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0 aumento significativo do número de casos notificados da Leishmaniose Tegumentar Americana (LTA) e a expansão geográfica da endemia tem motivado o desenvolvimento de novas tecnologias para auxiliar no diagnóstico das leishmanioses, visando minimizar as restrições apresentadas pelos testes diagnósticos disponíveis nos serviços de saúde. 0 presente trabalho empregou imunocitoquimica e imunohistoquímica (ICQ/IHQ) como métodos diagnósticos laboratoriais para LTA. Amostras de culturas de Leishmania in vitro e cortes histológicos de lesões em animais infectados experimentalmente foram submetidos a ICQ/IHQ, utilizando anticorpos policlonais desenvolvidos para este estudo e o complexo avidina-biotina modificado (Ultra Streptavidin®). Em comparação com outras técnicas empregadas para o diagnóstico da LTA, nos casos avaliados, a IHQ apresentou resultados semelhantes aos da histopatologia com coloração HE, com sensibilidade de 33,3% para formas amastigotas. Quando considerada a presenva de antígenos de Leishmania no padrão celular, a IHQ apresentou uma sensibilidade de 83,3%, significativamente maior que na histopatologia e compatível com metodos padrão ouro de cultura e PCR. As metodologias de ICQ/IHQ desenvolvidas neste trabalho foram capazes de demonstrar em biópsias de lesões, a presença de formas amastigotas e antígenos de Leishmania, oferecendo contribuição adicional ao diagnóstico da LTA, sendo de facil aplicação e podendo ser utilizada no sistema público de saúde.

The significant increase in cutaneous leishmaniasis (CL) notified cases and the geographic expansion of this endemy has motivated the development of new techniques to help in leishmaniasis diagnosis, seeking the minimization of the restrictions imposed by the diagnostic tests available at the health services. The current study applied immunocytochemistry and immunohystochemistry methods (ICC/IHC) for laboratory diagnosis of CL. Imprints and histological sections from tissue infected with Leishmania were submitted to ICC/IHC methods using polyclonal antibodies developed for this study and a modified avidin-biotin complex (Ultra Streptavidin®). The samples also were submitted for routinely stained hematoxylin and eosin (H&E) specimens and gold standard methods (culture and PCR). Compared with other useful techniques for the CL diagnosis, ICC/IHC showed the same sensitivity results (33%) as H&E stain for amastigotes recognition. When the presence of Leishmania antigens was evaluated, ICC/IHC presented 83,3% sensitivity, i.e., higher than that detected by histopathology and equivalent with gold standard methods (culture and PCR). The ICC/IHC techniques developed in the current study were able to recognize amastigote forms and also Leishmania antigens in lesion biopsies, offering an additional help to CL diagnosis and it can be easily applied in the public health system.

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The authors analyzed the results of 650 lesions of the central nervous system submitted to intraoperative cytological diagnosis by the smear technique. Cytological and paraffin section diagnoses were compared. The following statistical values were obtained: accuracy of 97.3%, sensitivity of 97.9%, specificity of 95%, positive predictive value of 99.1%, and negative predictive value of 89.6%. The authors comment on their main pitfalls using this cytological diagnostic procedure.

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Propylthiouracil is widely used to treat patients with hyperthyroidism. However, propylthiouracil-induced hepatitis is an uncommon entity. The case of a 15-year-old boy treated with propylthiouracil for hyperthyroidism who developed a cholestatic acute hepatitis is reported. Viral, metabolic and autoimmune liver diseases were excluded and liver biopsy showed a pattern suggestive of drug-induced cholestatic hepatitis. After discontinuing the drug, there was a progressive resolution of symptoms and normalization of liver biochemical tests. Despite its rarity, patients receiving propylthiouracil are exposed to develop severe hepatotoxicity.

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Only a small percentage of patients with Hodgkin's disease become clinically Jaundiced during their disease. This Jaundice may be secondary to biliary obstruction, hemolysis, direct hepatic infiltration by the disease, drug toxicity or viral hepatitis. Vanishing bile duct syndrome secondary to Hodgkin's disease is a rare cause of cholestasis in these patients, only 13 cases having been reported so far. The authors describe 2 patients who developed severe Jaundice secondary to Hodgkin's disease due to vanishing bile duct syndrome affecting small intrahepatic bile ducts.

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The authors present two cases of granular cell tumor affecting the esophagus. The patients, one male and one female, were 48 and 52 years old. Although both tumors were small (1 and 1.5 cm in diameter), they produced local symptoms. Endoscopical removal was done in both patients and histological examination revealed granular cell tumors. Immunohistochemistry showed positivity for S 100 protein in both cases further corroborating to a Schwann cell origin for these legions.

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The authors present the autopsy findings of two related patients and the biopsy findings of a third member of the family. The oldest member was 34 years old at death and on postmortem examination he had haemangioblastomas in the retina, cerebellum, medulla and spinal cord. Other findings were renal cell carcinoma, phaechromocytoma, cysts of kidney and pancreas, hydromyelia and atypical meningiomas. His brother died when 30 years old. The autopsy revealed haemangioblastomas of cerebellum, renal cell carcinoma and a clear cell cystadenoma of epididymus. The third patient was the daughter of the first and presented with headache and dizziness. CT-scan showed a cerebellar haemangioblastoma. Epidemiological considerations on the commonest visceral and CNS lesions and a review of current diagnostic criteria are discussed.

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