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Biomedical subjects

F Giangaspero

Publications and source records attributed to F Giangaspero.

At least 73 records · Page 4Linked to original sources

Analysis of N-ras gene mutations in medulloblastomas by polymerase chain reaction and oligonucleotide probes in formalin-fixed, paraffin-embedded tissues.

Precise data on the incidence of transforming ras oncogenes in pediatric tumors and the correlations with the histopathological properties of the tumors are very limited. Additionally the presence of ras activation in medulloblastomas has not been investigated so far. Using a combination of techniques including in vitro gene amplification by polymerase chain reaction (PCR) and detection of single base mutations by sequence-specific oligonucleotides we studied N-ras activation (mutations at codon 12, 13, and 61) in 32 medulloblastomas. DNA was isolated from 20 microns sections of formalin-fixed paraffin-embedded tissue. Mutations were found in 3 out of 32 examined medulloblastomas. In all cases only mutations of codon 61 were found: two of three mutations were C to A mutations at position 1 of the codon 61 (leading to a substitution of a glutamine residue for a lysine) and one was A to T mutation at position 3 in the same codon (glutamine-histidine). Our results indicate 10% incidence N-ras mutation in medulloblastoma, higher than in other CNS tumors studied so far. The main advantages of the procedure described are its greatly improved sensitivity, the increased speed with which tumor samples can be analyzed, and the possibility of using paraffin-embedded sections to analyze various rare tumors in retrospect.

Adolescent↗

"Desmoplastic" versus "classic" medulloblastoma: comparison of DNA content, histopathology and differentiation.

A microfluorometric analysis was performed to analyse the DNA content of 42 medulloblastomas (MBs) and to seek correlations, if any existed, between the DNA distribution and ploidy values, neoplasm types (i.e. classic vs desmoplastic), histological features of aggressiveness, and immunocytochemical features indicating glial and/or neuronal differentiation. Thirty-one cases were classified as classic and 11 cases as desmoplastic MBs. Ten of 11 desmoplastic MBs had a near-diploid main mode and the remaining 1 case had a near-tetraploid main mode. Moreover, 10 of 11 (90%) cases showed a "monomodal" DNA distribution diagram. All these cases showed a uniform histology. In contrast, classic MBs represented a heterogeneous group of neoplasms. Twenty-two cases were near-diploid, 5 cases were near-tetraploid and 3 cases were near-triploid. The histogram type distribution showed a similar heterogeneity. Twelve of 31 (39%) cases had a monomodal histogram, 12 (39%) cases had a bimodal diagram and 7 (22%) cases a complex DNA distribution. There was a statistically significant difference (P less than 0.001) in terms of prevalence of DNA monomodal histograms between classic and desmoplastic MBs. Significant correlations were not observed among classic MBs between histological features of aggressiveness, type and degree of differentiation and DNA distribution. The present study indicates that desmoplastic MBs represent a homogeneous group of neoplasms in terms of histology and DNA distribution. In contrast, classic MBs are lesions with different degrees of histologically apparent aggressiveness and a complex DNA distribution.

Adolescent↗

A preliminary study of human pineal gland concretions: structural and chemical analysis.

Acervuli and fragments of pineal gland obtained from 33 subjects of both sexes and age ranging from 1 to 87 years, (30 autopsy and 3 biopsy specimens) were analyzed by light microscopy, transmission and scanning electron microscopy, X-ray diffraction and X-ray energy dispersive microanalysis. It was found that primary mineralization occurs in an organic matrix formed by pinealocytes and that hydroxyapatite also takes place in mineral deposition. From our analysis, the formation of acervuli appears to be age and sex independent and can be possibly related to the secretory activity of the gland.

Adolescent↗

Massive neuronal destruction in human immunodeficiency virus (HIV) encephalitis. A clinico-pathological study of a pediatric case.

Human immunodeficiency virus (HIV) encephalitis in children with AIDS includes a diffuse white matter disease associated with an inflammatory cell infiltrate that features multinucleated giant cells. Cerebral cortex is relatively preserved and only focal loss of Purkinje cells in the cerebellum has been observed. We describe a case of encephalitis in a child with AIDS in which there was massive and diffuse destruction of the cerebral cortex with severe neuronal loss, marked inflammatory perivascular infiltrate with abundant multinucleated cells and large pleomorphic reactive astrocytes. Similar findings were present in the basal ganglia. Moreover, the cerebellum disclosed a complete loss of Purkinje and granule cells. These findings could not be related to an ischemic mechanism or to an associated opportunistic infection. Electron microscopy showed numerous HIV particles. This case illustrates a different pattern of CNS involvement by HIV and emphasizes the destructive capacity of this neurotropic virus for neural tissue.

Acquired Immunodeficiency Syndrome↗

Malignant peripheral nerve sheath tumors and spindle cell sarcomas: an immunohistochemical analysis of multiple markers.

An immunocytochemical study using a panel of commercially available antisera, has been performed to distinguish on the basis of their immunoreactivity a series of spindle cell sarcomas diagnosed solely on the histologic features: 11 malignant schwannomas (MS), 8 leiomyosarcomas (LMS) and 3 malignant fibrous histiocytomas (MFH). The results have been compared with those obtained in 12 benign and 8 malignant peripheral nerve sheath tumors (MPNST) in which the microscopic diagnosis was supported by their origin in a nerve trunk and/or in von Recklinghausen's (vR) disease. The following antisera were used: anti-S-100 protein, anti-Leu-7, anti-neuron specific enolase (NSE), anti-myelin basic protein (MBP), anti-glial fibrillary acidic protein (GFAP) and anti-actin. S-100 protein was present in 100% of benign and malignant peripheral nerve tumors and in 7/11 (63%) of MS diagnosed on histological basis only and in 3/8 (37%) LMS. MFH were negative. Leu-7 positivity was observed in 8/12 (66%) and 6/8 (75%), respectively, in benign and malignant PNS neoplasms, in 5/11 (45%) MS, 4/8 (50%) LMS and 2/3 (66%) MFH. NSE was present in 7/12 (58%) and 6/8 (75%), respectively, in benign and malignant PNS tumors, in 6/11 (54%) MS and in 1/8 (12%) LMS. MFH were negative. MBP resulted negative in peripheral nerve neoplasms and spindle cell sarcomas. GFAP positivity was observed in 2/12 (16%) and 1/8 (12%), respectively, in benign and malignant PNS neoplasms. All spindle cell sarcomas were negative. All cases of MPNST and spindle cell sarcomas showed actin immunoreactivity. These results indicate that: (1) MBP, Leu-7 and NSE do not represent markers of schwannian differentiation; (2) GFAP, although rarely expressed, may indicate schwannian differentiation, and (3) malignant peripheral nerve neoplasms and LMS share immunoreactivity for S-100, Leu-7, NSE and actin, therefore they cannot be differentiated on immunocytochemical basis using commercially available antisera.

Actins↗

Histochemical and ultrastructural study of the human pineal gland in the course of aging.

A histochemical and ultrastructural study was carried out on the pineal gland of 2 day- to 86-year-old subjects. Specimens were obtained by stereotaxis in the course of neurosurgery; other specimens were autoptical pineal fragments. Histochemical and ultrastructural analyses showed lipofuscin pigments, frequently localized in the proximity of blood capillaries and of cytoplasmic microacervuli. The brain sand amount does not appear to be age-related because microacervuli are barely present or frequently absent in the oldest subjects. Its involvement in the secretory activity rather than in gland atrophy is also suggested. The close relationship between cytoplasmic microacervuli and intermediate filaments suggests a possible role of the cytoskeleton in the formation of the brain sand.

Aged↗

Ependymomas: a clinicopathologic study.

Since 1924, when ependymomas were first classified as a distinctive glial neoplasm by Bailey, much has been published concerning these tumors, but there are important points of interest that are still not clear. In order to study more fully the clinical and pathologic characteristics of the ependymoma, we identified 62 patients with histologically proven neoplasms. Twenty-two were supratentorial, 21 were infratentorial, and 19 were intramedullary spinal cord tumors. These groups had mean ages of 17, 7, and 41 years, respectively, at the time of first symptoms. The presenting and accompanying symptoms were related to location and included headaches, nausea, visual changes, hemiparesis, and neck, back, and radicular pain. Neurological signs included papilledema, nystagmus, gait disturbance, cranial nerve palsies, altered mental status, paraparesis, and sensory dysfunction. Radiologic modalities of particular importance included computed tomography and myelography. Surgery and radiation therapy were the primary treatment modalities with median survival times from first symptoms being 92, 36, and 117 months for the above groups, respectively. Based on computer-generated survival curves, several characteristics significantly affected survival. These included tumor site, age, and neuraxis metastases. In patients with supratentorial tumors, cranial nerve palsies, microcystic changes, and mitotic figures were important, while in patients with infratentorial tumors, widened sutures, increased head circumference, age, epithelial features, and subependymal features significantly affected survival. Patients who had complete gross resection of a spinal cord tumor had no recurrences or mortality.

Brain Neoplasms↗

Diffuse axonal swellings in a case of acquired immunodeficiency syndrome.

We report a case of a 25-year-old woman affected by the acquired immunodeficiency syndrome in whom the neuropathologic examination disclosed the presence of diffuse axonal swellings in the brain stem and in selected areas of cerebral hemispheres. These lesions, although microscopically similar to those previously described as focal pontine leukoencephalopathy, differ in that their distribution was wider, there was an absence of associated necrosis of the adjacent nervous tissue, and there was a lack of calcification. It is suggested that axonal swellings represent a nonspecific reaction of the central nervous system to infection by opportunistic agents and/or human immunodeficiency virus in patients with the acquired immunodeficiency syndrome.

Acquired Immunodeficiency Syndrome↗

Comparison of cytologic composition with microfluorometric DNA analysis of the glioblastoma multiforme and anaplastic astrocytoma.

The DNA content of selected areas of 16 glioblastoma multiforme predominantly composed of small anaplastic cells was investigated. These findings were contrasted with those of five cases of anaplastic astrocytomas. The microfluorometric determination of DNA was performed on mechanically isolated single cells stained by the Feulgen method, obtained from selected areas of the neoplasms in paraffin blocks. Twelve of 16 cases of glioblastoma multiforme had a main population that was diploid-near diploid. Although four of the five anaplastic astrocytomas disclosed a diploid-near diploid main population there was a more complex DNA distribution than in the small cells in glioblastomas. These differences were evident using two numerical DNA indices obtained from the analysis of each tumor histogram which defined, respectively, the extent to which the main tumor cell population deviated from euploid values and the probabilities to have multiple stemlines with abnormal DNA content. The results suggest that small anaplastic cells which appear to represent the most aggressive population in glioblastomas have a DNA content diploid-near diploid, and in malignant gliomas the degree of aneuploidy of the main stemline is not related to the biologic behavior of the neoplasm.

Adult↗

Growth fraction in human brain tumors defined by the monoclonal antibody Ki-67.

The monoclonal antibody Ki-67, which reacts with cells in the active part of the cell cycle, was used to evaluate immunocytochemically the growth fraction in 22 primary brain neoplasms. The percentage of labelled cells reflected the histological grade of malignancy of each neoplasms. High percentage of Ki-67-positive cells were observed in one choroid plexus carcinoma (60%), one primary melanoma of meninges (40%), three medulloblastomas (40%-50%), one anaplastic astrocytoma and six glioblastomas (10%-40%). One ependymoma had 7% positive cells. Rare positive cells (1%) were present in one pilocytic astrocytoma and one ganglioglioma. Except one negative case, the meningiomas (five cases) had values of positivity ranging from 1% to 6%. Two acoustic schwannomas were negative. These results suggest that immunocytochemical staining with the Ki-67 may be a useful method for measuring the growth fraction in brain neoplasms.

Antibodies, Monoclonal↗

Degeneration of the corticospinal tract following portosystemic shunt associated with spinal cord infarction.

The clinicopathological aspects of a case of myelopathy that followed the creation of a surgical porto-caval shunt for hepatic cirrhosis and oesophageal varices are presented. Degeneration of the lateral corticospinal tracts associated with diffuse bilateral ischaemic changes of the spinal gray matter and proliferation of Alzheimer type 2 glia in the brain and brain stem were the most prominent findings. The association of corticospinal tract degeneration and ischaemic lesions of spinal gray matter in absence of any anatomical cause of spinal cord infarction suggests that a modification of the spinal blood flow caused by creation of portosystemic shunts might be the basic pathogenetic mechanism of this complication of severe liver disease.

Brain↗

Squamous cell carcinoma of the brain with sarcoma-like stroma.

A cerebral neoplasm containing a well differentiated epidermoid cyst surrounded by islands of infiltrating squamous cell carcinoma and a pleomorphic spindle cell stroma was described. By immunoperoxidase staining all these components contained keratin. The lesion was therefore similar to malignant squamous cell lesions with sarcoma-like stroma occurring in other body sites.

Brain Neoplasms↗

Suprasellar papillary squamous epithelioma ("papillary craniopharyngioma").

Six cases of a distinctive suprasellar papillary neoplasm are presented and the features of this lesion are contrasted with those of the classical adamantinomatous craniopharyngioma. Characteristics distinguishing the former from the latter include a predominate, and perhaps exclusive, occurrence in adulthood; frequent radiologic solidity and absence of calcification; macroscopic papillary nature; and, microscopically, a well-differentiated papillary squamous epithelium without calcification, palisaded cells, or keratoid nodules. We suggest that this papillary lesion is a clinicopathologic entity distinct from the classical adamantinomatous craniopharyngioma.

Adolescent↗

The glioblastoma multiforme and the metastatic carcinoma: a morphometric study of nuclear size and shape.

Thirty-one surgically excised glioblastomas multiforme (GBM) and 34 intracranial metastatic carcinomas were studied morphometrically to determine the confidence with which these two common lesions can be distinguished on the basis of their nuclear sizes and shapes. Planimetry was used to characterize the nuclei in these lesions and two primary variables were calculated: (1) the mean nuclear size and (2) a measure of roundness, the mean 'form PE'. The two neoplasms were then compared by logistic regression which calculated the coefficients of two equations expressing the probability that each of the 65 lesions was a GBM. There were significant differences between the two lesions (p = 0.001 or less) in both nuclear size and shape. The nuclei of the GBM were smaller and less round. The first logistic regression equation utilized mean nuclear size and mean form PE and 'correctly' classified 26 of the GBM and 30 of the carcinomas. The second equation utilized mean nuclear area and the coefficient of variation of nuclear area. Only 6 neoplasms, 3 metastatic carcinomas and 3 GBM, were 'incorrectly' classified. The results suggest that there are significant differences in nuclear size and shape in these two lesions and that these differences are amenable to morphometric and statistical study. Similar predictive equations should be tested as potential diagnostic aids.

Adult↗

Morpho-functional changes in normal cyclic endometrium.

Eight cases of normal endometrium in the early proliferative phase and an equal number of cases in the late secretive phase were stained histochemically for acidic mucosubstances and immunocytochemically for epithelial membrane antigen (EMA), carcinoembryogenetic antigen (CEA) and Gross Cyst Disease Fluid Protein -15 (GCDFP-15) production. Alcian blue positive material was observed in both phases of the cycle, although the distribution was different. Sulphated mucosubstances were only present in the secretive phase. No CEA nor GCDFP-15 immunoreactive material was detected. EMA positive staining was observed in all cases, but the distribution varied according to the two different phases of the cycle.

Adult↗

Small-cell osteosarcoma of the mandible. Case report.

A case of small-cell osteosarcoma of the mandible in an 8-year-old girl is reported. This unusual variant may simulate Ewing's sarcoma and other small-cell neoplasms affecting jaws in children. The correct recognition of this type of tumor may be important for an appropriate choice of treatment.

Child↗

Correlations between cytologic composition and biologic behavior in the glioblastoma multiforme. A postmortem study of 50 cases.

The brains of 50 adults with supratentorial glioblastoma multiforme were studied post mortem. The cytologic compositions of the neoplasms were examined in each of three sites: (1) in and around the original tumor bed; (2) zones of infiltration of contiguous structures; and (3) implants in the subarachnoid and/or ventricular spaces. For this purpose, six different cell types were defined: small anaplastic cells (SAC), small fibrillated cells (SFC), fibrillated astrocytes (FA), pleomorphic astrocytes (PA), gemistocytic astrocytes (GA), and large bizarre cells (LBC). In 16 cases with marked mass effect in the original tumor bed entirely due to the neoplasm, the cytologic composition of the neoplasm was predominantly SAC (14 cases) and SFC (2 cases). The prevalence of these two cellular types was evident in the infiltrated regions in 36 of 42 cases, and in the metastatic foci of 11 of 13 cases. In 10 of 11 cases in which there was mild or no mass effect, only limited infiltration in the ipsilateral hemisphere, and no metastases, the neoplasms were composed of a combination of FA, PA, GA, and LBC. The observations suggest that, in spite of the glioblastoma's cytologic heterogeneity, the pathologic substrate of aggressiveness in this malignant glioma is related largely to the proliferation of a population of small anaplastic cells. On the basis of this observation, as well as the consideration of certain clinical and therapeutic variables, an outline is presented summarizing the history of the glioblastoma multiforme from treatment until the time of death.

Adolescent↗