Biomedical subjects
Publications and source records attributed to E Bianchini.
The localization of granular cell tumor to the rectum is rare. We describe a case characterized by areas with spindle cell pattern, pleomorphic cells with acidophilic granular cytoplasm, nuclear variations and absence of mitoses. Diagnosis has been confirmed by immunohistochemical study. After 22-month follow-up the patient does not show evidence of recurrence or metastases.
Between 1980 and 1993, six cases of primary carcinoma of the fallopian tube were diagnosed and treated at the Hospital of Rovigo. Median age was 64.6 years; the most frequent symptom was atypical vaginal bleeding; only one patient presented a history compatible with hydrops tubae profluens. No patient in this series had a correct preoperative diagnosis. In Papanicolau smears and endometrial currettage, one case was positive for cancer. Primary surgical treatment was performed in all cases, followed by adjuvant chemotherapy. Histologic differentiation was Grade 2 in three patients and Grade 3 in three patients. Staging was by a system analogous to the FIGO classification for ovarian carcinoma. Two patients had Stage I disease; one, Stage II; two, Stage III; and one, Stage IV. Two patients died 14 and 37 months after the initial diagnosis. Three patients without clinical evidence of disease underwent second look procedures; the patients were alive and disease free with follow up ranging from 45 to 55 months. One patient is alive 4 months after surgery. In this series survival was not associated with grade, but was dependent upon stage. In our study, the prognostic value of the second- and third-look procedures are discussed.
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Authors report a case of embryonal rhabdomyosarcoma of the breast occurring in a 16-year-old girl. To date, 26 cases have been described in the literature of which only 4 in girls younger than 16 years. Histological features, immunohistochemical findings and differential diagnosis are discussed.
The authors report a case of Huntington's disease in an 11-year-old boy with onset at six years of age. The neurological signs and symptoms were midway between the hyperkinetic and rigid forms of chorea. Intellectual development was characterized by a medium-grade deficit. MRI revealed marked atrophy of the head of the caudate nucleus, with diffuse hyperintensity of the putamen. The most characteristic neuropsychological feature was ideomotor apraxia. Neuropsychological and neuroradiological data are discussed in relation to the role of the basal nuclei and frontal cortex in the organization of movement.
A case of endolymphatic stromal myosis is reported, recalling the rarity of this pathology. Its relations with other mesenchymal lesions of the uterus and the most likely differential diagnoses are considered.
Still nowadays the extrauterine pregnancy causes the 10% of maternal deaths, also in the most developed countries. The splenic localization is really exceptional. The authors of this article describe a case they have studied, by drawing the attention on the criteria followed in order to obtain an early and correct diagnosis for a reduced mortality rate.
A c-myc DNA with a deletion which includes 5' flanking, exon 1 and intron I sequences has been found in normal white blood cells of a mother and one daughter in a Northern Italian family. In addition, the degree of methylation of specific CCGG sites in the truncated DNA is lower in both mother and daughter than that found in normal DNA. It is of interest that deletions of the first exon and hypomethylation of the c-myc gene have usually been observed only in some neoplasias. However, our results demonstrate that the c-myc truncated DNA with the abnormal methylation pattern here reported is a genomic variant which by itself is not related to neoplastic transformation.
The antenatal echographic diagnostic aspects and anatomopathological features of two foetuses suffering from sirenomelia, or caudal pole regression syndrome, are examined. Conduction of the two cases is compared. In the first case, observed at the 22nd week, antenatal diagnosis of sirenomelia led to the therapeutic interruption of pregnancy. The second case, seen close to term, closed with the birth of an already dead sirenomelic foetus.
In a consecutive series of 35 cases of HCC, 21 (60%) had a habitual alcoholic intake of greater than 80 g/die and 26 (74.2%) were positive for at least one HBV serum marker. At tissue level, HBsAg was positive in non-tumoral tissue in 8 cases (22.9%) and HBcAg in 6 cases (17.1%) in non-neoplastic tissue and in 3 cases (8.6%) in neoplastic tissue with focal type positivity. The positivity of HBsAg presented at cytoplasmatic level and that of HBcAg almost exclusively at nuclear level. The comparatively low expression of HBV antigens at tissue level can be explained by the integration of viral DNA in the host genome which probably took place in many of these cases. Cirrhosis was associated with HCC in 23 cases (65.7%). In 9 (25.7%) cirrhosis was macronodular, in 4 (11.4%) micronodular and in 10 (28.6%) it was mixed. 18 cases (51.4%) presented an association of significant alcoholic consumption and positivity of at least one HBV marker. In 19 cases (54.3%), cirrhosis was associated with positivity of at least one HBV marker. Finally, in 14 cases (40%) there was an association of cirrhosis, alcohol and positivity of at least one HBV marker. These results suggest a multifactorial aetiology of HCC in our geographic area, identifying the factors in question in cirrhosis of the liver, independently of its aetiology (through the hyperplastic-regenerative process that characterises it) in HBV and in alcohol (with direct and independent pathogenetic mechanisms known only in part, or mediated by cirrhosis of which HBV and alcohol represent the two main aetiological agents). In cases in which more than one of the aetiological factors considered was observed, it is legitimate to admit a cocarcinogenic perhaps synergistic hypothesis of this cancer.
The clinicopathological and immunohistochemical features of three types of endometrial stromal neoplasms are analyzed. The tumors are divided into three groups on the basis of two observations: 1) the presence or absence of invasion; 2) the frequency of mitotic figures.
Estrogen Receptor (ER) RNA has been studied in ER positive and ER negative cells, grown in alpha medium and fetal calf serum (FCS), with and without estrogen addition. ER mRNA was detected only in ER positive cells. When cells were grown without estrogen addition, a progressive and transient increase of ER RNA levels was observed. When cells were cultured with estradiol, the ER RNA increase took place early and ER RNA levels remained 2 times higher than in untreated cells. Therefore, a down-regulation of ER RNA is not apparent in neoplastic breast cells. We hypothesize that the increase of ER expression is caused by stabilization of ER transcripts, due to the estrogen induced ER cytoplasmic depletion.
Despite combined treatment (surgery, radio--and chemotherapy) primary central nervous system lymphoma (PCNSL) has generally a poor prognosis. Long surviving cases (more than 5 years) are exceptional. We report a case of a patient completely symptom-free 79 months after craniotomy. Histological diagnosis was diffuse centroblastic-centrocytic malignant lymphoma. Immunohistological study of the lesion was performed. Repeated CT scans reveal no tumor recurrence and screenings for extraneural disease remain negative. The prognostic value of tumor histology is emphasized.
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The clinical features and results of serological studies of a patient with Sjögren's syndrome, IgA kappa monoclonal gammopathy, and hyperviscosity syndrome are reported. The novel aspect of this case is the selective localisation to the bone marrow of lymphoplasmacytoid cells secreting IgA kappa morphologically identical to the cells infiltrating the salivary glands. The serum of the patient contained large amounts of immunoglobulin-anti-immunoglobulin immune complexes. By gel filtration chromatography it was shown that the immune complexes formed a peak of molecular weight 680 kilodaltons. The immune complexes were dissociable under acidic conditions. The immunoglobulin with rheumatoid activity was characterised as monoclonal IgA kappa protein. Treatment with plasmapheresis combined with immunosuppressive treatment with cyclophosphamide reduced the serum viscosity with concomitant clinical improvement.
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Immunological test alterations in Hodgkin's disease are described. Cutaneous reactivity to various antigens (tuberculin, oidiomycin, trichophytin, parotitis virus, candida, etc.), cutaneous reactivity to sensitizing chemical agents (DNCB, DNFB), lymphocyte blastization in vitro with PHA and various antigens, the reaction of homologous lymphocytes transferred to the skin, and the stimulation by the Hodgkin lymphocytes of homologous lymphocytes in unidirectional mixed culture, are all impaired. Antibody immunity would appear to be normal. The impairment of the T system and normality of the B system would explain these patients' much greater susceptibility to viral than to bacterial diseases. On the basis of the most recent research, it is hypothesized that underlying these phenomena is a deficiency in the H-LA system which makes it unable to recognize certain neoplastic antigens (Reed-Strenberg reticular cells, for example); stimulation of the B system by the formation of anti-T antibodies and subsequent depletion of this system.
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