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Biomedical subjects

A Carbone

Publications and source records attributed to A Carbone.

At least 577 records · Page 32Linked to original sources

Gastric cancer with bone marrow invasion at presentation: case-report and review of the literature.

A case of extensive bone marrow infiltration due to gastric cancer is reported. A 65-year old man with an acute episode of anemia (Hb 4.1 mg/dl) and dyspnea was admitted to the Medical Department of a general hospital. Bone marrow biopsy showed extensive paratrabecular infiltration of a poorly differentiated adenocarcinoma of gastric origin. The primary tumor in the stomach was confirmed, and the patient was referred to our Institute and treated with combination chemotherapy (FAMTX) for 6 cycles. Due to the disappearance of bone marrow infiltration, the patient was considered for curative resection of the primary gastric cancer. After 27 months the patient is alive and in clinical complete remission.

Adenocarcinoma↗

The relevance of VDJ PCR protocols in detecting B-cell clonal expansion in lymphomas and other lymphoproliferative disorders.

AIMS AND BACKGROUND: The detection of immunoglobulin heavy chain variable (VH)-diversity (DH)-joining (JH) region gene rearrangement by polymerase chain reaction (VDJ PCR) has been recently proposed as a rapid approach to assess B-cell clonality in lymphoproliferative disorders. The aim of the present study was to determine the efficacy of VDJ PCR in a wide spectrum of lymphoproliferative disorders previously characterized by immunohistochemistry and Southern blot (SB). METHODS: 83 SB-rearranged B-cell non-Hodgkin's lymphomas (NHL) of different histotype, 22 cases of SB-unrearranged classical Hodgkin's disease (HD), 18 cases of HIV-related reactive lymphadenopathy, and 4 frankly pre-lymphomatous lesions (MESA) in the course of Sjögren's syndrome were investigated by 2 different VDJ PCR protocols (FR3, FR2). RESULTS: The detection rate in NHL was 64% and 71% using the protocols FR3 and FR2, respectively. However, the overall VDJ PCR efficacy increased to 81% by combining the results of both protocols. In addition, differences in the combined, as well as in the single FR3 or FR2 protocol efficacy, were noted in the different NHL subgroups. B-cell clonality was also detected in 4/22 (18%) SB-unrearranged classical HD cases and in 2/18 (11%) reactive lymphadenopathy cases, whereas it was demonstrated in all the MESA lesions, 2 of them being SB-negative. CONCLUSIONS: VDJ PCR represents a useful and rapid technique to detect B-cell clonality in NHL, although with some differences depending on the NHL histotype and the panel of primers employed. The technique may also be of value to investigate the possible progression of early B-cell clonal expansion into frankly B-cell malignancy and to contribute to the controversy about the clonal lineage origin of the putative HD malignant cells.

AIDS-Related Complex↗

Early gastric cancer: diagnosis, surgical treatment and follow-up of 45 cases.

AIMS AND BACKGROUND: The 5-year survival rate of early gastric cancer (EGC) is 85%-100% after "curative" resection, as compared to 20%-30% in advanced gastric cancer (AGC). Because of this relatively high cure rate, the interest in the diagnosis and therapy of EGC has been steadily increasing. The present study, based on 45 EGCs, is aimed at a critical evaluation of the diagnostic procedures and surgical options. METHODS AND RESULTS: Forty-five patients with early gastric cancer (27 men and 18 women; median age, 62 years; range, 28-84) were diagnosed and operated on. They represented 22.5% of all patients with gastric cancer (200) treated in the period July 1987 to January 1998. Forty-one patients were from the northeastern part of Italy. The most frequent symptom was epigastric pain (84%). Barium upper gastrointestinal radiography findings were strongly suggestive of malignancy in 41 cases (91%). Preoperative histopathological diagnosis of adenocarcinoma was performed in 43 cases (95.5%). In two cases (4.5%) severe epithelial dysplasia (associated with ulcer) was the first diagnosis, but the final diagnosis on the basis of the resected specimens was a well differentiated adenocarcinoma. The primary surgical procedure included i) subtotal distal resection (37 cases) with Billroth 11 (33) and Billroth I (4) reconstructions; ii) total gastrectomy (3) for proximal neoplastic extension; iii) proximal gastric resection (2) for cardial cancer; iv) degastro-total gastrectomy (3) for cancer of the stump. Two patients, previously treated with conservative surgery, underwent degastro-total gastrectomy for neoplastic microfocal extension to the margin of resection and for early anastomotic recurrence, respectively. Mural infiltration was limited to the mucosa and submucosa in 27 and 18 cases, respectively. Lymph node metastases were found in three mucosal and five submucosal tumor cases, involving either the first or the second echelon. No operative deaths or postsurgical complications occurred in this series. In the follow-up period (median, 36 months; range, 3-120) four patients died due to other causes; one developed liver metastases, another developed oropharyngeal cancer and two died of biopsy-proven lung cancer without evidence of gastric cancer recurrence. CONCLUSIONS: The clinical presentation of EGC is aspecific. Preoperative endoscopy with biopsy remains the most sensitive diagnostic procedure. For treatment, subtotal distal gastric resection with lymphadenectomy is the "gold standard" but in some instances total gastrectomy may be indicated. Accurate pathological examination establishes the depth of infiltration, as well as the superficial extension of tumors and the lymph node status. Although the prognosis of EGC is favorable, a medium-term follow-up should be planned.

Adenocarcinoma↗

Will the "new biology" affect the future of histopathology?

The technologies used in histopathology are changing as a consequence of the current revolutionary progress in several areas of biology. It is likely that general cancer management will improve because of the impact of molecular techniques and immunohistochemistry on tumor diagnosis and classification and on the determination of prognosis and response to therapy. Moreover, as therapies are starting to be modelled after the distinctive molecular characteristics of a specific tumor, the availability of molecular tests to all patients will become a matter of great importance.

Biomarkers, Tumor↗

New biotechnologies: spin-off on health and society.

New biotechnologies and the new biology deriving from them are having a revolutionary impact on economy and society and are consequently transforming the role of researchers, which is changing continually to meet the competence required. The advances in human genetics on the other hand make it necessary to look for different approaches and new rules in bioethics. Comprehensive views and careful considerations are therefore needed in order that this new biology may have a positive impact on health, being respectful of the social and ethical principles of human beings.

Biotechnology↗

Methylenetetrahydrofolate reductase genotype in diffuse large B-cell lymphomas with and without hypermethylation of the DNA repair gene O6-methylguanine DNA methyltransferase.

C677T and A1298C methylenetetrahydrofolate reductase (MTHFR) polymorphisms have been suggested to affect susceptibility to malignant lymphoma, possibly by altering DNA methylation. The DNA repair gene O6-methylguanine DNA methyltransferase (MGMT) is transcriptionally silenced by promoter hypermethylation in diffuse large B-cell lymphomas (DLBCL). We analyzed the MTHFR677 and MTHFR1298 genotypes in 111 DLBCL patients and 465 controls. No significant difference in the frequency of MTHFR polymorphisms between patients and controls and no significant association between MTHFR677 or MTHFR1298 genotypes and methylation of MGMT promoter were observed. These results indicate that MTHFR variants are not related to DLBCL development and MGMT hypermethylation.

Alleles↗

Significance of S-100 protein immunostaining in the immunohistological analysis of normal and neoplastic lymphoid tissues--an appraisal.

S-100 protein is a heterogeneous fraction of dimeric polypeptides (alpha and beta subunits) that can exist in different combination forms within the various tissues. Concerning the S-100 protein immunodetection within lymphoid tissue, the heterogeneity of the S-100 antigen, the tissue quality (frozen or paraffin-embedded after treatment with different fixatives) and the treatment of the tissue with different immunostaining methods and antibodies of different nature, all make for inconsistent results obtained in the immunohistological studies reported in the literature. Most of the S-100-positive cells of the lymphoreticular system are dendritic cells involved in the immune response (interdigitating reticulum cells, Langerhans cells, and follicular dendritic reticulum cells), other S-100-positive cells belonging to the mononuclear/phagocytic system. S-100 protein immunostaining may be used as a helpful immunohistological diagnostic clue to certain malignancies of the immune system (follicular center cell lymphomas) on the basis of their specifically related dendritic cell microenvironment. In addition to monoclonal antibodies for the immunophenotypic characterization of dendritic cells and macrophages and to enzyme reactions, the combined use of anti-S-100 antibodies specific for each of the S-100 protein subunits, tested with sensitive procedures, would be a very useful tool in the attempt to classify the proliferative disorders of dendritic cells and macrophages.

Biomarkers, Tumor↗

Enzyme and immunohistochemistry of follicular hyperplasia in AIDS-related lymphadenopathy.

We used a panel of monoclonal and polyclonal antibodies to analyze frozen and paraffin-embedded lymph node biopsy specimens from 25 intravenous drug abusers (IVDA) with acquired immunodeficiency syndrome (AIDS)-related lymphadenopathy histologically characterized by follicular hyperplasia. Our aim was to obtain diagnostic clues to this commonly occurring pattern. Double-labelling immunohistological studies were also performed on selected frozen sections and 13 plastic-embedded specimens were tested by a number of enzyme reactions. Consistent features in IVDA included abnormally high numbers of intrafollicular T-cells, positive for acid phosphatase and beta-glucuronidase, most of which had Leu-2a-positive phenotype; a marked reduction or loss of mantle zone B-cells (positive for surface IgD-IgM and alkaline phosphatase); and disarray of the network of follicular dendritic reticulum cells (DRCs), as revealed with DRC-1 and anti-S-100 protein antibodies or with reaction for 5'-nucleotidase. When present, distinctive intrafollicular clusters of Leu-2a-positive T-cells and mantle zone B-cells were nearly always associated with areas lacking DRCs in some patients. The intrafollicular hypervascularity invariably found in IVDA proved to be of a true capillary nature, as demonstrated by alkaline phosphatase, 5'-nucleotidase, and ATPase reactions. In control tissues, all showing absence of Leu-2a-positive intrafollicular T-cells, most of the above individual changes could be detected, although they were occasional, mild, and never associated within the same follicle. By contrast, combined immunohistological and enzyme histochemical findings in IVDA indicated that in most follicles such changes were marked and very often associated within the same follicle in each case.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Complex↗

S-100 protein detection in "follicular macrophages" of mouse lymphoid organs by ABC immunoperoxidase method.

The distribution of S-100 protein was investigated in normal or reactive lymphoid organs from adult mice, rats and humans by the avidin-biotin complex ABC) immunoperoxidase method. In mouse lymph nodes and spleen the protein appeared to be confined to the "tingible-body macrophages" and occasionally in sinus histiocytes in the lymph nodes. No immunoreaction product was detected in the other cell types present inside or outside the follicles. In the thymus the immunostained cells were located in the medullary area and corresponded morphologically to mononuclear PAS-positive cells with histiocytic appearance. By contrast, in rat and human organs S-100 protein was detected in interdigitating reticulum cells and dendritic reticulum cells. The present findings indicate that S-100 protein is located differently in mouse lymphoid organs and in other mammalian species.

Animals↗

Methods of simultaneous visualization of cytoplasmic enzyme reactivity and cell surface antigens (by cytochemistry combined with immunocytochemistry) in individual hematopoietic and lymphoid cells.

Enzyme cytochemistry alone, and more recently, immunocytohistochemistry have been satisfactorily used by hematologists and hematopathologists for the study, diagnosis and classification of human hematological and lymphoproliferative disorders. To enhance the potential of these techniques, the possibility of combining immunocytohistochemical techniques with enzyme cytohistochemistry with simultaneous visualization of both reaction products has been examined by some investigators. This approach has been applied to normal, reactive and neoplastic material using mainly cell suspensions and frozen sections, with the aim of improving cell identification in specimens containing different cell types, of determining the cytochemical profiles of well-defined lymphocyte subpopulations and of establishing the cell surface phenotypes of cells that are positive for certain enzymes. In this paper, published reports on this subject are reviewed and compared with the experience of our study group.

B-Lymphocytes↗

CD30/CD30 ligand and CD40/CD40 ligand in malignant lymphoid disorders.

CD30 and CD40 are members of the tumor necrosis factor (TNF) receptor family. These two receptors have pleiotropic biologic functions including induction of apoptosis and enhancing cell survival. This review will discuss the pattern of expression of these receptors in malignant lymphoid disorders and their prospective ligands. Understanding issues related to these two ligands and their receptors in lymphoid malignancies may help to improve the classification of these diseases and could open the doors for new treatment strategies.

CD30 Ligand↗

Lack of Fas and Fas-L mutations in patients with lymphoproliferative disorders associated with Sjögren's syndrome and type II mixed cryoglobulinemia.

OBJECTIVE: Murine models (MRL/gld/gld mice) and recent evidence in humans suggest a possible role of Fas and Fas ligand (Fas-L) germline mutations in the pathogenesis of autoimmune-related lymphoproliferation, including adult cases. In this study, the presence of Fas and Fas-L germline mutations was investigated in a consecutive series of adult patients with lymphoproliferative disorders occurring in the context of Sjögren's syndrome (SS) and type II mixed cryoglobulinemia (MC). METHODS: 11 patients (8 primary SS and 3 type II MC; F/M: 10/1; mean age 64 yrs.) were investigated. All patients were suffering from atypical lymphoproliferative disorders or MALT lymphoproliferative lesions (mean duration 3.5 yrs.). Four patients later developed a malignant lymphoma. DNA from peripheral blood mononuclear cells from 11 patients and 10 controls was tested for germline mutations in the Fas gene (exons 4, 8 and 9) and Fas-L gene (exon 4) by the polymerase chain reaction-single strand conformation polymorphism (SSCP) method. RESULTS: All DNA samples from both patients and controls showed amplification of Fas and Fas-L specific fragments. Identical SSCP migration patterns were observed in all the cases, indicating the lack of mutations in the whole series. CONCLUSION: Although it cannot be excluded that Fas and Fas-L mutations might be present in exons different from those analyzed, our data do not support the hypothesis that germline mutations in these genes are responsible for a major subset of lymphoproliferative syndromes in adult patients with SS and type II MC. Additional studies would be worthwhile in SLE-related lymphoproliferation, which is, however, a subset of limited clinical relevance when considering all cases with autoimmune-related lymphoproliferation.

Aged↗

Syphilitic aneurysm of the abdominal aorta.

A case of syphilitic aneurysm of the abdominal aorta is described. This unusual finding may be misdiagnosed as "inflammatory" abdominal aortic aneurysm, another condition associated with an intense periaortic inflammatory reaction. The authors discuss the differential diagnostic problems and the surgical technique advisable in these cases.

Aorta↗

Can Reed-Sternberg cells of classic Hodgkin's disease be considered B-cells?

During the last twenty years, the issue of the nature of Reed-Sternberg (RS) cells of Hodgkin's disease (HD) has been addressed by multiple methodological approaches. In recent times, a major insight into HD has been obtained through molecular studies of isolated cells which have proven the clonal nature of HD. In parallel to molecular investigations some novel biologic markers specifically associated with the different stages of mature B-cells have helped to define the cellular origin of HD. This review deals with histological features of HD and summarizes recent results from molecular and immunohistochemical studies focusing on the origin and the stage of differentiation of RS cells.

B-Lymphocytes↗

Is aging a real risk factor for urological pathologies in men and women?

OBJECTIVE: With the progressive aging of the population in industrialized countries, urological pathologies are also increasing and creating a socio-sanitary problem for the community. To investigate this problem we retrospectively analyzed a heterogeneous sample of 283 patients, 134 males and 149 females who attended our urodynamics laboratory. METHODS: The female patients were subdivided into 6 categories and the male patients into 7 categories according to their urodynamic diagnoses. Their age distributions were compared with those of the population of the region of Lazio in Italy in order to calculate the "risk tendency". RESULTS AND CONCLUSIONS: The most frequent pathologies in males were bladder outlet obstruction (BOO) associated or not with detrusor overactivity (DO), and in females it was cystocele associated or not with DO or obstruction. There is a significant increase in these urological pathologies in older people. The relative risks for the females increase from age 20-29, stabilize at around 50 to 69 years and decline thereafter. The risk approximately doubles every ten years of age from 20 to 50. At ages 50-69 the risk is about 8 or 9 times higher than the risk at age 20-29 and double that of women aged over 70 years. The risk for the males also approximately double for every ten years of age. Men aged 60-69 have about 25 times the risk of these pathologies than men aged 20-29, and in the oldest men, those over 70 years, the risk is almost 40 times as high.

Adult↗