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Biomedical subjects

C Paties

Publications and source records attributed to C Paties.

At least 19 recordsLinked to original sources

Mutations in the E2-PePHD region of hepatitis C virus type 1b in patients with hepatocellular carcinoma.

An interaction between the protein kinase (PKR)-eIF2-alpha phosphorylation homology domain (PePHD) within the E2 protein of hepatitis C virus (HCV) and cell protein kinase (PKR) may affect the control of protein synthesis and cell growth. In an attempt to investigate the genetic variability of the E2-PePHD domain in hepatocellular carcinoma (HCC), we studied sera and liver tissues from HCC patients. The partial E2-PePHD region was analysed by direct sequencing of the sera of 47 HCCs in cirrhotic livers and 31 cases of chronic active hepatitis (CAH), and tumoral and non-tumoral liver tissues from 13 HCC patients. A similar number of mutations was detected within the E2 domain in the HCC and CAH cases, but nine of the 47 HCCs (19%) showed an amino acid (aa) mutation at position 660, eight of which involved a change in the same aa (alanine instead of serine; A/S). No such mutation was detected in any of the PePHD sequences from the CAH patients: this difference was statistically significant (P = 0.008). The aa change at position 660 was also found in two sequences from tumoral but not non-tumoral tissue from the same liver. The analysis of 461 sequences obtained from GenBank supports the conclusion that the observed aa change is an infrequent event in HCV-infected patients, thus suggesting that it could be associated with HCC.

Aged↗

Natural killer-cell cytotoxicity in HIV-positive and HIV-negative patients with and without severe course of hepatitis B virus infection.

Natural killer (NK) cells represent the first line of defence against viral infections but, in the case of hepatitis B virus (HBV), may also be involved in liver injury. We here compared NK-cell activity of 11 patients with acute HBV infection, either HIV-positive or HIV-negative, with that of 11 healthy subjects. One of the HIV-positive patients, characterized by a severe immunodeficiency, died 3 weeks after hospitalization for HBV-related fulminant hepatitis (FH). He displayed a remarkable NK-cell cytotoxicity against both cell lines and autologous dendritic cells, whereas the NK-cell activity of the remaining patients was significantly reduced as compared with healthy individuals. Our findings suggest that NK-cell-mediated cytotoxicity could contribute to the development of HBV-related acute liver failure in HIV-positive patients with severe immunodeficiency. An immunopathological model of FH in immunocompromised patients was proposed.

AIDS-Related Opportunistic Infections↗

Benefits of using telemedicine and first results in Bosnia and Herzegovina.

In October 1996 the Institute of Pathology with the Radiology and Ophthalmology Clinic of the university hospital of Sarajevo joined the experimental telemedicine project SHARED. Two months after the project began, dermatology, paediatrics and haematology were also included. During the first phase we had 40 teleconsultations that showed us the benefits of using telemedicine. Our opinions and the opinions of the pathologist in Milan were similar for most of the biopsies (78%). The total time required for the consultation for the first 40 cases was 372 min, or 9.3 min each, on average. The longest consultation time was 25 min. The largest number of images was 44 per case, the smallest four. Because of problems of infrastructure and lack of experts, telemedicine will be important to a small country like Bosnia and Herzegovina.

Bosnia and Herzegovina↗

Isolated kidney localization of invasive Aspergillosis in a patient with AIDS.

Although the importance of Aspergillus in AIDS is now increasing, extra-pulmonary disease is still an unusual event, especially when a single localization occurs. A case of isolated renal aspergilloma in an AIDS patient is described. At onset, no recognized risk factors were present in our patient. An early surgical approach combined with antifungal chemotherapy (amphotericin B, Itraconazole) led to a good control of the disease, with no evidence of recrudescence at 8 months' follow-up.

AIDS-Related Opportunistic Infections↗

Apocrine carcinoma of the skin. A clinicopathologic, immunocytochemical, and ultrastructural study.

BACKGROUND: Apocrine carcinomas of the skin are rare and incompletely studied neoplasms. METHODS: An immunohistochemical and ultrastructural study is reported of specimens from six patients with apocrine skin carcinoma in various body sites. Three tumors were in the axilla; one, the eyelid; one, the ear; and one, the scalp. There were three local recurrences and three regional lymph node metastases, but no patient died of cancer (follow-up, 2-10 years). RESULTS: The most reliable histopathologic criteria for identifying apocrine skin carcinoma appear to be decapitation secretion, periodic acid-Schiff-positive diastase-resistant material in the cells or lumen, and immunoreactivity with gross cystic disease fluid protein 15. All specimens expressed common epithelial antigens (cytokeratins, carcinoembryonic antigen, and epithelial membrane antigen) and histiocytic-secretive antigens (Leu-M1, lysozyme, LN5, alpha-1-antitrypsin, and alpha-1-antichymotrypsin). S-100 protein was found in the three nonaxillary tumors. Ultrastructurally, the primary tumors, and especially the secondary lesions, were dedifferentiated compared with normal apocrine glands. CONCLUSIONS: Apocrine differentiation in skin tumors does not indicate an exclusive origin from the apocrine sweat glands; these neoplasms usually have an indolent clinical course.

Adult↗

[Pure and primary squamous cell carcinoma of the breast].

A case of a pure squamous cell carcinoma (SCC) of the breast is a 75 y.o. white female is reported. The cancer was discovered at the clinical exam requested by the patient for a growing mass in the left breast. Mammogram and an ultrasound exam showed a big cystic mass (4 cm x 4 cm) with a liquid content and a small polypoid mass of 0.5 cm x 0.5 cm arising from the inner surface of the cyst. A fine needle aspiration was done and the cytological report was consistent with squamous cell carcinoma. A left modified radical mastectomy was carried out. The skin was not involved and the lymph nodes were negative, and no other cutaneous tumor elsewhere was found. The stage was II (T 2a N o M o). The patient did well and was discharged 10 days post-op and now she is still doing well with no signs of recurrences or metastasis. This cancer should not be confused with a much more largely manifest metaplastic changes in a usual breast cancers. The criteria to define "pure" a squamous cell Ca of the breast are: 1) that no other neoplastic element such as ductal or mesenchymal ones are present in the tumor; 2) that the tumor is independent of adjacent cutaneous structure; 3) that no other distant epidermoid tumor exists in the patient. The origin of this tumor is controversial; it has been stated as arising from dermatoid cyst of the breast, chronic abscesses, complete metaplasia of glandular breast tissue. Despite the rarity of this neoplasia it should be kept in mind that in a cystic mass of the breast in older patient could arise a squamous cell carcinoma.

Aged↗

Multidirectional carcinoma of the thymus with neuroendocrine and sarcomatoid components and carcinoid syndrome.

We report a case of metastatic thymic neoplasm occurring in a 62-year-old Caucasian man. The tumor was polymorphic, with intimately admixed carcinoid, sarcomatous and undifferentiated components. Sarcomatous cells were spindle-shaped and immunoreactive for vimentin, actin and desmin. Carcinoid cells reacted for cytokeratin as well as with a panel of general neuroendocrine markers, including chromogranins A and B, synaptophysin, protein gene product (PGP) 9.5, neuron specific enolase (NSE), Leu 7 and Grimelius' silver. The endocrine nature of the latter cells was confirmed by ultrastructural evidence of abundant electron-dense granules 100 to 300 nm in size. Among the various hormones investigated immunohistochemically only the alpha chain of human chorionic gonadotropin (alpha-hCG) was detected in tumor cells. The neoplasm recurred after surgical resection and caused a typical carcinoid syndrome with skin flushing and increased urinary 5-hydroxyindolacetic acid (5-HIAA). The diagnosis of multidirectional thymic carcinoma with two lines of differentiation, of carcinoid and sarcomatoid type, was made.

Humans↗

Dextran deposits in tissues of patients undergoing haemodialysis.

Recently the possible storage of dextran-related material in patients undergoing regular haemodialysis has been suggested. We examined biopsy and autopsy specimens of 32 patients treated with regular haemodialysis for 61 +/- 34 months. All patients received dextran-40 as a plasma expander because of hypotension during haemodialysis. The same study was carried out in a control group of 11 haemodialysed patients who were given other plasma expanders. In the 11 patients who received larger doses of dextran-40 (0.38 g/kg body weight per week) we found particles in the cytoplasm of macrophages in various organs, which proved PAS positive and diastase resistant on light microscopy, and birefringent on polarisation. Electron microscopy revealed a fibrillar structure, but ionic analysis by electronic sampler on scanning electron microscopy excluded the presence of silicon. No intracellular inclusions were observed in the control group, nor in the patients given dextran-40 in doses lower than 0.08 g/kg body weight per week. As we also found a linear relationship between the number of particles and the dextran-40 doses given, we hypothesise that the material demonstrated in the macrophages is a structurally modified dextran.

Cytoplasm↗

[Multibacillary atypical mycobacteriosis].

A case of atypical multibacillary mycobacteriosis is described. The differential diagnosis is discussed on the basis of clinical, microbiological and histopathological parameters.

Adolescent↗

Immunocytochemical detection of prostate-specific antigen (PSA) in skin adnexal and breast tissues and tumors.

Prostate Specific Antigen (PSA) is regarded as a specific marker of prostatic epithelium and has never been detected by immunocytochemistry in extra-prostatic tissues. The casual finding of a strong positivity for polyclonal antisera to PSA in a sweat gland carcinoma prompted a study on a series of skin adnexial and breast specimens (normal and neoplastic). Normal axillary and perineal apocrine sweat glands, some apocrine foci in fibrocystic breast disease and two sweat gland and two breast apocrine carcinomas were stained by several PSA antisera; a recently introduced monoclonal to PSA, however, was unreactive. These observations cast doubt on the specificity of PSA for prostatic epithelium, especially when polyclonal antisera are employed. Immunocytochemical reactions obtained with PSA, in the investigation of skin, lesions must be interpreted with caution and confirmed if necessary with monoclonals to PSA and with PAP.

Antigens, Neoplasm↗

Angioimmunoblastic lymphadenopathy with disproteinemia associated with carcinoma. Case report and review of the literature.

Angioimmunoblastic lymphadenopathy with disproteinemia (AILD) is a rare lymphoproliferative disorder. The clinical course varies and about 15-20% of the patients develop a malignant lymphoma. The association of AILD and carcinoma is very rare: only 4 cases have been reported in the literature. They are reviewed here and 1 case is described. This case is of special interest for the following reasons: (1) the exceptional length of time which elapsed between the diagnosis of AILD and the onset of an adenocarcinoma of the colon (118 months); (2) the long survival (the patient is still alive and well 140 months after the diagnosis of AILD); (3) unlike the cases reviewed, in our patient the carcinoma was diagnosed when AILD was in clinical remission, so a radical treatment was possible. In the cases previously reported, carcinomas arose in the lung (2 patients), pancreas (1 case), and stomach (1 case). The rare association of AILD and carcinoma is probably coincidental; however, the growth of solid tumors of nonlymphoid nature may be related to the impaired T cell function, and should be kept in mind in the management of patients with AILD.

Adenocarcinoma↗

Liver histopathology in autopsied drug-addicts.

Liver specimens of 150 randomly selected autopsied drug addicts from the province of Milan (Italy) were studied using light microscopy, polarized light and immunohistochemical methods. Simple histological changes and the main diagnoses are described. The main histological diagnoses in order of frequency were: non-specific reactive hepatitis (NSRH) (52%), chronic aggressive hepatitis (CAH) (24%), acute hepatitis (AH) (12%), normal liver (6%), steatosis only (3.3%) and cirrhosis (2%). In 24 cases (16%) one or more viral antigens (HBsAg, HBcAg and Delta Ag) were detected in hepatocytes by immunohistochemical methods. Three liver specimens revealed epithelioid cell granulomas, but in no case was birefringent material identified in the liver. AH and CAH were more frequent in the group of livers with viral antigens. Our histological and immunohistochemical data confirm the current opinion that, in most cases, liver pathology in drug addicts has a viral aetiology, while no significant pathogenic role has been identified for drugs, alcohol or contaminants. Recurrent infections by one or several viruses possibly explain the relatively peculiar histological features of hepatitis in drug addicts.

Adult↗

Renal lesions in familial lecithin-cholesterol acyltransferase deficiency. Ultrastructural heterogeneity of glomerular changes.

Renal lesions of a new case of lecithin-cholesterol acyltransferase deficiency in an 18-year-old male are described. Large mesangial deposits and a sieve-like transformation of the peripheral basement membrane were the main glomerular lesions. Immunofluorescence identified C3 deposits in the mesangium. A heterogeneous pattern of ultrastructural findings was observed by electron microscopy. Thread-like structures with faint cross-striation and irregular tubular structures embedded in an amorphous material were found in mesangial and subepithelial sites. Mesangial areas and peripheral basement membranes showed irregular holes sometimes containing highly osmiophilic lamellar bodies. It is suggested that many mechanisms may be involved in the production of renal lesions induced by the lipoprotein abnormalities characteristic of the disease.

Adolescent↗

Anaplastic myeloma as extramedullary relapse of multiple myeloma in remission. Case report and review of the literature.

Anaplastic myeloma represents a rare variety of multiple myeloma, with poor prognosis and no response to therapy. 56 cases reported in the literature are reviewed and one case evaluated with immunohistochemical techniques is described. This case is of special interest in the following points: the anaplastic myeloma arose in extramedullary sites in a patient with typical multiple myeloma in remission; differential histological diagnosis between anaplastic myeloma and immunoblastic lymphoma was very difficult without immunohistochemical techniques; the anaplastic phase presented an atypical neurologic feature, the Collet-Sicard syndrome, and the treatment with radio-chemotherapy (including adriamycin) did not induce any clinical improvement.

Humans↗

Hansen's disease: a new endemic focus in the Piacenza Province? A description of four diagnosed cases by cutaneous biopsy.

Four cases of Hansen's disease (two lepromatous leprosy, one tuberculoid leprosy and one indeterminate leprosy) diagnosed from 1982 to today in Piacenza with histological and ultrastructural data are described in this study. Two cases (one lepromatous leprosy and one indeterminate leprosy) are probably imported, while the other two are apparently autochthonous. In all the cases the diagnosis or the suspicion of the disease are triggered after histological examination of the cutaneous biopsy, without any pre-existing clinical suspicion. In the discussion of the epidemiological significance of the number of cases the authors hypothesize the possible formation of an endemic area in Piacenza and intend to call attention of medical officials to the alarming fact of the probable existence of Hansen's disease in Italy.

Aged↗