. Because the productive cough persisted, the patient underwent chest CT, fiberoptic bronchoscopy, and open lung biopsy. She was diagnosed with lipoid pneumonia. The patient was questioned regarding the use of lipid substances, and she reported the chronic use of evening primrose oil. After the discontinuation of the substance and the maintenance of GERD treatment, her condition improved.


Assuntos
Óleo Mineral/efeitos adversos , Pneumonia Lipoide/etiologia , Anti-Infecciosos/uso terapêutico , Doença Crônica , Ciprofloxacino/uso terapêutico , Constipação Intestinal/tratamento farmacológico , Feminino , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/tratamento farmacológico , Humanos , Pessoa de Meia-Idade , Pneumonia Lipoide/tratamento farmacológico , Pneumonia Lipoide/patologia , Staphylococcus aureus/isolamento & purificação
19.
J. bras. pneumol ; 36(5): 657-661, set.-out. 2010. ilus
Artigo em Português | LILACS | ID: lil-564208

RESUMO

A pneumonia lipoide é uma doença pouco diagnosticada, causada pela aspiração de partículas oleosas para dentro dos pulmões. Os casos relatados têm sido relacionados ao uso de óleo mineral como laxativo, mas outras soluções oleosas também podem causar a doença. Relatamos o caso de uma paciente de 50 anos com queixa de tosse produtiva, sendo diagnosticada inicialmente com hiper-reatividade brônquica e doença do refluxo gastroesofágico (DRGE). A paciente foi submetida a tratamento para DRGE. Devido à persistência da tosse, a paciente foi submetida a TC de tórax, fibrobroncoscopia e biópsia pulmonar a céu aberto, sendo diagnosticada com pneumonia lipoide. A paciente foi questionada quanto ao uso de substâncias oleosas, relatando o uso crônico de óleo de prímula. Com a suspensão do uso da substância e a continuidade do tratamento para DRGE, houve melhora do quadro.


Lipoid pneumonia is an underdiagnosed disease that is caused by the aspiration of lipid particles into the lungs. Although most of the reported cases have been associated with the use of mineral oil as a laxative, other lipid substances can also cause the disease. We report the case of a 50-year-old female patient with a complaint of productive cough who was initially diagnosed with bronchial hyperresponsiveness and gastroesophageal reflux disease (GERD). The patient was treated for GERD. Because the productive cough persisted, the patient underwent chest CT, fiberoptic bronchoscopy, and open lung biopsy. She was diagnosed with lipoid pneumonia. The patient was questioned regarding the use of lipid substances, and she reported the chronic use of evening primrose oil. After the discontinuation of the substance and the maintenance of GERD treatment, her condition improved.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Óleo Mineral/efeitos adversos , Pneumonia Lipoide/etiologia , Anti-Infecciosos/uso terapêutico , Doença Crônica , Ciprofloxacino/uso terapêutico , Constipação Intestinal/tratamento farmacológico , Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/tratamento farmacológico , Pneumonia Lipoide/tratamento farmacológico , Pneumonia Lipoide/patologia , Staphylococcus aureus/isolamento & purificação
20.
Rev Inst Med Trop Sao Paulo ; 52(2): 83-8, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20464128

RESUMO

Isolation of Leishmania parasite and species identification are important for confirmation and to help define the epidemiology of the leishmaniasis. Mice are often used to isolate pathogens, but the most common mouse strains are resistant to infection with parasites from the Leishmania (Viannia) subgenus. In this study we tested the inoculation of interferon gamma knockout (IFNgamma KO) mice with biopsy macerates from Leishmania-infected patients to increase the possibility of isolating parasites. Biopsies from twenty five patients with clinical signs of leishmaniasis were taken and tested for the presence of parasites. Immunohistochemical assay (IHC) and conventional histopathology detected the parasite in 88% and 83% of the patients, respectively. Leishmania sp. were isolated in biopsy macerates from 52% of the patients by culture in Grace's insect medium, but 13% of isolates were lost due to contamination. Inoculation of macerates in IFNgamma KO mice provides isolation of parasites in 31.8% of the biopsies. Most isolates belong to L. (Viannia) subgenus, as confirmed by PCR, except one that belongs to L. (Leishmania) subgenus. Our preliminary results support the use of IFNgamma KO mice to improve the possibility to isolate New World Leishmania species.


Assuntos
Leishmania/isolamento & purificação , Camundongos Knockout/parasitologia , Pele/parasitologia , Animais , Biópsia , Humanos , Interferon gama/genética , Interferon gama/imunologia , Leishmania/classificação , Camundongos , Camundongos Endogâmicos C57BL , Reação em Cadeia da Polimerase , Fatores de Tempo
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