RESUMEN
The clinical histories and pathological findings of 27 autopsied cases of orthotopic liver transplantation (OLT) were reviewed. Fatal OLT was complicated in 93% of cases by neurological dysfunction, usually manifested by encephalopathy, with or without seizures. The etiology of the encephalopathy was largely multifactorial (44%) or undetermined (20%). Subarachnoid hemorrhage, central pontine myelinolysis, meningitis, brain infarction, polyclonal B cell lymphoma and spinal cord necrosis were common neuropathological findings. These diagnoses were often masked by other systemic illnesses. The role of cytomegalovirus (CMV) in neurologic dysfunction was explored with in situ hybridization and immunohistochemical techniques. OLT cases showed a significantly higher (89%) frequency of CMV genomic material in brain tissue compared to age-matched non immunocompromised (NIC) patients (23%). All OLT cases with encephalopathy of undetermined cause demonstrated usually prominent hybridization to the CMV probe. CMV may be an important cause of encephalopathy in such patients.
Asunto(s)
Infecciones por Citomegalovirus/complicaciones , Encefalopatía Hepática/etiología , Trasplante de Hígado/efectos adversos , Sistema Nervioso/patología , Adolescente , Adulto , Autopsia , Biotina , Niño , Infecciones por Citomegalovirus/patología , Sondas de ADN , Femenino , Encefalopatía Hepática/patología , Humanos , Técnicas para Inmunoenzimas , Masculino , Persona de Mediana Edad , Hibridación de Ácido Nucleico , Trasplante HomólogoRESUMEN
Although considerable evidence has accumulated linking herpes simplex virus (HSV) to carcinoma of the uterine cervix, only fragmentary evidence exists linking HSV to oral cancer. The purpose of this study was to search for HSV type 1 (HSV-1) proteins in tissue sections of 132 oral squamous cell carcinomas and 56 age- and site-matched controls. All tissues were incubated in rabbit anti-HSV-1 serum with the use of a modified direct immunoperoxidase technique. More than 42% of the cancers, but none of the controls, reacted positively. Thirteen selected oral carcinomas that exhibited positive polyclonal staining were incubated with the use of a peroxidase-antiperoxidase technique with a mouse monoclonal antibody raised against the 89 kilodalton HSV-1 envelope protein. None of these tissues exhibited a positive reaction. Similarly, no unequivocal ultrastructural viral particles were found in 11 oral carcinomas that stained positively with the polyclonal antibodies. These results are interpreted to indicate partial expression of a noninfectious viral genome. The presence of this genome in a high proportion of lesions in this study lends strong statistical support to the oncogenic relationship between HSV-1 and oral squamous cell carcinoma.