Estudo imunohistoquimico das citoqueratinas, do indice de proliferação celular e da resposta inflamatoria na paracoccidioidomicose bucal

AUTOR(ES)
DATA DE PUBLICAÇÃO

2004

RESUMO

Paracoccidioidomycosis (Pmycosis) is a common systemic mycosis in Latin America, with variable clinical presentation. The chronic form frequently involves the oral mucosa, showing multiple moriform like lesions. Microscopically, oral Pmycosis is cha_acterized by pseudoepitheliomatous hyperplasia (PEH), and granulomatous inflammatory response, besides polimorphonuclear (PMN) accumulation in the epithelium and connective tissue. This work describes, by immunohistochemistry, cytokeratins (CKs) expression and cellular proliferation in PEH, as well as the distribution of inflammatory cells in the epithelial and connective tissues. Additionally, a clinical case of oral Pmycosis is described. PEHs were evident in ali 28 oral Pmycosis specimens from the buccal mucosa, lip, gingiva and hard palate used to study CKs expression (AE1/AE3, 34_E12, CK1, CK5, CK6, CK7, CK8, CK10, CK14, CK16, CK18 and CK19) and cell proliferation (Ki-67). In the basal cell layer, the results were similar for ali CKs, in normal oral mucosa (NOM) and PEHs. Differences found in the suprabasal layer of NOM and PEH are described below. In Pmycosis, CK1 and CK10 were not expressed in spinous and superficial layers of the lip, gingiva and hard palate. CK14 was positive in suprabasallayer of the buccal mucosa and lip. CK6 was more frequently expressed in spinous layer of the lip, gingiva and hard palate, nevertheless CK16 expression was decreased in the spinous and superficial layers of the gingiva and hard palate. Cellular proliferation index was determined by Ki-67 immunostaining and quantification with the aid of an image analyzer system (Kontron 400). The proliferation index was 7.7 (:t3.6) and 28.2 (:t9.8) for NOM and PEH, respectively. Therefore in PEH, epithelial proliferation was increased, resulting in a thicker and parakeratotic epithelium. Proliferative index of moderate oral dysplasia, included for comparison was 46.0 (:t14.0). Organized granulomas showed a predominance of CD68+ cells, with CD4+ cells at the periphery. Similar number of CD4+ and CD8+ cells were found in non granulomatous areas. B Iymphocytes (CD20+) were sparsely distributed throughout the connective tissue. Dendritic cells (S100+) were found in the epithelium, sub-epithelial connective tissue and periphery of organized granulomas. PMN (CD15+) predominated in areas of intraepithelial microabscesses and ulcerations. Additionally, a clinical case of Pmycosis is described that showed a solitary chronic ulcerated lesion, similar to a spinous cell carcinoma of the alveolar ridge

ASSUNTO(S)

celulas - proliferação micoses fungos

ACESSO AO ARTIGO

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