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Os autores estudaram 1.000 casos de câncer gástrico levantados dos arquivos de biopsia e necropsia do Departamento de Anatomia Patológica e Medicina Legal da Faculdade de Medicina da UFMG. Após análise dos casos, tentou-se enquadrá-los nas classificações de Lauren, Kubo, Mulligan-Rember/Teglbjaerg e Chun-Ming. Os casos de padrão misto foram classificados de acordo com o tipo predominante. Correlacionou-se, quando possível, o quadro histológico com o sexo, idade, aspecto macroscópico, cor e evolução. Após análise do matérial segundo as quatro classificações acima referidas, concluíram: 1) a classificação que melhor se adaptou ao estudo foi a de Kubo: 2) o câncer gástrico foi mas frequente no homem: 3) a diferença das médias de idade dos casos de biopsia e necropsia não foi significativa: 4) nos casos biopsiados que tinham biopsia prévia, não houve discrepância nos diagnósticos: 5) os adenocarcinomas tiveram maior incidência entre os 50 e 60 anos, em ambos os sexos: 6) os carcinomas apresentaram incidência alta em faixas etárias mais baixas (40-49 anos) especialmente no sexo feminino: 7) preponderou nos mulatos seguido de perto pelos brancos: foi muito menos frequente nos negros: 8) a sede mais freqüente foi o antro e o piloro: 9) predominou o tipo estenosante nos carcinomas e o ulcerado e úlcero-vegetante nos adenocarcinomas.

Abstract Background Strongyloides stercoralis can undergo an alternative autoinfective life cycle in the host, which, in some individuals can lead to a lethal infection. However, due to a number of factors, such as, the majority of those infected are from low-income backgrounds and the limitation in experimental models for studying human S. stercoralis, strongyloidiasis remains neglected. Improved knowledge of animal models that are susceptible to this parasite is needed in order to investigate the immunological mechanisms involved during infection and in particular to further understand the natural history of the autoinfective cycle. Methods Callithrix penicillata were inoculated subcutaneously with 100 (n = 2), 300 (n = 4) or 500 (n = 9) third-stage infective larvae (L3i) of S. stercoralis of human origin. Three marmosets received smaller inocula (i.e., one received 100 and two received 300 L3i) to ensure a greater capacity to withstand the infection after immunosuppression, which was triggered by administration of dexamethasone during early patency. Qualitative faecal analyses began at 7 days post-infection (DPI), and semi-quantitative tests were also performed for the dexamethasone-treated primates and the three matched controls. During the necropsies, specimens of S. stercoralis were recovered and tissue fragments were processed for histopathology. Results The mean prepatency and patency periods were 16.1 ± 3.0 and 161.1 ± 72.2 DPI, respectively. The marmosets typically tolerated the infection well, but immunosuppressed individuals exhibited higher numbers of larvae in the faeces and progressive clinical deterioration with late disseminated infection. In these cases, the number of females recovered was significantly higher than the number of inoculated L3i. Large quantities of larvae were observed migrating through the host tissues, and histopathology revealed pulmonary and intestinal injuries consistent with those observed in human strongyloidiasis. Conclusions Both complicated and uncomplicated strongyloidiasis occur in C. penicillata that is described as a susceptible small non-human primate model for S. stercoralis. This host permits the maintenance of a human strain of the parasite in the laboratory and can be useful for experimental investigations of strongyloidiasis. In parallel, we discuss data related to the autoinfective cycle that provides new insights into the biology of S. stercoralis.

INTRODUCTION: Authors describe human schistosomal granuloma in late chronic phase, from the morphological and evolutionary viewpoints. METHODS: The study was based on a histological analysis of two fragments obtained from a surgical biopsy of peritoneum and large intestine of a 42-year-old patient, with a pseudotumoral form mimicking a peritoneal carcinomatosis associated to the schistosomiasis hepatointestinal form. RESULTS: Two hundred and three granulomas were identified in the pseudotumor and 27 in the intestinal biopsy, with similar morphological features, most in the late chronic phase, in fibrotic healing. A new structural classification was suggested for granulomas: zone 1 (internal), 2 (intermediate) and 3 (external). CONCLUSIONS: Regarding granuloma as a whole, we may conclude that fibrosis is likely to be controlled by different and independent mechanisms in the three zones of the granuloma. Lamellar fibrosis in zone 3 seems to be controlled by matrix mesenchymal cells (fibroblasts and myoepithelial cells) and by inflammatory exudate cells (lymphocytes, plasmocytes, neutrophils, eosinophils). Annular fibrosis in zone 2, comprising a dense fibrous connective tissue, with few cells in the advanced phase, would be controlled by epithelioid cells involving zone 1 in recent granulomas. In zone 1, replacing periovular necrosis, an initialy loose and tracery connective neoformation, housing stellate cells or with fusiform nuclei, a dense paucicellular nodular connctive tissue emerges, probably induced by fibroblasts. In several granulomas, one of the zones is missing and granuloma is represented by two of them: Z3 and Z2, Z3 and Z1 or Z2 and Z1 and, ultimately, by a scar.

The authors report one case of late cutaneous Schistosomiasis mansoni in a biopsy of a skin lesion in the sacral region in a 51-year-old female living in Contagem, Minas Gerais. The patient was treated successfully with oxamniquine (Mansil®).

Caso raro de forma tumoral da esquistossomose mansoni cerebelar diagnosticada pela biópsia, em um paciente de 15 anos, que apresentou sinais e sintomas neurológicos 60 dias antes da cirurgia. A tomografia computadorizada revelou lesão expansiva, hiperdensa, localizada no cerebelo, sugestiva de glioma. O exame histopatológico mostrou numerosos ovos de S. mansoni envolvidos por reação inflamatória granulomatosa na fase necrótico-exsudativa, confluentes, localizados principalmente na camada interna, granular, do cerebelo, formando pseudotumor no verme cerebelar e hemorragia recente na ponte. Foram medidas as áreas dos granulomas.An unusual case of the tumoral form of cerebellar Schistosomiasis mansoni, in a 15 year-old male diagnosed by biopsy, with neurological signs and symptoms 60 days prior to surgery. Computerized tomography show a hyperdense expanding lesion located in cerebellum, suggesting glioma. Histopathological examination showed numerous S. mansoni ova involved by granulomatous inflammation in necrotic-exudative phase, located mainly in the internal, granular layer of the cerebellum, creating a pseudotumor in the cerebellar vermis and a recent hemorrhage in the trunk. The areas of granulomas were measured.

We describe a schistosomal polyp in the anus of a 24-year-old patient, born in Viçosa, State of Minas Gerais, and living in Belo Horizonte, State of Minas Gerais. From 8 to 13 years of age, he swam in the rivers that bathe Viçosa. The histopathological examination has shown a lesion, lined by a keratinized squamous epithelium, ulcerated, with granulomas, centered or not by Schistosoma mansoni egg, laid, in loco, by the female present in the vascular lumen of a vein of the hemorrhoidal plexus. There was also a diffuse, nonspecific inflammation in the dermis. The patient was treated with praziquantel. Four months after the treatment, sigmoidoscopy showed a normal rectal mucosa, and negative oogram and stool tests. Ultrasound of abdomen was normal.

Relatamos um caso raro de linfoma maligno não-Hodgkin, nodular e de baixo grau, tipo MALT, com aspecto morfológico e imuno-histoquímico linfoplasmocitóide (classificação de REAL), de imunofenótipo de linfócitos B e monoclonalidade para a cadeia leve de imunoglobulina Kappa, com índice de proliferação < 10% (baixo grau). O tumor era primitivo da dura-máter parietal esquerda, em mulher de 36 anos de idade, cujos sintomas neurológicos surgiram quatro meses antes da cirurgia. Após a cirurgia, foi tratada com quimioterapia e radioterapia, com bom resultado.

BACKGROUND: American tegumentary leishmaniasis (ATL) is endemic in Latin America, where Brazil has over 27 thousand cases per year. The aim of the present study was to develop an immunohistochemical method (IHC) for ATL diagnosis. For this purpose, we used serum from a dog naturally infected with Leishmania (L) infantum (canine hyperimmune serum) as the primary antibody, followed by a detection system with a secondary biotinylated antibody. METHODOLOGY: Skin samples were obtained from 73 patients in an endemic area of Caratinga, Minas Gerais (MG) State, Brazil all testing positive for ATL with the Montenegro skin test, microscopy, and PCR. Canine hyperimmune serum of a dog naturally infected with Leishmania (L.) infantum was employed as a primary antibody in an immunohistochemical diagnostic method using streptavidin-biotin peroxidase. To assess the specificity of this reaction, IHC assays employing two monoclonal antibodies were carried out. As the polymer-based technology is less time-consuming and labor intensive than the IHC labeled streptavidin-biotin peroxidase method, we compared the two methods for all samples. RESULTS: The IHC method detected ATL in 67 of the 73 cases (91.8%). Immunolabeled parasites were primarily detected inside macrophages either in the superficial or the deep dermis. Detection was facilitated by the high contrast staining of amastigotes (dark brown) against the light blue background. A lower detection rate (71.2%) was observed with the both of the monoclonal Leishmania antibodies compared to the canine hyperimmune serum. This may have been due to a non-specific background staining observed in all histological samples rendering positive detection more difficult. The higher efficacy of the canine hyperimmune serum in the IHC method was confirmed by the method using streptavidin-biotin peroxidase as well as that with the polymer-based technology (biotin-avidin-free system). CONCLUSIONS: The data are encouraging with regard to validating IHC as a standard alternative method for ATL diagnosis.

In this study, which was undertaken in relation to the histopathologic behavior of two different strains (LE-Belo Horizonte, MG and SJ - São José dos Campos, SP) in infections and reinfections (homologous or heterologous) with Schistosoma mansoni, the authors confirmed a more accentuated pathogenicity of the SJ strain. All the reinfections showed the presence of typical granulomas of the acute phase, when performed either with the same strain (homologous) or with a different strain (heterologous) of the parasite of the primo infection. The possible mechanisms responsible for reactivation of the immunopathologic response in reinfections are discussed.No presente estudo, verificou-se o comportamento histopatológico das infecções e reinfecções, homólogas ou heterólogas, das cepas LE (Belo Horizonte, MG) e SJ (São José dos Campos, SP) de Schistosoma mansoni. Confirmou-se uma maior patogenicidade da cepa SJ de S. mansoni. As reinfecções, independentemente de terem sido feitas com a mesma cepa (homóloga) ou cepa diferente da primo infecção (heteróloga) do parasito, mostraram a presença de granulomas típicos da fase aguda. São discutidos os possíveis mecanismos responsáveis pela reagudização da resposta imunopatológica nas reinfecções.

Mice previously infected with Schistosoma mansoni, and cured by specific treatment (400mg/kg oxamniquine, p. o.) in the chronic phase of the disease, were reinfected 20 days after treatment to assess their capacityfor modulation ofthe granulomatous response. Histopathologic examination of the animals ' liver, at 60 days after reinfection, evidenced the presence of typical granulomas of the chronic phase in most animals. This infer that the capacity for modulation of the granulomatous response had been maintained, thus preventing a new acute phase of the disease. Conversely, a group of previously infected mice, untreated and submitted to reinfection, showed reactivation of the granulomatous response in 50% of the animals. The possible implications of these findings in human schistosomiasis mansoni are discussed.Para verificar a capacidade de modulação da resposta granulomatosa na esquistossomose murina, após cura quimioterápica, camundongos previamente infectadosforam curados com oxamniquina (400mg/kg, p. o.) e reinfectados 20 dias após tratamento. O exame histopatológico do fígado dos animais, aos 60 dias após reinfecção, mostrou, na maioria deles, a presença de granulomas nafase produtiva, típicos da fase crônica da doença, pertnitindo a inferência de que a capacidade de modulação da resposta granulomatosa foi mantida, prevenindo assim uma outra fase aguda da doença. Por outro lado, um grupo de camundongos previamente infectados e submetidos a reinfecção mostrou a reagudização da resposta granulomatosa em 50% dos animais. As possíveis implicações destes achados na esquistossomose mansoni humana são discutidas.

A intradermorreação de Montenegro, um teste de hipersensibilidade tardia, é um método muito utilizado no diagnóstico auxiliar da leishmaniose tegumentar americana (LTA) humana. Entretanto, são escassos os relatos a respeito das alterações histológicas induzidas experimentalmente peto teste cutâneo, sobretudo no cão. Frente a isso, a nível de campo, foram comparados dois testes cutâneos para diagnóstico da leishmaniose tegumentar canina (LTC), utilizando-se o LeishvacinR e o P10.000G como antígenos. Nos cães que receberam o PIO.OOOG, constatou-se reação inflamatória mais evidente e difusa que nos testados com o LeishvacinR.The Montenegro skin test is widefy used as a diagnostic method for American cutaneous leishmaniasis (ACL). However, there is little information about the histological changes that occur after administration of the antigen, especially indogs. Two intra dermal reactions were used in mongrel dogs during a clinical and epidemiolog ical study as a diagnostic method for canine cutaneous leishmaniasis at Virginópolis, Minas Gerais, Brazil. LeishvacinR and P10.000G were used as antigens. The inflammatory reaction was more intense and diffuse in dogs tested with PIO.OOOG than LeishvacinR.

Com o objetivo de demonstrar algumas modalidades distintas do comprometimento pulmonar na esquistossomose mansoni, ressaltando sempre a diversidade dé interação dos múltiplos fatores envolvidos, os Autores iniciam a publicação de uma seqüência de casos ilustrativos, embora considerados pouco comuns na clínica diária. No caso ora descrito, ao lado de sintomatologia definida dominantemente por surtos paroxísticos de asma, o estudo radiológico seriado, durante sete anos, revelou imagem pieuro-parenquimatosa caracterizada por irregularidades de radiopacidade com traves fibróticas extensas, notadamente à direita e desvio acentuado do mediastino para este lado; a área cardíaca encontrava-se aparentemente normal. À microtoracotomia, observou-se lesão pleural dominante com enclausuramento do LSD e condensação extensa subpleural do LSD, afetando amplamente o parênquima. Procedeu-se àdetorticação do LM e LID e reexpansão parcial de seus parénquimas, bem como à biopsia pulmonar. Apesar de o estudo histopatológico haver revelado uma arterite pulmonar grave, não foram registrados sinais e sintomas de cor pulmonale. Este comprometimento pulmonar verificou-se, entretanto, isoladamente de uma forma hepato-esplênica e, conseqüentemente, na ausência de síndrome de hipertensão portai a determinar a rota oreferencial de migração de ovos e, eventualmente, de vermes aos pulmões.To demonstrate some different modalities of lung lesions in schistosomiasis mansoni, the authors relate a series of illustrative, though unusual cases, stressing the diversity of the multiple factors involved. In the present studied case, besides a definite symptomatology of paroxistic attacks of asthma, a series of radiological studies through seven years showed a pleuro-parenchymatous image characterized by irregularities of radioopacity, with extensive fibrous proliferation especially on the rightside, and marked deviation of the mediastinum also to the right; cardiac area was apparently normal. Microthoracotomy showed dominant pleural lesion enclosing the right superior lobe, affecting widely the parenchyma. Decortication of medium and right inferior lobes, partial reexpansion of their parenchyma, and pulmonary biopsy were performed. Histopathological study disclosed a predomiantly focal, but relatively extensive, and severe case of pulmonary arteritis without cor pulmonale. This pulmonary involvement occured isolated, not related to a hepato-splenic symptomatology, and consequently there was no syndrome of portal hypertension to indicate the preferentiai way of migration of the eggs, and eventually of the worms to the lungs.

Foi feita a identificação dos tipos de colágeno em cortes histológicos de fragmentos de 15 corações de indivíduos portadores de doença de Chagas crônica com lesão vorticilar esquerda e ICC. As preparações coradas pelo Sirius Supra Red F3BA, preconizada por Junqueira e cols e examinadas em microscópio de polarização (Leitz) revelaram colágeno de tipo I e III nas zonas de fibrose. As primeiras preponderaram nos dois terços externos da região vorticilar, nas áreas de fibrose endomisial e perimisial do miocárdio sem ou com escasso infiltrado inflamatório e na região subendocárdica dos músculos papilares. O tipo III foi mais freqüente no terço interno da região vorticilar, no endocárdio da parede ventricular, em certas áreas do miocárdio onde a inflamação ainda estava em atividade e nas porções mais centrais dos músculos papilares. Os AA fazem um breve comentário sobre o possível mecanismo patogenético da fibrose na doença de Chagas.

Mice infected with 60 cercariae of Schistosoma mansoni were more resistant to the sarcoma 180 ascites tumor. Tumor inoculation was performed 50 days after schistosoma infection and the animals were observed and weighed at 48 hours intervals for development and progression of malignancy. In infected mice the weight gain (ascites formation) started later and was shorter than in uninfected Controls. Also, the number of tumor cells into the peritoneal cavity 72h after tumor implantation was shorter in infected group than incontrols. This in creased resistance against a transplantable tumor probably is related to the effect of endotoxin on tumoricidal activity of macrophages activated by the infection. The immunodepression induced by Schistosoma mansoni infection enhances the proliferation of endogenous bacteria increasing the amount of endotoxin absorbed from the gut.

Os aa. estudaram três casos da forma aguda, toxêmica, não tratados especificamente e que evoluíram, tanto quanto puderam averiguar, para a cura espontânea. Como se trata de uma nota prévia, não se aprofundaram em considerações de ordem teórica.

Os Autores descrevem um caso grave de esquistossomose mansoni numa criança de 9 anos de idade (forma hepática com hipertensão portai associada a forma pulmonar com hipertensão pulmonar e cor pulmonale) clinicamente caracterizado por episódios de insuficiência respiratória desencadeados em face de esforços físicos moderados. Sucessivos exames radiológicos de tórax revelaram comprometimento predominantemente arteriolar ao iado de uma micronodulação delicada e difusamente distribuída e configuração de cor pulmonale. Ao contrário do caso anteriormente descrito, a evolução se deu sem que se verificassem manifestações febris. Embora tenham sido afastadas várias hipóteses de associação da esquistossomose a concausas infectuosas, optou-se pelo tratamento de prova da tuberculose pulmonar. O fundo de olho também apresentava vários nódulos esbranquiçados disseminados pelo coróide e retina, caracterizando provável coroidite e retinite esquistossomótica. O tratamento antituberculoso resultou praticamente nulo. Não se procedeu ao tratamento específico da esquistossomose, considerando-se o alto risco da cardiopatia face aos esquistossomicidas disponíveis. A alta foi fornecida após treze meses de observação hospitalar. Não compareceu a ulterior controle.The Authors report a severe case of schistosomiasis mansoni in a 9-year-old child (heplus pulmonary form with pulmonary hypertension and cor pulmonalel The clinical features comprised episodes of respiratory insufficiency induced by moderate physical exercise. Serial chest X-raysshowed a predominantly arteriolar involvement associated with fine micronodules and the features of cor pulmonale. The fever episodes found in the case previously reported did not happen in th is patient. Even though various hypothesis of association of schistosomiasis and other infectious diseases were discarted, a trial of anti-tuberculous drugs was performed. Eye examination disclosed various whitish nodules disseminated throughout the retina and choroid, and this suggested schistosomiasis as the cause for the eye involvement. The antituberculous drugs did not change the clinical picture at all. Antischistosome drugs were. not used due to the risk of circulatory side-effects of the drugs available. The patient was discharged after 13' months and no follow-up has been done since.

Em 28,8% dos pacientes com esquistossomose mansoni tratados com oxamniquine ocorrem alterações radiológicas pulmonares caracterizadas por broncopneumonite (41%), pneumonite (35%), abaulamento do arco médio (17%) e congestão pulmonar (7%). As alterações são transitórias, com início até 3 dias após a terapêutica, em 50,7% regredindo em 15 dias, completa e espontaneamente. Predominam na faixa etária entre os 4 aos 12 anos, não dependem, de padrão radiológico pré-tratamento, cor, sexo, naturalidade ou fase/forma da doença. As alterações clínicas associadas às anormalidades radiológicas pós-tratamento são inexpressivas na forma aguda, toxêmica, enquanto na fase crônica surgem como estertores crepitantes e roncos. O encontro de eosinófilos no escarro até o décimo segundo dia após o tratamento correlaciona-se com o encontro de alterações radiológicas pulmonares pós-tratamento independentemente da fase/forma da doença.Pulmonary alterations on X-rays werefound in 28.8% of patients with schistosomiasis mansoni infection post-treatment with oxamniquine. They comprised bronchopneumonitis (41%), pneumonitis (35%), prominent medium arc (17%), and pulmonary congestion (7%). These alterations were transitory starting within 3 days after treatment. In 51% of the cases spontaneous, often complete, recovery occurred in 15 days. They were more common in patients, 4 to 12 years of age and did not depend on the pre-treatment radiologic pattern, race, sex, origin norphase of the disease. In the chronic phase of the disease there were clinical manifestations (ronchi and rales) associated with the X-ray alterations, while in the acute, toxemic phase these were absent or mild. The presence of sputum eosinophils up to the 12th day post-treatment had a direct correlation with the appearance of X-ray abnormalities and did not depend on the phase or form of the disease.

Estudamos as alterações ultra-estruturais dos hepatócitos na forma aguda, toxêmica, da esquistossomose, em cinco pacientes, membros de uma mesma família infectados em idênticas condições em um córrego existente próximo da lagoa de Pampulha, em Belo Horizonte (MG), e não tratados especificamente para a esquistossomose. Este estudo confirma os dados obtidos em trabalho anterior, em sete pacientes infectados no Município de Sabara (MG). Nos cinco casos, as alterações ultra-estruturais foram inespecíficas, pouco acentuadas, embora mais intensas do que as observadas anteriormente, e se caracterizaram sobretudo pelas modificações das organelas citoplasmáticas, explicando o freqüente encontro de células claras a microscopia óptica. A identificação de alguns granulomas a microscopia eletrônica permitiu verificar que estes mostram, no exstudato, granulócitos eosinófilos, macrófagos, plasmócitos, células epitelióides e mastócitos. Entre as células havia material amorfo e finos feixes de colágeno.In this paper the authors discuss the ultrastructural changes of liver cells in the acute toxaemic form of schistosomiasis mansoni in five member of the same family who got the infection in identical conditions in an endemic area located near the Pampulha Lake, in Belo Horizonte (MG) and that did not receive specific treatment for schistosomiasis. This study confirms the data obtained and documented in a prior communication in seven patients infected in Sabará (MG). In the five cases the ultrastructural changes were also non-specific, although more intense than observed previuosly and were characterized mainly by alteration of the cytoplasmic organelles that could explain the common feature of clear cells by light microscopy. The results of the observation of some granulomas in ultrathin sections have demonstrated eosinophils, macrophages, plasma cells, epithelioid cells and mast cells. Among these cells there were also ground substance and thin bundles of collagen.

Os Autores descrevem um caso grave de esquistossomose mansoni (forma hepática com hipertensão portal associada a forma pulmonar com hipertensão pulmonar e cor pulmonalej sobre o qual evoluiu uma sindrome toxi-infectuosa grave e de longa duração. Sucessivos exames radiológicos do tórax revelaram acometimento predominantemente arteriolar, ao lado de uma micronodulação pulmonar grosseira e difusa em ambos os hemitóraces e configuração de coração pulmonar. A histopatologia de material de biópsia pulmonar identificou basicamente uma arterite pulmonar característica, inflamação granulomatosa atípica provocada principalmente por vermes e raros ovos de S. mansoni envolvidos por escassa reação inflamatória. Para explicar a origem de constelação clínica toxi-infectuosa, foram afastadas as hipóteses de associação da esquistossomose a concausas infectuosas ou não, mas de curso febril, e a superposição de uma forma toxêmica sobre outra crônica pré-existente. Com base em dados clínicos, particularmente em subsídios da laparoscopia, e anatômicos, concluiu-se tratar o caso de uma forma crônica de esquistossomose reativada, provavelmente em virtude de alterações imunológicas inusitadas do hospedeiro. Ao que tudo parece indicar, o desvio de ovos e de vermes aos pulmões deveu-se à sindrome de hipertensão portal, cujos shunts entre a circulação portal e sistêmica determinaram a rota preferencial da migração.The Authors relate a case ofsevere schistosomiasis mansoni (hepatic form, with portal hypertension, associated with pulmonary form, with pulmonary hypertension and cor pulmonale), o ver which develloped a severe toxi-infectious syndrome of long duration. Serial chest X-rays showed that the arteriolae were predominantly affected, besides a gross and difuse pulmonary micronodulation in both hemithoraces, and pulmonary heart configuration. Histopathology of the pulmonary biopsy material identified basically a pulmonary arteritis characteristic of chronic pulmonary schistosomiasis and, simultaneously, the presence of schistosomatous granulomata in hyperergic reaction mainly produced by worms, one of the main anatômica! characteristics of the toxemic form. To explain the origin of the clinical toxi- infectious constelation, the hypotheses of an association with a co-existing infectious, or not infectious but fever producing cause, and of the superposition of a toxemic form over a pre-existing chronic one were eliminated. It was concluded, on the basis of clinical data, particularly those furnished by laparoscopy and the anatomical onas, that this a chronic case of schistosomiasis reactivated probably by the host uncommon immunological alteration. Everything points to the possibility that the unusual detour of the eggs, and of the worms to the lungs was due to the portal hypertension syndrome, and that the preferential route of this migration was determined by the shunts involving the portal and systemic circulations.

The post-treatment pulmonary alterations were evaluated in patients (Study 1) and in mice (Study 2) infected with Schistosoma mansoni. Study 1: the patients were examined pre and post-treatment (with ora oxamniquine) and the following exams were performed: sputum for eosinophils and chest x-ray. Study 2: four groups of mice (total = 64) were studied; Group I (infected and treated with oxamniquine); II (infected and not treated); III (not infected and treated) and IV (not infected and not treated). All were x-rayed to check for pulmonary abnormalities pre and post-treatment and lung specimens were studied by optical microscopy and immunofluorescence. We have found abnormalities in the parameters checked in both studies and the results suggest an immunological reaction, probably due to deposition of immune complexes in the lungs, with subsequent activation of the complement system. The experimental study showed that the alterations are not dependent of the presence of eggs and/or worms of S. mansoni in the lungs, thus corroborating the hypothesis of deposition of circulating material.

Os aa. estudaram as alterações ultra-estruturais do hepatócito na forma aguda, toxêmica, da esquístossomose em sete pacientes, membros de uma mesma família, infectatos em idênticas condições em um córrego existente no município de Sabará (MG) e não tratados especificamente para a esquistossomose. O estudo vem confirmar a nossa assertiva de que, na esquistossomose, não hâ um ataque direto e sistematizado aos hepatócitos e que as lesões destes são secundárias e decorrem, principalmente, das alterações do sistema vascular estromático. Nos sete casos estudados as alterações ultra-estruturais foram inespecfficas, pouco acentuadas e se caracterizaram sobretudo pelas modificações das organelas citoplasmáticas (dilatação das cisternas do reticulo, apagamento das cristas mitocondriais, desacoplamento de ribossomas, acúmulo de glicogênio). Foi freqüente, também, a presença de lisossomosvolumosos, inclusões e corpos residuais nos hepatócitos Estes achados à microscopia eletrônica espelham o comportamento funcional do hepatócito na vigência da forma aguda, toxêmica, da esquistossomose e explicam o freqüente encontro de células claras à microscopia óptica.

Os autores determinaram o diâmetro médio dos granulomas de fígado de camundongos infectados com cercárias de duas cepas geográficas bem definidas do, Schistosoma mansoni (LE, Belo Horizonte e SJ, São Paulo). No total foram medidos 1.170 granulomas. Os granulomas com 60 dias eram de dimensões maiores do que os de 90 dias. A modulação da resposta imunopatológica foi significativamente mais eficiente na cepa LE e os granulomas, tanto aos 60 como aos 90 dias, da cepa SJ eram significativamente maiores. Os dados obtidos indicam uma maior patogenicidade da cepa SJ. Especula-se se o significado destes achados poderiam, em parte, explicar a ocorrência das variações regionais das formas anatomo-clínicas da esquistossomose.The authors have determined the mean diameter of granulomas in the liver of mice infected with cercariae from two different and well definite geographic strains of Schistosoma mansoni (LE, Belo Horizonte, MG, and SJ, São José dos Campos, SP). A total of 1,170 granulomas has been measured. Granulomas measured on the 60th day after infection showed larger size than the other ones measured on the 90th day. Modulation of the immunopathologic response was significantly more efficient for the LE strain, whereas the granulomas ( with 60 and 90 days) related to SJ strain were significantly larger. Data suggested a higher pathogenicity for the SJ strain. It is speculated whether these findings could explain, in part, the occurence of regional variations of the anatomo-clinical forms of schistosomiasis.

Os aa. determinaram o diâmetro médio dos granulomas esquistossomóticos em suas várias fases evolutivas (necrótico-exsudativa, produtiva e em cura pór fibrose) em 332 casos de esquistossomose hepática humana: 167 na forma aguda, toxêmica e 165 nas formas crônicas (hepatesplênica, miliar). Foram medidos 286 granulomas em punções biópsias da primeira e 165 em punções biópsias e biópsias cirúrgicas da segunda.

Os AA. estudaram o tipo de colágeno em cortes histológicos de fragmentos de fígado de 12 indivíduos portadores da forma hepatesplênica da esquistossomose mansoni, pela técnica de coloração pelo Sirius Supra Red F3BA. Como controle usaram cortes histológicos de 12 fragmentos de fígado de indivíduos sem doenças fibrosantes. As preparações coradas pelo Sirius Supra Red F3BA e examinadas em microscópio de polarização (Leitz) revelaram que a fibrose periportal é constituída por colágeno de tipos I e III, com predominância do primeiro.Histologic typing of collagen fibers from 12 livers of patients with hepatosplenic Manson's schistosomiasis was tnade jusing the Sirius Supra Red F3BA stain according to Junqueira's method. The Controls were 12 livers without fibrosis. The preparations were stained with Sirius Supra Red F3BA and were examined under polarized light (Leitz photomicroscope) which revealed collagen fibers types I and III in the portal tracts.

The Montenegro skin test is widely used as a diagnostic method for American cutaneous leishmaniasis (ACL) but little is known about the histological changes that occur in the skin after administration of the antigen. This report is based on histological studies of biopsied material obtained, from inoculation sites, 48 hours after individuals had been given intradermal injections with a standardized Montenegro antigen. The material examined was obtained from four distinctly different test groups: naturally infected patients with parasitologically proved ACL and with positive Montenegro's reaction; individuals without previous history of ACL and not previously tested with Montenegro antigen; participants in anti-ACL vaccine trials who developed positive reactions to Montenegro antigen after vaccination; other participants in vaccine trials who had negative Montenegro responses after vaccination or had served as controls in the trials. The histological pictures of each group are described and discussed. Histologically, the reactions of vaccinated individuals were indistinguishable from those with naturally acquired infections.

Em estudo duplo-cego observou-se que as alterações radiológicaspulmonares após tratamento com oxamniquine de pacientes com esquistossomose mansoni crônica associam-se com a presença de eosinófilos no escarro (pIn a double-blind study, thepost-oxamniquine X-ray pulmonary alterations were associated with sputum eosinophilia (p < 0.01). This suggests the occurrence of a hypersensitivity reaction in treated human schistosomiasis mansoni infections.

A clinical and radiological picture of bronchopneumonia was observed in a patient between the second and third weeks post-infection with cercariae of S. mansoni. There was a spontaneous recovery without sequelae in 20 days and the clinical and radiological alterations were interpreted as associated with the passage of schistosomulae through the lungs.Relata-se o caso de um paciente que após 2 a 3 semanas de contato infectante com cercárias desenvolveu quadro clínico e radiológico de broncopneumonite. O paciente não possuía infecção esquistossomótica anterior. Houve recuperação espontânea, sem seqüela em 20 dias e as alterações clínico- radiológicas foram interpretadas em associação à passagem de esquistossômulos pelos pulmões.