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Biomedical subjects

S Di Lollo

Publications and source records attributed to S Di Lollo.

At least 37 records · Page 2Linked to original sources

A new protocol (MiCEP) for the treatment of intermediate or high-grade non-Hodgkin's lymphoma in the elderly.

Age has proved to be an important prognostic factor in patients with advanced non-Hodgkin lymphoma (NHL) and these patients require intensive and extensive therapy. Dose-reduction and therapy attenuation have reduced treatment-related toxicity, but have also decreased therapeutic efficacy. Between January 1990 and December 1992, 41 previously untreated patients, 65 years with stage 2-4 intermediate- or high-grade NHL were treated with a new therapeutic scheme which included Mitoxantrone, Etoposide, Cyclophosphamide and Prednisone (MiCEP). Twenty-eight patients achieved a complete remission, ten patients partial remission (overall response rate of 93%) and two cases were resistant. The overall survival was 66% with a median follow-up of 24 months from diagnosis: three patients relapsed after a median period of 7 months. The relapse-free survival was 92% after a median follow-up of 18 months. Blood and other organ toxicity was acceptable and 12% of patients experienced a grade 4 (WHO) neutropenia. In conclusion, MiCEP was effective in inducing a good remission rate with moderate toxic effects in elderly patients with intermediate- or high-grade NHL and appears to be a useful combination to use in this group of patients.

Aged↗

Detection of Epstein-Barr virus genome in sinonasal undifferentiated carcinoma by use of in situ hybridization.

Associations between Epstein-Barr virus and undifferentiated carcinomas of nasopharynx, parotid gland, and thymus have recently been reported. Epstein-Barr virus has also been associated with malignant lymphoma of the nose and paranasal sinuses. These findings raise the possibility that Epstein-Barr virus may additionally be linked to undifferentiated carcinoma of the nose and paranasal sinuses (SNUC), an uncommon but distinctive and highly aggressive neoplasm. Histologically, SNUC consists of small and medium cells, the precise characterization of which often requires immunocytochemical analysis. This study investigates the presence of DNA sequences of Epstein-Barr virus in biopsy specimens of 13 cases of SNUC that were defined immunocytochemically by use of previously reported criteria. In situ hybridization was used to detect Epstein-Barr virus genome in different cell types in routinely processed, paraffin-embedded tissues. Epstein-Barr virus-specific DNA sequences were detected in tumor cells of SNUC specimens from 5 of the 13 cases examined. No correlation was found between positive hybridization and primary tumor site, morphologic subtype, or disease course. Epstein-Barr virus DNA was detected in 38% (5 of 13) of the SNUC samples analyzed. This finding suggests that this virus may play a role in the pathogenesis of this rare neoplasm.

Adult↗

Unusual clinical aspects of oral non-Hodgkin lymphomas in patients with HIV infection.

Patients with HIV infection are at greater risk of developing malignancies. We report two HIV-seropositive patients with primary oral manifestation of a B-cell non-Hodgkin lymphoma (NHL). Localisations of tumours were the palate, with an unusual bifocal origin, and the tongue which is rarely the primary site of NHL. Ulcerations and extensive tissue necrosis were observed. Histologically both cases were high grade malignant lymphomas, immunoblastic. Epstein-Barr virus DNA was detected with in situ hybridisation in 1 patient.

Adult↗

Combined surgery and chemotherapy in primary gastric non-Hodgkin's lymphoma: a retrospective study in sixty-six patients.

Sixty-six consecutive patients with primary gastric non-Hodgkin's lymphoma are reported. All patients underwent surgery which consisted of radical resection in 23 patients (36%) and partial or palliative excision in the remaining 43 cases (36 and 7 respectively). Three patients died before starting chemotherapy, two refused the treatment and 61 completed the postoperative chemotherapeutic programme. We analysed this group of patients in order to assess the efficacy of chemotherapy following surgery. Chemotherapy included either CVP or the original protocols from our institution. Excluding patients who underwent radical resection, postoperative chemotherapy induced complete remission in 87% of the remaining 39 patients. After a median follow-up of 84 months (range 6-216), the 10-year cause-specific survival was 90% with a stable curve plateau after about 25 months. The survival was only influenced by response to therapy (p < 0.0001). The disease-free survival for patients who were not radically resected was 93%. We encountered only two relapses after 15 and 32 months. One of these was local and the other systemic. Our results indicate that chemotherapy following surgery induces long-term remission and survival in primary gastric lymphoma and in particular improves remission and survival, in stage II. In our opinion, surgery may also be fundamental for the treatment of gastric lymphoma in the majority of cases.

Adolescent↗

Detection of human herpesvirus-6 and Epstein-Barr virus genome in childhood Hodgkin's disease.

Two widespread human herpesviruses, the Epstein-Barr virus (EBV) and the Human Herpesvirus 6 (HHV-6), have been frequently associated with Hodgkin's Disease (HD) and, recently, it has been observed an HHV-6 transactivation effect on EBV replicative cycle. We studied the presence and the possible association between EBV and HHV-6 in childhood HD cases, nodular sclerosis subtype. We analyzed formalin-fixed and paraffin-embedded lymph nodes from 15 cases by PCR for HHV-6 genome, and by PCR and in situ hybridization (ISH) for EBV genome. One out 15 samples resulted positive for HHV-6 DNA PCR, while 5 resulted positive for EBV DNA PCR. Only one sample positive for HHV-6 resulted positive for both HHV-6 and EBV genome. All samples were negative in ISH. At the moment, it is not clear the exact role of EBV and HHV-6 in the lymphomagenesis, neither it is possible to establish the rate of their interaction; our data show that it does not exist in vivo an evidence of their association.

Adolescent↗

Myofibroblast and elastic and collagen fiber hyperplasia in the bronchial mucosa: a possible basis for the progressive irreversibility of airway obstruction in chronic asthma.

Considering the role proposed for myofibroblasts in inflammatory and hyperelastotic lung diseases, the possibility arises that these cells are involved in bronchial pathology, including asthma. To address this issue, we have analyzed by light microscopy, histochemistry and immunohistochemistry the structure of extra- and intra-pulmonary bronchi of patient died of asthma. We have demonstrated hyperplasia of connective tissue cells and fibers in the mucosa, all around the lumen of extra- and intra-pulmonary bronchi. The cells were thin and elongated, labeled by anti-actin and anti-vimentin antibodies and interspersed with many elastic and collagen fibers, therefore they were interpreted as myofibroblasts. These findings may explain the rigidity of the bronchial wall in patients with asthma, which causes the progressively more limited resolution of airway obstruction upon pharmacological treatment and the gross anatomical finding of bronchial stiffness at inspection of the lungs. The possibility should also be considered that myofibroblasts and elastic--not collagen--fibers have contributed to bronchial hyperreactivity at an early stage of the disease.

Aged↗

[CT-guided thoracic biopsy. Personal experience with DBNH Haaga 20 G needles].

CT-guided fine-needle biopsy of the chest is nowadays a conventional diagnostic procedure, which can be furtherly improved so as to increase its diagnostic sensitivity and to reduce complications. We studied a series of possible improvements over a 2-year period (1990-1992). In our radiology department 164 CT-guided biopsies were performed in 130 men and 34 women. DBNH Haaga 20-G (15 cm) needles (Cook, Denmark) were used. This kind of needle is a coaxial cutting-edge needle used for simultaneous cytological and histological sampling. Exams were performed with a Philip Tomoscanner CX-S (scanning time: 2.8 seconds). Of 164 tissue samples, 153 (93.4%) were adequate for histological diagnosis. As for suspected neoplastic disease, our results demonstrated 108 true positives, 27 true negatives, 18 false negatives and no false positive. Sensitivity, specificity and diagnostic accuracy were 85.7%, 100% and 88.2%, respectively. In 24 cases there were minor complications--i.e., 5 cases of parenchymal hemorrhage and 19 cases of minor pneumothorax. In one case only there was major pneumothorax which required surgical drainage. On the basis of our experience, we suggest the use of such coaxial catheters as the DBNH Haaga type for the collection of both histological and cytological material because this needle reduces the need for repeated invasive and potentially dangerous maneuvers.

Adult↗

Localization of the pathological process in Miller Fisher syndrome.

A 64 year old woman died at the third attack of MFS. Histological examination demonstrated segmental demyelination and axonal swelling of the peripheral nerves studied, oculomotor included. In the C.N.S. only mild chromatolytic changes and rare pyknosis of the nerve cells in the midbrain were found without signs of primary inflammation. We reviewed the findings in all the 4 anatomoclinical cases of MFS and in 2 cases of GBS with ophthalmoplegia or ataxia. With one exception, they appear to be concordant with those of our case. As the histological examination showed CNS involvement consequent upon peripheral nerve impairment, we are bound to change our opinion on the nosological position of MFS. Any small CT enhancements in the brain in MFS may be due, as in some cases of demyelinating polyneuropathy, to focal rupture of the blood-brain barrier.

Ataxia↗

[Isosporiasis and sarcocystosis. The current findings].

A review on infections by Isospora belli and Sarcocystis spp. both in healthy and in AIDS patients is done on the basis of literature and personal data. In this view a special focus is made on isospora belli infection in AIDS because of its high recurrence after successful attack therapy. Consequently the most recent protocols for maintenance and attack therapy in these patients are reported. At the end, concerning ultrastructural pathology, the features of some Isospora belli developing stages are described by means of electron microscopy on duodenal biopsy specimens from a patient.

AIDS-Related Opportunistic Infections↗

[Intestinal microbial pathology in AIDS. A clinical case series].

Microbial isolates from 60 diarrheic AIDS patients hospitalized to the Infectious Disease Division of Careggi hospital (Florence) are described. Clinical, microbiological and diagnostic features of each case are discussed with emphasis to some rare or underestimated entities in Europe: Campylobacter laridis bacteremia, Whipple-like disease by atypical Mycobacteria, Schistosoma mansoni proctocolitis. Results regarding newly AIDS-related microorganisms are also stressed.

Acquired Immunodeficiency Syndrome↗

[Pseudo-Whipple disease caused by atypical mycobacteriosis in AIDS: a clinical and electron microscopic study of 2 cases].

The Authors focus on two cases, studied by electron and light microscopy, of Whipple-like disease caused by atypical mycobacteria in AIDS. Differential characteristics between the cases and classical Whipple's disease are analyzed with regard to the diagnostic and therapeutical peculiarities of Mycobacterium avium-intracellulare infection which accounts for over 80% of atypical mycobacterial infections in AIDS. In this regard the Authors stress the role of histological findings of pale blue striated histiocytes as a marker of Mycobacterium avium-intracellulare infection.

Acquired Immunodeficiency Syndrome↗

In situ immunologic characterization of cutaneous involvement in Hodgkin's disease.

The current study assesses in situ the antigenic phenotype of cutaneous infiltrate in two cases of Hodgkin's disease affecting the skin. Immunostaining utilized monoclonal antibodies for T-lymphocyte and B-lymphocyte and mononuclear phagocyte markers. The same immunophenotypic pattern of cutaneous infiltrate was observed in both cases, despite a different histopathologic subtype (mixed cellularity in case one, nodular sclerosis in case two). The majority of infiltrating cells expressed T-lymphocyte markers, with a predominance of CD8+ phenotype. Few cells bore B-lymphocyte markers or had DRC-1+ phenotype. No CD1a+ dendritic cell was found in the dermal infiltrate. Variable numbers of cells reacted with mononuclear phagocyte markers. The authors believe that the antigenic phenotype of cutaneous Hodgkin's disease has not previously been reported. The immunophenotypic pattern of skin infiltrate is different from that described in lymphoid tissues. Such findings could be related to the previous therapy or to the possible influence of skin microenvironment.

Adult↗

Magnetic resonance imaging and high-resolution computed tomography in tumors of the lung and the mediastinum.

Magnetic resonance (MR) imaging and high resolution computed tomography (CT) have been compared in 37 patients who had expansive processes of the lung and the mediastinum. MR imaging and CT scanning gave identical results in 32 patients; in 5 patients, CT scanning has proved more useful in evaluating the stag e of primary lung tumors. MR imaging often gives more information about the actual size of the tumor, and the involvement of close structures, although it does not modify staging of the tumor. MR imaging has the advantage to differentiate hilar adenopathy from blood vessel structures. Evaluation of T2 relaxing time (that we have performed in the same location of thin-needle biopsy aspiration), however, did not prove to be of diagnostic significance; this indicates that MR imaging at the moment is not suitable for tissue typification.

Adult↗

[CT-guided percutaneous fine-needle biopsy in the histological characterization of mediastinal-pulmonary lesions].

CT-guided percutaneous fine-needle biopsy (FNB) is the method of choice in the histological characterization of mediastinum and lung lesions in which a diagnosis could not be reached through noninvasive methods such as cytology of the sputum, or biopsy during bronchoscopy. FNB represents an alternative to diagnostic thoracotomy: it is, in fact, less invasive, it can be carried out with no need for hospitalization, and has a low incidence of complications. FNB diagnostic accuracy is very high, as our results prove: accuracy 89.6%, sensitivity 87.6% and specificity 98%. Our series includes 419 percutaneous fine-needle biopsies.

Biopsy, Needle↗

Cutaneous fibrinolytic activity in primary hypertrophic osteoarthropathy.

Cutaneous fibrinolytic activity was investigated in 13 patients affected with Primary Hypertrophic Osteoarthropathy in the advanced phase. Biopsies were taken from periungueal skin of the ippocratic finger and from the dorsum of the first phalanx: cutaneous fibrinolytic activity was investigated with Todd's autohistographic method as modified by Lotti et al., showing increased activity in periungueal skin (10/13) and normal in the apparently uninvolved skin (9/13). We suggest that the increase in plasminogen activator activity, in the advanced phase of the disease, may be related to the increased growth of the connective tissue that is characteristic of the disease.

Adult↗