Biomedical subjects

Lucia Brambilla

Publications and source records attributed to Lucia Brambilla.

4 recordsLinked to original sources

PubMed2006

Quantitative and functional defects of dendritic cells in classic Kaposi's sarcoma.

In this study, we investigated whether dendritic cells (DCs) are altered in classic Kaposi's sarcoma (cKS), a lympho-angioproliferative disorder associated with human herpesvirus-8 (HHV-8) infection. By direct analysis of peripheral blood DCs (PBDCs), we demonstrated that cKS patients have lower frequency of myeloid and plasmacytoid DCs than controls. This reduction was greater in patients with advanced stages of disease. PBDCs from cKS patients also showed up-regulated expression of the scavenger receptor CD91 and impaired IL-12 expression. PB monocytes that represent DC precursors in vivo and in vitro showed the same alterations; accordingly, DCs differentiated in vitro from cKS monocytes were similarly affected. The same alterations were induced by addition of cKS plasma during DC differentiation from control monocytes. These results indicate that PBDCs and their precursors are altered in cKS and suggest that soluble circulating factors participate in this process. The study may provide new insights into the pathogenesis of cKS.

Adult↗

PubMed2006

Treatment of classic Kaposi's sarcoma-associated lymphedema with elastic stockings.

Lymphedema of the lower extremities is a frequent complication of Kaposi's sarcoma (KS). Compressive therapy is the basis of treatment for lymphatic disorders, but to the authors' knowledge, there are no controlled trials to evaluate its effectiveness in KS-related lymphedema. Sixty-five patients with classic KS-associated lymphedema limited to below the knee were studied. Fifty patients received below-knee elastic stockings, whereas the remaining 15 did not use any compressive device. Among treated patients, 60% (30/50) experienced a limb volume reduction, while 40% (20/50) had an increase of limb volume. In contrast, all patients (15/15) of the untreated group had an increase of limb volume. No correlation between lymphedema reduction and systemic or local chemotherapy was observed, supporting compressive therapy as the major strategy for the treatment of this condition. Our results suggest that elastic stockings may be important tools for the management of lymphedema associated to classic KS.

Adult↗

PubMedDate not supplied

Staging of classic Kaposi's sarcoma: a useful tool for therapeutic choices.

Three hundred patients with classic Kaposi's sarcoma (CKS) have attended our Department of Dermatology over a period of 20 years. Many of them have been treated by systemic chemotherapy with good responses. Due to the highly variable clinical evolution of the disease, it was, however, often difficult for us to decide whether or not to treat elderly patients. We therefore attempted to establish a new staging system based on objective criteria that more closely follow the clinical variability of CKS and make the therapeutic choices easier. The proposed staging system comprises 4 stages, each further divided according to the speed of disease evolution and presence of complications that can severely impair the quality of life. The application of this staging system to our patients has shown that evolution is prevalently slow in the maculo-nodular and infiltrative stages I and II and faster during the florid and disseminated stages III and IV. Complications are mainly present in the rapidly evolving florid and disseminated stages, with visceral involvement in the more aggressive forms. Based on these findings, we are employing systemic therapy in the florid and disseminated stages and in the infiltrative stage only in case of rapidly evolving or slowly evolving but complicated disease.

Aged↗

PubMedDate not supplied

Chordoma cutis.

We report a case of an 85-year-old white man with a diffuse form of psoriasis, who showed a large asymptomatic subcutaneous tumour in the sacrococcygeal region. On cut section there was a subcutaneous neoplasia with a glistening, friable surface. Histologically, the deep dermis was infiltrated by cords and nests of pleomorphic cells embedded in an abundant mucinous stroma, and characteristic physaliphorous (multivacuolated) cells were observed. The neoplastic cells were immunohistochemically positive for cytokeratins (using CAM 5.2 and AE1/AE3), vimentin, S100 protein, and epithelial membrane antigen (EMA), but negative for carcinoembryonic antigen (CEA). Histological and immunohistochemical findings led us to the diagnosis of classic chordoma. Chordomas are rare, slow growing malignant tumours of the spinal axis originating from remnants of the notochord. Occasionally, a skin lesion is the first sign of a primitive or metastatic chordoma.

Aged↗