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V A Livolsi

Publications and source records attributed to V A Livolsi.

At least 19 recordsLinked to original sources
PubMed2006

Gene expression profiling of human ovarian tumours.

There is currently a lack of reliable diagnostic and prognostic markers for ovarian cancer. We established gene expression profiles for 120 human ovarian tumours to identify determinants of histologic subtype, grade and degree of malignancy. Unsupervised cluster analysis of the most variable set of expression data resulted in three major tumour groups. One consisted predominantly of benign tumours, one contained mostly malignant tumours, and one was comprised of a mixture of borderline and malignant tumours. Using two supervised approaches, we identified a set of genes that distinguished the benign, borderline and malignant phenotypes. These algorithms were unable to establish profiles for histologic subtype or grade. To validate these findings, the expression of 21 candidate genes selected from these analyses was measured by quantitative RT-PCR using an independent set of tumour samples. Hierarchical clustering of these data resulted in two major groups, one benign and one malignant, with the borderline tumours interspersed between the two groups. These results indicate that borderline ovarian tumours may be classified as either benign or malignant, and that this classifier could be useful for predicting the clinical course of borderline tumours. Immunohistochemical analysis also demonstrated increased expression of CD24 antigen in malignant versus benign tumour tissue. The data that we have generated will contribute to a growing body of expression data that more accurately define the biologic and clinical characteristics of ovarian cancers.

Adenocarcinoma, Clear Cell↗
PubMed2000

Malignant epithelioid vascular tumors of the pleura: report of a series and literature review.

Primary malignant vascular tumors of the pleura are rare. The significance and difficulty of distinction between pleural epithelioid hemangioendothelioma (EHE) and angiosarcoma have not yet been addressed. A new series of pleural angiosarcoma is reported, and the relevant literature is reviewed. Five cases were identified from files of the authors' institutions and personal consultation cases (J.J.B.). Twenty-six cases of primary malignant vascular tumors of the pleura were identified in the literature. In a total of 31 cases, 22 were from the West and 9 from Japan. Patients were 22 to 79 years old (average, 57), and the male/female ratio was 9:1. Prior chronic pyothorax was identified only in cases reported from Japan. History of exposure to radiation or asbestos was noted in a few Western cases. The most common presentation was pleural thickening and effusion. Almost all of the patients died of disease shortly after diagnosis. A spectrum of histology ranging from characteristic high-grade epithelioid to relatively low-grade EHE-like features was observed in our cases and can be found in previous reports. Most cases showed variable spotty cytokeratin immunoreactivity. Endothelial markers (factor 8, CD34, or CD31) were invariably positive. Pleural angiosarcomas are often epithelioid and can be easily mistaken for mesothelioma or carcinoma clinically and histologically. Awareness of this rare tumor should prompt the use of endothelial markers when faced with a questionable mesothelioma. When cytokeratin is negative, or focal with strong vimentin reactivity, a vascular tumor should be suspected and confirmed with vascular markers. Because of their invariably aggressive behavior, all epithelioid vascular tumors of the pleura should be considered highly malignant regardless of the presence of EHE-like histological features.

Adult↗
PubMed2000

Increased angiogenesis in papillary thyroid carcinoma but lack of prognostic importance.

Angiogenesis is important for tumor growth and progress, and the intratumor density of microvessels is a significant prognostic factor in many tumor types. The role in thyroid cancer has not been well studied, and we therefore examined a series of 128 papillary carcinomas with respect to microvessel density (MVD) and patient survival. Follow-up was obtained for all cases (median, 145 months). We found a mean MVD of 216 per mm2 (range, 35-751), and there was an average of 3.14 times more vessels in the tumors, when compared with surrounding non-neoplastic thyroid tissue. MVD was inversely related to age, tumor diameter, histological grade, and primary tumor extent. Furthermore, increasing MVD tended to be associated with improved survival (P = .056). In conclusion, our data indicate that angiogenesis is important for the development and maintenance of papillary thyroid carcinomas, although it was not identified as a prognostic factor.

Adult↗
PubMed1999

Utility of immunohistochemistry in the evaluation of necrotic thyroid tumors.

We have previously shown that necrotic tumors retain their immunoreactivity for a range of cytokeratin antibodies. Some thyroid tumors undergo extensive necrosis after fine-needle aspiration (FNA) procedures. We evaluated the sensitivity of antibodies on necrotic thyroid tumors by examining a series of thyroid tumors consisting of 10 Hurthle cell neoplasms, 8 carcinomas, and 2 follicular adenomas (12 with post-FNA necrosis). These were stained with antibodies to AE1/3, PANCK, thyroglobulin and S100. Four of the cases of papillary carcinoma were also stained with antibodies to CK19. As a control for the specificity of thyroglobulin immunoreactivity in necrotic tissue, we also stained 11 nonthyroid tumors with extensive necrosis (7 carcinomas, 1 lymphoma, 2 melanomas, 1 sarcoma) for thyroglobulin. Six of 8 thyroid carcinomas were positive for AE1/3 and PANCK; AE1/3 reactivity was retained in necrotic areas of 4 of 6. AE 1/3 was positive in necrotic portions of 5 of 10 Hurthle cell lesions, whereas PANCKwas negative in all but 1. Thyroglobulin reactivity was present in 18 of 20 cases, and was preserved in necrotic portions of 5 of 6 carcinomas, as well as 8 of 10 Hurthle cell neoplasms. S100 cytoplasmic reactivity was present in 4 Hurthle cell neoplasms and 1 papillary carcinoma; this staining was lost in necrotic areas. No staining by thyroglobulin was observed in the viable or necrotic areas of nonthyroid neoplasms. The preservation of cytokeratin reactivity, measured by AE1/3, in thyroid neoplasms is a diagnostically useful feature in spontaneous and post-FNA infarction. PANCK is not a well-preserved marker in necrotic thyroid tissue. This difference may be due to detection of keratin 19 by AE1/3. Thyroglobulin is preserved in some necrotic thyroid carcinomas and in Hurthle cell lesions. Preservation of thyroglobulin reactivity in necrotic tissue is specific in that no staining was observed in nonthyroid neoplasms. These results suggest that thyroglobulin is useful in demonstrating thyroid lineage of both primary and metastatic necrotic tumor masses.

Adenoma↗
PubMed1998

Ret oncogene activation in papillary thyroid carcinoma: prevalence and implication on the histological parameters.

The Ret proto-oncogene is known to be rearranged in papillary carcinoma of the thyroid. The aim of this study was to investigate the in situ expression of Ret mRNA in thyroid tumors. Formalin-fixed, paraffin-embedded tissue specimens from 45 thyroid lesions were examined by in situ hybridization using manual capillary action technology (MicroProbe Staining System) and a 52-base synthetic biotinylated oligonucleotide probe complementary to the tyrosine-kinase domain of Ret proto-oncogene. The clinicopathological features of these patients with thyroid lesions also were noted. Ret was noted in 17 (43%) of 40 papillary carcinomas. In contrast, none of the three follicular carcinomas, follicular adenoma, nodular hyperplasia, and normal thyroids, showed evidence of Ret mRNA. Our results showed that, in papillary thyroid carcinoma, there is an important role of Ret activation. The Ret staining could be a useful marker for papillary carcinoma.

Adenocarcinoma, Follicular↗
PubMed1998

Simultaneous involvement of thyroid by Riedel's [correction of Reidel's] disease and fibrosing Hashimoto's thyroiditis: a case report.

We report an unusual thyroid lesion showing histologic features of both Riedel's [corrected] disease and fibrosing Hashimoto's thyroiditis in a 57-year-old white female. The clinical presentation was hypothyroidism associated with a solitary firm to hard cold nodule replacing the entire right lobe of thyroid gland. Pathological examination demonstrated extensive replacement of the thyroid parenchyma with dense keloidal fibrosis, intermixed well-developed lymphoid follicles, scattered lymphocytes, and plasma cells. The fibrotic process extended into the perithyroidal soft tissues and skeletal muscle with complete obliteration of the thyroid capsule. These findings were consistent with Riedel's [corrected] disease. However, the immunohistochemical stains for B and T markers and immunoglobulin light chains showed an immunoprofile consistent with Hashimoto's thyroiditis. This combination of Riedel's [corrected] disease and fibrosing Hashimoto's thyroiditis is rare and coincidental, as both represent two distinct clinicopathological entities.

B-Lymphocytes↗
PubMed1998

Fine-needle aspiration of thyroid: an institutional experience.

In this report we describe our institutional experience with fine-needle aspiration (FNA) of the thyroid. Six hundred sixty-two FNAs were performed in 616 patients in a 3 1/2 year period. The cytological diagnoses were categorized as: negative for malignancy, 455 (69%); indeterminate, 30 (4%); neoplasm/malignant, 105 (16%), and nondiagnostic, 72 (11%) including 29 cases from outside institutions. Surgical follow-up was available in 140 (21%) cases, 95 of which had preceding cytological diagnoses of positive or indeterminate for neoplasm/malignancy. For those cases with definite benign or neoplastic/malignant cytodiagnosis, a sensitivity of 92% and specificity of 84% was achieved. The cumulative false-positive and false-negative rates for these categories were 16% and 7.5%, respectively. On comparing discrepant diagnosis between cytological and histological specimens, two major factors were identified as causes for diagnostic misinterpretations: overlapping cytological features among follicular-derived lesions and inadequate/suboptimal specimens. The cytological features of follicular variant of papillary carcinoma were found to overlap those of hyperplastic/adenomatous nodules and follicular neoplasms due to the presence of abundant thin colloid, monolayer sheets of follicular cells and subtle nuclear features of papillary carcinoma. We suggest that awareness of variable cytological features in follicular lesions (especially in follicular variant of papillary carcinoma), following strict criteria of specimen adequacy in thyroid FNA, and clinicopathological correlation can markedly reduce false-negative results.

Adolescent↗
PubMed1997

Acute appendicitis secondary to metastatic bronchogenic adenocarcinoma.

Metastatic tumors to the appendix are not common. However, these tumors should be one of the differential diagnoses in patients with known primary malignancy, who present with signs and symptoms of acute appendicitis. We report a case of an elderly male with poorly differentiated bronchogenic adenocarcinoma which metastasized to the appendix.

Acute Disease↗
PubMed1996

Pulmonary venous aneurysm presenting as a middle mediastinal mass.

A large mediastinal mass in a 43-year-old man was proven at thoracotomy to comprise a right superior pulmonary vein aneurysm. Intraoperative transesophageal echocardiography was useful in defining the abnormality. Pulmonary venous aneurysm appears to represent an extremely rare but surgically correctable addition to the differential diagnosis of middle mediastinal masses.

Adult↗
PubMed1993

Measurement of vascular volume in experimental rat tumors by 19F magnetic resonance imaging.

RATIONALE AND OBJECTIVES: In-vivo assessment of tumor vascular volume may provide useful information for treatment planning or the assessment of treatment effectiveness. The goals of our study were to measure percent vascular volume in two experimental tumor sublines using 19F magnetic resonance imaging (MRI) and to assess changes in tumor blood volume with growth. METHODS: An emulsion of perfluorotributylamine (FTBA) was used as a vascular contrast agent for 19F MRI: The amount of emulsion in the tumor vasculature was measured by 19F MRI and used to calculate percent vascular volume. A separate ex-vivo study of vascular volume was conducted using the dye Hoechst 33342. A total of five rats were studied by MRI and 14 by the ex-vivo method. RESULTS: The ranges of percent vascular volume values measured in the imaging and Hoechst dye studies were 2% to 9% and 1.25 to 7%, respectively. A trend toward decreasing percent vascular volume with increasing tumor volume was evident in one tumor subline. CONCLUSIONS: The quantitative 19F MRI technique was effective for measuring percent vascular volume and changes in vascular volume with growth.

Adenocarcinoma↗
PubMed1992

Diabetic mastopathy: a distinctive clinicopathologic entity.

Insulin-dependent diabetics may manifest evidence of autoimmune diseases involving endocrine or other organs. Rare cases of a peculiar fibrous and inflammatory lesion of the breast in diabetic patients have been previously described; however, the pathologic and clinical features that uniquely characterize these cases have not been defined or distinguished from other chronic inflammatory and fibrosing conditions in the breast. We studied eight patients with breast masses and longstanding insulin-dependent diabetes and compared them with 36 nondiabetic or short-duration diabetic patients with fibrosis and chronic mastitis. The longstanding diabetic patients presented with clinical breast masses ranging in size from 2 to 6 cm. Six of the eight patients had documented diabetic nephropathy, retinopathy, or neuropathy. Pathologically, these lesions showed lymphocytic lobulitis and ductitis, lymphocytic vasculitis (predominantly B cell), and dense keloid-like fibrosis that in many cases (six of eight) contained peculiar epithelioid cells embedded in dense fibrous stroma. We have provisionally labeled these cells "epithelioid fibroblasts" (EFBs). Although the features of lymphocytic lobulitis, ductitis, and/or vasculitis may occasionally be encountered in nondiabetic breast biopsies, EFBs appear to be unique to the diabetic condition. Control cases of chronic mastitis in nondiabetic or short-duration diabetes patients failed to show the complete constellation of lymphocytic lobulitis and ductitis, vasculitis, keloidal fibrosis, and EFBs. Diabetic mastopathy may represent an immune reaction to abnormal matrix accumulation. A hypothesis is presented.

Adult↗
PubMed1992

Postmenopausal bleeding from unusual endometrial polyps in women on chronic tamoxifen therapy.

There are recent reports of postmenopausal bleeding from endometrial polyps in women receiving tamoxifen therapy for breast cancer. We describe four additional patients who presented with vaginal bleeding, and emphasize the pathology. These polyps demonstrated cystically dilated glands in all cases and stromal decidualization in two; in one instance, metastatic breast carcinoma was present in the polyp. The mechanisms by which tamoxifen may affect the development of these polyps are discussed.

Aged↗
PubMed1991

Germ cell tumor of testis in a patient with von Hippel-Lindau disease.

Germ cell testicular tumor is a previously undescribed entity in association with von Hippel-Lindau disease. This case exemplifies the variety of pathologic entities encountered in von Hippel-Lindau disease and stresses the importance of thorough evaluation of the patient, as well as careful follow-up, to ensure early detection of potentially malignant lesions.

Adult↗
PubMed1990

Adjuvant radiotherapy for recurrent granular cell tumor.

Granular cell tumor (GCT) is a rare neoplasm traditionally treated with surgical excision alone. However, recurrences and metastases of GCT have been reported. The authors review the literature and report the case of a 33-year-old black woman with a large, recurrent GCT. The patient was treated with adjuvant radiation therapy and followed without evidence of recurrence. Adjuvant radiotherapy may have a role in the treatment of certain GCT thought, by clinical or pathologic criteria, to be at high risk for recurrence or metastasis, especially in those cases where extensive surgical excision would produce unacceptable morbidity.

Adult↗