ABSTRACT Introduction Visceral leishmaniasis (VL) is an infectious disease caused by the protozoa of the genus Leishmania; it is predominant in tropical, subtropical, and temperate regions. Objective To characterize a series of cases of VL in patients treated at a referral hospital in the north of Minas Gerais over 18 years, as well as to describe the occurrence of cases, according to the climatic characterization, and correlate the distribution of the cases with rainfall and environmental temperature. Methods The study design was a series of cases compiled between 1999 and 2016. The data were extracted from medical records selected chronologically. Climate information was collected at the Center for semi-arid study at the Federal University of Montes Claros (Unimontes). Results There was a slight predominance of males (54.4%) and aged between one and four years (42.9%). The evolution time for clinical manifestations up to the time of admission ranged from five to 120 days, with the most frequent length of stay between 16 and 30 days (34.4%). Hepatomegaly, splenomegaly, skin pallor, and fever were manifestations present in more than 90% of patients at admission. The diagnosis was performed by serological methods in most cases (85.9%). The largest portion of admissions lasted between 16 and 30 days (44%), and hospital discharge with guidance for outpatient control was the most frequent outcome of admissions. The percentage of deaths was 2%. Conclusion The predominant characteristics of VL are male children aged 1 to 4 years who sought the health service with the classic triad of the disease: hepatosplenomegaly, skin pallor, and prolonged fever. In this study, there was no statistically significant association between temperature, rainfall, and the number of cases, however, there are nuances in the environmental factors that influence the dynamics of VL transmission, which vary from region to region.

ABSTRACT A 43-years-old Brazilian woman, Caucasian, premenopausal, was attended with a history of lower abdominal pain, distension, and bleeding. Pelvic and transvaginal ultrasound revealed an enlarged uterus with a large, well-defined, uniformly hyperechoic lesion. The patient underwent total hysterectomy and the specimen was sent for anatomopathological evaluation. The histopathological analyses revealed a leiomyoma with extensive cystic degeneration and atypical characteristics, the immunohistochemical study confirmed the benignity of the case. The finding of atypical leiomyoma with cystic degeneration is rare and should be carefully evaluated to exclude malignant diseases.

ABSTRACT Follicular lymphoid hyperplasia (FLH) is a reactive lymphoid proliferation that can simulates lymphomas, both clinically and histologically. The aim of the present study was to investigate the clinical, morphological and immunohistochemical characteristics of a series of FLH cases of the oral cavity, and discuss important diagnostic aspects and differential diagnosis concerning follicular lymphomas. A retrospective analysis of the records of a database comprising 38 years revealed nine cases diagnosed as FLH of the oral cavity. Patient age ranged from 8 to 44 years. Most lesions were located in the buccal mucosa and the presence of a painless nodule was the most common clinical finding. Histopathological analysis revealed the proliferation of lymphoid cells arranged in a follicular pattern, presenting primary and secondary follicles with a germinal center and mantle zone, with evidence of macrophages containing apoptotic bodies in their interior, as well as evidence of typical mitosis figures. Interfollicular region, lymphocytes, macrophages and epimioepithelial islands were observed. Immunohistochemical analysis revealed positivity of the lymphoid follicles for CD20, CD68, CD3 and B-cell lymphoma 2 (Bcl-2). The clinical presentation of FLH and histopathological evidence of lymphatic follicles presenting indistinct germinal centers with poorly defined mantle zone may represent a problem due to theresemblance to follicular lymphoma.

ABSTRACT Testicular cancers are classified in germ cell and non-germ cell tumors, as well as, liposarcomas. We report the case of a patient with a large testicular liposarcoma, submitted to surgical treatment with excision of scrotal pouch and segment of the spermatic cord, and the left testicle, showing a good evolution. This report presents one of the first cases of a sclerosing variant of well-differentiated testicular liposarcoma, large in size and with no association with another cancer. Due to their location, the diagnosis is difficult and unusual. Complete tumor resection and regular medical follow-up show a good prognosis, less recurrence, and little cellular differentiation.

ABSTRACT Interstitial mycosis fungoides (IMF) is a rare variant of mycosis fungoides, a cutaneous T-cell non-Hodgkin’s lymphoma. It is characterized by an interstitial dermal infiltrate of lymphocytes and histiocytes between collagen bundles. We report the case of a 54-year-old patient with pruritic hypochromic macules on the arms and forearms diagnosed with IMF. Special attention was given to the anatomopathological features that differentiate this entity from its differential diagnoses, such as inflammatory morphea, interstitial annular granuloma, and other variants of the mycosis fungoides itself. We also present a review of the literature on the classification of the IMF.

ABSTRACT Poliomyelitis is still an endemic disease in Afghanistan, Nigeria, and Pakistan despite the efforts to eradicate the disease. Therefore, there is a potential risk of international spread. Since the start of the polio eradication program by the Global Polio Eradication Initiative in 1988, the incidence of polio has been reduced by 99%. In the last decade, wild poliovirus type 2 (WPV2) was eliminated and declared eradicated in 2015. Wild poliovirus type 3 (WPV3) was last reported in November 2012. These changes have allowed the removal of Sabin poliovirus type 2 from the oral poliovirus vaccine (OPV) in April 2016 and countries either introduced bivalent OPV (bOPV) containing Sabin types 1 + 3 poliovirus or added at least one dose of inactivated poliovirus vaccine (IPV) into their routine immunization schedule. Many efforts are needed to eradicate polio, and new strategies should be implemented such as the development and approval of new genetically stable OPV, and vaccines that do not require infectious processes for virus growth, such as virus-like particles (VLPs), or packing-cell technology. IPV will increasingly be produced from Sabin strains, and further attenuated or genetically modified strains. Furthermore, there is also a need for the development of antiviral drugs to treat immunodeficient patients who are long-term excretors infected with poliovirus, thus avoiding contamination of individuals susceptible to polioviruses, due to reversal of pathogenicity. If all these measures are successfully implemented, the world will be close to the global