1
|
Reginelli A, Russo A, Berritto D, Patane V, Cantisani C, Grassi R. Ultra-High-Frequency Ultrasound: A Modern Diagnostic Technique for Studying Melanoma. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2023; 44:360-378. [PMID: 37068509 DOI: 10.1055/a-2028-6182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
The development of new ultra-high-frequency devices with a resolution of 30 μm makes it possible to use ultrasound in the study of new small anatomical units and to apply this tool to new fields of pathology. Cutaneous melanoma is a severe skin disease with an incidence of approximately 160 000 new cases each year and 48 000 deaths. In this paper, we evaluate the role of HFUS in the diagnosis of cutaneous melanoma, describe the sonographic appearance of skin layers in the pre-excision phase as well as of lesion features, and correlate the characteristics with pathological examination.
Collapse
Affiliation(s)
- Alfonso Reginelli
- Department of Precision Medicine, University of Campania, Luigi Vanvitelli School of Medicine and Surgery, Napoli, Italy
| | - Anna Russo
- Department of Radiology, University of Campania, Luigi Vanvitelli School of Medicine and Surgery, Napoli, Italy
| | - Daniela Berritto
- Department of Clinical and Experimental Medicine, Foggia University Hospital, Foggia, Italy
| | - Vittorio Patane
- Department of Precision Medicine, University of Campania, Luigi Vanvitelli School of Medicine and Surgery, Napoli, Italy
| | | | - Roberto Grassi
- Department of Precision Medicine, University of Campania, Luigi Vanvitelli School of Medicine and Surgery, Napoli, Italy
| |
Collapse
|
2
|
Gupta P, Shruti S, Siraj F, Bhargava A, Khullar G. Primary cutaneous large B cell lymphoma masquerading as lupus vulgaris. J Cancer Res Ther 2023; 19:1477-1479. [PMID: 37787336 DOI: 10.4103/jcrt.jcrt_54_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Primary cutaneous large B cell lymphoma, leg type is a rare and aggressive variant of cutaneous B cell lymphoma. It predominantly affects elderly women, with the lower limb being the most common site of presentation. The overall prognosis is poor, compared to other cutaneous B cell lymphomas. A 47-year-old man presented with a progressively enlarging nodule over the medial aspect of the left foot since 2 months. Clinical examination revealed a nodular plaque-like lesion with central ulceration that measured 7 × 7 cm, firm in consistency, and with ill-defined margins. The initial clinical diagnosis was lupus vulgaris. An incision biopsy was done, which on histopathology and immunohistochemistry revealed a rare diagnosis of primary cutaneous B cell lymphoma, leg type. The patient was started on chemotherapy; however, he succumbed to his illness about 1 year after the initial presentation. It is a rare type of cutaneous lymphoma, which may masquerade infectious disorders such as lupus vulgaris. A detailed histopathological and immunohistochemical analysis is essential for its correct diagnosis and management. Only a handful of cases of this rare condition are reported to date. This case has been reported in view of its rarity and unusual clinical presentation.
Collapse
Affiliation(s)
- Pooja Gupta
- Department of Pathology, ICMR-National Institute of Pathology, New Delhi, India
| | - Sharma Shruti
- Department of Pathology, ICMR-National Institute of Pathology, New Delhi, India
| | - Fouzia Siraj
- Department of Pathology, ICMR-National Institute of Pathology, New Delhi, India
| | - Aradhana Bhargava
- Apex Regional STD Center, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Geeti Khullar
- Department of Dermatology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| |
Collapse
|
3
|
Ronchi A, Vitiello P, D’Abbronzo G, Caccavale S, Argenziano G, Sica A, Alfano R, Savarese G, Berretta M, Cozzolino I, Franco R. Primary Cutaneous B-Cell Lymphomas with Large Cell Morphology: A Practical Review. Int J Mol Sci 2023; 24:ijms24076204. [PMID: 37047176 PMCID: PMC10094092 DOI: 10.3390/ijms24076204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/19/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
Most primary cutaneous lymphomas consist of T-cell lymphomas or small cell lymphomas; however, the skin may also be affected by lymphomas with large cell morphology, as a primary or secondary localization. A minority of cases consist of primary cutaneous B-cell lymphomas (PCBCLs). PCBCLs are a heterogeneous group of rare neoplasms with an overlapping morphological and immunohistochemical picture of the different subtypes. Nevertheless, differential diagnosis in the setting of this group of neoplasms is mandatory to identify the correct therapy and prognosis, but it may be challenging since, due to the rarity of these neoplasms, they may not always be familiar to pathologists. Indeed, immunohistochemistry may not be enough to distinguish the different histotypes, which overlap in immunohistochemical features. Furthermore, the ever-increasing knowledge of the molecular features of systemic B-cell lymphomas, such as gene rearrangements with clinical significance, has led in recent years to further investigation into the molecular landscape of PCBCLs with large cell morphology. This work aimed to provide a practical diagnostic guide for pathologists dealing with primary cutaneous large B-cell lymphomas.
Collapse
|
4
|
Uccella S, Goteri G, Maiorana A, Donati V, Tibiletti MG, Magnoli F, Facchi S, Merchiori D, Morsia E, Papotti R, Bettelli S, Forti E, Galimberti S, Rupoli S, Filosa A, Dardanis D, Bomben R, Braglia L, Pozzi S, Sacchi S. Clinico-Pathological, Cytogenetic and Molecular Profiles of Primary Cutaneous Diffuse Large B-Cell Lymphomas. Hum Pathol 2023; 136:44-55. [PMID: 36997030 DOI: 10.1016/j.humpath.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/09/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023]
Abstract
We analyzed the clinico-pathological, cytogenetic and molecular features of 18 Primary Cutaneous Diffuse Large B-Cell Lymphoma (PCDLBCL), and 15 DLBCL secondarily localized to the skin (SCDLBCL), highlighting biologic similarities and differences between the two groups. PCDLBCL were sub classified after histopathological review as PCDLBCL-Leg type (PCDLBCL-LT, 10 cases) and the PCDLBCL-not otherwise specified (PCDLBCL, NOS, 8 cases). Immunohistochemistry for Hans' algorithm markers, BCL2, and MYC was performed. The molecular study included the determination of the cell of origin (COO) by Lymph2Cx assay on Nano string platform, FISH analysis of IgH, BCL2, BCL6, and MYC genes, as well as the mutation analysis of MYD88 gene. At immunohistochemistry, BCL2 and MYC hyper expression was more frequent in LT than in NOS cases and, according to Hans' algorithm, PCDLBCL LT were mostly of the non-GC type (8/10), whereas in PCDLBCL NOS the GC type prevailed (6/8). The determination of COO using Lymph2Cx supported and further confirmed these results. At FISH analysis, all but one LT cases versus 5 out of 8 PCDLBCL NOS showed at least one gene rearrangement among IgH, BCL2, MYC or BCL6. In addition, MYD88 mutations were more frequently present in LT than in NOS subtypes. Interestingly, MYD88- mutated patients were older, with a non-GC phenotype and had worse OS, compared to MYD88 WT cases. Overall, SCDLBCL did not show, at the genetic and expression level, different profiles than PCDLBCL, even if they bear a significantly worse prognosis. At survival analysis, the most important prognostic factors in PCDLBCL patients were age and MYD88 mutation, whereas relapse and high Ki67 expression were relevant in SCDLBCL patients. Our study comprehensively analyzed the clinico-pathological and molecular features of PCDLBCL LT, PCDLBCL-NOS, and SCDLBCL, underlining the differnces among them and the importance of properly identifying these entities at the time of diagnosis.
Collapse
|
5
|
Vitiello P, Sagnelli C, Ronchi A, Franco R, Caccavale S, Mottola M, Pastore F, Argenziano G, Creta M, Calogero A, Fiorelli A, Casale B, Sica A. Multidisciplinary Approach to the Diagnosis and Therapy of Mycosis Fungoides. Healthcare (Basel) 2023; 11:healthcare11040614. [PMID: 36833148 PMCID: PMC9957453 DOI: 10.3390/healthcare11040614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/10/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Mycosis fungoides is the most common primary cutaneous T-cell lymphoma, characterized by skin-homing CD4+ T cells derivation, indolent course, and low-grade of malignancy. Mycosis fungoides's classic type typically onsets with cutaneous erythematous patches, plaque, and tumor. In WHO-EORTC classification, folliculotropic mycosis fungoides, pagetoid reticulosis, and granulomatous slack skin are recognized as distinct variants of mycosis fungoides, because of their clinical and histological features, behavior, and /or prognosis. Mycosis fungoides often shows diagnostic difficulties, due to its absence of specific features and lesional polymorphism. A patient's treatment requires staging. In about 10% of cases, mycosis fungoides can progress to lymph nodes and internal organs. Prognosis is poor at advanced stage and management needs a multidisciplinary team approach. Advanced stage disease including tumors, erythroderma, and nodal, visceral, or blood involvement needs skin directed therapy associated with systemic drugs. Skin directed therapy includes steroids, nitrogen mustard, bexarotene gel, phototherapy UVB, and photochemiotherapy, i.e., total skin electron radiotherapy. Systemic therapies include retinoids, bexarotene, interferon, histone deacetylase inhibitors, photopheresis, targeted immunotherapy, and cytotoxic chemotherapy. Complexity of mycosis fungoides associated with long-term chronic evolution and multiple therapy based on disease stage need a multidisciplinary team approach to be treated.
Collapse
Affiliation(s)
- Paola Vitiello
- Dermatology Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-39-3810-7860
| | - Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Stefano Caccavale
- Dermatology Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Maria Mottola
- Department of Heart Surgery and Transplantations, AORN Dei Colli-V Monaldi, 80131 Naples, Italy
| | | | - Giuseppe Argenziano
- Dermatology Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| | - Beniamino Casale
- Department of Pneumology and Tisiology, AO Dei Colli-V. Monaldi, 80131 Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
| |
Collapse
|
6
|
Kilaru S, Panda SS, Mishra S, Mohapatra D, Baisakh M, Kolluri S, Devaraj S, Moharana L, Biswas G. Cutaneous involvement in diffuse large B cell lymphoma at presentation: report of two rare cases and literature review. J Egypt Natl Canc Inst 2021; 33:25. [PMID: 34514544 DOI: 10.1186/s43046-021-00085-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 08/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diffuse large B cell lymphoma (DLBCL) can occur at nodal and/or extra-nodal sites. After the gastrointestinal tract, cutaneous involvement predominates in extra-nodal DLBCL. Skin involvement at presentation can be in the form of plaques, papules, nodules or ulcers. Differentiating primary cutaneous DLBCL from systemic DLBCL with cutaneous involvement is important for appropriate patient management. CASE PRESENTATION We describe here, two interesting cases of skin involvement in DLBCL- one primary cutaneous DLBCL and the other, cutaneous involvement in systemic DLBCL with different clinico-pathological profiles. Though both cases had almost similar morphology of the skin lesions (ulcero-proliferative) at presentation, the disease was confined to the skin in the former, while the latter had involvement of lymph nodes and bone marrow. CONCLUSIONS Meticulous clinical evaluation, appropriate histopathological and immunohistochemical workup helped in their diagnosis and correct classification of the disease status, guiding the further treatment decisions.
Collapse
Affiliation(s)
- Sindhu Kilaru
- Department of Medical Oncology, IMS and SUM Hospital, Siksha 'O' Anusandhan University, Bhubaneshwar, Odisha, India.
| | - Soumya Surath Panda
- Department of Medical Oncology, IMS and SUM Hospital, Siksha 'O' Anusandhan University, Bhubaneshwar, Odisha, India
| | - Sourav Mishra
- Department of Medical Oncology, Apollo Hospital, Bhubaneswar, Odisha, India
| | - Debahuti Mohapatra
- Department of Pathology, IMS & SUM Hospital, Siksha 'O' Anusandhan University, Bhubaneswar, Odisha, India
| | - Manas Baisakh
- Department of Pathology, Apollo Hospital, Bhubaneswar, Odisha, India
| | - Spoorthy Kolluri
- Department of Medical Oncology, IMS and SUM Hospital, Siksha 'O' Anusandhan University, Bhubaneshwar, Odisha, India
| | - Suma Devaraj
- Department of Medical Oncology, IMS and SUM Hospital, Siksha 'O' Anusandhan University, Bhubaneshwar, Odisha, India
| | - Lalatendu Moharana
- Department of Medical Oncology, IMS and SUM Hospital, Siksha 'O' Anusandhan University, Bhubaneshwar, Odisha, India
| | - Ghanashyam Biswas
- Department of Medical Oncology, IMS and SUM Hospital, Siksha 'O' Anusandhan University, Bhubaneshwar, Odisha, India.,Department of Medical Oncology, Sparsh Hospital, Bhubaneswar, Odisha, India
| |
Collapse
|
7
|
Wang Z, Ran X, Qian S, Hou H, Dong M, Wu S, Ding M, Zhang Y, Zhang X, Zhang M, Chen Q. GPNMB promotes the progression of diffuse large B cell lymphoma via YAP1-mediated activation of the Wnt/β-catenin signaling pathway. Arch Biochem Biophys 2021; 710:108998. [PMID: 34280359 DOI: 10.1016/j.abb.2021.108998] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/28/2021] [Accepted: 07/15/2021] [Indexed: 01/06/2023]
Abstract
Glycoprotein non-metastatic melanoma protein B (GPNMB) has been confirmed to be related to the pathogenesis of tumors. However, the potential impact of GPNMB on the progression of diffuse large B-cell lymphoma (DLBCL) is unclear. In this study, the expression levels of GPNMB and Yes-associated protein (YAP) were analyzed using qRT-PCT and Western blot assay. Cell counting kit-8, EdU, and flow cytometry assays were used to detect the proliferation and apoptosis of DLBCL cells. A nude mice xenograft model was established for in vivo research. Results showed that GPNMB and YAP1 were upregulated in DLBCL cell lines. Knockdown of GPNMB inhibited cell proliferation and promoted apoptosis in DLBCL cells. Additionally, the expression levels of YAP1 and the downstream effector of Hippo pathway (c-myc) were markedly decreased when GPNMB was knocked down. Moreover, knockdown of GPNMB inhibited the nuclear translocation of β-catenin protein, which could be abolished by YAP1 overexpression. Simultaneously, the anti-proliferative and pro-apoptotic effects of GPNMB knockdown could be reversed by YAP1 overexpression or LiCl (the activator of Wnt/β-catenin pathway). Furthermore, the mice xenograft model confirmed that inhibition of GPNMB restrained the tumorigenesis of DLBCL in vivo. In conclusion, GPNMB could partly activate the Wnt/β-catenin signaling pathway by targeting YAP1, so as to participate in tumorigenesis of DLBCL.
Collapse
Affiliation(s)
- Zeyuan Wang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, China
| | - Xianting Ran
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, China
| | - Siyu Qian
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, China
| | - Huting Hou
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, China
| | - Meng Dong
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, China
| | - Shaoxuan Wu
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, China
| | - Mengjie Ding
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, China
| | - Yue Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, China
| | - Xudong Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, China
| | - Mingzhi Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, China
| | - Qingjiang Chen
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, China.
| |
Collapse
|
8
|
Cascone R, Carlucci A, Messina G, Noro A, Bove M, Natale G, Sagnelli C, Opromolla G, Martone M, Santoriello C, Santoriello E, Verolino P, Creta M, Vicidomini G, Fiorelli A, Santini M, Sica A. Ultrasound-Guided Anterior Mediastinotomy: A Feasible Tool for Critical Lymphoma Patients. Healthcare (Basel) 2021; 9:healthcare9060770. [PMID: 34205526 PMCID: PMC8235016 DOI: 10.3390/healthcare9060770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/20/2022] Open
Abstract
A significant part of all neoplasms growing in anterior mediastinum are lymphomas (25%). Achieving a correct diagnosis and a clear definition of a lymphoma’s subtype is crucial for beginning chemotherapy as soon as possible. However, most patients present a large mediastinal mass that compresses vessels and airway, with serious cardiorespiratory repercussions. Therefore, having multiple tools available to biopsy the lesion without worsening morbidity becomes fundamental. Patients enrolled in this study were unfit for a surgical biopsy in general anesthesia and the need to begin chemotherapy as fast as possible prompted us to avoid percutaneous fine needle aspiration to prevent diagnostic failures. Our observational study included 13 consecutive patients with radiological findings of anterior mediastinal mass. Ultrasonography was performed directly in the theatre to mark the lesion and to localize vessels and vascularized neoplastic tissue. Open biopsy was carried out in spontaneous breathing with a laryngeal mask and with short-acting medications for a rapid anesthesia, performing an anterior mediastinotomy. The mean operative time was 33.4 ± 6.2 min and spontaneous respiration was maintained throughout the procedure. No complications were reported. All patients were discharged in the first or second postoperative day after a chest X-ray (1.38 ± 0.5 days). The diagnostic yield of this approach was 100%. With the addition of ultrasonography right before the procedure and with spontaneous breathing, anterior mediastinotomy still represents a useful tool in critical patients that could hardly tolerate a general anesthesia. The diagnostic yield is high, and the low postoperative morbidity allows a rapid onset of chemotherapy.
Collapse
Affiliation(s)
- Roberto Cascone
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Annalisa Carlucci
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Gaetana Messina
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Antonio Noro
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Mary Bove
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Giovanni Natale
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-33938107860 or +39-08119573375
| | - Giorgia Opromolla
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Mario Martone
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Carlo Santoriello
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Elena Santoriello
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Pasquale Verolino
- Plastic Surgery Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Luigi Vanvitelli University of Campania, 80131 Naples, Italy;
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Giovanni Vicidomini
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Mario Santini
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (R.C.); (A.C.); (G.M.); (A.N.); (M.B.); (G.N.); (G.O.); (M.M.); (C.S.); (E.S.); (G.V.); (A.F.); (M.S.)
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| |
Collapse
|
9
|
Belfiore MP, Reginelli A, Russo A, Russo GM, Rocco MP, Moscarella E, Ferrante M, Sica A, Grassi R, Cappabianca S. Usefulness of High-Frequency Ultrasonography in the Diagnosis of Melanoma: Mini Review. Front Oncol 2021; 11:673026. [PMID: 34178660 PMCID: PMC8226081 DOI: 10.3389/fonc.2021.673026] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/17/2021] [Indexed: 01/30/2023] Open
Abstract
High-frequency equipment is characterized by ultrasound probes with frequencies of over 10 MHz. At higher frequencies, the wavelength decreases, which determines a lower penetration of the ultrasound beam so as to offer a better evaluation of the surface structures. This explains the growing interest in ultrasound in dermatology. This review examines the state of the art of high-frequency ultrasound (HFUS) in the assessment of skin cancer to ensure the high clinical approach and provide the best standard of evidence on which to base clinical and policy decisions.
Collapse
Affiliation(s)
- Maria Paola Belfiore
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alfonso Reginelli
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Anna Russo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Gaetano Maria Russo
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Maria Paola Rocco
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Elvira Moscarella
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Marilina Ferrante
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Roberto Grassi
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
- Italian Society of Medical Radiology (SIRM) Foundation, Milan, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| |
Collapse
|
10
|
Sica A, Casale B, Sagnelli C, Di Dato MT, Rispoli M, Santagata M, Buonavolontà P, Fiorelli A, Vitiello P, Caccavale S, Creta M, Salzano AM, Sagnelli E, Saracco E, Gazzerro G, Famiglietti V, Tammaro D, Papa A. Chronic Chest Pain Control after Trans-Thoracic Biopsy in Mediastinal Lymphomas. Healthcare (Basel) 2021; 9:589. [PMID: 34069774 PMCID: PMC8157245 DOI: 10.3390/healthcare9050589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/01/2021] [Accepted: 05/10/2021] [Indexed: 12/14/2022] Open
Abstract
Chest pain following a trans-thoracic biopsy often has multiple etiologies, especially in patients with lymphomas. Pathological neuronal mechanisms integrate with an overproduction of IL-6, TNF-α, IL1-β by macrophages and monocytes, which amplifies inflammation and pain. In consideration of this complex pathogenesis, international guidelines recommend diversified analgesia protocols: thoracic epidural, paravertebral block, and systemic administration of opioids. This study reports an attempt to reduce chest pain and prevent chronic pain in 51 patients undergoing trans-thoracic biopsy for mediastinal lymphoma. The entity of pain, measured 72nd hour after biopsy by the Numerical Rating Scale (NRS), was compared with that seen at a 6th month checkpoint in 46 patients. The pain decreased in all cases. At the 6th month checkpoint, among 31 opioid-treated patients, none of the 16 patients with NRS < 6 within the 72nd hour post biopsy had developed chronic chest pain, while 8 of the 15 with higher values did (p < 0.01). Of 10 patients undergoing thoracotomy and treated with opioids, eight had a NRS of no more than 2, of which six had no chronic pain. Of the twenty-one patients who underwent VATS biopsy and were treated with opioids, fifteen had NRS no greater than 2, of which ten had no chronic pain. Subgroups of patients biopsied under mediastinotomy or video-assisted thoracoscopic surgery (VATS) and treated with thoracic epidural analgesia (TEA) or PVB were too small for such analysis.
Collapse
Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Beniamino Casale
- Department of Pneumology and Tisiology, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy;
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (C.S.); (E.S.)
| | - Maria Teresa Di Dato
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Marco Rispoli
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Mario Santagata
- Multidisciplinary Department of Medical Surgery and Dental Specialties, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Pietro Buonavolontà
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Paola Vitiello
- Dermatology Unit, University of Campania, 80131 Naples, Italy; (P.V.); (S.C.)
| | - Stefano Caccavale
- Dermatology Unit, University of Campania, 80131 Naples, Italy; (P.V.); (S.C.)
| | - Massimiliano Creta
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | - Anna Maria Salzano
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy; (C.S.); (E.S.)
| | - Elisabetta Saracco
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Giuseppe Gazzerro
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Vincenzo Famiglietti
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80131 Naples, Italy;
| | - Dario Tammaro
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| | - Alfonso Papa
- Pain Department, AORN Dei Colli-V. Monaldi, 80131 Naples, Italy; (M.T.D.D.); (M.R.); (P.B.); (A.M.S.); (E.S.); (G.G.); (D.T.); (A.P.)
| |
Collapse
|
11
|
Sica A, Santagata M, Sagnelli C, Rambaldi P, Franco R, Creta M, Vitiello P, Caccavale S, Tammaro V, Sagnelli E, Ronchi A. Primary Extra-Nodal DLBCL of Glands: Our Experiences outside Guidelines of Treatment. Healthcare (Basel) 2021; 9:healthcare9030286. [PMID: 33807793 PMCID: PMC8002204 DOI: 10.3390/healthcare9030286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023] Open
Abstract
Lymphomas usually involve lymph nodes and other lymphoid tissues, but sometimes occur in non-lymphoid organs, called extra-nodal sites. Primary diffuse extra-lymph node large B-cell lymphoma (DLBCL) of the thyroid and parotid gland have been observed rarely. According to the most accredited guidelines, primary extra-nodal DLBCL of the parotid and thyroid glands should be treated with three cycles of R-CHOP followed by radiotherapy of the involved site (ISRT). Surgery alone is not enough to treat DLBCL. We describe two unusual cases of primary extra-nodal DLBCL in elderly patients treated exclusively with surgical resection, given the inability to apply chemotherapy. Both patients achieved clinical recovery, which was maintained after a follow-up of more than 18 months, despite not having performed the indicated chemotherapy protocol. The two cases presented here, and a few others reported in the literature, should be considered exceptions to the rule, and do not allow the conclusion that surgery alone might be sufficient for complete remission.
Collapse
Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (A.S.); (P.R.)
| | - Mario Santagata
- Multidisciplinary Department of Medical Surgery and Dental Specialties, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
- Correspondence: ; Tel.: +39-3332253315 or +39-08119573375
| | - Piero Rambaldi
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (A.S.); (P.R.)
| | - Renato Franco
- Division of Pathology, Department of Mental Health and Preventive, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (R.F.); (A.R.)
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Paola Vitiello
- Dermatology Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (P.V.); (S.C.)
| | - Stefano Caccavale
- Dermatology Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (P.V.); (S.C.)
| | - Vincenzo Tammaro
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Andrea Ronchi
- Division of Pathology, Department of Mental Health and Preventive, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (R.F.); (A.R.)
| |
Collapse
|
12
|
Sica A, Sagnelli C, Casale B, Svanera G, Creta M, Calogero A, Franco R, Sagnelli E, Ronchi A. How Fear of COVID-19 Can Affect Treatment Choices for Anaplastic Large Cell Lymphomas ALK+ Therapy: A Case Report. Healthcare (Basel) 2021; 9:healthcare9020135. [PMID: 33572634 PMCID: PMC7912420 DOI: 10.3390/healthcare9020135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/11/2021] [Accepted: 01/25/2021] [Indexed: 12/16/2022] Open
Abstract
Background: The t (2; 5) chromosomal rearrangement of the ALK gene with nucleophosmin 1 gene (NPM1), resulting in an NPM1–ALK fusion, was first demonstrated in 1994 in anaplastic large cell lymphoma, (ALCL), a T-cell lymphoma responsive to cyclophosphamide, abriblastine, vincristine and prednisone in approximately 80% of cases; refractory cases usually respond favorably to brentuximab vedotin. These treatments are regarded as a bridge to allogeneic hematopoietic stem cell transplantation (allo-SCT). Nowadays, transplant procedures and the monitoring of chemotherapy patients proceed very slowly because the SARS-CoV-2 pandemic has heavily clogged the hospitals in all countries. Results: A 40-year-old Caucasian woman was first seen at our clinical center in June 2020. She had ALCL ALK+, a history of failure to two previous therapeutic lines and was in complete remission after 12 courses of brentuximab, still pending allo-SCT after two failed donor selections. Facing a new therapeutic failure, we requested and obtained authorization from the Italian drug regulatory agency to administer 250 mg of crizotinib twice a day, a drug incomprehensibly not registered for ALCL ALK +. Conclusions: The response to crizotinib was optimal since no adverse event occurred, and CT-PET scans persisted negative; this drug has proved to be a valid bridge to allo-SCT.
Collapse
Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-3332253315 or +39-08119573375
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.S.); (E.S.)
| | - Beniamino Casale
- Pain Department, AORN Dei Colli—V. Monaldi, 80131 Naples, Italy;
| | - Gino Svanera
- Department of Medical Area ASLNA2 NORTH, 80014 Giugliano, Italy;
| | - Massimiliano Creta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy;
| | - Armando Calogero
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy;
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (R.F.); (A.R.)
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (C.S.); (E.S.)
| | - Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (R.F.); (A.R.)
| |
Collapse
|
13
|
Sica A, Sagnelli C, Vitiello P, Franco R, Argenziano G, Ciccozzi M, Sagnelli E, Ronchi A. Rescue Therapy of Refractory Diffuse Large B-Cell Lymphomas BCL2 with Venetoclax: Case Report. Chemotherapy 2021; 65:161-165. [PMID: 33477155 DOI: 10.1159/000512541] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/23/2020] [Indexed: 11/19/2022]
Abstract
Eleven years ago, a 64-year-old Caucasian man had LNH Follicular 3a, IV A stage, FLIPI 2 as a prognostic index of follicular lymphoma. He received 8 cycles of RCHOP followed by rituximab maintenance, with complete remission. Due to a systemic recurrence, a new treatment schedule (RCOMP, 6 cycles) was introduced with partial remission persisting during a long-term maintenance treatment with rituximab. Three years ago, LNH Follicular 3a progressed into GC type diffuse large B-cell lymphomas (DLBCL); 6 cycles of rituximab and bendamustine were followed by R-ICE and R OXALI DHAP treatments without beneficial effect. Due to the worse general condition (ECOG 3-4), the patient was treated with pixantrone (6 cycles) until July 10, 2019, with a partial response. On Jan 13, 2020, an extreme compassioned treatment with venetoclax alone was started; this drug was well tolerated and provided a satisfactory clinical and laboratory improvement. In June 2020, however, he developed bone marrow toxicity and septic fever. Nasal and pharyngeal secretions were SARS-CoV-2 RNA negative. Blood cultures for mycotic agents and Gram-positive, Gram-negative, and anaerobic bacteria were negative, but few days later, the patients died of sepsis due to unidentified agents. The use of venetoclax as a single drug to treat DLBCL BCL2 patients deserves further investigation.
Collapse
Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy,
| | - Paola Vitiello
- Dermatology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Renato Franco
- Department of Mental and Physical Health and Preventive Medicine, Pathology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Massimo Ciccozzi
- Medical Statistics and Molecular Epidemiology, Campus Bio-Medico University, Rome, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Ronchi
- Department of Mental and Physical Health and Preventive Medicine, Pathology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
14
|
Qu G, Chen J, Huang G, Zhang M, Yu H, Zhu H, Chen L, Wang D, Pei B. A quantitative exploration of symptoms in COVID-19 patients: an observational cohort study. Int J Med Sci 2021; 18:1082-1095. [PMID: 33456367 PMCID: PMC7807191 DOI: 10.7150/ijms.53596] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/18/2020] [Indexed: 12/15/2022] Open
Abstract
Background: As the spreading of the COVID-19 around the global, we investigated the characteristics and changes of symptoms in COVID-19 patients. Methods: This was an ambispective observational cohort study, and 133 confirmed COVID-19 patients were included and all symptoms over the course were analyzed qualitatively. The symptoms, their changes over the course in the cohort and in the different clinical types, etc. were illustrated. Differences in different periods and severities were analyzed through Chi square test, association with severity was analyzed through LASSO binomial logistic regression analysis. Inter-correlation and classification of symptoms were completed. Major symptoms were screened and their changes were illustrated. Results: A total of 43 symptoms with frequencies as 6067 in this cohort. Differences of symptoms in different stages and clinical types were significant. Expectoration, shortness of breath, dyspnea, diarrhea, poor appetite were positively but vomiting, waist discomfort, pharyngeal discomfort, acid reflux were negatively correlated with the combined-severe and critical type; dyspnea was correlated with the critical type. The 17 major symptoms were identified. The average daily frequency of symptoms per case was decreased continuously before the transition into the severe type and increased immediately one day before the transition and then decreased. It was decreased continuously before the transition date of the critical type and increased from the transition into the critical type to the next day and decreased thereafter. Dyspnea (P<0.001), shortness of breath (P<0.01) and chest distress (P<0.05) were correlated with death and their corresponding coefficient was 0.393, 0.258, 0.214, respectively. Conclusion: The symptoms of COVID-19 patients mainly related to upper respiratory tract infection, cardiopulmonary function, and digestive system. The mild type and the early stage in other types mainly related to upper respiratory tract infection. The cardiopulmonary function and digestive system associated symptoms were found in all other types and stages. Dyspnea was correlated with critical type, and dyspnea, shortness of breath and chest distress were correlated with death. Respiratory dysfunction (or incompleteness) associated symptoms were the characteristic symptoms. The changes of symptoms did not synchronously with the changes of severity before the transition into the severe or critical type.
Collapse
Affiliation(s)
- Gaojing Qu
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei, China
| | - Junwen Chen
- Department of Respiratory and Critical Care Medicine, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei, China
| | - Guoxin Huang
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei, China
| | - Meiling Zhang
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei, China
| | - Hui Yu
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei, China
| | - Haoming Zhu
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei, China
| | - Lei Chen
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei, China
| | - Dengru Wang
- Yunnan Yanling Biological Technology co., LTD, Kunming 650224, Yunnan, China
| | - Bin Pei
- Department of Evidence-Based Medicine Center, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang 441000, Hubei, China
| |
Collapse
|
15
|
Sica A, Casale D, Rossi G, Casale B, Ciccozzi M, Fasano M, Ciotti M, Sagnelli E, Papa A, Sagnelli C. The impact of the SARS-CoV-2 infection, with special reference to the hematological setting. J Med Virol 2021; 93:223-233. [PMID: 32558961 PMCID: PMC7323149 DOI: 10.1002/jmv.26197] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 06/16/2020] [Indexed: 02/07/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a disease known from a few months, caused by a recently arisen virus and, consequently, it is little known. The disease has a benign course in most infected subjects (children and young adults), is often symptomatic in adults over the age of 50 and often serious and life threatening in people with comorbidities and the elderly. The few data published on coronavirus disease-2019 (COVID-19) in the blood-oncology field report a serious clinical presentation, a serious course of the disease, and a high mortality rate, as has also been reported for other cancer contexts. The current strategy for treating patients with SARS-CoV-2 includes antivirals that are effective against other viral infections and drugs that can moderate the cytokine storm. There is no specific vaccine and consequently all possible precautions must be taken to prevent SARS-CoV-2 infection in the areas of oncology, oncohematology, and bone marrow transplantation. In this reviewer's article, we report the information currently available on SARS-CoV-2 infection to help young doctors and hematologists to successfully manage patients with COVID-19.
Collapse
Affiliation(s)
- Antonello Sica
- Department of Precision MedicineUniversity of Campania Luigi VanvitelliNaplesItaly
| | - Danilo Casale
- Anesthesiology DivisionBuon Consiglio Fatebenefratelli HospitalNaplesItaly
| | - Giovanni Rossi
- Radiology DivisionAORN Dei Colli ‐ V. MonaldiNaplesItaly
| | | | - Massimo Ciccozzi
- Unit of Medical Statistics and Molecular EpidemiologCampus Bio‐Medico UniversityRomeItaly
| | - Morena Fasano
- Department of Precision MedicineUniversity of Campania Luigi VanvitelliNaplesItaly
| | - Marco Ciotti
- Division of Virology, Laboratory of Clinical Microbiology and VirologyPolyclinic Tor Vergata FoundationRomeItaly
| | - Evangelista Sagnelli
- Department of Mental Health and Public MedicineUniversity of Campania Luigi VanvitelliNaplesItaly
| | - Alfonso Papa
- Department of PainAORN Dei Colli ‐ V. MonaldiNaplesItaly
| | - Caterina Sagnelli
- Department of Mental Health and Public MedicineUniversity of Campania Luigi VanvitelliNaplesItaly
| |
Collapse
|
16
|
Sica A, Casale B, Sagnelli C, Di Dato MT, Buonavolontà P, Salzano AM, Sagnelli E, Famiglietti V, Saracco E, Tammaro D, Papa A. All-in-One Spinal Cord Stimulation in Lymphoproliferative Diseases. Front Neurol 2020; 11:550554. [PMID: 33281699 PMCID: PMC7691594 DOI: 10.3389/fneur.2020.550554] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/02/2020] [Indexed: 12/20/2022] Open
Abstract
Even patients with lymphoproliferative diseases may develop a persistent chronic pain not responsive to usual treatments due to changes in antibody production and to some treatments like radiotherapy, chemotherapy, and the administration of monoclonal antibodies, which further impair the immune defense and induce chronic inflammatory phenomena acting as a substrate for a persistent chronic pain. Five patients with indolent lymphoproliferative diseases were treated for severe pain nonresponsive to other pain reliever treatments with SCS applied with an All-in-One Shot (OS) procedure. For all patients, the estimated survival time was of 5 years or more. All patients showed a significant reduction of the intensity of pain: the mean Numerical Rating Scale was 7.4 before treatment and 2.2 after. No patient developed adverse events. Supported by the data of this study, we believe that the habit to deprive patients with an indolent form of lymphoproliferative diseases of the possibility to reduce the intensity of chronic pain by SCS treatment is extremely reductive and frustrating.
Collapse
Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Beniamino Casale
- Department of Pain Therapy Monaldi Hospital-Azienda Ospedaliera di Rilievo Nazionale Ospedali dei Colli, Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Maria Teresa Di Dato
- Department of Pain Therapy Monaldi Hospital-Azienda Ospedaliera di Rilievo Nazionale Ospedali dei Colli, Naples, Italy
| | - Pietro Buonavolontà
- Department of Pain Therapy Monaldi Hospital-Azienda Ospedaliera di Rilievo Nazionale Ospedali dei Colli, Naples, Italy
| | - Anna Maria Salzano
- Department of Pain Therapy Monaldi Hospital-Azienda Ospedaliera di Rilievo Nazionale Ospedali dei Colli, Naples, Italy
| | - Evangelista Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Vincenzo Famiglietti
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Elisabetta Saracco
- Department of Pain Therapy Monaldi Hospital-Azienda Ospedaliera di Rilievo Nazionale Ospedali dei Colli, Naples, Italy
| | - Dario Tammaro
- Department of Pain Therapy Monaldi Hospital-Azienda Ospedaliera di Rilievo Nazionale Ospedali dei Colli, Naples, Italy
| | - Alfonso Papa
- Department of Pain Therapy Monaldi Hospital-Azienda Ospedaliera di Rilievo Nazionale Ospedali dei Colli, Naples, Italy
| |
Collapse
|
17
|
Ronchi A, Zito Marino F, Vitiello P, Caccavale S, Argenziano G, Crisci S, Franco R, Sica A. A case of primary cutaneous B-cell lymphoma with immature features in an old man. Diffuse large B-cell lymphoma with immature features or B-cell lymphoblastic lymphoma? J Cutan Pathol 2020; 48:535-540. [PMID: 32623764 DOI: 10.1111/cup.13795] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/24/2020] [Accepted: 07/01/2020] [Indexed: 12/22/2022]
Abstract
Primary cutaneous B-cell lymphomas are a heterogeneous group of lymphoid neoplasms primarily occurring in the skin. Although most cases are represented by primary cutaneous follicle center cell lymphoma, primary cutaneous marginal zone lymphoma and leg-type diffuse large B-cell lymphoma, other diffuse large B-cell lymphomas and B-cell lymphoblastic lymphoma may rarely present primarily in the skin. In this setting, the presence of histopathologic and immunohistochemical features of cellular immaturity is exceedingly rare and may represent a diagnostic challenge. We present the first case of a primary cutaneous diffuse large B-cell lymphoma characterized by diminished expression of CD45, expression of TdT and rearrangement of MYC gene. The differential diagnosis mainly included B-cell lymphoblastic lymphoma, and required the genetic analysis of heavy chain (IGH) gene rearrangements.
Collapse
Affiliation(s)
- Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Federica Zito Marino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Paola Vitiello
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Stefano Caccavale
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Stefania Crisci
- Hematology-Oncology and Stem Cell Transplantation Unit, Istituto Nazionale Tumori, Fondazione "G. Pascale" IRCCS, Naples, Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonello Sica
- Oncology and Hematology Unit, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
18
|
Wollina U, Schönlebe J, Hansel G, Koch A. First case of primary diffuse large B-cell lymphoma of skin as Wolf's postherpetic isotopic response. Dermatol Ther 2020; 33:e13714. [PMID: 32472587 DOI: 10.1111/dth.13714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/16/2020] [Accepted: 05/26/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
| | - Jacqueline Schönlebe
- Institute of Pathology "Georg Schmorl," Städtisches Klinikum Dresden, Dresden, Germany
| | - Gesina Hansel
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
| | - André Koch
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
| |
Collapse
|
19
|
Sica A, DE Rimini ML, Sagnelli C, Casale B, Spada A, Reginelli A, Amarelli C, Maiello C, Belfiore MP, Creta M, Ciccozzi M, Sagnelli E, Troiani T, Cappabianca S. Post-heart transplantation lymphoproliferative diseases (PTLDs) and the diagnostic role of [18f] FDG-PET/CT. Minerva Med 2020; 112:338-345. [PMID: 32407047 DOI: 10.23736/s0026-4806.20.06607-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The incidence of cancer is higher in transplant patients than in the normal population, mostly due to the assumption of immunosuppressants able to reduce the possibility of rejection. In addition, immunocompromised patients have a greater susceptibility to EBV, HPV and HIV, infectious agents that by themselves may favor the onset of malignancies. Post-transplant lymphoproliferative diseases (PLDs) are among the most frequent neoplasms in transplant patients which like other aggressive neoplasms may be identified by the [18f] fluoro-D-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT). METHODS We evaluated the clinical use of FDG-PET/CT in detecting PTLDs and other neoplasms performed at the lowest clinical or laboratory suspicion of malignancy in 127 consecutive subjects who underwent heart transplantation. RESULTS A SUV>4 more confirmed the suspect of malignancy and induced us to further investigations. Of the 127 transplant subjects who underwent FDG-PET/CT, 64 showed a SUV value >4. Of these 64, 8 had PTLDs, 49 other neoplasms (urinary tract tumors, thyroid cancer, HPV cancer related, Kaposi' sarcoma and EBV related head and neck neoplasms) and 7 patients with chronic non-neoplastic inflammatory diseases. CONCLUSIONS In the present study, FDG-PET/CT examination was of great use for an early identification and for an early treatment of PTLDs and other neoplasms.
Collapse
Affiliation(s)
- Antonello Sica
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy -
| | - Maria L DE Rimini
- Diagnostic Service Department, AORN Dei Colli - V. Monaldi, Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Beniamino Casale
- Department of Pneumology and Tisiology, AORN Dei Colli - V. Monaldi, Naples, Italy
| | - Alessandro Spada
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Alfonso Reginelli
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Cristiano Amarelli
- Department of Heart Surgery and Transplantations AORN Dei Colli - V. Monaldi, Naples, Italy
| | - Ciro Maiello
- Department of Heart Surgery and Transplantations AORN Dei Colli - V. Monaldi, Naples, Italy
| | - Maria P Belfiore
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Massimiliano Creta
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, Federico II University, Naples, Italy
| | - Massimo Ciccozzi
- Medical Statistics and Molecular Epidemiology, Campus Bio-Medico University Hospital, Rome, Italy
| | - Evangelista Sagnelli
- Department of Pneumology and Tisiology, AORN Dei Colli - V. Monaldi, Naples, Italy
| | - Teresa Troiani
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| | - Salvatore Cappabianca
- Department of Precision Medicine, Luigi Vanvitelli University of Campania, Naples, Italy
| |
Collapse
|
20
|
Calogero A, Sagnelli C, Peluso G, Sica A, Candida M, Campanile S, Minieri G, Incollingo P, Creta M, Pelosio L, Tammaro V, Scotti A, Jamshidi A, Caggiano M, Sagnelli E, Dodaro CA, Carlomagno N, Santangelo M. Physical activity in elderly kidney transplant patients with multiple renal arteries. Minerva Med 2020; 113:119-127. [PMID: 32338484 DOI: 10.23736/s0026-4806.20.06573-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Kidney transplantation (KT) is the gold standard for treatment of patients with end- stage-renal disease. To expand the donor reserve, it is necessary to use marginal/suboptimal kidneys. METHODS We retrospectively evaluated the short/long-term outcome of 34 KT elderly patients who received allografts with vascular abnormalities (MRA group), in comparison with 34 KT patients who received a kidney with a single renal artery (SRA group) pair-matched by age, length of time on dialysis, comorbidity and donor age. RESULTS All participants completed the International Physical Activity Questionnaire at KT, and then 4, 8, and 12 weeks after transplantation. Our data indicate that kidney with vascular anatomical variants may be successfully transplanted, since the overall rate of surgical complications was 20.6% in the SRA group and 17.6% in the MRA group and that the 5-year survival rate after KT was 100% in both groups. CONCLUSIONS The data also underline that individualized physical activity programs induced similar excellent results in both groups, improving physical capacities, arterial pressure, lipid metabolism, insulin sensitivity, quality of life and physical and mental status.
Collapse
Affiliation(s)
- Armando Calogero
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.,Department of Nephrology, Urology, General Surgery and Kidney Transplants, Anesthesiology and Intensive Care, University Federico II, Naples, Italy
| | - Caterina Sagnelli
- Department of Mental Health and Public Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Gaia Peluso
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Maria Candida
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Silvia Campanile
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Gianluca Minieri
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Paola Incollingo
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Massimiliano Creta
- Department of Nephrology, Urology, General Surgery and Kidney Transplants, Anesthesiology and Intensive Care, University Federico II, Naples, Italy
| | - Luigi Pelosio
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Vincenzo Tammaro
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Alessandro Scotti
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Akbar Jamshidi
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Marcello Caggiano
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Evangelista Sagnelli
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy -
| | - Concetta A Dodaro
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.,Department of Nephrology, Urology, General Surgery and Kidney Transplants, Anesthesiology and Intensive Care, University Federico II, Naples, Italy
| | - Nicola Carlomagno
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Michele Santangelo
- General Surgery and Transplant Unit, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.,Department of Nephrology, Urology, General Surgery and Kidney Transplants, Anesthesiology and Intensive Care, University Federico II, Naples, Italy
| |
Collapse
|
21
|
Vitiello P, Sica A, Ronchi A, Caccavale S, Franco R, Argenziano G. Primary Cutaneous B-Cell Lymphomas: An Update. Front Oncol 2020; 10:651. [PMID: 32528871 PMCID: PMC7266949 DOI: 10.3389/fonc.2020.00651] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/07/2020] [Indexed: 12/13/2022] Open
Abstract
Primary cutaneous B-cell lymphomas (PCBCLs) comprise a group of extranodal B-cell non-Hodgkin lymphomas B-cell derived, which primarily involve the skin without evidence of extracutaneous disease at the time of diagnosis. They include ~25% of all cutaneous lymphomas and are classified in three major subgroups (World Health Organization (WHO) 2017): primary cutaneous marginal zone lymphoma (PCMZL), primary cutaneous follicle-center cell lymphoma (PCFCL), and diffuse large B-cell lymphoma, leg type (PCDLBCL, LT). This classification also includes some less common entities such as intravascular large B-cell lymphoma. Recently, WHO-EORTC added Epstein-Barr virus positive (EBV+) mucocutaneous ulcer, as a new provisional distinct entity, to cutaneous B-cell lymphomas. PCBCLs are classically characterized by patches, plaques, or nodules showing great variability for color, shape, and location. Diagnosis requires histological examination with immunohistochemical staining. In general, therapeutic options depend on the exact histological and immunohistochemical classification, disease presentation, and risk assessment. PCMZL and PCFCL are considered indolent lymphomas with a good prognosis and are associated with 5-year disease-specific survival ≥ 95%. In contrast, PCDLBCL, LT is considered an aggressive lymphoma with a survival rate in 5 years of lower than 60%. Patients with a solitary lesion or limited lesions in a single anatomical site require different treatments as compared to patients with generalized lesions or refractory disease or extracutaneous involvement. Therapeutic choice includes observation, local, or systemic therapy based on histology and disease extension. Patient management is multidisciplinary, including dermatologists, pathologists, hemato-oncologists, and radiation oncologists.
Collapse
Affiliation(s)
- Paola Vitiello
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Antonello Sica
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
- *Correspondence: Antonello Sica
| | - Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Stefano Caccavale
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | | |
Collapse
|