Vocal cord basement membrane in non-sudden infant death syndrome cases

Influence of inflammatory infiltrate and alterations of the blood flow in the etiopathogenesis of the basement membrane of the amniotic epithelium (BMAE) thickening in patients with hypertensive syndromes in pregnancy

PURPOSE

To evaluate the mechanisms involved in the etiology of the basement membrane of the amniotic epithelium (BMAE) thickening in patients with hypertensive syndromes in pregnancy (HSP).

METHODS

Eighty placentas from patients presenting HSP were morphologically examined in staining through hematoxylin-eosin and periodic acid Schiff method. Placental morphological changes were classified into: diagnostic of low placental blood flow, characterized by a larger number of syncytial knots, fibrin deposits, and a larger number of vessels in terminal villi; and placentas with inflammation that presented inflammatory infiltrate in membranes or placental villi. Measurements of thickness were made with an automatic image analyzing software.

RESULTS

BMAE thickness was higher in the group with HSP, particularly in cases with gestational hypertension and pre-eclampsia superimposed on chronic hypertension (PSCH). In the placentas of the HSP group, the thickness of the BMAE was higher in cases with inflammatory infiltrate. There was a positive and significant correlation between the BMAE thickness and the thickness of the amniotic epithelium. The BMAE thickening areas were associated with hyperplasia and edema of the amniotic epithelium.

CONCLUSIONS

BMAE thickening in cases with HSP is more evident when there is an interaction between the severe effects of uteroplacental hypoxia, with consequent death and remodelling of the amniotic epithelium cells, as in PSCH, with local inflammatory processes that make this thickening much more evident.

Morphological characterization of the false vocal cords as larynx-associated lymphoid tissue

The lymphoid follicles (LF) found in the false vocal cords (FVC) protect the upper air tracts, similar to the lymphoid tissue associated to the respiratory mucosas. However, studies that characterize the phenotype of cells like larynx-associated lymphoid tissue (LALT) are lacking. We analyzed the FVC of autopsied adults according to morphometric and immunohistochemical criteria and defined their possible role as LALT. We analyzed 249 FVC. Primary antibodies, CD68+ macrophages, CD20+, CD3+, and FDC+ were used for the evaluation of inflammatory cell phenotypes. In 40.6% of the cases, there was an inflammatory reaction. In 42.2% of the cases, LF were identified in the submucosa. In 17.3% of the cases, neither LF nor mononuclear cells were identified in the FVC, and these patients were from an older age group (p=0.013). A significant increase in the number of all LF cell phenotypes was observed in patients with pulmonary inflammation; the difference in both T- and B-lymphocytes was statistically significant (p=0.010). The morphological findings of LF suggest a probable participation of the FVC in the protection of the larynx and lungs, and similarity to LALT.

Histopathologic changes in human true vocal folds: a postmortem study

Several articles describe the gross pathology alterations of the true vocal cords (TVC), but the histopathology descriptions in adults are rare in the literature and are normally associated with neoplasia. The aim of this study is to identify the TVC morphological lesions in adult autopsies. This was a cross-sectional study of 266 adults' larynxes consecutively autopsied from 1993 to 2003. Histochemical and immunohistochemical methods were used for morphological analysis. Considering the morphological analysis, 97 TVC (36.5%) were considered normal. The following lesions were found in the TVC: thickening of the basal membrane of the TVC in 81 patients (30.5%), inflammatory reaction in 66 patients (24.8%), hemorrhage in 19 patients (7.1%), and ulceration in 3 patients (1.1%). Our study demonstrated that the TVC microscopic lesions are frequent, present different morphological patterns, and showed different causes from what had been described until nowadays by the literature. Despite this difference in the morphological pattern, we were able to identify a common lesion pathway for ethiological different diseases.

Thickening of the amnion basement membrane and its relationship to placental inflammatory lesions and fetal and maternal disorders

OBJECTIVE

The aim of this study is the morphological and morphometric analysis of the basement membrane amniotic epithelium of the chorionic plate to establish possible correlation between the basement membrane amniotic epithelium thickening and maternal and fetal disorders.

STUDY DESIGN

Ninety-one placentas of infants delivered in Medical Hospital School were studied with hematoxylin-eosin (H&E) and Periodic Acid Schiff (PAS) methods, morphometric and ultrastructural analysis.

RESULTS

Of the 91 placentas analyzed, 17 (18.6%) were normal with regard to placental morphology, fetal and maternal history. Basement membrane amniotic epithelium thickening was significantly greater in the cases associated with chorioamnionitis (P=0.013), villitis (P=0.040), maternal hypertension syndromes during pregnancy (P=0.027) and stillborn (P=0.040) babies. The electron microscopic examination of the basement membrane amniotic epithelium identified a structural alteration and edema of the dense lamina.

CONCLUSION

Thickening of the basement membrane amniotic epithelium was associated with morphologic placental abnormalities and/or fetal or maternal disorders. Thickening of the basement membrane amniotic epithelium was identified away from the site of placental inflammation, possibly being a consequence of cytokines, supporting more than a local effect. This could be a new insight into the pathogenesis of fetal and maternal complications associated with inflammatory placental lesions.

Relationship between the morphologic alterations of vocal cords from adult autopsies and the cause of death

PURPOSE

The purpose of this study was to identify the possible alteration in the thickness of the epithelium basal membrane of the vocal cords and correlate it with the cause of death.

METHOD

Larynxes collected from adult autopsies during the period of 1993 to 2001 were utilized. We used the hematoxylin-eosin and periodic acid-Schiff staining methods for the morphological and morphometric analysis.

RESULTS

Sixty-six vocal cords were analysed; increased thickness was identified in 14 cases (21.2%), with equal proportions between the genders. Increased vocal-cord thickness was more frequent in patients of the white ethnicity (12 cases, 85.7%). Respiratory alterations were found in 10 (71.4%) of the cases with increased vocal-cord thickness. Of the patients that were maintained with mechanical ventilation before death, 7 (18.4%) had thickening of the basal membrane. Among the smokers, 9 (19.63%) had basal membrane thickening.

CONCLUSION

No statistically significant differences were found between the cases in which the cause of death was related to respiratory diseases as compared to non-respiratory diseases and the thickening of the basal membrane of the vocal cords. However, new studies are needed in order to verify the etiopathogenesis of this thickening.