Topographic distribution of lymphocyte infiltrate in triple negative tumors and its impact on the survival of the patient with breast cancer

Introduction: Tumor infiltrating lymphocytes (TIL) are generally measured using subjective methods unable to differentiate subpopulations and to locate immune cells in the tumor microenvironment. The identification and location of these cells is of great importance as they present different responses to immune stimuli. Objective: to analyze the presence of TIL in early-stage breast cancer of the triple negative molecular subtype, and to evaluate the association of TIL with the overall survival time (OS). Methods: a cross-sectional study was carried out at the Hospital de Câncer de Pernambuco (HCP), where patients diagnosed with triple negative breast cancer were selected between 2009 and 2013. TIL evaluation was performed by two methods: on slides stained with hematoxylin and eosin (H&E), by two pathologists blindly and independently, and on slides submitted to immunohistochemistry, with CD3 and CD8 lymphocyte marking. In this case, the sample was then subjected to computerized histophotometry and morphometric analysis. Results: 87 patients were included, of which 22 patients had an event in the follow-up period. The evaluation of TIL, by two pathologists, showed regular agreement between the evaluators, with an intraclass correlation coefficient of 0.574 and p=0.001. CD3+ and CD8+ lymphocytes were in greater quantity in the intra tumor area compared to those outside the tumor margin (extra tumor). When the association between the presence of lymphocytes and the patient’s OS was analyzed, a directly proportional relationship with this survival was observed, that is, the greater the amount of lymphocytes, the lower the risk of death. Conclusion: results suggest that there is a correlation between the tumor lymphocyte infiltrate of triple negative breast cancer and OS. As this tumor subtype has a poor prognosis and does not have specific target therapy, TIL analysis can be explored as a prognostic marker for the treatment of breast cancer.

Hallazgos clínico patológicos de la enfermedad de Marek en aves de combate

Descripción de los casos. Se analizaron siete casos clínicos de doce aves de combate de diferentes edades, estos casos fueron documentados entre 2015 y 2016. El diagnóstico presuntivo fue la enfermedad de Marek, porque expresaron signos de esta enfermedadHallazgos clínicos e interpretación. Los signos clínicos fueron principalmente respiratorios, circulatorios y nerviosos. La observación histopatológica reveló cambios celulares importantes con infiltrado linfoide en diferentes tejidos, mayoritariamente en pulmón, hígado, encéfalo, nervios, intestino, riñón y bazo, con lo que se diagnosticó enfermedad de Marek.Tratamiento y evolución. Se desconoce si se aplicó tratamiento.Pruebas de laboratorio. En el estudio histopatológico, los cortes se incluyeron en formol al 10 % con tinciones de rutina. Las muestras analizadas fueron tejido perineural, encéfalo, nervio ciático braquial, pulmón, corazón, hígado, duodeno, páncreas, riñón, bazo, ciegos, bolsa de Fabricio y piel de los senos infraorbitarios. Se determinó la severidad y virulencia del virus infectante según el criterio de infiltrado linfocitario definido en las pruebas de laboratorio.Relevancia clínica. Debido a que la crianza de aves de combate se realiza en pequeña y mediana escala, y bajo métodos tradicionales, el virus de la enfermedad de Marek persiste en estas aves. Por lo tanto, se requiere el diseño y la implementación de programas especiales de vacunación, incluyendo la producción de vacunas en una presentación adecuada para pequeños avicultores. Clinical and pathological findings of Marek’s disease in fighting cocksCases report. Seven clinical cases of twelve fighting cocks of different ages, were analyzed, this cases were documented between 2015 and 2016. The presuntive diagnosis was Marek’s disease, because they expressed signs of this diseaseClinical findings. The clinical signs were mainly respiratory, circulatory and nervous. Histopathological observation revealed major cell changes with lymphoid infiltrates in different tissues, mostly in the lung, liver, brain, nerves, bowel, kidney, and spleen, leading to the diagnosis of Marek’s disease.Treatment and evolution. Whether treatment was applied is unknown.Laboratory tests. In the histopathological study, the cuts were included in 10 % formaldehyde with routine stains. The samples analyzed were perineural tissue, brain, sciatic brachial nerve, lung, heart, liver, duodenum, pancreas, kidney, spleen, blind, bursa of Fabricius and skin of infraorbital sinuses. The severity and virulence of the infecting virus was determined according to the lymphocyte infiltrate criterion defined in the laboratory tests.Clinical relevance. Because the breeding of fighting cocks is realized in small to medium scale and under traditional methods, the Marek’s disease virus persists in these birds. Therefore the design and implementation of special vaccination programs are required, including the production of vaccines in a presentation suitable for small flocks.Keywords. fighting cocks, Marek´s disease, tumor, vaccination

CLIPPERS Spectrum Disorder: A Rare Pediatric Neuroinflammatory Condition

CLIPPERS (chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids) is a recently described, rare neuroinflammatory disorder diagnosed by clinical symptoms involving the brain stem with a distinct pattern on neuroimaging and a perivascular T-lymphocyte infiltrate on brain biopsy. It is a condition usually described in adults in the fourth to fifth decade. We report a case of 13-year-old Indian boy who presented with recurrent episodes of ataxia and diplopia with onset at 7 years of age. He was investigated extensively to rule out infective, neoplastic, autoimmune, and demyelinating conditions over a span of 6 years. The diagnosis of CLIPPERS was entertained on the basis of clinico-radio-pathological correlation. Treatment with steroids and steroid-sparing agents, particularly methotrexate, seems to provide a promising outcome. With very few cases in literature so far, reporting of a larger case series with pediatric onset may expand it to CLIPPERS spectrum disorder.

Immunohistochemical evaluation of the inflammatory response in periodontal disease

In order to contribute to the knowledge of the pathogenesis of periodontal disease, an immunohistochemical analysis of the density of inflammatory mononucleated cells and the number of dendritic cells was performed using anti-CD4, anti-CD20, anti-CD25, anti-CD68 and anti-protein S-100 antibodies in 17 cases of chronic gingivitis (CG) and 25 of chronic periodontitis (CP). The CD4+ and CD68+ cells exhibited a diffuse distribution in the connective tissue. CD20+ cell distribution was predominantly in groups and the CD25+ cells exhibited a diffuse or focal distribution. The S-100+ cells were identified in the epithelium and the lamina propria, exhibiting distinct morphology and number. The statistical analysis showed no significant differences (p>0.05) between CG and CP regarding the density of the CD4+ and CD20+ cells and the number of S-100+ cells. However, significant differences (p<0.05) were found between the groups in the density of CD25+ and CD68+ cells . The density of macrophages was greater in CG and the level of cellular activation of the lymphocyte infiltrate was greater in CP. No differences were detected between the aforementioned conditions regarding the density of the T and B lymphocytes and to the number of the dendritic cells.