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Defraia B, Piumelli R, Buccoliero AM, Cannella G, Bugelli V, Grifoni R, Focardi M, Pinchi V. Postmortem diagnosis of 21-hydroxylase deficiency congenital adrenal hyperplasia: medico-legal issues. J BIOL REG HOMEOS AG 2019; 33:299-302. [PMID: 30729770] [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] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- B Defraia
- Section of Forensic Medical Sciences, Department of Health Sciences, University of Florence, Florence, Italy
| | - R Piumelli
- Sleep Disordered Breathing and SIDS Center, Meyer Children's Hospital, Florence, Italy
| | - A M Buccoliero
- Department of Histopathology and Molecular Diagnosis, Pathology Unit, University of Florence, Florence, Italy
| | - G Cannella
- Section of Forensic Medical Sciences, Department of Health Sciences, University of Florence, Florence, Italy
| | - V Bugelli
- Section of Forensic Medical Sciences, Department of Health Sciences, University of Florence, Florence, Italy
- Department of Medicine and Health Sciences (DiMeS), University of Molise, Campobasso, Italy
| | - R Grifoni
- Section of Forensic Medical Sciences, Department of Health Sciences, University of Florence, Florence, Italy
| | - M Focardi
- Section of Forensic Medical Sciences, Department of Health Sciences, University of Florence, Florence, Italy
| | - V Pinchi
- Section of Forensic Medical Sciences, Department of Health Sciences, University of Florence, Florence, Italy
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2
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van Scheppingen J, Iyer AM, Prabowo AS, Mühlebner A, Anink JJ, Scholl T, Feucht M, Jansen FE, Spliet WG, Krsek P, Zamecnik J, Buccoliero AM, Giordano F, Genitori L, Kotulska K, Jozwiak S, Jaworski J, Liszewska E, van Vliet EA, Aronica E. Expression of microRNAs miR21, miR146a, and miR155 in tuberous sclerosis complex cortical tubers and their regulation in human astrocytes and SEGA-derived cell cultures. Glia 2016; 64:1066-82. [PMID: 27014996 DOI: 10.1002/glia.22983] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [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: 01/25/2016] [Revised: 02/29/2016] [Accepted: 03/02/2016] [Indexed: 12/23/2022]
Abstract
Tuberous sclerosis complex (TSC) is a genetic disease presenting with multiple neurological symptoms including epilepsy, mental retardation, and autism. Abnormal activation of various inflammatory pathways has been observed in astrocytes in brain lesions associated with TSC. Increasing evidence supports the involvement of microRNAs in the regulation of astrocyte-mediated inflammatory response. To study the role of inflammation-related microRNAs in TSC, we employed real-time PCR and in situ hybridization to characterize the expression of miR21, miR146a, and miR155 in TSC lesions (cortical tubers and subependymal giant cell astrocytomas, SEGAs). We observed an increased expression of miR21, miR146a, and miR155 in TSC tubers compared with control and perituberal brain tissue. Expression was localized in dysmorphic neurons, giant cells, and reactive astrocytes and positively correlated with IL-1β expression. In addition, cultured human astrocytes and SEGA-derived cell cultures were used to study the regulation of the expression of these miRNAs in response to the proinflammatory cytokine IL-1β and to evaluate the effects of overexpression or knockdown of miR21, miR146a, and miR155 on inflammatory signaling. IL-1β stimulation of cultured glial cells strongly induced intracellular miR21, miR146a, and miR155 expression, as well as miR146a extracellular release. IL-1β signaling was differentially modulated by overexpression of miR155 or miR146a, which resulted in pro- or anti-inflammatory effects, respectively. This study provides supportive evidence that inflammation-related microRNAs play a role in TSC. In particular, miR146a and miR155 appear to be key players in the regulation of astrocyte-mediated inflammatory response, with miR146a as most interesting anti-inflammatory therapeutic candidate.
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Affiliation(s)
- J van Scheppingen
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - A M Iyer
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - A S Prabowo
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - A Mühlebner
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - J J Anink
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - T Scholl
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - M Feucht
- Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - F E Jansen
- Department of Pediatric Neurology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - W G Spliet
- Department of Pathology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - P Krsek
- Department of Pediatric Neurology, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - J Zamecnik
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine and Motol University Hospital, Prague, Czech Republic
| | - A M Buccoliero
- Pathology Unit, Anna Meyer Children's Hospital, Florence, Italy
| | - F Giordano
- Department of Neurosurgery, Anna Meyer Children's Hospital, Florence, Italy
| | - L Genitori
- Department of Neurosurgery, Anna Meyer Children's Hospital, Florence, Italy
| | - K Kotulska
- Department of Neurology and Epileptology, Children's Memorial Health Institute, Warsaw, Poland
| | - S Jozwiak
- Department of Child Neurology, Medical University of Warsaw, Warsaw, Poland
| | - J Jaworski
- Laboratory of Molecular and Cellular Neurobiology, International Institute of Molecular and Cell Biology, Warsaw, Poland
| | - E Liszewska
- Laboratory of Molecular and Cellular Neurobiology, International Institute of Molecular and Cell Biology, Warsaw, Poland
| | - E A van Vliet
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - E Aronica
- Department of (Neuro)Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Amsterdam, the Netherlands.,Stichting Epilepsie Instellingen Nederland (SEIN), the Netherlands
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Bassi A, Facchini F, Greco A, Buccoliero AM, Lazzeri S, De Filippi C, Messineo A, de Martino M. A rare case of angiokeratoma in a 8-month-old boy. Arch Dis Child 2015; 100:630. [PMID: 25678595 DOI: 10.1136/archdischild-2014-308124] [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] [Accepted: 01/24/2015] [Indexed: 11/04/2022]
Affiliation(s)
- A Bassi
- Department of Health Sciences, University of Florence, Florence, Italy Department of Paediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
| | - F Facchini
- Division of Plastic Surgery, Anna Meyer Children's University Hospital, Florence, Italy
| | - A Greco
- Department of Health Sciences, University of Florence, Florence, Italy Department of Paediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
| | - A M Buccoliero
- Division of Pathological Anatomy, Anna Meyer Children's University Hospital, Florence, Italy
| | - S Lazzeri
- Trauma Center, Anna Meyer Children's University Hospital, Florence, Italy
| | - C De Filippi
- Division of Radiodiagnostic and Interventional Radiology, Anna Meyer Children's University Hospital, Florence, Italy
| | - A Messineo
- Division of Plastic Surgery, Anna Meyer Children's University Hospital, Florence, Italy
| | - M de Martino
- Department of Health Sciences, University of Florence, Florence, Italy Department of Paediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
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Conti V, Pantaleo M, Barba C, Baroni G, Mei D, Buccoliero AM, Giglio S, Giordano F, Baek ST, Gleeson JG, Guerrini R. Focal dysplasia of the cerebral cortex and infantile spasms associated with somatic 1q21.1-q44 duplication including the AKT3 gene. Clin Genet 2014; 88:241-7. [PMID: 25091978 DOI: 10.1111/cge.12476] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [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: 05/12/2014] [Revised: 07/15/2014] [Accepted: 07/30/2014] [Indexed: 02/01/2023]
Abstract
Somatic and germline duplications or activating mutations of AKT3 have been reported in patients with hemimegalencephaly and megalencephaly. We performed array comparative genomic hybridization on brain tissue and blood in 16 consecutive patients with symptomatic epilepsy due to focal or multilobar malformations of cortical development who underwent surgical treatment of epilepsy. One patient with infantile spasms and a dysplastic left frontal lobe harboured a somatic trisomy of the 1q21.1-q44 chromosomal region, encompassing the AKT3 gene, in the dysplastic brain tissue but not in blood and saliva. Histopathology revealed severe cortical dyslamination, a thin cortex in the premotor area with microgyri and microsulci, immature neurons with disoriented dendrites and areas of cortical heterotopia in the sub-cortical white matter. These cytoarchitectural changes are close to those defining type Ib focal cortical dysplasia. Immunohistochemistry in brain specimens showed hyperactivation of the PI3K/AKT/mTOR pathway. These findings indicate that AKT3 upregulation may cause focal malformations of cortical development. There appears to be an etiologic continuum between hemimegalencephaly and focal cortical dysplastic lesions. The extent of brain malformations due to AKT3 upregulation may be related to the embryonic stage when the post-zygotic gene alteration occurs.
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Affiliation(s)
- V Conti
- Pediatric Neurology and Neurogenetics Unit and Laboratories, A. Meyer Children's Hospital - University of Florence, Florence, Italy
| | - M Pantaleo
- Medical Genetics Unit, A. Meyer Children's Hospital - University of Florence, Florence, Italy
| | - C Barba
- Pediatric Neurology and Neurogenetics Unit and Laboratories, A. Meyer Children's Hospital - University of Florence, Florence, Italy
| | - G Baroni
- Department of Critical Care Medicine and Surgery, University of Florence, Florence, Italy
| | - D Mei
- Pediatric Neurology and Neurogenetics Unit and Laboratories, A. Meyer Children's Hospital - University of Florence, Florence, Italy
| | - A M Buccoliero
- Pathology Unit, A. Meyer Children's Hospital, Florence, Italy
| | - S Giglio
- Medical Genetics Unit, A. Meyer Children's Hospital - University of Florence, Florence, Italy
| | - F Giordano
- Division of Neurosurgery, A. Meyer Children's Hospital, Florence, Italy
| | - S T Baek
- Department of Neurosciences, Howard Hughes Medical Institute, University of California San Diego, La Jolla, CA, USA
| | - J G Gleeson
- Department of Neurosciences, Howard Hughes Medical Institute, University of California San Diego, La Jolla, CA, USA
| | - R Guerrini
- Pediatric Neurology and Neurogenetics Unit and Laboratories, A. Meyer Children's Hospital - University of Florence, Florence, Italy.,Epilepsy and Clinical Neurophysiology Laboratory, IRCCS Stella Maris Foundation, Calambrone, Pisa, Italy
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5
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Buccoliero AM, Arganini L, Ammannati F, Gallina P, Di Lorenzo N, Mennonna P, Taddei GL. Oligodendrogliomas Lacking O6-Methylguanine-DNA-Methyltransferase Expression. J Chemother 2013; 17:321-6. [PMID: 16038527 DOI: 10.1179/joc.2005.17.3.321] [Citation(s) in RCA: 7] [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] [Indexed: 10/31/2022]
Abstract
O6-Methylguanine-DNA-Methyltransferase (MGMT) is a DNA repair protein considered to be a chemosensitivity predictor. We evaluated the immunohistochemical MGMT expression in 28 consecutive oligodendroglial tumors (21 oligodendrogliomas, 5 mixed oligoastrocytomas, and 2 glioblastomas with prominent oligodendroglial features; 13 treated with CCNU) and compared it with that of 13 glioblastomas. Twenty-six (93%) oligodendroglial tumors were MGMT-negative, 2 (7%) were MGMT-positive. Twelve (92%) patients treated with CCNU had MGMT-negative lesions and their median survival was 73 months; 1 patient had an MGMT-positive oligodendroglioma and is alive at 28 months. Three (23%) glioblastomas were MGMT-negative and 10 (77%) MGMT-positive. The lower MGMT expression in oligodendroglial tumors compared to glioblastomas (P < 0.05), which have different chemosensitivity, suggests a possible role of MGMT in the determination of chemoresistance. Nevertheless, the heterogeneous outcome of our MGMT-negative oligodendroglial tumors treated with CCNU, indicates that MGMT expression alone is insufficient to predict the response to alkylating drugs, presumably because of the numerous mechanisms involved.
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Affiliation(s)
- A M Buccoliero
- Department of Human Pathology and Oncology, University of Florence, Italy.
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Fambrini M, Buccoliero AM, Pieralli A, Taddei G. A pilot study evaluating liquid-based endometrial cytology and transvaginal ultrasonography in women with postmenopausal bleeding. Cytopathology 2012; 24:402-3. [DOI: 10.1111/cyt.12027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kim JH, Song HB, Kim DH, Park KD, Kim JH, Kim JH, Lee BJ, Kim DH, Kim JH, Khatua S, Kalkan E, Brown R, Pearlman M, Vats T, Abela L, Fiaschetti G, Shalaby T, Grunder E, Ma M, Grahlert J, Baumgartner M, Siler U, Nonoguchi N, Ohgaki H, Grotzer M, Adachi JI, Suzuki T, Fukuoka K, Yanagisawa T, Mishima K, Koga T, Matsutani M, Nishikawa R, Sardi I, Giunti L, Bresci C, Cardellicchio S, Da Ros M, Buccoliero AM, Farina S, Arico M, Genitori L, Massimino M, Filippi L, Erdreich-Epstein A, Zhou H, Ren X, Schur M, Davidson TB, Ji L, Sposto R, Asgharzadeh S, Tong Y, White E, Murugesan M, Nimmervoll B, Wang M, Marino D, Ellison D, Finkelstein D, Pounds S, Malkin D, Gilbertson R, Eden C, Ju B, Murugesan M, Phoenix T, Poppleton H, Lessman C, Taylor M, Gilbertson R, Sardi I, la Marca G, Cardellicchio S, Da Ros M, Malvagia S, Giunti L, Fratoni V, Farina S, Arico M, Genitori L, Massimino M, Giovannini MG, Giangaspero F, Badiali M, Gleize V, Paris S, Moi L, Elhouadani S, Arcella A, Morace R, Antonelli M, Buttarelli F, Mokhtari K, Sanson M, Smith S, Ward J, Wilson M, Rahman C, Rose F, Peet A, Macarthur D, Grundy R, Rahman R, Venkatraman S, Birks D, Balakrishnan I, Alimova I, Harris P, Patel P, Foreman N, Vibhakar R, Wu H, Zhou Q, Wang D, Wang G, Dang D, Pencreach E, Nguyen A, Guerin E, Lasthaus C, Guenot D, Entz-Werle N, Unland R, Schlosser S, Farwick N, Plagemann T, Richter G, Juergens H, Fruehwald M, Chien CL, Lee YH, Lin CI, Hsieh JY, Lin SC, Wong TT, Ho DMT, Wang HW, Lagah S, Tan IL, Malcolm S, Grundy R, Rahman R, Majani Y, Smith S, Grundy R, Rahman R, van Vuurden DG, Aronica E, Wedekind LE, Hulleman E, Biesmans D, Bugiani M, Vandertop WP, Kaspers GJL, Wurdinger T, Noske DP, Van der Stoop PM, van Vuurden DG, Shukla S, Wedekind LE, Kuipers GK, Hulleman E, Noske DP, Wurdinger T, Vandertop WP, Slotman BJ, Kaspers GJL, Cloos J, Sun T, Warrington N, Luo J, Ganzhorn S, Tabori U, Druley T, Gutmann D, Rubin J, Castelo-Branco P, Choufani S, Mack S, Galagher D, Zhang C, Lipman T, Zhukova N, Martin D, Merino D, Wasserman J, Samuel C, Alon N, Hitzler J, Wang JCY, Malkin D, Keller G, Dirks PB, Pfister S, Taylor MD, Weksberg R, Tabori U, Leblond P, Meignan S, Dewitte A, Le Tinier F, Wattez N, Lartigau E, Lansiaux A, Hanson R, Gordon I, Zhao S, Camphausen K, Warren K, Warrington NM, Sun T, Gutmann DH, Rubin JB, Nguyen A, Lasthaus C, Jaillet M, Pencreach E, Guerin E, Guenot D, Entz-Werle N, Kovacs Z, Martin-Fiori E, Shalaby T, Grotzer M, Bernasconi M, Werner B, Dyberg C, Baryawno N, Milosevic J, Wickstrom M, Northcott PA, Taylor MD, Kool M, Kogner P, Johnsen JI, Wilson M, Reynolds G, Davies N, Arvanitis T, Peet A, Zoghbi A, Meisterernst M, Fruehwald MC, Kerl K, Orr B, Haffner M, Nelson W, Yegnasubramanian S, Eberhart C, Fotovati A, Abu-Ali S, Wang PS, Deleyrolle L, Lee C, Triscott J, Chen J, Franciosi S, Nakamura Y, Sugita Y, Uchiumi T, Kuwano M, Leavitt B, Singh S, Jury A, Jones C, Wakimoto H, Reynolds B, Pallen C, Dunn S, Fletcher S, Levine J, Li M, Kagawa N, Hirayama R, Chiba Y, Kijima N, Arita H, Kinoshita M, Hashimoto N, Izumoto S, Maruno M, Yoshimine T. BIOLOGY. Neuro Oncol 2012; 14:i7-i15. [PMCID: PMC3483341 DOI: 10.1093/neuonc/nos095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
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Fambrini M, Buccoliero AM, Pieralli A, Andersson KL, Mattei A, Scarselli G, Taddei G, Marchionni M. [Tamoxifen, endometrial cancer risk and liquid based cytology. A paradigmatic case]. Minerva Ginecol 2011; 63:465-470. [PMID: 21926955] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Long-term users of tamoxifen (TMX) are at increased risk for developing endometrial cancer. Early diagnosis is mainly based on transvaginal scan (TVS) and hysteroscopy with endometrial biopsy. Nevertheless, TVS does not provide a definitive diagnosis in most cases, particularly due to its high false-positive rate. In addition TMX related changes, such as "pseudocistic" pattern, affect endoscopic evaluation of the endometrium and biopsy sampling (in particular blind procedures) frequently yields insufficient tissue for diagnosis. The cause of the high inadequacy rate of endometrial biopsies in women on TMX might be related to the increase in endometrial fibrous component. The present case emphasizes the main difficulties in surveillance and early diagnosis of endometrial pathologies in TMX users. Liquid-based endometrial cytology played a determinant role in the diagnostic pathway of this patient. We believe it could be used solely or in association with TVS leading to many advantages in the surveillance of women receiving TMX.
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Affiliation(s)
- M Fambrini
- Dipartimento di Scienze per la Salute della Donna e del Bambino, Sezione di Ginecologia ed Ostetricia, Università degli Studi di Firenze, Italia.
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Buccoliero AM, Castiglione F, Garbini F, Moncini D, Lapi E, Agostini E, Fiorini P, Taddei GL. Amniotic band syndrome: a case report. Pathologica 2011; 103:11-13. [PMID: 21837919] [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: 05/31/2023] Open
Abstract
Amniotic band syndrome is an uncommon congenital pathological condition that may lead to malformations and foetal-infant death. We report an autoptic case. The patient was a male preterm infant. At 14 weeks of gestation, a routine ultrasonography showed severe craniofacial anomalies and a close contiguity of the foetal head with the amnios. The neonate survived three days, after which an autopsy was carried out. The infant had a frontoparietal meningoencephalocele; a fibrous band was attached to the skin, close to the meningoencephalocele base. Cleft lip and palate, nose deformation and agenesis of the right eye were also present. At the opening of the cranial cavity, occipital hyperostosis was observed. The herniated brain showed anatomical abnormalities that made identification of normal structures difficult. Microscopically, the nervous parenchyma had architectural disorganization and immaturity, and the fibrous band consisted of amniotic membranes. As evident from this case report, amniotic band syndrome may cause severe malformations and foetal-infant death.
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Affiliation(s)
- A M Buccoliero
- Department of Biomedicine, Careggi Hospital, Florence, Italy.
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Castiglione F, Buccoliero AM, Garbini F, Gheri CF, Moncini D, Poggi G, Saladino V, Rossi Degl'Innocenti D, Gheri RG, Taddei GL. Gestational diabetes insipidus: a morphological study of the placenta. Pathologica 2009; 101:227-229. [PMID: 20387708] [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: 05/29/2023] Open
Abstract
Gestational diabetes insipidus (GDI) refers to the state of excessive water intake and hypotonic polyuria. Those cases manifesting in pregnancy and referred to as GDI may persist thereafter or may be a transient latent form that resolves after delivery. Microscopic examination of affected subjects has not been previously reported. In the literature, there are various case reports and case series on diabetes insipidus in pregnancy. In this study, we present a case that had transient diabetes insipidus during pregnancy in which the placenta was examined.
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Affiliation(s)
- F Castiglione
- Department of Human Pathology and Oncology, University of Florence, School of Medicine, Florence, Italy
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Buccoliero AM, Resta L, Napoli A, Taddei GL. Liquid-based endometrial cytology: the Florence and Bari experience. Pathologica 2009; 101:80-84. [PMID: 19886553] [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: 05/28/2023] Open
Abstract
Several diagnostic procedures are available to investigate the endometrium, i.e. sonography, hysteroscopy, biopsy, endometrial curettage and cytology. Among these, endometrial cytology is less commonly utilized. Although the use of cytology in the diagnosis of endometrial adenocarcinoma has already been proposed due to its low cost and simple execution, a general consensus has not been reached. The improvement of the diagnostic capacity of endometrial cytology following the introduction of a liquid-based method suggests that this test should be routinely used in endometrial diagnosis. The main advantages of this method are the reduction in confounding factors, the distribution of cells on a thin layer and the possibility to obtain more slides from the same sample. The aim of this article is to focus on the methodological procedures and diagnostic criteria in liquid-based endometrial cytology based on the experience in two Italian centres: Department of Pathology, University of Bari and Department of Human Pathology and Oncology, University of Florence. The sampling method used by the Bari authors consists in the collection of liquid for uterine distension during hysteroscopy, while the Florence group used an endometrial brush. The sensitivity and specificity at Bari were 75% and 83%, respectively, and were 94-100% and 95-100% at Florence, respectively. Endometrial cytology provided sufficient diagnostic material significantly more often than biopsy. We thus propose that endometrial cytology can be used in routine diagnosis either alone or in association with other diagnostic procedures in order to improve diagnostic accuracy.
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Affiliation(s)
- A M Buccoliero
- Department of Human Pathology and Oncology, University of Florence, Italy
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12
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Castiglione F, Buccoliero AM, Garbini F, Gheri CF, Mecacci F, Moncini D, Rossi Degl'Innocenti D, Taddei GL. Placental findings in pregnancy-associated haemolytic uremic syndrome: clinicomorphological study of three cases. Pathologica 2008; 100:451-453. [PMID: 19475885] [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: 05/27/2023] Open
Abstract
Acute renal failure occurring in pregnancy or postpartum is often associated with preeclampsia, HELLP syndrome or haemolytic uremic syndrome: differential diagnosis may be difficult due to the overlapping symptoms of these syndromes. We report our experience on diagnosis, management and outcome of women with pregnancy associated haemolytic uremic syndrome, focusing on placental features.
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Affiliation(s)
- F Castiglione
- Department of Human Pathology and Oncology, University of Florence, School of Medicine, Florence, Italy.
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Buccoliero AM, Castiglione F, Rossi Degl'Innocenti D, Paglierani M, Maio V, Gheri CF, Garbini F, Moncini D, Taddei A, Sardi I, Sanzo M, Giordano F, Mussa F, Genitori L, Taddei GL. O6-Methylguanine-DNA-methyltransferase in recurring anaplastic ependymomas: PCR and immunohistochemistry. J Chemother 2008; 20:263-8. [PMID: 18467255 DOI: 10.1179/joc.2008.20.2.263] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Ependymomas are the third most common brain tumor in children. The post surgical management is controversial. There are no convincing data on an effective role for chemotherapy. O(6)-Methylguanine-DNA-Methyltransferase (MGMT) is a DNA repair protein considered to be a chemosensitivity predictor. Hypermethylation of the MGMT gene promoter is an important cause of MGMT inactivation. We evaluated the MGMT gene promoter methylation and the immunohistochemical MGMT protein expression in 12 recurrent anaplastic ependymomas affecting children. Our purpose was to investigate the molecular rationale of the administration of alkylating agents to children affected by recurrent anaplastic ependymomas. All ependymomas lacked MGMT promoter hypermethylation and 9 (75%) showed high MGMT protein expression (>50% tumoral cells). Differences between different recurrences in the same patient were not observed. These results may indicate MGMT as a factor of chemoresistance to alkylating drugs in anaplastic ependymomas and support the uncertainties regarding the actual benefit of chemotherapy for patients with anaplastic ependymomas.
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Affiliation(s)
- A M Buccoliero
- Department of Human Pathology and Oncology, University of Florence, Florence, Italy.
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Abstract
STUDY DESIGN A case of a very rare type of schwannoma is reported. It is the sixth reported case of intramedullary melanotic schwannoma and the only one localized in the conus. METHODS A 56-year-old woman was treated in this department for a C5-C6 spondylodiscitis. After 6 months her arms showed a rapid recovery, but her incomplete flaccid paraplegia remained stable. Magnetic resonance imaging (MRI) with gadolinium enhancement of the lumbar tract revealed an intramedullary lesion at the level of Th12-L1. During surgery, an intramedullary, poorly vascularized, dark gray lesion was detected and was totally removed. One year after surgery, no recurrence was encountered and the patient showed significant improvement. CONCLUSION It had previously been hypothesized that intramedullary melanotic schwannomas originate from the rostral components of the neural tube. This case presented a different localization with respect to the previously described cases, all localized in the cervical or high thoracic tracts, and thus uncertainties are raised about the previous hypotheses. Nevertheless, it is agreed that total surgical removal is the best treatment.
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Affiliation(s)
- H Mouchaty
- Department of Neurosurgery, University of Florence, Florence, Italy.
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Fambrini M, Buccoliero AM, Bargelli G, Cioni R, Piciocchi L, Pieralli A, Andersson KL, Scarselli G, Taddei G, Marchionni M. Clinical utility of liquid-based cytology for the characterization and management of endometrial polyps in postmenopausal age. Int J Gynecol Cancer 2008; 18:306-11. [PMID: 17624992 DOI: 10.1111/j.1525-1438.2007.01019.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [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: 11/28/2022] Open
Abstract
The proper management of endometrial polyps still represents a clinical ongoing challenge, especially when they are asymptomatic and occasionally discovered. The aim of this study was to evaluate liquid-based endometrial cytology to manage endometrial polyps in postmenopausal age by its ability to exclude hidden premalignant and malignant changes within polyps. Three hundred fifty-nine consecutive postmenopausal patients who underwent hysteroscopic diagnosis of endometrial polyp over a 3-year period and who were scheduled for surgical removal within the three subsequent months were retrospectively evaluated. Histologic results after resection during operative hysteroscopy or during hysterectomy were compared with liquid-based cytology and endometrial biopsy obtained at the time of diagnostic hysteroscopy. Eight of 359 patients (2.2%) had malignant or premalignant polyps interpreted as benign finding at hysteroscopy. Unsatisfactory samples were higher for endometrial biopsy compared to liquid-based cytology in the whole series and in the subgroup of low-risk asymptomatic patients (P< 0.001). Endometrial biopsy and liquid-based cytology revealed a sensitivity of 62% and 87.5%, respectively and a 100% specificity. Considering the subgroup of low-risk asymptomatic patients, liquid-based cytology disclosed all the five pathologic lesions with a 100% sensitivity and specificity. In conclusion, liquid-based cytology proved to be a useful tool to establish the nature of endometrial polyps in postmenopausal patients. Complete removal of the lesion should be offered to all symptomatic patients and those with established risk factors for endometrial cancer. Conversely, a wait and see attitude should be considered in case of asymptomatic low-risk polyps with typical appearance on hysteroscopy and negative liquid-based cytology.
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Affiliation(s)
- M Fambrini
- Department of Gynecology, Perinatology, and Human Reproduction, University of Florence, School of Medicine, Florence, Italy.
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16
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Buccoliero AM, Gheri CF, Castiglione F, Garbini F, Barbetti A, Fambrini M, Bargelli G, Pappalardo S, Taddei A, Boddi V, Scarselli GF, Marchionni M, Taddei GL. Liquid-based endometrial cytology: cyto-histological correlation in a population of 917 women. Cytopathology 2007; 18:241-9. [PMID: 17559564 DOI: 10.1111/j.1365-2303.2007.00463.x] [Citation(s) in RCA: 33] [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] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Liquid-based cytology, because of its capacity to reduce the obscuring factors and to provide thin-layer specimens, represents an opportunity to reevaluate endometrial cytology. In order to assess the utility of the liquid-based method in endometrial diagnosis, we evaluated its accuracy in comparison with histology. METHODS Nine hundred and seventeen women scheduled for hysteroscopy were enrolled in the study. After providing informed consent, all the women proceeded sequentially to hysteroscopy, endometrial cytology and then biopsy endometrial sampling. RESULTS Cyto-histological correlations were possible in 519 cases (57%): in 361 (39%) cases the biopsy was inadequate, in 15 (2%) the cytology was inadequate, and in 22 (2%) both were inadequate. At biopsy 25 (3%) women had adenocarcinoma, 5 (1%) had adenomatous atypical hyperplasia and 21 (2%) had simple non atypical hyperplasia. At cytology two adenocarcinomas and one adenomatous atypical hyperplasia were underrated as atypical hyperplasias and as non-atypical hyperplasia; two simple non-atypical hyperplasias were reported as negative; and eight cases were false positive (non-atypical hyperplasia at cytology, negative at biopsy). In our population, the cytology provided sufficient material more often than biopsy (P < 0.04). Sensitivity was estimated at 96%, specificity at 98%, positive predictive value at 86% and negative predictive value at 99%. CONCLUSIONS We concluded that endometrial cytology may be an efficient diagnostic method. It could be applied to selected patients solely or in association with ultrasonography. The combination of these two noninvasive procedures may improve their diagnostic accuracy and reduce unnecessary hysteroscopies, thereby producing benefits for women and society.
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Affiliation(s)
- A M Buccoliero
- Department of Human Pathology and Oncology, University of Florence, Florence, Italy.
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17
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Benedetto N, Perrini P, Scollato A, Buccoliero AM, Di Lorenzo N. Intracranial meningioma containing metastatic colon carcinoma. Acta Neurochir (Wien) 2007; 149:799-803; discussion 803. [PMID: 17660939 DOI: 10.1007/s00701-007-1239-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [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: 08/30/2006] [Accepted: 02/21/2007] [Indexed: 11/24/2022]
Abstract
Tumour-to-tumour metastasis is a rare pathological entity. Meningioma is the most common intracranial tumour to host metastases, the majority of which arise from breast and lung cancers. We present the first report of a colonic cancer metastasis within an intracranial meningioma.A 76-year-old woman presented with a one month history of partial seizures. Her medical history included resection of an adenocarcinoma of the descending colon followed by adjuvant chemotherapy 1 year before our evaluation. Magnetic resonance imaging revealed a homogeneously enhancing lesion in the right frontal convexity.A well capsulated tumour attached to the frontal dura was surgically removed. The pathological examination demonstrated a mixture of fibrous meningioma and colloid adenocarcinoma. Possible explanations for the development of a cohesive chimeric mass of composite pathology are investigated.
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Affiliation(s)
- N Benedetto
- Neurosurgical Department, University of Florence, Firenze, Italy
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18
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Buccoliero AM, Castiglione F, Gheri CF, Garbini F, Fambrini M, Bargelli G, Pappalardo S, Scarselli G, Marchionni M, Taddei GL. Liquid-based endometrial cytology: its possible value in postmenopausal asymptomatic women. Int J Gynecol Cancer 2007; 17:182-7. [PMID: 17291251 DOI: 10.1111/j.1525-1438.2006.00757.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [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: 11/28/2022] Open
Abstract
The incidence of endometrial adenocarcinoma in asymptomatic women is low. Nevertheless, some of these women might require endometrial surveillance. In this study, we evaluated the accuracy of liquid-based endometrial cytology compared to biopsy in asymptomatic postmenopausal women. Three hundred twenty women scheduled for hysteroscopy were enrolled for this study. After hysteroscopy, patients were submitted to endometrial cytology and to biopsy. Two hundred ninety-three (92%) women had sonographically thickened endometrium (>5 mm), 53 (17%) were on tamoxifen, and 16 (5%) were on hormonal substitutive treatment. The evaluation of the biopsies determined that six (2%) women had adenocarcinoma, one (<1%) had adenomatous atypical hyperplasia, and eight (3%) had simple nonatypical hyperplasia. Endometrial cytology evidenced 5 (2%) neoplastic cases, 2 (<1%) hyperplastic with atypia cases, and 25 (8%) hyperplastic without atypia cases. Two hundred twenty-two biopsies (69%) and 17 (5%) cytologies were inadequate. One adenocarcinoma and one simple nonatypical hyperplasia were underrated by cytology resulting, respectively, as atypical hyperplasia and as negative. Four cases were false positive (simple nonatypical hyperplasias on cytology, negative on biopsy). The sensitivity and specificity were estimated, respectively, at 94% and 95%; the positive and negative predictive value were estimated, respectively, at 80% and 99%. Endometrial cytology provided sufficient material more often than biopsy (P < 0.01). We suggest to introduce liquid-based endometrial cytology in the management of some subpopulations of asymptomatic postmenopausal women. Particularly, the combination of liquid-based endometrial cytology and transvaginal sonography may improve their diagnostic accuracy and reduce unnecessary more invasive and expensive procedures.
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Affiliation(s)
- A M Buccoliero
- Department of Human Pathology and Oncology, University of Florence, viale G.B Morgagni 85, 50134 Florence, Italy.
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19
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Perrini P, Benedetto N, Buccoliero AM, Di Lorenzo N. Thoracic radiculopathy from a paravertebral mesothelial cyst. Acta Neurochir (Wien) 2006; 148:989-91. [PMID: 16804641 DOI: 10.1007/s00701-006-0815-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 12/15/2005] [Accepted: 05/03/2006] [Indexed: 10/24/2022]
Abstract
We report on an extremely rare case of a paravertebral thoracic mesothelial cyst in a young woman who presented with dorsal radiculopathy affecting the T5 dermatome. The patient underwent a standard transthoracic intercostal approach with removal of the cyst. During the operation, the T5 intercostal neurovascular bundle was found firmly attached to the lesion elucidating the origin of the radicular pain. To our knowledge, this is the first report of radiculopathy due to a paravertebral mesothelial cyst. Although highly unusual, paravertebral mesothelial cyst should be considered in the differential diagnosis for lesions inducing dorsal radicular pain.
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Affiliation(s)
- P Perrini
- Neurosurgical Department, University of Florence, Florence, Italy.
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20
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Buccoliero AM, Caldarella A, Gheri CF, Taddei A, Paglierani M, Pepi M, Mennonna P, Taddei GL. Inducible cyclooxygenase (COX-2) in glioblastoma--clinical and immunohistochemical (COX-2-VEGF) correlations. Clin Neuropathol 2006; 25:59-66. [PMID: 16550738] [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: 05/07/2023] Open
Abstract
Cyclooxygenase-2 (COX-2) is the inducible form of the enzyme responsible for the first step in the prostaglandin synthesis. COX-2 upregulation is demonstrated in different tumors. COX-2 products may modulate tumoral growth, apoptosis, metastasis, multidrug resistance and angiogenesis. Moreover, the antitumoral effect of the COX inhibitors has been documented. We studied the immunohistochemical expression and the prognostic value of COX-2 on 43 surgical specimens of glioblastoma-affected patients. Furthermore, we evaluated the correlation between the immunohistochemical expression of COX-2 and vascular endothelial growth factor (VEGF). Of the glioblastomas, 63% resulted as COX-2-positive. Median survival of the patients with COX-2-positive lesions was 10 months; median survival of the patients with COX-2 negative glioblastoma was 21 months (NS). All 4 patients who survived longer than 24 months had COX-2 negative lesions (p = 0.017). Concordance between COX-2 and VEGF was documented in 60% of the cases. Our findings show that glioblastoma can immunohistochemically express COX-2 and that its expression is unrelated with VEGF and significantly less frequent in the long survivors. Nevertheless, the absence of statistical correlation with survival time advises further studies on larger series to ascertain the concrete prognostic value of COX-2 in glioblastoma.
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Affiliation(s)
- A M Buccoliero
- Dipartimento di Patologia Umana e Oncologia, Università degli Studi di Firenze, Italy.
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21
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Gallina P, Mouchaty H, Buccoliero AM, Di Lorenzo N. Haemorrhagic central neurocytoma of the fourth ventricle. Acta Neurochir (Wien) 2005; 147:1193-4; discussion 1194. [PMID: 16041466 DOI: 10.1007/s00701-005-0585-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2005] [Accepted: 06/01/2005] [Indexed: 11/29/2022]
Affiliation(s)
- P Gallina
- Department of Neurosurgery, University of Florence, Italy.
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22
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Masi A, Becchetti A, Restano-Cassulini R, Polvani S, Hofmann G, Buccoliero AM, Paglierani M, Pollo B, Taddei GL, Gallina P, Di Lorenzo N, Franceschetti S, Wanke E, Arcangeli A. hERG1 channels are overexpressed in glioblastoma multiforme and modulate VEGF secretion in glioblastoma cell lines. Br J Cancer 2005; 93:781-92. [PMID: 16175187 PMCID: PMC2361632 DOI: 10.1038/sj.bjc.6602775] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Recent studies have led to considerable advancement in our understanding of the molecular mechanisms that underlie the relentless cell growth and invasiveness of human gliomas. Partial understanding of these mechanisms has (1) improved the classification for gliomas, by identifying prognostic subgroups, and (2) pointed to novel potential therapeutic targets. Some classes of ion channels have turned out to be involved in the pathogenesis and malignancy of gliomas. We studied the expression and properties of K+ channels in primary cultures obtained from surgical specimens: human ether a gò-gò related (hERG)1 voltage-dependent K+ channels, which have been found to be overexpressed in various human cancers, and human ether a gò-gò-like 2 channels, that share many of hERG1's biophysical features. The expression pattern of these two channels was compared to that of the classical inward rectifying K+ channels, IRK, that are widely expressed in astrocytic cells and classically considered a marker of astrocytic differentiation. In our study, hERG1 was found to be specifically overexpressed in high-grade astrocytomas, that is, glioblastoma multiforme (GBM). In addition, we present evidence that, in GBM cell lines, hERG1 channel activity actively contributes to malignancy by promoting vascular endothelial growth factor secretion, thus stimulating the neoangiogenesis typical of high-grade gliomas. Our data provide important confirmation for studies proposing the hERG1 channel as a molecular marker of tumour progression and a possible target for novel anticancer therapies.
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Affiliation(s)
- A Masi
- Department of Experimental Pathology and Oncology, University of Firenze, Viale GB Morgagni, 50, 50134 Firenze, Italy
| | - A Becchetti
- Department of Biotechnology and Biosciences, University of Milano Bicocca, Piazza della Scienza, 2, 20126 Milano, Italy
| | - R Restano-Cassulini
- Department of Biotechnology and Biosciences, University of Milano Bicocca, Piazza della Scienza, 2, 20126 Milano, Italy
| | - S Polvani
- Department of Experimental Pathology and Oncology, University of Firenze, Viale GB Morgagni, 50, 50134 Firenze, Italy
| | - G Hofmann
- Department of Experimental Pathology and Oncology, University of Firenze, Viale GB Morgagni, 50, 50134 Firenze, Italy
| | - A M Buccoliero
- Department of Human Pathology and Oncology, University of Firenze, Viale GB Morgagni, 88, 50134 Firenze, Italy
| | - M Paglierani
- Department of Human Pathology and Oncology, University of Firenze, Viale GB Morgagni, 88, 50134 Firenze, Italy
| | - B Pollo
- Istituto Neurologico Besta, Via Celoria, 11, 20133 Milano, Italy
| | - G L Taddei
- Department of Human Pathology and Oncology, University of Firenze, Viale GB Morgagni, 88, 50134 Firenze, Italy
| | - P Gallina
- Department of Neurosurgery, University of Firenze, Largo P Palagi 1, 50139, Firenze, Italy
| | - N Di Lorenzo
- Department of Neurosurgery, University of Firenze, Largo P Palagi 1, 50139, Firenze, Italy
| | - S Franceschetti
- Istituto Neurologico Besta, Via Celoria, 11, 20133 Milano, Italy
| | - E Wanke
- Department of Biotechnology and Biosciences, University of Milano Bicocca, Piazza della Scienza, 2, 20126 Milano, Italy
| | - A Arcangeli
- Department of Experimental Pathology and Oncology, University of Firenze, Viale GB Morgagni, 50, 50134 Firenze, Italy
- Department of Experimental Pathology and Oncology, University of Firenze, Viale GB Morgagni, 50, 50134 Firenze, Italy. E-mail:
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23
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Abstract
STUDY DESIGN Case report. OBJECTIVES To report on a case of paraganglioma presenting in an uncommon extradural thoracic localization. SETTING Department of Neurosurgery, Florence, Italy. CASE REPORT A 43-year-old woman with a thoracic lesion extending into the extradural space along four levels, T(1)-T(4), presented with sudden spastic incomplete paraplegia and paresthesia at the lower limbs. RESULTS The neoplasm was surgically resected 'en bloc' and histological findings corresponded to paraganglioma. One year after surgery, the patient was walking without assistance, a T(3)-T(4) hypoesthesia was still present and an magnetic resonance imaging (MRI) study showed no signs of focal recurrence. CONCLUSIONS The imaging features of thoracic paragangliomas may be misleading and an advanced malignant lesion could be primarily suspected; thus, a histological study is always needed. Total resection is the gold standard therapy. Owing to the risk of recurrence or multicentric growth, follow-up must be prolonged and accurate.
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Affiliation(s)
- P Conti
- 1Department of Neurosurgery, University of Florence, Florence, Italy
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24
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Buccoliero AM, Taddei GL. [Progression markers in gynecologic (endometrial) cytology]. Pathologica 2005; 97:198-9. [PMID: 16440660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Affiliation(s)
- A M Buccoliero
- Dipartimento di Patologia Umana e Oncologia, Università di Firenze, Firenze, Italia
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25
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Paglierani M, Castiglione F, Garbini F, Buccoliero AM, Raspollini MR, Lapini A, Vignolini G, Taddei GL. [FISH and thin layer in urinary cytology]. Pathologica 2005; 97:200. [PMID: 16440661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Affiliation(s)
- M Paglierani
- Dipartimento di Patologia Umana ed Oncologia, Università di Firenze
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26
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Di Lorenzo N, Cavedon C, Paier F, Compagnucci A, Buccoliero AM, Pansini G, Francescon P, Gallina P. Interstitial radiosurgery with the photon radiosurgery system in the minimally-invasive treatment of selected deep-seated brain tumors. J Chemother 2005; 16 Suppl 5:70-4. [PMID: 15675484 DOI: 10.1080/1120009x.2004.11782390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to evaluate the results of interstitial radiosurgery (IR) with Photon Radiosurgery System (PRS) in 18 patients (P) with deep-seated brain primary or secondary tumors. Follow-up varied from 2 to 53 months (mean, 13.6 mo). Seven P with glioblastomas died due to tumor progression. Five P with metastases died for systemic disease while local control was achieved in all. Six P with low-grade astrocytomas were well and imaging showed tumor control. We conclude that PRS IR is effective in the treatment of metastases while it provides lower benefit in malignant gliomas. It could play a major role in low-grade astrocytomas.
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Affiliation(s)
- N Di Lorenzo
- Department of Neurosurgery, University of Florence, Florence, Italy.
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27
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Buccoliero AM, Castiglione F, Caldarella A, Rossi Degl'Innocenti D, Taddei A, Ammannati F, Mennonna P, Taddei GL. [BCL-2 in primary central nervous system lymphomas. Immunohistochemistry and molecular biology]. Pathologica 2004; 96:425-9. [PMID: 15688978] [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: 05/01/2023] Open
Abstract
BCL-2 is a membrane protein known to be an apoptosis inhibitor. It is the product of the bcl-2 gene located on chromosome 18. Several different tumors show BCL-2 over-expression as result of a translocation or independently from it. More than 85% of follicular lymphomas and a smaller number of diffuse large cell B lymphomas contain t(14;18) (q32;q21). The aim of this study was to investigate the immunohistochemical expression of the BCL-2 protein and to ascertain, by means of traditional PCR (Polimerase Chain Reaction), its possible dependence from t(14;18) (q32;q21) in 9 primary central nervous system lymphomas. Six cases (67%) shoved immunohistochemical BCL-2 over-expression and 3 cases (33%) had t(14;18). Precisely: 2 cases (22%) had immunohistochemical BCL-2 over-expression and t(14;18) (q32;q21); 4 cases (44%) had BCL-2 over-expression without translocation; 1 case (11%) did not show diffuse BCL-2 over-expression in presence of the traslocation; the remaining 2 cases (22%) did not demonstrate BCL-2 over-expression or t(14;18) (q32;q21). In conclusion, our results indicate primary central nervous system lymphomas frequently show BCL-2 over-expression that in some case may be related to t(14;18) (q32;q21). Nevertheless, t(14;18) (q32;q21), as evaluated by traditional PCR, may not correspond to diffuse immunohistochemical BCL-2 positivity.
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MESH Headings
- Adult
- Aged
- Brain Neoplasms/chemistry
- Brain Neoplasms/genetics
- Brain Neoplasms/pathology
- Cerebellar Neoplasms/chemistry
- Cerebellar Neoplasms/genetics
- Cerebellar Neoplasms/pathology
- Chromosomes, Human, Pair 14/genetics
- Chromosomes, Human, Pair 14/ultrastructure
- Chromosomes, Human, Pair 18/genetics
- Chromosomes, Human, Pair 18/ultrastructure
- DNA, Neoplasm/analysis
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Immunoenzyme Techniques
- Lymphoma, Non-Hodgkin/chemistry
- Lymphoma, Non-Hodgkin/genetics
- Lymphoma, Non-Hodgkin/pathology
- Male
- Middle Aged
- Neoplasm Proteins/analysis
- Neoplasm Proteins/genetics
- Polymerase Chain Reaction
- Proto-Oncogene Proteins c-bcl-2/analysis
- Proto-Oncogene Proteins c-bcl-2/genetics
- Spinal Cord Neoplasms/chemistry
- Spinal Cord Neoplasms/genetics
- Spinal Cord Neoplasms/pathology
- Translocation, Genetic
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Affiliation(s)
- A M Buccoliero
- Dipartimento di Patologia Umana e Oncologia, Università degli Studi di Firenze, Universita di Firenze, Italy.
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28
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Taddei GL, Caldarella A, Raspollini MR, Buccoliero AM. [Decidual pathology in the diagnosis of early spontaneous abortion]. Pathologica 2003; 95:235-6. [PMID: 14988986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Affiliation(s)
- G L Taddei
- Dipartimento di Patologia Umana e Oncologia, Università di Firenze
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29
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Buccoliero AM, Caldarella A, Noci I, Borri P, Giachi M, Borrani E, Taddei GL. [Thin-layer cytology in endometrial diagnosis]. Pathologica 2003; 95:179-84. [PMID: 14577201] [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: 04/27/2023] Open
Abstract
Our purpose was to test the liquid-based thin layer method on the endometrial cytology. One hundred sixty two consecutive patients before the hysterectomy (55 women because of various causes; 107 asymptomatic postmenopausal women because of prolapsed uterus) had the endometrial cytology (all women) and the biopsy (107 postmenopausal women prolapsed uterus affected). Cytohistologic concordance was 98%: all endometrial neoplasms and atypical hyperplasia (10 cases) and 15 of the 18 (83%) simple hyperplasias were diagnosed by thin layer endometrial cytology. In asymptomatic postmenopausal women cytology gave sufficient material for the diagnosis significantively more often than endometrial biopsy (respectively 82% and 24%; p = 0.000).
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Affiliation(s)
- A M Buccoliero
- Dipartimento di Patologia Umana e Oncologia, Università di Firenze, viale G.B. Morgagni 85, 50134 Firenze.
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30
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Buccoliero AM, Caldarella A, Arganini L, Mennonna P, Ammanati F, Taddei A, Taddei GL. Oligodendroglioma: CD44 as a possible prognostic opportunity. Clin Neuropathol 2003; 22:169-75. [PMID: 12908752] [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: 03/04/2023] Open
Abstract
CD44, in its standard form as well in its isoforms, is a cell surface adhesion glycoprotein which occurs in a wide variety of non-neoplastic and neoplastic cells. CD44 has been considered to be implicated in tumoral growth and in metastatic potential. We studied the immunohistochemical expression of CD44 standard in 30 oligodendrogliomas (19 primary lesions and 11 recurrences) in order to verify its possible prognostic role. Twelve primary oligodendrogliomas (63%) and 8 recurrences (73%) were CD44-positive. Three of 9 (33%) primary oligodendrogliomas with a Smith grade A-B and 9 of 10 (90%) primary oligodendrogliomas with a Smith grade C-D were found to be in CD44H-positive (p = 0.020). Three of 9 (33%) primary oligodendrogliomas that had not relapsed and 9 of 10 (90%) successively relapsed primary lesions were found to be CD44H-positive (p = 0.020). Median survival of the patients with a CD44H-positive lesion was 84 months; median survival of the patients with a CD44H-negative lesion was 91 months. We conclude that CD44H could have prognostic value regarding the occurrence of relapses.
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Affiliation(s)
- A M Buccoliero
- Dipartimento di Patologia Umana e Oncologia, Università degli Studi di Firenze, Italy
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31
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Buccoliero AM, Caldarella A, Taddei A, Di Lorenzo N, Gallina P, Mennonna P, Ammannati F, Taddei GL. [Atypical, aplastic, and unusual meningiomas. Morphology and incidence in 300 consecutive cases]. Pathologica 2003; 95:83-7. [PMID: 12768876] [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: 03/02/2023] Open
Abstract
We morphologically studied 300 consecutive and primitive meningiomas surgically treated between march 1997 and april 2002 in order to evaluate the incidence of atypical, anaplastic, and morphologically unusual meningiomas. Two hundred and fifty-five meningiomas (85%) were WHO I, 33 (11%) were WHO II, 9 (3%) were WHO III; the remaining 3 meningiomas (1%) showed clear and diffuse oncocytic differentiation without cytologic or architectural atypia (oncocytic meningiomas). Forty-five of 255 WHO I meningiomas (18%) were infrequent histological subtypes: 18 (7%) psammomatous, 9 (4%) metaplastic, 9 (4%) secretory, 6 (2%) angiomatous, and 3 (1%) microcystic. Thirty of 33 WHO II meningiomas (91%) were atypical, 2 (6%) were clear cell meningiomas, and 1 (3%) was chordoid meningioma. Seven of 9 WHO III meningiomas (78%) were anaplastic and 2 (22%) were papillary. We evidenced the high morphological variability and the discrete occurrence of WHO I and WHO II meningiomas.
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Affiliation(s)
- A M Buccoliero
- Dipartimento di Patologia Umana e Oncologia Università di Firenze, Viale G. B. Morgagni 85, 50134 Firenze.
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Caldarella A, Buccoliero AM, Taddei GL. [Thin-layer cytology in urinary diagnosis]. Pathologica 2003; 95:37-41. [PMID: 12735284] [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: 03/02/2023] Open
Abstract
To evaluate the thin-layer method in urinary cytology we have compared cytospin smears, filter and thin layer. Cellularity, cellular morphology and background were evaluated. Thin layer method in urinary cytology improve cell recovery and cell preservation, reducing background artefact. Cytohistologic correlations with thin layer method were better than with filter and cytospin; an higher capacity to detect low grade transitional cell carcinomas, frequently undiscovered by cytology, was demonstrated.
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Affiliation(s)
- A Caldarella
- Dipartimento di Patologia Umana e Oncologia, Università degli Studi di Firenze, Viale Gian Battista Morgagni 85, 50134 Firenze.
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Cacciola F, Conti R, Taddei GL, Buccoliero AM, Di Lorenzo N. Cerebellar liponeurocytoma. Case report with considerations on prognosis and management. Acta Neurochir (Wien) 2002; 144:829-33. [PMID: 12181694 DOI: 10.1007/s007010200082] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [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: 11/25/2022]
Abstract
BACKGROUND Cerebellar liponeurocytoma has only recently been recognized as a distinct clinicopathological entity. Although the few cases described in literature support the relatively benign nature of this lesion, optimum treatment strategy and long term behaviour still have to be defined. CLINICAL PRESENTATION This 61-year-old man came under our observation with unspecific signs of intracranial hypertension and a symptomathology revealing a probable posterior fossa lesion. Imaging studies showed a cerebellar mass lesion with prevalent adipose content. INTERVENTION Gross total tumour removal was performed. The pathological examination revealed a lesion composed of medulloblastoma-like cells with prominent areas of lipidisation. A review of literature has been made in an attempt to investigate on recurrence patterns, importance of the extent of removal and the usefulness of radiotherapy. CONCLUSION The few cases reported in literature so far seem to confirm the relatively benign nature of cerebellar liponeurocytoma. No radiotherapy was given in our case and the reasons for this decision are reported.
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Affiliation(s)
- F Cacciola
- Department of Neurosurgery, University of Florence, Italy
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Taddei GL, Caldarella A, Raspollini MR, Taddei A, Buccoliero AM. [Estrogen and progesterone receptors in meningiomas: immunohistochemical (Mib-1, p53) and clinico-morphological correlations]. Pathologica 2002; 94:10-5. [PMID: 11912872] [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: 02/24/2023] Open
Abstract
We studied 98 meningiomas including 89 benign, 5 atypical, and 4 anaplastic tumors to determine the immunohistochemical expression of estrogen and progesterone receptors and its prognostic value in comparison to histological grade, Mib-1 and p53. Estrogen and progesterone receptor positivity was observed in 63% and 5% of the cases, respectively. In 79% of meningiomas only a minimal proliferative activity was documented, whereas in 36% we detected an overexpression of the p53 oncoprotein. Anaplastic meningiomas were constantly negative for PgR, ER, and highly positive for Mib-1; 75% were positive for p53. A statistical correlation was demonstrated between p53 protein and Mib-1. Specifically the p53-negative meningiomas were frequently negative for Mib-1 (p = 0.002); conversely the lesions strongly positive for Mib-1 were p53-positive (p = 0.001).
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Affiliation(s)
- G L Taddei
- Dipartimento di Patologia Umana e Oncologia, Viale G.B. Morgagni 85, I-50100 Firenze, Italia.
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Noci I, Borri P, Bonfirraro G, Chieffi O, Arcangeli A, Cherubini A, Dabizzi S, Buccoliero AM, Paglierani M, Taddei GL. Longstanding survival without cancer progression in a patient affected by endometrial carcinoma treated primarily with leuprolide. Br J Cancer 2001; 85:333-6. [PMID: 11487260 PMCID: PMC2364073 DOI: 10.1054/bjoc.2001.1900] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
We report here a case of a patient affected by endometrial cancer and treated primarily with leuprolide, the surgical approach being unfeasible due to her compromised conditions. The therapy was continued for more than 6 years, and no progression of the disease was observed. During this period, some histological and immunohistochemical evaluations of the tumour (morphology, grading, proliferation and apoptotic index, E-cadherin expression) were performed. Furthermore, the expression of m-RNA for luteinizing-hormone releasing hormone (LHRH) receptors was determined. The results showed a discrepancy between some biological parameters of the tumour and its clinical characteristics. In fact, despite features suggestive of a progression of the cancer (such as the increase of both tumour grading and proliferating capacity (MIB-1), and a fall in the reparative process (appearance of mutated p53, reduced expression of both bcl-2 and c-erb-2) being detected, neither local invasion nor metastatic lesions were clinically observed. This discrepancy might be due to the maintenance of high levels of E-cadhezin. Moreover, since this tumour was shown to express mRNA for LHRH receptors, new evidence is provided about the favourable impact of LHRH analogue treatment in patients affected by endometrial cancer.
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Affiliation(s)
- I Noci
- Department of Gynaecology, Perinatal Medicine and Human Reproduction, University of Florence, viale G. B. Morgagni 85, 50134, Firenze, Italy
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Taddei GL, Arganini L, Raspollini MR, Mennonna P, Vannelli B, Nesi G, Buccoliero AM. Oligodendroglioma: HMB-45 positivity using catalyzed signal amplification method: an immunohistochemical (HMB-45, CD31, p53, Mib-1) and ultrastructural study. Appl Immunohistochem Mol Morphol 2001; 9:35-41. [PMID: 11277413] [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: 02/19/2023]
Abstract
Although melanin synthesis and the presence of melanosomes are exceptionally reported in nervous system tumors, there is no record of melanotic oligodendrogliomas in the literature. The purpose of the current study was to evaluate whether melanosomes are immunohistochemically and ultrastructurally detectable in nonmelanotic oligodendrogliomas and to verify whether these data are related to prognosis. Thirty surgical specimens (19 primary lesions and 11 recurrences) from 19 patients were examined. Median survival was 80 months. Immunohistochemical studies were performed using the monoclonal antibodies HMB-45, CD31. Mib-1, and p53. Using catalyzed signal amplification (CSA), HMB-45 positivity was noticed in 3 (10%) of the oligodendrogliomas being studied. No correlation with survival was found. Ultrastructural examination displayed the presence of melanosomelike structures. Tumor vascularization, estimated by means of CD31 antibody, was increased in 6 of 19 primary lesions but there was no significant correlation with survival. Nine of the19 primary lesions were p53 negative. In these cases, survival was longer than in p53-positive tumors (P = 0.0213). Proliferation rate, evaluated with Mib-1, was unrelated to survival, but proved greater in recurrences (10 of 11 cases) than in primary tumors (7 of 19 lesions; P = 0.007).
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Affiliation(s)
- G L Taddei
- Department of Human Pathology and Oncology, University of Florence, Italy.
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Taddei GL, Buccoliero AM, Caldarella A, Conti R, Di Lorenzo N, Cacciola F, Franchi A. Cerebellar liponeurocytoma: immunohistochemical and ultrastructural study of a case. Ultrastruct Pathol 2001; 25:59-63. [PMID: 11297321 DOI: 10.1080/019131201300004690] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [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: 10/16/2022]
Abstract
The clinical, histopathological, and ultrastructural features of a cerebellar liponeurocytoma are reported. The tumor, a 3-cm mass localized in the right cerebellar hemisphere, was resected from a 61-year-old man clinically presenting with symptoms of intracranial hypertension. The lesion was composed of small, in some areas closely packed, medulloblastoma-like cells with prominent areas of lipidization phenomena. Moreover, mitoses, cellular atypia, and numerous vascular structures were focally observed. Glial and neuronal differentiation was immunohistochemically noted (glial fibrillary acidic protein, synaptophysin, neurofilaments, and neuron-specific enolase positivity). The p53 oncoprotein was detected in the majority of neoplastic cells and a moderate proliferation activity, evaluated by Mib-1 antibody, was focally appreciated. Ultrastructural study did not show evident neuritic processes, synapses, or dense core neuroendocrine granules. This cerebellar tumor previously called lipidized medulloblastoma and recently renamed cerebellar liponeurocytoma is considered an adult neoplasm with excellent prognosis histologically presenting prominent lipidized areas and, at the immunohistochemical and ultrastructural level, both glial and neuronal differentiation. The present study provides the first description of a less differentiated and histologically more aggressive form of this unusual tumor.
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Affiliation(s)
- G L Taddei
- Department of Human Pathology and Oncology, University of Florence, Italy.
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Cherubini A, Taddei GL, Crociani O, Paglierani M, Buccoliero AM, Fontana L, Noci I, Borri P, Borrani E, Giachi M, Becchetti A, Rosati B, Wanke E, Olivotto M, Arcangeli A. HERG potassium channels are more frequently expressed in human endometrial cancer as compared to non-cancerous endometrium. Br J Cancer 2000; 83:1722-9. [PMID: 11104572 PMCID: PMC2363441 DOI: 10.1054/bjoc.2000.1497] [Citation(s) in RCA: 113] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
HERG K(+)channels, besides contributing to regulate cardiac and neuronal excitability, are preferentially expressed in tumour cell lines of different histogenesis, where their role in the development and maintenance of the neoplastic phenotype is under study. We show here that both herg gene and HERG protein are expressed with high frequency in primary human endometrial cancers, as compared to normal and hyperplastic endometrium. RT-PCR and immunohistochemistry, using specific anti-HERG antibodies developed in our laboratory, were applied to tissue specimens obtained from 18 endometrial cancers and 11 non-cancerous endometrial tissues. herg RNA and HERG protein are expressed in 67% and 82%, respectively, of cancerous, while in only 18% of non-cancerous tissues. In particular, no expression was found in endometrial hyperplasia. Moreover, electrophysiological experiments confirmed the presence of functioning HERG channels on the plasma membrane of tumour cells. On the whole, these data are the first demonstration of the presence of HERG channels in primary human neoplasias, and could candidate HERG as a potential tool capable of marking cancerous versus hyperplastic endometrial growth.
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Affiliation(s)
- A Cherubini
- Department of Experimental Pathology and Oncology, University of Firenze, Viale G.B. Morgagni 50, Firenze, 50134, Italy
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Noci I, Coronnello M, Borri P, Borrani E, Giachi M, Chieffi O, Marchionni M, Paglierani M, Buccoliero AM, Cherubini A, Arcangeli A, Mini E, Taddei G. Inhibitory effect of luteinising hormone-releasing hormone analogues on human endometrial cancer in vitro. Cancer Lett 2000; 150:71-8. [PMID: 10755389 DOI: 10.1016/s0304-3835(99)00374-2] [Citation(s) in RCA: 14] [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] [Indexed: 11/19/2022]
Abstract
We studied the effects of luteinising hormone-releasing hormone (LHRH) agonist leuproreline (1 microM for 96 h) and LHRH antagonist cetrorelix on the cell growth of primary cultures from nine human endometrial cancers using the sulphorhodamine colorimetric test. Histological examinations and reverse transcription and polymerase chain reaction amplification (RT-PCR) for LHRH receptors were also performed. The endometrial cancers examined had a medium to high degree of proliferative activity and a low degree of apoptotic power; furthermore, they expressed the LHRH receptor RNA variably, detectable in 71% of cases. The addition of leuproreline or cetrorelix to cell cultures inhibited growth in a statistically significant way compared to untreated control cells; nevertheless, the percentage of cell growth inhibition obtained was very variable. These data suggest that LHRH analogues can exert differential inhibitory effects on the growth of endometrial cancer, which seems to be independent of the expression of specific LHRH receptors.
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Affiliation(s)
- I Noci
- Department of Obstetrics and Gynecology, University of Florence, Italy
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Taddei GL, Raspollini MR, Moncini D, Baroni G, Buccoliero AM. [Cervix adenocarcinoma and squamous cell carcinoma: 2 different morphologic entities?]. Pathologica 1999; 91:471-4. [PMID: 10783644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Affiliation(s)
- G L Taddei
- Istituto di Anatomia e Istologia Patologica Università degli Studi di Firenze
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Taddei GL, Moncini D, Raspollini MR, Mennonna P, Boddi V, Dini M, Buccoliero AM. [Metastatic brain tumors]. Pathologica 1999; 91:13-7. [PMID: 10396945] [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: 02/13/2023] Open
Abstract
211 patients operated on for brain metastases have been selected through a review of specimens from the Department of Pathology of the University of Florence covering the period between 1980 to 1995. 140 patients (66%) are males and 71 (34%) are females. Average age is 59 years ranging from 33 to 79 years of age. Lung tumours (47%) and breast cancer (9%) are most frequently responsible for brain metastases. In 17% of the patients, the primary lesion was unknown. The average survival was 14 months and in 8 patients (4%) it was more 5 years. In 36 cases (17%) recurrence appeared 8 months after the first operation. Survival in these patients averaged 20 months from the diagnosis of brain metastases and 11 months after the discovery of the relapses. It is not significantly different from that of patients without evidence of relapsed metastases in the brain (13 months). Prognostically renal carcinoma behaves more favourably, average survival (27 months); on the contrary prognosis of metastatic melanoma is ominous (7 months). Metastases from unknown primaries do not have a significant different prognosis from all the other lesions.
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Affiliation(s)
- G L Taddei
- Istituto di Anatomia e Istologia Patologica, Università degli Studi di Firenze.
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