Contribuição para o diagnóstico do pequeno cisto dentígero ou do cisto paradentário

The aim of this study was to verify the relationship between the radiographically measured width of the pericoronal space (PS) and the microscopic features of the follicle in order to contribute to the diagnosis of small dentigerous cysts and paradental cysts. One hundred and thirty unerupted teeth (UT) and thirty-five partially erupted teeth (PET) were radiographed and extracted. The radiographic analysis consisted of measuring the width of the PS. The results of the radiographic analysis were compared with those of the histopathologic examination of the dental follicle. The width of the PS ranged from 0.1 to 5.6 mm. The most frequently observed lining of the follicles was a reduced enamel epithelium (REE) (68.4%) in UT and a hyperplastic stratified squamous epithelium (HSSE) (68.5%) in PET. Inflammation was present in 36.1% of the UT and in 82.8% of the PET. There was a statistically significant association between the presence of stratified squamous epithelium (SSE) and PS enlargement for UT (p < 0.05). There was a tendency of association between inflammation and PS enlargements in PET and, possibly, in UT, despite the absence of statistical significance. Surgically, we did not detect bone cavitation or luminal cystic contents in pericoronal spaces smaller than 5.6 mm. We suggest that the first radiographic diagnosis for a PS enlargement, in most of the routine clinical cases, should be of "inflammation of the follicle". The hypothesis of "dentigerous cyst" or "paradental cyst" is suggested as a second diagnosis. The final differential diagnosis between a small dentigerous or a paradental cyst and a pericoronal follicle depends on clinical and/or surgical findings, such as the presence of bone cavitation and cystic content.Foi propósito deste estudo verificar a relação entre a largura do espaço pericoronário (EP) medida radiograficamente e os aspectos microscópicos do folículo. O objetivo foi contribuir com o diagnóstico de pequenos cistos dentígeros e cistos paradentários. Cento e trinta dentes não-irrompidos (DNI) e trinta e cinco dentes parcialmente irrompidos (DPI) foram radiografados e extraídos. O estudo radiográfico consistiu na medição da largura do EP seguida pelo exame microscópico do folículo. A largura do EP variou de 0,1 a 5,6 mm. O revestimento mais freqüentemente observado em DNI foi o epitélio reduzido do esmalte (ERE = 68,4%). Em DPI foi o epitélio pavimentoso estratificado hiperplásico (EPEH = 68,5%). Inflamação estava presente em 36,1% dos DNI e 82,8% dos DPI. Houve uma associação estatisticamente significante entre a presença de epitélio pavimentoso estratificado (EPE) com o alargamento do espaço pericoronário em DNI (p < 0,05). Houve uma tendência da inflamação estar associada com o alargamento do EP em DPI. Em espaços pericoronários menores que 5,6 mm não foram detectados cavidade óssea e conteúdo cístico cirurgicamente. Na maioria dos casos clínicos de rotina com alargamento do EP, sugerimos que o primeiro diagnóstico radiográfico deva ser "folículo inflamado". "Cisto dentígero" ou "cisto paradentário" deve ser sugerido como segundo diagnóstico. O diagnóstico diferencial final entre um pequeno cisto dentígero ou cisto paradentário e um folículo pericoronário dependerá de achados clínicos e/ou cirúrgicos de cavidade e conteúdo

Larva migrans in the oral mucosa: report of two cases

Cutaneous Larva migrans is a very common disease in tropical regions. In the oral mucosa, the infection occurs in the same way as in the skin, but it is rarer. This report describes two cases of Larva migrans in the oral mucosa. The first case was in a 27-year-old woman who presented an erythematous plaque located on the buccal mucosa, extending to a posterior direction, following a linear pattern, to other areas of the mouth. After incisional biopsy of the anterior-most portion of the lesion, morphological details obtained in multiple examined sections suggested Necator or Ancylostoma braziliense larvae as the cause of infection. The second case was in a 35-year-old male who presented a fusiform erythematous plaque in the palatal mucosa. This area was removed and submitted to microscopic examination under a presumptive diagnosis of "parasite migratory stomatitis". The histological characteristics were suggestive of a larva pathway. In both cases the lesion disappeared after biopsy and the patients were symptom-free.Larva migrans cutânea é uma doença muito comum em regiões tropicais. Na mucosa oral, a infecção ocorre da mesma forma como na pele, mas é raro. Este relato descreve dois casos de Larva migrans na mucosa oral. O primeiro caso foi de uma mulher de 27 anos de idade, que apresentou uma placa eritematosa localizada na mucosa julgal, estendendo-se posteriormente, em conformação linear, para outras áreas da boca. Após biópsia incisional da porção mais anterior da lesão, detalhes morfológicos obtidos em múltiplos cortes examinados sugeriram Necator ou larvas de Ancylostoma braziliense como a causa da infecção. O segundo caso foi de um homem de 35 anos de idade que apresentou uma placa fusiformes eritematosas na mucosa palatina. Esta área foi removida e submetida a exame microscópico, com diagnóstico presuntivo de "estomatite migratória por parasita". As características histológicas foram sugestivas de trajeto de larva. Em ambos os casos a lesão desapareceu após a biópsia e os pacientes estavam assintomáticos

Granulomatous Reactivation during the Course of a Leprosy Infection: Reaction or Relapse

Leprosy is a serious infectious disease whose treatment still poses some challenges. Patients are usually treated with a combination of antimicrobial drugs called multidrug therapy. Although this treatment is effective against Mycobacterium leprae, the bacillus that causes leprosy, patients may develop severe inflammatory reactions during treatment. These reactions may be either attributed to an improvement in the immunological reactivity of the patient along with the treatment, or to relapse of the disease due to the proliferation of remaining bacilli. In certain patients these two conditions may be difficult to differentiate. The present study addresses the histopathology picture of and the M. leprae bacilli in sequential biopsies taken from lesions of patients who presented such reactions aiming to improve the differentiation of the two conditions. This is important because these reactions are one of the major causes of the disabilities of the patients with leprosy, and should be treated early and appropriately. Our results show that the histopathology picture alone is not sufficient, and that bacilli's counting is necessary

A contribution to the diagnosis of the small dentigerous cyst or the paradental cyst

The aim of this study was to verify the relationship between the radiographically measured width of the pericoronal space (PS) and the microscopic features of the follicle in order to contribute to the diagnosis of small dentigerous cysts and paradental cysts. One hundred and thirty unerupted teeth (UT) and thirty-five partially erupted teeth (PET) were radiographed and extracted. The radiographic analysis consisted of measuring the width of the PS. The results of the radiographic analysis were compared with those of the histopathologic examination of the dental follicle. The width of the PS ranged from 0.1 to 5.6 mm. The most frequently observed lining of the follicles was a reduced enamel epithelium (REE) (68.4%) in UT and a hyperplastic stratified squamous epithelium (HSSE) (68.5%) in PET. Inflammation was present in 36.1% of the UT and in 82.8% of the PET. There was a statistically significant association between the presence of stratified squamous epithelium (SSE) and PS enlargement for UT (p < 0.05). There was a tendency of association between inflammation and PS enlargements in PET and, possibly, in UT, despite the absence of statistical significance. Surgically, we did not detect bone cavitation or luminal cystic contents in pericoronal spaces smaller than 5.6 mm. We suggest that the first radiographic diagnosis for a PS enlargement, in most of the routine clinical cases, should be of "inflammation of the follicle". The hypothesis of "dentigerous cyst" or "paradental cyst" is suggested as a second diagnosis. The final differential diagnosis between a small dentigerous or a paradental cyst and a pericoronal follicle depends on clinical and/or surgical findings, such as the presence of bone cavitation and cystic content

Manifestações neurológicas periféricas da periarterite nodosa: relato de três casos Involvement of peripheral nervous system in periarteritis nodosa: report of three cases

Após ligeiras considerações a propósito das manifestações neurológicas da periarterite nodosa, são relatados três casos com comprometimento do sistema nervoso periférico. É salientada a maior freqüência de comprometimento do sistema nervoso periférico. Entre as síndromes neurológicas periféricas é ressaltada a maior freqüência das mononeuropatias múltiplas com o relato de dois casos (casos 1 e 3). O caso 2 é caracterizado pelo comprometimento polirradicular (polirradiculoneurite). Finalmente, o caso 3 é caracterizado pela associação de mononeuropatias múltiplas com uma síndrome do forâme rasgado posterior. O diagnóstico da periarterite nodosa, em todos os casos, foi confirmado pelo exame histopatológico.<br>After brief considerations about neurologic manifestations in periarteritis nodosa, three cases with involvement of peripheral nerves are reported. Between the peripheral nerves syndromes the multiple peripheral neuritis (mononeuritis multiplex) is stressed and two cases are studied (cases 1 and 3). Case 2 was characterized by polyradicular involvement (polyradiculo-neuritis). Case 3 was characterized by the association of multiple peripheral neuritis with jugular foramen syndrome; there is not an alike case related in the medical literature. The correct diagnosis, in all cases, was made through histological examination. Necroscopic findings are reported in two eases. Clinical features are discussed

Manifestações neurológicas periféricas da periarterite nodosa: relato de três casos

Após ligeiras considerações a propósito das manifestações neurológicas da periarterite nodosa, são relatados três casos com comprometimento do sistema nervoso periférico. É salientada a maior freqüência de comprometimento do sistema nervoso periférico. Entre as síndromes neurológicas periféricas é ressaltada a maior freqüência das mononeuropatias múltiplas com o relato de dois casos (casos 1 e 3). O caso 2 é caracterizado pelo comprometimento polirradicular (polirradiculoneurite). Finalmente, o caso 3 é caracterizado pela associação de mononeuropatias múltiplas com uma síndrome do forâme rasgado posterior. O diagnóstico da periarterite nodosa, em todos os casos, foi confirmado pelo exame histopatológico

Hanseníase tuberculóide em paciente com Aids Tuberculoid leprosy in aids patient

Relata-se o caso de uma criança de oito anos, portadora de Aids, que desenvolveu hanseníase tuberculóide antes do início da terapia anti-retroviral. Apresentava lesões ulceradas nos membros, Mitsuda de 8,5mm, hipoestesia em perna esquerda, e o diagnóstico de hanseníase foi definido pela imuno-histoquímica antiproteína S-100, que mostrou fragmentos de ramos nervosos no interior dos granulomas. A incidência da hanseníase não aumentou com o advento da Aids, e não há modificações na apresentação clínica ou na resposta terapêutica nos casos de hanseníase associados à Aids. Também não se observou neste caso o desenvolvimento da reação tipo 1 como resultado da reconstituição imunológica devido ao tratamento anti-retroviral.<br>The authors present a 8 year-old child with AIDS who developed tuberculoid leprosy prior the beginning of the anti-retroviral treatment. The pacient presented ulcered lesions in arms and legs, the Mitsuda reaction was 8,5 mm, there was hypostesia of the left leg and the leprosy diagnosis was reached mainly supported by the anti-S100 protein immunohistochemistry staining that showed fragments of nerve branches inside granulomas. The incidence of leprosy has not increased because of AIDS. There haven’t been changes in the clinical presentation and in the response to therapy in cases of leprosy associated with AIDS. We haven’t also observed development of type 1 reaction in this patient resulting from restoring of the immune response after the anti-retroviral treatment

Localized cutaneous leishmaniasis of the plantar region: A 40-year outcome

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2017-08-14T18:50:11Z No. of bitstreams: 1 Barral AMP Localized cutaneous....pdf: 168027 bytes, checksum: 58df8e3206c22c6658f822a378d41880 (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2017-08-14T19:10:00Z (GMT) No. of bitstreams: 1 Barral AMP Localized cutaneous....pdf: 168027 bytes, checksum: 58df8e3206c22c6658f822a378d41880 (MD5)Made available in DSpace on 2017-08-14T19:10:00Z (GMT). No. of bitstreams: 1 Barral AMP Localized cutaneous....pdf: 168027 bytes, checksum: 58df8e3206c22c6658f822a378d41880 (MD5) Previous issue date: 2017Federal University of Rio Grande do Sul. Porto Alegre, RGS, BrazilLauro de Souza Lima Institute. Bauru, SP, BrasilLauro de Souza Lima Institute. Bauru, SP, BrasilFederal and Catholic University of Pelotas. Pelotas, RGS, BrazilFundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilWe report the case of a 78-year-old male Brazilian farmer, who presented with an extensive ulcer on the right foot that had an erythematous and raised border. This ulcer involved most of the right plantar region and had persisted for more than 40 years. Satellite erythematous papules and tumor-like growths were also seen on the right ankle. Extracutaneous involvement was not found. Light microscopy showed epithelial hyperplasia and diffuse histiocyte infiltration with intense plasmocytosis. Cultures for fungi and Leishmania were negative. The polymerase chain reaction with specific primers for Leishmania was performed using DNA extracted from the lesions; it showed an amplification of 120 pB. The patient had an excellent response after two 20-day cycles of intravenous N-methylglucamine antimonate (15mg/Kg/day). Leishmaniasis should be highly considered in the differential diagnosis of chronic ulcers in endemic areas