Imaging exams of bone lesions in patients with diffuse cutaneous leishmaniasis (DCL)

Abstract

We studied bone lesion alterations in three patients with diffuse cutaneous leishmaniasis (DCL) by imaging exams (radiography and scintigraphy) and histopathology. Two patients had bone lesions of distal extremities of hands and feet, and one infiltrating plaques in the skin. The study was conducted at three specialized centers (Presidente Dutra Hospital/Nucleus of Tropical Pathology, UFMA-MA; Gonçalo Moniz Research Center-FIOCRUZ-BA; Laboratory of Pathology of Infectious Diseases (LIM-50), University of São Paulo, SP). Three-phase bone scintigraphy demonstrated high sensitivity and specificity for bone lesions, showing increased uptake of the radiopharmaceutical at sites of active lesions. In contrast, radiography demonstrated lytic lesions, cortical destruction and local osteopenia of the bone extremeties in two patients. Histopathological analysis showed sequestration with presence of amastigote forms of Leishmania (osteomyelitis), mononuclear cells and macrophages containing amastigote forms of Leishmania in one patient. These preliminary data indicate that imaging exams (radiography and scintigraphy) are important in the evaluation of bone lesions in diffuse cutaneous leishmaniasis and should be included in the routine histopathological diagnosis of the disease and follow-up of bone lesions.

The limited knowledge of placental damage due to neglected infections: ongoing problems in Latin America

“…The non-classical cutaneous leishmaniasis transmission is less studied, because in this case, the parasites are predominantly found in cells of the phagocytic system and externally in the skin or in mucosal tissues, where the clinical symptoms of the disease occur. However, this does not make it impossible for the parasite to colonize other organs, such as the placenta and it is possible for parasites to reach the Hofbauer cells, considered as the central lineage of Leishmania target cells in this organ (Costa et al 2005;Reithinger and Dujardin 2007;Romero et al 2010).…”

Leishmania-host interactions: what has imaging taught us?

“…This has included the use of computer tomography (CT) scanning to examine tracheal involvement in cutaneous leishmaniasis (Viglianesi et al ., 2011) and identification of nodules in the liver and spleen of visceral leishmaniasis patients (Angarano et al ., 1998; Bukte et al ., 2004). Additionally, radiographic and scintigraphic studies were used to determine the level of bone involvement in a diffuse cutaneous leishmaniasis patient (Costa et al ., 2005). While not exhaustive, the above list of studies suggests that these methodologies may be of significant use and improvement in the sensitivity of these technologies may allow progress, albeit in a research capacity.…”

Expressão de Foxp3, IL-17 e IL-23 na Leishmaniose Tegumentar Americana causada por Leishmania (Leishmania) amazonensis e Leishmania (Viannia) braziliensis

“…Na forma clínica LCDB por L. (V.) braziliensis, predomina a reação exudativa, linfoplasmocitária, com poucos macrófagos parasitados, além de áreas de necrose associadas ou não ao granuloma epitelióide (Silveira et al, 2008 (Silveira et al, 1990(Silveira et al, , 2004. Em casos de LCAD muito avançados, com lesões ósseas de extremidade, pode ser observado um tipo de osteomielite causada por L. (L.) amazonensis (Costa et al, 2005;Costa et al, 2006). intenso infiltrado celular caracterizado por linfócitos, plasmócitos, poucos histiócitos e escassez de parasitas (Magalhães et al, 1986, Silveira et al, 2004.…”