In this report, we describe a case of ectopic cervical thymoma (medullary or type A thymoma, according to the WHO classification) located in the anterior cervical region (thyroid topography) that was submitted to ultrasound-guided fine-needle aspiration biopsy. The cytologic smears were moderately cellular to very cellular and were composed of numerous spindle-shaped cells placed predominantly in tissue fragments, with no specific arrangement. Isolated spindle-shaped cells were also present in a hemorrhagic background. The nuclei were elongated with finely granular chromatin and inconspicuous nucleoli. Mitosis, nuclear atypia, and necrosis were not detected. There was a scarce lymphoid population of small lymphocytes. The cytologic aspects, the correlation with histologic findings, and the differential cytologic diagnosis are reviewed.
From 1976 to 1987 on our Nephrological Unit, 57 patients with IgA nephropathy (IgAN) proven by renal biopsies were found. Three of those presented with acute tubular necrosis (ATN) and glomerulitis, without extrarenal predisposing cause in two; and showed, as prominent manifestation, a severe acute renal failure syndrome (ARFS), needing dialytic treatment. All three had hematuria, which was macroscopic in two and microscopic in one. Thus the prevalence of the association of glomerulitis and ATN was about 5.2%. There was complete recovery of renal functions in all three patients, but the usual symptomatology of IgAN. Two patients presented polymorphonuclear neutrophils infiltration of glomerular capillaries and in one of them, electron-dense deposits on the epithelial side of glomerular basement membrane ("humps") were observed, as well as those identified in the mesangial area. The glomerular polymorphonuclear neutrophils infiltration and endothelial cells proliferation (cases 1 and 3), the presence of "humps" (case 1), high antistreptolysin O (ASO) titers (cases 1 and 2), and low serum complement levels (case 1), suggest the possibility that antigens able to cause postinfectious glomerulonephritis (streptococcal or not) could induce in some individuals, by another immunopathogenetic route, mixed histopathological and clinical features of IgAN and postinfectious glomerulonephritis.
Relato de paciente com imunodeficiência rara e manifestação gastrointestinal incomum. Paciente masc, 26a., com Imunodeficiência Comum Variável (ICV), em uso de Prednisona, entre outras drogas, com diarréias recorrentes há 5a. e pesq. de S. stercoralis negativas. Há 3d., dor abd. difusa, náuseas, vômitos e parada de eliminação de gases efezes. Apresentava-se em MEG, descorado, desidratado, distensão abd., dor à palpação, DB+ e ausência de RHA. Ao RX abd., alças distendidas, edemaciadas e "empilhamento de moeda". Submetido à enterectomia do delgado médio por sinais de sofrimento, o exame da peça demonstrou estrongiloidíase transmural e necrose hemorrágica da muscularprópria, sem comprometimento da mucosa. Evoluiu com síndrome do intestino curto e choque séptico, com boa resposta a antibiótico e tiabendazol. Consideram os autores, após revisão de literatura, que a ICV é rara e estrongiloidíase associada é incomum, podendo ser mais encontrada quando em uso de corticóides. A necrose hemorrágica da muscular própria sem comprometimento da mucosa não foi detectada na literatura estudada.
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