Biomedical subjects
Publications and source records attributed to M Papotti.
A case of yolk sac tumor of the ovary exceptional for its size and rapid development is here presented and discussed. The patient was feeding her baby delivered only two months earlier. Hormonal influences of pregnancy and lactation might have played an important role in the progression of this neoplasm.
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Using immunoperoxidase methods, normal sweat glands, 44 benign and 4 malignant sweat gland tumors were tested for the presence of carcinoembryonic antigen (CEA), pregnancy-specific-B1-glycoprotein (SP1) and actin (ACT). CEA and SP1 stained the secretory and duct-lining cells of normal eccrine glands. Among benign tumors, 74% were positive for CEA and 44% for SP1. The staining reaction was found mainly in luminal secretions and surrounding cells. Staining by SP1 was reduced, but not suppressed, after absorption with the purified antigen. ACT was found in myoepithelial cells of the secretory tract of normal glands and in basal cells of all cases of hidradenoma papilliferum. Only 3 sweat gland carcinomas reacted for CEA. In a malignant chondroid syringoma, no ACT-positive cells were seen in the myxochondroid stroma. The potential value of CEA, SP1 and ACT in the diagnosis of sweat gland tumors is discussed.
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Antibodies against human prealbumin (HPA) give a strong immunoperoxidase staining of the A (glucagon) pancreatic cells and of glucagon-, insulin- and gastrin-producing pancreatic tumours. The majority of intestinal and bronchial carcinoids are also reactive. The staining may be related to presence in the C-terminal sequence of HPA of determinants in common with polypeptide (pro-) hormones.
To identify histological preneoplastic lesions and early neoplastic foci, a histological and immunohistochemical study has been conducted on a series of 18 cases with the rare association of multiple intraductal papillomas and in situ breast carcinoma. The pathological and clinical data of these cases have been collated. A close anatomical and spatial association between the benign papillomas and areas of in situ carcinoma (mostly of the cribriform type) was a frequent finding. In agreement with the results of our previous investigations, cytoplasmic CEA has been found to be a marker of intraductal carcinomas, while staining for actin has been found useful to identify the myoepithelial cells present in benign papillomas as opposed to carcinomas. The immunohistochemical procedures for these two markers have been conducted on parallel sections; alternatively, an immunoperoxidase/immuno-galactosidase sequence has been applied on the same section. The results indicate that, in cases with multiple papillomas, CEA-positive, myoepithelial cell-free carcinomatous areas can be anatomically associated with and even present inside the benign-looking papillary lesions. These findings can be interpreted as evidence of a malignant transformation of intraductal papillomas, or, less likely, of their 'cancerization' by ductal carcinoma.
A case of pituitary carcinoma is here presented, together with a review of the 25 cases so far reported in the literature. After a long-standing history of Cushing's disease, treated with interstitial pituitary irradiation and total adrenalectomy, Nelson's syndrome developed due to a pituitary neoplasm that finally spread through the subarachnoidal space, bringing the patient to death. The possible long-term role of surgery and radiotherapy in switching an aggressive behavior is also discussed.
Hamartomas of the breast are rare lesions that may grossly simulate carcinomas: up till now fibrous, adipose and glandular tissues have been recognized within them. Here we report and discuss a case with the typical features of hamartomas, but displaying a marked smooth muscle component. The structure and localization of this tumour, and that of the few similar lesions reported in the literature, suggest that this peculiar type of hamartoma originates in the subareolar tissue.
The histocytological diagnostic criteria and recently developed immunohistochemical procedures selective for either the epithelial or the myoepithelial mammary cells have been tested in a series of 60 cases of papillary lesions of the breast. These included 15 benign solitary intraductal papillomas, 41 papillary carcinomas (29 pure and 12 associated with other types of in situ or invasive ductal carcinoma), and four cases of "suspected" papillary carcinomas. Markers for epithelial cells (EMA) and for apocrine metaplasia (GCDFP-15) did not permit a distinction between benign and malignant papillary lesions; however, immunocytochemical staining for CEA using monoclonal antibodies, and for actin (a marker of the myoepithelial cells) was discriminative in this respect. Benign papillomas have a basal layer of actin-rich myoepithelial cells; the cytoplasm of the epithelial cells is CEA negative. Papillary carcinomas lack the myoepithelial layer, except in areas where multiple papillomas are present, associated with ductal or papillary cancer. CEA was detected in 85% of carcinomas. Two of the cases of "suspected carcinoma" lacked myoepithelial cells and were interpreted as carcinomas. It is concluded that the immunocytochemical methods for cell markers can offer valuable data in the study and diagnosis of papillary lesions of the breast; it is difficult, however, to be categorical in borderline cases since in our experience, the behavior of the malignant papillary lesions of the breast is usually favorable. Residual foci of multiple intraductal papillomas were found in seven cases of papillary carcinoma, supporting the pre-neoplastic potential of this condition.
A simple but accurate inhalation procedure for investigating the activity of antiasthmatic drugs is proposed. The procedure consists of the forced insufflation of the powdered drug, blended with micronised lactose, direct into the tracheobronchial tree. Beta-adrenoceptor agonists (isoproterenol and fenoterol) and antimuscarinics (atropine and ipratropium bromide) were tested using the method of Konzett and Rössler in the guinea-pig; their bronchodilator effects were tested both after forced insufflation and after intravenous administration. The proposed inhalation method supplied close-response curves qualitatively comparable to those obtained by the intravenous route, with the added advantage of more detailed information on the time-course effect. Forced insufflation may be the best procedure for investigating antiasthmatic drugs intended for use as inhalants.
Immunocytochemical methods have been applied to the demonstration of lactoperoxidase (LP) in the lactating bovine breast. Trypsin digestion and a MAGIC (Wachsmuth ED: Histochemie, 37:251, 1973) procedure, using anti-LP serum and then LP solution in sequence, made the sensitive and specific demonstration of LP in formalin-fixed paraffin-embedded sections possible. Peroxidase of the breast has been shown to be inducible by estrogen stimulation and it is considered to be a possible marker of estrogen dependency in breast carcinomas. The present technique, applied to human tissues, even on fixed and embedded biopsies, might make possible the detection of LP in human breast cancers and, thereby, an evaluation of estrogen dependency of such cancers.
A study was made of the pharmacological interaction between two bronchoselective antispasmodics, the beta2-agonist fenoterol and the antimuscarinic ipratropium bromide, in the counteraction of tracheobronchial smooth muscle contractions. Both the in vitro (isolated guinea-pig trachea stimulated by carbachol) and the in vivo experiments (bronchospasm induced by acetylcholine in the guinea-pig) pointed to an overadditive interaction. The evidence for a synergistic antagonism against cholinergic stimulation points to the potential value of the association between fenoterol and ipratropium bromide in the treatment of bronchial asthma, especially in view of the important role that the cholinergic system seemingly plays in this distance.
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BACKGROUND: Oncocytoma designates a usually benign tumor consisting of oncocytes (cells rich in mitochondria). Rarely do endocrine pancreatic tumors show oncocytic transformation, and consequently their liver metastases may resemble a hepatocellular carcinoma. CASES: Case 1, a 36-year-old male, presented with an 8-cm pancreatic mass with multiple liver metastases. Fine needle aspiration (FNA) biopsy was performed on the liver. The cytologic features were highly cellular material; numerous isolated cells and irregular, loose cellular aggregates; rare mitoses; round or polygonal cell shape; rosette formation; and large, granular, eosinophilic cytoplasm (suggestive of poorly differentiated hepatocellular carcinoma). Case 2, a 57-year-old female with hypoglycemia, had a 13-cm pancreatic mass. FNA material showed the same cytologic features as case 1. In situ hybridization to detect albumin mRNA was negative in both cases, while immunocytologic reactions for glandular epithelial cytokeratin and chromogranin A were positive. Case 2 was also positive for insulin. CONCLUSION: Oncocytic transformation in endocrine tumors of the pancreas is a rare occurrence and must be kept in mind in the diagnostic workup of FNA material from tumors of the hepatopancreatic region.
Carcinoembryonic antigen (CEA), though typically associated with malignant epithelial neoplasms, is known to be present at elevated levels even in the serum of normal individuals and of patients suffering from interstitial diseases of the lung. Few reports have addressed the question of the possible source of CEA immunoreactivity within the lung parenchyma. Two patients with elevated CEA serum levels were studied by immunohistochemistry on open lung biopsy specimens. Two different antibodies (one absorbed with non-specific cross-reacting antigen, NCA) were used. The results show that bronchiolar cells and type II pneumocytes are focally positive with both antibodies; the immunoreaction is preserved even after absorption with NCA. In agreement with experimental data on CEA synthesis in fetal bronchial cell lines, these findings indicate that interstitial lung disorders may induce abnormal CEA-like substance expression. In these cases, where no epithelial neoplasms subsequently develop, the cutoff level for CEA in serum should be raised. Bronchiolar and alveolar cells appear primarily responsible for CEA-like substance production.
The ultrastructural patterns of neuroendocrine (NE) differentiated breast carcinomas are analyzed and discussed. Reports in the literature describe wide variations in the size of observed dense-core membrane-bound granules and discrepancies in their interpretation. In the present study 24 cases of breast carcinoma with recognized morphologic, histochemical, and immunocytochemical features of NE tumors were investigated. Five different types of dense-core granules of neurosecretory (NS) type (confirmed by the ultrastructural localization of chromogranin A) and five different cell types were recognized. Some amphicrine cells were found to contain both mucin and NS granules. Another notable ultrastructural feature of breast NE carcinomas was the presence of clear vesicles of presynaptic type, which correlated with expression of synaptophysin.
A case of breast carcinoma with neuroendocrine features occurring in an elderly male patient is reported. Histologically, the tumor was characterized by solid growth with nests and ribbons of small to medium-size uniform neoplastic cells. Argyrophilia, expression of chromogranins at both protein and gene level, and the presence of dense granules of the neurosecretory type by electron microscopy were demonstrated.