Biomedical subjects
Publications and source records attributed to A Parenti.
The authors describe a case of liposarcoma of the renal sinus, a relatively uncommon tumor site. We briefly review its pathogenesis and underscore the importance of the preoperative differential diagnosis, particularly from other tumor masses that are often difficult to distinguish.
'Normal' dome biopsies from 20 cystectomies for infiltrating bladder carcinomas were studied with scanning electron microscopy (SEM). All cases showed alterations ranging from minimal changes to numerous pleomorphic microvilli, and were classified according to Herd and Jacobs. The SEM findings and grades were correlated with dome histology and the results were quite good. However, in our opinion, the Herd and Jacobs classification and subclassifications are poorly reproducible without morphometric analysis. Nevertheless the SEM study is useful to strengthen the diagnosis of dysplasia/carcinoma in situ in 'healthy'-looking urothelium.
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A retrospective study of 10 cases of malignant peritoneal mesothelioma from two centers is reported. All cases were initially diagnosed between 1967 and 1986 utilizing laparoscopy and the histologic interpretation of laparoscopic biopsy samples. Subsequently, the original diagnosis was confirmed by two independent pathologists employing both histological and histochemical techniques. In five cases immunohistochemical studies were also performed. The clinical findings and course of the disease were similar to other reported series. Laparoscopic findings of mesothelioma were indistinguishable from metastatic peritoneal neoplasms. However, the presence of homogeneous spreading of nodules, plaques, or fleshy masses on both parietal and visceral peritoneum; the absence of direct or indirect signs of other abdominal neoplasms; and the absence of hepatic metastases or the possible presence of nodules or plaques on Glisson's capsule without any parenchymal involvement, when observed, allowed the laparoscopist to suspect the disease in four of 10 cases. Laparoscopy may be useful in detecting mesothelioma. The diagnosis is mainly morphological, but even morphology has its inherent limitations. Further studies are necessary to improve the diagnostic accuracy of this tumor.
We report the clinical, histological, and ultrastructural study of two patients, mother and daughter, 32 and six years old, respectively, who presented with dermatitis and arthritis. From the clinical point of view, they appeared to be affected by Familial Histiocytic Dermatoarthritis (FHD), a diagnosis supported by the early age of onset, familial occurrence, and a typical ocular lesion in the mother (glaucoma, uveitis, and cataracts). However, histology revealed the presence of multinucleated giant cells that are usually associated with Multicentric Reticulohistiocytosis (MR). Unlike MR, in the cases here reported the PAS positive, intracytoplasmic material appeared to be glycogen. Electron microscopy disclosed pleomorphic bodies, which have also been described in MR. Thus, we conclude that FHD and MR probably do not represent separate entities, and that a spectrum of disorders exists between these two conditions.
A case of mesoblastic nephroma, hypercalcemia, and raised levels of prostaglandins in a 2-month-old female infant is reported. Plasma parathyroid hormone (PTH) was normal and urinary prostaglandins were raised. During surgery a prostaglandin arteriovenous gradient was demonstrated. A large quantity of PGE was extracted from the tumor by radioimmunoassay after incubation. Both blood calcium and urinary prostaglandins returned to normal after nephrectomy. These results show that this tumor produced prostaglandins, the mediators of hypercalcemia in this patient.
UNLABELLED: Idiopathic mitral valve prolapse (IMVP) is a very common cardiac abnormality that may be linked to carnitine deficit (inadequate nutritional intake or absorption). One patient with IMVP and related symptoms that were resistant to drug therapy was fully studied. Free plasma carnitine and 24-hour free urine carnitine were measured twice, 10 days apart, after an overnight fast. FINDINGS: Free plasma carnitine 23 and 28 microM/L (our laboratory N=38+/-2 microM/L); free urine C 25 and 44 microM/24 hr (N=255+/-66 microM/24 hr); FFA 0.88 mEq/L, Duncombe method (N=0.09-0.60); LDL 42% (N = 44-65); cholesterol 161 mg/dl (N = 180-280); triglycerides 84 mg/dl (N = 50-172); SGOT 79 MU/ml (N = up to 40); SGPT 147 MU/ml (N = up to 40); OCT 11.2 MU/ml (N = up to 10.0); aldolase 11.5 MU/ml (N = up to 3.1, Bruns method). Deltoid biopsy: light microscopy showed the presence of optically empty vacuoles; electron microscopy showed lipid droplets near the subsarcolemma area and intermyofibrillar spaces. The mitochondria contained electron dense granules. The electromyogram was also abnormal. In a random sample of four patients with IMVP and related classic symptoms, we have found low levels of plasma and/or urinary carnitine in each case. This study may be the first step towards L-carnitine therapy for what has previously appeared to be idiopathic cardiomyopathy.
The expressivity of carcinoembryogenic antigen CEA and ABO(H) isoantigens is studied in a group of 40 pelvic and ureteral transitional cell carcinomas. CEA was not shown to be a tumor marker since it is not found in all tumors whereas it is demonstrated in a case of cystic pyelitis. Nevertheless, it seems to be associated with certain prognostic morphologic markers, i.e., grading and vascular invasion. The ABO(H) isoantigens do not seem to be correlated with the prognosis; many advanced-stage and grade tumors showed, in fact, positivity for these isoantigens in most neoplastic cells. Association of histological techniques and immunohistochemical studies does not seem as useful in predicting the course of upper urinary tract transitional tumors as in bladder tumors.
The clinico-radiologic, gross, microscopic and ultrastructural findings in 2 cases of renal oncocytoma are reported. The diagnosis of renal oncocytoma has important clinical and prognostic implications, since the neoplasia is usually benign despite its often large size. The differential diagnosis with other renal neoplasms, in particular renal cell carcinoma, is discussed. The problem of the pre-operatory diagnosis of renal oncocytoma is explored on the basis of clinico-radiologic findings and/or histologic examination of pre- or intraoperatory biopsy. In view of the tumor's benign nature, this diagnosis implies tumorectomy, but its close resemblance to renal cell carcinoma at present counsels nephrectomy. A final diagnosis of oncocytoma may be formulated only after histologic examination of several specimens and ultrastructural confirmation.
Squamous carcinoma of the breast is a rare neoplasm and should not be confused with spindle cell skin carcinoma which derives from the nipple. Differential diagnosis includes other primary (e.g. medullary) carcinomas where more or less extensive zones of typical or atypical squamous metaplasia are found. The pathogenesis of this neoplasm as well as its biological behavior is discussed in the light of personal experience. Literature data are reviewed.
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Following in vitro stimulation of murine sarcoma virus Moloney isolate (M-MuSV)-immune spleen cells with syngeneic antigenically related Moloney leukemia cells, highly efficient cytotoxic T-lymphocytes (CTL's) were generated. The cytotoxic effect was directed only against H-2-compatible target cells bearing M-MuSV tumor-associated antigens (TAA). However, in a cold target competition assay a weak but detectable capacity to block CTL activity was also obtained when allogeneic Moloney leukemia cells were added. Moreover, when M-MuSV-immune spleen cells from mice inoculated with virus 14 days previously were stimulated by allogeneic Moloney leukemia cells, a strong cytotoxic effect toward syngeneic and allogeneic tumor cells bearing M-MuSV TAA was elicited.
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Angiogenesis is a tightly controlled process which depends on the balance between stimulating and inhibiting factors. When this balance is disrupted, angiogenesis acquires a pathological meaning. The list of molecules able to induce angiogenesis is heterogeneous with respect to their chemical characteristics and biological properties. Quantitative measurement of tumor angiogenesis is necessary for the choice of therapeutic strategies and as an endpoint for antiangiogenic therapy. We are developing a quantitative RT-PCR with measures the expression of specific factors in real time. With the use of this rapid technique, measurement of the expression of the angiogenic factors and inhibitors is also possible in specimens as small as biopsies.
PURPOSE: To evaluate the angiogenesis in Dukes' B colon cancer. PATIENTS AND METHODS: In 60 patients (age, 39-75 years), the microvessel density and the relationship between the angiogenesis and other histologic features were retrospectively evaluated. In an ongoing prospective study, 25 patients have been enrolled to determine the possible therapeutic implications of VEGF quantitative analysis. RESULTS: The retrospective portion of this study confirms the prognostic value of the angiogenesis in terms of recurrences and survival. At present, no conclusions can be drawn from the prospective portion of the study.
Central sleep apnoea (CSA) is a breathing disorder characterized by repetitive central apnoeas with hypoxia interrupted by hyperventilation phases. In the literature, there are reports of CSA caused by brainstem infarcts. We report two patients (38 and 53 years old) with longstanding history of central sleep apnoea who died during sleep. In both cases the autopsy revealed acute bilateral hypoxic lesions at the level of the solitary tract nuclei. In one case, symmetrical selective neuronal necrosis was found in the dorsal part of the solitary tract nuclei. A chronic obstructive vasculopathy was also found, with thickening and fibrosis of the smallest vessels of the medullary tegmentum. In the other case, bilateral infarctions were found with the base at the ependymal lining of the 4th ventricle floor and the apex towards the solitary tract. An acute intramural hemorrhagic lesion in the premedullary segment of the left vertebral artery was also found. Episodes of hypoxemic hypoxia during sleep may worsen the effects of focal oligohemic hypoxia in the medullary tegmentum. Selective stroke of the solitary tract nuclei may be the acute fatal lesion in patients with both central sleep apnoea and lesions of the vertebro-basilar system. To the best of our knowledge, this is the first neuropathologic report of acute medullary ischemic-hypoxic lesions which may not be considered the cause of the CSA because of their recent onset. Our findings suggest that CSA, besides being caused by ischemic events at the level of the medulla, may also contribute to pathogenesis of strokes, through hypoxia or hemodynamic oscillations.