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Biomedical subjects

M Barbareschi

Publications and source records attributed to M Barbareschi.

At least 109 records · Page 6Linked to original sources

Inflammatory pseudotumour of the lung. Immunohistochemical analysis on four new cases.

Inflammatory pseudotumour of the lung (I.P.) is a quite rare benign lesion, variously named by different authors. In the present report four new cases of I.P. are presented and immunohistochemically studied with a panel of antibodies. Microscopically, the most prominent histological features were the presence of interlacing bundles of elongated histiocytic-like cells, plasma cell aggregates and lymphoid follicles. Immunohistochemistry showed that plasma cells are polyclonal. The spindle cells were negative for desmin, cytokeratins, lysozyme and S-100 and immunoreactive for alpha-1-antichymotrypsin, vimentin and for smooth-muscle alpha-actin. Actin and desmin, were clearly evident in the vessels' smooth muscle layers, highlighting the angioinvasive behaviour of the lesions. Our data are in keeping with literature suggesting that I.P. is due to a mixed histiocytic-myofibroblastic-reactive proliferation and support the inflammatory nature of IP.

Actins↗

[Evaluation of the anti-comedo effect of azelaic acid using the technique of horny layer biopsy and scanning electron microscopy].

Hyperkeratosis of the follicular channel is the most common finding in acne skin. The hyperkeratosis may represent an altercated keratinization process or the consequence of the abnormal sebum production and excretion. Several review demonstrated the anti-comedo activity of azelaic acid in acneic skin. This action may be due either to an anti-hormonal effect or to a change in keratin production. The aim of this work is to investigate the anti-comedo activity of 20% azelaic acid cream topically applied in a group of teen-agers affected by acne. A horny layer biopsy with cyanoacrylate glue was performed before and after four months of treatment with azelaic acid cream in ten acne patients. About 1 cm square horny layer biopsy was metallized and observed at the scanning electron microscopy to count the number of comedos. With this method we detected a reduction of about 26% of the comedos after four months of azelaic acid treatment. The result we obtained is in accordance with previous works about the anti-comedo activity of azelaic acid.

Acne Vulgaris↗

Large cell neuroendocrine carcinoma of the lung.

Large cell neuroendocrine (LCNE) carcinomas of the lung are a newly recognized, highly aggressive and frequently misdiagnosed entity. We report a case of stage I LCNE lung carcinoma initially misdiagnosed as large cell undifferentiated carcinoma or poorly differentiated adenocarcinoma. The tumor was very extensively necrotic and its neuroendocrine differentiation was only demonstrable with immunohistochemical staining with PHE-5 monoclonal antibody and with antisera against synaptophysin and calcitonin. ACTH, somatostatin and neurofilaments were not demonstrable. The clinical course was ominous and the patient died within 17 months. The reason for this rapid fatal outcome could be ascribed either to the neuroendocrine phenotype of the tumor, or to the extensive necrosis, or both.

Adenocarcinoma↗

Bronchial carcinoid with paranuclear fibrillary inclusions related to cytokeratins and vimentin.

A bronchial carcinoid with globular intracytoplasmic inclusions is reported. The inclusions stain brown with Grimelius silver impregnation and some show distinct immunoreactivity for chromogranin A. Tumour cells stain positively with antisera to neuron specific enolase, chromogranin A and not with antisera against ACTH, somatostatin or S-100 protein. The cells show distinct immunoreactivity for cytokeratins and vimentin, which is particularly intense in the intracytoplasmic inclusions. Desmin and glial fibrillary acidic protein are absent. Ultrastructural analysis reveals that the inclusions are composed of aggregates of filaments of 8-10 nm of diameter, intrapping a few neurosecretory granules. Immunohistochemical and ultrastructural data support the hypothesis that the inclusions are composed of intermediate filaments, whose metabolism and synthesis have somehow been deranged.

Bronchial Neoplasms↗

Duodenal gangliocytic paraganglioma. Report of a case and review of the literature.

A case of gangliocytic paraganglioma (GP) of the ampulla of Vater is reported and the literature reviewed, with special attention to immunohistochemical studies. The present case, which occurred in a 56-year-old woman, shows the typical histological admixture of epithelioid, ganglion and spindle cells. Immunohistochemistry reveals strong reactivity for synaptophysin, Leu-7, somatostatin, S-100 protein and vimentin. A few ganglion cells are reactive for neurofilaments. Chromogranin A, myelin basic protein, desmin and cytokeratin are absent. Immunohistochemical data from literature regarding the cytoskeletal composition of GPs are not unequivocal: cytokeratin and neurofilament positivity is reported by some authors and denied by others. More uniformity is reported concerning the peptides produced by GPs: somatostatin and pancreatic polypeptide are the most frequently found antigens, followed by serotonin. General neuroendocrine markers like neuron specific enolase and protein gene product 9.5 are always positive, whereas chromogranins are rarely found. S-100 protein is always positive in the spindle cell component. Our data are in keeping with those previously reported and add the diffuse positivity for the Leu-7 antigen and the positivity of ganglion cells for synaptophysin. The nature of the tumour is still a matter of debate and it is difficult to agree with either of the proposed hypotheses--hamartoma/choristoma versus true neoplasm. However the recent reports of the occasional malignant evolution of GPs may support their true neoplastic nature.

Antigens, Differentiation↗

Substance P-like immunoreactive nerve fibers of the human laryngeal mucosa--preliminary report.

Substance P (SP) is considered a primary sensory transmitter and is widely distributed within the autonomic nervous system. This study is concerned with the distribution of SP-like immunoreactive nerve fibers in the human larynx. Individual SP-like immunoreactive nerve fibers were detected in the subepithelial connective tissue of the laryngeal mucosa, in the ventricular and subglottic glandular regions and in a few nervous ganglia in the deep connective tissue. No intraepithelial SP-like immunoreactive fibers were present in our material.

Humans↗

Mediastinal malignant carcinoid with Cushing's syndrome: immunohistochemical and ultrastructural study.

A case of thymic atypical carcinoid with Cushing's syndrome and unfavorable clinical course is reported. Immunohistochemical analysis reveals distinct staining of tumor cells for ACTH, neuron-specific enolase, chromogranins (CG) and S-100 protein and with PHE-5 monoclonal antibody. At an ultrastructural level, the cells are undifferentiated with only a few neurosecretory granules. In the present case, immunohistochemical stainings for CG and with PHE-5 antibody seem reliable diagnostic tools, easily demonstrating the neuroendocrine nature of the neoplasm. NSE immunoreactivity can be an additional criterion. S-100-positive cells, which are present throughout the tumor, recall 'sustentacular cells', described in other neuroendocrine tumors.

Adrenocorticotropic Hormone↗

Usefulness of surface topography analysis in psoriatic skin.

The study of skin reliefs attracted the attention of dermatologists because it may reflect development, assembly and functional activity of the stratum corneum--and therefore of the entire epidermis. Psoriasis is characterized by a deep alteration of surface texture: and this can be related to the severity of the disease. In this work we studied, by means of skin profilometry, the roughness parameters that better describe the distinctive features of psoriatic skin topography and the modification of psoriatic surface after topical therapy. For this purpose we analyzed psoriatic skin reliefs using silicone rubber replicas both before therapy and after coal-tar topical application. A statistically significant difference between uninvolved and psoriatic skin for Ra- but not for Rz- values was observed in replicas made before therapy. After therapy, replicas showed no significant difference either for Ra or for Rz values. The profilometric analysis of psoriatic skin can be considered a useful method to characterize psoriatic plaque and the improvement obtained by topical therapy.

Administration, Topical↗

Bronchial carcinoid with S-100 positive sustentacular cells.

A case of double bronchial typical carcinoid of the central type, with a nodal metastasis and paraneoplastic Cushing syndrome is reported. The case is remarkable because both the primary tumors and nodal metastasis were composed of a double cell population: one was arranged in nests, was argyrophilic, immunostained with PHE-5 monoclonal antibody, and contained neurosecretory granules; the other one was neither argyrophilic nor PHE-5-immunoreactive, but was strongly immunoreactive for S-100 protein, had a stellate morphology and was at the periphery of the nests of the other cells. The S-100 immunoreactive cells were regarded as a sort of "sustentacular" or "satellite" cells, which are themselves neoplastic. Bronchial carcinoids with S-100 positive cells, although strictly related with other bronchial carcinoids, may in fact represent a group of tumors with different histogenesis and/or differentiative pattern. More work should be done to elucidate whether there is any relevant clinical difference between bronchial carcinoids with or without S-100 reactive cells.

Adolescent↗

Schilder disease (1912): report of a case.

We describe a case of Schilder disease in a young woman pointing out the most reliable diagnostic criteria for differentiating the disease from adrenoleukodystrophy. We stress the diagnostic usefulness of ultrastructural analysis, even of poorly preserved specimens.

Adrenoleukodystrophy↗

Neuroendocrine lung structures and tumours: immunohistochemical study by specific markers.

Out of 360 lungs or lobes surgically removed, 13 non neoplastic specimens and 16 neuroendocrine (NE) tumours are investigated with immunohistochemical methods, in order to evaluate the presence of NE structures in normal and pathological human lungs. The markers used are neuron specific enolase (NSE), chromogranin (CG) and the 80 kd antigen (80 kdAg) of NE secretory granules detected by the new monoclonal Phe-5 antibody. In non-neoplastic lung specimens, clearcut immunoreactivity for all three markers appears in NE cells, neuroepithelial bodies (NEB), NE cell-hyperplasias and dysplasias. In the same specimens 4 tumourlets with analogous clearcut immunoreactivities were also observed. The NE tumours show distinct immunoreactivity for all three antisera in the 8 well differentiated cases. The 8 poorly differentiated tumours are variably immunoreactive for NSE and present low to nil staining with antisera to CG and 80 kdAg. The immunohistochemical data are interpreted according to current views about a possible relationship between NE tumours and parent normal NE lung structures.

Biomarkers↗

S-100 protein in human lung neuroendocrine neoplasms. Immunohistochemical study of 14 cases and review of the literature.

A group of lung neuroendocrine (NE) neoplasms are investigated in view of the possible presence of S-100 protein immunoreactivity in their cells. The selected tumours were classified according to Gould et al. (1983a) and Mosca et al. (1985). They comprise 5 carcinoids, 3 neuroendocrine carcinomas of the well-differentiated type, or peripheral carcinoids, 5 neuroendocrine carcinomas of the intermediate cell type, or intermediate-cell, poorly differentiated carcinomas, 3 neuroendocrine carcinomas of the microcytoma type, or small cell carcinomas-SCC and a nodal metastasis of microcytoma. All but 2 tumours were immunoreactive for neuron specific enolase (NSE). Few S-100 immunoreactive cells were detected in 4 out of 5 carcinoids, in 1 out of 3 peripheral carcinoids, in 4 out of 5 poorly differentiated carcinomas and in the 3 microcytomas examined. No S-100 positive cells were found in the SCC's nodal metastasis. The S-100 immunolabelled cells can be interpreted as dendritic reticulum cells migrating through the tumours. However, in one case of typical carcinoid, abundant S-100 positive cells were detected: their stellate morphology and their intimate relation with neoplastic cells suggest that they are part of the neoplasia as a sort of satellite cell.

Carcinoid Tumor↗

Neuroendocrine structures in normal and diseased human lung.

The increasing amount of histological, immunohistochemical and ultrastructural information on some endocrine secretions in human lung cancers suggest the need to revise the classification of neuroendocrine lesions on surgical material. The aim of the present investigation based on lung specimens removed surgically is to give further support to recent proposal for an updated classification of neuroendocrine lung carcinomas. Our study includes 58 squamous cell carcinomas, 58 adenocarcinomas, 6 large cell carcinomas, 27 neuroendocrine carcinomas, and 30 nontumourous cases. Using histological methods (HE, Alcian PAS, Grimelius silver impregnation), we illustrate the presence of neuroendocrine cells and neuroepithelial bodies with their pathological evolutions, ranging from hyperplasia, to dysplasia, and overt neoplasia. On the basis of our experience we propose the following classification of neuroendocrine carcinomas (NEC): typical carcinoids (NECNID), peripheral carcinoid or well-differentiated NEC (NECWED), NEC of intermediate or poorly differentiated type (NECINT) and NEC of small celled or microcytoma type (NECMIC).

Adenocarcinoma↗

Pseudo-precocious puberty associated with mediastinal teratoma and polycystic ovary.

A 10-month-old girl with sexual precocity of recent onset was found to have elevated levels of estrogens, progesterone and androgen precursors, associated with a polycystic left ovary. After ovariectomy, estrogen and androgen levels were normal, and the clinical symptoms began to regress. A few months later, a huge mediastinal mass was unexpectedly discovered. Removal of the mass, identified later as a benign teratoma, was followed by the total normalization of the clinical and hormonal findings. The patient's pseudo-precocious puberty might have been due to an ovarian overproduction of estroprogestins and androgens, associated with a paraneoplastic production of progesterone, or in theory, it might have been due to a gonadotropin-like stimulation of the ovary by the teratoma.

Chorionic Gonadotropin↗