Biomedical subjects
Publications and source records attributed to C Pesce.
Two cases of granular cell tumour of the oesophagus and one case of granular cell tumour of the larynx are reported. The light and electron microscope findings are discussed, as well as the much debated histogenesis of such tumours.
The accuracy and usefulness of the score classifications most currently in use to assess testicular biopsies for infertility were comparatively evaluated in 40 consecutive specimens of the years 1979-1982. Our results suggested that score methods should be rejected and a comprehensive estimate of the morphological characteristics of the testis should be given, if no specific cause of damage can be recognized.
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The appendectomy specimens submitted to surgical pathology exhibit a wide variety of morphological appearances. We have evaluated the activities of acid phosphatase, alpha-naphthyl esterase, and leucineaminopeptidase in 100 human appendixes divided into six age groups in order to ascertain whether any histochemical pattern was related to the age group rather than to pathological condition. Our findings support that the submucosal fibrosis is unrelated to the patient's age, as well as appendiceal obliteration. It is noteworthy that the mucosa of the appendix may retain its lymphoid constituents at any age and that young subjects may already show appearances of involution up to lumen obliteration.
At the autopsy of a 64-year-old man, a small ectopic liver lobe without biliary drainage was found in the retroperitoneum. Both the liver and the ectopic lobe showed micronodular cirrhosis. In the latter, biliary hyperplasia and bile plugs were also seen.
Histochemical techniques were employed to determine acid phosphatase and alpha-naphthylesterase activities in follicular cells from the mucosa of surgically removed human appendixes. These very reactive cells are found in two areas: in the middle of the light centre and in the surroundings of this centre. The former are globose, arranged with a certain degree of order, and have a reticular anchorage that does not appear to be particularly affected by the physiological and pathological events that occur in the appendix, whereas those of the border vary in number or may even be absent. They have an elongated shape and are also anchored in a reticulum that in this case is more consistent. The result is that in certain forms of appendiceal disease the pale centre of the follicle is closed in a kind of shell formed of very reactive cells. The identification and significance of these two groups of cells of the light centre are discussed.
Two degenerations of the mitral valve apparatus, namely myxoid degeneration of the mitral cusps and necrosis with subsequent calcification of the annulus fibrosus, are extensively reviewed and discussed. Both lesions are mainly noticed in elderly patients, with the possible exception of systemic dystrophies of the connective tissue associated with metabolic disorders. The clinicopathological correlations of several cases are reported, with special emphasis on modern diagnostic procedures and their wide anatomic spectrum.
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Five cases of melanosis of the larynx, verified by biopsy, are reported. All occurred in male patients. Melanocytes and melanin-laden epithelial cells were microscopically seen in the laryngeal mucosa. In one case squamous carcinoma coexisted. Current theories on melanin pigmentation at atypical sites are reviewed.
Argyrophil cells and melanocytes were sought with Grimelius' and Fontana-Masson's techniques in 43 specimens of laryngeal mucosa. In 7 cases, melanocytes were found in the squamous epithelium: in only 2 cases, rare argyrophil cells were found in the respiratory epithelium. The demonstration of argyrophil cells in the laryngeal mucosa constitutes the anatomic rationale for the insurgence of carcinoids and oat-cell carcinomas at this site.
This work is concerned with a morphometric analysis of cystadenolymphoma (CAL, Warthin's tumor), a growth generally found in the parotid gland. CAL is composed of various amounts of epithelium-lined cysts and of lymphoid stroma. Our results support the notion that the epithelium is the proliferating component in CAL. They also challenge the idea that CAL is a tumor, because its growth is slow and self-limiting, and occurs in a restricted space.
Giant-cell tumors (osteoclastomas) of the sphenoid body are rare, histologically benign lesions that can grow in different directions within the bony structures of the skull base. To date, the precise role of the different surgical strategies (radical versus partial resection; biopsy) and of supplementary postoperative radiotherapy remains undefined due to the short follow-up of the majority of the reported cases. We present a patient who is alive without symptoms or signs of recurrence 44 years after a macroscopically radical excision of the neoplasm followed by radiotherapy.
Pathologic findings in 25 autopsies of AIDS. The common and severe changes of the central nervous system, lungs, adrenals, heart, kidneys and gonads are reviewed in a series of autopsies of AIDS. In the brain, HIV infection induces directly inflammatory infiltrates including the typical multinucleated giant cells described by Sharer. In addition, primary lymphomas are seen as well as reactive and inflammatory lesions that are caused by opportunistic infections, such as those of poliomavirus, Cytomegalovirus and Toxoplasma gondii. In the lung, interstitial inflammation prevails, which may be related to direct HIV infection and include rare multinucleated giant cells like the ones described by Sharer. Opportunistic infections are often associated, and are commonly sustained by Cytomegalovirus and Pneumocystis carinii. A peculiar findings is the evolution from septal inflammation to fine fibrosis and hyaline degeneration, either focal or diffuse. We believe that the severe respiratory insufficiency that is commonly seen in the advanced stages of AIDS could be related to the interstitial damage. In the adrenal gland, the most common change is Cytomegalovirus infection affecting both the cortex and the medulla, and inducing massive necrosis in the cortex with little or no reaction. Again, adrenal involvement should be related to adrenal functional insufficiency, which may be over-looked clinically because of the preponderant lesions of other sites. In the heart, myocarditis is often discrete, and may be complicated by perivascular fibrosis and rare foci of myocytolysis; in some cases primary lymphomas may also develop. In the kidney, several histological lesions are found, including glomerular damage with segmental necrosis, cortical areas of hyporeactive necrosis, and mild interstitial inflammation. In the gonads, the changes are partly induced by drug abuse, and consist of atrophy with secondary hypoplasia of the germ cells and interstitial fibrosis. In conclusion, the most important abnormalities consist of opportunistic infections, hyporeactive necrosis, fibrotic evolution of the inflammatory infiltrates and neoplasias (Kaposi's sarcoma and lymphomas). In this work, the changes of the lymphoid organs are only mentioned, for they have been widely reviewed elsewhere.
Lesions of the central nervous system were seen in 13/22 autopsies of Italian subjects affected by the acquired immune deficiency syndrome and including 19 intravenous drug addicts. Multinucleated cells similar to those originally described by Sharer et al. [1985] in response to direct central nervous system lesions by the human immune deficiency virus were seen in five subjects. Isolated or multiple opportunistic infections of the brain including cerebral toxoplasmosis (7 cases), progressive multifocal leukoencephalopathy (4), cytomegalovirus encephalitis (3), and tuberculous meningoencephalitis (2) were recognized. Finally, three cases of primitive cerebral lymphoma of large round cells were found. The central nervous system is a target, like the lymphoid tissue, of direct damage for the human immune deficiency virus, and it is frequently affected by opportunistic infections due to the immunological impairment sustained by the acquired immune deficiency syndrome.
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Whereas the numbers of nerve cells in several areas of the cerebral cortex are reported to decrease with aging, the fate of the neurons of the subcortical nuclei is controversial. This work is concerned with a morphometric study of the nerve cell population of the putamen through cell counting in 24 subjects aged 62 to 90 years. Our data suggest that there is no significant decline in the small-cell density with aging, nor any differences according to sex. No conclusions on the functions of the aging brain should be inferred from cell counting alone, since other signs of functional damage, such as impairment of the synapses or decrease in their number probably precede cell loss.
The ultrastructural appearances of preneoplastic liver nodules induced in male Wistar rats through sequential treatment with diethylnitrosamine (DENA) and 2-acetylaminofluorene (2-AAF) followed by partial hepatectomy were investigated. Although separately non-specific, the lesions reported represented altogether a fairly characteristic pattern consistent with previous observations in tumors and in preneoplastic nodules induced by long-term treatment with single carcinogens. Such data support the view that sequential treatment followed by partial hepatectomy is a reliable method to study early phenotypic changes in hepatocarcinogenesis. Such treatment is also advisable because it requires only a short period of latency in comparison to other in vivo screening tests of potential carcinogens.
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