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Biomedical subjects

P Declich

Publications and source records attributed to P Declich.

At least 37 records · Page 2Linked to original sources

Melanotic schwannoma of the sympathetic ganglia: a histologic, immunohistochemical and ultrastructural study.

We describe the case of a 46-year-old male patient who presented with pain in the left thigh, often accompanied by lumbar pain. These symptoms were sustained by a neoplasm, which was located in the sympathetic ganglia, at the level of the 3rd left lumbar spinal root and which was completely excised. Immunohistochemical positivity for S100, HMB45, and NSE antibodies suggested that the lesion was a melanotic schwannoma (MS), with both schwannian and melanocytic differentiations, the latter containing melanosomes at ultrastructural examination. Non-recurrence after 16 months of follow-up further supports our diagnosis of MS.

Ganglia, Sympathetic↗

Parasitic nodule of the right carotid triangle.

We present the case of a woman in whom intraoperatory examination of a laterocervical mass in the right carotid triangle (thought to be a glomus tumor) disclosed thyroid tissue. Although the overwhelming majority of cases of "thyroid parenchyma in the laterocervical region" represent a lymph node metastasis from a primary occult thyroid carcinoma, the rare occurrence of a parasitic nodule, as in our case, must be considered.

Adult↗

Sporadic fundic gland polyps: an immunohistochemical study of their antigenic profile.

Fundic Gland Polyps (FGPs) are small sessile (2-5 mm), usually multiple polyps arising in the gastric, acid-secreting mucosa of disputed histogenesis. They have been described in a sporadic form, prevalently in middle aged females, or associated with familial adenomatosis coli-Gardner's syndrome. We performed an immunohistochemical study on 24 sporadic FGPs, using monoclonal antibodies (MAbs) against differentiation markers, class II MHC antigens (HLA-DR), oncofetal and proliferation antigens, aimed to characterize the antigenic profile of the polyps. A preliminary cytogenetic study on five polyps was also done, using an in situ culture method after collagenase treatment. Cytokeratins 8-18 (CAM 5.2 MAb) and 20 (IT-Ks 20.8 MAb), Epithelial Membrane Antigen (EMA) and Chromogranin A were normally expressed by FGPs. FGPs did not express HLA II DR. FGPs did not react with an anti-CEA MAb (F6), but they were frequently positive (22/24, 91.6%) with B72.3 MAb (reacting with the cancer-associated mucin epitope sialyl-Tn). The PC10 MAb (against PCNA or cyclin) showed enhanced expression in the deep glandular-cystic compartment of FGPs; the PCNA index of FGPs was significantly higher than in normal fundic mucosa. The cytogenetic study on the 5 cases analysed, revealed a normal karyotype. We have demonstrated that FGPs express in the paranuclear zone the sialyl-Tn epitope, a side-chain sugar normally masqued in adult gastric mucins, thus revealing an alteration in mucin synthesis; FGPs' higher proliferation index as compared with normal fundic mucosa supports the hypothesis of their hyperproliferative nature.

Antigens, Neoplasm↗

Atrio-ventricular nodal tumor associated with polyendocrine anomalies.

We report the clinical and autopsy findings of a young female suffering of complete heart block since the age of 11 and who suddenly died at the age of 32 because of a polycystic atrio-ventricular node tumor. In association with this tumor, we observed a hyperplasia of the islets of Langherans, a true thymic hyperplasia, bilateral multicystic ovaries, adrenal tissue heterotopia and clear cell adenomatosis in the right kidney. We suggest that the polycystic atrio-ventricular node tumor may be part of a complex syndrome with endocrine disorders and heterotopias.

Adenoma↗

Placental teratoma with three-germ layer differentiation.

A rare case of placental teratoma is described. Major features were the presentation as a pedunculated mass from the fetal surface of the placenta, the mixture of different tissues derived from all three germ layers (skin with dermal appendages, ganglion-like cells, and nervous structures, gut structures, osteocartilagineous and smooth and striated muscle), and the absence of segmental organization.

Adult↗

Tripartite differentiation (squamous, glandular, and melanocytic) of a primary cutaneous neuroendocrine carcinoma. An immunocytochemical and ultrastructural study.

We report a case of primary cutaneous neuroendocrine carcinoma (PCNEC) with squamous, glandular, and melanocytic differentiation and associated Bowen disease. The paranuclear globular positivity of low-molecular-weight cytokeratins agrees with the ultrastructural observations of paranuclear fibrous bodies in the small neuroendocrine cells, while the diffuse cytoplasmic positivity corresponds to the sparse intermediate filaments in large cells with squamous differentiation. "Transitional forms" are characterized by both diffuse and globular cytoplasmic positivity for cytokeratins and by the ultrastructural evidence of neuroendocrine and squamous features. Therefore the ultrastructural demonstration of intracytoplasmic tonofibrils and tonofilaments, intercellular glandular lumina, lined by well-formed microvilli, and immature premelanosomes in the neurosecretory cells supports the proposed tripartite differentiation of neuroendocrine cells of this case of PCNEC.

Aged↗

Selection for necropsy: evaluation of 321 autopsied cases from 3041 consecutive deaths among residents of a defined geographical area.

By undertaking to act as 'medico necroscopo' (the medical doctors in charge of authorizing every burial) in the Unità Socio-Sanitaria Locale (USSL) 70, a region containing 92,500 inhabitants, we were able to collect over a four-year period (1985-88) information on 3371 deaths among residents of the area. Of these, 68.1% died at home, 12.6% in hospital with no autopsy, 9.5% in hospital with an autopsy and 9.8% outside of the USSL region. For the analysis, age, sex and leading cause of death were considered as explanatory variables and place of death and proportion of autopsied cases as the response variables. The factors found to be associated with deaths occurring in hospital were non-neoplastic (particularly cardiovascular and digestive) pathological conditions in patients under the age of 60. People with malignant neoplasms usually died at home, especially when they had a gastric or breast cancer. Factors associated with autopsy were: death at a young age, short length of hospitalization and death from a cardiovascular disease. Sex did not appear to play a direct role in selection for necropsy. Our results indicate that, in our and similar regions, the cases selected for autopsy form a subset that is so specific that any extrapolation to the total deceased population is misleading.

Adult↗