Olfactory neuroepithelium in the superior and middle turbinates: which is the optimal biopsy site?

Introduction: Olfactory neuroepithelium (ON) biopsy has several therapeutic applications for both disorders of olfaction and neurodegenerative diseases. Successful collection of ON is still anything but routine due to a dearth of studies on the distribution of ON in the superior and middle turbinates. Aim: To determine the location in which ON is most likely to be present in endoscopically removed cadaver superior and middle turbinates as well as the influences of gender, age, and naris side on the presence of ON and the extent to which it is present. Methods: We conducted a prospective anatomical study. The superior and middle turbinates on both sides endoscopically removed from 25 fresh cadavers (less than 12 h post-mortem). The turbinates were halved into anterior and posterior segments for a total of 200 specimens, which were analyzed after hematoxylin and eosin and immunohistochemical staining. Hematoxylin and eosin-stained slides were subjected to blind examination by 3 independent pathologists, and the presence of ON was graded on a 5-point scale from 0 to 4. Kappa measurement was used to determine the agreement between pairs of observers. Results: ON was present in 82.9% of superior turbinate samples and in 17.1% of middle turbinate samples. Immunohistochemistry detected ON in superior turbinates only by S-100 staining and only in 15 fragments. Gender, age, and naris side had no statistically significant effects on the presence of ON. Conclusion: When biopsying ON, the posterior portion of the superior turbinate should be targeted whenever possible because it has the highest concentration of ON among the nasal structures

Immune receptors and adhesion molecules in human pulmonary leptospirosis

Pulmonary involvement in leptospirosis has been increasingly reported in the last 20 years, being related to the severity and mortality of the disease. The pathogenesis of pulmonary hemorrhage in leptospirosis is not understood. Lung endothelial cells have been proposed as targets in the pathogenesis of lung involvement in leptospirosis through the activation of Toll-like receptor 2 or the complement system, which stimulates the release of cytokines that lead to the activation of adhesion molecules. The aim of this study was to investigate the involvement of immune pathways and of the intercellular and vascular cell adhesion molecules (intercellular adhesion molecule and vascular cell adhesion molecule, respectively) in the lungs of patients with pulmonary involvement of leptospirosis. We studied the lungs of 18 patients who died of leptospirosis and compared them with 2 groups of controls: normal and noninfectious hemorrhagic lungs. Using immunohistochemistry and image analysis, we quantified the expression of the C3a anaphylatoxin receptor, intercellular adhesion molecule, vascular cell adhesion molecule, and Toll-like receptor 2 in small pulmonary vessels and in the alveolar septa. There was an increased expression of intercellular adhesion molecule (P <.03) and C3a anaphylatoxin receptor (P <.008) in alveolar septa in the leptospirosis group compared with the normal and hemorrhagic controls. In the vessels of the leptospirosis group, there was an increased expression of intercellular adhesion molecule (P=.004), vascular cell adhesion molecule (P=.030), and Toll-like receptor 2 (P=.042) compared with the normal group. Vascular cell adhesion molecule expression in vessels was higher in the leptospirosis group compared with the hemorrhagic group (P=.015). Our results indicate that immune receptors and adhesion molecules participate in the phenomena leading to pulmonary hemorrhage in leptospirosis. (C) 2012 Elsevier Inc. All rights reserved.Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq

Vascularização na cirrose hepática: estudo imunoistoquímico baseado em necropsias

RACIONAL: O processo patológico mais discutido na gênese da cirrose hepática é a fibrose progressiva, porém alterações na vasculatura do órgão têm sido apontadas como elementos fundamentais na fisiopatologia da doença e de suas complicações, como hipertensão portal, insuficiência hepática e carcinoma hepatocelular. OBJETIVO: Avaliar a densidade microvascular em 35 casos de necropsias de pacientes com cirrose hepática mediante pesquisa imunoistoquímica do marcador endotelial CD34 a fim de comparar os informes obtidos mediante semi-quantificação com aqueles registrados por método quantitativo morfométrico, além de relacionar as alterações vasculares encontradas com os principais agentes causais, padrões de lesão e complicações clínicas da doença. MÉTODOS: Foram estudados 35 casos de cirrose obtidos retrospectivamente de necropsias realizadas no SVOC/USP no período de março de 2002 a junho de 2003. Os casos foram reagrupados segundo padrão anatomopatológico em esteatohepatite e hepatite crônica. A microvasculatura foi avaliada através da reação imunoistoquímica com anticorpo anti-endotelio clone CD34, QBend. RESULTADOS: Observou-se associação significativa entre a abordagem semi-quantitativa e a quantificação morfométrica da densidade de vasos no parênquima, o mesmo não ocorrendo no septo. Não foram detectadas associações específicas entre a neovascularização e os tipos de complicação da hepatopatia aqui estudados. O principal achado foi que a neoformação vascular no parênquima é significantemente maior nas cirroses associadas a hepatites crônicas do que nas esteatohepatites. CONCLUSÃO: Todos esses achados requerem necessários estudos clínicos para avaliar a hipótese de que o estudo do rearranjo da microcirculação hepática, através de marcadores como o CD34, pode ser fator prognóstico em pacientes cirróticos

Isolated lymphadenitis due to Histoplasma capsulatum diagnosed by fine-needle aspiration biopsy and immunohistochemistry

In the disseminated form of histoplasmosis, isolation and further identification of Histoplasma capsulatum can be performed by several methods, namely, bone marrow aspiration, blood culture, and liver biopsy. Lymph node disease usually is diagnosed by excisional biopsy. Although fungal stains can identify this fungus, detection of specific antigens by immunohistochemistry shows a higher specificity and sensitivity. This approach can use the cell block method when the material is not sent to fungal cultures or fresh staining