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Biomedical subjects

R Colombari

Publications and source records attributed to R Colombari.

45 records · Page 3Linked to original sources

Preoperative embolization of arteriovenous malformations with polylene threads: techniques with wing microcatheter and pathologic results.

The technique with a wing microcatheter system and the pathologic aspects of 11 cerebral arteriovenous malformations (AVMs) surgically resected after embolization with polylene threads are reported. Embolization was performed once in eight patients and twice in three patients. Resected AVMs were submitted both to routine hematoxylineosin examination and to immunohistochemical workup in order to detect the type of immunologic response to thread emboli. In nine cases, 50% or more of the nidus was obliterated by the embolization. After embolization two patients developed reversible neurologic deficits. Pathologic specimens of resected AVMs demonstrated no vascular necrosis; however, a moderate inflammatory response could be seen, characterized by the presence of both mononuclear cells and foreign-body giant cells, associated with the absence of polymorphonuclear infiltrates. A granulomatous fibrotic process was identified that was present from the first month after embolization. Immunohistochemistry indicated that the immunologic response to thread emboli was cell-mediated, not humoral. Embolization with the wing microcatheter with the use of polylene threads proved to be a safe and efficient system of embolization, as a preoperative procedure. Polylene threads are a nontoxic and biocompatible material that can be used as an embolic agent for brain AVMs.

Adult

HCV RNA detection in parotid gland biopsy in a patient with chronic hepatitis C virus liver disease.

We report a case of a 75-year-old woman admitted to our Unit for chronic sialadenitis, characterized by histologic evidence of B and T lymphocyte infiltrate; laboratory and histologic tests revealed chronic hepatitis C, without autoimmune markers. We found hepatitis C virus (HCV) RNA in liver, in parotid gland, in saliva and in peripheral blood mononuclear cells, but not in serum. HCV RNA was detected by PCR technique. To our knowledge this is the first case of detection of HCV RNA in parotid gland. This finding raises the question about the relationship between sialadenitis and viral HCV infection.

Aged

Hepatoblastoma in adult age: a report of two cases.

Hepatoblastoma in adults is a rare malignancy that presents in the epithelial or mixed epithelial-mesenchymal variants. We report two cases, the former representing the epithelial and the latter the mixed type. A 21 year-old woman with epigastric pain had abdominal ultrasound and CT scans showing a large hepatic mass. A right trisegmentectomy was performed. The first and second recurrences were treated by resection. The third recurrence was treated by hepatic transarterial chemo-embolization, systemic chemotherapy and 19 percutaneous alcohol injections. A careful follow up by abdominal ultrasound and CT scans was able to detect the recurrence at an early stage. The patient is well at 151 months. A 39 year-old man with epigastric pain and dyspepsia had upper-GI series and abdominal CT scan showing a left hepatic mass involving the stomach. Liver resection and Billroth II hemigastrectomy were performed. A recurrence involving the left hepatic lobe, the spleen and the remaining stomach occurred 15 months later and the patient died from multi organ failure. Surgery is the treatment of choice of hepatoblastoma in adults. Recurrences can also be treated aggressively by surgical resections if no extrahepatic organs are involved. Other therapeutic modalities can be attempted whenever surgery is not possible.

Adult

Inflammatory pseudotumor of the liver: case report and review of the literature.

Inflammatory pseudotumors of the liver (IPL) are extremely rare focal lesions of the parenchyma. Up to now, the ethology of IPL has not been completely understood. Usually the clinical presentation is with fever, chills, hepatic mass. The fine needle biopsy shows a large amount of inflammatory cells, while the most common imaging techniques are not specific and do not reach a definitive preoperative diagnosis between a benign and a malignant tumor. From the examination of the Literature, the Authors found a mortality rate of 40% among patients treated by antibiotic therapy, while surgical procedures were successful in all but one case. Moreover, in Authors' case, successfully treated by hepatic resection, the preoperative diagnostic procedures were not helpful in differential diagnosis with a malignant lesion. For these reasons, the Authors believe surgery is the best therapeutic choice in case of a suspected IPL without an early clinical resolution after antibiotic therapy.

Diagnosis, Differential