OBJECTIVE: To review the value of biopathologic factors in single lymphomatous patients across the boundaries of histologic classification. STUDY DESIGN: In a series of previous studies, based on a large collection of biopsy samples, the value of the above biopathologic characteristics in individual lymphomatous patients was quantitatively evaluated. RESULTS: The relationships between apoptotic index and growth fraction, in light of the expression of oncogenes, which regulate cell birth and death, were of particular value in determining the growth pattern of different lymphoma cases across the boundaries of histologic classification. CONCLUSION: The study of mechanisms that regulate cell proliferation and death might have therapeutic implications as the proper therapeutic approach should be based on detailed knowledge of the kinetic and molecular characteristics of each tumor.

Apoptosis↗

PubMed1998

Congenital fibroepithelial polyp of prostatic urethra in an adult.

OBJECTIVE: To describe an unusual case of congenital fibroepithelial polyp of the prostatic urethra in an adult, presented with acute urinary retention. METHODS: Cystouretrographic, endoscopical and pathological investigations are discussed. RESULTS: The definitive diagnosis of the tenth case of this benign lesion was made only after endoscopic resection and pathological examination. The complete resolution of the symptoms has been quick. CONCLUSIONS: We stress this unusual pathology in order to focus its peculiarity in aetiopathogenesis, diagnosis and treatment.

Adult↗

PubMed1998

[Granulomatous prostatitis as collateral effect of intravesical immunotherapy with BCG].

Twenty-five male patients with superficial bladder cancer underwent intravesical Bacillus Calmette Guerin immunotherapy. A high incidence of side effects has occurred using three different substrains of BCG. Our interest has been focused on BCG related granulomatous prostatitis: we have found four asymptomatic patients with histologically diagnosed disease. We suppose therefore that its incidence is underestimated.

Adjuvants, Immunologic↗

PubMed1997

Kidney vascular damage and cocaine.

Cardiovascular damage is common in young cocaine addicts, and similar atherosclerotic lesions seem likely in the kidneys. To confirm this hypothesis, we performed histological examination of 40 kidney autopsy specimens classified as "cocaine-related deaths"; as controls, kidney specimens of 40 road accident victims were examined. Semiquantitative analysis showed that the ratio of the number of glomeruli affected by hyalinosis to the total number of glomeruli was 0.09 +/- 0.13 in addicts and 0.005 +/- 0.01 in controls; the difference was highly significant. The degree of periglomerular fibrosis was significantly higher in cocaine addicts than in accident victims. The ratio of glomeruli to tubular casts was 0.15 +/- 0.17 in cocaine addicts and 0.17 +/- 0.18 in controls (not significant). The degree of interstitial cellular infiltration was significantly higher in addicts than controls. A monunuclear cell infiltrate was observed prevalently in the medullary region. Arteriolar sclerosis was significantly higher in addicts than controls. Medial thickening, luminal narrowing and vessel obstruction were absent in the control group. Quantitative morphometric analysis of arterial structure showed significantly greater lumen circumference, intima circumference, media circumference, intima area, media area, intima thickness and media thickness in cocaine addicts than in controls.

Adult↗

PubMed1997

Villous adenoma of the bladder.

Villous adenomas of the bladder are rare tumors and up to now they have not been seen to undergo malignant transformation. We report a case of villous adenoma of the bladder with areas of adenocarcinoma in a 72-year-old man. We describe all the morphological, histochemical and immunohistochemical features characterizing this tumor. We recommend adequate pathological sampling and a thorough follow-up of patients with villous adenoma. The prognosis and the behaviour of these adenomatous papillary lesions, morphologically similar to colonic adenomas, in the bladder is unclear. We report a case with focal area of adenocarcinoma and review the literature.

Adenocarcinoma↗

PubMed1997

[Qualitative and quantitative parameters for prognosis in renal carcinoma in early and advanced stages].

AIM OF THE STUDY: A minority of stage I renal cell cancers have a bad prognosis, a minority of those in stage II-IV may behave favorably. Are there parameters which characterize such cases? In this study, a number of qualitative and quantitative parameters are used to detect differences between cases with at least 9 years of survival and those with a survival of less than 9 years. MATERIAL AND METHODS: 133 cases of renal cell cancer were subdivided into stage subgroups: Robson's I; Robson's II-IV. The following data and parameters were registered and/or measured: sex, stage, tumor size, histological type, mean nuclear profile area (mA) and pleomorphism (standard deviation of mean nuclear profile area--SDA) nuclear grade (NG) and combined nuclear grade (CNG), DNA index, cell proliferation, as determined by mitotic index (MI), per cent of PCNA positive cells (PCNA + cells %), per cent of S-phase cells (SP cells %), p53 and EGFR expression, intratumoral T lymphocytes. RESULTS: Older patients have a worse prognosis independently of the stage. Stage is the most discriminant qualitative parameter; tumor dimensions and both nuclear and combined nuclear grade are important too. Mean nuclear profile area and pleomorphism are also discriminant, while no prognostic value of histological type is shown and histology is not related to other parameters. Higher DNA index characterizes cases with worse prognosis, as well as MI, SP cells %, PCNA + cells %, and EGFR expression. No significant differences are detected for p53 expression and lymphoid infiltrates. A minority of patients with stage I tumors die within 9 years of diagnosis. They are older than survivors with the same stage, their tumors have larger nuclear area and greater pleomorphism, and are more frequently aneuploid with higher DNA index. A minority of patients with stage II-IV tumors survive at least 9 years from the time of diagnosis. They are younger than non-survivors in the same stages and have lower MI and PCNA positivity in the tumors, while other parameters are not discriminant.

Antigens, Neoplasm↗

PubMed1996

Stage-related differences of mitotic and apoptotic indices, and bcl-2 protein expression in diffusely growing non-Hodgkin's lymphomas.

The present study examined whether growth characteristics of diffusely growing non-Hodgkin's lymphomas (NHL) may differ as a function of stage. Among 105 NHL of various types and sub-types (REAL [Revised European-American Lymphoma] classification), localized (Ann Arbor pathologic stages I + II) lymphomas exhibited clearly higher indices for mitotic activity, apoptosis and cell turnover, as well as a significantly lower percentage of cells containing immunohistochemically detectable bcl-2 protein, than disseminated (stages III + IV) NHL. A similar pattern emerged when high-grade (Kiel classification) lymphomas only were evaluated. Low-grade NHL showed analogous, but less marked, stage-dependent characteristics, with the exception of median percentages of bcl-2+ cells, which remained comparable in all stages. Our findings are consistent with the notion that dissemination of diffusely growing NHL is usually associated with reduced cell turnover and, in high-grade lymphomas, with the generation of longer-lived cells.

Adolescent↗

PubMed1996

Transitional cell carcinoma of the ureteral stump 13 years after nephrectomy for benign disease.

A case of primary carcinoma of the ureteral stump occurring 13 years after nephrectomy for benign disease is reported. The literature is reviewed.

Aged↗

PubMed1995

Presence of the bcl-2 protein and apoptosis in non-Hodgkin lymphomas with diffuse growth pattern.

In an attempt to further clarify the role of the apoptosis-counteracting protein bcl-2, non-Hodgkin lymphomas (NHL, n = 170) were examined immunohistochemically, across the boundaries of histologic classification, for the presence of this oncoprotein, in comparison with apoptotic indices (AI) and percentages of Ki-67+ cells (growth fraction). The results of this retrospective study revealed a highly significant inverse relationship ("mirror image") between the proportion of bcl-2+ cells and the AI per case. Both these parameters, although variable, clearly distinguished low- from high-grade-malignancy lymphomas according to the Kiel classification. Cluster analysis detected 2 separate groups of high-grade NHL, one with rather high AI and low percentages of bcl-2+ cells, comprising most anaplastic large-cell lymphomas, the other group with reverse characteristics. We found no correlation between the percentage of bcl-2+ cells per case and overall survival.

Apoptosis↗

PubMed1995

Low versus high cell turnover in diffusely growing non-Hodgkin's lymphomas.

Cell loss, perhaps as important as cell production in determining the size of an expanding cell population, has not usually been registered in quantitative cellular kinetic analyses of neoplastic disorders. The present retrospective study on various types and subtypes of non-Hodgkin's lymphomas (NHLs; n = 170) was designed to test the usefulness of a novel additional parameter, the 'turnover index' (TI), which is the sum per case of the mitotic index and the apoptotic index. Results document that TIs clearly distinguished between categories and subtypes of NHLs according to the Kiel classification. Cluster analysis of TIs plotted against the percentage of Ki-67-positive cells per case revealed that about one-third of the high-grade malignancy lymphomas actually belonged to the low-turnover lymphomas. Overall survival was longer in the low- than in the high-turnover group of lymphomas. Assessment of TIs can, for practical diagnostic purposes, be replaced by counting mitotic figures and apoptotic cells in several high-power fields. The TI concept may help to interpret the kinetics of NHLs in terms of accumulation vs. proliferation of cells.

Adolescent↗

PubMed1995

Transitional cell carcinoma of residual kidney after partial nephrectomy for renal adenocarcinoma.

Transitional cell carcinoma of the superior calyces was found 1 year after ipsilateral partial nephrectomy for renal adenocarcinoma. The main special features of the case are the rare occurrence of two primary tumours in the same kidney and the previous conservative surgery. A review of the literature has revealed no earlier case of this type.

Carcinoma, Renal Cell↗

PubMed1994

Spatial distribution of mitosis, apoptosis and small blood vessels in malignant diffuse follicular-center-cell lymphomas: a nearest-neighbor analysis.

To better comprehend the relationships between cell birth and cell death in neoplastic disorders, the topography of these events needs to be considered. We applied a computerized nearest-neighbor analysis to malignant, diffuse follicular-center-cell lymphomas in order to examine the spatial distribution of pyknotic (apoptotic) cells/bodies (A) and mitotic figures (M) in relation to capillaries (C) and venules (V). The results revealed a complex dispersion pattern, with significant aggregations of A and M, in addition to an even greater random distribution component. The greatest clustering displayed by A was around capillaries (A-C, 42% reduction of object frequency between the first and second distance class), followed by A-A (33%), A-V (24%) and A-M (12%). Additional values for mitotic figures were: M-M (45%), M-V (33%) and M-C (22%). These findings may reflect the relative importance of inherent properties of the neoplastic and host factors, respectively, in the regulation of cell birth and cell death rates.

Adult↗