title: Interrelationship of clinical, histomorphometric and immunohistochemical features of oral lesions in chronic paracoccidioidomycosis.
abstract: BACKGROUND
  This study aimed to analyze the oral lesions of chronic paracoccidioidomycosis concerning their histomorphometric, immunohistochemical, and clinical features in a standardized sample.
  
  
  METHODS
  Fifty biopsy specimens of oral lesions of chronic paracoccidioidomycosis were submitted to hematoxylin and eosin (H&E), Grocott-Gomori and immunohistochemical staining. Data regarding disease duration and size and number of oral lesions, as well as erythrocytes, leukocytes, lymphocytes, hematocrit, hemoglobin, and erythrocyte sedimentation rate, were collected from medical charts. Granuloma density and number and diameter of buds and fungal cells, and IL-2, TNF-alpha and IFN-gamma expression, as well as clinical and hematological features, were quantified and correlated.
  
  
  RESULTS
  Bud diameter was significantly greater in intermediate density granulomas compared to higher density granulomas. The other variables (number of buds, number and diameter of fungi, expression of IL-2, TNF-alpha and IFN-gamma, and clinical and hematological features) did not significantly change with the density of granulomas. There was a positive correlation between bud number and fungal cell number (r = 0.834), bud diameter and fungal cell diameter (r = 0.496), erythrocytes and number of fungi (r = 0.420), erythrocytes and bud number (r = 0.408), and leukocytes and bud number (r = 0.396). Negative correlation occurred between number and diameter of fungi (r = -0.419), bud diameter and granuloma density (r = -0.367), TNF-alpha expression and number of fungi (r = -0.372), and TNF-alpha expression and bud number (r = -0.300).
  
  
  CONCLUSIONS
  The histological, immunological, and clinical features of oral lesions evaluated did not differ significantly between patients in our sample of chronic paracoccidioidomycosis. TNF-alpha levels were inversely correlated with intensity of infection.
authors.affiliation: Postgraduate Program of Dental College, Pontifical Catholic University of Rio Grande do Sul - PUCRS, Porto Alegre, RS, Brazil.
authors.forename: Mariana À
authors.initials: MÀ
authors.lastname: de Abreu E Silva
authors.forename: Fernanda G
authors.initials: FG
authors.lastname: Salum
authors.forename: Maria A
authors.initials: MA
authors.lastname: Figueiredo
authors.forename: Tiago G
authors.initials: TG
authors.lastname: Lopes
authors.forename: Vinicius D
authors.initials: VD
authors.lastname: da Silva
authors.forename: Karen
authors.initials: K
authors.lastname: Cherubini
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001799:Blood Sedimentation; D002908:Chronic Disease; D015169:Colony Count, Microbial; D004912:Erythrocytes / Q000473:pathology; D005260:Female; D006099:Granuloma / Q000382:microbiology; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D025301:Hyphae / Q000166:cytology; D007150:Immunohistochemistry; D007371:Interferon-gamma / Q000032:analysis; D007376:Interleukin-2 / Q000032:analysis; D007962:Leukocytes / Q000473:pathology; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000097:blood / Q000382:microbiology*; D010228:Paracoccidioides / Q000166:cytology; D010229:Paracoccidioidomycosis / Q000097:blood / Q000473:pathology*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D006454:Hemoglobins; D007376:Interleukin-2; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma