Malignant mixed Müllerian tumors of the uterus. A clinical and pathologic study of 34 cases.
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Aged↗
Biomedical subjects
S Pileri
Publications and source records attributed to S Pileri.
Postmastectomy angiosarcoma: ultrastructural study of a case.
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Aged↗
[Lymphoblastic lymphomas in children. Their recognizability as T- or B-cell neoplasms in histologic slides (routine sections) (author's transl)].
Sections of lymph node and tumor biopsies from 60 patients (51 children, 9 adults) with lymphoblastic lymphoma (lbL) were examined in a bind trial to determine whether the subtype of lbL can be diagnosed on the basis of morphologic criteria alone The diagnoses made in this trial were correct in 18 of 20 cases (adults and children) that had been classified as T-, B-, or non-T/non-B-lbL by immunologic, cytochemical (DAP IV, or virologic (EBV) analysis. In 48 of the 51 children, the subclassification made in the blind trial agreed with the definitive diagnosis. In addition to the results of the blind trial, the morphologic characteristics of T- and B-lbL are presented and the diagnostic value of cytochemical staining for acid phosphates is discussed.
Acid Phosphatase↗
Signet ring cell lymphoma: a case report.
The authors report a case of signet ring cell lymphoma, a rare variety of germinal (follicular) centre cell neoplasm. It clinical, histological and ultrastructural findings are compared with those of the nine cases previously described. Original immunocytochemical results are presented and discussed.
Adult↗
Müllerian adenosarcoma of the uterus: a report of 5 cases.
The clinicopathologic features of 4 cases of Müllerian adenosarcoma of the uterine body and 1 of the cervix are reported. They showed the characteristic pattern of benign epithelial growth within sarcomatous stroma. In the cervical tumor, malignant heterologous stromal cells were also present. All the patients are alive and well, confirming the good prognosis of this neoplasm. The authors think that the presence of a malignant heterologous component probably does not imply a worse prognosis.
Aged↗
Endodermal sinus tumor arising in the endometrium.
A case of primary endodermal sinus tumor (EST) of the endometrium in a 28-year-old woman is described. EST has been reported to arise in several extragonadal sites, but to the authors' knowledge this is the first documented instance of origin in the endometrium. The histologic study is verified by the detection of alpha-fetoprotein in the tumor by an immunoperoxidase-peroxidase-antiperoxidase technique reported here. Displaced germinal cells, abnormal ovum, and residual fetal tissues are considered as possible origins of the neoplasia.
Adult↗
The use of pronase enhances sensitivity of the PAP method in the detection of intracytoplasmic immunoglobulins.
Application of immunocytochemistry to formalin-fixed, paraffin-embedded material tends to provide capricious results, even when employing the unlabelled antibody peroxidase-antiperoxidase (PAP) method. This study shows that treatment of tissue sections with pronase, a protease isolated from a strain of Streptomyces griseus, prior to performance of the PAP procedure greatly enhances its sensitivity. The optimum conditions for use of this enzyme in detecting intracellular immunoglobulins are given.
Humans↗
[The first stage of sarcoidosis: the actual diagnostic possibilities (author's transl)].
A correct staging of sarcoidosis is of the uppermost importance in the diagnosis and treatment of the disease. In the last few years new concepts have been stated: --radiological staging of sarcoidosis is particularly difficult --in no one phase the radiological pattern can be considered typical but sometimes it is highly suggestive for sarcoidosis --anatomical studies recently showed that sarcoid disease seems to begin with a non granulomatous interstitial pneumonia. Following this individual microscopic deposit may conglomerate to form the typical non caseating granulomas. In the lung the disease seems to procede from the interstitium to the lymphnodes. Usually, in the first stage, possible sarcoidosis is diagnosed by the radiologist, but a confident diagnosis needs a pathological confirmation. Transbronchial biopsy guided by fluoroscopy is the first diagnostic choice for obtaining confirmation of the disease and for determining the type and entity of parenchymal lesions.
Adult↗
Neoplastic and reactive follicles within B-cell malignant lymphomas. A morphological and immunological study of 30 cases.
Thirty cases originally diagnosed as B-cell lymphomas, either LP immunocytoma, centrocytic (Cc), or centroblastic-centrocytic (Cb/Cc), containing follicular structures of an uncertain nature were critically reviewed using both morphological criteria and immunological techniques. In particular, they were tested by conventional antisera for detection of immunoglobulins in paraffin sections and also, in the 5 cases in which frozen material was available, by a panel of monoclonal antibodies. At the first histological evaluation the cases were divided into two groups. Group A consisted of 12 examples which showed homogeneous features and, because of the neoplastic nature of the follicular structures, could be classified as follicular centroblastic-centrocytic lymphomas with marked plasmacellular differentiation. Group B comprised 18 cases which at onset of disease revealed a mantle-fashion growth around reactive-appearing follicles formed by polytypic germinal centre cells. On closer examination, however, this group appeared heterogeneous: 13 cases displayed cytological and immunological findings consistent with the diagnosis of Cc and usually contained polytypic plasma cells; 5 cases were examples of LP immunocytoma consisting of monotypic elements only. Therefore, the so-called mantle-zone lymphoma does not appear to be an entity.
Antibodies, Monoclonal↗
Simultaneous occurrence of visceral leishmaniasis and disseminated histoplasmosis in an Italian patient with HIV infection.
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AIDS-Related Opportunistic Infections↗
[B-cell lymphomas (non-Hodgkin's lymphomas of B type) in children--morphologic and immunologic spectrum].
The non-Hodgkin's lymphomas (NHL) occurring in children are described on the basis of the Kiel classification. As a rule, the NHL in children are of high-grade malignancy. The morphologic and immunologic features of all types of high-grade malignant B-cell lymphoma are described. The most frequent type of B-NHL in children is B-lymphoblastic lymphoma, including Burkitt and non-Burkitt types. Centroblastic lymphoma, immunoblastic lymphoma and unclassified high-grade malignant NHL are less common in children. The difference between the morphologic term "unclassified" and the immunologic definition "non-B/non-T" or "null" (or "unclassified") is explained. The equivalents of the various lymphoma types in the Lukes-Collins and Rappaport classifications are given.
Adolescent↗
Ultrastructural and immunohistochemical contribution to the histogenesis of human cardiac myxoma.
The ultrastructural features of 8 human cardiac myxomas were analyzed and correlated with immunohistochemical data, with the aim to clarify the characteristics of the cell lines involved in the tumor genesis. Immunohistochemical studies were performed to detect the presence and the distribution of intracytoplasmic filaments (vimentin, desmin, actin, myosin) as well as myoglobin and factor VIII-related antigen, albumin, and lysozyme. Eighty percent of myxoma cells were simultaneously positive for vimentin, desmin, and actin, whereas 30% of them stained with antifactor VIII and antivimentin antibodies. The submicroscopic analysis revealed two main cell populations: (1) one composed of stellate-shaped cells with scanty organelles and sparse hyaloplasmic filaments scattered throughout the myxoid stroma and forming a loose network with their projections; (2) another one included cells with more cytoplasmic organelles, intermediate filaments, and myofilaments arranged either singly or in both solid and hollow cord-like structures. Our results support the hypothesis that cardiac myxoma may originate from a reserve multipotent mesenchymal cell able to differentiate more or less completely along two major evolutional lines: myoid and endothelial. The tumor tissue thus seems to be involved in vessel formation, suggesting a growth pattern akin to that manifested in other forms of endocardial pathological reactivity in which reserve mesenchymal cells are engaged.
Adult↗
MACOP-B regimen followed by involved-field radiation therapy in early-stage aggressive non-Hodgkin's lymphoma patients: 14-year update results.
A single-center, retrospective study was conducted to evaluate therapeutic results of the MACOP-B third-generation chemotherapy regimen followed by involved-field radiation therapy in a stage I-II aggressive non-Hodgkin's lymphoma (NHL) patients. From 1986 to 1995, 118 consecutive patients with the diagnosis of aggressive NHL, stage I-IE or II-IIE, with or without bulky disease were treated with MACOP-B regimen followed, when appropriate, by 30-36 Gy involved-field radiation therapy. The complete response (CR) rate was 95% after the combined modality treatment (97% for stage I-IE and 93% for stage II-IIE). Patients with bulky disease had a CR rate of 92%. Treatment was well tolerated and no deaths occurred from acute toxicity. After a median follow-up of 68 months, 24 (21%) patients relapsed. The 14-year projected relapse-free and overall survival rates were 78% and d 69%, respectively. MACOP-B regimen with/without involved-field radiation therapy provides a safe and effective combined modality treatment for early-stage aggressive NHL, with the possibility to definitively cure two thirds of the patients.
Adolescent↗
Hodgkin's disease: update of findings.
The authors critically review the problem of Hodgkin's disease (HD) in the light of new morphological, immunohistochemical, kinetic, genotypic, and virological findings. These support the lymphoid origin of neoplastic Hodgkin's and Reed-Sternberg cells, because of regular expression of the CD30 lymphoid activation antigen and frequent detection of B- or T-cell phenotypic and/or genotypic markers. It is possible to hypothesize the release of cytokines by tumoral elements as well as the presence of specific cytokine receptors on their surface. This might explain some clinical and pathological features, such as fever, loss of weight, eosinophilia and attraction of reactive elements that make up the composite cellular milieu of typical HD. Integration of monoclonal EBV in the genoma of neoplastic elements has repeatedly been shown, and this might play an essential role in the pathogenesis of the disease. On the basis of present concepts, the borderlines between HD and some categories of non-Hodgkin's lymphomas--especially the anaplastic large cell forms--have become somewhat blurred. Additional research work in the field of HD is desirable and might pave the way for new and more effective therapeutic approaches, designed on the basis of the natural history of the neoplasm.
Antigens, CD↗
MN (N = Novantrone) COP-B therapy on high and intermediate grade non-Hodgkin's lymphoma: an alternative to MA (A = adriamycin) COP-B?
BACKGROUND AND METHODS: From February, 1987 to August, 1988, fifty-one patients with high and intermediate grade non-Hodgkin's lymphoma (NHL) entered a chemotherapy program MNCOP-B (M = Methotrexate, N = Novantrone, C = Cytoxan, O = Oncovin, P = 6 methyl-prednisolone, B = Bleomycin). Forty patients received MNCOP-B as first-line therapy and 11 patients as salvage therapy after relapse-resistance to other schemes or radiotherapy. RESULTS: The overall remission rate was 51% with a similar distribution of remissions between the two groups under study. At a mean follow-up of 28 months, 20 patients (40%) remain in CR with a disease-free probability of 83% for patients treated with MNCOP-B as up-front therapy and 67% for patients treated with MNCOP-B as salvage therapy. The overall survival at 3 years is 45%; bulky, disease stages III-IV and symptoms are not correlated with poorer survival or a lower remission rate. Patients who received less than 70% of the scheduled doses paradoxically figure better than the others, showing an 87% remission rate, as compared to those who received 100% of the scheduled doses and obtained a 35% remission rate. Major toxicity consisted of mucositis, recorded in 15% and 9% of previously untreated and treated patients, respectively; severe neutropenia was recorded in 27% and 63%, respectively. Despite the number of recorded side effects, only one toxic death due to sepsis occurred. CONCLUSIONS: MNCOP-B is an effective regimen in intermediate and high grade NHL and easily manageable in the out-patient clinic. The incidence of mucositis is sensibly reduced as compared to the parental regimen MACOP-B reported in the literature; this result allows the use of MNCOP-B in older patients.
Adolescent↗
Lymphoproliferative diseases of uncertain classification.
In spite of the recent progress in the biology and histogenesis of the lymphoproliferative diseases, many doubts still remain about their possible evolution. On the one hand, many cases have been studied showing a benign course in spite of a typical monoclonal phenotype; on the other, some clinically aggressive forms of lymphoproliferation prove to be polyclonal throughout their course, even when checked with highly sophisticated techniques. In this article we have reviewed, in both clinical and etiopathogenetic terms, the classification of these processes in the light of the new findings provided by extensive use of the most advanced investigational techniques of genotype and phenotype analysis. We have recognized three main groups of lymphoproliferative disorders of uncertain significance, based on pathophysiological, anatomical and developmental considerations: 1) lymphoproliferative diseases that take place on a background of either congenital or acquired immunodeficiency, referred to as "opportunistic lymphoproliferative disorders"; 2) lymphoproliferative diseases deriving from "mucosa associated lymphoid tissue" (MALT); 3) lymphoproliferative diseases of uncertain histogenesis, now classified as "T lymphomas". The opportunistic lymphoproliferative disorders, particularly in HIV+ patients and transplant recipients, often show developmental and etiopathogenetic features which may help to elucidate their natural history. Frequent involvement of Epstein-Barr virus and the related host's immune response patterns provide powerful tools to outline the alternative developmental pathways of such disorders.2+ Worthy of note is acute infectious mononucleosis which, though self-limiting when occurring in the immunocompetent host, may be considered as a lymphoproliferative process and sometimes shows some "aggressive'' morphological aspects. Special attention is paid to the obscure origin of Hodgkin's disease.(ABSTRACT TRUNCATED AT 250 WORDS)
Autoimmune Diseases↗
Immunohistochemistry of malignant lymphomas. Advantages and limitations of the new monoclonal antibodies working in paraffin sections.
On the basis of the experience derived from the study of 2,000 biopsies, the authors critically review the problem of the newly generated monoclonal antibodies (mAbs) working in paraffin sections. The reliability and drawbacks of the most commonly used reagents are examined, with special reference to their employment in the diagnosis of malignant lymphomas. The authors underline that only a few mAbs are really specific, since most reagents give rise to a certain number of cross-reactivities. In the light of this, a wide panel of antibodies should always be applied in the diagnosis of lymphoid tumours in order to avoid possible misinterpretations, which can actually lead to wrong therapeutical decisions.
Antibodies, Monoclonal↗
Acute idiopathic interstitial giant cell myocarditis. A histological and immunohistological study of a case.
The Authors report on a case of acute idiopathic giant cell myocarditis, which occurred in a young man without previous history of immunodeficiency or tumours, and displayed a rapidly fatal clinical course. Autoptic examination showed diffuse damage to the myocardium, with myocytolysis, granuloma formation and abundant giant cell reaction. No significant changes were observed in the other organs and systems . Immunohistochemistry revealed that the giant cells strongly reacted with the antibody KP1--raised to the macrophage-associated antigen CD68--whereas they did not stain with the monoclonal against the muscle-specific marker desmin. In the light of their findings and previous reports in the literature, the Authors discuss the possible origin of giant cells, along with the pathogenesis of the condition.
Acute Disease↗