Chronic GVHD in minor salivary glands and oral mucosa: histopathological and immunohistochemical evaluation of 25 patients.
BACKGROUND
Graft-vs.-host disease (GVHD) is the major cause of morbidity and mortality in patients undergoing allogeneic Bone Marrow Transplantation (BMT). The aim of our study was to identify the most relevant histological features for diagnosis of chronic Graft-vs.-Host Disease (cGVHD) in oral mucosa and minor salivary glands of 25 patients, as well as to evaluate the immunophenotype of the inflammatory cells.


METHODS
Sixteen patients that were submitted to allogeneic BMT but did not present cGVHD were selected as a control group. The sections were studied on H & E and CD68, CD45, CD4, CD8, CD20 staining.


RESULTS
The most frequent histologic findings in oral mucosa at the day of diagnosis of cGVHD were: hydropic degeneration of the basal layer of the epithelium, apoptotic bodies, lymphocytic infiltration, and focal or total cleavage between the epithelial and connective tissue. In the labial salivary glands (LSG), lymphocytic infiltration, acinar loss and fibrosis were the main alterations. Cytotoxic CD8-T cells and macrophages were predominant both in the epithelium and connective tissue, as well as in minor salivary glands.


CONCLUSIONS
Histological features were useful in the diagnosis of oral cGVHD. It is suggested that CD8-T cells and macrophages play important role in the pathogenesis of the disease.
Soares
A B
AB
Department of Oral Pathology, State University of Campinas, Campinas-SP, Brazil. marialet@fcm.unicamp.br
Faria
P R
PR
Magna
L A
LA
Correa
M E P
ME
de Sousa
C A
CA
Almeida
O P
OP
Cintra
M L
ML
D000293:Adolescent; D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D018951:Antigens, CD20 / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D017209:Apoptosis; D015704:CD4 Antigens / Q000032:analysis; D016827:CD8 Antigens / Q000032:analysis; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology; D002908:Chronic Disease; D003238:Connective Tissue / Q000473:pathology; D004848:Epithelium / Q000473:pathology; D005260:Female; D006086:Graft vs Host Disease / Q000276:immunology / Q000473:pathology*; D006801:Humans; D017493:Leukocyte Common Antigens / Q000032:analysis; D008214:Lymphocytes / Q000473:pathology; D008264:Macrophages / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000276:immunology / Q000473:pathology*; D009061:Mouth Mucosa / Q000276:immunology / Q000473:pathology*; D012189:Retrospective Studies; D012466:Salivary Gland Diseases / Q000276:immunology / Q000473:pathology*; D012470:Salivary Glands, Minor / Q000276:immunology / Q000473:pathology*; D000097382:CD68 Molecule
D015703:Antigens, CD; D018951:Antigens, CD20; D015214:Antigens, Differentiation, Myelomonocytic; D015704:CD4 Antigens; D016827:CD8 Antigens; D017493:Leukocyte Common Antigens; C067980:CD68 antigen, human; D000097382:CD68 Molecule