J. Lopes de Faria

Basosquamous cell carcinoma of the skin with metastases

Two cases of basosquamous cell carcinoma of the skin with lymph node, lung and bone metastases are reported. Metastases occurred 4 and 7 years after identification of the primary tumour. Both the primary and metastatic lesions had areas of typical basal cell carcinoma and squamous cell carcinoma and also intermediate carcinomatous tissue. In the bone metastasis of one case there were rudimentary hair follicles and areas of matrical differentiation. These cases further support the existence of basosquamous cell carcinoma and emphasize its metastatic potential.

THE HISTOPATHOLOGY OF THE SKIN BASAL CELL CARCINOMA WITH AREAS OF INTERMEDIATE DIFFERENTIATION-A METATYPICAL CARCINOMA

The histopathology of the skin basal cell carcinomas (BCCs) with areas of intermediate differentiation (ID) has been investigated. In a series of 127 BCCs, areas of ID were found in 28 tumors (22%), and also in an additional 10 cases of other series. These areas consisted of compact masses of cells without peripheral palisading, and with intermediate differentiation between basal and squamous cells. In comparison with the common undifferentiated BCCs, the BCCs with the ID areas may behave in a more aggressive fashion, since they displayed more precocious ulceration in small tumors (p less than 0.001), greater infiltrative features (p less than 0.001), more atypical cells (p less than 0.001) with increased nuclear-cytoplasmic ratio and more mitoses (p less than 0.001). The relation of such basal cell carcinomas to the metatypical carcinoma of the skin was discussed. Metatypical carcinoma, however, has been poorly defined and thus has no general acceptance in the literature. The new definition of the basosquamous cell carcinoma and the presence of intermediate areas of differentiation in this tumor were emphasized, and it was suggested that metastatic basal cell carcinoma and metatypical carcinoma may be the same tumor.

Portuguese Type of Familial Amyloid Polyneuropathy

A family is reported, in which a Portuguese father and four Brazilian siblings are affected by Andrade’s familial amyloid polyneuropathy (FAP). The father was studied in 1940 and was the first case of

Reduced LRP6 expression and increase in the interaction of GSK3β with p53 contribute to podocyte apoptosis in diabetes mellitus and are prevented by green tea

In diabetes mellitus (DM), podocyte apoptosis leads to albuminuria and nephropathy progression. Low-density lipoprotein receptor-related protein 6 (LRP6) is WNT pathway receptor that is involved in podocyte death, adhesion and motility. Glycogen synthase kinase 3 (GSK3) interaction with p53 (GSK3-p53) promotes apoptosis in carcinoma cells. It is unknown if GSK3-p53 contributes to podocyte apoptosis in DM. In experimental DM, green tea (GT) reduces albuminuria by an unknown mechanism. In the present study, we assessed the role of the GSK3β-p53 in podocyte apoptosis and the effects of GT on these abnormalities. In diabetic spontaneously hypertensive rats (SHRs), GT prevents podocytes p-LRP6 expression reduction, increased GSK3β-p53 and high p53 levels. In diabetic SHR rats, GT reduces podocyte apoptosis, foot process effacement and albuminuria. In immortalized mouse podocytes (iMPs), high glucose (HG), silencing RNA (siRNA) or blocking LRP6 (DKK-1) reduced p-LRP6 expression, leading to high GSK3β-p53, p53 expression, apoptosis and increased albumin influx. GSK3β blockade by BIO reduced GSK3β-p53 and podocyte apoptosis. In iMPs under HG, GT reduced apoptosis and the albumin influx by blocking GSK3β-p53 following the rise in p-LRP6 expression. These effects of GT were prevented by LRP6 siRNA or DKK-1. In conclusion, in DM, WNT inhibition, via LRP6, increases GSK3β-p53 and podocyte apoptosis. Maneuvers that inactivate GSK3β-p53, such as GT, may be renoprotective in DM.

Predisposing effect of spontaneous mesenchymal intimal thickenings of rabbit aorta to early lipid deposition.

Ten rabbits received by gastric tube 0.3 to 0.8 g pure cholesterol every second day for 4 to 8 weeks. Ten animals were used as control. Total serum cholesterol was determined weekly in experimental and control groups. The mean value of the total serum cholesterol in the experimental group was 482±79.6 mg/100 ml, about 2.5 times more than the cholesterol value of the control group (206±51.0 mg/100 ml). Early and selective lipid deposition was present in spontaneous mesenchymal thickenings of all aortas of the animals receiving cholesterol. The deposition failed to be observed in the aortic intima without that thickening. The intimal thickening is a change of the arterial wall that predisposes to lipid deposition. This observation supports the view that the proliferative changes seen in human atherosclerosis precede the lipid deposition and are a predisposing factor to this deposition.

Necrotic Changes of the Rabbit Adenohypophysis Following Orthostatic Collapse

Summary The adenohypophysis of a total of 73 adult rabbits was studied, 56 (37 males and 19 females) had been submitted to orthostatic collapse and 17 (10 males and 7 females) served as controls. The animals either died from collapse or were sacrificed at regular periods of time up to 8 months following it. The first change observed was vacuolar alteration of the glandular cells seen 30 minutes after the collapse. This change is possibly related to a nutritive disturbance mainly hypoxic in nature due to shock. The next change seen was nuclear pyknosis, and at 6 or more hours following collapse necrosis of the glandular cells was found. This necrosis was slight, involving isolated cells or groups of them, and complete regeneration of the adenohypophysis occurred 2 months later.

Necrotic Changes of the Adrenal Cortex Following Orthostatic Collapse in Rabbits

The adreal gland was studied in 56 adult male rabbits; 44 had been subjected to orthostatic collapse, and 12 served as controls. The animals either died from collapse or were sacrificed at regular intervals up to 30 days after the experimental procedure. Nuclear pyknosis was seen in cortical cells of animals dying in collapse. At 6 or more hours following collapse, necrosis was found involving single cells, or rarely small groups of cells mainly in the zona fasciculata. Regenerative areas were present at 7 and 15 days after collapse. This necrosis may be related to a nutritive disturbance, largely hypoxic in nature (hypovolemia with blood stasis and thrombosis). The adrenal medulla showed only degranulation.

Actinomicose cerebral: observação anatomo-clinica e revisão da literatura brasileira

A case of central nervous system actinomycosis is reported. A 33-year-old male complained of headache, vomiting and blurred vision lasting for eight days prior to admission. On examination, a right hemiparesis, as well an intracranial hypertension were detected. The cerebrospinal fluid showed mild lymphomononuclear hypercytosis. Necropsy disclosed three abscess in the cerebral hemispheres, in addition to moderate cerebral edema on the left side but without purulent leptomeningitis. Actinomyces filaments and granules were demonstrated in the cerebral and lung abscesses. The Brazilian literature on actinomycosis is reviewed and six published cases with nervous system involvement were found. Relevant clinical and anatomical aspects of the cases and of the present one are discussed.

Glioblastoma multiforme of the medulla oblangata

SummaryA case of glioblastoma multiforme of themedulla oblongata in a 13-year-old girl is reported. Clinical features included two-month evolution, involvement of cranial nerves, tetraplegia and sudden respiratory arrest. Anatomically, a necrotizing glioblastoma multiforme involving the lower half of the medulla and the neighboring cervical cord was found. 18 examples of primary glioblastoma of theoblongata were collected from the literature, but it is suggested that several others are probably included, though not emphasized, in the numerous published series of brain stem gliomas.

Necrosis of gastric mucosa following orthostatic collapse in rabbits

Twenty-five rabbits were submitted to orthostatic collapse, divided into 6 groups and sacrificed about 4, 24 and 48 hours, 8, 15 and 30 days following collapse; two animals died during collapse and another 72 hours later. Seven animals were used as controls. Necrotic changes involving small areas of the gastric mucosa in the fundic and body portions were seen in successive stages up to regeneration. Such changes were present in all animals submitted to collapse, except three with no lesion. The necrosis is related to a nutritive disturbance of the gastric mucosa, mainly anoxic in nature. Grossly, the necrotic areas were similar to the acute erosions of the gastric mucosa seen in man.