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Biomedical subjects

G Viganotti

Publications and source records attributed to G Viganotti.

At least 19 recordsLinked to original sources
PubMed1992

[Nonpalpable breast lesions. General considerations and a review of the literature in the light of the authors' own experience with 344 cases located preoperatively].

The widespread use of mammography in breast cancer screening has increased the number of non-palpable breast lesions being detected in which the differential diagnosis between benign and malignant cases requires surgical biopsy. In order to remove these mammographically identified lesions the surgeon must be guided, which is why the techniques guiding the surgeon during lesions ablation have become most important. Accurate preoperative lesion localization must be done so that the excision can be complete and with the best cosmetic result. In this report we discuss localization methods, from the simplest to the most complicated ones. The commonest method has the advantage of employing no special instruments, and it is very simple, safe and fast. It requires a skilled hand and a little training. Instrumental methods are then discussed, from the simple dedicated compressor to the stereotactic techniques and, finally, the role of ultrasonography both in preoperative localization and in cytologic biopsy. The importance of mammographic examination of the surgical specimen is also stressed.

Adult↗
PubMed1990

Diagnostic efficacy of physical examination, mammography, fine needle aspiration cytology (triple-test) in solid breast lumps: an analysis of 1708 consecutive cases.

The clinical-radiologic-cytologic triplet was used for diagnostic evaluation in 1708 women over 30 years old with a breast lump. All the lumps were subjected to surgery except for 258 cases in which clinical resolution took place within 1-2 months. Seven-hundred and ninety-three out of 1450 nodules removed were cancers. Sensitivity of the clinical, mammographic and cytologic examinations was 82%, 73% and 68%, respectively. It increased to 95% when they were associated. Specificity was 63%, 80% and 97%, respectively. The predictive value of positive results of the triple test was 100%. No patient with malignant cytology was subsequently shown to have benign disease. The systematic use of the triple test in solid breast lumps for the early detection of cancer is recommended as a routine procedure. However, participation of experienced radiologists and pathologists as well as physicians skilled in fine needle puncture is required.

Biopsy, Needle↗
PubMed1990

Ultrasonographic evaluation of palpable breast masses: analysis of 134 cases.

Sonography has become a helpful adjunct to mammography mainly for a differential diagnosis between simple cysts and solid masses. The authors examined by ultrasound 134 palpable masses in the breast which had been previously evaluated by clinical examination and mammography and then submitted to biopsy or fine needle aspiration. The exact diagnosis of a simple cyst was made in 94.1% of the cases, whereas the diagnosis of fibroadenoma was made in 80% of the cases. Ultrasound examination proved to be useful in patients with dense breasts: in this group, 82.1% of the patients with a histologic diagnosis of benign status had a correct ultrasound diagnosis. In agreement with other authors, we believe that breast sonography has no part in screening programs.

Breast Neoplasms↗
PubMed1988

Localized mastalgia as presenting symptom in breast cancer.

The importance of breast pain as a presenting symptom of breast cancer was assessed in 200 women with localized mastalgia but negative physical examination and in 478 women with operable breast cancer. In the first group, mammography detected five cases of subclinical breast cancer at the site of pain. In the second group, 86 patients (18%) reported localized pain as presenting symptom, followed, at different intervals, by the detection of a breast lump. Localized pain can be considered a presenting symptom of breast cancer thus requiring a careful physical and mammographic examination, especially when risk factors are associated.

Adult↗
PubMed1988

[Radiodiagnosis of thymomas].

On the ground of the clinical experience gained on thymomas observed during the last decade and controlled by histopathology at the National Cancer Institute of Milan, the authors report and describe the typical morphology of the above neoplasms, which were studied with both the conventional and the most advanced imaging procedures. First of all, the authors point out the common problems of differential diagnosis with other lesions in the anterior mediastinum, with a special emphasis on lymphomas. Attention is also drawn to both the diagnostic and therapeutic value of conventional radiotomographic procedures combined with CT and MRI: in particular, the former can provide an extremely valuable diagnostic support to fine needle biopsy. In the authors' opinion, explorative surgery--e.g. mediastinal endoscopy-is immediately advisable when an unquestionable diagnosis is not reached even after a most rational combination of the different imaging procedures.

Adolescent↗
PubMed1987

Diagnostic efficacy of the clinical-radiological-cytological triad in solid breast lumps: results of a second prospective study on 631 patients.

The clinical-radiological-cytological triad was used for diagnostic evaluation in 631 women over 30 years old with a solid breast lump, excluding clinically obvious cancers. All the lumps were subsequently removed surgically, except for 105 cases which spontaneously regressed within 2 months. 285 of the 526 nodules removed were cancers, and 162 of 285 (57%) did not exceed 20 mm in size. The sensitivity of the individual tests (physical examination, mammography and fine-needle aspiration cytology) of the malignant lumps was respectively 0.83, 0.73 and 0.60, and it increased to 0.95 when they were associated. Of the remaining 346 benign lumps the specificity of the three tests was respectively 0.60, 0.78 and 0.98. The predictive value of a positive response (certain or probable) to the three tests was 0.63, 0.74 and 0.94. The certain positive responses of cytology (131 of 285 cases) reached a predictive value of 1.00. The predictive value of a negative response for the three tests was respectively 0.81, 0.80 and 0.82; in the absence of positive responses, the predictive value for benignancy of the triad was 0.93 (177 of 190 cases). The systematic use of the diagnostic triad and the organizational platform allowed the clinicians to select malignant cases and plan inpatient/outpatient surgical treatment.

Adult↗
PubMed1979

[X-ray diagnosis of malignant breast calcifications. (author's transl)].

The authors have taken into consideration the different features of malignant breast tumor calcification. Frequent, rare and extremely rare radiological pictures will be shown and a differential diagnosis with benign micro-calcifications will be considered. A correct mammographic and xerographic technical performance is absolutely necessary to enhance the images of the smallest micro-calcifications. At last we assess the importance of a radiographic control of the surgical blocks, after conservative surgery of the breast, to assure a complete removal of microcalcifications.

Breast Diseases↗
PubMed1978

Malignant pleural mesothelioma.

A series of 12 cases of mesothelioma is presented, and the data in the literature is reviewed in an attempt to formulate a program of treatment for this malignant, fast-growing and rapidly fatal tumor.

Adult↗
PubMed1978

Combined chemotherapy-radiotherapy approach in locally advanced (T3b-T4) breast cancer.

Combined treatment modality was applied in 110 consecutive women with primary inoperable (T3b-T4) Breast cancer. Treatment was started with four cycles of adriamycin plus vincristine (AV). This was followed in responders by high-energy radiotherapy (RT). At the end of combined therapy, patients in complete remission (CR) were randomized to either no further treatment or six more cycles of chemotherapy. AV induced objective response in 89% of patients (complete 15.5%, partial 54.5%, improvement 19%). At the end of RT, 81% of 98 (82.7%) patients responding to AV were classified in CR. The median duration of CR was 15 months. The median free interval was statistically prolonged by additional chemotherapy. The three-year survival was 52.8%. Altogether, present findings indicate that combined treatment modality has improved the three-year survival compared to the previous series treated with radiotherapy alone. However, to achieve a satisfactory control of T3b-T4 breast cancer a more aggressive and prolonged treatment is required.

Adult↗
PubMed1976

[Role of thermography in the diagnosis of breast neoplasms].

319 cases of breast pathology of doubtful clinical diagnosis were studied by means of thermography and mammography, with histological verification: 214 proved to be malignant tumours and 105 benign. The role of thermography is discussed on the basis of these results; it would appear to be restricted to diagnostic aid status associated with other procedures, particularly clinical examination and mammography.

Adenocarcinoma↗
PubMedDate not supplied

[Radiological study of complications and recurrences of esophageal carcinoma after surgery (author's transl)].

256 esophageal carcinoma patients subject to various surgical procedures were examined with a view to identifying as early as possible the complications and possible tumoral recurrences, early or late, at anastomosis level. The most caracteristic and frequent radiological features, especially of neoplastic recurrences are presented; the various morphological types are described and discussed and for the first time a radiographic classification is proposed, followed by a discussion of the criteria of differential diagnosis of these lesions, especially from postoperative perivisceritis. Correct identification and precise radiographic description of the early signs of neoplastic recurrence in the esophagogastric anastomoses make it possible to reoperate, at least in some patients.

Cardia↗
PubMedDate not supplied

[Radiological study of the topography and morphology of pulmonary cancer].

This study proposes a radiological, topographical and morphological classification of primary carcinoma of the lung based on a large radiographic case-series of the National Cancer Institute of Milan checked anatomopathologically. The aim is to standardise the X-ray findings and so make for easier understanding and more rewarding cooperation among those engaged on the diagnosis and treatment of this tumor. The classification of lung cancer into central and peripheral only is felt, in the light of present knowledge, to be inadequate. It is therefore suggested that central lung cancers be divided into purely endobronchial, endoperibronchial and exobronchial, taking into account both the repercussions on ventilation and extracentral spread. For peripheral lung carcinomas more detailed morphological and topographical features are considered in order to pinpoint the tumor and its hilomediastinal spread, especially in the case of paracentral tumors. A brief reference is made to the more relevant radiodiagnostic procedures.

Bronchial Neoplasms↗