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Biomedical subjects

L Cavanna

Publications and source records attributed to L Cavanna.

At least 73 records · Page 4Linked to original sources
PubMed1989

Complications of ultrasonically guided fine-needle abdominal biopsy. Results of a multicenter Italian study and review of the literature. The Cooperative Italian Study Group.

This report describes the complications following 10,766 ultrasonically guided fine-needle biopsies performed from 1979 to 1987 in 33 Italian echographic units. The mortality was 0.018%: the two reported deaths were due to hemoperitoneum and occurred in patients with hepatocellular carcinoma arising in a cirrhotic liver. Twenty patients (0.18%) had major complications. This series confirms that abdominal biopsy with fine needles is safe, even though our death rate was higher than in previous reports. Among the other nine fatalities following fine-needle abdominal biopsy reported in the literature, seven were secondary to hemorrhage. The biopsy of pancreatic carcinoma was more dangerous for needle-tract seeding (five of eight reported cases, including one in our series).

Abdomen↗
PubMed1988

Angioimmunoblastic lymphadenopathy with disproteinemia associated with carcinoma. Case report and review of the literature.

Angioimmunoblastic lymphadenopathy with disproteinemia (AILD) is a rare lymphoproliferative disorder. The clinical course varies and about 15-20% of the patients develop a malignant lymphoma. The association of AILD and carcinoma is very rare: only 4 cases have been reported in the literature. They are reviewed here and 1 case is described. This case is of special interest for the following reasons: (1) the exceptional length of time which elapsed between the diagnosis of AILD and the onset of an adenocarcinoma of the colon (118 months); (2) the long survival (the patient is still alive and well 140 months after the diagnosis of AILD); (3) unlike the cases reviewed, in our patient the carcinoma was diagnosed when AILD was in clinical remission, so a radical treatment was possible. In the cases previously reported, carcinomas arose in the lung (2 patients), pancreas (1 case), and stomach (1 case). The rare association of AILD and carcinoma is probably coincidental; however, the growth of solid tumors of nonlymphoid nature may be related to the impaired T cell function, and should be kept in mind in the management of patients with AILD.

Adenocarcinoma↗
PubMed1988

Epithelial alterations adjacent to 111 vulvar carcinomas.

Material from 111 invasive primary vulvar carcinomas was reviewed in order to study the histopathologic changes adjacent to the neoplasia. The histopathologic characteristics of the adjacent tissue were divided into categories. Dystrophic lesions were adjacent to invasive cancer in 57.6% of the cases, carcinoma in situ (CIS) in 21.6% and epithelial changes suggestive of human papillomavirus infection in 18.9%. A spectrum of epithelial changes, ranging from hyperplastic dystrophy without atypia to CIS, was found adjacent to nine cases of invasive carcinoma (8.1%). In 40.5% of the vulvar carcinomas there were no specific alterations surrounding the neoplasia. These data show that dystrophies and CIS were adjacent to invasive carcinomas in nearly 60% and 20% of cases, respectively.

Carcinoma in Situ↗
PubMed1988

Cellular atypia in vulvar dystrophies.

We studied the frequency and distribution of cellular atypia in 448 cases of vulvar dystrophy. The total frequency was 9.4%. Atypia was found almost exclusively in hyperplastic areas. Epithelial changes suggestive of human papillomavirus infection were found in 14.2% of the atypical dystrophies. During the follow-up of 78 patients with typical dystrophy, mild atypia developed in three cases, but with the continuation of medical treatment it disappeared in two cases. Eleven cases of atypical dystrophy were followed for 3-48 months; three patients with severe atypia underwent surgical treatment, and eight with mild atypia underwent medical treatment. Among the last patients, six showed regression and two, progression of the atypia.

Adult↗
PubMed1988

Vulvar dystrophies in young and premenopausal women.

Eighty-six cases of vulvar dystrophy in young and premenopausal women (age range, 6-53 years) were studied clinically and histopathologically. The most frequent symptom was pruritus associated with burning. Clinical examination showed the presence of white areas in 73% of the patients, red areas in 9% and other signs (such as melanosis) in 18%. Hyperplastic dystrophy was the most frequent type of dystrophy in these patients and was observed in 63% of cases. Cellular atypia was observed in 9.8% of the cases and was found almost exclusively in hyperplastic dystrophy. Epithelial changes suggestive of human papillomavirus infection were found in 4 of the 86 cases of dystrophy, and they were observed only in atypical dystrophies.

Adolescent↗
PubMed1987

240 hepatocellular carcinomas: ultrasound features, tumor size, cytologic and histologic patterns, serum alpha-fetoprotein and HBs Ag.

Two hundred and forty cases of hepatocellular carcinomas (HCC), diagnosed by ultrasonography and fine needle biopsy, were studied. The following parameters were investigated: 1. echo features (240 cases) - hypoechoic, 54; hyperechoic, 56; complex, 112; isoechoic with halo, 18; 2. tumor size (240 cases) - single tumor under 4.5 cm, 30; single tumor over 4.5 cm, 74; multiple masses or diffuse, 136; 3. cytologic pattern (240 cases) - well and medium differentiated, 144; pleomorphic, 43; poorly differentiated, 28; unclassified, 25; 4. histologic pattern (157 cases) - trabecular, 74; solid, 42; acinar, 1; mixed, 2; unclassified, 38; 5. alpha-fetoprotein (AFP) level (185 cases) - under 20 ng/ml, 79; between 20 and 320 ng/ml, 40; over 320 ng/ml, 66; 6. HBs Ag (208 cases) - present in 56 cases; 7. cirrhosis (102 cases) - present in 79 cases. Some of the above parameters were correlated with one another. There was: 1. a highly significant frequency of the hypoechoic feature among small HCC; 2. a percentage of AFP-producing tumors increasing with tumor size; 3. no relationship between AFP production and cytologic or histologic pattern; 4. no relationship between tumor size and cytologic or histologic pattern. However, among the small HCC, all the 9 HCC with a diameter of less than 3 cm showed a trabecular pattern and well-differentiated cells. Cirrhosis was present in every patient with a small HCC. Since the discovery of a small HCC is an incidental ultrasonographic finding in the context of severe liver disease, ultrasonographic monitoring of cirrhotic patients is the best available strategy to screen for small HCC.

Adult↗
PubMed1987

Ultrasound and ultrasonically guided biopsy in hepatic lymphoma.

From August 1982 to December 1985, 125 patients with lymphoma in different periods of the disease, underwent abdominal ultrasound (US) examination. The value of US in detecting lymphomatous involvement of the liver was determined in 75 histologically proved patients, to improve the US accuracy rate we combined it with ultrasonically guided fine needle aspiration biopsy (UGFNAB), whenever a focal lesion was disclosed in the liver. US had a sensitivity of 61.5%, a specificity of 93.5% with an overall accuracy of 88%. No specific pattern of involvement was revealed by US. The UGFNAB allowing a cytological diagnosis avoided false positive results and improved overall accuracy from 88 to 93%. We therefore believe that US should be regarded as the first imaging method to detect hepatic involvement by lymphoma and when a focal lesion is disclosed the UGFNAB should be the first invasive procedure to obtain a definite cytological diagnosis.

Adult↗
PubMed1987

Clinical and diagnostic features of 67 cases of hepatocellular carcinoma.

We analyzed the clinical-diagnostic features of 67 cases of hepatocellular carcinoma (HCC) collected from June 1981 to December 1985. The male-to-female ratio was 3.4:1, the average age was 66.7 years; alcohol abuse was present in 38 cases (56.7%); HbsAg positivity was present in 10 of 62 patients (16.1%); the alpha-fetoprotein (AFP) level was greater than 500 ng in 17 of 61 patients (28%) and normal in 24 of 61 (39.3%). Concomitant cirrhosis was found in 51 patients (76.1%). The median survival of the whole group was of 10 weeks from diagnosis. The clinical suspicion of HCC was arisen by ultrasound (US) and the diagnostic was confirmed cytologically in 57 patients out of 60 who underwent ultrasonically guided fine-needle biopsy (UG-FNB), with a sensitivity of 95% and specificity of 100%. In 7 cases (including the 3 false-negative FNB), the diagnosis was made by laparoscopic biopsy and, in 3 cases, on autopsy. US identified a single tumor in 27 cases (40.3%); 7 were smaller than 5 cm. Only 4 patients (5.9%) were considered for surgery. We conclude that the cirrhotic patients (above all those HbsAg positive) constitute a high-risk group requiring periodic (every 3 months) US examination. To confirm the HCC, we believe in the high diagnostic accuracy of UG-FNB, whereas laparoscopy should be confirmed to the cases where FNB gives a doubtful false-negative result or to complete the presurgical staging.

Adult↗
PubMed1986

Diagnostic accuracy of a new tumor serologic marker, CA 19-9: comparison with CEA.

Two hundred and twenty-one hospitalized patients underwent serum determination of CA 19-9, a recently developed tumor marker assay, and CEA. Among these, 53 had a gastrointestinal (GI) cancer, 59 a GI benign disease, 52 a non-GI cancer, and 57 a non-GI benign disease. CA 19-9 assay was more accurate than CEA to detect malignancy, especially of GI source (69.8% sensitivity vs. 24.5% in GI patients); when a cutoff level of 41 ng/ml for CA 19-9 was considered, only 6 false-positive cases were found and both markers showed excellent specificity (94.9% for CEA and 89.9% for CA 19-9 in gastric, hepatobiliary and pancreatic cancer). We conclude that CA 19-9 is a useful GI tumor marker and it seems to be better than CEA in some pathologic situations.

Antigens, Neoplasm↗
PubMed1986

Anaplastic myeloma as extramedullary relapse of multiple myeloma in remission. Case report and review of the literature.

Anaplastic myeloma represents a rare variety of multiple myeloma, with poor prognosis and no response to therapy. 56 cases reported in the literature are reviewed and one case evaluated with immunohistochemical techniques is described. This case is of special interest in the following points: the anaplastic myeloma arose in extramedullary sites in a patient with typical multiple myeloma in remission; differential histological diagnosis between anaplastic myeloma and immunoblastic lymphoma was very difficult without immunohistochemical techniques; the anaplastic phase presented an atypical neurologic feature, the Collet-Sicard syndrome, and the treatment with radio-chemotherapy (including adriamycin) did not induce any clinical improvement.

Humans↗