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E Fulcheri

Publications and source records attributed to E Fulcheri.

At least 55 records · Page 3Linked to original sources
PubMed1996

[The museums of pathologic anatomy: a very much neglected sector of scientific museology, worth of reconsideration].

This brief work aims at drawing attention to the problems affecting museums of pathological anatomy and the possibility to revise their role and give them other purposes than the merely educational ones for which they are established. Current educational methods and tools, using sophisticated and modern audio-visual and multimedia systems, have been so thoroughly renewed that the preservation of anatomic specimens for exemplification and illustration is no longer a fundamental requirement. Clearly enough, Pathological Anatomy Museums need to change in order to meet new requirements and achieve new goals. Therefore, the creation as well as the revamping of a Museum should be based on the use of multimedia and interactive systems. These should include the collection of pictures of rare or peculiar cases as well as the possibility to propose pre-established educational programmes to students, while offering to scholars other programmes with different levels of difficulties and historical-documentary information. This is the approach followed by the experimental model implemented in our Institute which is presented in this work. Also, the Museum should be responsible for collecting and safeguarding rare anatomic material or specimens of particular interest from a historical-geographical and chronological point of view. The Museum should be a biologic archive from which information can be trapped for study and research works. For this reason, it should not be located only in one place, but the information and data therein contained should be made available, through a computer network, in the various centres and departments of Pathological Anatomy. Secondly, collections of dried osteologic materials should be properly preserved, since they are an important educational tool of great value for paleopathological studies. Finally, particular attention should be given to the oldest museums hosting collections of anatomic artworks such as wax impressions and casts, which, being the expression of a specific age and scientific attitude, are to be considered as a cultural heritage to be safeguarded.

Humans↗
PubMed1995

The incidental finding of abnormal cervical histology in postmenopausal patients.

A report is supplied on 216 samples of cervical tissue incidentally found in 684 endometrial specimens collected during hysteroscopic examination of postmenopausal women with uterine bleeding and a recent negative Pap smear. We found 43 (19.9%) specimens including cervical tissue with some histologic sign of pathology. Twenty-five (11.6%) had histologic features suggestive for human papillomavirus (HPV) infection, while 18 (8.3%) had cervical intraepithelial neoplasia (CIN). Of the 18 CIN cases, 9 were CIN I, 6 CIN II and 3 CIN III. Altogether, the prevalence of dysplasia in postmenopausal women with recently referred normal cervical cytology was impressive. A significant number of dysplastic lesions (14 out of 18, 77.7%) did not present any histologic sign of HPV. Also, none of the histologic diagnoses of sub-clinical HPV infection was confirmed by the in situ hybridization. Considering the significant prevalence of high grade lesions (9 CIN II and III, 4.2% of the analysed samples) found in this randomly selected patient population, our data strongly suggest the need for a regular follow-up of the transformation zone in all postmenopausal women. Although in women of postmenopausal age some low grade lesions seem to have only a reactive-reparative significance, a more accurate screening procedure, taking into account the peculiar modifications of the menopausal uterine cervix, is advisable.

Adult↗
PubMed1994

Assessment of proliferating cell nuclear antigen expression in dysplastic intestinal type Barrett's esophagus. Gruppo Operativo per lo Studio delle Precancerosi Esofagee.

In the management of patients with Barrett's Esophagus (BE) the definition of a sub-group of patients at high risk for malignant transformation of the metaplastic epithelium is important. Undoubtedly, the histological evaluation of dysplasia is the most important and objective parameter to identify a malignant transformation of BE. In order to obtain additional data a group of cell proliferation markers was applied in dysplastic lesions. We studied PCNA in a selected group of patients with BE. One hundred six biopsies were examined, referring to fifty five patients with BE, who were followed up for a period of at least one year (1-5 years). All patients showed one or more biopsies positive for dysplasia. PCNA was detected immunohistochemically on formalin fixed and paraffin embedded biopsies, and positive cells were evaluated in a crude percent count. Our results showed a remarkable number of PCNA positive cells in high grade dysplasia and a variable amount of PCNA positive cells in the others groups. In addition, there was an overlap in the number of positive cases between low grade dysplasia (30%), indefinite (33%) and negative (34%). Therefore, the assessment of S-phase cells correlated with the degree of dysplasia seems to be of limited practical use. Cell proliferation is probably affected by many factors and mainly inflammation.

Adenocarcinoma↗
PubMed1994

Blood free endometrial sampling: a useful tool in routine diagnosis.

The presence of clots or of a great amount of blood in the specimen from curettage or endometrial aspiration may lead to considerable problems for the pathologist. The application of a lysis buffer/ethanol solution before applying conventional fixation techniques may solve this problem. This new technique was tested on a series of endometrial samples. No disadvantages have been recorded, quite the contrary, optimum specimens were obtained for histochemical and immunohistochemical studies.

Blood↗
PubMed1994

[Massive intestinal hemorrhage caused by leiomyoma of the jejunum. Report of a case].

Small-bowel leiomyoma is a rare tumour. The authors report a case complicated by severe bleeding. Esophagus-gastro-duodenal endoscopy was not decisive enough, while TC was the most reliable instrumental investigation. Because of dimensions basic than 10 cm, the presence of a pseudocapsule end the absence of cariokinetic figures, the histopathologic test supports the hypothesis that it was a benign disease. One year follow-up, negative for relapse, confirm that the lesion is benign.

Aged↗
PubMed1992

Radicular compression by extradural spinal endometriosis. Case report.

The case of a 35 years old woman affected by endometriosis located inside the spinal canal in the extradural space at the level of the third left lumbar root, and developing through the corresponding foramen into the paraspinal muscles, is presented. The clinical aspect, radiological picture and surgical treatment are described. Pathogenesis is discussed on the basis of the literature. Furthermore it is stressed that only the histopathological examination gave the correct diagnosis and permitted the definitive hormonal treatment. To our best knowledge no comparable case has been published in the literature.

Adult↗
PubMed1992

Endometrial response in sequential cyclic therapy assessed with associated hysteroscopy and histology.

A morphologic study was performed on the endometrium in 37 asymptomatic postmenopausal women under effects of cyclically administered oestrogens. Eighty-seven postmenopausal women were taken as control group. Medroxyprogesterone acetate (MPA), 10 mg daily, was administered in association with two types of oestrogen replacement therapy: conjugated equine oestrogens 0.625 mg (CEE) or transdermal 17 beta-oestradiol 0.05 mg (E2-TTS). Endometrial biopsies were taken under hysteroscopic control before treatment and on days 8-12 of combined therapy at the 6th month. Follow-up at 12 and 18 months was only performed in 8 and 5 patients, respectively, with transdermal 17 beta-oestradiol treatment. Various types of endometrial response were identified from atrophy to hyperplasia and secretory patterns. No atypical hyperplasia was found. All cases of simple or complex hyperplasia showed a regression after increased MPA dosage treatment (20 mg). This work is aimed at investigating the endometrial response during sequential cyclic therapy by using morphologic criteria based on hysteroscopy and histology. A large number of patients with hyperplasia can be detected with target biopsy under hysteroscopy, thus playing an important role in the management of patients during replacement therapy in research protocols.

Adult↗
PubMed1992

Mucin histochemical analysis in the interpretation of Barrett's esophagus. Results of a multicenter study. The Operative Group for the Study of Esophageal Precancer.

A multicentric study of Barrett's esophagus (BE) was started in November 1987 to evaluate (1) the prevalence of BE among subjects undergoing upper gastrointestinal endoscopic examination; (2) the pathologic features of BE; and (3) the correlation between BE and early malignant changes. In 157 of 330 patients who underwent multiple standardized biopsies, BE was confirmed with histologic evaluation. Specialized intestinal-type BE was observed in 84 patients. By applying Alcian blue (pH 2.5)-periodate oxidation-Schiff, high-iron diamine-Alcian blue (pH 2.5), and periodate borohydride-saponification-periodate oxidation-Schiff techniques, the intestinal type of BE was subclassified into colonic and ileal types, both complete and incomplete. Fifty cases had incomplete colonic metaplasia with sulphomucins in the columnar cells and 64 had complete colonic intestinal metaplasia, 49 of them containing O-acetylated sialomucins in the goblet cells. These patients are being included in a short-term follow-up. Dysplasia (six low grade, two high grade) was observed in eight patients in areas of intestinal colonic-type epithelium; in these patients, a complete loss of O-acetylated sialomucins in the dysplastic areas and a remarkable reduction of these mucins in the surrounding tissue were observed. The reduction of O-acetylated sialomucins might indicate relative tissue immaturity, which could represent an early sign of neoplastic dedifferentiation. Therefore, the relevance of O-acetylated sialomucin content in BE, first demonstrated in intestinal type, is now evident, although its biologic importance is being studied.

Adolescent↗
PubMed1991

Patterns of intestinal metaplasia in gastric biopsies. A comparison of different histochemical classifications.

A total of 217 cases of gastric intestinal metaplasia (IM), out of 491 cases of consecutive multiple gastric biopsies, were examined using various histochemical methods. Three classifications were adopted (1) Jass and Filipe's (1979), (2) Segura and Montero's (1983), and (3) our own distinguishing two types of small intestine IM (incomplete and complete) and two types of colonic IM (incomplete and complete). Our classification revealed (1) a group of 'pure' IM cases (44%), (2) a group of 'combined' IM cases (15%), either small intestinal or colonic, expressing a maturating line, and (3) a conspicuous group of mixed 'mosaic' IM cases (41%) consisting of all possible combinations between the basic IM types. No significant correlations were found between each IM type and associated diseases (i.e. gastritis, stump gastritis, ulcer, adenoma and adenocarcinoma). However, a suggestive association between colonic IM and malignancy was observed. Our results confirmed the heterogeneity of IM and indicated two differentiation cell lines (ileal and colonic), thus providing additional evidence of impaired maturation and aberrant differentiation along various cell lines, supporting Leblond's (1976) unifying theory on the origin of intestinal epithelial cells.

Adult↗
PubMed1991

Significance of the smooth muscle cell component in Peutz-Jeghers and juvenile polyps.

We have previously reported the presence of smooth muscle cells (SMCs) in the lamina propria of both tubular and villous adenomatous polyps. In the current study, we investigated the presence and distribution of SMCs with immunohistochemical techniques using anti-alpha smooth muscle actin and anti-desmin antibodies on a series of hamartomatous polyps. In five Peutz-Jeghers polyps, large tree-like branches of SMCs were observed, while in 13 juvenile polyps, rare elongated SMCs were found in the lamina propria, partially surrounding cystically dilated glands. Apart from the quantitative differences, the SMC distribution was similar in the two types of hamartomatous polyps and not dissimilar from the pattern described in neoplastic polyps. These findings make the category "juvenile polyp" less clear and its differentiation from other histologic types of polyp less sharp. Thus, the presence or absence of SMCs cannot form the basis of the differential diagnosis between adenomatous and hamartomatous polyps.

Adolescent↗
PubMed1990

Histochemical study of mucinous ovarian cystomas of intestinal and mixed types: O-acetylated sialomucin content in relation to biologic behavior.

The subgroup of mucinous ovarian cystomas of intestinal type containing site 8 O-acetylated sialomucins and its relation to malignant behavior were studied. Of 75 mucinous cystomas of the ovary from the files of the Institute of Pathological Anatomy and Histology (University of Genoa), 54 were endocervical, 19 were mixed, and 2 were intestinal. As regards their histologic pattern, the 54 mucinous endocervical cystomas were benign, whereas the 19 mixed type group included 8 benign, 5 borderline and 6 malignant; the 2 intestinal type tumors were borderline. According to histochemical investigations, the frequency of tumors with goblet cells containing site 8 O-acetylated sialomucins (positive to PB/KOH/PAS) was 47% in the mixed type cystomas and 100% in the intestinal type cystomas. Twenty-five percent of benign mixed cystomas, 60% of borderline mixed cystomas, and 67% of mixed cystadenocarcinomas were positive to PB/KOH/PAS. One hundred percent of the borderline cystomas of intestinal type were positive. Our results confirm that among mucinous ovarian cystomas, those containing intestinal type epithelium are the most likely to fall within the borderline or malignant categories. Moreover, of all ovarian cystomas of intestinal type, those characterized by site 8 O-acetylated sialomucins seem to be more aggressive and, in general, to have a more malignant behavior than the mucinous cystic tumors of müllerian or endocervical type.

Acetylation↗
PubMed1990

Squamous cell carcinoma with prominent myxoid stroma.

Three cases of a squamous cell carcinoma with a prominent myxoid stroma are reported. One case in a 70-year-old woman had presented as a lump in the breast, the other two presented as polypoid lesions of the larynx and cervix uteri in a 65-year-old man and 61-year-old woman, respectively. The carcinomatous component was immersed in abundant extracellular mucosubstances. In addition to occasional squamous pearls, it displayed immunocytochemical evidence of high-weight keratin present in the neoplastic cells and, in one case, desmosomal attachment under electron microscopy. The extracellular mucosubstances proved to be similar to those seen in connective tissue. The differential diagnosis with histologically similar lesions has been taken into consideration, and it has been suggested that this newly described entity showing abundant myxoid stroma has to be distinguished from numerous benign and malignant myxoid soft tissue tumors.

Aged↗
PubMed1990

Prognostic value of the Jass histopathologic classification in left colon and rectal cancer: a multivariate analysis.

Variables correlated to survival were studied in 121 patients who had undergone potentially curative surgery for left colon and rectal cancer. To investigate the prognostic value of the parameters both univariate and multivariate analysis were carried out. Minimum follow-up was 5 years. Multivariate analysis showed that while disease stage (p less than 0.0001) and site of primary tumor (p less than 0.0006) independently influenced survival, type of surgical procedure and histopathologic grade had no impact on survival. Jass histopathologic classification predicted survival for patient group I and IV whereas no significant relationship was observed for group II and III, which, in our series, were the most frequently encountered groups. Of the three parameters considered for Jass classification, tubule configuration, pattern of tumor growth and lymphocytic infiltration, only the latter was significantly correlated to survival (p less than 0.005). Different results were obtained when the prognostic values of Jass group was investigated separately for the 49 patients with adenocarcinoma of the left colon and the 72 patients with rectal cancer. Further investigation is required before routine clinical application of the Jass classification can be recommended.

Adenocarcinoma↗
PubMed1990

[The prognostic value of Jass' histopathological classification of cancer of the left colon and rectum].

Histological material from 121 patients who underwent surgery for cancer of the left colon and rectum was reexamined by two pathologists according to criteria put forward in Jass' histopathological classification. A prevalence of Jass' grades II (36.4%) and III (47.9%) were observed in this series. There was no correlation between the site of neoplasia but there was a clearly increased incidence of advanced stages C and D according to Dukes-Kirklin's classification within Jass' grades II, III and IV (p less than 0.005) and growth pattern, but not for the configuration of tubules. The new histopathological model proved to be more reliable in prognostic terms in the case of cancer of the rectum compared to that of the left colon, but at present its clinical significance is limited to specifying the site and stage of the neoplasia. The latter was found to be the most reliable prognostic parameter.

Adenocarcinoma↗
PubMed1989

Prognostic value of the immunocytochemical detection of extramural venous invasion in Dukes' C colorectal adenocarcinomas. A preliminary study.

In postsurgical staging of colorectal adenocarcinomas, it is sometimes difficult to determine the range of possible venous spread. Distinguishing between the extramural veins (especially when the neoplastic embolus takes up the whole lumen and the endothelium cannot be identified) and the smallest extramural lymph nodes (when they are completely replaced by metastatic carcinoma, leaving the capsule alone) is also difficult. This work proposes a more precise definition of true venous invasion to improve histopathologic staging. Immunohistochemical techniques employing commercial antibodies against Factor VIII RAG, with and without enzymatic digestion, and UEA I lectin for residual endothelium detection, were applied, as well as antibodies against vimentin, desmin, and alpha sm-1 actin to detect wall components. The immunohistochemical evaluation of colorectal adenocarcinomas, in particular by anti-alpha sm-1 actin antibodies, permitted a reliable morphologic distinction of the true venous invasion. This factor proved to be relevant for survival rate prediction.

Actins↗
PubMed1988

Distribution and significance of the smooth muscle component in polyps of the large intestine.

Immunocytochemical staining for alpha smooth muscle actin specifically reveals the distribution of the muscularis mucosae and pericryptal intramucosal smooth muscle fibers in the normal mucosa and polyps of the large intestine. In the latter, the muscular component is hyperplastic, especially in pedunculated polyps, which display a thick "muscular zone" at the top of the stalk. The diagnostic (and prognostic) significance of the distribution pattern of the muscular component in polyps, and in "early invasion" cases, is discussed.

Adenoma↗