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Biomedical subjects

M Trojani

Publications and source records attributed to M Trojani.

At least 73 records · Page 4Linked to original sources

[Histological changes after chemotherapy of soft tissue sarcomas in the adult].

The variations of histologic patterns inside the primary tumor have been studied in 15 patients with locally advanced soft tissue sarcomas who were given induction (neo adjuvant) chemotherapy. Increase of tumor necrosis and decrease of tumor cellularity were the predominant aspects identified. The mitosis count tend to be lower, while the nuclear atypies and the number of giant malignant cells tend to increase. In 2 cases, a better tumor differentiation, attributable to the induction chemotherapy was noted. In 10/15 cases, it was concluded to a tumoricidal effect of the chemotherapy. According to tumor grade, 6 among 10 patients with grade III tumor presented a histological response (greater than 50 p. cent of tumor destruction) while none among 5 lesions of grade I or II exhibited a response of such a level. So, the histological study allows an evaluation of the response to chemotherapy which usefully completes the clinical appreciation, and that may be useful for the selection of postoperative adjuvant treatment, as it is in osteosarcomas.

Adult↗

[Breast hamartoma. Apropos of 11 cases. Review of the literature].

Eleven cases of breast hamartoma are reviewed. This benign lesion can be diagnosed on the basis of its mammographic appearance. It is characterized clinically by a well-circumscribed lump which can be readily shelled out at surgery; radiologically by its typical features of a clear or heterogeneous picture with a radiolucent zone; and histologically by its normal mammary tissue (a mixture of fibrous stroma, fatty tissue, ducts and lobules). Surgical enucleation is not mandatory, and is only performed when the hamartoma is uncomfortable and/or unsightly.

Adult↗

Soft-tissue sarcomas of adults; study of pathological prognostic variables and definition of a histopathological grading system.

The pathological features of 155 adult patients with soft-tissue sarcomas were studied retrospectively, in an attempt to set up a grading system for these tumors. As the first step, seven histological criteria (tumor differentiation, cellularity, importance of nuclear atypia, presence of malignant giant cells, mitosis count, pattern of tumor necrosis and presence of vascular emboli) were evaluated in a monofactorial analysis. Five of these (tumor differentiation, cellularity, mitosis count, tumor necrosis, and vascular emboli) were correlated with the advent of metastases and with survival. A multivariate analysis, using a Cox model, selected a minimal set of three factors (tumor differentiation, mitosis count, and tumor necrosis) the combination of which was necessary and sufficient to retain all the prognostic information. A grading system was elaborated, which turned out to be correlated with the advent of metastasis and with patients' survival. A second multivariate analysis introducing clinical prognostic features showed that the histological grade was the most important prognostic factor for soft-tissue sarcomas. Thus, this grading system appears to be highly interesting because of its prognostic value and the facility of its elaboration. However, its reproducibility should be tested.

Adolescent↗

Liposarcoma: patterns of tumor differentiation following induction chemotherapy.

This report describes the clinical and pathological features and evolution of 2 cases of locally advanced undifferentiated liposarcoma. In each case, a tumor differentiation was noted after induction chemotherapy, which otherwise determined in both patient a dramatic tumor response. This may be explained by heterogenicity of the primary tumors, which may include several cell contingents with different responses to chemotherapy. This constitutes a potential impediment to the efficacy of induction or adjuvant chemotherapy.

Adult↗

Lymphoblastic lymphoma with convoluted nuclei. A report of 19 cases.

A clinically homogeneous population of patients who presented with lymphoblastic lymphoma of convoluted nuclear type was isolated using a histopathological criterion that can easily be applied by trained pathologists. This disease type preferentially affects young male patients, in over half of whom there is initial mediastinal involvement. There is a tendency for the disease to become leukemic and to invade the central nervous system. In spite of heavy chemotherapy and early neuromeningeal prophylaxis, the prognosis is poor.

Adolescent↗

[Histological types of 876 breast cancers according to the 1981 WHO classification].

This work presents the results of the classification by histological types of 876 cancers, operated on between November 1979 and December 1982, according to the new WHO's classification of 1981. Noninfiltrating cancers represent 6.5 per cent of the total. Among the infiltrating cancers (93.5%), the individualization of the type "infiltrating duct carcinoma with a marked intraductal component" (14.5%) is interesting for this form justifies a special treatment in consideration of its multicentric and sometimes bilateral character. Its purely quantitative criteria of definition is subject to criticism and discussion.

Breast Neoplasms↗

[Analysis of 1125 partial breast resections for diagnostic purposes. Occurrence of cancer and its histology].

One thousand two hundred and twenty-five partial breast resections, examined in serial gross sections have been retrospectively reviewed. The percentage of benign lesions in comparison with malignant lesions is 70 per cent-30 per cent. The percentage of malignant lesions is maximum (43%) in clustered microcalcifications which are so the best criteria of malignancy. A diagnosis of non infiltrating carcinoma has been misdiagnosed at the first examination in 6 per cent of cases. This misdiagnosis is partially explained by very small foci of carcinoma and recent recognition of certain histological types of early carcinoma. It must be noticed the unsuspected frequence of carcinoma (17%) detected by random in ipsilateral breast tissue from plastic surgery, after controlateral reconstruction for carcinoma. The analysis of benign lesions associated with carcinoma shows a significative frequent association with carcinoma in two types of lesion: radial scar and late phase of blunt duct adenosis.

Breast↗

[Uterine sarcoma. Retrospective analysis of a series of 22 cases].

37 uterine tumors originally diagnosed as uterine sarcomas at Fondation Bergonié between 1970 and 1982 were histologically reclassified. 15 patients were excluded from this study because of inadequate data or not confirmed initial diagnosis. The 22 remaining cases were classified as leiomyosarcomas 13, endometrial stromal sarcomas 7 and mixed mesodermal sarcomas 2. The mean age of the patients was 56. The cases were classified according to the FIGO staging system. 5 patients had previously undergone (between 1 and 8 years) a subtotal hysterectomy for uterine leiomyoma. 5 patients had stage 1 sarcoma, 13 patients stage III and 2 patients stage IV. 13 patients are dead, 7 are alive without evidence of disease, 2 are alive with evidence of disease. The 5 year actuarial survival rate was 30%. Tumor extent at diagnosis was not correlated with survival. Analysis of failures revealed : 4 metastatic, 5 metastatic and pelvic and 6 isolated pelvic failures. Prognosis was not significantly different between leiomyosarcomas and endometrial stromal sarcomas. There was no pelvic failure in patients with stage I sarcoma (treated by surgery plus radiotherapy). Survival was not found to be correlated with histopathological grade as described in soft tissue sarcomas. Nevertheless a correlation (non significant) was found between survival and mitosis count. Chemotherapy (Cyvadic) was administered in 8 advanced tumors with partial response (always below 50% of the initial tumor) in 5 patients.

Antineoplastic Combined Chemotherapy Protocols↗

[Primary non-Hodgkin's malignant lymphomas of the brain. Anatomoclinical and immunopathological study of 21 cases].

Twenty one cases of primary malignant lymphoma of the brain are studied. These tumors very seldom extend from the brain (one case in 21). There were no nodular forms and tumors of high-grade malignancy predominated (Kiel's classification). Immunopathological studies performed in eighteen cases showed immunoglobulin secretions in seven. Unlike other locations of non-Hodgkin lymphoma, prognosis depends on therapy and not on histological type. The outcome was improved by radiotherapy, sometimes combined with chemotherapy. Mean survival time was one month for untreated patients or patients treated only by surgery, and 32 months for patients treated by brain irradiation and chemotherapy.

Adult↗

[Inflammatory breast cancers: correlation between anatomopathology and steroid receptor assay].

From a series of 89 clinically inflammatory breast cancers, the authors settle a subgroup of tumors, the infiltrative ductal carcinomas with a pleomorphic structure. They have better histological and hormonal prognostic criteria than the other carcinomas, especially the infiltrative ductal carcinomas with an atypical structure: lower SBR grading (p = 6.10(-5)), estrogen and progesterone receptors positive rate more frequently (p = 10(-4)). A prospective study will allow to confirm the better response to treatment and especially the better survival rate of this metastatic high risk breast cancer subgroup.

Adult↗

[Axillary lymph nodes in breast cancer. Comparison of standard histological analytical technics and macroscopic serial sections].

Lymph nodes in breast cancer have been examined by two histological techniques in 324 patients who underwent axillary node dissection. A routine pathologic examination consisted in the examination of only one pathological section while in the other, the lymph nodes were macroscopically serially sectioned. With the latter, an increase of 18.8 per cent in the number of detected metastases was noted. However this increase can be considered of prognostic and therapeutic importance only in 8.6 per cent of cases: half corresponding to those cases in which more than the initial threshold number of three lymph nodes were found, the other half corresponding to those cases in which one lymph node was found while the initial examination was negative. In the latter case, the increase of lymph node involvement was mainly due to "clandestine" metastases, i.e. lymphatic embolisation of micrometastases.

Adenocarcinoma↗