CONTEXTO: Linfoma primário do sistema nervoso central (LP-SNC) é raro subgrupo de linfomas relacionado à AIDS, geralmente associado EBV. OBJETIVO: Identificar os achados clínico-patológicos dos pacientes com LP-SNC. MÉTODO: Foram analisados dados clínicos, histológicos e imuno-histoquímicos de dez necrópsias de LP-SNC, oito deles de pacientes com AIDS, identificados entre 265 autopsias destes. RESULTADOS: Sete pacientes foram masculinos e a idade média foi 40,9 anos. A sintomatologia neurológica mais freqüente era focal (70%). Seis exibiram lesão única. Histologicamente, eram neoplasias densamente celulares e polimorfas, com angiocentrismo em 90% dos casos. Em quatro casos, houve associação com outras afecções. A maioria dos casos foi de linfoma não-Hodgkin difuso de grandes células B. A pesquisa para EBV foi positiva em um caso. CONCLUSÃO: Predominaram os LP-SNC associados à AIDS, com sintomatologia focal, lesão em massa ou multifocal, com predominância de células B CD-20.

CONTEXT: Primary central nervous system lymphomas (PCNSL) are a rare subgroup of lymphomas generally associated with HIV and EBV. OBJECTIVE: To study ten autopsy cases of PCNSL, to describe the neuropathological findings, to characterize the phenotype of the neoplastic cells, to detect EBV in the lesion and to compare the findings with the clinical and laboratory data of the patients. METHOD: The clinical, histological and immunohistochemical data of ten cases of PCNSL, eight cases from patients with AIDS, identified among 265 autopsies of these patients were analyzed. RESULTS: Seven patients were males and the mean age was 40.9 years. The most frequent symptomatology was focal neurologic deficit (70%). Six patients presented with only one lesion. Histologically, densely cellular and polymorphous neoplasms with angiocentrism were observed, in 90% of cases. An association with other diseases was observed in four cases. Most patients had diffuse large B cell non-Hodgkin’s lymphoma. EBV was detected by immunohistochemistry in only one case. The lack of detection of the virus might have been due to the long time of fixation of the brain which might have inactivate epitopes therefore compromising the testing. CONCLUSION: In the present series, PCNSL presented with focal symptoms, with unifocal or multifocal lesions, with a predominant B-cell CD20 positive phenotype, rarely associated with EBV.

OBJECTIVE: To study the healing process of the myocardium in hypertensive rats undergoing inhibition of nitric oxide synthesis. METHODS: Two groups of animals were studied: one received L-NAME, 12mg/kg/day, and the other was a control group. The presence of type III collagen, fibronectin, and alpha-smooth muscle actin-positive cells was assessed by immunohistochemistry. RESULTS: Fibronectin was seen in both early and late lesions, while type III collagen was seen mainly in areas of incomplete healing, situated among myocytes and around the intramyocardial branches of the coronary arteries. Areas representing early and late lesions showed a population of spindle-shaped cells. Immunohistochemistry showed that these cells were positive for alpha-smooth muscle actin. CONCLUSION: In the myocardium of hypertensive rats, the alpha-smooth muscle actin-positive cells are related to the accumulation of type III collagen and fibronectin in the areas of myocardial damage.

Lipomas intracranianos são raros, em geral sem expressão clínica, localizados mais freqüentemente no corpo caloso. Outras localizações incluem medula espinhal, teto mesencefálico, vermis superior, tuber cinereum, infundibulum e mais raramente o ângulo ponto-cerebelar, hipotálamo, véu medular superior e insula. Relatamos o achado de necrópsia de um lipoma do colículo inferior esquerdo em uma mulher com câncer de mama. Embora haja relatos de lipomas intracranianos em pacientes com tumores malignos não há explicação para a co-existência dos dois tumores. O presente tumor também inclui o segmento de um nervo, o que não é incomum, mas um achado menos comum foi a presença de ninhos de células de Schwann no tumor, mostradas por imuno-histoquímica.

Intracranial lipomas are rare, usually do not have clinical expression and are located mare frequently in the corpus callosum. Other locations include the spinal cord, midbrain tectum, superior vermis, tuber cinereum, infundibulum and more rarely cerebellopontine angle, hypothalamus, superior medullary velum and insula. We report the case of a lipoma of the left inferior colliculus which was a post-mortem finding in a woman who died of breast cancer. Although there are reports of intracranial lipomas in patients with malignant tumors there is no explanation for the co-existence of the two tumors. The present tumor also includes a segment of a nerve which is not uncommon, but a less common finding was the presence of nests of Schwann cells within it, shown by immunohistochemistry.

São relatados dois casos de mielopatia transversa subaguda associada a tumores malignos. O primeiro paciente apresentava neoplasia de células reticulares histiocitárias e o segundo, carcinoma renal. Os autores fazem revisão dos casos similares descritos na literatura. As alterações anátomo-patológicas medulares encontradas foram semelhantes às descritas nos relatos prévios, sendo que no primeiro caso havia também intenso infiltrado inflamatório perivascular e a presença de astrócitos bizarros. Tais alterações encontradas sugerem ser esta afecção de natureza viral.

Two clinico-pathological cases of necrotic myelopathies with a distant malignancy are presented. The first patient had histiocytic medullary reticulosis and the second one had a renal cell carcinoma. The authors refered to other similar cases found in the literature. In both patients the pathological features in the spinal cord were similar to the other cases reported, but in their first case they found an intense inflammatory reaction and hyperplasia of astrocytes into bizarre giant forms. The cause of necrotizing myelopathy associated with neoplasms remain unknow. The authors think that the presence of inflammatory reaction and the changes in the astrocytes in their first case are consistent with the effects of a virus.