Defining the biology of intrahepatic cholangiocarcinoma: molecular pathways and early detection of precursor lesions

Intrahepatic cholangiocarcinoma (ICC) is a rare malignant tumor of the biliary tract with growing incidence and dismal prognosis. It is responsible for 10-20% of primary liver cancer worldwide, but early diagnosis is still a challenge and few treatment options are available. Aim of this review is to summarize the current knowledge about biological features and arising molecular patterns of this disease. The identification of emerging biomarkers and early detection of precursor lesions shall play a key role in the perspective of future tailored targeted therapies.

Possible role of tocopherols in the modulation of host microRNA with potential antiviral activity in patients with hepatitis B virus-related persistent infection: a systematic review

Hepatitis B virus (HBV) infection represents a serious global health problem and persistent HBV infection is associated with an increased risk of cirrhosis, hepatocellular carcinoma and liver failure. Recently, the study of the role of microRNA (miRNA) in the pathogenesis of HBV has gained considerable interest as well as new treatments against this pathogen have been approved. A few studies have investigated the antiviral activity of vitamin E (VE) in chronic HBV carriers. Herein, we review the possible role of tocopherols in the modulation of host miRNA with potential anti-HBV activity. A systematic research of the scientific literature was performed by searching the MEDLINE, Cochrane Library and EMBASE databases. The keywords used were 'HBV therapy', 'HBV treatment', 'VE antiviral effects', 'tocopherol antiviral activity', 'miRNA antiviral activity' and 'VE microRNA'. Reports describing the role of miRNA in the regulation of HBV life cycle, in vitro and in vivo available studies reporting the effects of VE on miRNA expression profiles and epigenetic networks, and clinical trials reporting the use of VE in patients with HBV-related chronic hepatitis were identified and examined. Based on the clinical results obtained in VE-treated chronic HBV carriers, we provide a reliable hypothesis for the possible role of this vitamin in the modulation of host miRNA profiles perturbed by this viral pathogen and in the regulation of some cellular miRNA with a suggested potential anti-HBV activity. This approach may contribute to the improvement of our understanding of pathogenetic mechanisms involved in HBV infection and increase the possibility of its management and treatment.

Merkel cell carcinoma of the parotid gland associated with Warthin tumour: report of two cases

AIMS

Two cases of Merkel cell carcinoma occurring simultaneously and in close association with a Warthin tumour of the parotid gland are reported.

METHODS AND RESULTS

The patients were a 65-year-old man and a 70-year-old man, respectively. The Merkel cell carcinoma component was immunoreactive for chromogranin and keratin 20 and contained neuroendocrine-type granules at the ultrastructural level.

CONCLUSIONS

The histogenesis of this heretofore undescribed combination is discussed.

Orbital (desmoid type) fibromatosis

A case of extra-abdominal fibromatosis (EF) of the orbit is described in a 35-year-old man presenting with progressive exophthalmos, right ptosis and diplopia. MRI showed an orbital mass of intermediate signal in T1-weighted images (WI) and low signal in T2WI, which enhanced non-homogeneously after contrast injection. The histological diagnosis of EF was made and the lesion was surgically removed. No recurrence occurred in 40 months of follow-up.

Leiomyoma of the uterus showing skeletal muscle differentiation: a case report

A case of uterine leiomyoma with skeletal muscle differentiation is described. The patient is a 40-year-old woman who underwent abdominal hysterectomy and left salpingo-oophorectomy for fibroids. Evidence of skeletal muscle differentiation was evident at light and electron microscopy in one out of three "ordinary" leiomyomas. This was also shown by positive immunoreactions with antiskeletal muscle actin and myoglobin antisera. To our knowledge, this is the second case reported of the occurrence of skeletal muscle differentiation within a uterine leiomyoma and highlights the divergent differentiating potential of smooth muscle cells.

[Follicular dendritic cell tumor and unusual vascular lesion in lymph node with Castleman's disease. Description of a case]

INTRODUCTION

A case of follicular dendritic cell tumour arising in a lymph-node with Castleman's disease, hyaline-vascular type and associated with a vascular lesion of the capsule is described.

MATERIALS AND METHODS

The lesion is documented by immunohistochemistry.

RESULTS

The patient is a 57 year old man with a large extrathoracic mass showing the combination of the lesions previously mentioned. In addition, he was found to have metastatic deposits in a cervical lymph-node and in the bone. He underwent radiotherapy and died shortly after with post-therapeutical complications.

DISCUSSION

The present case constitutes the second report of follicular dendritic cell tumour associated with Castleman's disease and a benign vascular lesion. This association is discussed.

Microcalcifications in ductal carcinoma in situ of the breast: histochemical and immunohistochemical study

Thirty cases of ductal carcinoma in situ (DCIS) of the breast, showing histological microcalcifications, were studied to clarify their mechanism of formation. Undecalcified sections revealed three types of calcium precipitates: type I and II granular calcifications (GCs) and laminar calcifications (LCs). In type I GCs the core on which the calcium had deposited was constituted mainly by nuclear debris. Type II GCs were predominantly composed by mucosubstances. LCs were the result of calcium deposits on mucoid or proteinaceous material, arranged in concentric lamellae. LCs and type II GCs were mainly present in well and intermediately differentiated DCIS. Type I GCs were observed in only DCIS with necrosis, frequently being present in intermediately and poorly differentiated DCIS.

[Solitary fibrous tumor of the cheek]

INTRODUCTION

A case of solitary fibrous tumour of the cheek is described.

MATERIAL AND METHODS

The lesion is documented by immunohistochemistry.

RESULTS

The patient is a 55 year old man and the tumor is constituted by a nodule measuring 2 cm in its greatest axis. The neoplastic cells are spindle shaped and arranged in a storiform pattern. They stain for vimentin and CD34.

DISCUSSION

The differential diagnosis from morphologically similar lesions, such as leiomyoma, schwannoma, benign fibrohistiocytoma and myoepithelioma of the salivary glands was taken in consideration. The present case, together with those reported in the literature, indicates that solitary fibrous tumours arise in any site of the organism.

[Breast carcinoma metastatic to meningioma: review of the literature and description of 2 new cases]

Two cases of breast carcinoma metastatic to meningioma are described in patients 69 and 62 years old respectively.

MATERIAL AND METHODS

Cases were documented by radiological, histological and immunohistochemical techniques.

RESULTS

Both meningiomas contained an invasive duct carcinoma of the breast, one of which was apocrine in nature.

CONCLUSION

It is suggested that metastasis to meningioma is not so rare as it appears from the literature.