[Cytologic diagnosis in the lymph node pathology].
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Adenocarcinoma↗
Biomedical subjects
S Pilotti
Publications and source records attributed to S Pilotti.
[Correlation between the histopathology and natural history of intestinal adenocarcinoma and diffuse undifferentiated carcinoma of the stomach].
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Adenocarcinoma↗
[Nuclear morphology in false negative and negative rectal biopsies (author's transl)].
An typical nuclear structure consisting of a cribriform and condensed chromatin pattern with hyperchromasia, a small nucleolus and a moderately increased nuclear-cytoplasmic ratio was observed in the epithelial cells of the crypts and in the stromal and muscular cells of 51 out of 70 oncologically negative biopsies of the rectal mucosa. The subsequent retrieval of all clinical and histologia data revealed that the 51 cases included 39 of adenocarcinoma of the large intestine either present (15 cases) at a variable distance from the false negative biopsy or removed previously (24 cases), 7 of extra-intestinal malignant tumor (parotid gland, urinary bladder, endometrium, breast, stomach, metastatic, anus) and 5 with benign conditions of the large intestine. Of the remaining 19 cases whose biopsies did not reveal the atypical nuclear structure 16 had benign lesions of the large intestine and nowhere evidence of malignancy, two had an adenocarcinoma of the large bowel (one present and one removed previously) and one a carcinoma of the anus. In the rectal biopsies examined the atypical nuclear structure was detected in 93.9% of the cases with a malignant tumor either present or removed previously and in 19% of the cases with benign conditions. The morphologic evidence indicated that the atypical nuclear structure was compatible with a possible distrubance of the mitotic cycle since the findings were restricted to the generative compartment of rectal epithelium. The results are discussed in connection with their possible practical use as a diagnostic aid in the evaluation and interpretation of false negative and negative rectal biopsies as well as with their possible significance in the biology of tumor-bearing hosts.
Adenocarcinoma↗
[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↗
The ultrastructure of malignant fibrous histiocytoma (case report).
A soft tissue malignant fibrous histiocytoma was studied by light and electron microscopy. The presence of fibroblast-like cells, histiocyte-like cells, undifferentiated stem cells, and xanthomatous cells was confirmed. Fibroblast- and histiocyte-like multinucleated giant cells were also observed. The observation of lysosomes in some fibroblast-like cells, the features of undifferentiated stem cells, and the presence of cells and intermediate characteristics common to xanthomatous, histiocytic, and stem cells suggest a strict relationship among these cellular types.
Adolescent↗
Thyroid cancer in childhood.
From 1956 to 1975 21 patients (13 females and 8 males) with thyroid cancer developed by age 14 have been observed at the Istituto Nazionale Tumori of Milan. Follicular adenocarcinoma was diagnosed in 4 cases and papillary adenocarcinoma in 17. Five patients (24%) had been given previous cervical irradiation for benign conditions. At admission lung metastases were evident in 2 patients (one affected by follicular and the other by papillary adenocarcinoma). All patients were submitted to surgical treatment, which in most cases consisted in total thyroidectomy plus elective lymph node dissection; serious postoperative complications were not observed. External irradiation was given to 4 patients, since surgery had not been radical. Radioiodine treatment was performed in the 2 patients with lung metastases: in the patient with follicular adenocarcinoma metastases disappeared after 131I treatment, whereas in the other one they still persist unmodified 10 years later. A local recurrence occurred in 3 cases and pulmonary metastases in one: all of them made an apparent recovery after surgical and/or radioiodine treatment. All patients are alive and, except one, without evidence of disease after a follow-up period from 14 months to 21 years. Although differences in evolution have been noted according to the histotype, the prognosis of thyroid cancer in childhood is good, even if distant metastases are present.
Adenocarcinoma↗
New SCM (structuredness of the cytoplasmatic matrix)-based approach in breast cancer detection.
AIMS AND BACKGROUND: We evaluate the possibility to use a combination of techniques such as lymphocyte stimulation and the Cell Scan Instrument for early detection of breast cancer. This method can detect differences in lymphocytes activation in the presence of absence of cancer. METHODS: The Cell Scan is a static cytometer system able to examine cellular membrane polarization. We screened 88 women with benign breast lesions, 207 women with mammary carcinoma and 325 healthy blood donors. After lymphocytes separation, each blood sample was incubated with encephalitogenic factor (EF), phytohaemagglutinin (PHA) and Breast Antigen (-BrAg) then SCM test was performed. RESULTS: Positivity was 50% among breast cancer patients, 34% among women affected by benign disease and 27% and 22% respectively among healthy female and male controls with an increase of the specific predictivity of the test during the period of ovulation. A significant difference (P < 0.0001) was observed between healthy donors and breast cancer patients. CONCLUSIONS: This results suggest that the Cell Scan test could be useful to investigate patient's immunogenicity to molecules known to be involved in tumor development and progression, such as oncogene or suppressor gene products, which could be appropriate targets for immune-derived therapeutic approaches.
Antigens, Neoplasm↗
Unusual breast lumps.
Two new Italian cases of breast infection by Dirofilaria Repens are presented. In one case the correct diagnosis was clinically achieved through needle aspiration. This case is documented by a surprising macrophotography.
Breast Diseases↗
Adult granulosa cell tumor of the ovary: a clinico pathologic study of 35 cases.
AIMS AND BACKGROUND: Adult granulosa cell tumor has a low malignant potential but requires an extensive follow-up of more than 5 years to accurately assess tumor activity. The aim of the present study was to evaluate the clinical characteristics, the treatment and the outcome of this rare ovarian tumor. STUDY DESIGN: A retrospective review of 35 cases treated at primary onset of disease during a 23-year period from 1971 to 1993. RESULTS: The disease-free survival rate for stages IA-B-C at 5 and 10 years was 90% and 84%, respectively; for stages III-IV the 5-year freedom from progression rate was 16%. CONCLUSIONS: The most important prognostic factor appears to be the extent of tumor involvement outside of the ovary.
Adolescent↗
Limited role of TP53 and TP53-related genes in myxoid liposarcoma.
AIMS: Circumstantial evidence suggests that genetic changes may lead to tumor progression within the myxoid liposarcoma tumors (MLTs) carrying non-random chromosomal translocation t(12;16). METHODS: To address this subject an immunophenotypic analysis, applying antibodies against proteins encoded by TP53, MDM2 and CDK4 genes, complemented by molecular analysis of eight suitable cases, was performed on 104 consecutive cases. Chromosomal translocations were assessed either by cytogenetic analysis or by RT-PCR in 9 suitable cases and chimeric transcripts were found in all cases but two pleomorphic liposarcomas. RESULTS: Based on immunophenotyping and tumor site, the case material consisted of three groups. The first one was made up of 92 non-retroperitoneal cases carrying a null p53, mdm2, cdk4 immunophenotype, which remained unchanged over the time of recurrences and along the gamut of histologic subtypes. The second group was represented by five p53+, mdm2-, cdk4- non-retroperitoneal cases, 4 of which were further analysed by PCR-SSCP for p53 mutation. The immunophenotypic profile of these cases, complemented by the molecular findings, supported a role of TP53 in tumor progression in three high-grade MLTs. The third group, consisting of 7 retroperitoneal cases, showed a heterogeneous immunophenotype, sharing immunophenotypic and molecular features with the well-differentiated/evoluted (dedifferentiated) liposarcoma group. CONCLUSIONS: TP53 mutations seem to play a role in tumor progression in a few cases of MLTs (2.8%) showing more aggressive histologic characteristics. The unexpected finding that a number of retroperitoneal LMTs display the immunophenotypic profile of the well differentiated/evoluted (dedifferentiated) liposarcomas, deserves further investigation.
DNA Mutational Analysis↗
Percutaneous intraductal sampling for cyto-histologic diagnosis of biliary duct strictures.
BACKGROUND: Percutaneous transhepatic biliary drainage (PTBD) allows ductal material to be collected for cyto-histologic examination. We evaluated the data from a large series of patients with a PTBD in whom endobiliary cyto-histologic sampling techniques were employed in order to define a strategy for their use in the diagnostic work-up. PATIENTS AND METHODS: Ductal samples for cyto-histologic examination were obtained from 409 consecutive patients with a PTBD for stenosing lesions of the biliary tree. Bile aspirate cytology was performed for all patients and ductal biopsy specimens were obtained, generally after negative cytology, from 49 of them (11.9%), all candidates for a therapeutic procedure. The cyto-histologic results of intraductal sampling were compared with pathologic surgical data in 210 patients and with clinical-radiologic follow-up in 199. RESULTS: Overall, 22 out of the 409 patients had a final diagnosis of benign stenosis and 177 had samples positive for neoplastic disease. The sensitivity of bile cytology was 43.8% while ductal biopsies showed a sensitivity of 60.4%. The combination of the two sampling techniques achieved a sensitivity of 65.1%. For both sampling methods the specificity was 100%. Hilar metastases from neoplastic lesions of the GI tract and primary lesions of the biliary ducts showed the highest sensitivity. CONCLUSION: Cyto-histologic assessment of stenosing lesions of the biliary ducts is mandatory when highly sophisticated interventions (e.g. wide hepatic resection or liver transplantation) or non-surgical treatments are envisaged. The collection of cyto-histologic samples from bile ducts, in patients with a percutaneous bile drainage, is an easy, safe and valuable method to obtain the diagnosis. In view of the absence of false positive results in our series and in others, intraductal biopsy serves no purpose when positive exfoliative cytology is positive for malignancy. In the presence of negative cytology it is felt that an intraductal biopsy should be mandatory when the choice of a therapeutic program depends on the result of the cyto-histologic diagnosis.
Adolescent↗
Two novel monoclonal antibodies against the MUC4 tandem repeat reacting with an antigen overexpressed by lung cancer.
In this study we investigated the immunochemical and cytochemical reactivity of two monoclonal antibodies against the 16-amino acid tandem repeat of MUC4 to demonstrate a possible variation of the mucin core peptide expression related to lung cancer. The immunocytochemical anti-MUC4 reactivity was analyzed in four lung cancer cell lines (Calu-1, Calu-3, H460, SKMES) and in other tumor cell lines, as well as in frozen materials from 21 lung adenocarcinomas (ACs), including five bronchioloalveolar carcinomas (BACs), and 11 squamous cell lung carcinomas (SqCCs). A weak fluorescence anti-MUC4 positivity (range: 10.3-16.2) was observed only in acetone-fixed lung cancer cell lines Calu-1, Calu-3 and H460. These three lung cancer cell lines also showed a cytoplasmic immunoperoxidase reactivity. The immunostaining in lung cancer tissues showed a granular cytoplasmic reactivity: 15/21 (71%) and 17/21 (80%) ACs were positive with BC-LuC18.2 and BC-LuCF12, respectively. All BACs were positive. Moderate to strong reactivity was present in well-differentiated ACs. In the normal lung parenchyma counterparts weak reactivity was found only in bronchiolar cells. All SqCCs were negative. Anti-MUC4 reactivity was also observed in the alveolar mucus. In conclusion, our anti-MUC4 MAbs detect a secretion product present in mucus and this product is elaborated by lung cancer cells and overexpressed in well-differentiated lung ACs.
Adenocarcinoma↗
Ultrastructural characterization of poorly differentiated rhabdomyosarcomas.
Twenty-five rhabdomyosarcomas, histopathologically and immunocytochemically classified as embryonal (12 cases), alveolar (11 cases), and pleomorphic (two cases), were studied by routine and immunogold electron microscopy, to identify, in poorly differentiated cells, reproducible markers useful for diagnostic purposes. Rhabdomyoblasts with rudimentary sarcomeres were observed in 12 cases (48%). Large cells (named oval cells) with an oval shape and an eccentric nucleus, like rhabdomyoblasts but lacking organized myofilaments, were observed in 20 cases (80%). By immunogold electron microscopy, performed on four of 25 cases, both oval cells and rhabdomyoblasts showed abundant intermediate filaments positive for desmin. Oval cells may be used as markers of poorly differentiated rhabdomyosarcomas.
Adolescent↗
Immunocytochemical and immunoelectron microscopical analysis of BCL2 expression in thyroid oxyphilic tumors.
In both human lymphoma and carcinoma, BCL2 expression contributes to the neoplastic development by preventing normal turnover due to programmed cell death. In thyroid carcinoma it was shown that BCL2 expression is related to cell differentiation and appears to be associated with a less aggressive behavior. Using immunogold electron microscopy labeling techniques on ultrathin frozen sections, the authors undertook an analysis of bcl-2 protein localization in 7 cases of thyroid tumor with (4 cases) or without (3 cases) oncocytic differentiation, which displayed histopathological features, corresponding to different degree of aggressiveness. All thyroid tumors and a lymphoblastoid cell line overexpressing BCL2 showed a preferential labeling of mitochondrial circumference, while the 4 cases with oncocytic differentiation displayed a bcl-2 protein location, not only on the circumference but also on the cristae of a consistent number of mitochondria. These results may indicate a bcl-2 protein interaction with intramitochondrial constituents related to the neoplastic transformation in oncocytic tumor.
Adenoma, Oxyphilic↗
Prognostic value of clinicopathologic characteristics including neuroectodermal differentiation in osseous Ewing's sarcoma family of tumors in children.
AIMS AND BACKGROUND: The aim of the present study was to determine the relationship between clinico-pathologic parameters, including neuroectodermal differentiation, and their impact on survival in a series of pediatric patients with osseous tumors of the Ewing's sarcoma family admitted to the Pediatric Department of the Istituto Nazionale Tumori of Milan. METHODS: Seventy-three patients were enrolled. The variables analyzed were sex, age, site of primary tumor, serum lactate dehydrogenase (LDH) level at diagnosis, involvement of periosseous soft tissues by primary tumor, presence of metastatic disease, status of disease after the treatment plan, as well as the presence of mitoses, morphologic and immunocytochemical neural markers, and neuroendocrine markers in the primary tumor. RESULTS: Neural and neuroendocrine markers were not significantly associated with any of the other parameters. In the univariate analysis, significant risk factors related to unfavorable outcome were elevated LDH, metastatic disease, lack of complete remission after treatment, presence of mitoses and of morphological neural markers; immunocytochemical neural and neuroendocrine markers lacked prognostic value. In the multivariate analysis, only LDH levels and the status of disease following the treatment were retained. CONCLUSIONS: LDH level at diagnosis might be a useful marker to identify different risk levels; neuroectodermal differentiation might have no clear-cut impact on the clinical management of osseous Ewing's sarcoma family of tumors.
Adolescent↗
A feasibility study of cisplatin administration with low-volume hydration and glutathione protection in the treatment of ovarian carcinoma.
Glutathione (GSH) is a sulfur-containing nucleophile that protects against cisplatin-induced renal toxicity without reducing the antitumor activity of the cytotoxic agent. To document further the clinical role of GSH in improving the outcome of cisplatin-containing regimens, the feasibility of the GSH/cisplatin combination using a low-volume hydration protocol was evaluated in untreated ovarian cancer patients. Twelve patients at stage III (minimal residual disease) and 23 with localized disease at high risk for recurrence were treated with cisplatin (90 mg/m2, i.v. in 250 ml of normal saline over 30 min) and cyclophosphamide (600 mg/m2 i.v.) every 3 weeks. GSH (5 g in 200 ml of normal saline) was administered by a short-term infusion (15 min) prior to cisplatin. The hydration protocol consisted of 1 liter of fluids without diuretics. The treatment was well tolerated; no nephrotoxic or neurotoxic manifestations were observed. The renal excretion of cisplatin (23%) at 24 hours following infusion was lower than expected using a standard i.v. hydration protocol. No reduction of renal elimination of cisplatin could be detected in subsequent courses, thus suggesting a minimal degree of impairment in renal function. In the series of evaluable patients (11) with stage III disease, 9 had complete pathological response. In the series of patients with no clinically detectable disease initially, all were disease-free at treatment completion. Taken together with previous observations, these results support the view that the use of GSH is a successful approach in the attempt to optimize cisplatin treatment, providing a new modality of drug administration for out-patient treatment.
Acetylglucosaminidase↗
The frequency of human papillomavirus infections, with or without associated cervical intraepithelial neoplasia, in cervicovaginal smears.
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Adult↗
Malignant transformation of host cells by a human small cell lung cancer xenografted into nude mice.
Malignant transformation of mouse host cells by a human small cell lung cancer (SCLC) was demonstrated by short-term in vitro cultivation of the tumor cells from a xenograft at two different transplant generations. Isoenzyme (LDH) and chromosome analysis showed that out of the 3 cell lines established from this tumor, 1 retained a human karyotype similar to that of the xenograft and 2 were murine transformed cell lines. These murine cell lines produced fibro-sarcoma-like tumors when injected into nude mice. Because of the early in vitro emergence of murine transformed cell populations, it is likely that the transformation process had occurred in vivo. Since in our experience the induction of transformation of host murine cells, also observed directly in vivo, is more frequent with SCLC than other histotypes (lung and colorectal adenocarcinoma), it is suggested that the known production of growth factor by these tumors may contribute to this transformation.
Animals↗