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R Sarnelli

Publications and source records attributed to R Sarnelli.

36 records · Page 2Linked to original sources
PubMed1986

Multicentricity in breast cancer: a submacroscopic study.

One hundred human female breasts surgically removed by radical mastectomy for clinical cancer were analyzed under a dissecting microscope to search for other submacroscopic (less than 0.5 cm) foci collateral to and independent from the clinical one. These foci were found in 36 percent of cases, either in situ (17 percent), or infiltrating (12 percent), or both in situ and infiltrating (7 percent). This high percentage of multiple cancer confirms previous data, suggesting the wide intramammary distribution of breast cancer disease. Multicentricity appears to be significantly associated with the incidence of familial breast cancer (p less than 0.05) and advanced patient age in the range between 71 and 80 years (p less than 0.005). Axillary lymph node metastases are significantly associated with collateral foci of in situ cancer (p less than 0.025), but not with submacroscopic foci of infiltrating cancer and the general character of the mammary glandular parenchyma, tumor size or histologic type of the clinical neoplasm. The critical question is whether multicentricity makes a difference clinically and especially to women who do not have their entire breast removed. Radical mastectomy results in a severe cosmetic and functional problem for patients. According to many authors, the goal of the treatment should be the removal of breast cancer by conservative surgical techniques (lumpectomy, subcutaneous mastectomy, quadrantectomy), using adjuvant radiotherapy and/or chemotherapy. The use of radiotherapy as primary treatment of early breast cancer has been also suggested. There is disagreement about surgical management of breast cancer. In fact, some investigators emphasize that the natural biologic history of multicentric cancers has not been documented by any adequate follow-up series in women who do not have their entire breast removed. Thus far, no difference has been seen in disease-free or overall survival between groups of patients with early breast cancer treated by an alternative therapeutic procedure and patients treated by radical mastectomy. However, Veronesi et al. (1981) refer to 4 second primary tumors of the ipsilateral breast in the 352 cases of small cancers treated by quadrantectomy, axillary dissection, and adjuvant radiotherapy. Moreover, Hellman et al. (1980), using radiation therapy without mastectomy for the primary treatment of 176 patients with early breast cancer, found 1 case of new cancer in a separate quadrant. Further evaluation is necessary to establish the long-term results of the alternative treatments of breast cancer and for the understanding of the clinical significance of microscopic multifocal tumor in the mammary gland.

Adult↗
PubMed1985

Ultrasonic energy-based technique for characterizing atherosclerosis.

For the characterization of atherosclerotic disease in human aortic specimens two indices of ultrasonic signal loss have been developed. They are based on an energy evaluation of broadband pulsed ultrasound and have been introduced in order to minimize phase cancellation artifacts caused by phase sensitive transducers. Both indices are derived from the transfer function H(f) of the specimen, they are: the slope of ln H(f) for the evaluation of signal loss due to absorption and scattering inside the specimen thickness, and s ln H(f) df, which reflects changes in both the internal and the intimal surface properties of the aorta. The results indicate that methods based on the evaluation of signal loss inside the aortic thickness are insensitive to surface irregularities and to the angle of the incident ultrasound. The complete progression of atherosclerosis may be followed by indices reflecting changes in both the thickness and the surface acoustic properties of the specimen.

Aorta↗
PubMed1985

Fibrosis, lipids, and calcium in human atherosclerotic plaque. In vitro differentiation from normal aortic walls by ultrasonic attenuation.

This study was designed to determine whether attenuation of ultrasound by the aortic wall is potentially useful in characterizing the atherosclerotic lesion. Measurements were made on fresh specimens taken from a human aorta at autopsy. Four hundred different sites, 4 mm in diameter each, corresponding to the dimension of the ultrasonic beam at the focal zone, were ultrasonically analyzed and histologically studied. Attenuation of ultrasound in each site was assessed by Fourier analysis of the echo produced by a specular reflector placed behind the specimen. Two parameters were measured over the range 7-11 MHz: the integrated attenuation index (per cm), and slope (per cm per MHz) of the best fit straight line relating attenuation and frequency. Histological examination--performed for each of the 400 sites where attenuation had been measured--identified four subsets (100 samples each): normal aortic walls, fibrous plaques, fibrofatty plaques, and calcified plaques. Results obtained from ultrasonic and histological analyses showed that the integrated attenuation index was lowest in normal walls (24 +/- 2.1, mean +/- SE) and progressively increased in fibrous (32 +/- 3.1), fibrofatty (82 +/- 6.5), and calcific (185 +/- 8.7) subsets (all intergroup differences were significant, except for the normal vs. fibrous comparison). The slope value was significantly lower in the fibrous than in the normal subsets: (10(-3)) 31.9 +/- 4.5 vs. (10(-3)) 99.5 +/- 9.1, respectively. Values of fibrofatty and calcific plaques overlapped: (10(-3)) 383 +/- 21 vs. (10(-3)) 320 +/- 23, respectively. Both were significantly different from normal and fibrous groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗
PubMed1984

Independent submacroscopic foci of infiltrating carcinoma in breasts removed for clinical cancer.

The aim of our study was the detection and the characterization of submacroscopic foci of infiltrating carcinoma in the human female mammary glandular tree collateral to clinical cancer. Accordingly, we analyzed 100 breasts surgically removed by radical mastectomy. Five thin slices per case were analyzed under a dissecting microscope by subgross method of observation. Submacroscopic foci of invasive cancer, well separated and apparently independent of the primary tumor, were found in 19% of the cases and were confirmed by histologic examination. Foci of submacroscopic cancer were either single (79%) or multiple (21%), and were located in slices including or not the main tumor mass (31% and 69% of cases, respectively). Their size ranged from 1 to 4 mm. Four histologic types were represented: 1) invasive ductal NOS with productive fibrosis, scirrhous type (36% of cases); 2) invasive ductal NOS without productive fibrosis, simplex type (32% of cases); 3) invasive ductal with tubular component (16% of cases); 4) medullary (16% of cases). Concordance between histology of clinical and submacroscopic cancers was assessed in 42% of cases. A significant association of the tubular type (invasive ductal carcinoma with a consistent tubular component) of primary tumor was demonstrated (P less than 0.05), as well as with the presence of ductal and lobular proliferative changes in the collateral glandular tree (intraductal papillomas, P less than 0.01; atypical lobules, P less than 0.02). No relationship was found between submacroscopic foci of infiltrating carcinoma and neoplastic familiarity, patients' age by decades, axillary lymph node metastases, size of clinical tumor or profile of the collateral mammary glandular tree. These data support the hypothesis of a multicentric origin of human breast cancer and suggest a systemic nature of the neoplastic mammary disease. Prognostic and therapeutic implications of this concept are discussed.

Adenocarcinoma, Mucinous↗
PubMed1983

Different degrees of atherosclerosis detected by backscattered ultrasound: an in vitro study on fixed human aortic walls.

The aim of the study was to establish whether ultrasonic backscattered signals may characterize the atherosclerotic process, providing a quantitative assessment of severity. Measurements on aortic specimens were made in vitro by a transducer acting as transmitter and receiver. Two different indices were measured, one based on peak amplitude value (Vmax) and the other on fast Fourier transform (FFT) analysis of ultrasonic reflected signal (IBI). Two hundred fixed aortic wall specimens (50 normal, 50 fatty streaks, 50 fibrofatty, and 50 calcific) were first characterized ultrasonically and then pathologically, both macroscopically (before ultrasonic study) and histologically (after it). Differentiation of normal, fibrofatty and calcific specimens was achieved using Vmax. Values obtained in fatty streaks overlapped with normal wall but significantly differed from values of fibrofatty and calcific subsets. The results with IBI were similar except that the difference between normal and fibrofatty specimens was not statistically significant. Such changes in acoustic behavior of atherosclerotic walls could be due to increased deposition of highly echogenic biological materials, such as collagen, cholesterol crystals (in fibrofatty specimens), and calcium salts (in calcific ones). Therefore, backscattered signals appear to provide in vitro simple parameters indicative of changes in the arterial wall structure due to the atherosclerotic process.

Aorta↗
PubMed1980

Subgross physiopathology of the breast associated with clinical cancer.

Fifty human breasts removed for cancer by radical mastectomy were submitted to subgross analysis of the glandular tree as a whole, stained thin sections (2 mm) under a dissection microscope, followed by histologic study of the lesions found. The glandular tree was more often atrophic (70%) than hyperplastic (30%). The frequencies of physiopathologic changes were as follows: ductal papilloma (4%), ductal hyperplasia (6%), fibroadenoma (16%), sclerosing adenosis (24%), cysts (28%), apocrine cysts (18%), cystic ducts (40%), blind terminal ducts (60%), atrophic lobules (88%), sclerotic lobules (34%), hyperplastic lobules (28%), cystic lobules (52%), persistent lobules in otherwise atrophic breasts (30%), lobules with aporcine metaplasia (30%), atypical lobules with proliferative changes (38%), and independent foci of microscopic cancer (20%). The data indicate: 1) a frequent lack of correlation between ovarian function (menstrual cycles, menopause) and type of mammary glandular tree (hyperplastic, atrophic); 2) a rarity of ductal lesions compared with the frequency of lobular lesions; 3) a ubiquitous distribution of the lesions either near or far from clinical cancer; 4) a significant association of atypical lobules with lobular sclerosis (p < 0.001) and apocrine metaplasia (p < 0.05). The frequency and ubiquity of lobular changes suggest further investigation among them to search for suitable candidates as preneoplastic or predictive lesions.

Adenofibroma↗
PubMed1979

Ganglioglioma of the spinal cord. A case with a long survival.

A case of ganglioglioma or neuroastrocytoma of the spinal cord in a 78-year-old man is reported. Diagnosis was based on the histological identification of the neoplastic cells and on the study of the architecture of the tumour. The presence of cellular anaplasia, sometimes of marked degree, and of small nests of infiltration suggested an initial malignant behaviour regarding both cellular types. A survey of the five reported cases of spinal ganglioglioma is presented.

Aged↗
PubMedDate not supplied

Frequency-dependent attenuation in breast tissue characterization.

The aim of this study is to establish whether an index derived from the slope of the frequency-dependent ultrasonic attenuation can provide quantitative information on normal and pathological breast tissue. Ultrasonic measurements were performed by using pulsed transmitted ultrasound in the frequency range 2-8 MHz. Thirty-three specimens were selected for their probable pathologic classification, by macroscopic observation, before ultrasonic study, and subsequently histologically classified. Ultrasonic results suggest the possibility that the examined specimens fall into four groups: (1) fat, fibroadenoma, giant fibroadenoma, infiltrating ductal carcinoma, medullary carcinoma; (2) infiltrating lobular carcinoma, tubular carcinoma, scirrhous carcinoma; (3) fibrosis; (4) fibrofatty tissue, fibrocystic disease. Correlative morphological studies indicate that the employed index can classify breast tissues on the basis of their cellular and fibrous composition and the inhomogeneity of their structure.

Adenocarcinoma↗
PubMedDate not supplied

Estrogen, progesterone receptors and proliferating activity evaluated by immunocytochemistry in breast cancer.

The correlation of the most important prognostic indicators was evaluated in 75 breast cancer cases. Estrogen-progesterone receptors and proliferating activity were analyzed by immunocytochemical methods (ER-ICA, PR-ICA, Ki-67). Both steroid receptors were inversely correlated with the proliferating activity (ER-ICA vs Ki-67, p less than 0.003; PR-ICA vs. Ki-67, p less than 0.0001). No correlation was found between steroid receptors or cell kinetics and tumor size or lymph node status. These findings confirm the relevance of biochemical and kinetic parameters as independent markers in breast cancer and suggest a routine use of the simple immunocytochemical methods in assessing the biological behavior of tumors.

Adult↗
PubMedDate not supplied

67Ga-citrate imaging in rhabdomyosarcoma.

A 22-year-old female patient with a swelling in the right forearm near the elbow underwent a 67Ga-citrate scan because of paraesthesia on the ulnar side of the right hand. The 67Ga total body scan showed intense focal uptake on the forearm in the same position as the swelling. At surgery a histological diagnosis of alveolar rhabdomyosarcoma was made. Five months later, a repeat 67Ga scan was normal. Eight months after the diagnosis, the patient complained of pain in the left lumbar region extending to the hypogastric area. A third 67Ga scan showed intense uptake near the spinal column which at surgery was found to be a metastasis of the primary tumor.

Adult↗
PubMedDate not supplied

Correlations between histologic type of clinical breast cancer and physiopathologic profile of the mammary glandular tree.

The relationships between cancer histotype and characters of the mammary glandular tree have been studied in 100 human breasts removed for clinical cancer by radical mastectomy. The group of invasive ductal carcinomas, including 78 cases, was subclassified in not otherwise specified (53 cases), with intraductal (19 cases), and with tubular component (6 cases). The other cancer histotypes were invasive lobular carcinoma (9 cases), medullary carcinoma (7 cases), mucinous carcinoma (4 cases), and papillary carcinoma (2 cases). The pattern of the mammary glandular tree was atrophic (67 cases) or adenosic, i.e., rich in mammary lobules (33 cases), but mammary lobules (normal, paranormal, atypical, or persistent in otherwise atrophic breasts) were present in 83% of the cases. A significant prevalence of not otherwise specified cancer (X2 = 10.20; p less than 0.01) was found in atrophic breasts (64%) and, even more, in breasts without lobules (76%). By contrast, intraductal component, tubular component, invasive lobular, and medullary cancers were, with two single exceptions, only in breasts with lobules, and this concentration was also significant (X2 = 7.26; p less than 0.01). It is concluded that breast cancer histotype is influenced by, or related to, the surrounding microenvironment, i.e., the pattern of the mammary glandular tree.

Adult↗
PubMedDate not supplied

The microenvironment of human breast with clinical cancer.

The characteristics of the mammary glandular tree have been studied in 100 human breasts removed for clinical cancer by radical mastectomy. The glandular tree was observed in whole thin (2 mm) stained sections under a stereoscopic microscope with removal of any suspicious or interesting change for histology. The results allow to categorize as follows the microenvironments in which mammary neoplasia may clinically appear. In respect to the main characteristics of the collateral glandular tree, clinical breast cancer may occur in: (a) atrophic breasts without lobules or lesions in 17% of cases; (b) atrophic breasts with persistent lobules and minor pathologic changes such as cysts, apocrine metaplasia, sclerosing adenosis, fibroadenoma and ductal hyperplasia in 19% of cases; (c) atrophic breasts with proliferative lobular changes (atypical lobules), duct papillomas, in situ carcinomas and/or microscopic independent foci of infiltrating carcinoma in 31% of cases; (d) adenosic breasts, which are breasts rich in mammary lobules, with the minor pathologic changes specified under (b) in 14% of cases; (e) adenosic breasts with the severe proliferative changes specified under (c) in 17% of cases, and (f) adenosic breasts with normal lobules and without lesions in 2% of cases. Therefore, 83% of the cancerous breasts have normal or pathologic lobules and 81% have lesions of various degrees of severity in the glandular tree.

Adult↗