Glomerular involvement in human kala-azar. A light, immunofluorescent, and electron microscopic study based on kidney biopsies.

Glomerular involvement characterized by mesangial cell proliferation with fibrillar thickening of the axial region and deposits of immune complexes is reported in three human cases of kala-azar. IgG was seen in all 3 and Igm in 2 patients. Complement (C3) was detected in the glomeruli in all cases and fibrinogen in the only case in which it was tested for. The deposits appeared mainly along the mesangium and their staining was particularly strong for complement and IgG. Electron microscopy detected granular electron dense deposits mainly close to mesangial cells. In one case clumps made us of electron dense lamellae were seen in the glomerular basal membrane interpreted as evidence of focal membranolysis. No granulocytes were seen in the glomeruli. Attempts to demonstrate antigen were unsuccessful. The pattern of the lesion resembles that described in the kidney of human cases of hepatosplenic schistosomiasis, and the distribution of the deposits suggests that relatively large, poorly soluble complexes formed either in the presence of excess antigen or, under certain circumstances, in the presence of excess antibody, are trapped in the glomerular capillaries. The aggregates are partially shunted to the mesangial cells, which enlarge and proliferate.

[Surgical treatment of acquired palpebral ptosis (lymphocytoma cutis)]. / Tratamento cirúrgico da ptose palpebral adquirida (linfocitoma cútis).

A clinical case of acquired palpebral ptosis caused by a rare pathology, lymphocytoma cutis, is reported. An eyelid ptosis was characterized with the patient unable to lift the eyelid. The resection of the eyelid nodules was performed using blefaroplasty incision as access and the result of the anatomopathological examination confirmed the diagnosis: lymphocytoma cutis. The surgical result was satisfactory not only esthetically but also functionally (2-year follow-up).

Tratamento cirúrgico da ptose palpebral adquirida (linfocitoma cútis) / Surgical treatment of acquired palpebral ptosis (lymphocitoma cutis)

Os autores descrevem um caso clínico de ptose palpebral causada por uma patologia rara, o linfocitoma cútis. A paciente apresentava o quadro clínico do linfocitoma cútis em sua forma disseminada, com sintomatologia visual causada por nódulos palpebrais. A conduta cirúrgica realizada foi a ressecçäo dos nódulos palpebrais por meio de incisÒo de blefaroplastia, e o exame histológico confirmou o diagnóstico de linfocitoma cútis. O tratamento cirúrgico realizado foi eficiente para a melhora funcional das pálpebras.

Abdominoplasty: a personal approach to the aponeurotic muscle system

A new approach to the correction of distasis and flaccidness of the aponeurotic muscle system of the abdominal wall is presented, leading to the obtention of better results.

Disseminated lymphocytoma cutis

Lymphocytoma cutis is rare pathology affecting mainly the head and neck. Because of its rarity, the authors describe a clinical case in which the face was severely affected, as well as the histological examination and surgical management for functional eyelid improvement.