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Biomedical subjects

F Nardi

Publications and source records attributed to F Nardi.

At least 19 recordsLinked to original sources

A randomized trial of ultrasound-guided anterior subcostal liver biopsy versus the conventional Menghini technique.

An ultrasound-guided double pass biopsy technique using a large bore cutting needle via an anterior subcostal route (USAB) is described. The diagnostic adequacy of this biopsy procedure was evaluated in comparison with the traditional Menghini technique in 200 cases of suspected chronic liver disease randomly assigned to the two different procedures. Retrieval rate was better in the USAB group. The sample length was less than 15 mm in four cases in the USAB group and in 19 cases in the Menghini group. In three cases in the USAB group the second pass modified the diagnosis of the first specimen from chronic active hepatitis to active cirrhosis. In order to evaluate the safety and discomfort of the two procedures 340 patients assigned to the different techniques had liver ultrasound scans 6 and 24 h following percutaneous biopsy. USAB was associated with a reduced frequency of complications (one out of 170 patients vs. seven out of 170 patients who had the intercostal Menghini procedure). In our study, USAB seems to offer better sampling and size of individual samples, together with reduced frequency of major and minor complications.

Biopsy

[Echo-guided needle biopsy of the thyroid. An assessment of 52 thyroid neoplasms found in 1042 consecutive patients].

The authors report on a series of 1,043 fine-needle biopsies of the thyroid performed under US guidance; the patients had been selected for thyroid pathologic conditions. Fifty-two neoplasms were observed (46 papillary carcinomas, 1 medullary carcinoma, 2 follicular carcinomas, and 3 metastases), which had been detected by cytology and confirmed by histology or autopsy. The authors focus on 46 cases of papillary carcinoma: their US features were studied which, through a correlation of variables, allow a quick and "safe" recognition of the type of carcinoma (papillary carcinomas account for nearly 60% of thyroid neoplasms). Tumor echogenicity and outline, and the presence/absence of calcifications were evaluated: in most cases, papillary carcinomas presented as focal lesions (alone or associated with other goiter lesions), with irregular and blurred outline, no hypo/anechoic halo and, in about 1/3 of the cases, with calcifications and colliquative areas. In 17% of papillary neoplasms, metastases to loco-regional nodes were observable at US; in 3 cases the carcinoma did involve a loco-regional node but there were no US signs suggestive of it. The incidence of neoplasms on the total of fine-needle biopsies is 4.9%, while in a previous series of 3,038 fine-needle biopsies, without US guidance, on clinically detectable lesions, the figure was about 2%.

Adenocarcinoma

Hürthle cell hyperplasia and sarcoidosis of the thyroid.

We report of a case of Hürthle cell hyperplasia of the thyroid that was correctly identified preoperatively by fine-needle aspiration cytology but was unexpectedly associated with sarcoid granulomas. To our knowledge, the association has not been previously reported. The rarely described thyroid involvement by sarcoidosis is briefly reviewed.

Biopsy, Needle

Hydatid cyst: primary diagnosis by fine-needle aspiration biopsy.

Two cases of soft-tissues echinococcosis are presented in which the definitive diagnosis was established by identifying laminated layer remnants on fine-needle aspiration smears. Large polygonal pieces of acellular material with delicate parallel striations were seen, while neither scolices nor hooklets were found. The cases reported most likely represent the occurrence of sterile hydatid cysts. A diagnosis of echinococcosis should be considered when fragments suggestive of laminated layer are identified on smears, even in unusual sites and without evidence of hooklets and/or scolices.

Biopsy, Needle

Silver staining of interphase nucleolar organizer regions in cytologic smears previously stained by the Papanicolaou and May-Grünwald-Giemsa techniques.

Malignant cells are known to display a distinctive argyrophilic nucleolar organizer region (Ag-NOR) protein distribution compared with distribution in their benign counterparts. In this study, Ag-NOR staining was applied to smears from reactive and malignant serous effusions. The smears were either unstained or had been previously stained with the Papanicolaou or May-Grünwald-Giemsa (MGG) technique. The purpose of this study was to assess the feasibility and usefulness of Ag-NOR staining in diagnostic cytopathology and to set up a procedure that could be used on prestained smears in retrospective studies. The one-step silver staining method was applied to prestained smears after a weak destaining step in trichloracetic acid and to unstained smears after a postfixation step in Carnoy's fluid. Positive results were observed on both destained and unstained preparations, MGG-stained smears showing a better visualization of the silver deposits than Papanicolaou-stained smears. Major differences in size, shape, and distribution patterns of the Ag-NOR-positive granules were observed between neoplastic and reactive cells. Furthermore, the mean number of silver-stained dots per cell was significantly higher in malignant cells (33.32 +/- 2.23) than in reactive mesothelial cells (9.71 +/- 0.66). These data indicate that this Ag-NOR technique can be profitably applied to prestained cytologic smears to assist in the diagnosis of malignancy and that the technique has the advantage that cellular morphology and silver staining can be evaluated on the same slide.

Ascitic Fluid

Nucleolar organizer regions in the fine needle aspirates of lung tumours.

Nucleolar organizer region associated proteins (AgNOR proteins) have been identified by means of an argyrophil technique in smears of 60 consecutive fine needle aspirates from lung tumours. AgNOR proteins were visualized as silver-positive granules distributed in loose, intranuclear aggregates. Variations in the number as well as differences in the distribution pattern of AgNOR granules were found among different types of tumours. Except for small cell lung carcinoma, the count of AgNOR granules increased when the differentiation of tumours decreased. In particular well differentiated tumours had relatively few AgNOR granules, distributed in cohesive aggregates. Poorly differentiated tumours had many AgNOR granules organized in loose clusters and small cell lung carcinoma had relatively few granules dispersed throughout the nucleoplasm, showing characteristics unique among all lung neoplasms. The application of the AgNOR technique in cyto-preparations is useful in discriminating between small cell and non-small cell lung carcinomas. Moreover, the pattern of distribution of AgNOR proteins may be of diagnostic value in the assessment of tumours displaying overlap in AgNOR counts.

Adenocarcinoma

Ultrastructural histochemistry of mesotheliomas and adenocarcinomas in malignant effusions.

The results of electron microscopic examination of cytologic specimens from six cases of mesothelioma and 10 cases of metastatic carcinoma of different origins are presented. The formation of cell clusters in malignant effusions from the two neoplasms has been thoroughly investigated: in mesotheliomas, cells had longer, more slender microvilli than in carcinomas and more abundant bundles of intermediate filaments; the central cavity often seen in the clusters frequently contained collagen and showed basement membrane production. The application of periodic acid-silver methenamine (PASM) and phosphotungstic acid (PTA) demonstrated a peculiar ultrastructural difference in cell coat staining in the two tumor types: in mesotheliomas, PTA and PASM were consistently negative along the outer surface of the cell aggregates, while carcinomas displayed a positive reaction either on the outer surface or on both inner and outer surfaces of the clusters. The diagnostic significance of the above-mentioned difference between the two neoplasms will require further investigation in a larger number of cases.

Adenocarcinoma

Mitochondrial inclusions in human cancer of the gastrointestinal tract.

Four cases of adenocarcinoma of the gastrointestinal tract have been examined. Large electron-dense mitochondrial inclusions were found in the mitochondria of many cells; after detailed histochemical tests they could be classified into two types. The first type of inclusion consisted of clusters of electron-dense, calcium-containing granules linked to a glycoproteic substrate. These inclusions were linked to a glycoproteic substrate. These inclusions were always associated with cristae and were found in the mitochondria of cells that showed clear signs of degeneration. The second type of inclusion was found much more frequently and consisted essentially of phospholipids of which electron density was strictly osmium dependent. Their structure was usually at least partly lamellar, but in some cases it was homogeneous throughout. It is hypothesized that inclusions of the second type may have the same biological role as the morphologically identical inclusions found in the mitochondria of brown fatty tissue in the perinatal rat and in yeasts during glucose repression or anaerobiosis. The resemblance between the homogeneous variety of inclusions within the second type and the mitochondrial inclusions recently described in human leukemic lymphoblasts and monoblasts has been stressed to bring out the need for a histochemical check on the supposedly viral nature of the latter inclusions.

Adenocarcinoma

Congenital extracardial malformations accompanying congenital heart disease.

A statistical review of 1,354 autopsies performed in cases of congenital heart disease in three major Italian hospitals was carried out. In 446 cases one or more extracardial malformations were found; those most commonly encountered were malformations of the urinary tract, anomalies of the respiratory tract, malformations of the intestine and spleen and trisomy 21. Ventricular septal defects and persistent common atrioventricular canals occurred in a higher percentage of cases with extracardial malformations than in those where congenital heart defects were the only malformations. The reverse was true of endocardial fibroelastosis and transposition of the great vessels. Ventricular septal defects are particularly common in the Klippel-Feil syndrome, in trisomy 18 and, together with a persistent common atrioventricular canal and atrial septal defects, in trisomy 21. The typical picture of so-called "congenital heart disease associated with asplenia" was found in cases with splenic agenesis, either with or without situs inversus viscerum, but also in cases with situs inversus viscerum without asplenia.

Abnormalities, Multiple

The diagnostic usefulness of electron microscopy investigation of orbital embryonal rhabdomyosarcomas.

The ultrastructural study of three malignant orbital tumors, only one of which was correctly diagnosed as embryonal rhabdomyosarcoma upon histologic examination, is reported. In all 3 cases electron microscopic investigation revealed the presence of rhabdomyoblasts. These are easily recognizable in one case in which the diagnosis was made on the basis of the optical microscopic study. The other two cases needed further tests to evince rhabdomyoblasts. The importance of an ultrastructural study for a histogenetic characterization of this kind of tumor is emphasized. As far as embryonal rhabdomyosarcomas are concerned the electron microscopic study is possible, and it gives useful results even when material fixed with routine histologic methods (formalin, Bouin's solution) are used.

Child