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Biomedical subjects

F Venuta

Publications and source records attributed to F Venuta.

At least 91 records · Page 5Linked to original sources
PubMed1992

Well-differentiated thymic carcinoma: a clinico-pathological study.

Well-differentiated thymic carcinoma (WDTC) is a recently described epithelial tumour of the thymus previously classified as cortical or predominantly epithelial thymoma. The authors have reviewed a series of 15 cases of WDTC with the aim of further defining the clinicopathological features of this neoplasm. Histologically, the number of lymphocytes was always low; perivascular spaces and epithelial palisading around blood vessels and/or along fibrous septa were prominent features; 6 cases (40%) were associated with areas of typical cortical thymoma. All cases showed slight to moderate cytological atypia and nuclear grooving was frequently detected. Mitotic activity was variable but usually low. Clinically, all but 3 cases (80%) were invasive at surgery; myasthenia gravis was present in 9 cases (60%); 5 patients (33.3%) died due to disease and 2 additional patients (13.3%) had tumor recurrence. Our study indicates that WDTC has fairly distinctive clinicopathological features and that it is histologically and histogenetically related to cortical thymoma. The definition "well-differentiated carcinoma" is justified because of low-grade cytological atypia and retention of some organotypical histological features, in a tumour otherwise often displaying aggressive and sometimes clear-cut malignant clinical behaviour.

Adult↗
PubMed1992

Computed tomography for preoperative assessment of T3 and T4 bronchogenic carcinoma.

Between January 1986 and January 1991, 175 patients with suspected T3 or T4 bronchogenic carcinoma underwent computed tomographic (CT) examination of the chest before thoracotomy. We considered two groups of patients: group 1 includes 98 patients with a paramediastinal mass on standard chest X-ray; invasion of hilar and mediastinal structures was preoperatively investigated with CT and then assessed at thoracotomy. The sensitivity, specificity and accuracy were 72%, 75% and 73%, respectively; positive and negative predictive values were 71% and 76%. In group 2 77 patients had a peripheral tumor suspected of invading the parietal pleura and the soft tissues of the chest wall (patients with evident rib or vertebral invasion were not included). Sensitivity, specificity and accuracy of CT were 52%, 86% and 71%, respectively; positive and negative predictive values were 74% and 70%. We conclude that CT with injection of contrast material is indispensable when direct lung cancer infiltration must be ruled out; its accuracy is however not sufficient to be relied upon in all patients.

Adult↗
PubMed1992

Microscopic thymoma: histological evidence of multifocal cortical and medullary origin.

Twenty cases of macroscopically non-neoplastic thymuses obtained from patients with myasthenia gravis have been studied histologically. Seven cases were characterized by lymphoid follicular hyperplasia and 13 by involutional changes of variable degree. In three cases (15%), one with lymphoid follicular hyperplasia and two with involutional changes, multiple microscopic epithelial lesions, 0.2-0.4 mm in diameter and consistent with foci of microscopic thymoma, were observed. Most of them were related to the thymic cortex and one, displaying a different histological pattern, was located in a medullary area. These observations provide morphological evidence of a possible multifocal origin of thymoma from distinct epithelial clones present in the different topographic areas of the human thymus.

Adolescent↗
PubMed1992

Effects of low-dose steroids on bronchial healing after sleeve resection. A clinical study.

We prospectively evaluated the effect of low-dose steroids after bronchial sleeve resection in 20 consecutive patients. Ten patients (group I) did not receive steroids. Ten patients (group II) received 10 mg of methylprednisolone intravenously intraoperatively and 10 mg intramuscularly every day for 10 days. In addition, group II patients received 250 mg of hydrocortisone succinate endobronchially before extubation and 5 mg of methylprednisolone daily in an aerosol solution. Bronchoscopy was performed in all patients before extubation, every day for 10 days, and 1 and 3 months after the operation. Bronchial healing was graded endoscopically from grade I (no edema, excellent healing) to grade V (dehiscence). In group I, three patients showed grade I, four had grade II, one indicated grade III, one revealed grade IV (granuloma), and one showed grade V (dehiscence) healing. Mean postoperative hospital stay was 9.7 days. In group II all 10 patients showed grade I healing. Mean postoperative hospital stay was 7.3 days. We conclude that low-dose steroids improve the postoperative course in patients undergoing bronchial sleeve resection.

Adult↗
PubMed1990

Analysis of prognostic factors and clinicopathological staging of thymoma.

The prognostic value of four clinical variables (age and sex of patients, association with myasthenia gravis, and clinical stage) and histological type was analyzed in 83 consecutive patients with thymoma, histologically classified as cortical, medullary, and mixed. Age, sex, and association with myasthenia gravis did not prove to represent significant prognostic factors; clinical stage and histological type, on the contrary, had a highly significant prognostic value (p less than 0.001). A model of clinicopathological staging, based on both clinical stage and histological type, in which three major prognostic groups are considered is proposed. The degree of significance of this model is higher (p less than 0.0001) than that of clinical stage and histological type considered individually; its validity is further supported by the results of multivariate analysis according to the Cox regression model (p = 0.0001). We think it represents a prognostically valuable approach to the problem of management of thymoma.

Actuarial Analysis↗
PubMed1990

Diagnostic imaging and surgical treatment of dumbbell tumors of the mediastinum.

We describe the diagnostic procedures and surgical approaches employed in 5 patients with dumbbell tumors of the mediastinum. Magnetic resonance imaging accurately described the existence and longitudinal extension of the intraspinal component of the tumor and assisted in choosing the appropriate surgical approach. Both the intrathoracic and intraspinal components of the tumor were resected at one time by a thoracic and neurosurgical team. We employed the Grillo technique three times and a separate laminectomy and thoracotomy approach. Magnetic resonance imaging proved the most useful diagnostic technique for suspected dumbbell mediastinal tumors. In our experience, the extended thoracotomy proposed by Grillo and co-workers worked well for small tumors involving only one foramen in which the intraspinal extension was limited to 2 to 3 cm, and when no more than two laminectomies were required. On the other hand, thoracotomy and a longitudinal paravertebral incision are preferable for larger tumors (more than 4 cm) involving more than one foramen in which the intraspinal extension exceeds 2 to 3 cm, for tumors requiring multiple laminectomy, and when bony infiltration is present.

Adult↗
PubMed1990

Low grade neuroendocrine tumors of the lung (bronchial carcinoids)--25 years experience.

From 1960 to 1986, 69 patients with low grade neuroendocrine tumours (LGNT) of the lung were admitted to our institution. Of these, 36 were male and 33 were female. The mean age was 43 years with a range of 9-76 years. Sixty-eight patients were operated upon of whom 11 had metastatic mediastinal lymphnodes. A complete follow-up ranging from 3 to 25 years was obtained in 61 patients. Actuarial survival was 95% at 5 years and 87% at 10 years. The most important factor influencing the prognosis was mediastinal lymph node involvement. In 9 patients with mediastinal lymph node metastases at operation, the survival at 5 and 10 years was 75% and 46%, respectively, with highly significant difference (P less than 0.0001) as compared with the nonmetastatic group. In conclusion, bronchial LGNT are generally benign, but encompass a potential for malignancy. The prognosis depends on the presence of regional lymph node metastases. The choice of adequate surgical treatment depends on the size, location and aggressiveness of the tumour and the status of the mediastinal lymph nodes. The condition of the lung parenchyma distal to the lesion must be taken into account.

Adolescent↗
PubMed1990

The prognostic implication of thymoma histologic subtyping. A study of 80 consecutive cases.

In this study the authors have investigated the clinicopathologic correlations in 80 consecutive cases of thymoma in order to establish the clinical usefulness of histologic subtyping of these tumours. All cases were histologically examined and classified according to Salyer and Eggleston and to Marino and Müller-Hermelink classifications. Therefore, thymomas were subtyped as predominantly lymphocytic, mixed and predominantly epithelial and cortical, mixed and medullary, respectively. The frequency of the different histologic subtypes was determined, and histologic findings were related to patients' age, surgical stage, and survival. Through the application of Salyer and Eggleston classification, the three histologic subtypes did not correlate with patients' ages at time of diagnosis, surgical stage as determined by local infiltration, and prognosis as determined by survival curves. On the contrary, when Marino and Müller-Hermelink classification was applied, statistically significant relationships between histologic results and age, surgical stage, and prognosis were demonstrated. These results and their implications are discussed, with special reference to the important problem of histogenesis of thymomas and of their clinicopathologic staging.

Adult↗
PubMed1990

Leiomyoma of the esophagus.

Leiomyoma of the esophagus was surgically treated in 15 patients in 1962-1987. Six patients were asymptomatic and nine presented with dysphagia alone or combined with retrosternal pain, vague thoracic discomfort, dyspnea and cough, or palpitations. Barium swallow and esophagoscopy provided the correct diagnosis preoperatively in most cases. Transthoracic enucleation of the tumor was performed via right thoracotomy in nine patients and left thoracotomy in six. The location of tumor was the upper third of the thoracic esophagus in three cases, middle third in six and lower third in six cases. There was no surgical mortality or morbidity. Surgical removal of esophageal leiomyoma thus gave relief of symptoms, with minimal risk and excellent functional outcome.

Adult↗
PubMed1990

[Mechanical staplers in exeresis surgery of pulmonary cancer].

Surgical stapling devices are widespread in many branches of surgery and are employed with success in thoracic surgery. Our experience is in line with that of other Authors: stapling of the bronchus is faster, does not contaminate the operative field and reduces the incidence of bronchopleural fistulas (4.76% to 1.59%). Parenchymal stapling is indicated for resection of bullae, metastases and peripheral lesions. The mechanical suture is air-tight and faster than manual suture. Pulmonary vessels may also be closed mechanically; however, we do not advocate the use of stapling devices especially in the closure of the pulmonary artery.

Aged↗
PubMed1990

Surgical approach to isolated mediastinal lymphoma.

With the aim of assessing the role of surgery in the management of isolated mediastinal lymphoma, we have reviewed the data of 123 operations performed on 102 patients (64 with Hodgkin's disease and 38 with non-Hodgkin's lymphoma). One death and four major complications occurred in these patients. Macroscopically radical resection was performed in 14 patients who are free of disease after 1 to 14 years. Debulking resection was performed in five patients: Three are alive after 5 to 11 years and two died after 36 and 40 months. Ten patients (seven with non-Hodgkin's lymphoma and three with Hodgkin's disease) had residual mediastinal masses of more than 2 cm after chemotherapy; to assess the nature of the lesion (fibrosis or residual disease), we subjected these patients to surgical restaging of the mediastinum: Results were negative in seven and positive in three. We conclude that open biopsy is indispensable to obtain good tissue specimens suitable for histologic and immunohistochemical assessment. Biopsy must be performed as a major surgical procedure to avoid reoperation: Mediastinoscopy and sternal splitting incisions proved the most reliable approaches. Locally radical or debulking resection might be considered in selected cases to enhance long-term results.

Adolescent↗
PubMed1989

True thymic hyperplasia: a clinicopathological study.

In this report, we describe the clinicopathological features of 4 patients with true thymic hyperplasia. This controversial thymic lesion has only recently been defined as a variable, often massive enlargement of the thymus characterized by a nearly normal microscopic structure. Our study of 4 patients and review of the literature indicate that true thymic hyperplasia has a well-defined clinicopathological profile: prevalence in children or young male patients, absence of associated autoimmune diseases, and often presence of respiratory distress or peripheral blood lymphocytosis, or both. True thymic hyperplasia should be considered in the differential diagnosis of anterior mediastinal masses in children and young adolescents.

Adolescent↗
PubMed1989

Intrathoracic lobe of the liver. Case report and review of the literature.

A case of a heterotopic intrathoracic lobe of the liver connected through a normal diaphragm to the main organ by a vascular and biliary pedicle is described. Eight similar cases reported in the literature are reviewed and a comparative evaluation is undertaken to elucidate the correct clinical diagnosis and the indications for operative exploration. Because the occurrence of ectopic supradiaphragmatic hepatic tissue should be considered, it is believed that the preoperative evaluation of a solid, smooth lump in the diaphragmatic region should include gallium liver scans prior to invasive procedures.

Adult↗