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Biomedical subjects

I Pecorella

Publications and source records attributed to I Pecorella.

At least 19 recordsLinked to original sources

Co-occurrence of psoriatic arthritis with collagenous colitis: clinicopathologic findings of a case.

A 58-year-old man developed psoriatic arthritis and, after 6 months, persistent watery diarrhoea. Biopsies from the colorectal mucosa showed thickened subepithelial collagen consistent with collagenous colitis. There also was an inflammatory cell infiltration (mainly lymphocytes and monocytes) in the chorion. These findings and the parallel course of articular and bowel complaints suggest a clinicopathologic correlation between arthritis and colic involvement.

Anti-Inflammatory Agents, Non-Steroidal↗

Orbital osteoclastoma of apparent extraskeletal origin in a pagetic patient: a case report.

A large mass in the right orbit, causing proptosis, ptosis of the right upper eyelid, and limitation to eye movements, was surgically removed from a 51-year-old woman suffering from Paget's bone disease (PBD). Histologically, a giant cell tumor of the bone (osteoclastoma) was diagnosed. No bony involvement was apparent either operatively, microscopically, or on preoperative computed tomographic scans. The neoplasm has not recurred in a 3-year follow-up. In addition to the fact that osteoclastoma complicating PBD is rare, the extraskeletal origin of the tumor is a matter of interest and can be tentatively explained by an unusually powerful systemic stimulus acting on circulating osteoclast precursors. HUM PATHOL 31:1527-1531.

Female↗

Postmortem histological survey of the ocular lesions in a British population of AIDS patients.

AIMS: To study ocular pathology and systemic correlations in a series of 73 postmortem eyes from British patients who died from AIDS before the introduction of a HAART regimen. METHODS: The eyes were studied with conventional histology, special histochemical stainings, and immunohistochemistry. RESULTS: 72.6% of the cases showed chronic uveal inflammation, caused by opportunistic agents in 37.7% of them (cytomegalovirus (CMV) in 30.1%, C neoformans in 5.6%, and Gram positive bacteria in 1.8%). Cytoid bodies were noted in 10/73 eyes, three linked to CMV retinitis. Six retinal haemorrhages, four of which were secondary to CMV, were found. 14 specimens (19. 1%) showed foci of calcification, and a further 11 (15%) calcium oxalate deposits. In no cases were the calcific deposits suspected clinically. Six eyes (8.2%) did not show any abnormality. CONCLUSIONS: CMV retinitis is the most common (28.7%, 21/73) ocular infection in this series and may occur either during or in the absence of systemic dissemination. Conversely, ocular cryptococcosis appears to be an epiphenomenon of systemic and CNS disease. No other opportunistic ocular infections were present in this series. Interesting findings were the presence of intraocular precipitates of calcium oxalate and calcium phosphate or carbonate in a significant number of cases (15% and 19%, respectively), and the high prevalence of idiopathic uveal inflammation (43.8%).

AIDS-Related Opportunistic Infections↗

Herpesvirus infection of eye and brain in HIV infected patients.

OBJECTIVES: To compare histological with genome detection methods for diagnosis of herpesvirus infection in eye and brain of HIV infected patients undergoing necropsy and to correlate these findings with both antemortem clinical findings and postmortem evidence of extraocular herpesvirus infection, especially in the CNS. METHODS: A prospective study of 31 consecutive HIV infected patients undergoing necropsy. In life 11 patients had been assessed by an ophthalmologist because of ocular symptoms. Ocular and brain samples were examined for herpesviruses by conventional histological methods and by nested polymerase chain reaction (nPCR) for all eight human herpesviruses; evidence of extraneural herpesvirus infection was sought by histological methods. RESULTS: Although only 12 out of 31 patients (39%) had antemortem clinical evidence of ocular or CNS herpesvirus associated disease, herpesviruses were detected by nPCR in eye and brain from 26 (84%) patients; six patients had more than one herpesvirus infection. There was concordance between ocular and CNS findings in 15 of 19 patients (79%) with CMV infection. 17 of 31 patients (55%) had extraocular or CNS CMV infection at necropsy. Genome detection using nPCR was superior to histological methods for diagnosis of ocular and CNS herpesvirus infection. CONCLUSION: Herpesvirus infection of eye and brain was a frequent finding at necropsy in this group of HIV infected patients; almost a fifth were co-infected by more than one herpesvirus. This was more than twice the incidence predicted from clinical evidence before death. Genome detection using nPCR was superior to histological methods for diagnosis of ocular and CNS herpesvirus infection.

Adult↗

Histological findings in the eyelids of AIDS patients.

PURPOSE: The eyelids of 15 AIDS patients (17 specimens) were examined histologically at postmortem. METHODS: Formalin-fixed, paraffin-embedded and haematoxylin-eosin stained sections were examined by conventional light microscopy. The presence of calcific deposits was confirmed by special stains and elemental analysis (X-ray energy dispersive spectroscopy). RESULTS: 6 cases had abnormal microscopical findings. In two cases deposits of calcium oxalates were observed in the wall of dermal blood vessels and in epithelial cells of sweat and sebaceous glands, respectively. Precipitates of calcium phosphate were observed in the superficial substantia propria of the palpebral conjunctiva in an additional patient. Other histological findings in the remaining three patients included flat warts, an unusual elastotic degeneration of the forniceal palpebral conjunctiva and more common lesions (chalazion, Demodex folliculorum infestation of the eyelashes, trichilemmal cyst). CONCLUSION: The presence of microscopical lesions in nearly half of this small series demonstrates that the eyelids may be affected subclinically in AIDS patients.

Acquired Immunodeficiency Syndrome↗

Ocular, cerebral and systemic interrelationships of cytomegalovirus infection in a post-mortem study of AIDS patients.

PURPOSE: Eighty-six post-mortems of AIDS patients were reviewed microscopically and the presence of cytomegalovirus (CMV) infection in the viscera, brain and eye was recorded. METHODS: Immunohistochemical stains and in situ hybridisation with a CMV probe were performed. RESULTS AND CONCLUSION: CMV infection was observed in 63% of the cases. Visceral, cerebral and ocular involvement were overall 49%, 33% and 29%, respectively. The visceral form with no concomitant ocular and/or cerebral infection was the main cause of death (31%) in the 54 CMV-infected patients. Although CMV retinitis occurred mostly (20%) as a component of systemic disease, in 13% of the CMV-infected patients the eyes only were involved, while there were no cases with CMV limited to the brain. In the absence of systemic involvement, 9% of the cases showed concomitant ocular and cerebral infection, but because we failed to observe CMV optic neuritis without ocular involvement, retrograde viral spread from the brain through the optic nerve appears to be an infrequent mechanism of CMV retinitis.

AIDS-Related Opportunistic Infections↗

Diagnostic value of anti-hepatitis C virus (HCV) core immunoglobulin M in recurrence of HCV infection after orthotopic liver transplantation.

The significance of anti-hepatitis C virus (HCV) core immunoglobulin M (IgM) and its relationship with genotypes, alanine aminotransferase abnormality, and histological data were studied for 18 patients who had undergone orthotopic liver transplantation due to HCV-related end-stage disease. During follow-up, IgM response seemed to be associated with the recurrence of HCV infection but did not correlate with abnormal alanine aminotransferase levels and histological data. In addition, the results of this study indicated that the detection of HCV RNA is critical for diagnosis of reinfection in liver transplantation.

Hepacivirus↗

Ostensible oncocytoma of accessory lacrimal glands.

Benign oncocytomas of the accessory lacrimal glands can be found in the lacrimal caruncle, plica semilunaris or conjunctival fornices, but are extremely rare. A series of 15 supposed oncocytomas of the ocular adnexa was reviewed retrospectively, and histological differences were noted with respect to the parotid gland counterpart. Lesions could be divided into three histological groups: (1) tumours composed of tubules lined by tall columnar epithelium with finely granular cytoplasm; the tubules often had dilated lumens containing mucinous secretion; (2) cystic tumours with prominent epithelial tufts projecting from much of the cyst wall; (3) tumours with solid areas composed of variably cuboidal or polygonal cells, largely in trabecular arrangement, and co-existing with the previously described tubular and cystic elements. A striking resemblance to Warthin's tumour without a lymphocytic component, such as may affect the parotid salivary gland, was noted in several tumours.

Adenoma, Oxyphilic↗

Acquired immunodeficiency syndrome and ocular calcification.

We report the presence of peculiar nonbanded calcification of the cornea in three patients with acquired immunodeficiency syndrome, discovered on postmortem histological examination of the globes. In one patient, multiple calcium salt precipitates also affected other ocular and orbital structures. Calcium deposits were present in the corneal stroma but spared Bowman's layer, as is usually seen in primary and secondary corneal calcification. The calcified areas were positive to von Kossa, alizarin red, alcian blue, and colloidal iron stains. Electron probe analysis of the three cases showed the presence of calcium and phosphorus in a ratio characteristic for hydroxyapatite. No predisposing factors could be found. The possible role of associated alterations in the mucopolysaccharide content or composition in the calcified areas is unclear.

Acquired Immunodeficiency Syndrome↗

Histological study of oxalosis in the eye and adnexa of AIDS patients.

Review of a series of 98 eyes removed at autopsy from 86 AIDS patients identified 12 cases (14%) showing varying degrees of microscopic calcium oxalate deposition. The oxalate crystals were birefringent using polarisation microscopy and were stained histochemically by the silver nitrate-rubeanic acid method (Yasue), a stain considered to be specific for calcium oxalate. In two cases, the deposition was extensive and involved the surface of the ciliary processes, ciliary body and pars plana of the retina, the retinal and optic nerve blood vessel wall, a few retinal pigment cells, and the anterior inner sclera. A lesser degree of intraocular involvement was observed in the remaining 10 cases. In all but two eyes, where a peripheral active area of cytomegalovirus retinitis was present, no other significant microscopical abnormality was found. Clinically, these patients were asymptomatic. At autopsy, oxalate deposits were found in the kidney and/or thyroid in seven of the patients.

Acquired Immunodeficiency Syndrome↗

Are most intraocular "leiomyomas" really melanocytic lesions?

BACKGROUND: Intraocular smooth muscle tumors have long been a subject of controversy. The advent of immunohistochemistry with antibodies against HMB-45, S-100, smooth muscle actin, desmin, and vimentin has helped greatly in the distinction between smooth muscle tumors and melanocytic lesions. METHODS: Twenty-seven archival tissue blocks from patients who had had intraocular leiomyomas or leiomyosarcomas diagnosed were located and fresh sections cut and stained for the above markers. The cases constituted 24 iris lesions and 3 ciliary body lesions. RESULTS: All 24 iris tumors were reclassified as iris melanocytic lesions. Two of the three ciliary body leiomyomas retained their classification, and the third was reclassified as a spindle B-cell melanoma. CONCLUSION: The authors suggest that intraocular leiomyomas are much rarer than previously suggested and that many of the cases previously reported in the literature are open to question.

Actins↗

Clear cell hepatocellular carcinoma treated with liver transplantation.

We report a case of a 35-year-old female who underwent total hepatectomy and liver transplantation for a diffuse clear cell variant of hepatocellular carcinoma in non-cirrhotic liver. Preoperative clinical evaluation showed no extrahepatic metastatic involvement. However, scheletal metastases of the tumour were detected five months later. Although clear cell variant is generally considered to run a relatively favorable course, this case proved rapidly progressive and seems therefore to be a debatable candidate for liver transplantation among primary hepatic cancers.

Adenocarcinoma, Clear Cell↗

Osteo-odonto-keratoprosthesis. Description of surgical technique with results in 85 patients.

Osteo-odonto-keratoprosthesis is a technique designed for patients with severe corneal opacification who would be at high risk of graft rejection should donor tissue transplantation be performed. Because of the isolation of the prosthetic implant from the tissues that the technique provides, the authors are of the opinion that it is the only viable option in such patients. The visual outcome and complications of the procedure in a series of 85 cases are presented.

Adult↗

Detection of nephrotoxicity in cyclosporine-A amyotrophic lateral sclerosis patients by means of urinary cytology.

Exfoliative urinary cytology was used for two amyotrophic lateral sclerosis patients treated with 3 mg/kg/day cyclosporine (CsA) therapy in order to detect the onset of the nephrotoxic side-effects of the drug before the apparent deterioration of the patients' clinical condition. Of the two patients, only one showed clear morphological features of drug-related damage in a one year course of cyclosporine therapy, but these followed the increase in the serum kidney and liver laboratory parameters and did not prove useful for the early detection of nephrotoxicity. However, in this patient the renal damage was hallmarked by an increasing number of tubular cells or clusters of ill-defined renal cells in the urinary specimen, suggesting an ongoing tubular injury. The slight cytological alterations may possibly be due to the low CsA dosage used for these patients. The significance of these observations is tempered by the limited number of patients and specimens studied to date and further studies in nontransplanted patients are therefore advocated, particularly when higher CsA doses are employed.

Amyotrophic Lateral Sclerosis↗

Strampelli's osteo-odonto-keratoprosthesis. Clinical and histological long-term features of three prostheses.

The histological features are reported of osteo-odonto-acrylic laminae removed from three patients who for differing underlying causes received Strampelli's osteo-odonto-keratoprostheses (OOK) 20, 16, and 12 years previously. It appears that preservation of the alveolar-dental ligament plays a definitive role in the maintenance of the prosthesis. If this tissue undergoes necrosis as a consequence of an inflammatory disease the implanted material is eventually lost. However when no such event occurs the OOK is well preserved and well tolerated even 20 years after implantation.

Alveolar Process↗