RESUMEN
BACKGROUND: Schwannoma is a rare benign tumor derived from nerve sheaths. When derived from the cervical sympathetic chain, it usually presents itself as an asymptomatic mass located in the posterior cervical region, at paravertebral level. Its diagnosis is not easy, usually requiring multiple imaging tests. Its differential diagnosis includes parathyroid adenoma. CLINICAL CASE: A new case of schwannoma of the cervical sympathetic chain in a patient with a synchronous overactive parathyroid adenoma is reported. This case adds to the sixty described in the literature, although to our knowledge no association between schwannoma and parathyroid adenoma has been reported to date. CONCLUSIONS: Despite being a benign tumor, its treatment is a complete surgical resection. The most common complication after the surgery needed for these tumors is ipsilateral Horner syndrome.
Asunto(s)
Adenoma/patología , Neoplasias de Cabeza y Cuello/patología , Neoplasias Primarias Múltiples/patología , Neurilemoma/patología , Neoplasias de las Paratiroides/patología , Adenoma/complicaciones , Adenoma/diagnóstico , Adenoma/cirugía , Femenino , Ganglios Simpáticos/patología , Ganglios Simpáticos/cirugía , Neoplasias de Cabeza y Cuello/diagnóstico , Neoplasias de Cabeza y Cuello/cirugía , Síndrome de Horner/etiología , Humanos , Hipercalcemia/etiología , Hiperparatiroidismo Primario/etiología , Imagen por Resonancia Magnética , Persona de Mediana Edad , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Primarias Múltiples/cirugía , Neurilemoma/diagnóstico , Neurilemoma/cirugía , Neoplasias de las Paratiroides/complicaciones , Neoplasias de las Paratiroides/diagnóstico , Neoplasias de las Paratiroides/cirugía , Paratiroidectomía , Complicaciones Posoperatorias/etiología , Tomografía Computarizada por Rayos XRESUMEN
Autonomic nervous system involvement occurs at early stages in both Parkinson's disease (PD) and incidental Lewy body disease (ILBD), and affects the sympathetic, parasympathetic, and enteric nervous systems (ENS). It has been proposed that alpha-synuclein (α-SYN) pathology in PD has a distal to proximal progression along autonomic pathways. The ENS is affected before the dorsal motor nucleus of the vagus (DMV), and distal axons of cardiac sympathetic nerves degenerate before there is loss of paravertebral sympathetic ganglion neurons. Consistent with neuropathological findings, some autonomic manifestations such as constipation or impaired cardiac uptake of norepinephrine precursors, occur at early stages of the disease even before the onset of motor symptoms. Biopsy of peripheral tissues may constitute a promising approach to detect α-SYN neuropathology in autonomic nerves and a useful early biomarker of PD.
Asunto(s)
Enfermedad de Parkinson/patología , Enfermedad de Parkinson/fisiopatología , Animales , Sistema Nervioso Autónomo/metabolismo , Sistema Nervioso Autónomo/patología , Sistema Nervioso Autónomo/fisiopatología , Biomarcadores/metabolismo , Ganglios Simpáticos/metabolismo , Ganglios Simpáticos/patología , Humanos , Enfermedad de Parkinson/metabolismo , Sistema Nervioso Simpático/metabolismo , Sistema Nervioso Simpático/patología , alfa-Sinucleína/metabolismoRESUMEN
Protein deficiency is one of the biggest public health problems in the world, accounting for about 30-40% of hospital admissions in developing countries. Nutritional deficiencies lead to alterations in the peripheral nervous system and in the digestive system. Most studies have focused on the effects of protein-deficient diets on the enteric neurons, but not on sympathetic ganglia, which supply extrinsic sympathetic input to the digestive system. Hence, in this study, we investigated whether a protein-restricted diet would affect the quantitative structure of rat coeliac ganglion neurons. Five male Wistar rats (undernourished group) were given a pre- and postnatal hypoproteinic diet receiving 5% casein, whereas the nourished group (n = 5) was fed with 20% casein (normoproteinic diet). Blood tests were carried out on the animals, e.g., glucose, leptin, and triglyceride plasma concentrations. The main structural findings in this study were that a protein-deficient diet (5% casein) caused coeliac ganglion (78%) and coeliac ganglion neurons (24%) to atrophy and led to neuron loss (63%). Therefore, the fall in the total number of coeliac ganglion neurons in protein-restricted rats contrasts strongly with no neuron losses previously described for the enteric neurons of animals subjected to similar protein-restriction diets. Discrepancies between our figures and the data for enteric neurons (using very similar protein-restriction protocols) may be attributable to the counting method used. In light of this, further systematic investigations comparing 2-D and 3-D quantitative methods are warranted to provide even more advanced data on the effects that a protein-deficient diet may exert on sympathetic neurons. (c) 2009 Wiley-Liss, Inc.
Asunto(s)
Ganglios Simpáticos/patología , Intercambio Materno-Fetal/fisiología , Neuronas/patología , Deficiencia de Proteína/patología , Análisis de Varianza , Animales , Animales Recién Nacidos , Atrofia/metabolismo , Atrofia/patología , Glucemia/metabolismo , Recuento de Células , Tamaño de la Célula , Femenino , Ganglios Simpáticos/metabolismo , Leptina/sangre , Masculino , Degeneración Nerviosa/metabolismo , Neuronas/metabolismo , Tamaño de los Órganos , Embarazo , Deficiencia de Proteína/metabolismo , Ratas , Ratas Wistar , Triglicéridos/sangreRESUMEN
Ramicotomy is a surgical procedure, with less adverse effects than conventional sympathectomy, however, it was abandoned due to the high recurrence rate. Twenty-eight pigs underwent bilateral videothoracoscopic ramicotomy and were divided into five groups. The animals were sacrificed at 15th, 45th, 90th, 135th and 180th postoperative days (POD). The segments were removed and evaluated for macroscopic regeneration and histological analysis. The data were compared to the control group of 10 intact segments of the sympathetic. There was no macroscopic regeneration on the 15th POD, and present on 41.6% on the 180th POD (P<0.05). The Schwann cells presented a similar evolution in both rami beginning at the 45th POD, with a smaller count in the gray rami. The collagen and reticular fibers presented a negative correlation (r=-0.414; P<0.01). The deposition of the collagen fibers was greater in the gray rami with a peak deposition on the 135th POD and a diminishing rate in the 180th POD (P<0.05). Ramicotomy allows complete section of all rami communicantes of the sympathetic ganglia. The histological regeneration might be greater than the recurrence rates of clinical symptoms seen in a human being due to non-functional regenerations.
Asunto(s)
Ganglios Simpáticos/cirugía , Regeneración Nerviosa , Simpatectomía/métodos , Cirugía Torácica Asistida por Video , Animales , Colágeno/metabolismo , Ganglios Simpáticos/patología , Ganglios Simpáticos/fisiopatología , Inflamación/patología , Inflamación/fisiopatología , Reticulina/metabolismo , Células de Schwann/patología , Porcinos , Simpatectomía/efectos adversos , Cirugía Torácica Asistida por Video/efectos adversos , Factores de TiempoRESUMEN
Solitary schwannomas of the head and neck are uncommon tumors arising from any cranial or autonomic nerve. Twenty-five percent to 45% of extracranial schwannomas occur in the head and neck. A total of 28 consecutive patients treated be tween January 2000 and August 2006 for solitary schwannomas in different major nerves of the head and neck were included in this study. Most affected trunks were cranial nerves in 14 patients (50%), cervical sympathetic chain in 7 (25%), and brachial plexus in 7 (25%). The most common sign was an isolated well-demarcated lesion placement at the lateral aspect of the neck for those tumors arising from vagus, lingual, and sympathetic nerves. Total resection with nerve conservation was the treatment of choice for these tumors. In 26 patients (94%), no functional sequels were detected; in 2 other patients (6%), Horner syndrome was a consequence of sympathetic chain resection. No relapse was detected in all 28 patients.
Asunto(s)
Neoplasias de Cabeza y Cuello/cirugía , Neurilemoma/cirugía , Adolescente , Adulto , Anciano , Enfermedades del Sistema Nervioso Autónomo/cirugía , Plexo Braquial/patología , Neoplasias de los Nervios Craneales/cirugía , Femenino , Ganglios Simpáticos/patología , Síndrome de Horner/etiología , Humanos , Enfermedades del Nervio Hipogloso/cirugía , Nervio Lingual/patología , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Neoplasias del Sistema Nervioso Periférico/cirugía , Tomografía Computarizada por Rayos X , Enfermedades del Nervio Vago/cirugía , Adulto JovenRESUMEN
Diabetes mellitus is the most common endocrine disturbance of domestic carnivores and can cause autonomic neurological disorders, although these are still poorly understood in veterinary medicine. There is little information available on the quantitative adaptation mechanisms of the sympathetic ganglia during diabetes mellitus in domestic mammals. By combining morphometric methods and NADPH-diaphorase staining (as a possible marker for nitric oxide producing neurons), type I diabetes mellitus-related morphoquantitative changes were investigated in the celiac ganglion neurons in dogs. Twelve left celiac ganglia from adult female German shepherd dogs were examined: six ganglia were from non-diabetic and six from diabetic subjects. Consistent hypertrophy of the ganglia was noted in diabetic animals with increase of 55% in length, 53% in width, and 61.5% in thickness. The ordinary microstructure of the ganglia was modified leading to an uneven distribution of the ganglionic units and a more evident distribution of axon fascicles. In contrast to non-diabetic dogs, there was a lack of NADPH-diaphorase perikarial labelling in the celiac ganglion neurons of diabetic animals. The morphometric study showed that both the neuronal and nuclear sizes were significantly larger in diabetic dogs (1.3 and 1.39 times, respectively). The profile density and area fraction of NADPH-diaphorase-reactive celiac ganglion neurons were significantly larger (1.35 and 1.48 times, respectively) in non-diabetic dogs compared to NADPH-diaphorase-non-reactive celiac ganglion neurons in diabetic dogs. Although this study suggests that diabetic neuropathy is associated with neuronal hypertrophy, controversy remains over the possibility of ongoing neuronal loss and the functional interrelationship between them. It is unclear whether neuronal hypertrophy could be a compensation mechanism for a putative neuronal loss during the diabetes mellitus.
Asunto(s)
Diabetes Mellitus Tipo 1/veterinaria , Enfermedades de los Perros/patología , Ganglios Simpáticos/patología , NADPH Deshidrogenasa/metabolismo , Animales , Estudios de Casos y Controles , Diabetes Mellitus Tipo 1/enzimología , Diabetes Mellitus Tipo 1/patología , Neuropatías Diabéticas/metabolismo , Neuropatías Diabéticas/veterinaria , Enfermedades de los Perros/enzimología , Perros , Femenino , Ganglios Simpáticos/anatomía & histología , Ganglios Simpáticos/ultraestructuraRESUMEN
Con el objetivo de determinar en nuestro medio el valor de la citología aspirativa con aguja fina, al evaluar una linfadenopatía cervical asintomática, como procedimiento diagnóstico preliminar, se realizó un estudio de 40 pacientes que acudieron a la consulta de otorrinolaringología del Hospital Clinicoquirúrgico Docente "Joaquín Albarrán", durante el año 1994, en los cuales se practicó primero biopsia aspirativa con aguja fina y posteriormente la extirpación quirúrica de los ganglios afectados para evaluar los diagnósticos citopatológicos realizados. El 72,5 por ciento de los pacientes tenían más de 50 años y el 62,5 por ciento era del sexo masculino. Se diagnosticaron lesiones metastásicas en el 45 por ciento, tumores primarios en el 20 por ciento, adenitis aguda en 7,5 por ciento. En la correlación se encontraron 2 falsos positivos (5 por ciento) e igual número de falsos negativos. La eficacia del método fue de 90 por ciento, sensibilidad de 92,3 por ciento y especialidad de 85,75 por ciento. Los índices predictivos positivos y negativos fueron 92,3 y 85,7 por ciento(AU)
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Anciano , Ganglios Simpáticos/cirugía , Ganglios Simpáticos/patología , Biopsia con Aguja , Metástasis de la Neoplasia/patología , Carcinoma de Células Escamosas/patología , Linfadenitis/patología , Trastornos Linfoproliferativos/patologíaRESUMEN
Con el objetivo de determinar en nuestro medio el valor de la citología aspirativa con aguja fina, al evaluar una linfadenopatía cervical asintomática, como procedimiento diagnóstico preliminar, se realizó un estudio de 40 pacientes que acudieron a la consulta de otorrinolaringología del Hospital Clinicoquirúrgico Docente "Joaquín Albarrán", durante el año 1994, en los cuales se practicó primero biopsia aspirativa con aguja fina y posteriormente la extirpación quirúrica de los ganglios afectados para evaluar los diagnósticos citopatológicos realizados. El 72,5 por ciento de los pacientes tenían más de 50 años y el 62,5 por ciento era del sexo masculino. Se diagnosticaron lesiones metastásicas en el 45 por ciento, tumores primarios en el 20 por ciento, adenitis aguda en 7,5 por ciento. En la correlación se encontraron 2 falsos positivos (5 por ciento) e igual número de falsos negativos. La eficacia del método fue de 90 por ciento, sensibilidad de 92,3 por ciento y especialidad de 85,75 por ciento. Los índices predictivos positivos y negativos fueron 92,3 y 85,7 por ciento
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Biopsia con Aguja , Carcinoma de Células Escamosas/patología , Ganglios Simpáticos/cirugía , Ganglios Simpáticos/patología , Linfadenitis/patología , Trastornos Linfoproliferativos/patología , Metástasis de la Neoplasia/patologíaRESUMEN
Mal seco is a grass sickness-like syndrome of horses which has mainly been observed in Patagonia, Argentina, although some reports indicate that the disease may exist in other Argentinian provinces and in the south of Chile. The aetiology of mal seco remains unknown but the disease seems to be restricted to animals grazing on natural pastures and not receiving supplementary feeding. Mal seco is clinically characterized by total or partial bowel stasis and the main findings at post-mortem examination are almost exclusively restricted to the bowel. The most striking histopathological changes found consisted of degenerative changes in the coeliaco-mesenteric ganglia and also in other central and peripheral structures of the nervous system.
Asunto(s)
Enfermedades de los Caballos/etiología , Poaceae , Enfermedad Aguda , Animales , Argentina/epidemiología , Enfermedad Crónica , Sistema Digestivo/patología , Ganglios Simpáticos/patología , Enfermedades de los Caballos/epidemiología , Enfermedades de los Caballos/patología , Caballos , SíndromeRESUMEN
'Mal seco' is a grass sickness-like syndrome of horses in Argentina. A histopathological study was made of the coeliaco-mesenteric ganglia of four horses with 'mal seco' and of four horses that died from other causes. The severity and extent of the lesions found in the horses with 'mal seco' was greatest in the two with the shortest clinical course. Degenerative changes consisted mainly in the loss of Nissl substance, cytoplasmic vacuoles, neuronophagia, intercellular and intracytoplasmic eosinophilic bodies, and pyknotic and eccentric nuclei. The coeliaco-mesenteric ganglia of the control horses had no histological lesions. The histological lesions in the horses with 'mal seco' were very similar to those described in the coeliaco-mesenteric ganglia of horses with grass sickness in Europe and it is suggested that 'mal seco' and grass sickness may be the same disease.
Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/veterinaria , Ganglios Simpáticos/patología , Enfermedades de los Caballos/patología , Animales , Argentina , Enfermedades del Sistema Nervioso Autónomo/patología , Femenino , Caballos , Masculino , Degeneración Nerviosa , Neuronas/patología , Síndrome , VacuolasRESUMEN
O Linfoma Linfocítico Plasmocitóide é uma variante com origem nos linfócitos "B", de ocorrência rara entre os linfomas, com características difusas de crescimento, podendo ocasionalmente apresentar nodularidade e fibrose ao exame anátomo patológico de peças comprometidas. Seus sintomas podem se superpor aos apresentados por moléstias inflamatórias, ou näo inflamatórias, podendo ser inespecíficos. O diagnóstico é obtido pelo exame anatomo-patológico. Neste caso apresentava-se reiteradamente como um processo inflamatório inespecífico, o que näo significou um diagnóstico definitivo, como pode ocorrer nos linfomas näo hodgkinianos. O motivo maior desta publicaçäo está na ênfase da insatisfaçäo do médico ao se defrontar, mesmo repetidamente, com um diagnóstico mais simples, vago e facilmente aceitável que, em absoluto, se compatibiliza com a história clínica, sua evoluçäo reincidente e a gravidade dos sintomas
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Ganglios Simpáticos/patología , Leucemia Linfocítica Crónica de Células B/patología , Biopsia , Diagnóstico DiferencialRESUMEN
O estudo histológico dos ramos interganglionares do tronco simpático tóraco-lombar do camundongo demonstrou que eles säo constituídos, predominantemente, de fibras nervosas amielínicas. Nossos achados foram equivalentes aqueles descritos no rato e substancialmente diferentes daquele observados no gato, no macaco, na rä e no homem, onde predominam fibras mielinizadas
Asunto(s)
Ratones , Animales , Masculino , Ganglios Simpáticos/patología , Fibras Nerviosas Mielínicas/patología , Sistema Nervioso Autónomo/patologíaRESUMEN
Histological methods were used for studying the left superior cervical ganglia of control and T. cruzi infected female rats killed 13, 20, and 34 days after inoculation. Concomitantly, the sympathetic innervation of the heart auricular appendages and of the submandibular gland was studied by a glyoxylic acid-induced fluorescence method for catecholamines. At day 34 of infection, the superior cervical ganglia of an additional group of control and infected animals were studied morphometrically through the determination of ganglion volume, total number, and nuclear diameter of the principal neurons. No amastigote pseudocyst could be detected inside the ganglia at any time during infection. Inflammatory reactions were very discrete or absent at day 13 of infection, but were clearly present at day 20 as periganglionitis (in all infected animals) or ganglionitis (in 62.5% of the infected animals). These reactions again became very discrete at day 34 of infection. None of the morphometric parameters analyzed were altered by Chagas' disease. Histochemical studies on the sympathetic innervation of the heart and submandibular gland showed disappearance or rarefaction of fluorescent nerve fibers, starting around the 13th day of infection. The involvement of sympathetic nerve terminals in Chagas' disease is a local phenomenon rather than a consequence of parasitism or destruction.
Asunto(s)
Enfermedad de Chagas/patología , Ganglios Simpáticos/patología , Animales , Femenino , Corazón/inervación , Histocitoquímica , Neuronas/patología , Ratas , Glándula Submandibular/inervaciónRESUMEN
Foi realizado um estudo quantitativo dos neurônios de gânglios atriais (parassimpáticos) e de gânglios estrelados (simpáticos) em controles e em cardiopatas chagásicos, sendo analisada a relaçäo entre o número de neurônios atriais e o peso dos coraçöes. Observou-se, nos cardiopatas chagásicos crônicos, denervaçäo tanto nos gânglios atriais (reduçäo de 60% em relaçäo aos controles) como nos gânglios estrelados (reduçäo de 51% em relaçäo aos controles). Näo houve correlaçäo entre denervaçäo atrial e hipertrofia do miocárdio (coeficiente de correlaçäo de Pearson + 0,3), näo se observando também maior grau de denervaçäo nos chagásicos com insuficiência cardíaca. Essas observaçöes mostram que nem a denervaçäo parassimpática nem o predomínio simpático explicam a hipertrofia do miocárdio e a insuficiência cardíaca no chagásico crônico
Asunto(s)
Ganglios Parasimpáticos/patología , Ganglios Simpáticos/patología , Cardiomiopatía Chagásica/patología , Neuronas/patologíaRESUMEN
Presentamos un caso de enfermedad de Whipple diagnosticado con biopsia de ganglio linfático periférico,donde se encontró característicos macrófagos PAS-positivos.Al mismo tiempo,las muestras de biopsia de intestino delgado tanto a la microscopía óptica como electrónica no mostraron dichas alteraciones ni presencia de bacilos.Era un paciente peruano de 52 años de edad,cuyas manifestaciones clínicas más importantes fueron síndrome de malabsorción, artralgias,pigmentación cutánea,desnutrición y ascitis subclínica.El tratamiento con penicilina y tetraciclina dio excelentes resultados.Discutimos la importancia de realizar el diagnóstico en presencia de manifestaciones extraintestinales de la enfermedad y las razones por las cuales el estudio histológico del intestino puede ser negativo aun cuando haya malabsorción intestinal.El presente caso es el primero reportado en el Perú y probablemente en América Latina.