title: Immunohistopathology of the Newly Discovered Giant Papillae Tongue Disorder in Organ-Transplanted Children.
abstract: Giant papillae tongue disorder (GPTD) is a newly discovered, long-lasting clinical disorder that may develop in organ-transplanted pediatric recipients. The key feature of this disorder is the unique tongue lesion, which comprises swollen fungiform papillae. The aim of this study was to characterize the immunohistopathology of this novel inflammatory condition.
  
  
  
  Six organ transplanted children with GPTD were included in the study. Routine histopathology and immunohistochemical stainings for CD3, CD4, CD8, CD25, FOXP3, CD20, CD138, CD68, CD1a, CD15, CD23, and mast cell tryptase were performed.
  
  
  
  Immunohistochemical analyses of the oral lesions revealed a subepithelial infiltrate that was primarily composed of CD3- and CD4-positive T cells, CD20-expressing B cells, macrophages, and CD138-positive plasma cells. The CD20-positive cells did not display the typical B cell morphology, having in general a more dendritic cell-like appearance. The CD138-expressing plasma cells were distinctly localized as a dense infiltrate beneath the accumulation of T cells and B cells. Increased numbers of CD1a-expressing Langerhans cells were detected both in the epithelium and connective tissue. Because no granulomas were observed and only single lesional eosinophils were detected, GPTD does not resemble a granulomatous or eosinophilic condition.
  
  
  
  We describe for the first time the immunopathological characteristics of a novel inflammatory disorder of the oral cavity, which may develop after solid organ transplantation in children.
authors.affiliation: 1 Department of Stomatology, University of São Paulo, São Paulo, Brazil. 2 Stomatology Department, A.C. Camargo Hospital, São Paulo, Brazil. 3 Department of Oral Medicine and Pathology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 4 Department of Liver Transplantation, A.C. Camargo Hospital, São Paulo, Brazil. 5 Pediatrics Department, University of São Paulo, São Paulo, Brazil. 6 Department of Anatomic Pathology, Hospital AC Camargo, Sao Paulo, SP, Brazil. 7 Department of Oral Pathology, Malmö University, Malmö, Sweden. 8 Department of Paediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Fábio de Abreu
authors.initials: FA
authors.lastname: Alves
authors.forename: Gita
authors.initials: G
authors.lastname: Gale
authors.forename: Ana Paula Molina
authors.initials: APM
authors.lastname: Vivas
authors.forename: Gilda
authors.initials: G
authors.lastname: Porta
authors.forename: Felipe D Almeida
authors.initials: FDA
authors.lastname: Costa
authors.forename: Gunnar
authors.initials: G
authors.lastname: Warfwinge
authors.forename: Mats
authors.initials: M
authors.lastname: Jontell
authors.forename: Robert
authors.initials: R
authors.lastname: Saalman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D001938:Brazil; D002648:Child; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007249:Inflammation / Q000276:immunology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016377:Organ Transplantation / Q000009:adverse effects*; D013548:Sweden; D014060:Tongue Diseases / Q000276:immunology* / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007166:Immunosuppressive Agents