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Biomedical subjects

P Gangemi

Publications and source records attributed to P Gangemi.

18 recordsLinked to original sources

[Benchmarking in pathological anatomy].

Data from five different Institution of Pathological Anatomy Hospital Services are presented in order to show one (the benchmark) of the multiple existing ways to approach the budget problem and the macroeconomic management of our Services. The aim of this work is not to show the "best" way to work in terms of cost-efficacy but only a methods to compare our results with others. Nevertheless from this study is possible also to make some considerations about medical and technical workload in different services with different habits.

Autopsy↗

[A rare case of drug-induced hepatitis].

This paper describes a case of drug-induced hepatitis that onset in a patient who was hospitalised in our department after administration of calcium heparin. The rarity of the case was shown not only by the very short time elapsed between cause (drug administration) and effect (bio-humoral changes detected), but also by the histology results of the liver biopsy. This latter confirmed that mechanisms of idiosyncrasy, which may cause liver cell necrosis, can occur after administration of any drug.

English Abstract↗

Presacral myelolipoma. A case report.

Presacral myelolipoma is a rare benign tumour composed of fat and haemopoietic tissue. Ultrasound, computed tomography and magnetic resonance imaging are of help to achieve the diagnosis, but pathologic confirmation is mandatory. The Authors report an asymptomatic case whose diagnosis has been achieved by means of CT scan-guided percutaneous needle biopsy. Unnecessary surgical treatment was avoided in this case. Clinical approach and role of surgery are discussed.

Adrenal Gland Neoplasms↗

[Quality control in pathology: prospective peer review on routine cases].

To describe a prospective method of quality assurance adjusted to an ideal group of pathologists, easily feasible in routine surgical pathology. The Authors examined the same slides (EE) independently and without time-limits. In the same session the individual diagnosis were compared and discussed in order to provide only one conclusive diagnoses. After the discussion, diagnostic agreement is 100%. Peer and simultaneous review yields sufficient benefits in increasing the accuracy of diagnostic reports. It stimulates discussion of diagnostic criteria and terminology, creates more uniform reports, and serves as an educational vehicle for pathologists.

Humans↗

Functional insulin receptors are overexpressed in thyroid tumors: is this an early event in thyroid tumorigenesis?

BACKGROUND: Insulin receptor (IR), a member of the receptor tyrosine kinase family, is expressed in normal thyroid cells and affects thyroid cell proliferation and differentiation. METHODS: The authors measured IR content in benign and malignant thyroid tumors by three independent methods: a specific radioimmunoassay, 125I-insulin binding studies, and immunohistochemistry. The results obtained were compared with the IR content in paired, adjacent, normal thyroid tissue. To assess IR function in thyroid carcinoma cells, glucose uptake responsiveness to insulin was also studied in a human transformed thyroid cell line (B-CPAP) and in follicular carcinoma cells in primary culture. RESULTS: In 9 toxic adenomas, the average IR content was similar to that observed in the 9 paired normal thyroid tissue specimens from the same patients (2.2+/-0.3 vs. 2.1+/-0.3). In 13 benign nonfunctioning, or "cold," adenomas, the average IR content was significantly higher (P < 0.001) than in paired normal tissue specimens (4.3+/-0.5 vs. 1.8+/-0.1). In 12 papillary and 10 follicular carcinomas, IR content was significantly higher (P < 0.001) than in the adjacent normal thyroid tissue (4.0+/-0.4 vs. 1.6+/-0.2 and 5.6+/-1.0 vs. 1.8+/-0.2, respectively). The finding of a higher IR content in benign "cold" adenomas and in thyroid carcinomas was confirmed by both binding and immunostaining studies. CONCLUSIONS: The current studies indicate that 1) IR content is elevated in most follicular and papillary differentiated thyroid carcinomas, and 2) IR content is also elevated in most benign follicular adenomas ("cold" nodules) but not in highly differentiated, hyperfunctioning follicular adenomas ("hot" nodules), which very rarely become malignant. This observation suggests that increased IR expression is not restricted to the thyroid malignant phenotype but is already present in the premalignant "cold" adenomas. It may contribute, therefore, to thyroid tumorigenesis and/or represent an early event that gives a selective growth advantage to transformed thyroid cells.

Cells, Cultured↗

In situ evidence of neoplastic cell phagocytosis by macrophages in papillary thyroid cancer.

We evaluated the occurrence, tissue distribution, and prognostic value of tumor-associated macrophages in 121 papillary thyroid carcinomas using immunohistochemical staining with anti-CD68 antibody in archival paraffin-embedded sections. Lymphocytic infiltration and dendritic cell presence were also evaluated. Three groups were identified according to the presence and characteristics of macrophages: 1) tumors without evidence of infiltrating macrophages: (n = 35); 2) tumors with infiltrating macrophages but no evidence of neoplastic cells phagocytosis (n = 68); and 3) tumors with infiltrating macrophages and in situ evidence of active neoplastic cell phagocytosis (n = 18). Neoplastic cell phagocytosis by macrophages was positively correlated with both lymphocytic infiltration and dendritic cells (P = 0.0000), whereas it was negatively correlated with vascular invasion (P = 0.0032). Distant metastases developed in none of the 18 tumors with neoplastic cell phagocytosis, but occurred in 15 of 103 of the remaining tumors (P = 0.0647) and were significantly and negatively associated with lymphocytic infiltration or dendritic cells. The present study indicates, therefore, that immune reaction, involving neoplastic cell phagocytosis by macrophages and lymphocytic infiltration, plays a role in the development of distant metastases in patients with papillary thyroid cancer.

Adult↗

Negative/low expression of the Met/hepatocyte growth factor receptor identifies papillary thyroid carcinomas with high risk of distant metastases.

To investigate the clinical impact of Met/hepatocyte growth factor receptor (HGF-R) expression in thyroid cancer we studied 163 thyroid carcinomas (129 papillary, 21 follicular, and 13 anaplastic) from patients followed-up for 25-147 months postthyroidectomy. Forty-nine thyroid adenomas were also studied. Met/HGF-R expression was evaluated by semiquantitative immunohistochemistry, measuring both the proportion (scale of 0-5) and the intensity (scale, 0-5) of stained cells and calculating a total score (scale of 0-10). Met/HGF-R was absent in the normal thyroid tissue, absent or focally expressed in follicular and anaplastic tumors, and expressed at various levels in most papillary carcinomas, including microcarcinomas. Papillary carcinomas were thus categorized as having negative/low Met/HGF-R (n = 50; total score, < or = 5) or high Met/HGF-R expression (n = 70; total score, > 5). High Met/HGF-R was inversely associated with vascular invasion (P = 0.0308), but not with other prognostic factors. Negative/low Met/HGF-R expression was the most effective predictor by multivariate Cox analysis of distant metastases (hazard ratio = 9.71; P = 0.0036), higher than extrathyroid invasion (hazard ratio = 4.25; P = 0.0181), age (< or = 45 vs. > 45 yr; hazard ratio = 3.99; P = 0.0099), and vascular invasion (hazard ratio = 3.19; P = 0.0358). These findings suggest a role for Met/HGF-R in papillary thyroid cancer and its clinical use to select patients with a high risk of distant metastases.

Adenocarcinoma, Follicular↗

Early occurrence of a thyroid carcinoma in a patient who developed Graves' disease after treatment for Hodgkin's disease.

We report the case of a patient who developed Graves' disease and a papillary thyroid cancer only 5 years after irradiation and adjuvant chemotherapy for Hodgkin's disease. This case is peculiar for the very short latency time between Hodgkin's disease treatment and thyroid cancer development, an event possibly related to Graves' disease with elevated serum levels of TSAb. We conclude that, in patients treated for Hodgkin's disease, continued follow-up by clinical examination and sonography of the thyroid is needed, especially if they develop Graves' disease.

Adult↗

[Buschke Scleredema, case report].

Buschke Scleredema is a rare connective tissue disorder of unknown aetiology, characterized by thickening of the dermis whose characteristics may mainly to mime systemic sclerosis, eosinophilic fasciitis and cutaneous amyloidosis. Scleredema may be associated with a history of an antecedent febrile illness, diabetes mellitus, or blood dyscrasia. Scleredema can be classified into three clinical groups; each has a different history, course, and prognosis. Each one of these share reduction in chest articular movements and limitation of limbs movements. The skin histology is characterised by thickened dermis and increased spaces between large collagen bundles due to increased deposition of mucopolysaccharide in the dermis. Differential diagnosis can be made considering the typical clinical features and the histologic peculiarity. No therapy has been found effective. The authors describe a case of Buschke Scleredema successfully treated by steroids and colchicine. Clinical evaluation of skin induration and thickness as well as ultrasonography were performed at baseline and after treatment.

Adrenal Cortex Hormones↗

[Heterotopy of gastric glands in the submucosa of the stomach].

Heterotopic gastric glands in the submucosa of the stomach is underestimated condition. It is still controversial whether the lesion is caused by inflammation or maldevelopment. Pathologists must recognized this entity and distinguish it from adenocarcinoma in biopsies. The case of a 37 year old man, unusual as to the appearance of local growth, is reported.

Adult↗

[Pneumatosis cystoides intestinalis].

Pneumatosis Cystoides Intestinalis. Pneumatosis Cystoides Intestinalis is usually associated with intrinsic disease of the bowel. A case of the ileum associated with duodenal ulcer and a case of the large bowel associated with diverticular disease are reported. It was an unexpected finding in both patients. The histiocytic origin of the cells which line the gas cysts and the pathogenesis are discussed.

Colonic Diseases↗

[Pretreatment evaluation of CA 72.4 in patients with carcinoma of the stomach (0-IV stage) versus CEA, TPA, CA 19-9, FER].

Before surgical treatments, sera of 54 pts suffering from gastric cancer, histologically typed and clinically staged (from stage 0 to 4), were assayed to evaluate CEA, TPA, CA 19-9 and Ferritin versus a new tumoral marker called TAG-72, in order to determine the biological behaviour and the relation to the clinical stage of this last one. Starting from their results, Authors say that the new marker TAG 72 has an increasing sensibility according to the clinical stage (4 th more than 1 st), and that the association of the TAG-72 plus CEA and/or TPA is rather significant in order to evaluate the evolution of the gastric cancer than other markers.

Aged↗

[Angiomyolipoma of the kidney].

The renal angiomyolipoma is a rare, benign, no epithelial neoplasm. It is frequently associated with tuberous sclerosis, above all in young patients. It may be under an asymptomatic form, especially if it deals of a small volume neoplasm, and sometimes it becomes evident only when it occurs an haemorrhagic complication. When we have a sure diagnosis and a small tumor, the treatment is preservative; on the contrary it is surgical either for big symptomatic neoplasms or haemorrhagic complications. The authors report a clinical case of renal angiomyolipoma in a pregnant patient, who had an haemorrhagic complication and was treated with nephrectomy.

Adult↗