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Biomedical subjects

F Rilke

Publications and source records attributed to F Rilke.

At least 145 records · Page 8Linked to original sources
PubMed1982

Histologic evidence for an association of cervical intraepithelial neoplasia with human papilloma virus infection.

All the cytologic and histologic material pertaining to 100 patients who underwent cervical conization for advanced cervical intraepithelial neoplasia (CIN) was reviewed. The revision of the histology of the biopsies and cones showed in 56 cases the association of CIN with viral cytopathic effects (VCE) attributable to human pappiloma virus (HPV) and in 52 the coexistence of a predominantly flat condyloma. The comparison of the two groups of CIN, with and without VCE, showed that in the first the association had favored in 20% of the cases the histologic overestimation of the severity of the lesion. Of the patients with CIN III, 46% showed additional changes due to VCE. The mean age of the patients with CIN and VCE was 39.8 years and that of the patients with CIN was 48.6 (p less than 0.0001). The exocervix was significantly more often involved by CIN + VCE than by CIN alone (p less than 0.00001). Follow-up studies revealed in both groups the same percentage of residual disease and, preliminarily, a trend to a better control of CIN with VCE. New disease developed more often in the group of patients with CIN without VCE. Cytologic sensitivity for VCE in cervical smears was high (95%) in the cases of CIN II and somewhat lower (81%) in those with CIN III. Cytologic follow-up showed the persistence of VCE in 17% of the patients treated surgically for CIN and VCE. The morphologic and clinical features displayed by CIN associated with VCE warrant its recognition as a distinct variant of CIN.

Adult↗
PubMed1982

Endometrial carcinoma: stage I. A retrospective analysis of 262 patients.

From 1969 to 1977, 420 patients with endometrial carcinoma were observed and treated at the National Tumor Institute of Milan. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed in 351. After careful clinical and pathologic review, 262 patients were classified as having stage I disease. Further treatment included post-operative radium therapy to the vaginal vault. There were 247 cases with adenocarcinoma, 10 with adenoacanthoma, and 5 with adenosquamous or clear cell carcinoma. Of 257 cases with adenocarcinoma or adenoacanthoma, 63 were grade 1, 161 grade 2, and 33 grade 3. Of the total series, only 41 cases had disease limited to the mucosal surface. The 5-year actuarial survival was 91.4% and the recurrence-free survival was 93.4%. The case material was evaluated according to the risk factors, and results were 1) premenopausal patients had a better prognosis (100% recurrence-free survival versus 92.8% for postmenopausal women, P = .003); 2) length of the uterine cavity was not a significant prognostic factor; 3) myometrial invasion alone was not prognostic but correlated with grade of tumor; 4) the grade of the tumor was an important determinant of recurrence (grade 1 98% recurrence-free survival, grade 2 95%, grade 3 79%). With the described therapy, vaginal recurrences were absent. The recurrences were distant in 20% and local with or without distant metastases in 80%.

Adenocarcinoma↗
PubMed1981

Childhood non-Hodgkin's lymphoma: long-term results of an intensive chemotherapy regimen.

Twenty-nine consecutive children with untreated non-Hodgkin's malignant lymphoma were admitted to Istituto Nazionale Tumori of Milan during the period from 1974 through 1976 and underwent treatment with chemotherapeutic regimens consisting of Adriamycin, Cytoxan, vincristine, and prednisone (two month induction phase) and 6-mercaptopurine, methotrexate, Adriamycin, vincristine, and prednisone (maintenance phase). Each patient, regardless of clinical stage of histologic subgroup, was given the same chemotherapy. The complete response rate was 66%. Due to the high incidence of recurrence of the initial bulky lymphomatous mass and of spread to the central nervous system (CNS), local radiotherapy was given to ten children and CNS prophylaxis (brain radiotherapy + intrathecal methotrexate) to 11 children. After a follow-up period in excess of 40 months, there were five disease-free survivors (17%). Each patient who had a relapse died from the disease. The main reason for first treatment failure was relapse at the level of the primary bulky tumor site or spread to the CNS. This type of CNS prophylaxis did not prevent relapse at this site.

Adolescent↗
PubMed1981

Comparing radical mastectomy with quadrantectomy, axillary dissection, and radiotherapy in patients with small cancers of the breast.

From 1973 to 1980, we carried out a controlled study at the National Cancer Institute in Milan to consider the value of a conservative procedure in patients with breast cancer of small size. We randomized 701 patients with breast cancer measuring less than 2 cm in diameter and with no palpable axillary lymph nodes to Halsted radical mastectomy or to "quadrantectomy" with axillary dissection and radiotherapy to the ipsilateral residual breast tissue. We treated 349 patients with Halsted mastectomy and 352 with quadrantectomy. The two groups were comparable in age distribution, size and site of primary tumor, menopausal status, and frequency of axillary metastases. There were three local recurrences in the Halsted group and one in the quadrantectomy group. Actuarial curves showed no difference between the two groups in disease-free or overall survival. From these results, mastectomy appears to involve unnecessary mutilation in patients with breast cancer of less than 2 cm and no palpable axillary nodes.

Aged↗
PubMed1981

Condylomata of the uterine cervix and koilocytosis of cervical intraepithelial neoplasia.

In 202 women with koilocytotic atypia in cervical smears, 136 had predominantly small condylomata of the uterine cervix, and 66 had cervical intraepithelial neoplasia (CIN) of varying degree either with koilocytosis of the neoplasia or associated with condylomata. Koilocytosis correlated well with the histological diagnosis of condylomata, but occasionally it obscured the cytological evidence of CIN. Human papilloma virus particles were found in the cells of condylomata in 10 cases and in those of CIN II with koilocytosis in two cases of 21 examined ultrastructurally. There was evidence that the condyloma of the uterine cervix is a well-defined morphological entity and also that cytopathie changes similar to those seen in condylomata are present in some cases of CIN.

Adolescent↗
PubMed1980

Primary malignant neoplasms associated with chronic lymphocytic leukemia.

Over the past 2 decades there has been an almost exponential increase in the frequency with which cases of leukemia associated with another primary malignant lesion have been reported. In this study we reported the occurrence of a second primary neoplasm to 82 consecutive cases of chronic lymphocytic leukemia (CLL) admitted to the Istituto Nazionale Tumori of Milan from September 1962 to December 1978. In 16 of these (19.5%), an assoicated neoplasm was diagnosed subsequently (8 cases) or concurrently (8 cases) to CLL. Head and neck carcinomas and breast cancer had the highest incidence (5 and 3 cases, respectively). The results of this study further support the hypothesis that patients with CLL are prone to develop subsequent cancer. The defective cellular and humoral immunity in CLL may have an etiological role in the development of an additional primary malignancy. Although alkylating agents are known carcinogens in experimental animals and man, our results support the lack of a correlation between treatment with alkylating agents and incidence of second primary neoplasms, as demonstrated by Greene et al. (10).

Breast Neoplasms↗
PubMed1980

Second malignancies in Hodgkin's disease: a complication of certain forms of treatment.

A total of 764 patients with Hodgkin's disease treated with radiotherapy (RT) or chemotherapy or both were reviewed 3-186 months (median 43 months) after initial treatment to assess the incidence of second malignancies. Incidence of solid tumours and acute non-lymphoblastic leukaemia (ANLL) were calculated by a life-table method and percentages of patients affected derived from life-table plots. Within 10 years after initial treatment the overall incidence of second solid tumours was 7.3%, and over a comparable period 2.4% of patients developed ANLL. Solid tumours occurred only in patients given RT with or without adjuvant chemotherapy, and ANLL occurred only after treatment with MOPP (mustine, vincristine, procarbazine, and prednisolone) or modified MOPP regimens. Neither solid tumours nor ANLL occurred in patients given ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine). The highest incidence of leukaemia (5.4%) occurred after treatment with extensive RT plus (5.4%) occurred after treatment with extensive RT plus MOPP; hence the benefits of this approach in Hodgkin's disease must be weighed against its carcinogenic potential.

Adult↗
PubMed1980

Retroperitoneal metastases from ovarian carcinoma: reassessment of 365 patients studied with lymphography.

From 1973 through 1978, 365 patients with ovarian carcinoma were evaluated with lymphography. The extent of disease was assessed by clinical and conventional radiologic examinations, peritoneoscopy with visualization of diaphragmatic leaves, peritoneal cytology, and, in some patients, exploratory laparotomy. The highest incidence of metastases was found in advanced stages (31.1% in stage III and 60% in stage IV) and in recurrences (75.9%). In 87 patients with early disease, the incidence was 9.2%. In 36 pretreated patients with no evidence of disease, this incidence was 11.1%. Biopsies of the nodes were performed in 96 patients: radiologic accuracy was confirmed in 33 of 33 positive and in 55 of 63 negative cases. Of the patients, 33% had metastases only in the pelvic nodes, and 7.9% only in the paraaortic nodes; in 79.1%, both chains were involved simultaneously. These data confirm the importance of lymphography in diagnosis, treatment planning, and surveillance of ovarian carcinoma.

Adenocarcinoma↗
PubMed1979

Clinical classification and survival in chronic lymphocyte leukemia.

Sixty-one consecutive patients with chronic lymphocytic leukemia (CLL) treated at the Istituto Nazionale Tumori of Milan from September 1962 to August 1976 were classified according to the staging system of Rai et al. (16). Analysis of this series showed the following median survival (in months) from diagnosis: stage 0-I, 73; stage II, 44; stage III-IV, 32. In 11 patients without peripheral palpable adenopathies, the lymphangiogram showed abnormal retroperitoneal lymph nodes. Therefore, the initial stage was changed from 0 to I in 5 cases. The median survival for the entire series was 50 months. Patients with "indolent" disease had a median survival of 52 months, while in patients with "active" CLL, the median survival was 32 months. Both sex and age were shown to be poor predictors of survival. Increased duration of survival was observed in patients with less compared to those with more than 30,000 lymphocytes/mm3 (66 versus 41 months). The method of staging proposed by Rai et al. and utilized to classify this series at the time of diagnosis was confirmed to be a reliable predictor for survival.

Adult↗
PubMed1979

Childhood non-Hodgkin Malignant lymphomas: a clinicopathologic retrospective study.

Between 1968 and 1975, 44 evaluable children under 16 years of age with the histologic diagnosis of non-Hodgkin malignant lymphoma (ML) were treated at the Istituto Nazionale Tumori of Milan. Histologic diagnoses were reclassified as follows: 13 lymphoblastic (others) ML, 15 convoluted cell type lymphoblastic ML, 9 Burkitt type ML, and 7 immunoblastic ML. Only 36% of the patients had stage I and II disease. At diagnosis 25% showed malignant cells in the bone marrow smears. Bone marrow infiltration was particularly frequent in the convoluted cell type lymphoblastic ML and in the lymphoblastic (others) ML subgroups. Burkitt type ML frequently was associated with abdominal lesions and subsequently a high incidence of central nervous system involvement. Patients with stage I and II ML were encountered mostly in the immunoblastic ML subgroup. After 1973 more intensive chemotherapy plus radiotherapy seems to have slightly improved the survival of the patients, except in the Burkitt type ML Subgroup.

Adolescent↗
PubMed1978

Proposal for a new histopathological classification of the carcinomas of the nasopharynx.

A new classification scheme for malignant tumors of the nasopharynx is proposed in which the undifferentiated carcinoma of nasopharyngeal types as a prominent position. This term replaces the previous obsolete term lymphoepithelioma on the basis of its clinicopathologic identity, its separation from squamous cell carcinoma, and its potential origin from anatomical areas other than the nasopharynx.

Carcinoma, Squamous Cell↗
PubMed1978

Hairy cell leukemia: enzyme-histochemical and ultrastructural investigation of one case.

The investigation was carried out on blood smears, bone marrow aspirates, one lymph node biopsy, and the surgically removed spleen of a 53-year-old man with hairy cell leukemia. In the blood smears stained with May-Grünwald-Giemsa, 60 to 70% of the hairy cells contained tubular inclusions that corresponded to the ribosome-lamella complexes demonstrated at electron microscopy. In blood smears, imprints and cryostatic sections of the lymph node and of the spleen, hairy cells revealed tartrate-resistant acid phosphatase, beta-glucuronidase and adenosine-triphosphatase activity. In the spleen neutral esterase and alkaline phosphatase demonstrated the numerical increase of the histiocytes, which ultrastructurally displayed phagocytic activity. The presence in the spleen of pseudosinuses lined by hairy cells was confirmed by electron microscopy as well as by cytoenzymology.

Blood Cells↗