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Biomedical subjects

A Carbone

Publications and source records attributed to A Carbone.

At least 433 records · Page 24Linked to original sources

Non-Hodgkin's lymphoma in the elderly: a retrospective evaluation of toxicity related to aggressive vs. conservative treatments.

The outcome of 70 elderly patients aged 65 years or more (median, 71 years) with non-Hodgkin's lymphoma (NHL) treated between 1973 and 1981 with aggressive (AM) or conservative modalities (CM) was retrospectively evaluated. A significantly higher incidence of lethal and severe toxicity was observed in patients treated with AM than in those treated with CM (32% vs 3%, p less than 0.01), with 10% treatment related deaths in the AM group. Only 56% of the deaths were attributed to NHL; other major causes were treatment-related deaths, infection and cardiac diseases. No significant difference in response and survival was found between AM and CM groups (complete remission rates were 35% vs 42%, and 10 year survival rates were 31% vs 19%, respectively), but the prevalence of stages III-IV in patients treated with AM makes these results meaningless. Prospective randomized trials with AM vs CM are clearly needed in elderly patients with advanced unfavorable NHL.

Aged↗

Expression of Leu-8 surface antigen in B-cell lymphomas. Correlation with other B-cell markers.

Using in situ immunohistological analysis, expression of Leu-8 and its correlation with other B-cell markers were investigated in 21 selected lymphomas of different categories, each one expressing its own typical immunophenotype. These categories included eight follicular centroblastic/centrocytic (CB/CC) lymphomas, eight intermediately differentiated lymphocytic lymphomas (ILL)/mantle zone lymphomas (MZL), and five lymphocytic lymphomas (LL) associated with chronic lymphocytic leukaemia (CLL). Four reactive lymph nodes and three tonsils were also studied using double immunolabelling procedures. Cell suspensions were also performed in three CB/CC and four ILL/MZL cases. Leu-8 was consistently expressed in ILL/MZL and LL but it was absent in most (7/8) CB/CC lymphomas. In reactive tissues, the Leu-8-positive B cells were strictly confined to the mantle zones. A close association emerged between Leu-1 (CD5) and Leu-8, both being present in ILL/MZL and LL but absent in CB/CC. A consistent lack of association was found between Leu-8 or CD5 antigens and common acute lymphoblastic leukaemia antigen (CD10) and BA-2 (CD9) antigen, whereas Leu-8 and CD5 were strictly associated with surface IgD. Reactivity with Leu-8 provides a means of distinguishing between CB/CC and ILL/MZL. Furthermore, shared immunoreactivity for Leu-8 in ILL/MZL and LL may represent a potential clue to the still uncertain cellular derivation of LL/B-CLL.

Antigens, Differentiation, T-Lymphocyte↗

Heterogeneous immunostaining patterns of follicular dendritic reticulum cells in human lymphoid tissue with selected antibodies reactive with different cell lineages.

A comparative immunohistologic study of the cell density and distribution pattern of follicular dendritic reticulum cells (DRCs) within their follicular microenvironments (germinal centers and mantle zones) was performed by immunoperoxidase technique with a selected panel of antibodies either operationally specific for DRCs (DRC-1) or reported as having additional immunoreactivity with DRCs (antibodies to B- and T-cells, leukocytes, monocytes/macrophages, desmosomal components, and S-100 protein). Twenty-five biopsy specimens, including reactive lymph nodes and tonsils as well as normal spleen tissue, were analyzed. Serial frozen sections were tested either with single antibodies or paired monoclonal reagents in double-labeling procedures. Our results consistently indicated that DRCs positive for Leu M3 and BA-2 antibodies were confined to the central portion of germinal centers, whereas DRCs immunoreactive for S-100 protein and desmoplakin 1 and 2 were localized mostly in the central and pericentral portion of germinal centers. All the DRCs extending from the central portion of germinal centers to the mantle zones were labeled with DRC-1 and, unexpectedly, with OKB7 antibodies. Other immunostainings, such as those for HLA-DR antigens, common leukocyte antigen, and Leu 3a, were not contributory in defining topographic differences of DRCs within the follicle. The consistent heterogeneity of the labeling patterns appears to suggest a possible in situ immunophenotypic grouping of DRCs, and the concept of their possible heterogeneity appears to be corroborated.

Antibodies, Monoclonal↗

The xanthogranulomatous process. Xanthogranulomatous inflammation.

The precise histopathological features of the xanthogranulomatous process (XP) have been defined in an extensive review of all cases from various organs available in our files. The result was that the XP has the following aspecific but characteristic findings: the presence of granular, eosinophilic, PAS positive histiocytes in the initial stages; the mixture of foamy macrophages and activated plasma cells; the presence of suppurative foci and hemorrhages. Abscess, necrosis and most of all hemorrhages play a a role in eliciting this inflammatory response. This is in accordance with the observations so far reported in the literature. A very interesting result of our study is that some unquestionable cases of XP in cutaneous soft tissue had a histopathological picture indistinguishable from xanthoma. Basing on our experience and on an extensive study of the literature we suggest that the XP mechanism may in some way play a role in several diseases where the inflammatory or reactive nature is more or less ascertained or suspected and the secondary significance of foam cell production is overtly manifest.

Foam Cells↗

Chemotherapy of advanced non-small-cell lung cancer with cyclophosphamide, adriamycin, methotrexate, and procarbazine versus cisplatin and etoposide. A randomized study.

All consecutive eligible patients with non-small-lung carcinoma seen at Centro di Riferimento Oncologico and Istituto Nazionale per la Ricerca sul Cancro were entered into a randomized chemotherapy study. Conditions of eligibility included advanced stage (stage III not amenable to radiation therapy or i.v.), measurable or evaluable lesions, age less than 70 years, performance status (PS) greater than 40, and no previous chemotherapy. Patients were randomized to either CAMP (cyclophosphamide 300 mg/m2 i.v., adriamycin 20 mg/m2 i.v., methotrexate 15 mg/m2 i.v. days 1 and 8, procarbazine 100 mg/m2 orally from day 1 to day 10, every 4 weeks) or DE (cisplatin 20 mg/m2 i.v. for five consecutive days and etoposide 75 mg/m2 i.v. on the same days, every 3 weeks). Treatment was continued until progression. Out of the 136 patients randomized, 133 were eligible (CAMP 62, DE 71) and 108 evaluable. Patient characteristics included male/female ratio 57/5 (CAMP) and 61/10 (DE), median age of 60 years (CAMP) and 59 years (DE), PS greater than or equal to 70 for 39 (CAMP) and 50 (DE), PS less than 70 for 23 (CAMP) and 21 (DE), stage III for 18 (CAMP) and 15 (DE), and stage IV for 44 (CAMP) and 56 (DE). DE was superior to CAMP in terms of response rate, defined as responding/evaluable patient ratio (38.2% versus 20.8%); however, the responding/eligible patient ratio was not significantly different in the two groups. The superiority of DE tended to be more marked in stage III patients, in patients with PS greater than or equal to 70, and in the squamous histological type. Toxicity was acceptable (one toxic death) and evenly distributed in the two treatment groups; only renal toxicity was prevalent in the DE group. Survival (all eligible patients) was significantly better in the DE than in the CAMP group. Whether DE chemotherapy is superior to a no-chemotherapy approach has not been evaluated in this study and remains to be determined.

Antineoplastic Combined Chemotherapy Protocols↗

Dendritic reticulum cell pattern as a microenvironmental indicator for a distinct origin of lymphoma of follicular mantle cells.

Follicular dendritic reticulum cells (DRCs) are known to be normally present in primary follicles and both follicular centres and mantle zones of secondary follicles of peripheral lymphoid tissue. Involved frozen biopsy tissue specimens from eight cases of intermediate lymphocytic lymphoma/mantle zone lymphoma (ILL/MZL); eight cases of follicular centre cell lymphomas (FCCL) of the centroblastic/centrocytic type; and seven cases of well-differentiated lymphocytic lymphoma (WDLL) consistent with chronic lymphocytic leukaemia (CLL) were analysed immunohistologically with R4/23 (DRC-1) monoclonal antibody reactive with 'bystander' DRCs. As opposed to FCCL and most WDLL/CLL cases, the DRCs consistently formed a loose, ill-defined meshwork with a radiating or blurred outline in all MZL cases and one ILL. On the basis of the observed findings as well as from those reported in literature, the hypothesis is proposed that ILL/MZL originates from the follicular mantle zone and represents a distinct lymphoma entity owing to its peculiar immunostaining pattern of DRCs that allows it to be separated from both FCCL and WDLL/CLL. Moreover, the absence of DRCs in the microenvironment of other B-cell malignancies such as prolymphocytic leukaemia and hairy cell leukaemia, analogously with most CLL cases, would speak in favour of their different--possibly extrafollicular--compartment of origin within lymphoid tissue.

Dendritic Cells↗

Study of AIDS-related lymphadenopathy in the intraparotid and perisubmaxillary gland lymph nodes.

Salivary gland lymph node involvement is rare in patients at risk for AIDS. Intraparotid and perisubmaxillary gland lymph node biopsies from 2 intravenous drug abusers serologically positive for human immunodeficiency virus (HIV) affected by persistent generalized lymphadenopathy (PGL) were also analyzed immunohistologically. We found hypervascular reactive lymphoid hyperplasia with prevalence of suppressor T-cells within follicular centers often lacking surface IgD-positive mantle zone cells and showing disruption of the network of dendritic reticulum cells revealed with DRC-1 and anti-S-100 protein antibodies. Within the nodes there were numerous cysts lined by metaplastic squamous epithelium/positive for epithelial membrane antigen and containing numerous lymphocytes positive for leukocyte common antigen, macrophages positive for alpha 1 -antichymotrypsin, and Langerhans cells positive for OKT6. Salivary gland lymph nodes are immunohistologically similar to those of other sites in PGL and their increased epithelial metaplastic component containing cells involved in the immune response might represent an exuberant reaction to HIV infection.

AIDS-Related Complex↗

Type II estrogen-binding sites and 17 beta-hydroxysteroid dehydrogenase activity in human peripheral blood mononuclear cells.

Type II estrogen-binding sites (type II EBS) have been demonstrated in human peripheral blood mononuclear cells (PBMC) using a whole cell assay with [6,7-3H]estradiol [( 3H]E2) as tracer. During whole cell incubations for 60 min at 37 C for type II EBS quantification, we found that PBMC contain 17 beta-hydroxysteroid dehydrogenase (17 beta HSD) activity, which led to errors in estimating type II EBS concentrations by diminishing, by about 70%, the amount of available labeled E2. On the other hand, after 150 min at 4 C only 16% of the tracer was converted to estrone. Thus, we measured the maximal steady state binding in PBMC by incubating the cells with [3H]E2 at 4 C for 150 min. Equilibrium binding analysis of PBMC yielded sigmoid saturation curves with a saturation point at a ligand concentration of about 40 nmol/L. Scatchard analysis of binding data yielded a concave plot, which together with a Hill coefficient of 2.13, suggests that the type II EBS may have multiple binding sites which display positive cooperativity. The apparent equilibrium dissociation constant (Kd), determined from the [3H]E2 concentration required for half-saturation, was about 22 nmol/L. The type II EBS were estrogen specific, as demonstrated by competition experiments. Only those steroids with estrogenic activity inhibited binding of [3H]E2; nonestrogenic steroids did not. The type II EBS were found to be 3S macromolecules based on analysis of postlabeled fractions prepared by sucrose density gradient centrifugation. The number of type II EBS in PBMC from normal women was highest during the late follicular-early luteal phase of the menstrual cycle. We conclude that human PBMC specifically take up, retain, and metabolize E2.

17-Hydroxysteroid Dehydrogenases↗

Superficial extending carcinoma of the larynx.

Superficial extending carcinoma of the hypopharynx is a recently recognized form of carcinoma regarded as a possible pharyngeal counterpart to early gastric cancer and superficial esophageal carcinoma. In this study we report the radiological, clinical, and pathological features of three carcinomas of the larynx, which show architectural and histopathological features similar to those previously described in superficial extending carcinoma of the hypopharynx. These cases were singled out from a series of 37 consecutive laryngectomy specimens of primary infiltrating laryngeal carcinomas that were uniformly studied by means of a whole-organ sections technique. Pathologically, these cases showed a clearly invasive growth through the basal membrane into the lamina propria and an entire or predominant, extensive, superficial type of spread; infiltration of underlying muscle or gland structures was restricted to a few microscopic foci, regardless of the presence of lymph node metastases. The present study demonstrates that infiltrating carcinomas with a preferential superficial type of growth may also be encountered in the larynx. Differences between the histological features of these carcinomas of the larynx and the histopathological spectrum of so-called early laryngeal cancer are emphasized.

Aged↗

Immunologic abnormalities related to antigenaemia during HIV-1 infection.

The expression of phenotypic markers on T and B lymphocytes in long-term human immunodeficiency virus type 1 (HIV-1) seropositive, antigen negative patients, in seropositive, antigen positive individuals without AIDS and in seronegative intravenous drug abusers was examined by two colour flow cytometry. Seropositive, antigen positive patients showed decreased CD4+ lymphocyte numbers, causing lower CD4/CD8 ratios when compared to seropositive, antigen negative subjects. While CD4 CDw29+ (4B4) lymphocytes are selectively reduced in seropositive, antigen negative individuals, both CD4 CDw29+ and CD4 CD45R+ (2H4) lymphocytes are decreased when antigenaemia is present. An increased percentage of CD3 HLA DR+ activated T lymphocytes and of CD20+ (B1) Leu 8 negative activated B cells was seen in HIV-1 seropositive antigen positive patients. These results demonstrate that, in long-term seropositive individuals, antigenaemia is associated with peculiar phenotypic changes of lymphocyte subsets.

Acquired Immunodeficiency Syndrome↗

Clinical and laboratory findings at presentation in persistent generalized lymphadenopathy vs malignant lymphoma.

The purpose of this study is to compare the clinical and laboratory findings at presentation of 38 intravenous drug abusers with pathologically documented persistent generalized lymphadenopathy and 50 patients with biopsy proven malignant lymphoma (30 Hodgkin diseases, 20 non-Hodgkin's lymphomas) not related to acquired immunodeficiency syndrome, all aged 40 years or less and consecutively seen and evaluated with a similar clinicopathological approach since May 1984 in a single institution, Centro di Riferimento Oncologico, Aviano, Italy. Our results document that, although pathology is the decisive diagnostic tool, selected clinical and laboratory findings may contribute to a better differentiation of persistent generalized lymphadenopathy from malignant lymphoma not related to acquired immunodeficiency syndrome. Therefore, young patients presenting with generalized lymphadenopathy, apparently not related to known groups at risk for acquired immunodeficiency syndrome, should be evaluated also according to a protocol which includes the detection of symptoms, signs, and laboratory data that are known to be significantly increased among patients with persistent generalized lymphadenopathy.

Adult↗

Malignant tumors other than lymphoma and Kaposi's sarcoma in association with HIV infection.

Since 1981 there has been a constant rise in the incidence of squamous cell carcinoma of the oral cavity and the anorectum among homosexual men in the United States. In addition, lung cancer, testicular cancer, chronic lymphocytic leukemia, malignant melanoma, basal cell carcinoma, cervical cancer, and multiple myeloma have been recently reported in persons at risk for AIDS with HIV infection, with some peculiar clinicopathological features, including age, histological type, and clinical aggressiveness. Within the GICAT (Gruppo Italiano Cooperativo AIDS & Tumori) framework, we have identified four cases of testicular cancer, two cases of leukemia, and 1 case each of cervical cancer, carcinoma of the oral cavity, lung cancer, brain tumor, and multiple myeloma in persons at risk for AIDS, mainly i.v. drug abusers, with HIV infection, diagnosed in different Italian institutions. Work is in progress in order to collect histological and clinical data on these tumors. Although these data are preliminary and are not indicative of an actual increase in the incidence of malignancies other than malignant lymphomas and Kaposi's sarcoma in the AIDS setting, clinicians should be aware of the possible association of these tumors with HIV infection.

Acquired Immunodeficiency Syndrome↗

Pleomorphic (anaplastic) neuroblastoma.

Four very unusual cases of neuroblastoma in children are reported. Clinically, they had a similar presentation: advanced disease at onset, diffuse abdominal spread, poor treatment response, and rapid progression. Pathologically, the four cases were characterized by a striking degree of cellular and nuclear pleomorphism and anaplasia with bizarre and monstrous expressions. Although some authors have referred to the immature ganglion cells found in neuroblastoma as "bizarre ganglion cells," they usually mean the enlarged, maturing neuroblasts that are typical of ganglioneuroblastoma but far from the extreme anaplasia seen in our cases. A correlation between the clinical course and the histological picture could be hypothetically suggested, but additional evidence and confirmation is needed. These cellular aberrations might represent an unsuccessful and impaired attempt at maturation. Independent from prognosis, the definition of anaplastic neuroblastoma is a useful conceptual specification in the study of this tumor and of giant cell and pleomorphic malignant neoplasms of childhood.

Adrenal Gland Neoplasms↗

Heterogeneous in situ immunophenotyping of follicular dendritic reticulum cells in malignant lymphomas of B-cell origin.

The phenotype of follicular dendritic reticulum cells (DRC) was analyzed with monoclonal antibodies (DRC-1, OKB7, BA-2, Leu-M3, and antidesmoplakin 1 and 2) in 28 frozen biopsy specimens of both morphologically and phenotypically analyzed B-cell lymphomas and 21 normal or reactive controls. The former included 15 follicular center cell lymphomas (FCCL), four intermediately differentiated lymphocytic lymphomas (ILL), four mantle zone lymphomas (MZL), and five well-differentiated lymphocytic lymphomas (WDLL). In controls, DRC-1+ and OKB7+ DRC were localized in both follicular centers (FC) and mantle zones (MZ), but BA-2+ and Leu-M3+ DRC were confined to FC only. FCCL were usually accompanied by DRC-1+, OKB7+, and BA-2+ DRC, and either lost or maintained positively with Leu-M3 from case to case. By contrast, MZL consistently lacked BA-2+ and Leu-M3+ DRC, and was associated with DRC-1+ and OKB7+ DRC only. Desmoplakin-positive DRC occurred in variable proportions in both FCCL and MZL. As opposed to FCCL and MZL, all WDLL and all but one of the ILL (associated only with DRC-1+, OKB7+, and desmoplakin+ DRC) did not show any DRC as identifiable with the antibody panel used. Remarkably, the difference in the distribution of BA-2+ and Leu-M3+ DRC in the normal FC and MZ appears to be maintained in their neoplastic counterparts (FCCL and MZL) also. Such a difference represents an example of the possible interactions between lymphoma cells of different phenotype and their microenvironment, as portrayed by phenotypically heterogeneous DRC.

Antibodies, Monoclonal↗