Ligia Maria Barbosa Coutinho | Universidade Federal de Ciências da Saúde de Porto Alegre (original) (raw)

Papers by Ligia Maria Barbosa Coutinho

JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA, 2018

O ganglioglioma desmoplásico infantil (GDI) é um tumor raro, que pertence ao grupo dos tumores mi... more O ganglioglioma desmoplásico infantil (GDI) é um tumor raro, que pertence ao grupo dos tumores mistos neurogliais, descrito pela primeira vez por VandenBerg, em l98716: São tumores supratentoriais, volumosos, apresentando freqüentemente envolvimento leptomeníngeo. O exame anatomopatológico evidencia intensa desmoplasia, com diferenciação astrocítica e ganglionar, bem como o teste imunoistoquímico apresenta resultado positivo para “glial fibrillary acidic protein” (GFAP). São relatados dois casos de GDI e discutidos os aspectos clínicos e terapêuticos dos referidos casos.

Arquivos de Neuro-Psiquiatria, 1988

Foram estudados 190 casos de AVC autopsiados no Departamento de Patologia da Fundação Faculdade F... more Foram estudados 190 casos de AVC autopsiados no Departamento de Patologia da Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, tendo sido encontrados 94 (49,4%) casos de hemorragia, 67 (35,26%) de infartos e, em 29 (15,26%) casos, observou-se associação de hemorragia e infarto. Tanto os infartos quanto as hemorragias foram mais freqüentes em homens que em mulheres. As médias de idade foram 34,9 anos para as hemorragias e 48,6 anos para os infartos. Dos AVC hemorrágicos, a variedade intraparenquimatosa foi a mais freqüente. Os infartos predominaram em território da artéria cerebral média. As causas determinantes de hemorragia foram principalmente a hipertensão arterial sistêmica e processos infecciosos. No grupo dos infartos, a aterosclerose predominou.

Arquivos de Neuro-Psiquiatria, 1987

The observation of generalized GM1 gangliosidosis type 1 (Norman-Landing disease) is reported. Th... more The observation of generalized GM1 gangliosidosis type 1 (Norman-Landing disease) is reported. The case is typical, featuring all the main clinical and biological signs of the disease. Diagnosis was established by the demonstration of a severe deficit in beta-galactosidase activity in leucocytes, by the demonstration of oligosacarides in the urine, and by the histological examination after the fatal outcome before the age of two with severe respiratory distress.

J Bras Neurocir, Dec 1, 1994

Rev Hcpa Fac Med Univ Fed Rio Gd Do Sul, Jun 1, 1986

Open Journal of Pathology, 2012

This study aimed to assess the effect of intracellular prolactin (ICPRL) and hyperprolactinemia o... more This study aimed to assess the effect of intracellular prolactin (ICPRL) and hyperprolactinemia on cell replication, using an immunohistochemical (IHC) technique for Ki-67 and Mcm-2, and angiogenesis, using IHC for endoglin CD-105, in central nervous system (CNS) tumors. This cross-sectional study included 79 cases of surgically excised primary CNS tumors of neuroepithelial origin (41.8% of all cases: 10.2% astrocytomas, 24% glioblastomas and 7.6% oligodendrogliomas) and meningeal origin (58.2% of all cases). Ki-67 and Mcm-2 indexes were calculated as a percentage of marked cells. The medians for Ki-67 and Mcm-2 indexes were significantly lower in meningiomas than in glioblastomas (p < 0.001 for Ki-67 and p < 0.001 for Mcm-2) and oligodendrogliomas (p < 0.001 for Ki-67 and p = 0.02 for Mcm-2). A good correlation was observed between the Ki-67 and Mcm-2 (r S = 0.60) replication markers. There were no significant differences in vascular density between the different histological types. Immunohistochemistry for ICPRL was positive in 45.6% of the tumors. Serum prolactin (PRL) was elevated in 30.6% of the cases. Multiple regression analysis revealed no important correlation of ICPRL and serum PRL on Ki-67 and Mcm-2 indexes or vascular density. The analysis of the combined impact of ICPRL and serum PRL variables revealed a trend towards an increase in microvessel density in tumor tissue and a significant increase in cell replication markers (p = 0.009 for Ki-67 and p = 0.05 for Mcm-2). PRL in tumor tissue may be one of the modulating factors of cell proliferation in the CNS.

Hepato-gastroenterology

Tumor angiogenesis has been proposed as essential to tumor growth, proliferation and metastases h... more Tumor angiogenesis has been proposed as essential to tumor growth, proliferation and metastases however, for gallbladder neoplasia, these data remain obscure. Therefore, it was performed this study with the objective of evaluating the prognostic value of angiogenesis in gallbladder cancer. Thirty cases of gallbladder carcinoma were studied by immunohistochemical technique with antibody anti-CD105 for the identification of neoformed intratumoral vessels. The intratumoral micro vessel density was evaluated by Chalkley counting method, and researched the association of this index with the survival rate and the prognostic factors. It was obtained, starting from the analysis of these data, a cut off in the index of the tumor vascular density at 8.5. It was observed an association between high intratumoral micro vessel density (index above or equal to 8.5) and survival rate lower to 6 months in 84.6% of cases. The present study confirms the hypothesis that a high vascular density, apprais...

Neuropathology, 2010

Evidence suggests that sex hormones may play a role in the tumorigenesis of meningiomas, and stud... more Evidence suggests that sex hormones may play a role in the tumorigenesis of meningiomas, and studies have demonstrated the expression of hormone receptors in these tumors. Aromatase expression has been detected in several normal tissues, including neurons in the CNS, and tumor tissues. We aim to assess the expression of aromatase (ARO) and of progesterone receptor (PR), estrogen receptor (ER) and androgen receptor (AR) in both normal and neoplastic meningeal cells. A cross-sectional study was conducted with 126 patients diagnosed with meningioma (97 women and 29 men; mean age, 53.6 years) submitted to neurosurgery at Hospital São José, Complexo Hospitalar Santa Casa de Porto Alegre, southern Brazil. Control sections of normal meningeal cells, 19 patients, were obtained by evaluating the arachnoid tissue present in the arachnoid cyst resected material. Immunohistochemistry was applied to assess ARO, PR, ER and AR. Aromatase expression was detected in 100% of the control patients and in 0% of the patients with meningioma. ER was present in 24.6% of the meningiomas and in 0% of the controls, AR in 18.3% of the meningiomas and in 0% of the controls, and PR in 60.3% of the meningiomas and in 47.4% of the controls. A positive association was observed between the presence of AR and ER (OR 3.7; P = 0.01) in meningiomas. There were no significant differences in the presence of hormone receptors between meningioma histological subtypes. PR expression in women with meningioma was significantly higher than that found in men (OR 2.3; P = 0.08). Behavior pattern differences observed between aromatase expression, present in normal tissues and absent in meningiomas, and estrogen and androgen hormone receptors, absent in normal tissues and present in meningiomas, suggest that there is heterogeneity in modulation by sex steroids in the development of these tumors.

Endocrine Pathology, 2010

Pituitary adenomas (PA) occasionally show aggressive behavior, with invasion of the surrounding t... more Pituitary adenomas (PA) occasionally show aggressive behavior, with invasion of the surrounding tissues. The identification of markers able to recognize aggressive PA in early stages remains a challenge. We aimed to determine the expression of a new cell proliferation marker, Mcm2, and the presence of apoptosis in PA, and to evaluate the association of clinicopathological features with the apoptotic and proliferative indices. Additionally, the TGF-β1 expression, an inducer of apoptosis, was determined. The proliferative index was determined in GH-secreting or clinically nonfunctioning PA using immunohistochemical (IH) methods for Mcm2 and Ki-67 antigens. The apoptosis was assessed by the TUNEL method and the TGF-β1 expression by IH. A significant positive correlation was found between log Mcm2 index and log Ki-67 index (p<0.001). Mcm2 and Ki-67 detected a similar number of proliferating cells. Mcm2 index showed a significant association with tumor extension (p=0.02), but not with tumor invasion. Apoptosis was detected in 17% of the adenomas, with a maximum apoptotic index of 0.77%. Immunoreactivity to TGF-β1 was observed in 77% of the adenomas, showing an association with tumor extension. We concluded that, in this sample, Mcm2 was similar to Ki-67 in the identification of the proliferating cells and that apoptosis was rare.

Brazilian Journal of Medical and Biological Research, 2004

Pituitary adenomas sometimes show rapid growth and recurrence, and about one third invade the str... more Pituitary adenomas sometimes show rapid growth and recurrence, and about one third invade the structures surrounding the sella turcica. In an attempt to determine aggressive behavior at an early stage, we used the MIB-1 antibody to identify the Ki-67 antigen. The present study was designed to evaluate pituitary adenomatous tissue in terms of secretion and proliferation and to correlate the Ki-67 index with hormone phenotype and invasive behavior. Material from 159 patients submitted to one or more resections of pituitary adenomas was evaluated. Forty-two non-secretory adenomas and 43 adenomas immunoreactive for growth hormone, 19 for prolactin, 18 for growth hormone and prolactin, 16 for adrenocorticotropic hormone (ACTH), and 21 cases of plurihormonal/gonadotropin adenomas were detected by immunohistochemistry. The MIB-1 antibody was positive in 139 samples and the Ki-67 index ranged from 0.16 to 15.48% (mean = 1.22 ± 2.09%), with no significant difference between genders, age groups, or secretory and non-secretory status. The Ki-67 index was higher in ACTH-secreting adenomas. Invasive pituitary adenomas had a significantly higher Ki-67 index (2.01 ± 3.15%) than macroadenomas with or without supra-sellar extension (1.12 ± 1.87%; P = 0.02). The index was not significantly different in the subgroup of adenomas with invasion of the cavernous sinus compared to groups with other types of invasion. We conclude that tumoral proliferative activity evaluated by the detection of the Ki-67 antigen is significantly higher in invasive than noninvasive adenomas, information which can be useful in therapeutic postoperative management since index cutoff values associated with aggressive behavior can be established.

Arquivos de Neuro-Psiquiatria, 1981

É relatado um caso de paciente feminina. 28 anos, preta, que iniciou sintomatologia por distúrbio... more É relatado um caso de paciente feminina. 28 anos, preta, que iniciou sintomatologia por distúrbios de comportamento e, alguns meses após, apresentou alterações neurológicas. A tomografia computadorizada do encéfalo revelou lesões granulomatosas múltiplas, com calcificação. A paciente faleceu e a autópsia revelou lesões encefálicas granulomatosas, com necrose central do tipo caseosa, que demonstrou, ao exame microscópico, serem produzidas pelo Histoplasma capsulatum. Os autores ressaltam ser o primeiro caso de histoplasmoma encefálico publicado no Brasil. Assinalam também a importância da tomografia computadorizada no diagnóstico das lesões, bem como as alterações do líquido cefalorraquidiano encontradas nesses casos.

Arquivos de Neuro-Psiquiatria, 2008

Medulloblastoma (MB) is the most common malignant brain tumor in childhood. The alterations found... more Medulloblastoma (MB) is the most common malignant brain tumor in childhood. The alterations found include: presence of oncoproteins p53 and HER2, elevated mitotic index, and presence of neuronal differentiation. The aim of this study was to determine the immunohistochemical expression of markers Ki-67, NeuN, synaptophysin, HER2 and p53 in 40 MB samples and their correlation with clinicopathologic parameters and survival. In 29 patients (72.5%), >20% of cells were positive for Ki-67. Males showed greater ki-67 expression (p=0.02) and smaller survival rates (p=0.002). NeuN and synaptophysin were negative in 16 (40%) and 8 (20%) cases, respectively. P53 was positive in 18 (45%) cases, with 11 (61%) weakly positive and 7 (39%) strongly positive. HER2 was positive in 23 (57.5%) of the samples and did not show statistical association with survival (p=0.07).

Arquivos de Neuro-Psiquiatria, 1999

Fazemos uma análise das alterações neuropatológicas encontradas em 300 casos consecutivos de ciru... more Fazemos uma análise das alterações neuropatológicas encontradas em 300 casos consecutivos de cirurgia da epilepsia realizadas durante período de 6 anos. O material foi predominantemente de lobo temporal (70,33%), sendo a esclerose hipocampal o diagnóstico mais frequente (44%), seguido das neoplasias (15%) e dos distúrbios da migração neuronal (10%). Os tumores mais frequentes foram o ganglioglioma (42,22%) e tumor neuroepitelial disembrioplástico (20%). Segue revisão dos diagnósticos mais comuns em epilepsia baseados nessa série e relatados na literatura.

Arquivos de Neuro-Psiquiatria, 2004

Glioblastoma is the most common neuroectodermic tumor. It is also the most malignant one. Many ge... more Glioblastoma is the most common neuroectodermic tumor. It is also the most malignant one. Many genetic changes are found in glioblastomas, among them, the presence of oncoproteins p53 and blc-2, as well as a high mitotic level and the presence of apoptosis. The utility of such findings through immunohistochemistry for the prognosis of patients remains uncertain. Our objectives in this study were to verify the presence of apoptosis, blc-2, p53, and the proliferative index (MIB-1), through immunohistochemistry, in 30 glioblastomas obtained by surgical resection between August 2000 and August 2001, as well as correlations between those immunohistochemical variables and the patient's age and survival time. Correlations between immunohistochemical variables themselves were also examined. For correlation calculations, Pearson's and Spermann's correlations were used and the time of survival was calculated with the Kaplan-Meier method. RESULTS: No correlation was found between i...

Arquivos de Neuro-Psiquiatria, 1974

Foi realizado um estudo de 34 casos de reticulossarcomas localizados no tecido epidural intraespi... more Foi realizado um estudo de 34 casos de reticulossarcomas localizados no tecido epidural intraespinal. Assinala-se sua maior freqüência entre homens com mais de 50 anos, embora pacientes mais jovens possam ser acometidos, principalmente entre 15 e 29 anos. A distribuição segmentar dos tumores permite um diagnóstico diferencial, sendo a região torácica a sede mais freqüentes de sarcomas. O principal sintoma encontrado nos pacientes com reticulossarcoma foi a dor, do tipo radicular, que serve para diferenciar os tumores intra e extra-medulares, tendo sido de aparecimento precoce em 15 dos pacientes estudados, precedendo em muitos meses e até anos os demais sintomas. Classificou-se os tumores reticulohistiocitários epidurais do canal vertebral em três grupos, de acordo com seu aspecto tecidual e celular e, principalmente, com a presença e distribuição da reticulina. Relacionou-se o tempo de evolução desses tumores com seu aspecto histopatológico, chegando-se à conclusão que os tumores c...

Arquivos de Neuro-Psiquiatria, 1976

É relatado um caso de paciente, de 60 anos, que apresentou tumor nos segmentos apical e posterior... more É relatado um caso de paciente, de 60 anos, que apresentou tumor nos segmentos apical e posterior direitos, cujo diagnóstico histopatológico foi de carcinoma indiferenciado. O paciente foi submetido à cobaltoterapia, tendo melhorado por três meses, quando foi novamente hospitalizado por dor lombar. A mielografia com lipiodol mostrou processo expansivo intrarraqueano. Mediante cirurgia foi encontrado tumor intra-dural, englobando raízes nervosas. O diagnóstico microscópico foi de carcinoma indiferenciado infiltrando os espaços epi e peri-neurais.

Arquivos de Neuro-Psiquiatria, 1978

É relatado um caso com associação de glioblastoma heteromorfo e de meningioma meningotelial, cuja... more É relatado um caso com associação de glioblastoma heteromorfo e de meningioma meningotelial, cuja manifestação inicial foi crise convulsiva focal. Por ser infrequente a associação de neoplasias intracranianas, discute-se a forma de expressão clínica, as teorias referentes à presença concomitante de tais associações tumorais e, ainda, o valor do diagnóstico pré-operatório no estabelecimento da conduta cirúrgica e do prognóstico em tais ocasiões.