CD30+ anaplastic large-cell lymphoma, null type, with signet-ring appearance.
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Biomedical subjects
Publications and source records attributed to S Ascani.
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The RING-finger promyelocytic leukemia (PML) protein is the product of the PML gene that fuses with the retinoic acid receptor-alpha gene in the t(15; 17) translocation of acute promyelocytic leukemia. Wild-type PML localizes in the nucleus with a typical speckled pattern that is a consequence of the concentration of the protein within discrete subnuclear domains known as nuclear bodies. Delocalization of PML from nuclear bodies has been documented in acute promyelocytic leukemia cells and suggested to contribute to leukemogenesis. In an attempt to get new insights into the function of the wild-type PML protein and to investigate whether it displays an altered expression pattern in neoplasms other than acute promyelocytic leukemia, we stained a large number of normal and neoplastic human tissues with a new murine monoclonal antibody (PG-M3) directed against the amino-terminal region of PML. As the PG-M3 epitope is partially resistant to fixatives, only cells that overexpress PML are detected by the antibody in microwave-heated paraffin sections. Among normal tissues, PML was characteristically up-regulated in activated epithelioid histiocytes and fibroblasts in a variety of pathological conditions, columnar epithelium in small active thyroid follicles, well differentiated foamy cells in the center of sebaceous glands, and hypersecretory endometria (Arias-Stella). Interferons, the PML of which is a primary target gene, and estrogens are likely to represent some of the cytokines and/or hormones that may be involved in the up-regulation of PML under these circumstances. In keeping with this concept, we found that PML is frequently overexpressed in Hodgkin and Reed-Sternberg cells of Hodgkin's disease, a tumor of cytokine-producing cells. Among solid tumors, overexpression of PML was frequently found in carcinomas of larynx and thyroid (papillary), epithelial thymomas, and Kaposi's sarcoma, whereas carcinomas of the lung, thyroid (follicular), breast, and colon were frequently negative or weakly PML+. We did not observe any changes in the levels of PML expression as the lesion progressed from benign dysplasia to carcinoma. Our immunohistological data are consistent with the hypothesized growth suppressor function of PML and strongly suggest that PML expression levels are likely to be modulated by a variety of stimuli, including cytokines and hormones.
Because the therapeutic approach to gastric carcinoma differs according to the stage of development, a study was carried out to investigate whether there are any factors which would allow the depth of infiltration of a gastric carcinoma to be evaluated preoperatively. The criteria used were endoscopic and histological. The first provide information on size and macroscopic aspect; the second reveal the relationship between bioptic specimens that are positive for carcinoma and those that are negative. On the basis of these standards, small, benign-looking neoplasias with bioptic positivity for carcinoma lower than 30% were classified as probably early. Of the 200 gastric carcinomas investigated, 55 were considered probably early and 145 probably advanced. Surgical fragment findings confirmed the diagnosis in 169 cases (37 true negatives and 132 true positives) and failed to confirm it in the other 31 cases (13 false positives and 18 false negatives). The specificity, sensitivity, negative predictive value, positive predictive value, and total diagnostic accuracy indices were 74.00%, 88.00%, 67.27%, 91.03%, and 84.50%.
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While fine-needle aspiration (FNA) allows the diagnosis of deep masses, it does not always permit histologic classification. In the case of sites such as the sacrococcygeal region, in which a large number of benign or malignant, epithelial or connective, primary or secondary tumors may arise, it is necessary to choose between conservative treatment and radical surgery. This means that preoperative diagnosis must be as certain as possible. In order to increase the diagnostic accuracy of the method, when even immunohistochemistry is of no aid, it is useful to examine the histologic architecture of the specimen by preparing cell blocks from the aspirates. We report the comparative findings from the examination of the histologic architecture of tissue fragments embedded in methacrylate prepared from the aspirates of four cases of tumors: two chordomas, one metastasis of renal clear-cell carcinoma, and one of mucus-secreting carcinoma, all of them arising in the sacrococcygeal region.
Plastic-adherent depleted or not depleted peripheral mononuclear blood cells (PMBC) from healthy donors showed enhanced lytic activity against 51Cr-labelled K562 target cells when exposed to thymostimulin (TS), 1 microgram ml-1, for 3 h, washed and incubated in TS-free medium before testing for natural killer (NK) cytotoxicity. No modification of NK cell activity was seen when effector cells were treated with placebo (splenic extract). The NK boosting activity of TS was lost when effector cells were treated for 3 h immediately before the performance of the cytotoxic test or when this thymic extract was added directly to the mixture of effector and target cells during the lytic phase of 51Cr release assay.
During a 5-year period, we examined by endoscopy or surgery 2634 stomachs: 2536 (group A) were free of lesions commonly recognized as mucosal "polyps"; 74 (group B) exhibited hyperplastic polyps; and 24 (group C) were found with neoplastic (adenomatous) polyps. Carcinomas were present in 318 (12.5%) of specimens in group A, compared with 10 (13.5%) in group B and 20 (83.3%) in group C. In the third group, 14 carcinomas were encountered within polyps, and 4 carcinomas occurred separately. The frequency of cancer associated with neoplastic polyps was relatively low (1 of 3) in patients younger than 50 years, but significantly high (19 of 21) in older patients. This series confirms the prevailing concept that patients harboring gastric adenomatous polyps are at distinct risk of gastric carcinoma, a risk that sharply rises with age. We conclude that patients found with gastric adenomatous polyps should be subject to careful and continued surveillance to ensure that supervening carcinoma be detected at the earliest possible phase.
OBJECTIVE: To evaluate the utility of fine needle aspiration biopsy (FNAB) in the study of salivary gland pathologies and to assess its capacity to provide an accurate diagnosis and discriminate between cases requiring surgery or not. STUDY DESIGN: From January 1985 through December 1995, FNABs were carried out on 153 patients with salivary gland tumors. In 4 of the 153 cases the aspiration was inadequate. Of the remaining 149 FNAB diagnoses, 63 were checked histologically and 86 clinically. RESULTS: Regarding the capacity to discriminate between neoplastic (malignant and benign) and nonneoplastic lesions FNAB correctly diagnosed 144 lesions (135 true negative [TN] and 9 true positive [TP]) and failed in 5 cases (false negative [FN]). Regarding the capacity to discriminate between tumors requiring surgery or not, the FNAB diagnoses were true in 146 cases (83 TP, 63 TN) and false in 3 (2 FN, 1 false positive). The values for sensitivity, specificity, negative predictive value and total diagnostic accuracy were 97.64%, 98.43%, 96.92% and 97.98%, respectively. CONCLUSION: FNAB has an impact on the treatment of salivary gland masses. The data on its ability to distinguish between lesions requiring surgery or not are encouraging.
During a 3.5-year period (January 1, 1987, to June 30, 1990) 420 percutaneous fine needle aspiration (FNA) biopsies were performed on 390 patients (309 males, 81 females) suffering from one or more intrathoracic, radiologically visible lesions. Aspirations were carried out using 21- or 23-gauge Chiba needles under fluoroscopic or computed tomographic control. The aspirates were used to make minibiopsies and cytologic smears. Diagnosis was possible in 373 cases (95.64%): on the first pass in 344 cases, on the second in 28 cases and on the third in 1. In 17 cases (4.36%) the aspirate was inadequate for diagnosis. There were complications in 10 cases (2.56%) (9 pneumothorax and 1 hemophtysis) requiring intensive care. The 373 percutaneous FNA biopsy diagnoses included 256 malignant tumors (68.63%), of which 234 were primary and 22 were secondary, and 117 benign lesions (31.37%), 5 of them neoplastic and 112 nonneoplastic. Three hundred two of 373 percutaneous FNA biopsy diagnoses were followed (80.96%). One hundred twenty-three follow-ups were histologic (40.73%), including secondary tumors, which could be compared with the primary histotype. Twenty-eight follow-ups were cytologic (9.27%), and 151 were clinical (50.00%), using progression of the disease or the beginning of chemoradiotherapy as a criterion for malignancy and a stable condition or regression of the lesion with nononcologic medical treatment as a criterion for benignity. Percutaneous FNA biopsy diagnoses were confirmed in 288 cases (221 true positives and 67 true negatives) and unconfirmed in 14 (1 false positive and 13 false negatives). Specificity, sensitivity, negative predictive value, positive predictive value and total diagnostic accuracy were, respectively, 98.52, 94.44, 83.75, 99.54 and 95.36%. The histologic typing accuracy of percutaneous FNA biopsy on 70 specimens of surgically removed malignant epithelial neoplasias was 70.00%. These results confirm that percutaneous FNA biopsy is a reliable method of diagnosing intrathoracic masses and reduces the need for diagnostic thoracotomy.
In a 66-year-old male, fine needle aspiration biopsy (FNAB) of an osteolytic vertebral lesion determined the diagnosis of a liver cell carcinoma, until then clinically silent. FNAB confirmed the diagnosis of the tumor and the identification of the primary site without resorting to surgery.
A case of sarcoma of thymic stroma with features of liposarcoma associated with breast carcinoma is presented. No previous reference was found in the literature to this association. It is possible that this event could be not entirely fortuitous but an element sustaining the pathogenetic theory relating stromal and epithelial neoplasias in the thymus.