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Righi A, Faustini-Fustini M, Morandi L, Monti V, Asioli S, Mazzatenta D, Bacci A, Foschini MP. The changing faces of corticotroph cell adenomas: the role of prohormone convertase 1/3. Endocrine 2017; 56:286-297. [PMID: 27491554 DOI: 10.1007/s12020-016-1028-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 06/18/2016] [Indexed: 10/21/2022]
Abstract
The spectrum of corticotroph cell adenomas is very wide. Though rarely, silent corticotroph cell adenomas (SCA) may transform into corticotroph cell adenomas associated with Cushing's disease (CD). The aim of the study was to investigate the role of prohormone convertase 1/3 (PC1/3) in the transformation of SCA into CD. We reviewed the records of 1259 consecutive endoscopic endonasal procedures for pituitary adenomas from 1998 to 2013. Of these, 132 were CD and 44 were SCA. During the follow-up, three patients with SCA showed a clear transformation from SCA into CD and underwent surgery once again to remove the recurrent tumour. The PC1/3 expression was analysed by both immunohistochemistry and quantitative real time-polymerase chain reaction (qRT-PCR) in primary and recurrent tumours. The immunohistochemical PC1/3 expression was negative or weak in the three patients in the initial phase of SCA, while a strong expression was observed in the majority of neoplastic cells in tissue specimens obtained from the same three patients at the time of recurrence as CD. The immunohistochemical PC1/3 expression showed a strict correlation with the PC1/3 levels obtained by qRT-PCR. In 14 cases of SCA with no change of phenotype during the follow-up, the immunohistochemical PC1/3 expression was low and strictly associated with the level of PC1/3 obtained by qRT-PCR both in primary (14/14 cases) and in recurrent tumours (4/4 cases). Our study provides insight into the crucial role of the PC1/3 protein in the transformation of phenotype from SCA to CD.
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Affiliation(s)
- Alberto Righi
- Department of Pathology, Rizzoli Institute, Bologna, Italy
| | - Marco Faustini-Fustini
- IRCCS Institute of Neurological Sciences of Bologna (ISNB), Bellaria Hospital, Via Altura, 3, Bologna, 40139, Italy.
| | - Luca Morandi
- Department of Biomedical and Neuro-Muscular Sciences, Section of Anatomic Pathology 'M.Malpighi' at Bellaria Hospital, University of Bologna, Bologna, Italy
| | - Valentina Monti
- Department of Biomedical and Neuro-Muscular Sciences, Section of Anatomic Pathology 'M.Malpighi' at Bellaria Hospital, University of Bologna, Bologna, Italy
| | - Sofia Asioli
- Department of Biomedical and Neuro-Muscular Sciences, Section of Anatomic Pathology 'M.Malpighi' at Bellaria Hospital, University of Bologna, Bologna, Italy
| | - Diego Mazzatenta
- Department of Neurosurgery, Center of Pituitary Tumors and Endoscopic Skull Base Surgery, IRCCS Institute of Neurological Sciences of Bologna (ISNB), Bellaria Hospital, Bologna, Italy
| | - Antonella Bacci
- Department of Neuroradiology, IRCCS Institute of Neurological Sciences of Bologna (ISNB), Bologna, Italy
| | - Maria Pia Foschini
- Department of Biomedical and Neuro-Muscular Sciences, Section of Anatomic Pathology 'M.Malpighi' at Bellaria Hospital, University of Bologna, Bologna, Italy
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Brandes AA, Franceschi E, Paccapelo A, Tallini G, De Biase D, Ghimenton C, Danieli D, Zunarelli E, Lanza G, Silini EM, Sturiale C, Volpin L, Servadei F, Talacchi A, Fioravanti A, Pia Foschini M, Bartolini S, Pession A, Ermani M. Role of MGMT Methylation Status at Time of Diagnosis and Recurrence for Patients with Glioblastoma: Clinical Implications. Oncologist 2017; 22:432-437. [PMID: 28275120 PMCID: PMC5388380 DOI: 10.1634/theoncologist.2016-0254] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 11/11/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND MGMT methylation status represents a powerful prognostic factor in newly diagnosed glioblastoma (GBM). Recently, its role in recurrent tumors has also been suggested; however, few data investigating the stability of this biomarker during the clinical course of the disease are available. In this study, we evaluated the rate of change of MGMT methylation status between diagnosis and first recurrence in patients who received tumor resection for recurrent GBM. METHODS We included patients who received temozolomide concurrent with and adjuvant to radiotherapy after diagnosis of GBM and had a second surgery performed at least 3 months after radiotherapy completion. Other eligibility criteria were age ≥18 years and Eastern Cooperative Oncology Group performance status 0-2. We evaluated the MGMT methylation status by methylation-specific polymerase chain reaction. RESULTS From our institutional data warehouse, 295 patients with recurrent GBM who underwent second surgery were evaluated. MGMT methylation status at both first and second surgery was available for 108 patients. MGMT was methylated in both surgeries in 38 patients (35.2%), while it was unmethylated in 43 patients (39.8%). We found a significant concordance between the first and the second MGMT methylation assessments (K = 0.500, p < .001), MGMT methylation being stable in 75% of the cases. CONCLUSION MGMT methylation presents relative stability during the clinical course of GBM. The Oncologist 2017;22:432-437 IMPLICATIONS FOR PRACTICE: MGMT methylation is a prognostic factor in newly diagnosed glioblastoma. In this study, we evaluated the rate of change of MGMT methylation during the clinical course of the disease, and we found a significant concordance between the first and the second MGMT methylation assessments, with MGMT methylation being stable in 75% of the cases. Thus, re-testing this biomarker at recurrence does not provide further information for clinicians. MGMT methylation at first surgery, extent of resection at second surgery, and time between first and second surgery are significantly correlated with overall survival. Age and extent of resection are correlated with post-progression survival.
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Affiliation(s)
| | | | | | - Giovanni Tallini
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Section of Pathology, M. Malpighi, Bellaria Hospital, Bologna, Italy
| | - Dario De Biase
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Section of Pathology, M. Malpighi, Bellaria Hospital, Bologna, Italy
| | | | | | | | - Giovanni Lanza
- Department of Pathology, S. Anna University Hospital and University of Ferrara, Ferrara, Italy
| | | | - Carmelo Sturiale
- Neurosurgery Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Lorenzo Volpin
- Neuroscience and Neurosurgery, San Bortolo Hospital, Vicenza, Italy
| | | | - Andrea Talacchi
- Section of Neurosurgery, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, University Hospital, Verona, Italy
| | - Antonio Fioravanti
- Neurosurgery Bellaria Hospital, Azienda USL - IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Maria Pia Foschini
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Section of Pathology, M. Malpighi, Bellaria Hospital, Bologna, Italy
| | | | - Annalisa Pession
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Section of Pathology, M. Malpighi, Bellaria Hospital, Bologna, Italy
| | - Mario Ermani
- Department of Neurosciences, Statistic and Informatic Unit, Azienda Ospedale-Università, Padova, Italy
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Pavolucci L, Giannini G, Giannoccaro MP, Foschini MP, Lang B, Avoni P, Tinuper P, Vincent A, Liguori R. Paraneoplastic cerebellar degeneration and lambert-eaton myasthenia in a patient with merkel cell carcinoma and voltage-gated calcium channel antibodies. Muscle Nerve 2017; 56:998-1000. [PMID: 28006860 DOI: 10.1002/mus.25530] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2016] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Merkel cell carcinoma is a rare cutaneous, aggressive tumor. Although it shares many neuroendocrine features with small cell lung carcinoma, it has only occasionally been reported with paraneoplastic neurological syndromes. METHODS A healthy 67-year-old man developed acute ataxia, vertigo, and nausea. Subsequently he also developed dysarthria, diplopia, xerostomia, fatigability and progressive anorexia. He underwent a full diagnostic workup and was found to have a high titer of voltage-gated calcium channel antibodies in serum and cerebrospinal fluid, neurophysiological findings compatible with Lambert-Eaton myasthenia and neurological signs compatible with cerebellar degeneration. RESULTS A positron emission tomography study revealed a hypermetabolic lesion in the axilla, subsequently biopsied and consistent with Merkel cell carcinoma. CONCLUSIONS In most previous reports, neurological symptoms preceded the Merkel cell carcinoma diagnosis, and the primary localization was in lymph nodes. This tumor should be considered in patients with paraneoplastic syndrome, and particularly Lambert-Eaton myasthenia after exclusion of small cell lung carcinoma. Muscle Nerve 56: 998-1000, 2017.
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Affiliation(s)
- Lucia Pavolucci
- Department of Biomedical and Neuromotor Sciences (DiBiNeM), University of Bologna, Via Altura 3, 40139, Bologna, Italy
| | - Giulia Giannini
- Department of Biomedical and Neuromotor Sciences (DiBiNeM), University of Bologna, Via Altura 3, 40139, Bologna, Italy
| | - Maria Pia Giannoccaro
- Department of Biomedical and Neuromotor Sciences (DiBiNeM), University of Bologna, Via Altura 3, 40139, Bologna, Italy.,Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Maria Pia Foschini
- Department of Biomedical and Neuromotor Sciences (DiBiNeM), University of Bologna, Via Altura 3, 40139, Bologna, Italy
| | - Bethan Lang
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Patrizia Avoni
- Department of Biomedical and Neuromotor Sciences (DiBiNeM), University of Bologna, Via Altura 3, 40139, Bologna, Italy.,IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Paolo Tinuper
- Department of Biomedical and Neuromotor Sciences (DiBiNeM), University of Bologna, Via Altura 3, 40139, Bologna, Italy.,IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Angela Vincent
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Rocco Liguori
- Department of Biomedical and Neuromotor Sciences (DiBiNeM), University of Bologna, Via Altura 3, 40139, Bologna, Italy.,IRCCS Institute of Neurological Sciences, Bologna, Italy
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Tarsitano A, Asioli S, Morandi L, Monti V, Righi A, Morselli Labate AM, Nardi E, Foschini MP, Marchetti C. Laminin-5 and insulin-like growth factor-II mRNA binding protein-3 (IMP3) expression in preoperative biopsy specimens from oral cancer patients: Their role in neural spread risk and survival stratification. J Craniomaxillofac Surg 2016; 44:1896-1902. [PMID: 27863864 DOI: 10.1016/j.jcms.2016.07.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 06/08/2016] [Accepted: 07/13/2016] [Indexed: 11/29/2022] Open
Abstract
Perineural invasion (PNI) hinders the ability to establish local control of oral squamous cell carcinoma (OSCC). To date, PNI can be evaluated only in surgical specimens and not in preoperative biopsy material, rendering timely therapeutic planning impossible. Insulin-like growth factor-II mRNA binding protein-3 (IMP3) expression appears to be of diagnostic and prognostic utility for many solid tumours, and laminin-5 expression in surgical specimens has been identified as a valid predictor of neural spread of head-and-neck neoplasms. The ability to use preoperative biopsy material to identify patients exhibiting PNI is fundamental for good management of OSCC. We examined a series of 64 consecutive patients treated (primarily via surgery) for OSCC between 2009 and 2014 at the Maxillofacial Surgery Unit, University of Bologna. We evaluated IMP3 and laminin-5 expression in preoperative biopsy material using immunohistochemistry and quantitative reverse transcription polymerase chain reaction. We sought to correlate expression of IMP3 and laminin-5 with PNI evident in surgical specimens. Expression of IMP3 and laminin-5 in preoperative biopsy material appeared to be predictive of PNI in patients with OSCC (P < 0.001). Additionally, the results of multivariate analyses showed that IMP3 status was an independent predictor of death of patients with OSCC (P = 0.001). The present study demonstrates that IMP3 and laminin-5 expression in preoperative biopsy material correlate well with PNI status and may allow accurate preoperative risk stratification of patients with OSCC.
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Affiliation(s)
- Achille Tarsitano
- Department of Biomedical and Neuromotor Sciences, Section of Maxillofacial Surgery, University of Bologna, Policlinico S. Orsola, Bologna, Italy.
| | - Sofia Asioli
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology, University of Bologna, Bellaria Hospital, Bologna, Italy
| | - Luca Morandi
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology, University of Bologna, Bellaria Hospital, Bologna, Italy
| | - Valentina Monti
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology, University of Bologna, Bellaria Hospital, Bologna, Italy
| | - Alberto Righi
- Unit of Anatomic Pathology, Istituto Ortopedico Rizzoli, Bologna, Italy
| | | | - Elena Nardi
- Laboratory of Biostatistics, Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Maria Pia Foschini
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology, University of Bologna, Bellaria Hospital, Bologna, Italy
| | - Claudio Marchetti
- Department of Biomedical and Neuromotor Sciences, Section of Maxillofacial Surgery, University of Bologna, Policlinico S. Orsola, Bologna, Italy
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55
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Gissi DB, Gabusi A, Tarsitano A, Badiali G, Marchetti C, Morandi L, Foschini MP, Montebugnoli L. Ki67 Overexpression in mucosa distant from oral carcinoma: A poor prognostic factor in patients with long-term follow-up. J Craniomaxillofac Surg 2016; 44:1430-5. [DOI: 10.1016/j.jcms.2016.06.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/19/2016] [Accepted: 06/13/2016] [Indexed: 10/21/2022] Open
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Zannoni GF, Ciucci A, Marucci G, Travaglia D, Stigliano E, Foschini MP, Scambia G, Gallo D. Sexual dimorphism in medulloblastoma features. Histopathology 2015; 68:541-8. [DOI: 10.1111/his.12770] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 06/27/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Gian Franco Zannoni
- Department of Histopathology; Catholic University of the Sacred Heart; Rome Italy
| | - Alessandra Ciucci
- Department of Female, Maternal, Newborn, Child and Adolescent Health; Catholic University of the Sacred Heart; Rome Italy
| | - Gianluca Marucci
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM); Section of Pathology ‘M. Malpighi’; Bellaria Hospital; University of Bologna; Bologna Italy
| | - Daniele Travaglia
- Department of Female, Maternal, Newborn, Child and Adolescent Health; Catholic University of the Sacred Heart; Rome Italy
| | - Egidio Stigliano
- Department of Histopathology; Catholic University of the Sacred Heart; Rome Italy
| | - Maria Pia Foschini
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM); Section of Pathology ‘M. Malpighi’; Bellaria Hospital; University of Bologna; Bologna Italy
| | - Giovanni Scambia
- Department of Female, Maternal, Newborn, Child and Adolescent Health; Catholic University of the Sacred Heart; Rome Italy
| | - Daniela Gallo
- Department of Female, Maternal, Newborn, Child and Adolescent Health; Catholic University of the Sacred Heart; Rome Italy
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Gizzi G, Foschini MP, Fabbri C, Fuccio L. A 52-year-old man with heartburn and weight loss. Gut 2015; 64:1267, 1288. [PMID: 25573417 DOI: 10.1136/gutjnl-2014-308938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 12/22/2014] [Indexed: 12/08/2022]
Affiliation(s)
| | - Maria Pia Foschini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Anatomic Pathology at Bellaria Hospital, Bologna, Italy
| | - Carlo Fabbri
- Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy
| | - Lorenzo Fuccio
- Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
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Del Corso G, Gissi DB, Tarsitano A, Costabile E, Marchetti C, Montebugnoli L, Foschini MP. Laser evaporation versus laser excision of oral leukoplakia: A retrospective study with long-term follow-up. J Craniomaxillofac Surg 2015; 43:763-8. [DOI: 10.1016/j.jcms.2015.04.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 04/08/2015] [Accepted: 04/08/2015] [Indexed: 01/10/2023] Open
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Farnedi A, Rossi S, Bertani N, Gulli M, Silini EM, Mucignat MT, Poli T, Sesenna E, Lanfranco D, Montebugnoli L, Leonardi E, Marchetti C, Cocchi R, Ambrosini-Spaltro A, Foschini MP, Perris R. Proteoglycan-based diversification of disease outcome in head and neck cancer patients identifies NG2/CSPG4 and syndecan-2 as unique relapse and overall survival predicting factors. BMC Cancer 2015; 15:352. [PMID: 25935541 PMCID: PMC4429505 DOI: 10.1186/s12885-015-1336-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 04/22/2015] [Indexed: 01/07/2023] Open
Abstract
Background Tumour relapse is recognized to be the prime fatal burden in patients affected by head and neck squamous cell carcinoma (HNSCC), but no discrete molecular trait has yet been identified to make reliable early predictions of tumour recurrence. Expression of cell surface proteoglycans (PGs) is frequently altered in carcinomas and several of them are gradually emerging as key prognostic factors. Methods A PG expression analysis at both mRNA and protein level, was pursued on primary lesions derived from 173 HNSCC patients from whom full clinical history and 2 years post-surgical follow-up was accessible. Gene and protein expression data were correlated with clinical traits and previously proposed tumour relapse markers to stratify high-risk patient subgroups. Results HNSCC lesions were indeed found to exhibit a widely aberrant PG expression pattern characterized by a variable expression of all PGs and a characteristic de novo transcription/translation of GPC2, GPC5 and NG2/CSPG4 respectively in 36%, 72% and 71% on 119 cases. Importantly, expression of NG2/CSPG4, on neoplastic cells and in the intralesional stroma (Hazard Ratio [HR], 6.76, p = 0.017) was strongly associated with loco-regional relapse, whereas stromal enrichment of SDC2 (HR, 7.652, p = 0.007) was independently tied to lymphnodal infiltration and disease-related death. Conversely, down-regulated SDC1 transcript (HR, 0.232, p = 0.013) uniquely correlated with formation of distant metastases. Altered expression of PGs significantly correlated with the above disease outcomes when either considered alone or in association with well-established predictors of poor prognosis (i.e. T classification, previous occurrence of precancerous lesions and lymphnodal metastasis). Combined alteration of all three PGs was found to be a reliable predictor of shorter survival. Conclusions An unprecedented PG-based prognostic portrait is unveiled that incisively diversifies disease course in HNSCC patients beyond the currently known clinical and molecular biomarkers. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1336-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Farnedi
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology, University of Bologna, Bellaria Hospital, Bologna, Italy.
| | - Silvia Rossi
- COMT - Centre for Molecular Translational Oncology & Department of Life Sciences, University of Parma, Parma, Italy.
| | - Nicoletta Bertani
- COMT - Centre for Molecular Translational Oncology & Department of Life Sciences, University of Parma, Parma, Italy.
| | - Mariolina Gulli
- Department of Life Sciences, Division of Genetics and Environmental Biotechnology, University of Parma, Parma, Italy.
| | - Enrico Maria Silini
- COMT - Centre for Molecular Translational Oncology & Department of Life Sciences, University of Parma, Parma, Italy. .,Department of Pathology and Laboratory Medicine, University of Parma, Parma, Italy.
| | - Maria Teresa Mucignat
- S.O.C. of Experimental Oncology 2, The National Tumour Institute Aviano - CRO-IRCCS, Aviano, Pordenone, Italy.
| | - Tito Poli
- Maxillofacial Surgery Section, Head and Neck Department, University of Parma, Parma, Italy.
| | - Enrico Sesenna
- Maxillofacial Surgery Section, Head and Neck Department, University of Parma, Parma, Italy.
| | - Davide Lanfranco
- Maxillofacial Surgery Section, Head and Neck Department, University of Parma, Parma, Italy.
| | - Lucio Montebugnoli
- Unit of Maxillo-Facial Surgery, Department of Oral Sciences, University of Bologna, Bellaria Hospital, Bologna, Italy.
| | - Elisa Leonardi
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology, University of Bologna, Bellaria Hospital, Bologna, Italy.
| | - Claudio Marchetti
- Department of Biomedical and Neuromotor Sciences, Unit of Maxillo-Facial Surgery, University of Bologna, S. Orsola Hospital, Bologna, Italy.
| | - Renato Cocchi
- Unit of Maxillo-facial Surgery at Bellaria Hospital, Bologna, Italy. .,Unit of Maxillo-facial Surgery, "Casa Sollievo della Sofferenza", San Giovanni in Rotondo, Italy.
| | - Andrea Ambrosini-Spaltro
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology, University of Bologna, Bellaria Hospital, Bologna, Italy.
| | - Maria Pia Foschini
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology, University of Bologna, Bellaria Hospital, Bologna, Italy.
| | - Roberto Perris
- COMT - Centre for Molecular Translational Oncology & Department of Life Sciences, University of Parma, Parma, Italy. .,S.O.C. of Experimental Oncology 2, The National Tumour Institute Aviano - CRO-IRCCS, Aviano, Pordenone, Italy.
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Sambugaro S, Di Ruvo M, Ambrosio MR, Pellegata NS, Bellio M, Guerra A, Buratto M, Foschini MP, Tagliati F, degli Uberti E, Zatelli MC. Early onset acromegaly associated with a novel deletion in CDKN1B 5'UTR region. Endocrine 2015; 49:58-64. [PMID: 25645465 DOI: 10.1007/s12020-015-0540-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 01/23/2015] [Indexed: 10/24/2022]
Abstract
Genetic alterations frequently are involved in the development of a pituitary adenoma in young age. We here characterize the functional role of a deletion in CDKN1B 5'-UTR region (c.-29_-26delAGAG) identified in an acromegalic patient that developed a growth hormone in pituitary adenoma during childhood. Our results show that the identified novel heterozygous deletion in the CDKN1B 5'-UTR region associates with a reduction in CDKN1B mRNA levels, a predicted altered secondary mRNA structure, and a reduced CDKN1B 5'-UTR transcriptional activity in vitro. The patient displayed loss of heterozygosity in the same CDKN1B 5'-UTR region at tissue level and the 5'UTR region containing the deleted sequence encompasses a GRE. These findings indicate that the identification of functional alterations of newly discovered genetic derangements need to be fully characterized and always correlated with the clinical manifestations.
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Affiliation(s)
- Silvia Sambugaro
- Section of Endocrinology and Internal Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
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Marucci G, Fabbri PV, Morandi L, De Biase D, Di Oto E, Tallini G, Sturiale C, Franceschi E, Frezza GP, Foschini MP. Pathological spectrum in recurrences of glioblastoma multiforme. Pathologica 2015; 107:1-8. [PMID: 26591624 DOI: pmid/26591624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Glioblastoma (GBM) is the most frequent primary malignant brain tumour. Despite advances in treatment its prognosis remains poor. Histological features of GBM are well known. On the contrary histological description of recurrences is still not available. The aim of this study was to describe the morphological, immunohistochemical and molecular features of recurrent GBMs. METHODS 25 recurrent GBMs, diagnosed after 2005, were collected. All patients had undergone an adjuvant treatment regimen (temozolomide and/or radiotherapy). All cases were immunostained using anti-GFAP, Olig2 and Nogo-A antisera. MGMT and IDH1 status was reassessed. Features of the recurrences were compared with those of primary GBMs, time of recurrence and survival. RESULTS Recurrences were divided morphologically into three groups: 1) recurrences displaying the same features of primary GBM, were highly cellular, had the fastest progression and the worst prognosis; 2) recurrences changing dramatically morphological appearance, had a slightly longer survival, 3) poorly cellular recurrences, with sparse neoplastic cells intermingled with reactive and necrotic tissue, displayed the slowest progression and longer survival. MGMT and IDH1 status remained unchanged between primary tumours and recurrences. DISCUSSION GBM histological subtypes display different reactions to adjuvant treatments, offering a possible role in predicting different recurrence and survival time.
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Morandi L, Tarsitano A, Gissi D, Leonardi E, Balbi T, Marchetti C, Montebugnoli L, Foschini MP. Clonality analysis in primary oral squamous cell carcinoma and related lymph-node metastasis revealed by TP53 and mitochondrial DNA next generation sequencing analysis. J Craniomaxillofac Surg 2014; 43:208-13. [PMID: 25530302 DOI: 10.1016/j.jcms.2014.11.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Revised: 10/13/2014] [Accepted: 11/12/2014] [Indexed: 12/23/2022] Open
Abstract
The chance of developing a neck nodal metastasis after initial treatment of oral squamous cell carcinoma varies from 12.4% to 62%. Despite being the main reason for cancer-related mortality, nodal metastases are still rarely subjected to molecular analyses, and our knowledge of the clonal heterogeneity of multiple lesions within the same patient is limited. The aim of the present study was to evaluate the relationship between primary oral cancer and lymph node metastasis in a series of patients with synchronous and metachronous metastases by 2 clonality tests: mt-DNA and TP53 sequence analysis. The study population consisted of 10 consecutive patients. Data identified in this study demonstrate that our assay based on next-generation analysis of TP53 and mt-DNA is simple, is reliable, allows high throughput, and may be applied to retrospective cases. The combination of mt-DNA and TP53 data analysis helped us to evaluate more precisely and consistently the genetic relationship among different tumor clones.
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Affiliation(s)
- Luca Morandi
- Department of Biomedical and Neuro-motor Sciences, Section of Anatomic Pathology "M. Malpighi" at Bellaria Hospital, University of Bologna, Bologna, Italy
| | - Achille Tarsitano
- Department of Biomedical and Neuro-motor Sciences, Unit of Maxillofacial Surgery, S. Orsola Hospital, University of Bologna, Bologna, Italy.
| | - Davide Gissi
- Department of Biomedical and Neuro-motor Sciences, Unit of Maxillofacial Surgery, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Elisa Leonardi
- Department of Biomedical and Neuro-motor Sciences, Section of Anatomic Pathology "M. Malpighi" at Bellaria Hospital, University of Bologna, Bologna, Italy
| | - Tiziana Balbi
- Unit of Anatomic Pathology, S. Orsola Hospital, Bologna, Italy
| | - Claudio Marchetti
- Department of Biomedical and Neuro-motor Sciences, Unit of Maxillofacial Surgery, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Lucio Montebugnoli
- Department of Biomedical and Neuro-motor Sciences, Unit of Maxillofacial Surgery, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | - Maria Pia Foschini
- Department of Biomedical and Neuro-motor Sciences, Section of Anatomic Pathology "M. Malpighi" at Bellaria Hospital, University of Bologna, Bologna, Italy
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Del Corso G, Righi A, Bombardi M, Rossi B, Dallera V, Pelliccioni GA, Marchetti C, Foschini MP. Jaw cysts diagnosed in an Italian population over a 20-year period. Int J Surg Pathol 2014; 22:699-706. [PMID: 25015670 DOI: 10.1177/1066896914541000] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cysts of the jaws (JCs) are an important topic of oral pathology, but few epidemiological data are present in the literature, in particular about the potential of recurrence. The aim of this study was to describe a case series of JCs from a single institution, evaluating the frequency, the site, the age distribution, and the percentage of recurrence of all types of JCs. METHODS All JCs present in the histological records of the Section of Anatomic Pathology of the University of Bologna at Bellaria Hospital from 1992 to 2012 were retrieved. RESULTS A total of 1136 jaws cysts were obtained, of which 1117 (98.3%) were odontogenic and 19 (1.7%) were nonodontogenic. About odontogenic cysts (OCs), the most frequent was the radicular cyst (538 cases), followed by parakeratinized keratocystic odontogenic tumor (pKOT, 193 cases) and dentigerous cyst (120 cases). Among pKOT, 21 out of 193 cases (10.89%) showed a recurrence after a mean time of 4.5 years (range, 1-12 years). During follow-up (mean 11 years, range 1-19 years), all 3 cases of botrioid cysts, 12 out of 46 cases of unicystic ameloblastoma (26.09%), 2 out of 20 cases of calcifying OCs (10%) and 2 out of 538 cases of radicular cyst (0.37%) showed a recurrence. CONCLUSION Our study confirms that the distribution pattern of JCs in Italy is relatively similar to other studies worldwide and emphasizes the importance of recognizing the different histological types of JCs for their potential local aggressive behavior.
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Affiliation(s)
| | - A Righi
- Rizzoli Hospital, Bologna, Italy
| | - M Bombardi
- Bellaria Hospital, University of Bologna, Bologna, Italy
| | - B Rossi
- Bellaria Hospital, University of Bologna, Bologna, Italy
| | - V Dallera
- Bellaria Hospital, University of Bologna, Bologna, Italy
| | | | - C Marchetti
- Policlinico S. Orsola, University of Bologna, Bologna, Italy
| | - M P Foschini
- Bellaria Hospital, University of Bologna, Bologna, Italy
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Abstract
In the skin and breast, endocrine tumors are composed of a heterogeneous mixture of endocrine and exocrine cells. The definition of "pure" endocrine carcinomas is a matter for debate, and as a consequence, there is lack of uniform diagnostic criteria. There are no significant clinical differences in either overall or disease-free survival between matched neoplasms with endocrine and without endocrine differentiation nor between the degree of endocrine differentiation and tumor size, stage, or prevalence of vascular invasion for both sites (skin and breast). Here, endocrine tumors of the skin and breast are grouped respectively into three categories that include most of the neuroendocrine tumors of the skin and breast as seen in routine practice. It was felt that the number of different types of neuroendocrine tumors is so conspicuous that it is impossible to organize them in an orderly classification. It has been proposed therefore, for practical diagnostic routine purposes, to arrange these neoplasms into a working formulation. The latter includes heterogeneous lesions respectively of the skin and breast within the same group that have clinical features in common.
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Affiliation(s)
- Sofia Asioli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Section of Anatomic Pathology "M. Malpighi," Bellaria Hospital, Bologna, Italy
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65
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Cinocca S, Rosini F, Asioli S, Del Vecchio M, Cucchi MC, Saguatti G, Betts CM, Foschini MP. Cytological features of nipple adenoma in scraping smears. Pathologica 2014; 106:41-44. [PMID: 25291865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Nipple adenoma (NA) is a benign epithelial lesion of the breast that can clinically simulate Paget's disease or invasive ductal carcinoma. Therefore, correct pre-operative diagnosis is important for appropriate management. METHODS Cytological samples may be obtained by different methods such as fine needle aspiration, nipple discharge or nipple scraping. Herein, the cytological features of three cases of NA are described in which samples were derived from nipple scraping. RESULTS In all three cases, patients were adult females presenting with a sub-areolar nodule, showing skin ulceration in 2 of 3 cases. The nipple scraping cytological smears were characterised by a bloody background with epithelial cells arranged in clusters or singularly, showing an irregular nuclei profile. These features could simulate a malignant process. However, at higher magnification, fine nuclear chromatin with inconspicuous nucleoli and presence of myoepithelial cells were helpful to exclude malignancy. DISCUSSION NA may present "worrisome" cytological features on smears derived from nipple scraping. Therefore, knowledge of the cytological spectrum of this lesion is important to avoid misdiagnosis.
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Marucci G, Morandi L, Mazzatenta D, Frank G, Pasquini E, Foschini MP. MGMT promoter methylation status in clival chordoma. J Neurooncol 2014; 118:271-276. [PMID: 24771251 DOI: 10.1007/s11060-014-1445-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 04/13/2014] [Indexed: 01/01/2023]
Abstract
Chordomas are rare, slow-growing neoplasms, characterized by locally aggressive growth patterns and high local recurrence rates. To the best of our knowledge, the MGMT promoter methylation status has not been studied in a population of patients with chordomas to determine if a biologic rationale exists to support the use of temozolomide. We here show for the first time that methylation of MGMT promoter is present in a significant portion or recurring clival chordomas; on the contrary in clival chordomas without recurrence MGMT promoter was always unmethylated (p = 0.0317). Although these observations need to be confirmed in a larger study population, our results (1) indicate that methylation of MGMT promoter is present in a significant portion of recurring chordomas, and (2) prompt further investigation into the potential role of temozolomide as an adjuvant treatment of these tumors.
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Affiliation(s)
- Gianluca Marucci
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Section of Pathology "M. Malpighi", Bellaria Hospital, Via Altura 3, 40139, Bologna, Italy.
| | - Luca Morandi
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Section of Pathology "M. Malpighi", Bellaria Hospital, Via Altura 3, 40139, Bologna, Italy
| | - Diego Mazzatenta
- Center of Surgery of Pituitary Tumors and Endoscopic Skullbase, IRCCS Istituto delle scienze neurologiche, Bologna, Italy
| | - Giorgio Frank
- Center of Surgery of Pituitary Tumors and Endoscopic Skullbase, IRCCS Istituto delle scienze neurologiche, Bologna, Italy
| | - Ernesto Pasquini
- Center of Surgery of Pituitary Tumors and Endoscopic Skullbase, IRCCS Istituto delle scienze neurologiche, Bologna, Italy
| | - Maria Pia Foschini
- Department of Biomedical and NeuroMotor Sciences (DiBiNeM), University of Bologna, Section of Pathology "M. Malpighi", Bellaria Hospital, Via Altura 3, 40139, Bologna, Italy
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Cserni G, Vörös A, Liepniece-Karele I, Bianchi S, Vezzosi V, Grabau D, Sapino A, Castellano I, Regitnig P, Foschini MP, Zolota V, Varga Z, Figueiredo P, Decker T, Focke C, Kulka J, Kaya H, Reiner-Concin A, Amendoeira I, Callagy G, Caffrey E, Wesseling J, Wells C. Distribution pattern of the Ki67 labelling index in breast cancer and its implications for choosing cut-off values. Breast 2014; 23:259-63. [PMID: 24613255 DOI: 10.1016/j.breast.2014.02.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 01/13/2014] [Accepted: 02/14/2014] [Indexed: 01/08/2023] Open
Abstract
The Ki67 labelling index (LI - proportion of staining cells) is widely used to reflect proliferation in breast carcinomas. Several cut-off values have been suggested to distinguish between tumours with low and high proliferative activity. The aim of the current study was to evaluate the distribution of Ki67 LIs in breast carcinomas diagnosed at different institutions by different pathologists using the method reflecting their daily practice. Pathologists using Ki67 were asked to provide data (including the LI, type of the specimen, receptor status, grade) on 100 consecutively stained cases, as well as details of their evaluation. A full dataset of 1709 carcinomas was collected from 19 departments. The median Ki67 LI was 17% for all tumours and 14% for oestrogen receptor-positive and HER2-negative carcinomas. Tumours with higher mitotic counts were associated with higher Ki67 LIs. Ki67 LIs tended to cluster around values ending with 5 or 0 both in cases where the values were obtained by counting the proportion of stained tumour cell nuclei and those where the values were obtained by estimation. On the basis of the distribution pattern described, some currently used Ki67 LI cut off values are not realistic, and it is proposed to select more realistic values ending with 0 or 5.
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Affiliation(s)
- Gábor Cserni
- Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary; Department of Pathology, University of Szeged, Hungary.
| | - András Vörös
- Department of Pathology, University of Szeged, Hungary
| | | | - Simonetta Bianchi
- Section of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, AOU Careggi, Largo GA Brambilla 3, 50134 Florence, Italy
| | - Vania Vezzosi
- Section of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, AOU Careggi, Largo GA Brambilla 3, 50134 Florence, Italy
| | - Dorthe Grabau
- Department of Pathology, Skåne University Hospital, Lund, Sweden
| | - Anna Sapino
- Department of Medical Sciences, University of Turin, Italy
| | | | - Peter Regitnig
- Medical University of Graz, Institute of Pathology, Auenbruggerplatz 25, A-8036 Graz, Austria
| | - Maria Pia Foschini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Anatomic Pathology at Bellaria Hospital, Via Altura, 3, 40139 Bologna, Italy
| | - Vassiliki Zolota
- Department of Pathology, Medical School, University of Patras, Rion, Patras, Greece
| | - Zsuzsanna Varga
- Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Paulo Figueiredo
- Lab Histopatologia, Av Bissaya Barreto, Apartado 2005, 3001-651 Coimbra, Portugal
| | - Thomas Decker
- Department of Pathology, Dietrich Bonhoeffer Medical Centre, Allendestraße 30, D-17036 Neubrandenburg, Germany
| | - Cornelia Focke
- Department of Pathology, Dietrich Bonhoeffer Medical Centre, Allendestraße 30, D-17036 Neubrandenburg, Germany
| | - Janina Kulka
- 2nd Department of Pathology, Semmelweis University Budapest, Üllői út 93, H-1091 Budapest, Hungary
| | - Handan Kaya
- Marmara University School of Medicine, Department of Pathology, Istanbul, Turkey
| | | | - Isabel Amendoeira
- Department of Pathology, Centro Hospitalar de S. João and Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Portugal
| | - Grace Callagy
- Discipline of Pathology, NUI Galway, Galway, Ireland
| | - Emer Caffrey
- Discipline of Pathology, NUI Galway, Galway, Ireland
| | - Jelle Wesseling
- Department of Pathology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands; Department of Molecular Pathology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Clive Wells
- Department of Pathology, University College Hospital, London, United Kingdom
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Tot T, Going J, Foschini MP, Pekar G, Tucker L, Sapino A. E04. Balancing between classic morphology and molecular medicine. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70056-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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69
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Gabba S, Giannini E, Borghi L, Fellegara G, Marcialis C, Grugni M, Foschini MP, Repetti E, Dorji T, Vittadini G, Grazioli V. Evaluation of hTERC (3q26) gain by fluorescence in situ hybridization (FISH) to predict the behavior of oral epithelial precursor lesions. EPMA J 2014. [PMCID: PMC4125941 DOI: 10.1186/1878-5085-5-s1-a57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Tarsitano A, Foschini MP, Farneti P, Pasquini E, Marchetti C. Metastasizing "benign" pleomorphic salivary adenoma: a dramatic case-report and literature review. J Craniomaxillofac Surg 2014; 42:1562-5. [PMID: 24507933 DOI: 10.1016/j.jcms.2014.01.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 09/07/2013] [Accepted: 01/03/2014] [Indexed: 10/25/2022] Open
Abstract
Pleomorphic salivary adenomas are the most common benign neoplasms affecting the salivary glands. Very occasionally however, metastatic lesions are identified in patients with a history of PSA, which, on detailed pathological evaluation, are found to exhibit all the histological hallmarks of the preceding benign lesions. Diagnosis of benign metastasizing pleomorphic adenoma of the salivary gland is extremely rare and still under debate. We present the first case-report in literature of multiple metachronous nasal cavity, scalp and encephalic metastases of a pleomorphic adenoma of the parotid gland in a young girl.
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Affiliation(s)
- Achille Tarsitano
- Maxillofacial Surgery Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Maria Pia Foschini
- Department of Hematology and Oncology, Section of Pathological Anatomy, Bellaria Hospital, University of Bologna, Bologna, Italy
| | - Paolo Farneti
- ENT Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Ernesto Pasquini
- ENT Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Claudio Marchetti
- Maxillofacial Surgery Unit, Alma Mater Studiorum University of Bologna, Bologna, Italy
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71
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Montebugnoli L, Gissi DB, Flamminio F, Gentile L, Dallera V, Leonardi E, Beccarini T, Foschini MP. Clinicopathologic Parameters Related to Recurrence and Locoregional Metastasis in 180 Oral Squamous Cell Carcinomas. Int J Surg Pathol 2013; 22:55-62. [DOI: 10.1177/1066896913511982] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Lymph node metastasis (LNm), local recurrence (LR), and second primary tumor (SPT) after primary surgery for oral squalmous cell carcinoma (OSCC) have been considered poor prognostic entities in terms of survival rate. The purpose of this study was to identify the clinicopathologic parameters significantly related to LNm, LR, and SPT. Records from 180 patients who underwent radical surgery for OSCC were retrospectively reviewed. Perineural invasion was significantly related to LNm (18% vs 8%) and LR (15% vs 5%), while the status of the surgical margin (10% in case of clear margins, 18% close margins, and 24% involved margins), namely epithelial precursor lesions (43%) was an independent factor influencing SPT. Perineural invasion proved a good prognostic factor for early events, either LNm or LR, while a surgical margin width less than 5 mm or with epithelial precursor lesions may be considered a risk factor for late events such as SPT.
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Affiliation(s)
| | | | | | | | | | - Elisa Leonardi
- University of Bologna, Bologna, Italy
- Bellaria Hospital, Bologna, Italy
| | - Tommaso Beccarini
- University of Bologna, Bologna, Italy
- Bellaria Hospital, Bologna, Italy
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72
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D'Andrea M, Reggiani C, Fasano D, Betts CM, Montanari F, Lanzoni A, Reggiani M, Foschini MP. Tumours of the skin adnexa: a case series with focus on multiple segmental forms. Pathologica 2013; 105:337-341. [PMID: 24730337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE Skin adnexal tumours (SAT) as a whole are rare tumours, and most of our current knowledge on SAT is from single case reports or small series focused on single histotypes. The purpose of this paper is to review a series of benign and malignant SAT diagnosed in a 20-year period. METHODS All consecutive cases of SAT diagnosed between January 1992 and Dicember 2011 were retrieved. All slides were reviewed and diagnosed according to currently accepted criteria. RESULTS 281 consecutive cases of SAT were found. The majority of cases (94.3%) were benign, the most frequent histotypes were eccrine spiradenoma, hidrocystoma, eccrine poroma, syringoma, sebaceous adenoma and trichofolliculoma. Benign SAT affected adult males more frequently (M/F = 153/112) (mean age 59 years). Recurrences were rare (2/265). Three cases of multiple segmental spiroadenoma were observed. Malignant SAT consituted only 5.7% of all cases comprising sebaceous carcinoma, extramammary Paget disease and apocrine carcinoma. There was a slight female predilection (M/F = 7/9) (mean age 72 years), although patients were older than those affected by benign SAT. All neoplasms were small and no recurrences were recorded. CONCLUSION SAT are rare and most frequently benign. Correct diagnosis and complete surgical removal are important.
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73
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Marucci G, Maresca A, Caporali L, Farnedi A, Betts CM, Morandi L, de Biase D, Cerasoli S, Foschini MP, Bonora E, Vidone M, Romeo G, Perli E, Giordano C, d'Amati G, Gasparre G, Baruzzi A, Carelli V, Eusebi V. Oncocytic glioblastoma: a glioblastoma showing oncocytic changes and increased mitochondrial DNA copy number. Hum Pathol 2013; 44:1867-76. [PMID: 23664543 DOI: 10.1016/j.humpath.2013.02.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 02/23/2013] [Accepted: 02/28/2013] [Indexed: 02/05/2023]
Abstract
Ten cases of glioblastomas showing oncocytic changes are described. The tumors showed mononuclear to multinuclear cells and abundant, granular, eosinophilic cytoplasm. The cytoplasm of these same cells was filled by strongly immunoreactive mitochondria. At ultrastructure, numerous mitochondria, some of which were large, were evidenced in the cytoplasm of neoplastic cells. Finally, 9 of 10 of these cases had a significantly high mitochondrial DNA content compared with control tissue (P < .01). It seems that, for these tumors, the designation of oncocytic glioblastoma is appropriate. To the best of our knowledge, oncocytic changes have not been previously reported in such neoplasms. Oncocytic glioblastomas have to be added to the long list of various tumors that can manifest "unexpected" oncocytic changes in different organs. Albeit failing to show statistical significance (log-rank test, P = .597; Wilcoxon test, P = .233), we observed a trend for longer median survival in oncocytic glioblastomas, when compared with "ordinary" glioblastomas (median survival of 16 versus 8.7 months). Thus, it seems that the definition of neoplasms showing oncocytic changes, currently based on classic morphological parameters (ie, histology, ultrastructure, and immunohistochemistry), can be expanded by including the quantitative assessment of mitochondrial DNA content.
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Affiliation(s)
- Gianluca Marucci
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Section of Pathology, M. Malpighi, Bellaria Hospital, via Altura 3, 40139 Bologna, Italy
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Magro G, Foschini MP, Eusebi V. Palisaded myofibroblastoma of the breast: a tumor closely mimicking schwannoma. Hum Pathol 2013; 44:1941-6. [DOI: 10.1016/j.humpath.2013.01.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Accepted: 01/14/2013] [Indexed: 12/15/2022]
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75
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Montebugnoli L, Leonardi E, Morandi L, Farnedi A, Gissi DB, Marchetti C, Tarsitano A, Balbi T, Gentile L, Cocchi R, Foschini MP. Genetic relationship between multiple squamous cell carcinomas arising in the oral cavity. Head Neck 2013; 36:94-100. [DOI: 10.1002/hed.23259] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2013] [Indexed: 12/31/2022] Open
Affiliation(s)
- Lucio Montebugnoli
- Section of Oral Science; Department of Biomedical and Neuro-Muscular Sciences; University of Bologna; Bologna Italy
| | - Elisa Leonardi
- Section of Anatomic Pathology at Bellaria Hospital; Department of Biomedical and Neuro-Muscular Sciences; University of Bologna; Bologna Italy
| | - Luca Morandi
- Section of Anatomic Pathology at Bellaria Hospital; Department of Biomedical and Neuro-Muscular Sciences; University of Bologna; Bologna Italy
| | - Anna Farnedi
- Section of Anatomic Pathology at Bellaria Hospital; Department of Biomedical and Neuro-Muscular Sciences; University of Bologna; Bologna Italy
| | - Davide Bartolomeo Gissi
- Section of Oral Science; Department of Biomedical and Neuro-Muscular Sciences; University of Bologna; Bologna Italy
| | | | | | - Tiziana Balbi
- Department of Hematology and Oncology; Operative Unit of Anatomic Pathology at S. Orsola Hospital; Bologna
| | - Luciano Gentile
- Unit of Maxillofacial Surgery; Bellaria Hospital; Bologna Italy
| | - Roberto Cocchi
- “Casa sollievo della sofferenza” Hospital; San Giovanni Rotondo (FG); Italy
| | - Maria Pia Foschini
- Section of Anatomic Pathology at Bellaria Hospital; Department of Biomedical and Neuro-Muscular Sciences; University of Bologna; Bologna Italy
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Meretoja TJ, Leidenius MHK, Heikkilä PS, Boross G, Sejben I, Regitnig P, Luschin-Ebengreuth G, Žgajnar J, Perhavec A, Gazic B, Lázár G, Takács T, Vörös A, Saidan ZA, Nadeem RM, Castellano I, Sapino A, Bianchi S, Vezzosi V, Barranger E, Lousquy R, Arisio R, Foschini MP, Imoto S, Kamma H, Tvedskov TF, Kroman N, Jensen MB, Audisio RA, Cserni G. International multicenter tool to predict the risk of nonsentinel node metastases in breast cancer. J Natl Cancer Inst 2012; 104:1888-96. [PMID: 23117131 DOI: 10.1093/jnci/djs455] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Axillary treatment of breast cancer patients is undergoing a paradigm shift, as completion axillary lymph node dissections (ALNDs) are being questioned in the treatment of patients with tumor-positive sentinel nodes. This study aims to develop a novel multi-institutional predictive tool to calculate patient-specific risk of residual axillary disease after tumor-positive sentinel node biopsy. METHODS Breast cancer patients with a tumor-positive sentinel node and a completion ALND from five European centers formed the original patient series (N = 1000). Statistically significant variables predicting nonsentinel node involvement were identified in logistic regression analysis. A multivariable predictive model was developed and validated by area under the receiver operating characteristics curve (AUC), first internally in 500 additional patients and then externally in 1068 patients from other centers. All statistical tests were two-sided. RESULTS Nine tumor- and sentinel node-specific variables were identified as statistically significant factors predicting nonsentinel node involvement in logistic regression analysis. A resulting predictive model applied to the internal validation series resulted in an AUC of 0.714 (95% confidence interval [CI] = 0.665 to 0.763). For the external validation series, the AUC was 0.719 (95% CI = 0.689 to 0.750). The model was well calibrated in the external validation series. CONCLUSIONS We present a novel, international, multicenter, predictive tool to assess the risk of additional axillary metastases after tumor-positive sentinel node biopsy in breast cancer. The predictive model performed well in internal and external validation but needs to be further studied in each center before application to clinical use.
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Affiliation(s)
- Tuomo J Meretoja
- Helsinki University Central Hospital, Breast Surgery Unit, PO Box 140, FI-00029 HUS, Finland.
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Montebugnoli L, Frini F, Gissi DB, Gabusi A, Cervellati F, Foschini MP, Marchetti C. Histological and immunohistochemical evaluation of new epithelium after removal of oral leukoplakia with Nd:YAG laser treatment. Lasers Med Sci 2011; 27:205-10. [DOI: 10.1007/s10103-011-0941-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 06/01/2011] [Indexed: 12/16/2022]
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78
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Montebugnoli L, Cervellati F, Cocchi R, Farnedi A, Pennesi MG, Flamminio F, Foschini MP. Immunohistochemical expression of p16(INK4A) protein as a helpful marker of a subset of potentially malignant oral epithelial lesions: study on a series with long-term follow-up. Histopathology 2011; 57:528-34. [PMID: 20955378 DOI: 10.1111/j.1365-2559.2010.03671.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM To examine a group of lesions that progressed to oral squamous cell carcinoma (OSCC) to determine whether p16(INK4A) expression is an early finding during malignant transformation, and whether immunohistochemical evaluation of p16(INK4A) is an appropriate prognostic marker. METHODS AND RESULTS Twenty cases of OSCC were investigated. All cases had had a biopsy on the same site as OSCC performed at least 1year before OSCC (range 1-11years; mean 3.15±3.1years). Twenty specimens from normal oral mucosa served as controls. p16(INK4A) expression was evaluated by immunohistochemical analysis and cases showing >5% of stained cells were defined as 'positive'. All 20 control cases were negative for p16(INK4A) . Oral lesions were p16(INK4A) -positive in nine cases and negative in 11. No significant relationship was found between p16(INK4A) positivity and the presence/absence of dysplasia. Among OSCC, nine tumours showed p16(INK4A) positivity and 11 showed negativity. A significant relationship (χ(2)=7.1; P<0.01) was found between the presence/absence of p16(INK4A) staining in OSCC and the presence/absence of p16(INK4A) staining in lesions preceding OSCC. CONCLUSIONS p16(INK4A) immunohistochemistry has a potential role in detecting a subset of p16(INK4A) -positive lesions with malignant potential.
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Affiliation(s)
- Lucio Montebugnoli
- Department of Oral Sciences, University of Bologna Unit of Maxillo-Facial Surgery, Bellaria Hospital, Bologna, Italy.
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79
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Montebugnoli L, Venturi M, Gissi DB, Flamminio F, Foschini MP. Low-grade myofibroblastic sarcoma of the gingiva. BMJ Case Rep 2010; 2010:2010/nov22_1/bcr0720103166. [PMID: 22797208 DOI: 10.1136/bcr.07.2010.3166] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Low-grade myofibroblastic sarcoma is a malignant tumour from myofibroblasts, which has only recently become clearly defined. It represents a rare entity developing in the soft tissues of the head and neck. About 20 cases have been reported in the oral cavity, especially in the tongue and bone, while gingiva as the primary site has been described only once to date. Diagnostic methods include histology and immunohistochemistry. The present report concerns a case of a 37-year-old man who presented with a persistent gingival ulcerated swelling that was interpreted for a long time as a gingival epulis. A low-grade myofibrosarcoma was diagnosed and the patient underwent a segmental osteotomy of the mandibular symphisys for complete excision. There was no sign of recurrence or metastatic disease during the 18-month postoperative period.
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Affiliation(s)
- L Montebugnoli
- Department of Oral Science, University of Bologna, Bologna, Italy.
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80
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Montebugnoli L, Felicetti L, Cervellati F, Foschini MP. Glycogenic acanthosis presenting as leukoplakia on the tongue. BMJ Case Rep 2010; 2010:2010/oct05_1/bcr0120102634. [PMID: 22778105 DOI: 10.1136/bcr.01.2010.2634] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
This report describes a rare case of glycogenic acanthosis (GA) located on the tongue of a 72-year-old man. The patient presented with a white plaque that had been on the right side of the tongue for 5 years. Histologically, the lesion was characterised by thickened squamous epithelium with abundant intracellular glycogen deposits. No epithelial dysplasia was noted. This is the first report of GA involving the tongue. This benign condition should be added to the large number of lesions responsible for leukoplakia in this anatomical location.
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Affiliation(s)
- L Montebugnoli
- Department of Oral Science, University of Bologna, Bologna, Italy.
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81
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Fulciniti F, Losito NS, Ionna F, Longo F, Aversa C, Botti G, Foschini MP. Sclerosing polycystic adenosis of the parotid gland: report of one case diagnosed by fine-needle cytology with in situ malignant transformation. Diagn Cytopathol 2010; 38:368-73. [PMID: 19937766 DOI: 10.1002/dc.21228] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Sclerosing polycystic adenosis (SPA) is a rare pathological condition affecting the salivary glands, first described by Smith etal. in 1996. Even though this lesion is being increasingly diagnosed, less than 50 cases have been published in the world literature to date. In line with numerous other pathological analogies between breast and salivary gland lesions, SPA shares with fibrocystic disease of the breast many histopathological features, i.e., fibrosis, oncocytic (apocrine) changes, hyperplasia of ductal and acinar epithelium, cystic dilation of ducts, and, often, atypical epithelial changes. Most of the described cases have followed a benign clinical course, despite the frequent possibility of atypical hyperplasia in more than 50% of the cases and of the more than occasional in situ malignant transformation. In this article, we introduce a new case occurring in the parotid gland of a 57-year-old male showing atypical epithelial hyperplasia and low-grade in situ mucoepidermoid carcinoma. Fine-needle cytology (FNC) was performed on the lesion and, when a diagnosis of SPA was prospected, the variegated cytological features of the obtained sample posed several differential diagnostic problems. The spectrum of pathological lesions entering differential diagnosis comprised sebaceous adenoma, Warthin's tumors with presence of sebaceous remnants, and low-grade mucoepidermoid carcinoma. Histopathological examination disclosed SCA with intraductal neoplastic transformation resembling noninvasive low-grade mucoepidermoid carcinoma. The cytological diagnosis of SPA should be entertained whenever a polymorphous picture is found on FNC samples comprising oncocytic/apocrine changes, sebaceous cells, cystic background, and epithelial hyperplasia with low-grade cytological atypias.
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Affiliation(s)
- Franco Fulciniti
- S.S.D. di Citopatologia, A.F. di Anatomia Patologica e Citopatologia, 80131 Naples, Italy.
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82
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Panzacchi R, Gallo C, Fois F, Dalpiaz G, Cucchi MC, Degli Esposti R, Foschini MP. Primary sarcoidosis of the breast: case description and review of the literature. Pathologica 2010; 102:104-107. [PMID: 21171514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Sarcoidosis is a systemic granulomatous disease of unknown aetiology. The breast is involved in less than 1% of cases. Breast can be either a primary or a secondary site of presentation. Breast sarcoidosis often mimics carcinomas at clinical examination. We report a case of breast sarcoidosis detected during screening mammography in a 57-year-old woman. The lesion presented as a 1.4 cm nodule located in the right breast. On histology, it was characterized by non-caseating giant cell granulomas. Differential diagnoses included idiopathic granulomatous mastitis, tuberculosis, fungal infection, cat-scratch disease and sarcoid-like reactions to cancer. Further clinical and laboratory investigations were consistent with a diagnosis of sarcoidosis. Specifically, serum levels of angiotensin-converting enzyme (ACE) were elevated and a CT scan showed small bilateral pulmonary nodules distributed along the pleura and bronchovascular bundles (perilymphatic pattern), as well as enlarged bilateral hilar and mediastinal lymph nodes. The patient received corticosteroid treatment, and is presently asymptomatic. Breast involvement by sarcoidosis, although rare, should be considered when dealing with granulomatous lesions of the breast.
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Affiliation(s)
- R Panzacchi
- Department of Hematology and Oncology, "L. and A. Seragnoli" University of Bologna, Section of Anatomic Pathology at Bellaria Hospital, Bologna, Italy
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83
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Steri V, Farnedi A, Montinari E, Foschini MP. Fast track biopsy method: a rapid approach to preoperative diagnoses. Pathologica 2010; 102:41-45. [PMID: 23596755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION It is well known that the use of a microwave oven greatly reduces the time for histoprocessing. OBJECTIVE Apply the microwave-based histoprocessing method "Fast Track Biopsy" (FTB), previously described for breast needle-core biopsies, to samples of other organs. METHODS From 01/09/2008 to 31/12/2008, 125 normal and neoplastic tissue samples (thickness from 0.2 and 1.2 cm) were collected, processed according to the FTB technique, stained with haematoxylin/eosin (H/E) and analysed with tissue-specific immunohistochemical (IHC) markers. RESULTS The quality of both H/E and IHC stained sections was comparable to that obtained with standard methods. Sample thickness less than 0.5 cm gave better results. DISCUSSION the FTB method is suitable for most tissue types, and is thus useful for preoperatory diagnoses.
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Affiliation(s)
- V Steri
- Section of Anatomic Pathology, Department of Haematology and Oncology "L. e A. Seragnoli", University of Bologna, Bellaria Hospital, Bologna, Italy
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84
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Gabrielli L, Bonasoni MP, Lazzarotto T, Lega S, Santini D, Foschini MP, Guerra B, Baccolini F, Piccirilli G, Chiereghin A, Petrisli E, Gardini G, Lanari M, Landini MP. Histological findings in foetuses congenitally infected by cytomegalovirus. J Clin Virol 2009; 46 Suppl 4:S16-21. [PMID: 19879801 DOI: 10.1016/j.jcv.2009.09.026] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 09/17/2009] [Accepted: 09/21/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) infection is a major cause of central nervous system damage leading to sensorineural hearing loss, mental retardation and cerebral palsy. OBJECTIVES Identify the type of organ involvement and understand the histopathogenesis of damage in foetuses of women with a CMV-highly positive amniotic fluid. STUDY DESIGN 34 foetuses with congenital CMV infection documented by prenatal diagnosis were studied. Three foetuses died in utero. The remaining pregnancies were electively terminated at 20-21 weeks gestation. RESULTS Foetal organs positive for CMV antigens were: placenta (100%), pancreas (100%), lung (87%), kidney (87%), liver (71%), brain (55%) and heart (44%). Inflammatory infiltrate was almost always present in CMV-infected foetal organs and the severity of the inflammatory response was correlated with the organ damage. Brain damage with necrosis was observed in 33% (9/27) and a mild telencephalic leukoencephalopathy in 22% (6/27) of foetuses studied. CONCLUSIONS Focal necrosis was observed very frequently in organs such as pancreases, livers, hearts and kidneys. However the damage in these organs is likely to be resolved by parenchymal regeneration. Brain damage, which seems to be the results of a combined effect of viral infection, inflammatory infiltration and hypoxia due to severe placentitis, is less likely to be resolved because of the low regeneration ability of this organ.
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85
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Marucci G, Faustini-Fustini M, Righi A, Pasquini E, Frank G, Agati R, Foschini MP. Thyrotropin-secreting pituitary tumours: significance of “atypical adenomas” in a series of 10 patients and association with Hashimoto thyroiditis as a cause of delay in diagnosis. J Clin Pathol 2008; 62:455-9. [DOI: 10.1136/jcp.2008.061523] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Thyrotropin-secreting adenomas (TSH-As) are rare and, according to the World Health Organization criteria (WHO 2004), a significant proportion of them present features of atypical adenomas at the time of diagnosis.Aims:To determine the frequency of “atypical adenomas” and the significance of this definition as regards follow-up. To investigate their possible association with Hashimoto thyroiditis, leading to a delay in diagnosis.Methods:Case notes for patients who underwent trans-sphenoidal surgery between 1992 and 2006 were retrieved. Follow-up ranged from 6 to 180 months.Results:Ten cases of TSH-As out of 908 pituitary adenomas were selected. Before surgery, eight patients had hyperthyroidism, one was euthyroid and another one showed hypothyroidism associated with Hashimoto thyroiditis. All cases were macroadenomas; six of them were invasive. Three cases met the criteria for classification as atypical. In none of the cases, including the three “atypical adenomas”, were clinical or radiological signs of recurrence observed.Conclusions:The three cases with features of atypical adenoma did not recur or metastasise, suggesting that, at least in the present series, a strict relationship between the morphological criteria for diagnosing atypical adenomas and biological behaviour may be sometimes lacking. Furthermore, the casual association of TSH-As with Hashimoto thyroiditis may led to an adjunctive delay in diagnosis, because of low thyroid hormone levels.
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86
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Montebugnoli L, Felicetti L, Gissi DB, Cervellati F, Servidio D, Marchetti C, Prati C, Flamminio F, Foschini MP. Predictive Role of p53 Protein as a Single Marker or Associated to Ki67 Antigen in Oral Carcinogenesis. Open Dent J 2008; 2:24-9. [PMID: 19088879 PMCID: PMC2581531 DOI: 10.2174/1874210600802010024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2007] [Accepted: 01/09/2008] [Indexed: 11/22/2022] Open
Abstract
p53 over-expression has been proposed as a reliable marker associated to oral carcinogenesis, although only about 50% of oral carcinomas (OSCC) are associated with p53 over-expression and even p53-negative lesions can progress to OSCC. The aim of the study was to determine whether the combination of p53 over-expression and p53 low-expression associated with Ki67 over-expression (high Ki67/p53 ratio) could lead to a more sensitive parameter. Immunohistochemical expression of Ki67 and p53 was measured in 54 specimens from OSCC; 27 specimens from moderate/severe epithelial dysplasia; 32 specimens from oral leukoplakias without epithelial dysplasia, and 13 specimens with normal epithelium. p53 over-expression was found in 31 (53%) samples from OSCC, in 10 (37%) samples from severe dysplasias, and in 5 (15%) samples from non-dysplastic lesions, while the combination of high p53 values with high Ki67/p53 ratio was observed in 93% of OSCC, in 81% of dysplastic lesions, and in 50% of non-dysplastic lesions. This parameter may have a clinical implication to detect early lesions with an impairment of p53 pathway, and probably at risk of progress to OSCC.
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87
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Pozzati E, Zucchelli M, Schiavina M, Contini P, Foschini MP. Rapid growth and regression of intracranial meningiomas in lymphangioleiomyomatosis: case report. ACTA ACUST UNITED AC 2007; 68:671-674. [PMID: 17586005 DOI: 10.1016/j.surneu.2006.11.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2006] [Accepted: 11/28/2006] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lymphangioleiomyomatosis is a progressive interstitial lung disease that affects young women. It has been suggested that estrogens play a role in its evolution, and progesterone therapy is often provided in these cases. CASE DESCRIPTION We present a case of a postmenopausal woman with LAM treated with progesterone; subsequently, rapid growth of multiple intracranial meningiomas was observed. One prominent lesion was excised, and 3 other lesions regressed spontaneously over 2 years. CONCLUSIONS This is a rare case of a non-pregnancy-related regression of meningiomas in a woman affected by LAM. The significance of this association and the hormonal treatment of the disease are discussed.
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Affiliation(s)
- Eugenio Pozzati
- Division of Neurosurgery and Service of Pathology, Bellaria Hospital and Respiratory Pathophysiology, S. Orsola Policlinic, Bologna 40100, Italy.
| | - Mino Zucchelli
- Division of Neurosurgery and Service of Pathology, Bellaria Hospital and Respiratory Pathophysiology, S. Orsola Policlinic, Bologna 40100, Italy
| | - Mario Schiavina
- Division of Neurosurgery and Service of Pathology, Bellaria Hospital and Respiratory Pathophysiology, S. Orsola Policlinic, Bologna 40100, Italy
| | - Paola Contini
- Division of Neurosurgery and Service of Pathology, Bellaria Hospital and Respiratory Pathophysiology, S. Orsola Policlinic, Bologna 40100, Italy
| | - Maria Pia Foschini
- Division of Neurosurgery and Service of Pathology, Bellaria Hospital and Respiratory Pathophysiology, S. Orsola Policlinic, Bologna 40100, Italy
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88
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Pozzati E, Marliani AF, Zucchelli M, Foschini MP, Dall'Olio M, Lanzino G. The neurovascular triad: mixed cavernous, capillary, and venous malformations of the brainstem. J Neurosurg 2007; 107:1113-9. [DOI: 10.3171/jns-07/12/1113] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
The four types of cerebrovascular malformations may sometimes be combined and more often occur in pairs; triads are exceptional. The authors present six patients with the clinicoradiographic profile of mixed vascular malformations of the brainstem, including cavernous malformation (CM), capillary telangiectasia, and developmental venous anomaly (DVA).
Methods
Five patients (one of whom was a child) suffered from hemorrhage, suggesting that this complex association has a high bleeding potential. Progressive growth, rebleeding, and de novo occurrence of the associated CM were documented in three cases. Magnetic resonance imaging of the brain was obtained in all patients by using one or more of the following modalities: T1-weighted sequences before and after gadolinium administration; T2-weighted sequences; T2-weighted fluid attenuated inversion recovery; T1-weighted fast spin echo; and diffusion weighted, diffusion tensor, and perfusion imaging in three cases.
Results
Three patients were surgically treated with the intention of excising the hemorrhagic lesion, but only two patients had their malformations successfully removed. In the third case, diffuse pontine telangiectasia precluded the safe excision of the CM. Histological examination demonstrated a blended pathological milieu characterized by coalescent telangiectasia and venules associated with loculated endothelial chambers resembling an immature or de novo CM. Three patients were treated conservatively; recurrent minor hemorrhage occurred in one case. The authors found these malformations to be arranged in two basic relationships: CM inside the telangiectasia and CM in the radicles of the DVA. Stenosis of the main venous collector and dilation of the medullary veins were important findings.
Conclusions
The pathogenesis of this malformation may be referred to a developmental deviance of the brainstem capillary–venous network associated with transitional vessels and loculated endothelial vascular spaces related to genetic and acquired origins, probably in a restrictive venous outflow milieu.
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Affiliation(s)
- Eugenio Pozzati
- 1Department of Neurosurgery, Sections of Neuroradiology and Pathology, Bellaria Hospital, Bologna, Italy; and
| | - Anna Federica Marliani
- 1Department of Neurosurgery, Sections of Neuroradiology and Pathology, Bellaria Hospital, Bologna, Italy; and
| | - Mino Zucchelli
- 1Department of Neurosurgery, Sections of Neuroradiology and Pathology, Bellaria Hospital, Bologna, Italy; and
| | - Maria Pia Foschini
- 1Department of Neurosurgery, Sections of Neuroradiology and Pathology, Bellaria Hospital, Bologna, Italy; and
| | - Massimo Dall'Olio
- 1Department of Neurosurgery, Sections of Neuroradiology and Pathology, Bellaria Hospital, Bologna, Italy; and
| | - Giuseppe Lanzino
- 2Department of Neurosurgery, Illinois Neurological Institute, University of Illinois College of Medicine, Peoria, Illinois
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89
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Scipioni A, Ferretti E, Soda G, Tosi E, Bruno R, Costante G, Meringolo D, Arturi F, Durante C, Amorosi A, Foschini MP, Nardi F, Russo D, Filetti S. hNIS protein in thyroid: the iodine supply influences its expression and localization. Thyroid 2007; 17:613-8. [PMID: 17696829 DOI: 10.1089/thy.2007.0064] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Nonfunctioning thyroid nodules (NFTNs) display a diminished iodide-concentrating ability, owing to defective expression and cell membrane targeting of the sodium-iodide symporter (NIS). Since NIS expression is primarily modulated by thyroid iodine content in vitro and in animal models, we attempted to determine whether iodine supply influences the expression and localization of human NIS (hNIS) in NFTNs. DESIGN Using immunohistochemistry, we analyzed cold hyperplastic nodules and nonnodular thyroid samples (controls) from patients living in iodine-sufficient (n = 19) or severely iodine-deficient (n = 15) areas. MAIN OUTCOME Nodules from the iodine-sufficient area exhibited weak or absent hNIS immunostaining whereas almost all nodules from the iodine-deficient area were hNIS positive. Heterogeneous hNIS staining was common among the iodine-deficient samples (p = 0.028). hNIS was localized on membrane in all nodular samples from the iodine-deficient area and in less than 40% in the iodine-sufficient area. CONCLUSIONS hNIS is adequately expressed and appropriately localized in NFTNs cell membrane from iodine-deficient areas and its expression in vivo is modulated by iodine supply.
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Affiliation(s)
- Angela Scipioni
- Department of Clinical Sciences and Department of Experimental Medicine and Pathology, University of Rome, La Sapienza, 00161 Rome, Italy
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90
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Cserni G, Bianchi S, Vezzosi V, Arisio R, Bori R, Peterse JL, Sapino A, Drijkoningen M, Kulka J, Eusebi V, Foschini MP, Bellocq JP, Marin C, Thorstenson S, Amendoeira I, Reiner-Concin A, Decker T. Sentinel lymph node biopsy and non-sentinel node involvement in special type breast carcinomas with a good prognosis. Eur J Cancer 2007; 43:1407-14. [PMID: 17531465 DOI: 10.1016/j.ejca.2007.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2007] [Revised: 03/30/2007] [Accepted: 04/05/2007] [Indexed: 11/21/2022]
Abstract
This study aimed at identifying factors related to sentinel lymph node (SLN) involvement in patients with tubular, cribriform, mucinous or papillary breast carcinoma and those related to non-SLN metastases if an SLN was positive. Multivariate analyses involved logistic and stepwise regressions. The SLNs harboured metastases in 85 of 572 cases, 78 of whom underwent axillary dissection; 19 presented non-SLN positive disease. Lack of lymphovascular invasion, a tumour size < or = 10 mm and a single SLN removed were the factors predicting an SLN metastasis rate <10%, and patients with these features could be candidates for no surgical axillary staging. A positive SLN proportion of < or = 50% and no lymphovascular invasion were associated with a <10% rate of non-SLN invasion; patients with a positive SLN and these features could be candidates for the omission of completion axillary dissection. The opposite presentation of these factors would mandate SLN biopsy and axillary dissection, respectively.
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Affiliation(s)
- Gábor Cserni
- Department of Pathology, Bács-Kiskun County Teaching Hospital, Nyiri út 38, H-6000 Kecskemét, Hungary.
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91
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Farneti P, Balbi M, Foschini MP. Neuroglial choristoma of the middle ear. Acta Otorhinolaryngol Ital 2007; 27:94-7. [PMID: 17608139 PMCID: PMC2640011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Neuroglial choristoma is a rare cerebral heterotopia which can involve various locations. Even if its occurrence is more frequent in midline structures, it can also be found in the non-midline structure such as, for example, even if only rarely, the middle ear. The described case is that of a 74-year-old male who had been operated on for a neuroglial choristoma located in the tympanic cavity and in the mastoid bone. High resolution computed tomography and intra-operative findings did not reveal any connection with the upper cerebral structures, thus excluding the hypothesis of an encephalocele. After careful histopathological examination, the aetiopathogenetic hypothesis are analysed. Only 8 similar cases have been reported in the literature.
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Affiliation(s)
- P Farneti
- Department of Otolaryngology, General Hospital, Budrio, Azienda USL Bologna, Italy.
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92
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Righi A, Foschini MP. [Values and limits in fine needle aspiration in the diagnosis of Warthin tumour of the parotid gland]. Pathologica 2006; 98:635-9. [PMID: 17285840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
UNLABELLED Recent paper state that cytological diagnosis of Warthin Tumour of the parotid gland is poorly reproducible and that aspiration procedures damage the tumoral tissue as to make difficult the histological diagnosis. Aim of the present study is to review cytological sampling performed with fine needle sampling without aspiration and to compare them with the relative surgical specimens in order to determine the value of fine needle aspiration in the diagnosis of Warthin Tumour and to quantify' the damage in histological tissue. MATERIALS AND METHOD All cases with cytological and/or histological diagnosis of Warthin Tumour during the period 1/1/98 to 30/6/04 were retrieved. In all cases both cytological and histological slides were reviewed and compared. In all cases fine needle aspiration (FNA) was performed according to the technique described by Zajdela et al. in 1987. A cytologic sample was considered diagnostic when there were in the same sample mucoid substance, lymphocytes scattered with a range of maturation and oncocytes organized in flat sheets of cells. RESULTS 38 cases were selected corresponding to 37 patients (1 case of Warthin Tumour bilateral): all tumors were localized in the parotid gland. Fine needle sampling were 43. Nine cytological sample (20.9%) were inadequate. Sensitivity and specificity, in the preent series, had the same value, being 97.1%. A spectrum of histologic alterations were observed in 30/38 cases (79%). These alterations were squamous metaplasia (7 cases), acute and chronic hemorrhage and inflammation with multinucleated giant cells (26 cases) and granulation tissue with subsequent fibrosis (24 cases). In all cases the histologic alterations from fine needle were focal, limited to less than 20% of the tumoral area (first category of Batsakis 'classification), and did not prevent the histologic diagnosis of Warthin Tumour. CONCLUSIONS These data suggest that fine needle aspiration without aspiration is a valuable tool for the per-operative diagnosis of Warthin Tumour. In addition it creates only minor histological changes, that always allow the histological diagnosis.
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Affiliation(s)
- A Righi
- Dipartimento di Scienze Oncologiche, Sezione di Anatomia Patologica, Università di Bologna, Ospedale Bellaria, Bologna
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93
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Marucci G, Barbanera A, Tosi AL, Andreoli A, Simonetti L, Magrini E, Farnedi A, Foschini MP. Epithelioid hemangioendothelioma of the spinal cord: Description of a case with cytogenetic analysis. Int J Surg Pathol 2006; 14:340-3. [PMID: 17041204 DOI: 10.1177/1066896906292451] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A case of epithelioid hemangioendothelioma of the cauda equina is reported. The patient presented with rapidly worsening low back pain. Magnetic resonance imaging revealed a sharply demarcated intradural lumbar lesion. A bluish-red lesion, attached to the filum terminale, was removed. The patient is alive without evidence of recurrence 18 months after surgery. The tumor was composed of variously sized vessels lined by epithelioid endothelial cells with clear cytoplasm and centrally located, moderately atypical nuclei. These cells were immunoreactive for CD31 and factor VIII antibodies. Cytogenetic analysis disclosed two clones: 44-45X, - Y [cp3]/46XY[11]. Epithelioid hemangioendothelioma may arise in several sites, the most common being soft tissues. It is a borderline tumor that may recur, may metastasize, and rarely causes death. The present case appears to be the first example of epithelioid hemangioendothelioma of the spinal cord.
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Affiliation(s)
- Gianluca Marucci
- Section of Anatomic Pathology, Department of Oncological Sciences, University of Bologna, Bellaria Hospital, Bologna, Italy
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94
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Foschini MP, Cocchi R, Marucci G, Pennesi MG, Magrini E, Ligorio C, Lombardini F, Tosi AL, Marchetti C. High DeltaN p63 isoform expression favours recurrences in odontogenic keratocyst--odontogenic keratocystic tumour. Int J Oral Maxillofac Surg 2006; 35:673-5. [PMID: 16687239 DOI: 10.1016/j.ijom.2006.02.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2006] [Revised: 02/20/2006] [Accepted: 02/28/2006] [Indexed: 10/24/2022]
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95
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Del Vecchio M, Foschini MP, Peterse JL, Eusebi V. Lobular carcinoma of the breast with hybrid myoepithelial and secretory ("myosecretory") cell differentiation. Am J Surg Pathol 2006; 29:1530-6. [PMID: 16224222 DOI: 10.1097/01.pas.0000164616.15329.d5] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Three cases of lobular carcinoma of the breast showing a complex morphology that included myoepithelial cell differentiation are reported. One case was a pure in situ acinar lesion, while the other 2 cases were in situ and invasive carcinomas. Three different cell types were seen in these tumors: one was the phenotype commonly seen in the garden variety of in situ lobular carcinoma (LCIS) constituted by noncohesive round to ovoid cells with round nuclei and positivity for epithelial membrane antigen (EMA), estrogen receptor (ER), and progesteron receptor (PR). E-cadherin was negative in these cells. The second type was represented by cohesive elements with irregular nuclei. These cells were immunoreactive for smooth muscle actin, calponin, keratin 14, p63, and e-cadherin. EMA, ER, and PR were consistently negative. The third type, seen in a minority of cell population of case nos. 2 and 3, consisted of cells showing at the same time EMA and smooth muscle actin in their cytoplasm. This type was defined as "hybrid myosecretory cell" to highlight contractile and secretory properties present at the same time. Cells with hybrid features probably indicate that myoepithelial and secretory cells are strictly related and the existence of a stem cell, at least for these cases, is not necessary.
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Affiliation(s)
- Marina Del Vecchio
- Section of Histopathology and Cytopathology, University of Bologna at Bellaria Hospital, Bologna, Italy
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96
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Franceschi E, Cavallo G, Scopece L, Esposti RD, Paioli G, Paioli A, Palmerini E, Foschini MP, Marliani AF, Crinò L. Temozolomide-induced partial response in a patient with primary diffuse leptomeningeal gliomatosis. J Neurooncol 2005; 73:261-4. [PMID: 15980977 DOI: 10.1007/s11060-004-5672-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2004] [Accepted: 11/01/2004] [Indexed: 10/25/2022]
Abstract
Herein we describe the case of a patient with primary diffuse leptomeningeal gliomatosis (PDLG). After surgery and ventriculoperitoneal shunt placement, due to poor general conditions, the patient was not eligible for radiotherapy. For this reason we decided to start a systemic chemotherapy treatment with Temozolomide (150 mg/m2 per day for 5 days every 4 weeks). After three cycles a partial response was achieved with a clear improvement of general conditions. In our knowledge, this is the first time that PDLG treatment with Temozolomide has been described.
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Affiliation(s)
- Enrico Franceschi
- Department of Medical Oncology, Bellaria Hospital, Via Altura 3, Bologna, 40139, Italy
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97
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Marucci G, Betts CM, Michal M, Foschini MP. Peripheral ameloblastoma with Merkel cells. Virchows Arch 2004; 446:204-5. [PMID: 15735981 DOI: 10.1007/s00428-004-1159-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2004] [Accepted: 09/30/2004] [Indexed: 11/29/2022]
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98
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Morandi L, Pession A, Marucci GL, Foschini MP, Pruneri G, Viale G, Eusebi V. Intraepidermal cells of paget’s carcinoma of the breast can be genetically different from those of the underlying carcinoma. Hum Pathol 2003; 34:1321-30. [PMID: 14691919 DOI: 10.1016/s0046-8177(03)00405-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Paget's carcinoma (PC) of the breast is characterized by neoplastic cells of "glandular" type located within the epidermis of the nipple-areolar complex, often associated with an underlying ductal carcinoma, either in situ or invasive. At present the origin of PC cells is controversial, although there is a widespread opinion that PC cells are "foreign" elements to the epidermis resulting from an epidermotropic migration of neoplastic elements from an underlying ductal carcinoma. An alternative view is that some cases result from neoplastic transformation of preexisting, innocent intraepidermal clear cells of the nipple-areolar complex (Toker cells) that migrate from nonneoplastic ducts. Consequently, 10 cases were studied using methods for clonality (ie, loss of heterozygosity and mitochondrial DNA displacement loop sequence analysis). Microdissection of intraepidermal neoplastic cells and of cells from underlying duct carcinomas and metastases was performed. In no fewer than 2 cases, PC cells were genetically different from underlying lesions, which showed consistent homology among themselves. Therefore, it is suggested that the rule of epidermotropism by neoplastic cells from an underlying carcinoma is not applicable to all cases, and that in some cases PC cells might be the result of neoplastic transformation of preexisting intraepidermal nonneoplastic cells. Consequently, the underlying tumors are coincidental neoplastic lesions (collision tumors).
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/analysis
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Carcinoma, Intraductal, Noninfiltrating/genetics
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Cell Transformation, Neoplastic
- DNA, Mitochondrial/genetics
- DNA, Neoplasm
- Female
- Humans
- Immunohistochemistry
- Loss of Heterozygosity
- Lymphatic Metastasis
- Male
- Microdissection
- Middle Aged
- Mutation
- Paget's Disease, Mammary/genetics
- Paget's Disease, Mammary/pathology
- Polymerase Chain Reaction
- Sequence Analysis, DNA
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Affiliation(s)
- Luca Morandi
- Department of Oncology, Section of Pathology, University of Bologna, Ospedale Bellaria, Italy
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99
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Lazzarotto T, Gabrielli L, Foschini MP, Lanari M, Guerra B, Eusebi V, Landini MP. Congenital cytomegalovirus infection in twin pregnancies: viral load in the amniotic fluid and pregnancy outcome. Pediatrics 2003; 112:e153-7. [PMID: 12897321 DOI: 10.1542/peds.112.2.e153] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Human cytomegalovirus (CMV) is the most common cause of viral intrauterine infection and fetal damage largely attributable to maternal primary infection. Most cases of congenital CMV infection in twins reported in the literature involved only 1 twin. We assessed the validity of polymerase chain reaction (PCR) and quantitative PCR on amniotic fluid (AF), at 21 to 22 weeks' gestation and at least 6 to 8 weeks after seroconversion, to predict the outcome of newborns in twin pregnancies. Two pregnant women with twin pregnancies and 1 woman with a triple pregnancy with primary CMV infection defined by the presence of immunoglobulin (Ig) M and low IgG avidity and/or by the presence of clinical symptoms and abnormal liver enzyme values were evaluated. CMV infection was found in 6 fetuses/newborns, 3 of whom were symptomatic. In the first twin pregnancy with diamniotic-dichorionic separate placentas, CMV symptomatic infection of the female twin was demonstrated by positive virus isolation and high viral load in AF. The male fetus was not infected as demonstrated by negative CMV culture and DNA detection in AF. In the triple pregnancy, the woman had a placenta with 2 monozygotic twins (females) and a separate placenta with a heterozygotic twin (male). The quantitative PCR results were 10(3) genome equivalents (GE)/mL of females AF and 1.9 x 10(5) GE/mL of male AF. Both female twins were asymptomatic at birth, whereas the male presented petechiae, thrombocytopenia, and cerebral ventriculomegaly. In the last twin pregnancy with fused dichorionic placentas, congenital CMV infection of both twins was diagnosed at birth in contrast with prenatal diagnosis. At time of amniocentesis, the left side twin was not infected as shown by negative results of CMV culture and DNA detection in the AF. CMV infection of the right side twin was demonstrated by positive CMV DNA detection with a CMV DNA load of 4.9 x 10(4) GE/mL and positive virus isolation in the AF. The morphologic and histologic examinations of the placentas strongly supported a prenatal horizontal acquisition of CMV infection. These twin pregnancies showed a marked difference in the quantity of virus load documented by the prenatal diagnosis suggesting that twin fetuses may react differently to primary maternal infection despite being exposed to the same maternal influences. A high viral load is correlated with congenital CMV infections symptomatic at birth. In such cases, with fetal infection of only 1 twin (at amniocentesis) and fusion of placentas, fetal outcome of both twins needs to be evaluated for the possibility of viral transfer from one fetus to the other.
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Affiliation(s)
- Tiziana Lazzarotto
- Section of Microbiology, Department of Clinical and Experimental Medicine, St Orsola Malpighi General Hospital, University of Bologna, Bologna, Italy
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100
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Di Tommaso L, Macchia S, Morandi L, Leoncini S, Pession A, Dal Monte PR, Foschini MP. Correlation between histologic staging, hepatitis C virus genotypes and clinical features in HCV chronic hepatitis: evidence of a new pattern. Int J Surg Pathol 2003; 11:197-204. [PMID: 12894351 DOI: 10.1177/106689690301100306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Genome heterogeneity may be related to the wide variability of clinical and pathological features in hepatitis C virus (HCV)-related chronic liver disease. This paper addresses the possible association between HCV subtypes and clinical and histological features of chronically infected patients. Sixty-eight consecutive liver biopsies of chronic hepatitis constituted the basis of the study. HCV genotyping was performed on frozen tissue. Grading of necroinflammatory activity and staging of fibrosis were histologically assessed. Serologic HCV-RNA and liver function were assessed at the same time. All information was compared with clinical data including age, sex, HCV serology, and probable data and route of infection. Two cases were excluded as inadequate tissue was available. Five cases were negative to HCV-RNA in both serum and tissue. In 61 cases HCV RNA was present at the same time in serum and liver tissue. Forty-four patients were men (72%) and 17 (28%) were women. Two peaks of age were observed: 1 in the 4th decade of life, the 2nd in the 7th. The 2 groups had different HCV genotypes. Patients with genotypes 1b (mean age 50.7 years), 2c (mean age 61.3 years), and a subgroup of coinfections (mean age 60 years) were older than patients with genotypes 1a (mean age 35.5 years), 3 (mean age 36 years), and a subgroup of coinfections (mean age 33 years). Patients with genotypes 1b, 2, or 2c and a subgroup of coinfections more frequently had a history of blood transfusion and or surgical intervention dating up to 49 years previously. Patients with HCV 1a, 3, and a subgroup of coinfections frequently admitted a period of intravenous drug abuse. Patients with advanced liver disease, i.e., severe fibrosis and cirrhosis, showed the same 2 peaks of incidence: in the 4th and 7th decades of life, the first group mainly comprising patients with HCV types 1a and 3, the second, patients with HCV types 1b and 2c. Both these groups shared a clinical history of a long-standing infection. Two profiles of patients emerged. The largest group was composed of elderly patients, infected by HCV genotypes 1b or 2c, with a history of blood transfusion and/or surgery, presenting an advanced stage of liver disease (namely, severe fibrosis or cirrhosis). The second group was composed of younger patients, mainly in the 4th decade of life, infected by HCV types 3 or 1a, often presenting with chronic hepatitis in the stage of severe fibrosis or cirrhosis. The latter could be the profile of HCV infection in the near future.
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Affiliation(s)
- L Di Tommaso
- Department of Oncology, Section of Anatomic Pathology Marcello Malpighi, University of Bologna, Italy
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