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V Poletti

Publications and source records attributed to V Poletti.

67 records · Page 4Linked to original sources

Transbronchial lung biopsy in infiltrative lung disease. The importance of the pathologic approach.

Infiltrative diffuse lung diseases represent a heterogenous group of lesions with overlapping clinical and roentgenological features. Their diagnosis frequently needs a pathologic approach. We report our experience (671 patients with lung infiltrates) with transbronchial lung biopsy (TBB) procedure. The results of morphologic investigation were subdivided into three groups: 1) A specific morphologic diagnosis was made in 192 cases (29%) 2) Histopathologic changes well consistent with the clinical pattern were present in 258 patients (38%) 3) Non-specific lesions were found in 221 cases (33%). The diagnosis yield of the method was of 67%. UIP, DIP, Pulmonary Angiitis and Granulomatosis, Bronchiolitis Obliterans-Organizing Pneumonia and other rarer lung diseases may not be diagnosed on the basis of lesions present in TBB specimens.

Biopsy↗

Transbronchial lung biopsy in pulmonary sarcoidosis. Is it an evaluable method in detection of disease activity?

To assess the value of transbronchial lung biopsy in the evaluation of disease activity in pulmonary sarcoidosis, lung biopsy specimens obtained from 37 patients with this disease and their cellular patterns of bronchoalveolar lavage were studied. Morphologic analysis has showed peculiar lesions: predominant interstitial alveolitis consisting of mononuclear cells and scattered neutrophils, and eosinophils, diffuse in 13 cases and focal in 11 cases, interstitial nodular clusterings of mononuclear cells (five cases), diffuse intraalveolar infiltration of macrophages (one case), granulomas (27 cases), hyaline membranes (one case), intraalveolar (two cases) and interstitial (six cases) fibrosis, and finally cuboidal metaplasia of alveolar lining cells (eight cases). Hyaline membranes were always combined to a diffuse alveolitis consisting of some neutrophils. Only diffuse alveolitis was significantly associated with a high lymphocytosis in BAL (p less than 0.05).

Adult↗

A cerebral ependymoma with extracranial metastases.

A case is presented of a 30-year-old woman with a malignant ependymoma with extracranial metastases involving the cervical lymph nodes. The positive reaction to antibody against glial fibrillary acidic protein confirmed the ependymoma origin of the lymph node metastases.

Adult↗

Ependymoma of the foramen of Monro: ultrastructural characterization.

The characteristics of clear cells of an ependymoma of the foramen of Monro have been studied by electron microscopy to precisely define its organellar composition and to establish the tumor histogenesis. Our data confirm that the once-thought oligodendroglial is, in fact, an ependymal tumor. Both the scarce number of organelles, owing to the low degree of differentiation, and the abundance of hyaloplasmic lipid vacuoles can account for the clear appearance of these tumor cells.

Adult↗

[Endobronchial administration of netilmicin in patients with bronchopulmonary infections seen in the neurosurgical intensive care unit].

The Authors report the results obtained in the treatment of bronchopulmonary infections in patients hospitalized in the Neurosurgical Intensive Care Unit. Netilmicin was administered by systemic and endobronchial routes. The cleaning of the bronchial tree was always performed. Twenty-six patients (16 males and 10 females) were enrolled and assigned to one of the following groups. Group A: 16 patients with confirmed pneumonia; Group B: 10 patients without bronchopulmonary infections, as controls for serum pharmacokinetic study. In the majority of the cases pneumonia was caused by Staphylococcus aureus and Pseudomonas aeruginosa. The results obtained were positive: pneumonia resolution was observed in 10 patients (67%), improvement in 4 (27%) and failure in one case (6%). A pharmacokinetic study has confirmed bacteriologically active serum levels of netilmicin and also the availability of netilmicin within the bronchial secretions. Endobronchial plus systemic netilmicin administration was active and well tolerated in these critical patients.

Bronchi↗

Bronchoalveolar lavage in the diagnosis of disseminated lung tumors.

We report our experience with bronchoalveolar lavage (BAL) and its value in the diagnosis of malignant lung infiltrates. A total of 162 patients with biopsy- or autopsy-proven cancer had an analysis of BAL fluid performed. Cytologic examination showed malignant cells in 123 (76%) patients. The diagnostic accuracy varied depending on the neoplastic nature and growth pattern of the disease. BAL disclosed cancer cells in 93% of 44 bronchioloalveolar carcinomas. Carcinomatous lymphangitis due to metastatic cancer was diagnosed in 83% of 69 cases. Hematogenous metastases (with sharply circumscribed nodules on chest radiography) were diagnosed in 45% of 22 such cases. We recognized 67% of 15 non-Hodgkin's lymphomas and 3 of 9 cases of Hodgkin's disease with pulmonary involvement. Immunocytochemistry using monoclonal and/or polyclonal antibodies was of value in the identification and classification of cells in non-Hodgkin's lymphoma.

Adenocarcinoma, Bronchiolo-Alveolar↗