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Biomedical subjects

S Pilotti

Publications and source records attributed to S Pilotti.

At least 217 records · Page 12Linked to original sources
PubMed1982

Problems in fine-needle aspiration biopsy cytology of clinically or mammographically uncertain breast tumors.

From June 1978 to December 1980 at the Istituto Nazionale Tumori of Milano, a fine-needle aspiration biopsy was performed on each of 4834 cases of palpable mammary nodules, the large majority of which were clinically and mammographically suspicious for cancer and only a small part clinically definitely positive. Of these, 1173 underwent surgery at this institution, and 534 (45.5%) had a histologically proven carcinoma. The aspirations were performed by individuals different from those who read the cytologic smears. The aspirations were never repeated, and methods for the retrieval of cells were never applied. Under the circumstances, sensitivity was 0.67, specificity 0.98, and the predictive value for positive results 0.97. The high percentage of inadequate samples (25.5%) influenced the low sensitivity. The few false-positive results occurred exclusively during the first year. Frozen sections can be avoided in those cases (about 50%) with definitely positive cytologic diagnosis by the application of strict criteria. The intrinsic incapability of cytology to yield any information on the extent and the invasiveness of a malignant lesion does not seem to effect its preoperatory conclusiveness.

Biopsy, Needle↗
PubMed1982

Natural history of dysgerminoma.

Data on 56 patients with pure dysgerminoma are discussed. Forty-nine patients were classified as having new disease or were to have reassessment of disease, and seven cases were to be restaged (one with and six without clinical evidence of disease). Of new and reassessment cases, 44 patients underwent lymphography, 16 underwent peritoneoscopy with diaphragmatic inspection and 30 had peritoneal cytologic testing performed. Positive lymphography resulted in restaging in 31.6% of patients. Diaphragmatic inspection was always negative. Peritoneal cytologic testing was positive for malignant cells in three patients and worsened the stage in one. Pathologic staging of disease was as follows: Stage IA, 24; Stage IB, one Stage IC, one; Stage III peritoneal disease, two. Stage III retroperitoneal disease, 12; Stage III peritoneal and retroperitoneal disease; four. The 5-year relapse-free survival rates were 91% in patients with pathologic Stages IA, IB, and IC; 74% in those with Stage III retroperitoneal disease, and 24% in patients with Stage III peritoneal disease or peritoneal plus retroperitoneal disease. The results indicate that the prognosis is excellent for patients with Stage I and Stage III retroperitoneal disease whereas peritoneal involvement is associated with a poor prognosis.

Adolescent↗
PubMed1982

[Echography and percutaneous fine needle biopsy].

Echography, even if it is a procedure widely used in numerous protocols, is not devoid of diagnostic inaccuracy. However, when fine needle percutaneous biopsy is associated to echography, the diagnostic accuracy raises to 88%. This combined procedure is easily carried out, it is inexpensive, without discomfort to the patient and devoid of major complications. When it is performed, other more invasive techniques, such as arteriography or laparotomy may be useless. Methods of application and case-reports are illustrated.

Adenocarcinoma↗
PubMed1982

Nasopharyngeal carcinoma in childhood.

We have retrospectively evaluated a series of 27 consecutive children observed from 1965 to 1980 with nasopharyngeal carcinoma (NPC). Histological diagnosis in each patient was undifferentiated carcinoma of nasopharyngeal type (UCNT) with prominent lymphocytic infiltration. Regional node involvement was present in 26 of 27 patients and two children presented with distant metastases. Twenty evaluable children with primary nasopharyngeal tumor with or without positive cervical nodes underwent radiotherapy (RT) with uniform criteria in technique. Adjuvant cyclophosphamide (CPM) was administered to a total of 11 children. The actuarial relapse-free survival and overall survival are 40% and 55% at four years, respectively. In this series, the most important prognostic factor was represented by the extent of the tumor in the nasopharynx. Permanent control of the primary tumor was obtained in 85% of patients. CPM given after RT did not reduce the incidence of relapse. However, the fact that 45% of patients developed distant metastases as first treatment failure suggests that combined chemotherapy should be tested in the management of NPC in children, especially when primary tumor is locally advanced.

Adolescent↗
PubMed1982

Neuroendocrine (Merkel cell) carcinoma of the skin.

Merkel cell carcinoma was diagnosed in 10 patients (eight females and two males) with a mean age of 66 years and a range of 44-84. The most common sites of the primary tumor were the skin of the limbs, girdles, and head. Sixty percent of the cases had recurrences and 50% regional nodal metastases that appeared within 1 year. Of the patients treated variably with surgery, chemotherapy, and radiotherapy and followed for a mean period of 28 months, two were alive and free of disease, two were alive with disease after 3 and 6 years, and two have died of metastatic disease to the lungs and liver. The primary lesions showed quite distinctive clinical and gross features in terms of size, shape, and color. Histologically, the growth was usually diffuse and occasionally trabecular or pseudoglandular; infiltration was predominantly in the papillary and reticular dermis. The uniform, poorly cohesive cells contained argyrophilic granules in the cytoplasm and round to oval nuclei with frequently indented membranes. The mitotic index was high. Ultrastructurally, in two cases, two cell types were identified that probably represented the neoplastic counterpart of normal Merkel cells in different stages of maturation. Both cell types contained cytoplasmic neurosecretory granules and intermediate filaments, even though their cytoplasms were differently shaped.

Adenocarcinoma↗
PubMed1982

Histologic evidence for an association of cervical intraepithelial neoplasia with human papilloma virus infection.

All the cytologic and histologic material pertaining to 100 patients who underwent cervical conization for advanced cervical intraepithelial neoplasia (CIN) was reviewed. The revision of the histology of the biopsies and cones showed in 56 cases the association of CIN with viral cytopathic effects (VCE) attributable to human pappiloma virus (HPV) and in 52 the coexistence of a predominantly flat condyloma. The comparison of the two groups of CIN, with and without VCE, showed that in the first the association had favored in 20% of the cases the histologic overestimation of the severity of the lesion. Of the patients with CIN III, 46% showed additional changes due to VCE. The mean age of the patients with CIN and VCE was 39.8 years and that of the patients with CIN was 48.6 (p less than 0.0001). The exocervix was significantly more often involved by CIN + VCE than by CIN alone (p less than 0.00001). Follow-up studies revealed in both groups the same percentage of residual disease and, preliminarily, a trend to a better control of CIN with VCE. New disease developed more often in the group of patients with CIN without VCE. Cytologic sensitivity for VCE in cervical smears was high (95%) in the cases of CIN II and somewhat lower (81%) in those with CIN III. Cytologic follow-up showed the persistence of VCE in 17% of the patients treated surgically for CIN and VCE. The morphologic and clinical features displayed by CIN associated with VCE warrant its recognition as a distinct variant of CIN.

Adult↗
PubMed1981

Childhood non-Hodgkin's lymphoma: long-term results of an intensive chemotherapy regimen.

Twenty-nine consecutive children with untreated non-Hodgkin's malignant lymphoma were admitted to Istituto Nazionale Tumori of Milan during the period from 1974 through 1976 and underwent treatment with chemotherapeutic regimens consisting of Adriamycin, Cytoxan, vincristine, and prednisone (two month induction phase) and 6-mercaptopurine, methotrexate, Adriamycin, vincristine, and prednisone (maintenance phase). Each patient, regardless of clinical stage of histologic subgroup, was given the same chemotherapy. The complete response rate was 66%. Due to the high incidence of recurrence of the initial bulky lymphomatous mass and of spread to the central nervous system (CNS), local radiotherapy was given to ten children and CNS prophylaxis (brain radiotherapy + intrathecal methotrexate) to 11 children. After a follow-up period in excess of 40 months, there were five disease-free survivors (17%). Each patient who had a relapse died from the disease. The main reason for first treatment failure was relapse at the level of the primary bulky tumor site or spread to the CNS. This type of CNS prophylaxis did not prevent relapse at this site.

Adolescent↗
PubMed1981

Condylomata of the uterine cervix and koilocytosis of cervical intraepithelial neoplasia.

In 202 women with koilocytotic atypia in cervical smears, 136 had predominantly small condylomata of the uterine cervix, and 66 had cervical intraepithelial neoplasia (CIN) of varying degree either with koilocytosis of the neoplasia or associated with condylomata. Koilocytosis correlated well with the histological diagnosis of condylomata, but occasionally it obscured the cytological evidence of CIN. Human papilloma virus particles were found in the cells of condylomata in 10 cases and in those of CIN II with koilocytosis in two cases of 21 examined ultrastructurally. There was evidence that the condyloma of the uterine cervix is a well-defined morphological entity and also that cytopathie changes similar to those seen in condylomata are present in some cases of CIN.

Adolescent↗
PubMed1981

[Fine needle biopsy with ultrasound guidance: 263 cases (author's transl)].

The combination between ecography and fine needle aspiration biopsy has greatly speeded up diagnostic procedures. Often this technique is better than other more invasive and expensive investigations, such as angiography and laparotomy, for its high diagnostic accuracy, the limited upsetting of the patient, the absence of serious complications and the simplicity to perform it. Here are some information on the technique, on the indications and on the complications of the procedure. The results of 263 cases of abdominal biopsy are presented.

Abdominal Neoplasms↗
PubMed1981

Restaging of patients with ovarian carcinoma.

Sixty-four patients, 34 with no clinical evidence of disease (NED) and 30 with clinical evidence of disease (ED), were submitted to restaging with peritoneoscopy plus diaphragmatic inspection, peritoneal cytology, and lymphography. Eleven patients (32.2%) in the NED group and 25 (83.3%) in the ED group had positive restaging findings. The 3 diagnostic procedures, in combination, are important in establishing occult disease and therefore in the planning of further treatment.

Female↗
PubMed1979

Laparoscopy combined with peritoneal cytology in staging and restaging ovarian carcinoma.

The merits of laparoscopy, with inspection of the diaphragmatic leaves, and of peritoneal cytology (free fluid or washing) in staging and restaging were studied in 153 patients with ovarian carcinoma. Of 153 patients examined, 83 were new cases, 34 were restaging in patients without clinical and/or radiological signs of disease, and 36 in patients with evident disease. The conversion rate for diaphragmatic metastases alone was 6%. Information about the spread of disease (diaphragmatic metastases) was obtained in 33 new cases (39.7%). In pretreated patients, laparoscopy was positive in 4 of 34 NED restaging and in 24 of 36 ED restaging. The conversion rate for peritoneal cytology was 6.6%, but information about the cellular intraperitoneal spread of the disease was obtained in 31 new cases (37.8%). In pretreated patients, peritoneal cytology was positive in 4 of 34 NED restaging and in 13 of 36 ED restaging.

Ascitic Fluid↗
PubMed1979

Childhood non-Hodgkin Malignant lymphomas: a clinicopathologic retrospective study.

Between 1968 and 1975, 44 evaluable children under 16 years of age with the histologic diagnosis of non-Hodgkin malignant lymphoma (ML) were treated at the Istituto Nazionale Tumori of Milan. Histologic diagnoses were reclassified as follows: 13 lymphoblastic (others) ML, 15 convoluted cell type lymphoblastic ML, 9 Burkitt type ML, and 7 immunoblastic ML. Only 36% of the patients had stage I and II disease. At diagnosis 25% showed malignant cells in the bone marrow smears. Bone marrow infiltration was particularly frequent in the convoluted cell type lymphoblastic ML and in the lymphoblastic (others) ML subgroups. Burkitt type ML frequently was associated with abdominal lesions and subsequently a high incidence of central nervous system involvement. Patients with stage I and II ML were encountered mostly in the immunoblastic ML subgroup. After 1973 more intensive chemotherapy plus radiotherapy seems to have slightly improved the survival of the patients, except in the Burkitt type ML Subgroup.

Adolescent↗
PubMed1978

Proposal for a new histopathological classification of the carcinomas of the nasopharynx.

A new classification scheme for malignant tumors of the nasopharynx is proposed in which the undifferentiated carcinoma of nasopharyngeal types as a prominent position. This term replaces the previous obsolete term lymphoepithelioma on the basis of its clinicopathologic identity, its separation from squamous cell carcinoma, and its potential origin from anatomical areas other than the nasopharynx.

Carcinoma, Squamous Cell↗
PubMed1978

Bronchial involvement by Hodgkin disease.

Two cases of Hodgkin disease, lymphocyte depletion type, with bronchial involvement are described. One patient revealed involvement of the right upper lobar bronchus, the other patient of the left main bronchus. The correct diagnosis was made by fiberbronchoscope examination with cytologic brushing and biopsy. That bronchial involvement by Hodgkin disease is very rare is confirmed by the literature, where only 20 cases have been so far reported.

Bronchial Neoplasms↗
PubMed1978

Hairy cell leukemia: enzyme-histochemical and ultrastructural investigation of one case.

The investigation was carried out on blood smears, bone marrow aspirates, one lymph node biopsy, and the surgically removed spleen of a 53-year-old man with hairy cell leukemia. In the blood smears stained with May-Grünwald-Giemsa, 60 to 70% of the hairy cells contained tubular inclusions that corresponded to the ribosome-lamella complexes demonstrated at electron microscopy. In blood smears, imprints and cryostatic sections of the lymph node and of the spleen, hairy cells revealed tartrate-resistant acid phosphatase, beta-glucuronidase and adenosine-triphosphatase activity. In the spleen neutral esterase and alkaline phosphatase demonstrated the numerical increase of the histiocytes, which ultrastructurally displayed phagocytic activity. The presence in the spleen of pseudosinuses lined by hairy cells was confirmed by electron microscopy as well as by cytoenzymology.

Blood Cells↗