Intense Inflammatory Infiltrate Research Articles

Health of Holochilus chacarius (Rodentia: Cricetidae) in rice agroecosystem in a neotropical wetland assessed by histopathology.

Small mammals have a short lifetime and are strictly associated with their environment. This work aimed to use histopathology to assess the health of Holochilus chacarius in a rice agroecosystem in the Pantanal of Mato Grosso do Sul. During necropsy, fragments of the lung, kidney, skin, liver, and reproductive system of 33 animals were collected and submitted to histological processing. Tissue damages were evaluated as mild, moderate, and severe and arranged in a matrix for further statistical analysis. Furthermore, we used generalized linear models to verify the influence of tissue changes on the body condition, obtained by a regression between body mass and length. In the lungs, we found an intense inflammatory infiltrate associated with anthracosis that had a negative influence on the body's condition. Also, we observed degenerative and inflammatory changes in the liver, kidneys, skin, and reproductive system that ranged from mild to moderate. The histopathological lesions observed in this study may be associated with environmental alterations of anthropic origin such as the exposure to soot from wildfires and heavy metals, evidenced by lesions in the lung, kidney, and liver. The present study provided a histopathological matrix as a new approach that allows to classify and quantify the tissue alterations. Tissue changes when associated with body condition demonstrated to be an effective tool to assess the health of small free-living mammals, showing that these animals can be used as bioindicators of environmental condition.

Abstract 5660: Gene expression signatures from FFPE to predict recurrent metastatic nasopharyngeal cancer

Abstract Nasopharyngeal cancer (NPC) is an EBV-driven epithelial cancer endemic to Southeast Asia, Southern China and the Middle East. Accurate profiling of the gene expression of NPC has been challenging because of its intense inflammatory infiltrate, as well as the 3 - 4mm size of biopsies limiting the amount of available material. Here we present a large cohort of 339 micro-dissected gene expression libraries from formalin-fixed paraffin-embedded (FFPE) biopsies from NPC patients treated at the National University Health System, Singapore, as well as healthy controls. NPC tumors from patients who subsequently developed recurrent or metastatic disease (Group A), and patients who did not develop recurrent or metastatic disease (Group B) were profiled. Tumor epithelial and microenvironment compartments were separately obtained using laser-capture microdissection, followed by library preparation performed for RNA-Seq using an in-house specialised technique. Gene signatures for NPC tumor epithelial and microenvironment content were used to validate the purity of gene expression libraries. Our preliminary analysis revealed that primary, pre-treatment tumors from patients who subsequently developed recurrence (Group A) showed downregulation of processes related to interferon gamma and interferon alpha response (p-adj <0.001 for both), while processes related to epithelial-mesenchymal transition (p-adj < 0.05) were enriched compared to patients who remained healthy (Group B). In contrast to primary tumors, recurrent tumors in Group A were enriched for cellular respiration including oxidative phosphorylation (p-adj < 0.0001). Our approach highlights the utility of whole transcriptome profiling from small quantities of archival FFPE material. The gene signatures identified from the primary tumors of high-risk patients are biologically relevant and have the potential to be used in precision medicine to guide additional targeted intervention. Citation Format: Joshua K. Tay, Wei Keat Teo, Joseph W. Foley, Luvita Suryani, Bing Cheng Wu, Chor Hiang Siow, Kwok Seng Loh. Gene expression signatures from FFPE to predict recurrent metastatic nasopharyngeal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5660.

Ruptured Saccular Aneurysm Caused by Necrotizing Arteritis of the Polyarteritis Nodosa Type in Primary Angiitis of Central Nervous System.

Primary angiitis of central nervous system (PACNS) is a rare idiopathic vasculitis that typically involves small arteries. An 18-year-old woman was operated on for resection of a ruptured aneurysm in a cerebral artery. Multiple aneurysms of cerebral arteries had been detected by neuroimaging examinations since the age of 12, and she had been administered drugs following a diagnosis of PACNS since the age of 15. The resected aneurysm was a ruptured saccular aneurysm occurring in a medium-sized artery. Histologically, necrotizing arteritis of the polyarteritis nodosa (PAN) type was noted in the aneurysmal wall. It consisted of an admixture of acute and healing stages. In the acute stage, fibrinoid necrosis in the intima and media and intense inflammatory cell infiltrate in the entire wall were present. The inflammatory cells mainly consisted of lymphocytes, including plasma cells, neutrophils, and macrophages. In the healing stage, disappearance of fibrinoid necrosis, fibrosis in the intima and media, and scarce inflammatory cells were noted. The acute stage was mainly present near the ruptured site. From these findings, the aneurysm was considered to have been caused by necrotizing arteritis of the PAN type. Although saccular aneurysmal formation in a medium-sized artery is rare in PACNS, an understanding of aneurysms produced by necrotizing arteritis of the PAN type offers useful information for the diagnosis and treatment of PACNS.

The effect of biopolymer gel derived from sugarcane on healing of traumatic oral ulcers: an experimental study.

The extracellular polysaccharide (EPS) is produced by the bacterium Zoogloea sp. and plays a positive role in tissue repair. The purpose of this study was to clinically and histologically compare the effects of EPS in the healing of traumatic oral ulcers in rats with the effects of triamcinolone. Ulcers were induced in the oral mucous of 45male Wistar rats, divided into three groups: control group, treated with triamcinolone, and treated with biopolymer gel. In the clinical evaluation, we considered the weight variation of the animals and the size of the lesion area, at baseline and on treatment days 1, 3and7. The histological parameters evaluated were the type and intensity of the inflammatory infiltration, the presence of necrosis and foreign body granuloma and the degree of re-epithelialization of the lesion. The reduction of the lesion area was greater in the animals treated with EPS, with no difference in the intensity of the inflammatory infiltration between the groups on days 3 and 7 of treatment. The results suggest that topical application of EPS in traumatic oral ulcers of rats promotes faster repair than triamcinolone ointment, without increasing the intensity of inflammatory infiltration under the lesion.

Toxinological profile and histopathological alterations induced by Bothrocophias campbelli venom from Colombia

Snakebite envenomings most frequently reported in Colombia are caused by snakes of the genera Bothrops, Bothriechis, Bothrocophias, and Porthidium. Their venoms induce local and systemic pathophysiological effects, sometimes leading to permanent sequelae such as reduced mobility of the limbs, amputations, besides the risk of death. The genus Bothrocophias includes nine species, among which B. campbelli has a distribution restricted to the department of Nariño in Colombia. In this work we determined the toxinological profile its venom, by performing assays for the lethal, hemorrhagic, edematogenic, and myotoxic activities in mouse models, as well as for in vitro coagulant activity on human plasma. The lethal toxicity of the venom was 142.7 µg venom/mouse (111.4–179.8 µg/mouse; 6.6–10.6 µg/g body weight) by intraperitoneal route. Its hemorrhagic activity (minimum hemorrhagic dose: 12.7 ± 2.3 µg) is generally weaker compared to other South American vipers, but edematogenic (minimum edematogenic dose 1.0 ± 0.3 µg), and myotoxic (minimum myotoxic dose 3.9 ± 2.5 µg) activities are very potent. Histopathological examination of the injected mouse gastrocnemius muscle showed prominent disorganization of the myofibrils, myonecrosis, and an intense inflammatory leukocyte infiltrate. In vitro, the minimal coagulant dose was 12.3 ± 0.5 µg. Overall, this toxinological profile would predict that the clinical picture of envenomings by B. campbelli might be characterized by moderate disturbances in the coagulation cascade, mild local hemorrhage, and, conversely, severe myonecrosis and edema, which could potentially lead to compartment syndrome and gangrene.

Intraplaque Neovascularization, CD68+ and iNOS2+ Macrophage Infiltrate Intensity Are Associated with Atherothrombosis and Intraplaque Hemorrhage in Severe Carotid Atherosclerosis.

Atherosclerosis is a progressive disease that results from endothelial dysfunction, inflammatory arterial wall disorder and the formation of the atheromatous plaque. This results in carotid artery stenosis and is responsible for atherothrombotic stroke and ischemic injury. Low-grade plaque inflammation determines biological stability and lesion progression. Sixty-seven cases with active perilesional inflammatory cell infiltrate were selected from a larger cohort of patients undergoing carotid endarterectomy. CD68+, iNOS2+ and Arg1+ macrophages and CD31+ endothelial cells were quantified around the atheroma lipid core using digital morphometry, and expression levels were correlated with determinants of instability: ulceration, thrombosis, plaque hemorrhage, calcification patterns and neovessel formation. Patients with intraplaque hemorrhage had greater CD68+ macrophage infiltration (p = 0.003). In 12 cases where iNOS2 predominated over Arg1 positivity, the occurrence of atherothrombotic events was significantly more frequent (p = 0.046). CD31 expression, representing neovessel formation, correlated positively with atherothrombosis (p = 0.020). Intraplaque hemorrhage is often described against the background of an intense inflammatory cell infiltrate. Atherothrombosis is associated with the presence of neovessels and pro-inflammatory macrophages expressing iNOS2. Modulating macrophage polarization may be a successful therapeutic approach to prevent plaque destabilization.

Impaired intestinal immunity and microbial diversity in common carp exposed to cadmium

Waterborne cadmium (Cd) accumulates in the fish intestine and causes irreversible toxicity by disrupting intestinal immunity and microbial diversity. To explore the toxicity of environmentally available high Cd concentration on intestinal immunity and microbial diversity of fish, we selected the widely used bioindicator model species, Common carp (Cyprinus carpio). Literature review and Cd pollution data supported sequential doses of 0.2, 0.4, 0.8, 1.6, 3.2, and 6.4 mg/L Cd for 30 days. Based on intestinal tissue Cd accumulation, previous studies, and environmentally available Cd data, 0.4 and 1.6 mg/L Cd were selected for further studies. Intestinal Cd bioaccumulation increased significantly to ~100 times in fish exposed to 1.6 mg/L Cd. We observed villous atrophy, increased goblet cells with mucus production, muscularis erosion, and thickened lamina propria due to intense inflammatory cell infiltration in the intestine at this Cd concentration. Cd-induced immunosuppression occurred with increased lysozyme, alkaline phosphate (AKP), and acid phosphate (ACP). High levels of catalase (CAT), total antioxidant capacity (T-AOC), malondialdehyde (MDA), and hydrogen peroxide (H2O2) suggested induced oxidative stress and poor metabolism by α-amylase and lipase suppression for Cd toxicity. Proteobacteria (41.2 %), Firmicutes (21.8 %), and Bacteroidetes (17.5 %) were the dominant bacterial phyla in the common carp intestine. Additionally, potential pathogenic Cyanobacteria increased in Cd-treated fish. The decrease of beneficiary bacteria like Aeromonas, and Cetobacterium indicated Cd toxicity. Overall, these findings indicate harmful consequences of high Cd concentration in the intestinal homeostasis and health status of fish.

An oxygen-releasing agent promotes healing of skin wounds in rats.

To evaluate the local effect of a slow oxygen-release gel on the healing of standardised skin wounds caused in rats. Skin wounds were created on the backs of male rats (Rattus norvegicus, Wistar) that were randomly allocated into two groups. In the treated (T) and control (C) groups, oxygen gel and distilled water, respectively, were applied to the wounds on alternate days for 28 days. Postoperatively, euthanasia was performed at 5, 10, 14, 21 and 28 days, followed by clinical, histological (Masson's trichrome) and immunohistochemical analysis. Data were subjected to analysis of variance (ANOVA) and Bonferroni's test. The cohort comprised 50 rats. On clinical and histological analysis, groups C and T showed similar characteristics 5 days post-operation. Subsequently, group T showed better healing at 14, 21 and 28 days and presented more intense inflammatory infiltrate up to 10 days. At days 14, 21 and 28, group T exhibited a reduction in oedema and increased angiogenesis, granulation tissue formation, and deposition of collagen fibres than group C. Immunohistochemical analysis showed the presence of tumour necrosis factor (TNF)-α and vascular endothelial growth factor (VEGF) in both the groups, but the levels were significantly higher in group T (p<0.05). The local application of slow oxygen-release gel accelerated the healing of standardised skin wounds created surgically in rats, with increased angiogenesis and better collagen fibre formation.

Modulation of blood redox status by the progression of induced apical periodontitis in rats.

This study aimed to investigate if apical periodontitis in different periods changes systemic levels of the antioxidant and pro-oxidant parameters in Wistar rats. Twenty-four rats were randomly allocated into healthy animals, apical periodontitis at 14days (AP14) and apical periodontitis at 28days (AP28). The first mandibular molars were accessed in the AP groups, and the pulp chamber was exposed to the oral environment, inducing the apical lesion. After 14 and 28days, the animals were anesthetized, euthanized, and hemimandibles were collected for micro-computed tomography (micro-CT) analysis to measure lesion volume, bone volume (BV), percent of bone to total tissue volume (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular space (Tb.Sp). A histological examination of the remaining bone was also performed. Finally, blood samples were collected for oxidative biochemistry analysis, investigating glutathione (GSH), Trolox equivalent antioxidant capacity (TEAC), and lipid peroxidation (TBARS). The lesion volume was greater at 28 than at 14days, as shown by micro-CT. AP14 and AP28 had decreased BV and Tb.Th, but only AP28 showed a reduction in BV/TV. Tb.N and Tb. Sp were increased in apical periodontitis at 28 days. In the histopathological analysis, AP14 had focal regions of moderate mononuclear inflammatory infiltrate, and AP28 had an intense inflammatory infiltrate with bacterial colonies. In the biochemical evaluation, GSH, TEAC, and TBARS were increased after 14 days. However, GSH returned to control levels, TEAC was similar to AP14, and TBARS increased significantly after 28days. Therefore, the oxidative biochemistry response was modulated according to the progression of periapical damage. After 14days, the organism could still react to the injury. However, at 28days, the antioxidant response decreased, associated with an increase in TBARS.

Intestinal Ameboma Involving the Jejunum: First Case Reported in Medical Literature

We present the case of a 58-years-old caucasian male who was hospitalized in our hospital with an early diagnosis of a jejunal tumor. However, all the instrumental and laboratory testing conducted were inconclusive and a preoperative diagnosis was not established. Patient was scheduled for surgery and en-bloc resection of the jejunal mass was performed. Microscopic analysis of the specimen reported the presence of intense mixed lympho-granulocytic inflammatory infiltrate of the mucosa associated with entamoeba parasites and a diagnosis of intestinal ameboma was ruled out. Ameboma is a rare complication of chronic amoebic colitis. usually found in the cecum and ascending colon. To our knowledge, this is the first case of an intestinal ameboma involving the jejunum to be reported in medical literature.

Protective properties of AgNPs green-synthesized by Camellia sinensis on ovalbumin-induced allergic conjunctivitis

Allergic conjunctivitis is the main usual red eye cause influencing many people. Allergic conjunctivitis is like an umbrella that includes different types of clinical manifestations, from a mild but annoying form of IgE-dependent allergy to inhaled allergens to very severe forms such as keratoconjunctivitis. Cornea involvement in allergic conjunctivitis needs the steroids use, which can cause severe eye complications. Research on allergic conjunctivitis should focus more on more severe forms of eye allergies to gain a better the pathophysiology understanding of the disease, diagnosis methods should be standardized and new treatment methods should be suggested. In the recent study, due to high therapeutic effects of Camellia sinensis, we used its aqueous extract for green-synthesizing of the silver nanoparticles and allergic conjunctivitis treatment in the in vivo condition. UV–Vis spectroscopy, FE-SEM and TEM were used for characterization of nanoparticles. This research therefore evaluated the AgNPs@Camellia sinensis antiallergic potential in ovalbumin-induced allergic conjunctivitis and attempted to predict its mode of action. ELISA determined serum ovalbumin-specific total IgE, IgE and IgG. Clinical scores for allergic conjunctivitis induced by intraperitoneal ovalbumin sensitization and topical conjunctival challenge in Dunkin-Hartley guinea pigs were estimated after treatment with 10, 20, 40 and 80 µg kg−1 AgNPs@Camellia sinensis, 10 mg kg−1 chlorpheniramine, 30 mg kg−1 prednisolone, or 10 mL kg−1 PBS. Serum ovalbumin-specific total IgE, IgE and IgG decreased significantly (p < 0.01). The conjunctival tissue in AgNPs@Camellia sinensis treated guinea pigs had mild mononuclear infiltration compared to the PBS-treated ones, which had intense conjunctival tissue inflammatory infiltration. The 40 and 80 mg kg−1 AgNPs@Camellia sinensis treatment resulted in allergic conjunctivitis low clinical score.

Formulation of a drug for the treatment of allergic conjunctivitis: Copper nanoparticles containing Olea europaea leaf aqueous extract

Olea europaea or Olive is the main ingredient of the Mediterranean diet. They are associated with many health benefits, especially for heart health and cancer prevention. Olive is rich in antioxidants and its health benefits range from fighting inflammation to reducing the growth of microorganisms. Recently, metallic nanoparticles green-formulated by ethnomedicinal plants have been used due to the antioxidant and anti-inflammatory potentials. Present research discloses the CuNPs biosynthesizing capability of the leaves of pharmacologically important Olea europaea. In addition, we investigated the Olea europaea green-formulated copper nanoparticles for the treatment of ovalbumin-induced allergic conjunctivitis. For determining the physicochemical properties of the recent nanoparticles, FT-IR, FE-SEM, UV-Vis and TEM were used. ELISA test was applied to measure the serum ovalbumin-specific IgG and IgE and total IgE. Clinical scores for allergic conjunctivitis induced by intraperitoneal ovalbumin sensitization and topical conjunctival challenge in guinea pigs were determined after a week’s daily treatment with 30 mg kg−1 prednisolone, 10 mg kg−1 chlorpheniramine, 2, 4, 8 and 16 µg kg−1 copper nanoparticles, or 10 mL kg−1 PBS. Ovalbumin-specific IgG and IgE as well as total serum IgE also decreased significantly (p<0.01). All doses of copper nanoparticles treatment resulted in a significantly (p<0.01) low clinical score of allergic conjunctivitis. The conjunctival tissue in copper nanoparticles treated guinea pigs had mild mononuclear infiltration compared to the PBS-treated ones, which had intense conjunctival tissue inflammatory infiltration.

CLINICOPATHOLOGICAL FEATURES OF ORAL EOSINOPHILIC ULCERS: A CASE SERIES

Eosinophilic ulcers of the oral mucosa are fast-growing lesions that may persist for a few weeks before spontaneous regression. They can occur at all ages, and the most common site of involvement is the tongue. The present study aims to report a case series of seven eosinophilic ulcers. The mean age was 55 years, with a slight female preponderance (n = 4). The evolution time ranged from 30 to 180 days. Most cases (n = 5) were on the border of the tongue, and the other two cases were located on the buccal vestibule and floor of the mouth. Among the clinical hypotheses, squamous cell carcinoma was the most common. The histopathological examination revealed ulceration on the surface epithelium and intense inflammatory infiltrate in the underlying connective tissue, comprised mainly of neutrophils and eosinophils. After the incisional biopsy, the patients were examined and regression of the lesion was observed. Eosinophilic ulcers of the oral mucosa are fast-growing lesions that may persist for a few weeks before spontaneous regression. They can occur at all ages, and the most common site of involvement is the tongue. The present study aims to report a case series of seven eosinophilic ulcers. The mean age was 55 years, with a slight female preponderance (n = 4). The evolution time ranged from 30 to 180 days. Most cases (n = 5) were on the border of the tongue, and the other two cases were located on the buccal vestibule and floor of the mouth. Among the clinical hypotheses, squamous cell carcinoma was the most common. The histopathological examination revealed ulceration on the surface epithelium and intense inflammatory infiltrate in the underlying connective tissue, comprised mainly of neutrophils and eosinophils. After the incisional biopsy, the patients were examined and regression of the lesion was observed.

WELL-DIFFERENTIATED SQUAMOUS CELL CARCINOMA LOCATED ON THE PALATE: A CASE REPORT

Squamous cell carcinoma (SCC) represents about 90% to 95% of the cases of oral cancer, affecting mostly men, from the 4th decade of life. A 64-year-old man, smoker and alcoholic, was admitted to our clinic with nodular lesions and ulcerated and hardened areas in the mucosa of the hard and soft palate, and pain symptoms, with about 9 months of evolution. Incisional biopsy of the lesion was performed with the hypothesis of carcinoma. Histological analysis revealed the proliferation of islands and cords of malignant squamous epithelial cells, infiltrating the underlying connective tissue, cell and nuclear pleomorphism, areas of extensive keratinization forming multiple scales and keratin pearls, and intense chronic inflammatory infiltrate. The diagnosis was well-differentiated SCC. The patient was referred to oncology services and is undergoing clinical follow-up. Squamous cell carcinoma (SCC) represents about 90% to 95% of the cases of oral cancer, affecting mostly men, from the 4th decade of life. A 64-year-old man, smoker and alcoholic, was admitted to our clinic with nodular lesions and ulcerated and hardened areas in the mucosa of the hard and soft palate, and pain symptoms, with about 9 months of evolution. Incisional biopsy of the lesion was performed with the hypothesis of carcinoma. Histological analysis revealed the proliferation of islands and cords of malignant squamous epithelial cells, infiltrating the underlying connective tissue, cell and nuclear pleomorphism, areas of extensive keratinization forming multiple scales and keratin pearls, and intense chronic inflammatory infiltrate. The diagnosis was well-differentiated SCC. The patient was referred to oncology services and is undergoing clinical follow-up.

Green formulation and characterization of Camellia azalea synthesized copper nanoparticles and its application in the treatment of ovalbumin-induced allergic conjunctivitis

Camellia azalea can treat many stubborn and malignant diseases, according to traditional Chinese medicine. In addition, it has been indicated that copper nanoparticles containing the plant have many therapeutic effects. Recently, metallic nanoparticles have been used due to the antioxidant and anti-inflammatory potentials. Present research discloses the CuNPs biosynthesizing capability of the leaves of pharmacologically important Camellia azalea. For determining the physicochemical properties of the recent nanoparticles, FE-SEM, FT-IR, TEM and UV-Vis were used. This study therefore assessed the antiallergic potential of copper nanoparticles in ovalbumin-induced allergic conjunctivitis and attempted to predict its action mode. ELISA test was applied to measure the serum ovalbumin-specific IgG and IgE and total IgE. Clinical scores for allergic conjunctivitis induced by intraperitoneal ovalbumin sensitization and topical conjunctival challenge in Dunkin-Hartley guinea pigs were determined after a week’s daily treatment with 10 mg kg−1 chlorpheniramine, 30 mg kg−1 prednisolone, 15 and 80 µg kg−1 copper nanoparticles, or 10 mL kg−1 PBS. The 15 and 60 mg kg−1 copper nanoparticles treatment resulted in a significantly (p < 0.01) low clinical score of allergic conjunctivitis. Ovalbumin-specific IgG and IgE as well as total serum IgE also decreased significantly (p < 0.01). The conjunctival tissue in copper nanoparticles treated guinea pigs had mild mononuclear infiltration compared to the PBS-treated ones, which had intense conjunctival tissue inflammatory infiltration.

New Histoprognostic Factors to Consider for the Staging of Colon Cancers: Tumor Deposits, Invasive Tumor Infiltration and High-Grade Budding

Colorectal cancer is a major public health issue due to its high incidence and mortality. It is, therefore, essential to identify histological markers for prognostic purposes and to optimize the therapeutic management of patients. The main objective of our study was to analyze the impact of new histoprognostic factors, such as tumor deposits, budding, poorly differentiated clusters, mode of infiltration, the intensity of inflammatory infiltrate and the type of tumor stroma, on the survival of patients with colon cancer. Two hundred and twenty-nine resected colon cancers were fully histologically reviewed, and survival and recurrence data were collected. Survival was analyzed using Kaplan-Meier curves. A univariate and multivariate Cox model was constructed to identify prognostic factors for overall survival and recurrence-free survival. The median overall survival of the patients was 60.2 months and the median recurrence-free survival was 46.9 months. Overall survival and recurrence-free survival were significantly worse in the presence of isolated tumor deposits (log rank = 0.003 and 0.001, respectively) and for an infiltrative type of tumor invasion (log rank = 0.008 and 0.02, respectively). High-grade budding was associated with a poor prognosis, with no significant difference. We did not find a significant prognostic impact of the presence of poorly differentiated clusters, the intensity of the inflammatory infiltrate or the stromal type. In conclusion, the analysis of these recent histoprognostic factors, such as tumor deposits, mode of infiltration, and budding, could be integrated into the results of pathological reports of colon cancers. Thus, the therapeutic management of patients could be adjusted by providing more aggressive treatments in the presence of some of these factors.

Environmental enteric dysfunction and small intestinal histomorphology of stunted children in Bangladesh.

There is lack of information on the histological characteristics of the intestinal mucosa in Bangladeshi children. Collection of intestinal biopsy samples and assessment of the histomorphological features is considered to be the traditional gold standard for diagnosis of environmental enteric dysfunction (EED). The purpose of the study was to evaluate the intestinal histological characteristics of stunted children aged between 12-18 months with possible EED. 110 children with chronic malnutrition (52 stunted with length-for-age Z score, LAZ<-2 and 58 at risk of stunting with LAZ <-1 to -2) from the Bangladesh Environmental Enteric Dysfunction (BEED) study protocol who underwent upper gastrointestinal (GI) endoscopy were selected for this study. To explore the association of EED with childhood stunting, upper GI endoscopy was done and the biopsy specimens were studied for histopathology. Villous height and crypt depth were measured and the presence and intensity of inflammatory infiltrates in the lamina propria was investigated. Bivariate analysis was performed to examine the relationship between stunting and histologic morphology. More than 90% children irrespective of nutritional status were diagnosed to have chronic non-specific duodenitis on histopathology. Half of the children from both groups had villous atrophy as well as crypt hyperplasia and lymphocytic infiltration was present in more than 90% children, irrespective of groups. However, no statistically significant difference was observed when compared between the groups. The prevalence of chronic non-specific duodenitis in Bangladeshi children, irrespective of nutritional status, was high. A significant number of these children had abnormal findings in intestinal histomorphology. Trial registration number: ClinicalTrials.gov ID: NCT02812615 Date of first registration: 24/06/2016. https://clinicaltrials.gov/ct2/results?cond=NCT02812615&term=&cntry=&state=&city=&dist.

Inmixed and Bellicose-Adenosquamous Carcinoma-Uterine Cervix

Adenosquamous carcinoma of uterine cervix is a preponderantly high grade neoplasm configured of admixed glandular articulations and squamous epithelium wherein glassy cell carcinoma emerges as an exceptional, aggressive variant. Adenosquamous carcinoma is posited to arise from sub-columnar reserve cells confined to endocervical basal epithelium. Cytological smears depict papillary articulations admixed with bland columnar epithelial cells and high grade squamous intraepithelial lesion. The biphasic tumour is composed of well defined, malignant components of glandular articulations and poorly differentiated squamous epithelium. Glassy cell carcinoma demonstrates solid cell nests comprised of pleomorphic, polygonal tumour cells pervaded with glassy, eosinophilic cytoplasm, enlarged, eosinophilic nuclei, prominent nucleoli and distinct cytoplasmic membrane. Neoplastic cells appear enmeshed within an intense inflammatory cell infiltrate with significant eosinophils. Glassy cell carcinoma appears immune reactive to MUC1, MUC2, epithelial membrane antigen (EMA), CAM5.2 or p63 with focal immune reactivity to carcinoembryonic antigen (CEA). Adenosquamous carcinoma requires segregation from neoplasms such as adenocarcinoma with coexisting squamous intraepithelial lesion (SIL), adenoid basal carcinoma, cervical extension of endometrial adenocarcinoma, and squamous cell carcinoma with focal mucin droplets, large cell non keratinizing squamous cell carcinoma or lymphoepithelioma-like carcinoma. Tumefaction may be appropriately treated by radical abdominal hysterectomy followed by adjuvant chemotherapy and radiation therapy.

P160 Paracoccidioidomycosis severe: Bizarre presentation in the face

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM IntroductionParacoccidioidomycosis is a systemic mycosis caused by the dimorphic fungus Paracoccidioides brasiliensis. The disease is restricted to Latin America. It is the principal systemic mycosis in Brazil, with higher incidences in the southern, southeastern and central regions.ObjectivesIt's to report a case of paracoccioidomycosis with a bizarre presentation on the face.Case ReportA 54-year-old male farmer from Açailândia, Maranhão, with a history of an extensive ulcerated lesion that started in the right wing of the nose. After 6 months of evolution, the lesion had already spread reaching the nasal and oral mucosa, evolving with acute respiratory failure, requiring tracheostomy (Fig.1). He was referred to the Cancer Hospital for a biopsy, which was referred for pathological examination, showing an intense inflammatory infiltrate consisting of lymphocytes, histiocytes, neutrophilis with giant, multinucleated cells that phagocytize refrigerant bodies, compatible with paracoccidioidomycosis. Material sent for direct examination and culture, showed positive for Paracoccidioides sp. After PCR amplification of the genetic material and sequencing, P. brasiliensis was identified. Chest tomography showed sparse ground-glass attenuation, but affecting both lungs and radiodense striations in the lower lobes bilaterally. Treatment was established with liposomal amphotericin B, with a good therapeutic response (Fig. 2). The patient was discharged from the hospital using itraconazole and still upper outpatient follow-up, with good healing of the lesions.ConclusionParacoccidioidomycosis can get a severe presentation, distancing the physician from the diagnosis, showing that in all these situations, simple tests, such as the direct examination of lesional material or sputum can elucidate the diagnosis. We need to think about it in endemic area.

IMMUNOHISTOCHEMICAL EXPRESSION OF METALLOPROTEINASES AND TFN-Α BY MACROPHAGES AND LANGERHANS CELLS IN RADICULAR CYSTS

Objectives This research aimed to evaluate the relationship between Langerhans cells, macrophages, matrix metalloproteinases (MMPs-9, -13), and tumor necrosis factor (TNF)-α in the lining epithelium of cystic lesions to elucidate the cyst expansion. Study Design A sectional and retrospective study was performed with 20 radicular cysts (RCs) and 20 residual radicular cysts (RRCs) by anti-CD68, anti-CD1a, anti-MMP-9, anti-MMP-13, and anti-TNF-α antibodies. Results The immunoexpression of MMP-13 and CD68 was significantly higher in RCs when compared to RRCs (P = .011 and P = .012, respectively). An intense inflammatory infiltrate was significantly correlated with CD68 immunoexpression in RCs (P = .025). Macrophages demonstrated a significant positive correlation with MMP-13 (P = .015). A moderate correlation was observed between MMP-9 and MMP-13 (P = .01). TNF-α expression was more common in RCs (P = .001). Langerhans cells were more frequently expressed in atrophic epithelium (P = .041) and significantly correlated with TNF-α (P = .014) in RCs. Conclusions Macrophages induce a greater release of TNF-α. Higher immunoexpression of MMP-13 and MMP-9 is observed in the early stages of RCs compared to RRCs. The microorganisms are the main factors triggering a proinflammatory immune response and greater cystic expansion in the early stages of these cysts. This research aimed to evaluate the relationship between Langerhans cells, macrophages, matrix metalloproteinases (MMPs-9, -13), and tumor necrosis factor (TNF)-α in the lining epithelium of cystic lesions to elucidate the cyst expansion. A sectional and retrospective study was performed with 20 radicular cysts (RCs) and 20 residual radicular cysts (RRCs) by anti-CD68, anti-CD1a, anti-MMP-9, anti-MMP-13, and anti-TNF-α antibodies. The immunoexpression of MMP-13 and CD68 was significantly higher in RCs when compared to RRCs (P = .011 and P = .012, respectively). An intense inflammatory infiltrate was significantly correlated with CD68 immunoexpression in RCs (P = .025). Macrophages demonstrated a significant positive correlation with MMP-13 (P = .015). A moderate correlation was observed between MMP-9 and MMP-13 (P = .01). TNF-α expression was more common in RCs (P = .001). Langerhans cells were more frequently expressed in atrophic epithelium (P = .041) and significantly correlated with TNF-α (P = .014) in RCs. Macrophages induce a greater release of TNF-α. Higher immunoexpression of MMP-13 and MMP-9 is observed in the early stages of RCs compared to RRCs. The microorganisms are the main factors triggering a proinflammatory immune response and greater cystic expansion in the early stages of these cysts.