Biomedical subjects
Publications and source records attributed to P L Chiodera.
The authors describe a case of lymphoepithelioma-like carcinoma (LELC) of the esophagus occurring in a 77-year-old man. To date, 13 cases have been described in the literature, all in natives of Japan. Histological features, immunohistochemical findings and differential diagnosis are discussed. In our case epithelial neoplastic cells were completely negative for the EBV genome.
The authors describe a case of malignant lymphoepithelial lesion (MLEL), commonly referred to as lymphoepithelial carcinoma of parotid gland, that is a very rare tumour. There is a relatively high incidence in Eskimos of Alaska and Greenland, but some cases are described in natives of south China. The immunophenotypic profile and histopathological aspect of this neoplasm are discussed, and the differential diagnosis in regard to other primitive or metastatic tumours of parotid is also considered. In our case a diffuse positivity of epithelial neoplastic cells for EBV genome was found using in situ hybridization. The possible role of EBV in the ethiopathogenesis of this rare lesion is herein discussed.
We present a case of diffuse alveolar damage (DAD) that occurred in a male aged 68 yrs treated with gemcitabine, a novel antineoplastic agent, that was given for hepatic relapse of a previously resected non-small cell lung cancer. The patient developed acute respiratory failure after the sixth drug dose, and died 4 days after admission. Autopsy revealed a pattern of DAD. No evidence of infection or other specific aetiologies could be found. To our knowledge, only three cases of pulmonary toxicity resulting from treatment with gemcitabine have been published; two of them were fatal and postmortem examination revealed a pattern consistent with acute respiratory distress syndrome. A careful survey may determine the incidence of pulmonary toxicity of this new drug in the future.
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We conducted a review of all the bronchoscopies performed at our institutions for benign tumors from 1980 to 1991 to determine the endoscopic characteristics of these lesions. We reviewed the charts, the endoscopic characteristics from our video records, and finally the pathologic findings of these cases. We tried to identify the effectiveness of laser resections in each group. Of a total of 3,937 patients, 185 (4.7%) were benign tumors. On these patients, 317 procedures were carried out. There were 3 myoblastomas, 53 papillomas, 1 adenoma, 8 chondromas, 4 fibromas, 45 hamartomas, 15 hamartochondromas, 6 lipomas, 19 angiomas, 5 leiomyomas, 4 schwannomas, 1 neurofibroma, and 21 amyloidomas. Results of laser resection were "very good" in 115 (62%) and "good" in 70 (38%). Complications were minimal: two mediastinal emphysemas, one pneumothorax, and one anesthesia-related cardiac arrest leading to the single death in this series. In general, benign tumors of the proximal endobronchial tree responded well to laser resection when their endoscopic appearance is recognized and prognosis known. Even when recurrent, repeated procedures can be performed easily with good results. This series is probably the largest in the world's literature about endoscopic recognition and the role of laser resection in patients presenting with benign endobronchial tumors.
We report the case of a 51 year old white woman with an asymptomatic solitary pulmonary nodule, fortuitously discovered on chest radiography. Her physical examination and biochemical tests were unremarkable for pathological findings. Thoracic computed tomography (CT) scan and nuclear magnetic resonance (NMR) spectroscopy confirmed the presence of a dishomogeneous thick lesion of lobular shape, localized between the middle and lower lobe of the right lung. Fibreoptic bronchoscopic examination failed to produce histological diagnosis of the lesion. Surgical removal of the lesion demonstrated intraparenchymal localization of Castelman's disease (giant lymph node hyperplasia). Three years after surgery, no sign of disease recurrence has been recorded.
We have investigated the presence of smooth muscle cells with immunoreactivity for melanoma-related marker HMB45 in pulmonary lymphangiomyomatosis (PLAM). Of 75 lung specimens, including a variety of lesions (obtained with both transbronchial and open lung biopsies), only PLAM (six specimens from three patients) showed the presence of HMB45-positive cells. In addition, 20 specimens of normal lung were unreactive with this monoclonal antibody. It is concluded that the smooth muscle cells of PLAM regularly exhibit a peculiar phenotype, characterized by HMB45 immunoreactivity, distinct from other smooth muscle proliferations; and the histological diagnosis of PLAM can be made when only a transbronchial biopsy is available.
The conventional chest radiographs were studied of 18 patients with primary pulmonary hypertension, waiting for, or treated with lung transplantation in the Papworth Hospital. The goal of the study was to find out whether there is a pattern characteristic of primary pulmonary hypertension. The following points were considered: a) pulmonary transparency; b) the hila; c) the left hemidiaphragm; d) the pulmonary artery; e) the right ventricle; f) the right atrium; g) the left ventricle. A score was assigned for any degree of abnormality of the points mentioned above. As a result, a radiological pattern was found that can: 1) confirm the presence of pulmonary hypertension; 2) exclude that this hypertension has a detectable cause; 3) measure the severity of the disease, particularly with regard to hypertension degree. The conclusion is that there is a radiological pattern strongly suggestive of primary pulmonary hypertension and that conventional radiology can help in detecting and monitoring this rare disease, which today can only be treated by means of transplantation.
An accurate morphological study has been done on splenic grafts in rats after 7-15-30 days from their implant in omental or subcutaneous pouches. Observation after 7 days confirmed the necrosis of all the central portion of the implants. Anyway, marginal parts of the graft survived to ischaemia and showed to be supplied by vessels, coming from the contiguous tissues. In these parts the rigenerative process had begun from the structures of red residual pulp, by reticular cells proliferating so to rigenerate the capsula limiting the place of the central necrotic area. After 15 days the neocapsula was completed and from it neoformed trabecolae departed accompanied with chords, sinus capillary, venular and arteriolar vessels which reformed the structure of red pulp both in peripheral and central area, now undistinguishable. After 30 days lymphocytes aggregating around the neoformed vessels promoted a rudimental reconstruction of the white pulp too. In conclusion, splenic implants are able to get over the ischaemic phase and after 30 days the red pulp is morphologically reconstructed and probably functioning, while the white pulp is still primordial.
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The treatment of 15 patients with neoplastic pleurisy and 25 with spontaneous pneumothorax occurring for the second time is described. All were given endopleural tetracycline therapy for symphyseal purposes. In the neoplastic pleurisy cases, the treatment reduced the number of thoracenteses required. In only 1 case did spontaneous pneumothorax recur a short time after treatment.
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Explore the source record for details and available documents.
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A series of 234 malignant lymphomas (121 Hodgkin lymphomas and 113 non-Hodgkin lymphomas) observed at the Brescia City Hospital between 1981 and 1987 has been reviewed. This paper is aimed at assessing: 1) in which sectors of the staging radiology is indicated; 2) which radiological techniques are needed for the staging of chest lymphomas; 3) which impact they have on the therapeutic program. All patients underwent chest X-ray, which was integrated by conventional tomography in 80% of cases. Only 76 patients underwent CT: 35 times for staging, and 69 times for restaging (overall figure: 104). The two techniques were compared: in untreated patients CT gave supplementary information in 19 out of 35 cases (54.3%). In 7 patients (20%) the findings were such as to determine a change in the previous staging; only in a case (2.8%) was the management affected; in treated patients CT proved to be superior to conventional radiology in 28 out of 69 cases (40.56%) and allowed the possibility of a recurrence (which was suggested by clinical and radiological findings) to be ruled out in 23 patients (33.3%). In our opinion, CT should not be used as a routine investigation in the staging of malignant thoracic lymphomas; on the contrary, it should be limited to selected cases, when a radical radiotherapy is to be performed, or when clinics and plain radiographs proved unable to assess the nature of a pathologic thoracic condition.