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Biomedical subjects

A Assi

Publications and source records attributed to A Assi.

At least 19 recordsLinked to original sources

Laser photocoagulation alters the pattern of staining for neurotrophin-4, GFAP, and CD68 in human retina.

AIMS: To investigate the staining pattern of neurotrophin-3 (NT3), neurotrophin-4 (NT4), and brain derived neurotrophic factor (BDNF) as well as glial fibrillary acid protein (GFAP) and CD68 in lasered human retina. METHODS: Retinal laser photocoagulation was performed on four patients (two males, two females) with choroidal malignant melanoma 1-6 days before enucleation. Three other enucleated eyes with malignant melanoma and three normal cadaveric donor eyes were used as controls. Immunohistochemistry was performed to investigate the pattern of staining of NT3, NT4, BDNF, GFAP, and CD68 in 7 mm sections of fixed specimens. RESULTS: Expression of NT4 was detected in the inner and outer nuclear layers of all the retinal sections examined but no NT3 and BDNF staining was seen. NT4 staining was found to be less intense in lasered and melanoma controls compared to normal cadaveric donor retinas. There was an upregulation of GFAP expression in both lasered and control eyes with melanoma in comparison with normal controls. CD68 staining was only observed in retinal pigment epithelium and choroid of lasered eyes. CONCLUSION: NT4 is expressed in inner and outer nuclear layers of normal human retina and its expression is downregulated following laser photocoagulation. This occurs in parallel with an increased expression of GFAP suggesting that reactive changes in Muller cells may be responsible for reduced NT4 staining. Expression of CD68 at the site of laser injury is consistent with a wound healing process as a response to local damage.

Aged↗

Progression on metastatic neuroendocrine carcinoma from a recurrent prolactinoma: a case report.

A 54 year old man was referred to the department of neurosurgery for frontal headache and vomiting. The patient was known in the department because of previous multiple surgery for a locally invasive pituitary prolactinoma (eight years, three years, and one year previously). The neurological examination revealed a frontal mass, which adhered to the dura, suggesting a meningioma. One year later, a left temporal metastasis was removed. Three months later, the patient died, with spinal metastases, of massive lung embolism. Histology revealed a progression of adenohypophyseal prolactinoma on neuroendocrine carcinoma, with an increase in proliferating indexes and modification of hormone production. This study documents a 10 year history of a rare prolactin producing pituitary carcinoma, which metastasised via liquoral flow.

Carcinoma, Neuroendocrine↗

Repeatability and reproducibility of upper eyelid measurements.

AIM: The aim of this study was to assess the repeatability and reproducibility by physicians of upper lid measurements and to investigate the influence of clinical experience on the learning curve effect. METHODS: Both eyes of 22 outpatients were assessed for three basic measures of ptosis: marginal reflex distance (MRD) for upper and lower lids, upper lid skin crease (SC), and levator function (LF). Patients with variable eyelid positions were excluded. The patients were measured twice by a consultant and once by each of a clinical fellow, a specialist registrar, and a senior house officer in random order. Each observer was masked to their colleagues' results and followed a standard measurement protocol. Data were analysed using Bland-Altman plots. RESULTS: Consultant repeatability was high and consistent, the median difference between measures being 0 for each of the four parameters. Clinically acceptable reproducibility was shown in all measurements for even the least experienced physician and was particularly consistent for extreme observations. There was evidence of a learning curve effect. CONCLUSIONS: These results suggest that interobserver and intraobserver variability in assessment of upper lid ptosis using a standard measurement protocol is low and clinically acceptable when the technique of assessment is standardised.

Blepharoptosis↗

Combined phacoemulsification and transpupillary drainage of silicone oil: results and complications.

AIM: To review retrospectively 74 consecutive cases of combined phacoemulsification and transpupillary drainage of silicone oil. METHODS: Candidate patients for intraocular silicone oil removal and cataract extraction underwent combined phacoemulsification and transpupillary drainage of silicone oil through a planned posterior capsulorrhexis and without the use of a pars plana infusion line. RESULTS: The retina remained attached in 59 (79.7%) patients postoperatively. In this success group, the postoperative visual acuity improved in 42 (71.2%) patients. There was no association between age, duration of silicone oil tamponade, preoperative diagnosis, macular status or number and nature of previous surgery, and the incidence of redetachment following silicone oil removal. CONCLUSION: Combined phacoemulsification and transpupillary drainage of silicone oil is a safe and reliable technique that offers the main advantage of diminished surgical trauma.

Adolescent↗

Fine-needle aspiration of testicular lesions: report of 17 cases.

In this article we report on our diagnostic experience of fine-needle aspiration biopsies (FNAB) performed on 17 patients with testicular lesions in the period from 1994-1998. The cytological diagnosis was consistent with seminoma in 7 cases, sex cord-stromal tumors in 3 cases (2 Sertoli cell tumors, 1 Leydig cell tumor), embryonal carcinoma in 3 cases, and yolk-sac tumor in 1 case; the other 3 patients were suffering from flogistic pathology. The cytological diagnosis was confirmed in all cases after surgery. According to our experience, ultrasound FNAB of testicular lesions proved to be a very reliable technique in predicting malignancy with high sensitivity and specificity. None of the patients developed local recurrences or inguinal lymph-node metastasis due to FNAB. Therefore, tumor stage classification (TNM) was not modified in any patient.

Adolescent↗

Hepatic amyloidosis with light chain deposition disease. A rare association.

Monoclonal immunoglobulin deposition diseases are due to pathological protein deposition in various tissues and organs. Protein deposits may be found in a single tissue or systemically and the organs most frequently involved are kidney, heart, peripheral nerves and the liver. Depending on the pattern of the deposits and the type of immunoglobulin, these diseases are distinguished as primary amyloidosis, light chain deposition disease. Differential diagnosis is made in tissue specimens: microscopically by the identification of positive Congo red staining of the deposits, by immunohistochemical demonstration of proteins reacting with light chain (lambda or kappa) antisera or by recognition of fibrillar structures on electron microscopy. We report an unusual case of light chain deposition disease associated with amyloidosis, where hepatomegaly was the presenting manifestation and liver failure the cause of death, without any kidney involvement.

Amyloidosis↗

[Application of PCR in the diagnosis of B-type non-Hodgkin's lymphomas in cytological specimens from fine-needle aspiration].

UNLABELLED: The application of PCR to detect monoclonality at the immunoglobulin heavy chain gene locus in FNA cytologic specimens was evaluated. MATERIALS AND METHODS: Immunoglobulin heavy chain gene rearrangement analysis was performed by a nested PCR for the VDJ region on 27 lymph nodes FNA paraffin embedded by cell blocking technique specimens (1 suspicious of NOS lymphoma, 1 Hodgkin's disease, 6 B cell non Hodgkin's lymphomas, 10 reactive hyperplasias). RESULTS: A monoclonal band was seen in 13 of 17 suspicious or positive malignant cases. The other 4 specimens gave a policlonal pattern. Specimens from reactive lymph nodes produced policlonal bands in 8 cases, no product in 1 case and 1 specimen gave a monoclonal band. When needed, the results of PCR examinations were compared with the subsequent histologic evaluation of the same lymph-node. CONCLUSIONS: From our experience we can see that clonal analysis by PCR based IgH gene rearrangement analysis can be applied to FNA material and can be useful in diagnosis.

Antibodies, Monoclonal↗

Occult sporadic medullary microcarcinoma with lymph node metastases.

A sporadic form of medullary occult microcarcinoma was cytologically diagnosed, by fine-needle aspiration biopsy (FNAB), on metastatic cervical lymph nodes. The cytologic specimens were partially smeared and partially zinc-formalin-fixed, so that a microinclusion clot for immunohistochemical studies would be possible. The reactivity to calcitonin of neoplastic cells obtained from metastatic cervical lymph nodes supported the search for a thyroid tumor, which only a careful echographic study revealed. Under sonographic guidance, FNAB on a 0.5-cm hypoechoid nodule was performed. The smears were diagnostic of medullary carcinoma. A total thyroidectomy with node dissection was made. Diagn. Cytopathol. 1999;21:203-206.

Biopsy, Needle↗

Estimation of the retinal nerve fibre layer thickness in the papillomacular area of long standing stage IV macular holes.

AIM: To compare the thickness of the retinal nerve fibre layer (RNFL) in the papillomacular area of patients with long standing stage IV macular holes with age matched controls, using a scanning laser polarimeter. METHODS: The nerve fibre analyser (NFA) was used to measure the mean thickness of the RNFL around the optic nerve head, the thickness values of temporal and nasal 45 degrees sectors and the integral values in 10 patients with macular holes and in 10 age matched controls. RESULTS: The mean RNFL thickness around the optic nerve head was 79.71 (SD 15.06) microm in the macular hole group and 75.1 (10.8) microm in the control group (p = 0.44). The mean thickness in the temporal sector was 63.69 (12.08) microm in the macular hole group and 58.65 (8.9) microm in the control group (p = 0.3). The mean ratio between the temporal and nasal sector thickness values was 0.8441 in the macular hole group and 0.7819 in the controls (p = 0.42). CONCLUSIONS: There was no significant difference in the thickness of the RNFL in the papillomacular area in the two groups. This suggests that there may be no changes in the thickness of the RNFL in patients with long standing macular holes.

Adult↗

[Renal hydatid cyst: cytological diagnosis using fine needle biopsy (FNA)].

We report the case of a 21 years old man with renal cholics in whom the diagnosis of renal hydatid disease was established by FNA. Considering the high risk of anaphylactic shock reactions and dissemination of daughter cysts, the use of FNA for the diagnosis of hydatid disease has to be limited to unexpected cases with unusual primary localization.

Adult↗

Secretory meningioma, a rare meningioma subtype with characteristic glandular differentation: an histological and immunohistochemical study of 9 cases.

AIM: We studied the immunophenotype of 9 cases of secretory meningioma (SM), a rarely reported meningioma variant, characterized by small gland-like lumina filled with a PAS-positive, diastase-resistant substance. METHODS: Three samples of arachnoid tissue and 9 SMs were studied with a panel of monoclonal antibodies (MoAbs) against cytokeratins (Ck) 7,8, 20, vimentin, EMA, CEA and the mucin epitopes sialyl-Tn, Tn, CA19.9, CA125, against the BerEP4 and CD15; 3 colonic adenocarcinomas metastatic to the brain and a case of meningioma with metastasis from a gastric signet-ring cell carcinoma were also studied with the same panel of MoAbs for comparison. RESULTS: The 3 samples of arachnoid cap cells were positive only for EMA and vimentin in the supportive stroma. All 9 SMs resulted Ck7+, Ck8+, Ck20-, EMA+, CEA and mucin epitopes+, confirming at an immunohistochemical level the glandular differentiation. Notable exceptions were the negativity for BerEP4 and CD15 antigens. Conversely, the 3 metastatic colonic adenocarcinomas to the brain were Ck7-, Ck8+, Ck20+, CEA and mucin epitopes+, BerEP4 and CD15+; the gastric signet-ring cell carcinoma metastatic to a meningioma showed the same immunophenotype as the other metastatic adenocarcinomas with the exception of BerEP4 negativity. CONCLUSION: The different pattern of cytokeratin expression (Ck7+/Ck20- for SMs, and Ck7-/ Ck20+ for adenocarcinomas) and the negativity for BerEP4 and CD15 epitopes of SMs, could be relevant for the distinction between SMs and metastatic adenocarcinomas.

Adenocarcinoma↗

Pure yolk sac tumors in genital and extragenital sites: study on three pedriatic cases, with cytological findings on two.

Cytopathological findings on three pedriatic gonadic-extragonadic pure yolk sac tumor are reported: the highly variable histological patterns (reticular, solid, festooning or pseudopapillary, polyvesicular vitelline), reflecting differentiation towards extraembryonic yolk sac structures, are not appreciated in cytologic samples. Since the tumor's cytologic spectrum is very broad, the most diagnostic differential difficulty with yolk sac tumor is adenocarcinoma. The presence of intracellular and extracellular hyaline globules, that are periodic acid-Schiff stain (PAS) positive and diastase resistant and correspond to alpha-fetoprotein production, alpha-fetoprotein positivity of the neoplastic cells; showing nuclear pleomorphism and vacuolated "bubbly" cytoplasm are the most consistent cytologic hallmarks of this neoplasm, which diagnosis would be confirmed by histologic, immunocytochemical and clinical findings.

Adenocarcinoma↗