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Biomedical subjects

R Musumeci

Publications and source records attributed to R Musumeci.

At least 127 records · Page 7Linked to original sources
PubMedDate not supplied

Magnetic resonance imaging in the initial staging of Hodgkin's disease and non-Hodgkin lymphoma.

Seventy-four consecutive previously untreated patients with Hodgkin's disease (HD) and non-Hodgkin lymphomas (NHL) were evaluated with chest, abdominal and pelvic magnetic resonance (MRI) for initial staging. All patients underwent routine radiological staging procedures which included chest radiographs and lymphography (LAG). These studies were followed in most of cases by laparoscopy, during which biopsies of the liver and the spleen were taken, and bone marrow aspiration and histology. A correlation of the results of MRI with both other imaging studies and histopathologic diagnoses was performed, and discordant cases were assessed to determine the impact on clinical staging. Additional evidence of disease involvement was provided mainly in the chest, where MRI demonstrated the presence of unsuspected disease in 21% of involved patients (9 of 42). Retroperitoneal lymph nodes were correctly assessed in 97% of cases if MRI was compared with LAG. Extranodal abdominal disease was identified both in the spleen (14%) and in the liver (1%). Bone marrow abnormalities were detected in 19% of patients (14 of 74). MRI findings influenced the staging of HD and NHL patients in 11 of 74 cases (15%).

Abdomen↗
PubMedDate not supplied

Lobular breast cancer: how useful is breast magnetic resonance imaging?

RATIONALE AND OBJECTIVES: To review magnetic resonance imaging (MRI) findings in lobular breast carcinoma, the in situ or infiltrating subtype, with special attention to the dynamic curves with the aim to evaluate possible differences with ductal carcinoma. METHODS: In 2 years, 27 patients with lobular and one with tubular carcinoma underwent MRI at the Istituto Nazionale Tumori of Milan. RESULTS: All lobular carcinomas demonstrated early or late enhancement (100% sensitivity), without significant differences in morphology compared with ductal carcinoma, but frequently with a different shape of the dynamic curves. CONCLUSIONS: Due to its infiltrative growth associated to only limited connective tissue reaction, lobular carcinoma often encounters difficulties in mammographic diagnosis. In contrast, MRI can be very helpful in evaluating the true extension of the disease, especially when breast conservation is considered. Due to a more consistent fibrotic stroma, these lesions sometimes show a delayed enhancement, which suggests that more than one set of subtracted images should be evaluated during MRI analysis.

Breast Neoplasms↗
PubMedDate not supplied

[Study of the retroperitoneal lymphatic spread of müllerian ovarian carcinoma, using lymphography].

From January 1973 to May 1974, 117 patients with ovarian carcinomas were evaluated with lymphography. The tumors were staged and classified histopathologically according to FIGO (1971). Considering all cases, lymphography showed nodal metastases in 44 patients (38%). Lymphography was positive in 36% of serous cystoadenocarcinomas, in 26% of mucinous cystoadenocarcinomas, in 15% of endometrioid carcinomas and in 36% of unclassified carcinomas. Of the 10 cases not identified by cell type, lymphography was positive in 40% of cases. In 68% of cases bilateral involvement was found. The site of metastatic nodes was in 32% of cases only in the iliac chains were both involved. Considering the single node chains we found 36% of para-aortic, 27% of common iliac, 35% of external iliac and 2% of inguinal involvement. Metastases were observed, regardless of histological type, in 25% of cases in stage III, 62% iin stage IV, 54% in recurrences and only in 5% of cases in stage I. Therefore the lymphatic spread seems to occur in more advanced stages and in recurrences. In 28 of 117 patients node biopsy was performed. Histological-lymphographic correlation was correct in 7/7 positive cases and in 19/21 negative cases (93%). These results show that lymphography is a reliable tool in the evaluation of ovarian cancer.

Adenocarcinoma↗
PubMedDate not supplied

[Long-term results and planning of therapy of seminal tumors of the testis].

The paper retrospectively reviews the modalities and the long-term results of treatment of 200 consecutive patients with pure seminoma and of 125 patients with testicular carcinomas admitted to the Istituto Nazionale per lo Studio e la Cura dei Tumori of Milan from 1929 to Jan 1973. Radical orchiectomy with high ligation of the spermatic cord at the internal inguinal ring was performed in all previously untreated patients. Those who had had a scrotal operation performed elsewhere were radically reoperated upon. Lymphography and cobalt 60 telecurietherapy were introduced in 1960 and new treatment plans were employed for the irradiation of the deep lymphnodes. Since 1968 all operable carcinomas have undergone bilateral retroperitoneal lymphadenectomy and since 1964 all patients with advanced disease have been treated with chemotherapy (single agent or combination). Survival rates were calculated by the actuarial method. The new treatment modalities proved to be significantly superior to the old ones. In pure seminoma a 92% cure rate was obtained in NO patients after prophylactic irradiation of retroperitoneal nodes (2,500-3,000 rad in 3 weeks). In NI-3 patients the cure rate was as high as 75% after radical irradiation of retroperitoneal nodes (3,500-4,000 rad in 4 weeks) as well as prophylactic irradiation of mediastinum and both supraclavicular fossae. Extended radical radiotherapy (combined with chemotherapy in some patients) cured 2/6 N4 and 3/8 M1 patients. According to the old modalities of treatment, figures were respectively 72% in NO cases, 40% in N1-3 and 0% in N4 and M1 patients. In carcinomas, the cure rate after retroperitoneal lymphadenectomy was 91% in N--patients and 47% in N+ cases. In N+ patients post-operative radiation was also performed (4,000-5,000 rad in 5 weeks). After radiotherapy alone (without lymphadenectomy) the rates were 62% in NO and 28% in N1-2 patients. In primary inoperable patients (N3-4 and M1) chemotherapy, with or without radiation, significantly prolonged the survival rate. It is concluded that radiotherapy is the treatment of choice for pure seminoma and in N4 and M1 cases a full course of chemotherapy must be combined with extensive irradiation. Retroperitoneal lymphadenectomy is mandatory in all operable cases of testicular carcinoma while adjuvant chemotherapy may further improve the prognosis in N+ cases. For inoperable carcinomas chemotherapy (plus radiotherapy) is the treatment of choice. The new multiple drug regimens are providing encouraging results.

Adolescent↗
PubMedDate not supplied

[Convoluted cell lymphoblastic lymphoma (author's transl)].

The recent identification among non-Hodgkin's malignant lymphomas of a high-grade malignancy entity of possible thymic origin and defined as lymphoblastic convoluted-cell lymphoma allowed the morphologic and radiological diagnosis of nine cases of this disease. Males outnumbered females (6/9) and the age ranged from 6 to 54 years. The histologic diagnosis relied upon the characteristic non cohesive cellularity as well as upon the peculiar cribriform nuclear structure, the convoluted appearance of the nuclei, the anisokaryosis, the paucity of the cytoplasm and the minimal size of the nucleoli. The anatomical distribution of the disease was ascertained in the lymph nodes, spleen, liver and several other extranodal sites. Bone marrow invasion was observed in seven cases and presence of lymphoma cells in the peripheral blood in six. A thymic mediastinal mass was present radiologically in seven cases and lymphography was positive in five. Follow-up data revealed death of four patients within 10 months and survival of two up to 17 months. The cellular morphology of the malignant lymphoma seems to be sufficiently diagnostic. This entity deserves an autonomous position within the classifications of malignant lymphomas as it appears in the functional one proposed by Lukes and Collins (21) as well as in the Kiel classification (13).

Adolescent↗
PubMedDate not supplied

[Uro-radiographic investigations in patients with tumors in the large bowel (author's transl)].

At the Istituto Nazionale Tumori, from 1970 to 1974, 154 patients with cancer of the large bowel underwent urography; 80 cases before surgery and 74 after surgery. Preoperative findings, correlated with neoplasia, were found in 4 patients, while non-neoplastic lesions were found in 32 patients. During postoperative evaluation, 21 patients showed lesions by locoregional diffusion of the neoplasia with involvement of the ureters especially by metastatic nodes. Less frequent was the finding of bladder involvement. 30 patients presented lesions due to surgery. Urography is useful for evaluating patients with neoplasia of the large bowel, especially after surgery and during follow-up.

Anus Neoplasms↗