Histological and immunohistochemical aspects of cutaneous leishmaniasis in nicaragua

Mariscotti, Cesare; Barbareschi, Mattia; Missoni, Eduardo; Morelli, Rosella; Guevara, Uriel; Munguia-Barrera, Juan

doi:10.1590/S0036-46651987000400005

Abstracts

Sixty skin biopsies of fifty-eight non-treated patients with cutaneous leishmaniasis from Nicaragua were studied. Biopsies were classified according to Ridley's histopathologic groups: 36 (60%) were included in group B (diffuse necrosis), 14 in group C (focal necrosis), 7 (11.6%) in group D (reactive tuberculoid). Only three biopsies remained unclassified. None of our cases could be included in groups A and E. Immunohistochemistry disclosed in 17 cases Russel's bodies secreting IgM and only one IgG positive. There was no correlation between the histopathologic groups and the presence of Russel's bodies. However, we believe the presence of Russel's bodies help the diagnosis of leishmaniasis. Correlation between morphological patterns and the different leishmania species was also considered.

Cutaneous leishmaniasis; Nicaragua; Pathology; Histological classification; Immunohistochemistry; Russel's bodies

Foram estudadas 60 biopsias cutâneas de 58 pacientes nicaraguenses com leishmaniose tegumentar e ainda não em tratamento terapêutico. Quase todas as biopsias foram classificadas nos grupos histopatológicos de Ridley: 36 (60%) foram incluídas no grupo B ("diffuse necrosis"), 14 (23%) no grupo C ("focal necrosis"), 7 (11.6%) no grupo D ("reactive tuberculoid"). Somente 3 biopsias ficaram sem classificação. Não se achou nenhum caso que se pudesse classificar nos grupos A e E. Em 18 casos, usando método imunohis-toquímico, foram observados corpúsculos de Russel. Destes 18 casos 17 eram IgM positivos e só 1 IgG positivo. Não se descobriu correlação entre os grupos histopatológicos e a presença de corpúsculos de Russel. Todavia se imagina que os corpúsculos de Russel possam ter um significado diagnóstico (como um critério adjunto). Pode-se supor também uma correlação entre as numerosas alterações morfológicas e as diferentes espécies de leishmanias.

ORIGINAL ARTICLE

Histological and immunohistochemical aspects of cutaneous leishmaniasis in nicaragua

Aspectos histológicos e imunohistoquírnicos da leishmaniose cutânea na Nicarágua

Cesare Mariscotti^I; Mattia Barbareschi^I; Eduardo Missoni^II; Rosella Morelli^III; Uriel Guevara^IV; Juan Munguia-Barrera^IV

^I3rd. Chair of Morbid Anatomy and Histopathology, University of Milan, Italy

^IIHealth Center "Fidel Ventura", Waslala, Republic of Nicaragua

^IIIDepartment of Infectious Diseases, City Hospital "L. Sacco", Milan, Italy

^IVDepartment of Pathology, Leon University, Nicaragua

^{Address for correspondence} Address for correspondence: Prof. Cesare Mariscotti. IIICattedra di Anatomia ed Istologia Patológica Via Commenda 19; I - 20122 Milano, Italy.

SUMMARY

Sixty skin biopsies of fifty-eight non-treated patients with cutaneous leishmaniasis from Nicaragua were studied. Biopsies were classified according to Ridley's histopathologic groups: 36 (60%) were included in group B (diffuse necrosis), 14 in group C (focal necrosis), 7 (11.6%) in group D (reactive tuberculoid). Only three biopsies remained unclassified.

None of our cases could be included in groups A and E.

Immunohistochemistry disclosed in 17 cases Russel's bodies secreting IgM and only one IgG positive. There was no correlation between the histopathologic groups and the presence of Russel's bodies. However, we believe the presence of Russel's bodies help the diagnosis of leishmaniasis. Correlation between morphological patterns and the different leishmania species was also considered.

Key words: Cutaneous leishmaniasis - Nicaragua; Pathology; Histological classification; Immunohistochemistry; Russel's bodies.

RESUMO

Foram estudadas 60 biopsias cutâneas de 58 pacientes nicaraguenses com leishmaniose tegumentar e ainda não em tratamento terapêutico.

Quase todas as biopsias foram classificadas nos grupos histopatológicos de Ridley: 36 (60%) foram incluídas no grupo B ("diffuse necrosis"), 14 (23%) no grupo C ("focal necrosis"), 7 (11.6%) no grupo D ("reactive tuberculoid"). Somente 3 biopsias ficaram sem classificação.

Não se achou nenhum caso que se pudesse classificar nos grupos A e E.

Em 18 casos, usando método imunohis-toquímico, foram observados corpúsculos de Russel. Destes 18 casos 17 eram IgM positivos e só 1 IgG positivo.

Não se descobriu correlação entre os grupos histopatológicos e a presença de corpúsculos de Russel.

Todavia se imagina que os corpúsculos de Russel possam ter um significado diagnóstico (como um critério adjunto).

Pode-se supor também uma correlação entre as numerosas alterações morfológicas e as diferentes espécies de leishmanias.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

ACKNOWLEDGEMENTS

We wish to thank Prof. D. S. Ridley, Bland Sutton Institute of Pathology, Middlesex Hospital Medical School, London, for his useful comments and suggestions.

Recebido para publicação em 23/10/86.

1. ALLEN, A. C - The skin. A clinicopathologic treatise. St. Louis, CV. Mosby Company, 1954. p. 496-501.
2. AZADEH, B.; SAM AD, A. & ARDEHALI, S. - Histological spectrum of cutaneous leishmaniasis due to leishmania tropica. Trans, roy. Soc. trop. Med. Hyg , 79: 631-666, 1985.
3. BARB ARESCHI, M.; MARISCOTTI, C.; MISSONI, E. & MORELLI, R. - Russel bodies in New World cutaneous leishmaniasis. Pathologica, 77: 87-90, 1985.
4. HAGHIGHI, P. & R£ZAI, H. R. - Leishmaniasis: a review of selected topics. Path. Ann., 12: 63-89, 1977.
5. JANSSEN, P.; VAN BOGAERT, L. & HAYMAKER, W. - Pathology of the pheripheral nervous system in African trypanosomiasis. J. Neuropath. Neurol., 15: 269-287, 1956.
6. JONES, T. C - Interactions between murine macrophages and obbligate intracellular protozoa. Amer. J. Path., 102: 127-132, 1981.
7. LAINSON, R. - The American leishmaniasis: some observations on their ecology and epidemiology. Trans, roy. Soc. trop. Med. Hyg., 77: 569-596, 1983.
8. LEVER, W. F. - Histopathology of the skin. Philadelphia, Lippincott, 1977.
9. MAGALHÃES, A. V.; CHIARINI, L. H. & RAICK, A. N. - Histopatologia da leishmaniose tegumentar. Rev. Inst. Med. trop. S. Paulo, 24: 268-276, 1982.
10. MISSONI, E. & MORELLI, R. - Survey of 59 cases of American cutaneous leishmaniasis in Nicaragua. J. trop. Med. Hyg., 87: 159-165, 1984.
11. MORIEARTY, P. L.; GRIMALDI, G.; GALVÃO-CASTRO, B.; OLIVEIRA NETO, M. P. & MARZOCHI, M. C. A. - Intralesional plasma cells and serological responses in human cutaneous leishmaniasis. Clin, exp. Immunol., 47: 59-64, 1982.
12. PLORDE, J. J. - Leishmaniasis. In: Harrison's principles of internal medicine. 10th ed. New York, Mc draw Hill, 1983. p. 873-876.
13. RIDLEY, D. S. - A histological classification of cutaneous leishmaniasis and its geographical expression. Trans, roy. Soc. trop. Med. Hyg., 74: 515-521, 1980.
14. RIDLEY, D. S. - Histopathogenic mechanisms in leishmaniasis. Pathologica, 75: 471-479, 1983.
15. RIDLEY, D. S. - The pathogenesis of cutaneous leishmaniasis. Trans, roy. Soc. trop. Med. Hyg., 73: 150-160, 1980.
16. RIDLEY, D. S.; MARSDEN, P. D.; CUBA, C. C. & BARRETTO, A. C. - A histological classification of mucocutaneous leishmaniasis in Brazil and its clinical evaluation. Trans, roy. Soc. trop. Med. Hyg., 74: 508-514, 1980.
17. RIDLEY, D. S. & RIDLEY, M. Y. - The evolution of the lesion in cutaneous leishmaniasis. J. Path., 141: 83-96, 1983.
18. RHODE, R. - Mikroskopische und kulturelle Diagnostik der kutanen Leishmaniase. Der Hautarzt, 31: 560-561, 1980.
19. SEHGAL, V. N.; SINGH, K. & GHORPADE, A. - Cutaneous leishmaniasis. A few salient revelations. Dermatologica, 166: 111-112, 1983,
20. SELLS, P. G. & BURTON, M. - Identification of Leishmania amastigotes and their antigens in formalin fixed tissue by immunoperoxidase staining. Trans, roy. Soc. trop. Med. Hyg., 75: 461-468, 1981.
21. STERNBERGER, L. A.; HARDY, P. H.; CUCULIS, J. J. & MEYER, H. G. - - The unlabeled antibody enzyme method of immunohistochemistry. Preparation and properties of soluble antigen-antibody complex (horseradish peroxidase-antihorseradish peroxidase) and its use in identification of spirochetes. J. Histochem. Cytochem., 18: 315-333, 1970.
²²
UNDP/WORLD BANK/WHO - Special programme for research and training in Tropical Diseases. TDR/PR-6/ 83.7-LEISH, 1983.
23. URCUYO, F. G. & ZAIAS, N. - Oral ketoconazole in the treatment of leishmaniasis. Int. J. Derm., 21: 414-416, 1982.
24. WHO - The Leishmaniasis. Report of a WHO Expert Committee. Wld. Hlth. Org. techn. Rep. Ser., (701): 43, 1984.
25. WINSLOW, D. J. - Histopathologic diagnosis of protozoal diseases. Path. Ann., 3: 29-54, 1968.

Address for correspondence:

Prof. Cesare Mariscotti.

IIICattedra di Anatomia ed Istologia Patológica

Via Commenda 19; I - 20122 Milano, Italy.

Publication Dates

Publication in this collection
17 Feb 2011
Date of issue
Aug 1987

History

Received
23 Oct 1986

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ALLEN, A. C - The skin. A clinicopathologic treatise. St. Louis, CV. Mosby Company, 1954. p. 496-501.

[2] 2. AZADEH, B.; SAM AD, A. & ARDEHALI, S. - Histological spectrum of cutaneous leishmaniasis due to leishmania tropica. Trans, roy. Soc. trop. Med. Hyg , 79: 631-666, 1985.

[3] 3. BARB ARESCHI, M.; MARISCOTTI, C.; MISSONI, E. & MORELLI, R. - Russel bodies in New World cutaneous leishmaniasis. Pathologica, 77: 87-90, 1985.

[4] 4. HAGHIGHI, P. & R£ZAI, H. R. - Leishmaniasis: a review of selected topics. Path. Ann., 12: 63-89, 1977.

[5] 5. JANSSEN, P.; VAN BOGAERT, L. & HAYMAKER, W. - Pathology of the pheripheral nervous system in African trypanosomiasis. J. Neuropath. Neurol., 15: 269-287, 1956.

[6] 6. JONES, T. C - Interactions between murine macrophages and obbligate intracellular protozoa. Amer. J. Path., 102: 127-132, 1981.

[7] 7. LAINSON, R. - The American leishmaniasis: some observations on their ecology and epidemiology. Trans, roy. Soc. trop. Med. Hyg., 77: 569-596, 1983.

[8] 8. LEVER, W. F. - Histopathology of the skin. Philadelphia, Lippincott, 1977.

[9] 9. MAGALHÃES, A. V.; CHIARINI, L. H. & RAICK, A. N. - Histopatologia da leishmaniose tegumentar. Rev. Inst. Med. trop. S. Paulo, 24: 268-276, 1982.

[10] 10. MISSONI, E. & MORELLI, R. - Survey of 59 cases of American cutaneous leishmaniasis in Nicaragua. J. trop. Med. Hyg., 87: 159-165, 1984.

[11] 11. MORIEARTY, P. L.; GRIMALDI, G.; GALVÃO-CASTRO, B.; OLIVEIRA NETO, M. P. & MARZOCHI, M. C. A. - Intralesional plasma cells and serological responses in human cutaneous leishmaniasis. Clin, exp. Immunol., 47: 59-64, 1982.

[12] 12. PLORDE, J. J. - Leishmaniasis. In: Harrison's principles of internal medicine. 10th ed. New York, Mc draw Hill, 1983. p. 873-876.

[13] 13. RIDLEY, D. S. - A histological classification of cutaneous leishmaniasis and its geographical expression. Trans, roy. Soc. trop. Med. Hyg., 74: 515-521, 1980.

[14] 14. RIDLEY, D. S. - Histopathogenic mechanisms in leishmaniasis. Pathologica, 75: 471-479, 1983.

[15] 15. RIDLEY, D. S. - The pathogenesis of cutaneous leishmaniasis. Trans, roy. Soc. trop. Med. Hyg., 73: 150-160, 1980.

[16] 16. RIDLEY, D. S.; MARSDEN, P. D.; CUBA, C. C. & BARRETTO, A. C. - A histological classification of mucocutaneous leishmaniasis in Brazil and its clinical evaluation. Trans, roy. Soc. trop. Med. Hyg., 74: 508-514, 1980.

[17] 17. RIDLEY, D. S. & RIDLEY, M. Y. - The evolution of the lesion in cutaneous leishmaniasis. J. Path., 141: 83-96, 1983.

[18] 18. RHODE, R. - Mikroskopische und kulturelle Diagnostik der kutanen Leishmaniase. Der Hautarzt, 31: 560-561, 1980.

[19] 19. SEHGAL, V. N.; SINGH, K. & GHORPADE, A. - Cutaneous leishmaniasis. A few salient revelations. Dermatologica, 166: 111-112, 1983,

[20] 20. SELLS, P. G. & BURTON, M. - Identification of Leishmania amastigotes and their antigens in formalin fixed tissue by immunoperoxidase staining. Trans, roy. Soc. trop. Med. Hyg., 75: 461-468, 1981.

[21] 21. STERNBERGER, L. A.; HARDY, P. H.; CUCULIS, J. J. & MEYER, H. G. - - The unlabeled antibody enzyme method of immunohistochemistry. Preparation and properties of soluble antigen-antibody complex (horseradish peroxidase-antihorseradish peroxidase) and its use in identification of spirochetes. J. Histochem. Cytochem., 18: 315-333, 1970.

[22] ²²
UNDP/WORLD BANK/WHO - Special programme for research and training in Tropical Diseases. TDR/PR-6/ 83.7-LEISH, 1983.

[23] 23. URCUYO, F. G. & ZAIAS, N. - Oral ketoconazole in the treatment of leishmaniasis. Int. J. Derm., 21: 414-416, 1982.

[24] 24. WHO - The Leishmaniasis. Report of a WHO Expert Committee. Wld. Hlth. Org. techn. Rep. Ser., (701): 43, 1984.

[25] 25. WINSLOW, D. J. - Histopathologic diagnosis of protozoal diseases. Path. Ann., 3: 29-54, 1968.

Brasil

Brasil

Histological and immunohistochemical aspects of cutaneous leishmaniasis in nicaragua

Aspectos histológicos e imunohistoquírnicos da leishmaniose cutânea na Nicarágua

Abstracts

Publication Dates

History