[Morphologic and morphometric parameters of infiltrating duct carcinoma of the breast and receptor state in fluorescence: correlations in 104 cases (1983 case survey)].
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Biomedical subjects
Publications and source records attributed to C Gambini.
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The authors report the case of a patient harbouring a parietal convexity tumor whose clinical and CT features were suggestive of a meningioma. Unexpectedly the tumor was a well differentiated adenocarcinoma from a colon cancer with a markedly PAS positive intragland content represented by wide areas of mucoid degeneration. Brain metastases from colon cancer are usually late occurrences and it is extremely rare that the brain lesion be discovered while the primary tumor is still unknown. The authors discuss about the pathogenesis of the CT appearance of adenocarcinoma which is, usually, slightly hyperdense. On the basis of the reported findings it is suggested that mucoid degeneration may induce the development of a well defined CT pattern represented by a very high density appearance with no contrast enhancement.
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A patient with Gorlin-Goltz syndrome (nevoid basal cell carcinoma syndrome) is described. This disease has an autosomal dominant inheritance pattern with complete penetrance and extremely variable expressivity. The case report seems to represent a new mutation. Gorlin-Goltz syndrome is characterized by a lot of symptoms primarily involving the skin, central nervous system, and skeletal system. In 90% of the patients, nevoid basal cell carcinoma syndrome is associated with recurring odontogenic keratocysts. Also our patient showed recurrent jaw and maxillary cysts, for this reasons he has been followed for 10 years to the Oral Pathology Service of Galliera Hospital.
P53 protein in cutaneous melanoma. We report the results of an immunohistochemical analysis about the nuclear phosphoprotein P53 expression performed on 48 primary and 10 metastatic cutaneous melanoma in order to assess the prevalence of the expression of mutant P53 protein (m-P53) in this skin tumour. In our study m-P53 was found in about 46% of primary tumours without any significant relationship with the corresponding metastatic lesions. Therefore the P53 count in cutaneous melanoma is not a prognostic marker of tumour spread and aggressiveness.
By means of an AgNOR technique, the authors have carried out a retrospective study on proliferative activity in 170 cases of infiltrating ductal breast carcinoma (so-called carcinoma NOS). The follow-up period was 138 months. A statistically significant correlation was found between AgNOR score and outcome of the disease ("vital status"), clinical stage and OS respectively. By means of discriminant analysis a threshold value of AgNOR score was identified (= 9.5) which distinguished two risk groups among the cases under examination. Those cases with an average AgNOR score below the threshold value showed a favourable prognosis. The cases with an AgNOR score greater than 9.5 had an unfavourable outcome. The authors suggest that AgNOR score may be used as a prognostic parameter in breast carcinoma.
A 3-year-old boy with erythema multiforme-like manifestations and severe articular involvement is reported. Because of the unusual onset of the cutaneous lesion a skin biopsy was performed, revealing the typical features of a leukocytoclastic vasculitis. A direct immunofluorescent study revealed C3 and IgM deposition within the wall and around the small vessels. The clinical and immunopathological findings in this patient were similar to those reported for the acute hemorrhagic edema of infancy (AHE) described in children younger than 2 years of age. The present case supports the hypothesis that AHE is a distinctive leukocytoclastic vasculitis of childhood, irrespective of the age at onset.
Bone marrow biopsy is very important in diagnosis and follow-up of children affected by neuroblastoma (NB). Between June 1995 and May 1997 we studied 55 patients with NB stage 4. Specimens were obtained at the diagnosis (in 8 patients) and after chemotherapy (in 55 patients) in order to evaluate the effects of treatment on bone marrow disease. 88% of 343 biopsies were representative versus 99% of 639 aspirates. Of 8 stage 4 patients evaluated at diagnosis, 15/16 biopsies versus 9/15 aspirates were positive. Following chemotherapy, out of 298 evaluable sites examined, 111 biopsies versus 30 aspirates (37 versus 10%) were positive. Of 111 positive biopsies 53 showed a focal pattern (35 differentiated, 18 undifferentiated), while 51 showed a diffuse pattern (18 differentiated, 40 undifferentiated). Our results confirm previous literature data indicating a better efficacy of histology versus morphology in detecting residual bone marrow disease (especially in case of focal differentiated pattern). The recent introduction of a specific monoclonal antibody, called anti-GD2, has improved our capacity to detect minimal residual disease in patients' bone marrow. The inclusion of anti-GD2 immunohistochemistry in our evaluation will possibly increase our overall sensitivity to detect minimal residual disease and may provide information capable to direct the physician's decision into a more rational patient's treatment.