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Biomedical subjects

V Franco

Publications and source records attributed to V Franco.

At least 19 recordsLinked to original sources

[LAT (linker for activation of T cells): a useful marker for megakaryocyte evaluation on bone marrow biopsies].

Detection of atypical megakaryocytes in bone marrow biopsies, especially in cases of myelodysplastic syndromes (MDS), chronic myeloproliferative disorders (CMPD) and acute leukemias, is facilitated by staining for markers such as Ulex europaeus agglutinin (UEA)-J, CD31, CD61 and von Willebrand factor (VWF), the latter being considered the most sensitive. Recently, LAT (linker for activation of T cells), a molecule involved in T-cell activation and platelet aggregation, was found to be expressed by megakaryocytes and platelets in tissue sections. We compared VWF and LAT immunoreactivity on megakaryocytes in 64 bone marrow biopsies from 12 normal controls (NC), and from patients with MDS (n=18), CMPD (n=21) and acute megakaryocytic leukemia (AML-M7, n=13). Immunostaining was performed on paraffin sections with polyclonal antibodies against VWF and LAT. Immunoreactivity was evaluated by counting positive megakaryocytes in 10 high-power fields, and values were compared using Student's t test for paired data. Both VWF and LAT predominantly stained the cytoplasm of megakaryocytes, although LAT was also recognizable on the cell membrane. In most biopsies, the immunoreactivity of the two antibodies was quite similar. No significant differences were noticed between the mean values of VWF+ and LAT+ megakaryocytes. However, in 22 cases (5 NC; 5 MDS; 6 CMPD; 6 AML-M7), the number of LAT+ megakaryocytes was at least 30% higher than VWF+cells, while in 3 cases opposite findings were found. In 3 AML-M7 cases, anti-LAT antibodies stained numerous megakaryocytes, but anti-VWF staining was practically negative; in another 5 AML-M7 cases, anti-LAT labeling was much stronger than anti-VWF staining. LAT represents a useful immunohistochemical marker for megakaryocytes in normal and pathological conditions. It seems to be expressed by megakaryocytes more than VWF in most cases and, particularly, in conditions associated with poorly differentiated megakaryocytes, such as acute megakaryocytic leukemias. The use of LAT staining should be recommended in association with other megakaryocyte markers in the study of bone marrow biopsies in cases of hematopoietic disorders.

Adaptor Proteins, Signal Transducing↗

[Lipothymia and syncope in adolescents].

Syncope is the transient loss of consciousness and postural tone resulting from inadequate cerebral perfusion. The most common type of syncope in healthy children and adolescents is the vasovagal syncope, which is a benign and transient condition. The evaluation of syncopal children or adolescents is on a detailed history and physical examination. ECG is mandatary, other laboratory tests must be guided by pertinent positives or negatives in the history and physical examination. The pathology of syncope seems to follow a common pathway with many inciting stimuli. Cerebral perfusion is compromised by a transient decrease in cardiac output caused by vasomotor changes decreasing venous return, primary dysrhythmia, or impairment of cerebral vascular tone. Tilt table testing can be useful in selecting therapy by demonstrating the physiologic response leading to syncope in an individual patient. Treatment is usually targeted to those in whom syncope is recurred or has been associated with physical injury. In others, treatment involves removal or avoidance of agents that predispose to hypotension or dehydration, including alcohol, vasodilating anti-hypertensive medications, and diuretics. However, when these measures fail to prevent the recurrence of symptoms, pharmacologic therapy is usually recommended. The efficacy of beta blockers, midodrine and SRIs have been confirmed in randomized, prospective clinical trials. In addition to these 3 agents, there is also considerable clinical experience suggesting the value of fludrocortisone.

Adolescent↗

[Pneumoparotid: a case report and review of the literature].

This article reports a case of peneumoparotid in a ten-year-old girl. This pathology is caused by insufflation of air into the acini of the parotid gland via Stensen's duct. A review of the literature shows that it has many aetiologies but more frequently it presents as an occupational hazard among glassblowers and wind instrumentalists. It may also occur by auto-insufflation in adolescence who often have psychological problems. The diagnosis is made from the history and imaging. The treatment is aetiologic and symptomatic.

Child↗

Splenectomy influences bone marrow infiltration in patients with splenic marginal zone cell lymphoma with or without villous lymphocytes.

BACKGROUND: Splenic marginal zone cell lymphoma (SMZL) is a low grade B-cell lymphoma in which patients can have circulating villous lymphocytes and can show a peculiar intrasinusoidal bone marrow (BM) infiltration. Splenectomy is the reported treatment of choice for these patients. The objective of this study was to evaluate the effects of splenectomy on patients with BM lymphomatous infiltration. METHODS: BM biopsies of 16 patients with SMZL were studied morphologically and immunohistochemically. In 12 patients, BM biopsies were taken before and after splenectomy. Four patients did not undergo splenectomy, and their BM biopsies were performed with an approximately 1 year interval. RESULTS: BM infiltration ranged from 10% to 40% of overall cellularity and was mostly of the intrasinusoidal type. After splenectomy, BM infiltration tended to become frankly nodular and showed an increase in tumor burden. Nonsplenectomized patients showed an unmodified picture. CONCLUSIONS: Splenectomy seems to induce important changes in patients with BM infiltration, probably through the lack of microenvironmental factors on circulating cells. These effects suggest reconsidering the role of splenectomy in the treatment of patients with SMZL.

Adult↗

Concomitant inflammatory pseudotumor of the liver and spleen.

We report the case of a 53-year-old man with inflammatory pseudotumor (IPT) of the liver and spleen. This concomitant association has rarely been reported. The patient presented with a hypoechoic mass in the liver and a clinical picture of recurrent sepsis; hematochemical exams and imaging data were nonspecific. Antibiotic therapy improved the clinical course, but did not resolve it definitively. After 50 days of therapy, as the hepatic mass decreased a similar lesion appeared in the spleen. The final diagnosis was made on splenectomy and an intra-operative biopsy of the residual liver lesion. The diagnostic problems encountered in this very rare association of IPT of the liver and spleen were similar to those for isolated IPT in the respective single organ sites. After 15 months of follow-up, the patient is in good health and no recurrence of symptoms or masses has been observed.

Angiography↗

Response to low-dose oral methotrexate and prednisone in two patients with angio-immunoblastic lymphadenopathy-type T-cell lymphoma.

INTRODUCTION: AILD-type T-cell lymphoma is characterized by very poor prognosis in most patients and the response rate to conventional chemotherapy is unsatisfactory. MATERIALS AND METHODS: Two patients (a 65 year old female and a 67 year old male) with AILD-type lymphoma who did not respond to conventional treatment with steroids or aggressive chemotherapy were treated with Methotrexate and Prednisone. Both patients received a weekly dose of MTX (10 mg/m(2)) that was administered orally in combination with PDN at an initial dose (15 mg/day), given on a daily basis. RESULTS: Both patients responded rapidly showing marked improvement with no major side effects. Complete clinical remission was recorded in the two patients who were treated with this combination after conventional chemotherapy had failed to produce any improvement. CONCLUSION: Our observations in two patients with refractory/relapsed AILD-type lymphoma who were given low-dose oral MTX as salvage treatment, suggest that this agent has immunosuppressive effects that can be beneficial for treating patients with AILD-type T-cell lymphoma. Pilot clinical trials are needed to verify its efficacy in this setting.

Administration, Oral↗

Gastric and gingival localization of mucosa-associated lymphoid tissue (MALT) lymphoma. An immunohistochemical, virological and clinical case report.

Non-Hodgkin's lymphomas (NHL) of the mucosa-associated lymphoid tissue (MALT) are characterized by their mucosal and glandular tissue localization. The case described here falls into the European-American classification of a low-grade B-cell lymphoma of the MALT type, with a gingival lesion 2 years after a gastric lesion. The pathogenetic mechanisms of NHL in oral MALT and the diagnosis and treatment are discussed.

DNA, Viral↗

The epulis vascularity. A morphometric study.

BACKGROUND: A computerised morphometric analysis of some vascularisation aspects of epulides is presented. The aim of this study is to evaluate the correlation between morphometric aspects and histological classification of epulides and to investigate its usefulness for the histopathologic diagnosis. METHODS: The study was carried out on epulides from 72 patients (30 males, 42 females, age-range 16-60). Epulides were fixed in alcohol, paraffin embedded, and stained with haematoxyilin eosin, thereafter epulides were histopathologically classified as granulomatous epulides, fibrous epulides and giant cell epulides. Images of histological samples were then digitised, and by an image analysis system some morphometric vessels characteristics were evaluated: percent image area occupied by vessels, vessels number, mean vessels area and standard deviation of vessels area. Finally, the correlation between morphometric data and the histological classification of epulides was evaluated. RESULTS: The statistic evaluation of morphometric data allowed to classify epulides in six groups characterised by a various degree of vascularisation, these groups showed a good correlation with histopathological classification. CONCLUSIONS: The morphometric analysis of vessels is a powerful aid for the histopathologic diagnosis and for a better knowledge of the etiopathogenetic factors of epulides.

Adolescent↗

Bilateral hairy polyp of the oropharynx.

Hairy polyp of the nasopharynx is an unusual but well-recognized entity, generally presenting as a single mass at birth or in the first year of life. We describe the clinico-pathological features of a previously unreported bilateral hairy polyp in an adult and briefly discuss the pathogenesis of this condition.

Female↗

Intrasinusoidal bone marrow infiltration: a possible hallmark of splenic lymphoma.

A particular type of lymphomatous bone marrow infiltration defined as intrasinusoidal and occurring in seven patients with splenomegaly and mild to moderate thrombocytopenia is reported. Immunocytochemistry highlighted the intrasinusoidal pattern and showed a mature B-cell phenotype. Four patients underwent splenectomy and a diagnosis of splenic marginal cell lymphoma was made. The disease course seems to be chronic and quite indolent. All patients are alive and well; follow-up ranges from 2 to 42 months. The value of bone marrow biopsy as a primary diagnostic tool in splenic marginal zone lymphomas is discussed.

Adult↗

Immunophenotypical comparison of Gaucher's and pseudo-Gaucher cells.

An immunohistochemical study on bone marrow biopsies and spleens of patients with Gaucher's disease and chronic myeloid leukemia was performed to investigate the immunophenotype of Gaucher's cells and pseudo-Gaucher cells. A panel of antibodies was used which were reactive on paraffin-embedded tissues and directed against different hematopoietic lineage cells. Gaucher's cells and pseudo-Gaucher cells expressed a very similar immunophenotype and displayed an intense reaction for the monocytic antibodies tested, thus confirming their common origin and that they belong to the same system. The expression of HLA-DR antigens was much stronger in Gaucher's than in pseudo-Gaucher cells. This last finding, together with other serological data, suggests that Gaucher's cells could not behave simply as phagocytic cells but might play an active role in the chronic stimulation of the immune system that sometimes occurs in patients with Gaucher's disease.

Adult↗

The double patella syndrome.

First described by A. Trillat, the double patella is an uncommon clinical feature following repetitive injuries of the extensor mechanism of the knee. The first injury is a tendo-periosteal avulsion of the suprapatellar or, less frequently, infrapatellar tendon from the corresponding patellar pole. Often these avulsions are misdiagnosed and therefore treated only with a cast or no immobilization at all. Subsequent giving-way episodes lead to extensive ossification which is adjacent to or separated from the patella. The peculiar shape of this ossification overriding or underlying the primary kneecap justifies the denomination of double patella. Surgical treatment consists of removal of the calcification and reattachment of the tendon to the patella by transosseous sutures.

Adolescent↗

Giant cell tumor of the ovary. Immunohistochemical evidence of origin from stromal ovarian cells.

Giant cell tumor (GCT) of the ovary is a rare condition, found almost invariably in the context of a mucinous tumor and presenting a microscopic picture indistinguishable from GCT of bone. We describe a case of GCT in the wall of a serous cyst of the ovary. An immunohistochemical study was performed using a panel of antibodies to epithelial, mesenchymal and leukocyte antigens. Mononuclear and giant tumor cells were positive for vimentin; CD 68 and LCA were found only in giant cells whereas actin was only found in mononuclear tumor cells. The immunophenotypic profile of the stromal cells of the residual ovary was identical to that of mononuclear tumor cells. The presented data suggest that GCT of the ovary is probably a non-neoplastic lesion of the mesenchymal stromal cells that react against substances of the associated tumor or cyst.

Actins↗

[Immunophenotyping of early-phase chronic myeloid leukemia and leukemoid reaction].

Early chronic myeloid leukemia (CML) and leukemoid reaction (LR) sometimes show similar histological pictures. In order to assess the efficacy of immunohistochemistry in the discrimination of the two forms, twenty bone marrow (BM) trephines of patient with CML and twenty with LR were immunostained and studied. A wide spectrum of antibodies effective on paraffin-embedded tissues (NP 57 anti-neutrophil elastase, Leu M1, MAC 387, KP1, Y2/51, LCA, UCHL1, L26, BerH2 and Glycophorin A) and directed against granulopoietic, erythropoietic, megakaryocytic, monocytic and lymphoid cells was tested by means of the alkaline phosphatase anti-alkaline phosphatase (APAAP) method. Expression of neutrophil elastase in CML and LR showed a different pattern of reactivity in normal and neoplastic granulocytic cells and Y2/51 put in evidence significant discrepancies of megakaryocytes in the two groups. Moreover, a greater number of histiocytic, lymphoid and erythropoietic cells were detected in LR after immunostaining with KP1, LCA, UCHL1, L26 and Glycophorin A. The different immunophenotypical pictures observed, suggest the value of immunohistochemistry as a supplementary diagnostic tool for the differential diagnosis between early CML and LR.

Adult↗