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V Poletti

Publications and source records attributed to V Poletti.

At least 73 records · Page 4Linked to original sources

Transbronchial lung biopsy and bronchoalveolar lavage in diagnosis of diffuse infiltrative lung diseases.

We investigated 801 patients with lung infiltrates who underwent transbronchial lung biopsy (TBB) and performed cytologic studies of lavage fluid of 491 patients who also underwent bronchoalveolar lavage (BAL). A specific histopathological diagnosis was made in 232 cases (29%). Histopathological changes consistent with the clinical pattern were present in 296 cases (37%). The diagnostic yield of TBB was 66%. Routine evaluation of BAL fluid allowed us to make a specific diagnosis in 49 cases. The role of the pulmonary pathologist in the interpretation of TBB and BAL specimens is discussed.

Biopsy↗

Phenotypical and functional analysis of bronchoalveolar lavage lymphocytes in patients with HIV infection.

The lungs of patients with acquired immunodeficiency syndrome (AIDS) are frequently affected by opportunistic and nonopportunistic infections and pulmonary localizations of Kaposi's sarcoma. The aim of this study was to verify whether, in patients with human immunodeficiency virus (HIV) infections, immunologic pulmonary abnormalities set the stage for the lung complications. For this purpose, a phenotypic and functional characterization of lymphocytes recovered from the bronchoalveolar lavage (BAL) fluid of 24 patients with clinical symptoms and signs of HIV infections was performed (six patients with constitutional disease, five patients with neurologic manifestations, and 13 patients with full-blown AIDS). Our data showed that (1) in patients with HIV, the percentage and absolute number of pulmonary CD8 cells were significantly increased over those in control subjects (in 25% of these patients, mostly with full-blown AIDS, CD8 cells sustained an alveolitis); (2) lung CD4 cells were reduced in percentage but not in absolute number, with the exception of patients with AIDS in whom a significant decrease of the absolute number of BAL CD4 cells has been found (further phenotypic analysis of CD4 lymphocytes showed a reduction of the expression of T4A, B, and E with respect to the T4, T4C, T4D, and T4F epitopes); (3) although the number of BAL cells bearing NK-related determinants was increased, we were unable to demonstrate any in vitro natural killer cell activity. We suggest that the impairment of a proper NK activity in the lungs of these patients might be central to the mechanisms leading to the in situ immunodeficiency state and to the pulmonary complications characterizing AIDS.

Acquired Immunodeficiency Syndrome↗

Histiocytosis-X: a rare cause of radiculopathy.

A rare case of histiocytosis-X of the spine is presented. The clinical and histological features of histiocytosis-X are reviewed. Complete neurological recovery was exhibited by the patient after surgical treatment and radiotherapy. The literature dealing with the eight cases previously reported is reviewed.

Adult↗

Transbronchial lung biopsy in infiltrative lung disease. The importance of the pathologic approach.

Infiltrative diffuse lung diseases represent a heterogenous group of lesions with overlapping clinical and roentgenological features. Their diagnosis frequently needs a pathologic approach. We report our experience (671 patients with lung infiltrates) with transbronchial lung biopsy (TBB) procedure. The results of morphologic investigation were subdivided into three groups: 1) A specific morphologic diagnosis was made in 192 cases (29%) 2) Histopathologic changes well consistent with the clinical pattern were present in 258 patients (38%) 3) Non-specific lesions were found in 221 cases (33%). The diagnosis yield of the method was of 67%. UIP, DIP, Pulmonary Angiitis and Granulomatosis, Bronchiolitis Obliterans-Organizing Pneumonia and other rarer lung diseases may not be diagnosed on the basis of lesions present in TBB specimens.

Biopsy↗

Transbronchial lung biopsy in pulmonary sarcoidosis. Is it an evaluable method in detection of disease activity?

To assess the value of transbronchial lung biopsy in the evaluation of disease activity in pulmonary sarcoidosis, lung biopsy specimens obtained from 37 patients with this disease and their cellular patterns of bronchoalveolar lavage were studied. Morphologic analysis has showed peculiar lesions: predominant interstitial alveolitis consisting of mononuclear cells and scattered neutrophils, and eosinophils, diffuse in 13 cases and focal in 11 cases, interstitial nodular clusterings of mononuclear cells (five cases), diffuse intraalveolar infiltration of macrophages (one case), granulomas (27 cases), hyaline membranes (one case), intraalveolar (two cases) and interstitial (six cases) fibrosis, and finally cuboidal metaplasia of alveolar lining cells (eight cases). Hyaline membranes were always combined to a diffuse alveolitis consisting of some neutrophils. Only diffuse alveolitis was significantly associated with a high lymphocytosis in BAL (p less than 0.05).

Adult↗

A cerebral ependymoma with extracranial metastases.

A case is presented of a 30-year-old woman with a malignant ependymoma with extracranial metastases involving the cervical lymph nodes. The positive reaction to antibody against glial fibrillary acidic protein confirmed the ependymoma origin of the lymph node metastases.

Adult↗

Ependymoma of the foramen of Monro: ultrastructural characterization.

The characteristics of clear cells of an ependymoma of the foramen of Monro have been studied by electron microscopy to precisely define its organellar composition and to establish the tumor histogenesis. Our data confirm that the once-thought oligodendroglial is, in fact, an ependymal tumor. Both the scarce number of organelles, owing to the low degree of differentiation, and the abundance of hyaloplasmic lipid vacuoles can account for the clear appearance of these tumor cells.

Adult↗

Endoscopic removal of a right main bronchus glomus tumor.

Glomus tumours in the respiratory tract are very rare. The majority of the reported cases have been surgically treated. An approach with rigid bronchoscopy to endobronchial lesions suspected to be carcinoid or other well vascularized tumours, as glomus tumor is, should be considered because it can allow a safe diagnosis and eventually be therapeutic avoiding more invasive and surgical procedures.

Adult↗

Differential diagnosis between usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP) assessed by high-resolution computed tomography (HRCT).

PURPOSE: The aim of this study was to assess the accuracy of high-resolution CT in the differential diagnosis between UIP and NSIP, and the correlations with histological and functional findings. MATERIALS AND METHODS: Patients underwent thin-collimation spiral CT (1 mm), with 10-mm interval. Pulmonary function was assessed with a pneumotacograph and body plethysmograph connected with a computer for data analysis. Three pathologists, blinded to the clinical and functional data, provided a histological diagnosis based on established criteria reported in the literature. The study group only included patients with a histological diagnosis of either UIP or NSIP. RESULTS: We achieved a correct diagnosis of NSIP in 86.6% of cases (76.4% sensitivity; 84.6% specificity), whereas UIP was correctly diagnosed in 73.3% of cases (84.6% sensitivity; 76.5% specificity). An 80% agreement was achieved between the HRCT and histological findings in the whole case series (73% sensitivity, 87% specificity, p<0.01). CONCLUSIONS: The most important finding of our study was that a ground glass appearance equal to or greater than 15% is highly suggestive of NSIP. Therefore, our results could be useful to confirm a suggested diagnosis of NSIP.

Journal Article↗

[Endobronchial administration of netilmicin in patients with bronchopulmonary infections seen in the neurosurgical intensive care unit].

The Authors report the results obtained in the treatment of bronchopulmonary infections in patients hospitalized in the Neurosurgical Intensive Care Unit. Netilmicin was administered by systemic and endobronchial routes. The cleaning of the bronchial tree was always performed. Twenty-six patients (16 males and 10 females) were enrolled and assigned to one of the following groups. Group A: 16 patients with confirmed pneumonia; Group B: 10 patients without bronchopulmonary infections, as controls for serum pharmacokinetic study. In the majority of the cases pneumonia was caused by Staphylococcus aureus and Pseudomonas aeruginosa. The results obtained were positive: pneumonia resolution was observed in 10 patients (67%), improvement in 4 (27%) and failure in one case (6%). A pharmacokinetic study has confirmed bacteriologically active serum levels of netilmicin and also the availability of netilmicin within the bronchial secretions. Endobronchial plus systemic netilmicin administration was active and well tolerated in these critical patients.

Bronchi↗