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Biomedical subjects

R Volpe

Publications and source records attributed to R Volpe.

At least 109 records · Page 6Linked to original sources
PubMed1987

Splenic irradiation in chronic lymphocytic leukemia. A 10-year experience at a single institution.

A group of 38 patients with a median age of 70 years and chronic lymphocytic leukemia (CLL) were treated using a cobalt 60 U or a 6-MeV linear accelerator. A direct field or two opposite fields covered the palpable spleen area in most patients. 100 cGy were administered weekly for a total dose of 10 Gy, given over 10 weeks. The stage arrangement (according to Rai) for the 32 evaluable patients was as follows: Stage I: 11 patients, Stage II: nine patients, Stage III: three patients, and Stage IV: nine patients. Patients in Stages I and II were treated when symptomatic. Twenty-five patients (78%) achieved hematologic response (HR), defined as normalization of the differential leukocyte count, of the total blood cell count, and of bone marrow infiltration. However, no complete response according to the standard criteria of response has been obtained. The median response time of HR was 7 months (range, 1.5 months to greater than 120 months). The overall median survival time from the start of splenic irradiation (SI) was 40 months. More than 50% splenomegaly reduction was obtained in 63% of patients, whereas no benefit was verified in the lymphadenopathy. The incidence of second tumor was 29%. Fourteen patients benefited from a further 21 SI cycles. SI does not result in a complete remission and therefore cannot modify the course of CLL. This treatment is most advisable for elderly patients with predominant bone marrow lymphocytosis, for patients with previous extensive chemotherapy or radiotherapy, and for patients with poor marrow reserve. Moreover, because of the absence of toxicity subsequent treatment is not compromised.

Aged↗
PubMed1987

Reed-Sternberg cells and their cell microenvironment in Hodgkin's disease with reference to macrophage-histiocytes and interdigitating reticulum cells.

Fifty-eight paraffin-embedded lymph node biopsies from patients with Hodgkin's disease (36 nodular sclerosis, 14 mixed cellularity, five lymphocyte depletion, and three lymphocyte predominance) were immunostained with a panel of monoclonal (anti-Leu-M1, antileukocyte common antigen) and polyclonal (to lysozyme, alpha 1-antitrypsin, alpha 1-antichymotrypsin, and S-100 protein) antibodies by using the avidin-biotin immunoperoxidase technique. Both the immunostaining features of the Reed-Sternberg (R-S) cells and their variants, and the numbers of immunostained accompanying cells morphologically corresponding to macrophage-histiocytes (M-H) and to interdigitating reticulum cells (IRC) were analyzed. Variable numbers of R-S cells and their variants were positive for Leu-M1 in 83% of the cases, for alpha 1-antitrypsin in 40%, for alpha 1-antichymotrypsin in 30%, and for leukocyte common antigen in 3.4%; they were constantly negative for lysozyme and S-100 protein. Whereas the average numbers of accompanying cells immunostained for Leu-M1 were very low, the numbers of S-100-positive IRC were relatively high in all the Hodgkin's subtypes. The average numbers of M-H were lower (P less than 0.1 for lysozyme; P less than 0.001 for alpha 1-antichymotrypsin) in the nodular sclerosis than in the other pooled subtypes. In the nodular sclerosis subtype, however, R-S cells and their variants that stained positive for Leu-M1 appeared to express more frequently the lineage markers of M-H (alpha 1-antitrypsin and/or alpha 1-antichymotrypsin). These data appear to suggest that there is not an apparent qualitative correspondence between the immunostaining features of the cellular microenvironment composed of M-H and IRC and the features of the R-S cells.

Antigens, Differentiation, T-Lymphocyte↗
PubMed1987

Proliferative activity in human urologic malignancies: a preliminary study.

Cellular proliferative activity was evaluated by the determination of 3H-thymidine labeling index (LI) in 20 specimens of human urologic malignancies (13 renal cell carcinomas and 7 transitional cell bladder carcinomas). Very low LI values were found in renal cell carcinomas, with a median value of 0.28%. Slightly higher proliferative activities were observed in bladder carcinomas, with a median LI value of 1.96%. No significant correlations were found between proliferative activity and pathologic stage or histologic grading in renal cell carcinomas. Although the number of bladder carcinomas evaluated does not allow any definite conclusion, an increase in LI values was found from in situ to invasive carcinoma and from tumors at stage I to tumors at stage III.

Aged↗
PubMed1987

Practical importance of routine paraffin-embedded bone marrow biopsy in multiple myeloma.

Paraffin-embedded bone marrow biopsy specimens obtained prior to (37) or after (25) therapy from 62 patients with multiple myeloma (MM) were analyzed with particular reference to infiltration pattern, extent of infiltration, and myeloid to myeloma tissue percentage ratio (MMR) to verify their mutual relationships and clinicopathologic relevance. Fifty-nine biopsies were evaluable for infiltration pattern (diffuse in 27, interstitial in 25, and nodular in 7). Diffuse and interstitial patterns were more common (P less than 0.025) in stage III and stage I patients, respectively. A higher (P less than 0.001) mean serum paraprotein level was found in patients with the diffuse pattern than in those with the interstitial pattern. The average extent of infiltration by myeloma cells in the residual myeloid tissue was higher (P less than 0.001) and a high extent (75% or more) was more frequently (P less than 0.005) seen in diffuse than in interstitial pattern cases. The average MMR value was lower (P less than 0.001) and a MMR value less than 1 was more frequently (P less than 0.005) seen in the diffuse pattern group than in the interstitial pattern group. All these differences were present also when a separate analysis was performed for treated and untreated patients. It seems that a diffuse histologic pattern, as opposed to interstitial, would significantly predict a bone marrow extent of infiltration of 75% or more, a MMR lower than 1, a higher serum paraprotein level, and a clinical stage III. Bone marrow biopsy appears thus to play a role in providing parameters of prognostic relevance in MM also in the course of the disease. Prospective studies are needed to establish whether histologic pattern has an independent prognostic value.

Biopsy↗
PubMed1987

S-100 protein immunostaining in teratomatous well-differentiated tissues.

The presence and distribution of S-100 protein were studied in a case of ovarian teratoma using avidin-biotin complex immunoperoxidase method. S-100 immunoreactivity within the well-differentiated teratomatous tissues appeared to mirror that of their normally developed human counterparts, although we could unexpectedly detect S-100 immunoreactivity in bone osteoblasts and osteocytes, and in tooth germ odontoblasts. Choroid plexus-like formations present in the teratoma were also positive. Our results suggest that the presence of S-100 protein might be associated with a basic cell function regardless of the presence of a physiologically end-developed human organism.

Female↗
PubMed1987

Doxorubicin distribution in human breast cancer.

Using a high-performance liquid chromatographic method coupled with fluorimetric detection, we evaluated plasma pharmacokinetics of doxorubicin (DX) and tissue distribution in seven patients suffering from locally advanced breast cancer. Tumor biopsies were performed 30 minutes and 24 hours after DX injection. In addition at 48 hours, during surgery, biopsies were obtained from primary breast cancer, nodes, and other accessible tissues, and DX concentrations were analyzed. A triexponential equation gave the best fit for plasma levels and the values (mean +/- SE) were: elimination half-life, 37.6 +/- 4.9 hours; volume of distribution, 605 +/- 61 L/m2; and clearance 200 +/- 27 ml/min/m2. There was greater interindividual variability in tumor DX concentrations than in plasma concentrations. DX reached much higher (range at 48 hrs, 1.54-14.17 micrograms/g) and longer-lasting concentrations in tumor than in plasma. At 48 hours tumor concentrations were 55.2-337.4 times the plasma concentrations. DX concentrations in normal breast were lower or similar to those in breast carcinoma. DX levels were very low in fat and skin, slightly higher in muscle, and very high in normal or metastasized lymph nodes.

Breast Neoplasms↗
PubMed1986

S-100 protein, fibronectin, and laminin immunostaining in lymphomas of follicular center cell origin.

Forty-nine paraffin-embedded biopsy specimens of involved nodal and extranodal tissue (bone marrow, spleen, and liver) from 13 patients with follicular center cell lymphomas (FCCL) and 14 with small lymphocytic lymphomas (SLL), including 11 cases with chronic lymphocytic leukemia, were tested for S-100 protein immunoreactivity. Analysis for fibronectin and laminin immunoreactivities was limited to the lymph node biopsy specimens. In FCCL, S-100-positive dendritic reticulum cells (DRCs) were found in 23 of the 26 tissue specimens examined, regardless of the involved sites and the growth pattern. Cases with completely or predominantly follicular pattern were usually associated with a spherical meshwork pattern of S-100-positive DRCs; in the FCCL specimens with a diffuse pattern (lymph nodes and bone marrow) as well as in the specimen areas with a minimally follicular tumor pattern, S-100-positive DRCs were consistently fewer in number and composed loosely aggregated nests. No S-100-positive DRCs were found in all the biopsy specimens in SLL. Concerning fibronectin and laminin immunostainings, results showed that no differences were present between areas of follicular and diffuse neoplastic growth and that the neoplastic growth of FCCL maintained for each antiserum the same distribution pattern as that seen in normal follicles. Analysis of the microenvironmental components as revealed with antisera used in the current study--particularly with anti-S-100 protein antiserum--appears to be a useful adjunct for the identification of FCCL in paraffin-embedded biopsy specimens, especially in extranodal sites.

Dendritic Cells↗
PubMed1986

Immunohistochemical, enzyme histochemical, and immunologic features of giant lymph node hyperplasia of the hyaline-vascular type.

A combined histologic, immunohistologic, enzyme histochemical, and immunologic study has been carried out in a 7-year-old girl with recurring extramediastinal monocentric giant lymph node hyperplasia of hyaline-vascular type. A large panel of monoclonal and polyclonal antibodies to lymphoid and nonlymphoid cell markers were tested on frozen and paraffin-embedded lymph node tissue as well as on cell suspension and peripheral blood. Tissue enzyme histochemical study, including a conventional hematologic panel, was performed on frozen and plastic-embedded sections. The pattern was dominated by nodular aggregates of round BA-1+ Leu-14+ HLA-DR+ ATPase+ lymphocytes with polyclonal sIgD and sIgM positivity and lacking cIg and BA-2 staining. Leu-1+/Leu-4+, OKT6+, OKT10+, Leu-7+, and CALLA+ cells were few or absent in the nodules, whereas DRC-1+ BA-2+ HLA-DR+ 5'-Nuc+ cells formed a dendritic network in the outer portion of the nodules. No immunoreactivity for lymphoid and nonlymphoid cell markers, including cytokeratin and keratin, was detected in centrinodular histiocytic-like cells. Particularly, the Hassall's-like structures contained a target-like positivity for laminin, and consisted of flattened acid phosphatase (AP), alpha-naphthyl acetate esterase (ANAE), 5'-nucleotidase (5'-Nuc), and adenosine triphosphatase (ATPase) positive cells, whose enzyme profile overlapped with that of the histiocytic-like cells. The extranodular areas were mainly composed of Leu-1+/Leu-4+ lymphocytes with Leu-3a+/OKT4+ phenotype and, to a lesser extent, of OKT6+ OKT10+ lymphoid cells and scattered cells with markers of histiocytic lineage. The abundant vascular component was generally identified by laminin positivity and, in smaller proportion, it was positive for Factor VIII-related antigen. Most of the medium-sized vessels with high endothelium had marked AP, ANAE, and ATPase activities. The process observed resulted from vascularized nodular aggregates of nontransformed B-cells with the phenotype of primary follicle lymphocytes, associated to centrinodular histiocytic-like cells with a distinct enzyme profile.

Antibodies, Monoclonal↗
PubMed1986

Non-Hodgkin's lymphoma in the elderly. A retrospective clinicopathologic study of 50 patients.

The pathologic and clinical findings of 50 patients aged 65 or older (median, 71.5 years) with non-Hodgkin's lymphomas (NHL) are reported. These patients formed 27% of all cases of NHL seen in a single institution over a 7-year period. Forty patients presented with nodal and 10 with extranodal NHL. According to the Ann Arbor system, 20 were clinical and/or pathologic Stages I and II, and 30 were Stages III and IV; of the 10 patients presenting with extranodal NHL, 8 were Stages I and II. Histologically, 84% of the cases were of the intermediate and high-grade groups according to the Working Formulation; diffuse histiocytic was the most frequent histotype (34%) according to the Rappaport classification. The pattern was diffuse in 94% of the cases. Five patients received no treatment; treatments were conservative (monochemotherapy and/or local radiotherapy) in 19 patients and aggressive (polychemotherapy and/or extended-field radiotherapy) in 26. Four patients of the latter group died of toxicity; 22 patients died of lymphoma and 13 of other causes; the other 11 (22%) patients are still alive. The overall median survival was 2.2 years. A significantly better survival was observed in patients with Stages I and II (P less than 0.025) and in those with intermediate grade (P less than 0.05) when compared with patients having Stages III and IV and high-grade histology, respectively. Apparently, no significant difference both in response and survival was found between the groups of patients which arbitrarily underwent conservative or aggressive treatments on the basis of their general conditions. Randomized clinical trials should be designed in order to draw more significant conclusions on the correct management of elderly patients with NHL.

Aged↗
PubMed1986

Enzyme- and immunohistochemical study of a case of histiocytic necrotizing lymphadenitis.

A combined morphological, immunohistological, and enzyme histochemical analysis was performed on frozen and fixed lymph node tissue in a case of histiocytic necrotizing lymphadenitis (HNL) using conventional histology, a panel of monoclonal and polyclonal antibodies, and a series of common haematological enzyme reactions. Histology showed multiple paracortical necrotizing foci which, in a prominently necrobiotic background devoid of granulocytes, contained large numbers of foamy histiocytes and macrophages intermingled with cells resembling degenerating plasmacytoid T-cells. Most of the histiocytes were alpha1-antichymotrypsin positive and foamy cells were also distinctly Leu-M1 positive. Strong granular acid phosphatase (AP) positivity was present in the cytoplasm of the macrophages and histiocytes. The cells with plasmacytoid features showed weaker and homogeneously diffuse AP staining. Alpha-naphthyl acetate esterase (ANAE) activity was much less striking than AP in the necrotizing foci and most of the ANAE negative cells corresponded to those with plasmacytoid features. No cells with B-cell lineage markers were present within the necrotizing foci; most of the occasional T-cells (Leu-1+, Leu-4+) present in the foci were Leu-2a+ (OKT8+) whereas OKT10+ lymphoid cells were abundant and appeared to correspond with the cells with plasmacytoid features. Our combined data confirm that the special type of necrosis found in HNL develops within foci of plasmacytoid T-cells undergoing regressive changes and apparently exhibiting distinct immunohistological and enzyme histochemical features.

Adult↗
PubMed1986

Giant lymph node hyperplasia: a disease of primary follicle/mantle zone lymphocytes?

Histological, immunohistochemical, and immunological features of a lymph node from a patient with Castleman's disease (CD), hyaline vascular type, were investigated. The results substantiate a peculiar immunological identity of this disease. CD lymph nodes consisted mainly of polyclonal primary follicle/mantle zone lymphocytes. Germinal center cells and plasma cells were absent, while T-lymphocyte subsets were not modified.

Antibodies, Monoclonal↗
PubMed1986

A histopathologic study of persistent generalized lymphadenopathy in intravenous drug abusers.

Persistent generalized lymphadenopathy (PGL) has been reported in groups at risk for the acquired immunodeficiency syndrome including intravenous (iv) drug abusers. We investigated the histology of the lymph node biopsies obtained from 18 iv heroin abusers. All the patients (13 males and 5 females; median age 23.5) had generalized lymphadenopathy. This was associated with one or more systemic symptoms in 72% of the cases. Immunologic abnormalities were present in most of the patients. The overall histological picture consisted of a fairly repetitive pattern dominated by an exuberant and diffuse hyperplasia of frequently misshapen and poorly outlined follicles, associated with a striking proliferation of capillary vessels and a very consistent amount of plasma cells both extending in the follicular and interfollicular areas. Multinucleated giant cells of the Warthin-Finkeldey type ("mulberry cells") were encountered in 22% of the cases. It would appear that in the follicular district the most indicative diagnostic clues of PGL can be obtained if one considers the abnormal morphology of the follicles associated with a consistent presence of plasma cells and a scattered fine network of proliferating capillary vessels.

Adult↗
PubMed1986

Persistent generalized lymphadenopathy: clinical characteristics of a lymphadenopathy syndrome in intravenous drug abusers.

Persistent generalized lymphadenopathy (PGL) is the most frequent AIDS related manifestation in homosexual men. From May 1984 to March 1985, 45 (38%) out of 117 intravenous (iv) drug abusers evaluated had PGL. Thirty-two were males and 13 females (median age 25 years). All patients referred to the frequent sharing of syringes. The median duration of lymphadenopathy was 3 months (range 3-60) with a median number of involved extrainguinal sites of 4 (range 2-7). Systemic symptoms and energy to skin tests were common, whereas splenomegaly and past infections were less frequently encountered. Hypergammaglobulinemia and an inverted T helper/suppressor ratio and lymphopenia were found in 78%, 43%, and 20% of the patients, respectively; the presence of HTLV-III antibodies was demonstrated in 12 (46%) of the 26 tested patients. Histologically, excised lymph nodes from 14 patients exhibited a marked follicular hyperplasia, diffuse plasmacytosis, and a conspicuous capillary proliferation. All patients are followed on a regular basis with clinical examination and laboratory tests; in no case has AIDS or a malignant lymphoma so far developed.

AIDS-Related Complex↗