Analysis of the expression of heat-shock protein 27 in patients with oral lichen planus.

OBJECTIVE: Heat-shock protein 27 (hsp27) has been implicated in several biological events. In this experimental study, we aimed at analysing, for the first time, the expression of hsp27 in the diverse stages of oral lichen planus (OLP) lesions. MATERIALS AND METHODS: Thirty-six biopsy specimens of patients with OLP and 10 of healthy patients were selected. OLP specimens were divided into three groups: G1 - moderate or mildly active OLP; G2 - active or moderately active atrophic OLP; G3 - mild or inactive atrophic OLP. Hsp27 expression was analysed by immunohistochemistry (staining intensity and percentage of stained cells), and results of staining were compared between the different groups. Gender, age and anatomical location were also studied. RESULTS: In the basal layer, an increase of hsp27 expression in both G2 and G3 was observed when compared to G1 and control group. In contrast, a decrease of hsp27 expression in the superficial layer was observed in all groups when compared to control group. CONCLUSION: The increased expression of Hsp27 in the basal layer observed during the OLP evolution and the less staining in the superficial layers in all cases of OLP suggest that hsp27 may have a role in the OLP pathogenesis.

[Ischemia-reperfusion syndrome and role of preservation graft technique after laparoscopic versus open nephrectomy in a experimental model of living donor kidney transplant]. / Evaluación del síndrome isquemia-reperfusión y papel de la preservación del injerto en la extracción renal laparoscópica versus abierta en un modelo experimental porcino de donante vivo.

INTRODUCTION: Delayed graft function alter living donor transplantation is a subject of debate. Delayed graft function can be partially explained by renal ischemia-reperfusion injury, when severe is associated with decreased graft survival. In this experimental living donor model study, we analyze the hemodynamic, histological and biochemical effects of laparoscopic nephrectomy. We also, analyze the effect of a pulsatile machine perfusion for kidney preservation during cold ischemia time. MATERIAL AND METHODS: Twenty large-white pigs (average weight 40-45 kgrs) were divided in 4 experimental groups: Group A: Laparoscopic nephrectomy+ immediate graft perfusion in pulsatile vacuum pump+autotransplant Group B: Laparoscopic nephrectomy+ immediate graft perfusion by gravity+autotransplant Group C: Open nephrectomy+immediate graft perfusion in pulsatile vacuum pump+autotransplant Group D: Open nephrectomy+ immediate graft perfusion by gravity+autotransplant Both laparoscopic and open nephrectomy were completed transperitoneally according to standardized technique. Hypothermic perfusion was done in a system designed in our lab. RESULTS: We observed a decreased renal artery flow in kidneys procured laparoscopically compared to open nephrectomy. We found an artery flow recovery during the first 60 minutes after revascularization. Renal machine perfusion during cold ischemia time seems to have no beneficial effect, but shows a deleterious effect on hemodynamic event for renal transplantation. Lower plasma nitric oxide level is observed in kidneys obtained by laparoscopy compared with open surgical technique. And finally, we also found higher histological damage in proximal tubular and endothelial cell, in kidneys obtained by laparoscopy compared with open surgery. CONCLUSIONS: In our experience: Laparoscopic nephrectomy versus open nephrectomy produces, in a model of living donor transplant, a lower value or renal blood flow and a higher value of renal vascular resistanse. These hemodynamic findings tend to normalize by 60 min after the reperfusion. A lower blood concentration of nitric oxide after the transplant was detected in laparoscopic group Vs open surgery group.

[Clinicopathological features of solitary fibrous tumors of the pleura: a case series and literature review]. / Tumor fibroso solitario pleural: características clinicopatológicas de una serie de casos y revisión de la bibliografía.

We assessed the clinicopathological features of solitary fibrous tumors of the pleura in a case series comprising 30 patients (20 women, 66.6%) with a mean age of 58.39 years. Forty-five percent of the cases were asymptomatic. In 70% of the cases the tumors arose in the visceral pleura. Twenty percent presented multiple tumors, a finding that was associated with intrapulmonary localization and malignant behavior (P<.0001) Histology revealed low cell density in 15% of the cases, moderate density in 50%, and high density in 35%; further findings showed atypia in 45% of the cases, necrosis in 25%, and hemorrhage in 15%. More than 4 mitoses per 10 high-power fields were noted in 30% of the cases. Immunohistochemistry results were positive for vimentin in all cases; cells were CD34+ in 85% of the cases, BCL2+ in 65%, and CD99+ in 40%. Findings for keratin and protein S100 were negative in all cases. Malignant biological behavior (local recurrence and metastasis) was observed in 4 cases, 2 of which were CD34-. Solitary fibrous tumors of the pleura are uncommon neoplasms with unpredictable biological behavior; follow-up should therefore be based on early detection of recurrence or metastasis.

Antigenic profile of human bronchial gland.

Bronchial glands have been regarded as modified salivary glands. It is well known that there no previous reviews concerning the antigenic profile of the bronchial wall. The aim of this study is a systematic survey of the antigenic profile and to describe the histology of normal human bronchial glands. Six formalin-fixed, paraffin-embedded surgical specimens were studied using a panel of 22 polyclonal and monoclonal antibodies by the avidin-biotin-peroxidase method. Bronchial glands disclosed a tubuloacinar structure. The smallest ducts intercalated originated from a cluster of secretory acini and converge to form an excretory duct. No striated duct was observed. Acinar united is composed by mucous, serous and mixed units. Myoepithelial cells are found in relation to the intercalated ducts and secretory acinis. Secretory cells of bronchial glands reacted strongly with cytokeratin AE1 and moderately for CK7, CK18. Additionally, serous acinar cells reacted with AE3, CK19, CK5/6/8/18, CK8/18/19, and Leu7. Myoepithelial cells reacted strongly with a-smooth muscle actin, CD10 and CK34betaE12. Ductal system cells differed from acinar secretory cells in expressing CK34betaE12 and HSP27. In conclusion, the detailed knowledge of the immunohistochemical reactivities of normal cell types of normal human bronchial glands will prove useful in studies of bronchial pathology, especially of neoplastic processes.

Unusual duodenal presentation of leishmaniasis.

This case report describes an atypical case of duodenal leishmaniasis in an elderly patient not infected with human immunodeficiency virus. Investigation of this 84 year old woman with a constitutional syndrome and dysphagia revealed anaemia of chronic disorder, a high erythrocyte sedimentation rate, and polyclonal hypergammaglobulinaemia. Abdominal ultrasonography revealed thickening of the stomach wall, which was seen to be inflamed during gastroscopy. Duodenal histology revealed numerous leishmania amastigotes within macrophages. This was confirmed by bone marrow biopsy and leishmania serology. This case report stresses the importance of atypical symptoms and the unusual location of visceral leishmaniasis, not only in immunodepressed patients, but also in elderly immunocompetent patients.

Bronchial granular cell tumor. Presentation of three cases with tissue culture and ultrastructural study.

Three granular cell tumors, two arising from the bronchi and one from the trachea, are described. Two of the cases were studied by tissue culture and electron microscopy of the original tumor tissue and the cultivated cells. The granular cells grew actively in culture and showed a specific pattern in vitro different from tumors of fibrohistiocytic and schwannian origin. Ultrastructural examination of the newly grown cells allowed follow-up of the progressive cytoplasmic granulation of cells, with a transition from elements with an ultrastructural morphology consistent with the "early granular cells" described in tumor tissue in previous studies to fully developed mature granular cells.

Atypical bronchial carcinoid with oncocytoid features. Its ultrastructure, with special reference to its granular content.

A case of atypical bronchial carcinoid with oncocytoid features was studied. The tumor contained mitochondria-laden cells with scanty neurosecretory granules, heavily granulated cells, and intermediate forms. The neurosecretory granules were of three types as reported in previous cases: type P, type 3, and a double-core granule. The ultrastructural findings are characteristic of this type of tumor.

Lectin histochemistry of normal bronchopulmonary tissues and common forms of bronchogenic carcinoma.

Normal bronchopulmonary tissues, areas of basal cell hyperplasia and of squamous metaplasia, and 26 pulmonary carcinomas, including the three major types (squamous cell carcinoma, adenocarcinoma, and oat cell carcinoma), were studied with 12 biotinylated plant lectins. The study demonstrated a rather characteristic lectin-binding profile for most normal epithelial cell types, while pulmonary tumors showed a variation in the lectin reactivity when compared with the whole spectrum of normal cells, with binding of some lectins that were not reactive with normal tissues and a loss of reactivity with others that bound to normal tissues. Adenocarcinomas showed the highest density of reacting sites, while undifferentiated carcinomas were the less-reacting variant. Areas of metaplasia and hyperplasia showed some variation in the lectin-binding profile with normal tissues, but as a whole, there was a much smaller number of reacting sites than tumors.

Expression of blood group antigens by normal bronchopulmonary tissues and common forms of pulmonary carcinomas.

The expression of ABH and Lewis antigens has been studied in a series of pulmonary carcinomas, in areas of squamous metaplasia, and in normal adjacent bronchopulmonary tissues by means of a panel of lectins and monoclonal antibodies. All respiratory epithelial cells can express antigens, with the exception of glandular serous cells. The expression of AB antigens is rather homogeneous, while Lewis antigens are expressed in a more irregular pattern, alternating positively stained cells with negatively stained cells in the same microscopic field. The expression of blood group antigens allows the identification of residual pneumocytes inside the tumor and the proper classification of some neoplasms. Metaplastic areas show a variation in the staining profile when compared with normal tissues and pulmonary carcinomas. The most significant findings are the deletion of A antigen and the strong expression of Le antigen. Pulmonary carcinomas are composed by a heterogeneous population and tend to express antigens in the more differentiated cases or areas. The most important findings are the deletion of AB antigens and the strong expression of Le(y) antigen.

Sclerosing hemangioma of the lung. An immunohistochemical study of intermediate filaments and endothelial markers.

Three cases of so-called pulmonary sclerosing hemangioma have been studied for endothelial markers (alkaline phosphatase, adenosine triphosphatase, factor VIII-related antigen, and Ulex europaeus I lectin), for intermediate filaments (keratin, vimentin), and for carcinoembryonic and epithelial membrane antigen. Not one of the neoplasms expressed endothelial markers, carcinoembryonic antigen, or keratin reactivity. The tumor cells showed a positive reaction for epithelial membrane antigen and vimentin. The findings exclude an endothelial origin for this group of tumors and favored an epithelial origin as the probable genesis of the neoplastic proliferation.

Type II pneumocytes in pulmonary tumors. Implications for histogenesis.

Bronchioloalveolar carcinomas (n = 45), intravascular bronchiolo-alveolar tumors (n = 8), and sclerosing hemangiomas of the lung (n = 2) were stained for surfactant apoprotein by the immunoperoxidase method. Of the bronchiolo-alveolar carcinomas, 12 were found to be carcinomas of type II pneumocytes and the remaining 33 tumors were designated as nontype II pneumocytic bronchiolo-alveolar carcinomas. Twenty-five of these tumors displayed trapped benign type II pneumocytes within the tumor masses. In the case of intravascular bronchioloalveolar tumors, none of the tumors demonstrated staining of tumor cells for surfactant apoprotein. In the two cases of sclerosing hemangiomas, the type II pneumocytes were exuberant and numerous, and in one case contained intranuclear inclusions of surfactant apoprotein. This article discusses the implication of the presence of benign type II pneumocytes in pulmonary tumors.

[Large cell lymphoepithelioma-like carcinoma of the lung]. / Carcinoma anaplásico tipo linfoepitelioma de pulmón.

Lymphoepithelioma-like carcinoma of the lung is a rare tumor that is considered a subtype of undifferentiated large cell carcinoma with abundant invasion by lymphocytes. Although initially described as a tumor occurring in the nasopharynx, this type of carcinoma has since been seen in many other organs. We report the case of a 59-year-old male smoker diagnosed with lymphoepithelioma-like carcinoma.

[Neurocutaneous melanosis]. / Melanosis neurocutánea.

INTRODUCTION: Neurocutaneous melanosis is an infrequent condition characterized by the presence of numerous gigantic cutaneous naevi and melanocytic infiltration of the central nervous system and/or the leptomeningeal layers. Different clinical features may be seen: endocranial hypertension due to hydrocephalus, cranial nerve paralysis, myelopathy, convulsive seizures, etc. The prognosis is considered to be malignant. Only positive CNS histological findings confirm the diagnosis. CLINICAL CASE: We present the case of a man with cutaneous lesions compatible with the diagnosis of neurocutaneous melanosis since birth, with benign self-limiting epilepsy in early childhood. Cerebral CT and MR scans were normal until the age of 17, when hipper-signal lesions appeared on MR, infiltrating the leptomeninges of the deep temporal pole and anterior aspect of the cerebral peduncles, which suggested the presence of melanocytes in the CNS. CONCLUSIONS: There are cases of neurocutaneous melanosis with a good medium-term prognosis and benign manifestations until infiltration of the CNS occurs. Then they start to show the classical behavior of cases with a malignant prognosis. MR should be included as part of the diagnostic criteria for neurocutaneous melanosis. MR should be done periodically in patients with cutaneous lesions suggestive of this condition.

Expression of histo-blood group antigens in bronchial squamous metaplasia.

The aim of the present study was to evaluate the expression of blood group antigens in squamous bronchial metaplasia in order to determine whether this factor could identify patients at risk of lung cancer. In total, 100 bronchial biopsies were included in the present study. The cases were classified according to the World Health Organization grading system. Immunohistochemical stains for histo-blood groups A and B, and reactivity tests to p53 and the cellular proliferation index were performed. A total of 56 (56%) patients belonged to blood group A. Among them, six (10.7%) patients who did not express antigen in squamous metaplasia, showed carcinoma at the moment of the biopsy (n = 3) or developed synchronous lung carcinoma (n = 3). A total of nine (9%) patients belonged to blood group B. Loss of antigenic expression was observed in five cases. All of them developed synchronous lung carcinoma. The patients with low- and high-grade dysplasia developed lung cancer in 71 and 100% of the cases, respectively. In conclusion, the findings of the present study suggest that the loss of histo-blood antigens expression is an event in the carcinogenesis of bronchial mucosa and it is usually associated with high-grade lesions and hyperproliferative activity.