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Dubbini MV, De Marco L, Baldi L, Vignolo L, Ilariucci F. Apoptotic colitis secondary to Brentuximab Vedotin: an immune mediated adverse event responsive to steroid treatment. Leuk Lymphoma 2023; 64:1497-1499. [PMID: 37282612 DOI: 10.1080/10428194.2023.2220453] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/08/2023]
Affiliation(s)
| | - Loredana De Marco
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Licia Baldi
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Luana Vignolo
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Fiorella Ilariucci
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Zanelli M, Sanguedolce F, Palicelli A, Zizzo M, Martino G, Caprera C, Fragliasso V, Soriano A, Gozzi F, Cimino L, Masia F, Moretti M, Foroni M, De Marco L, Pellegrini D, De Raeve H, Ricci S, Tamagnini I, Tafuni A, Cavazza A, Merli F, Pileri SA, Ascani S. EBV-Driven Lymphoproliferative Disorders and Lymphomas of the Gastrointestinal Tract: A Spectrum of Entities with a Common Denominator (Part 3). Cancers (Basel) 2021; 13:6021. [PMID: 34885131 PMCID: PMC8656853 DOI: 10.3390/cancers13236021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/27/2021] [Accepted: 11/28/2021] [Indexed: 12/28/2022] Open
Abstract
EBV is the first known oncogenic virus involved in the development of several tumors. The majority of the global population are infected with the virus early in life and the virus persists throughout life, in a latent stage, and usually within B lymphocytes. Despite the worldwide diffusion of EBV infection, EBV-associated diseases develop in only in a small subset of individuals often when conditions of immunosuppression disrupt the balance between the infection and host immune system. EBV-driven lymphoid proliferations are either of B-cell or T/NK-cell origin, and range from disorders with an indolent behavior to aggressive lymphomas. In this review, which is divided in three parts, we provide an update of EBV-associated lymphoid disorders developing in the gastrointestinal tract, often representing a challenging diagnostic and therapeutic issue. Our aim is to provide a practical diagnostic approach to clinicians and pathologists who face this complex spectrum of disorders in their daily practice. In this part of the review, the chronic active EBV infection of T-cell and NK-cell type, its systemic form; extranodal NK/T-cell lymphoma, nasal type and post-transplant lymphoproliferative disorders are discussed.
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Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | | | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Giovanni Martino
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (D.P.); (S.A.)
| | - Cecilia Caprera
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (D.P.); (S.A.)
| | - Valentina Fragliasso
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Alessandra Soriano
- Gastroenterology Division, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Fabrizio Gozzi
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.G.); (L.C.)
| | - Luca Cimino
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (F.G.); (L.C.)
| | - Francesco Masia
- Dipartimento di Medicina, Università degli Studi di Perugia, 05100 Terni, Italy; (F.M.); (M.M.)
| | - Marina Moretti
- Dipartimento di Medicina, Università degli Studi di Perugia, 05100 Terni, Italy; (F.M.); (M.M.)
| | - Moira Foroni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | - Loredana De Marco
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | - David Pellegrini
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (D.P.); (S.A.)
| | - Hendrik De Raeve
- Pathology, University Hospital Brussels, 1090 Brussels, Belgium;
- Pathology, O.L.V. Hospital Aalst, 9300 Aalst, Belgium
| | - Stefano Ricci
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | - Ione Tamagnini
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | - Alessandro Tafuni
- Pathology Unit, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy;
| | - Alberto Cavazza
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (M.F.); (L.D.M.); (S.R.); (I.T.); (A.C.)
| | - Francesco Merli
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Stefano A. Pileri
- Haematopathology Division, European Institute of Oncology-IEO IRCCS Milan, 20141 Milan, Italy;
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (D.P.); (S.A.)
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Palicelli A, Bonacini M, Croci S, Magi-Galluzzi C, Cañete-Portillo S, Chaux A, Bisagni A, Zanetti E, De Biase D, Melli B, Sanguedolce F, Zanelli M, Bonasoni MP, De Marco L, Soriano A, Ascani S, Zizzo M, Castro Ruiz C, De Leo A, Giordano G, Landriscina M, Carrieri G, Cormio L, Berney DM, Gandhi J, Santandrea G, Gelli MC, Tafuni A, Ragazzi M. What Do We Have to Know about PD-L1 Expression in Prostate Cancer? A Systematic Literature Review. Part 2: Clinic-Pathologic Correlations. Cells 2021; 10:3165. [PMID: 34831388 PMCID: PMC8618408 DOI: 10.3390/cells10113165] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 02/08/2023] Open
Abstract
Many studies have investigated the potential prognostic and predictive role of PD-L1 in prostatic carcinoma (PC). We performed a systematic literature review (PRISMA guidelines) to critically evaluate human tissue-based studies (immunohistochemistry, molecular analysis, etc.), experimental research (cell lines, mouse models), and clinical trials. Despite some controversial results and study limitations, PD-L1 expression by tumor cells may be related to clinic-pathologic features of adverse outcome, including advanced tumor stage (high pT, presence of lymph node, and distant metastases), positivity of surgical margins, high Grade Group, and castration resistance. Different PD-L1 positivity rates may be observed in matched primary PCs and various metastatic sites of the same patients. Over-fixation, type/duration of decalcification, and PD-L1 antibody clone may influence the immunohistochemical analysis of PD-L1 on bone metastases. PD-L1 seemed expressed more frequently by castration-resistant PCs (49%) as compared to hormone-sensitive PCs (17%). Some series found that PD-L1 positivity was associated with decreased time to castration resistance. Treatment with ipilimumab, cyclophosphamide/GVAX/degarelix, or degarelix alone may increase PD-L1 expression. Correlation of PD-L1 positivity with overall survival and outcomes related to tumor recurrence were rarely investigated; the few analyzed series produced conflicting results and sometimes showed limitations. Further studies are required. The testing and scoring of PD-L1 should be standardized.
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Affiliation(s)
- Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.B.); (E.Z.); (M.Z.); (M.P.B.); (L.D.M.); (G.S.); (M.C.G.); (A.T.); (M.R.)
| | - Martina Bonacini
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.B.); (S.C.)
| | - Stefania Croci
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.B.); (S.C.)
| | - Cristina Magi-Galluzzi
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (C.M.-G.); (S.C.-P.)
| | - Sofia Cañete-Portillo
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (C.M.-G.); (S.C.-P.)
| | - Alcides Chaux
- Department of Scientific Research, School of Postgraduate Studies, Norte University, Asunción 1614, Paraguay;
| | - Alessandra Bisagni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.B.); (E.Z.); (M.Z.); (M.P.B.); (L.D.M.); (G.S.); (M.C.G.); (A.T.); (M.R.)
| | - Eleonora Zanetti
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.B.); (E.Z.); (M.Z.); (M.P.B.); (L.D.M.); (G.S.); (M.C.G.); (A.T.); (M.R.)
| | - Dario De Biase
- Department of Pharmacy and Biotechnology (FABIT), University of Bologna, 40126 Bologna, Italy;
| | - Beatrice Melli
- Fertility Center, Department of Obstetrics and Gynecology, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | | | - Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.B.); (E.Z.); (M.Z.); (M.P.B.); (L.D.M.); (G.S.); (M.C.G.); (A.T.); (M.R.)
| | - Maria Paola Bonasoni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.B.); (E.Z.); (M.Z.); (M.P.B.); (L.D.M.); (G.S.); (M.C.G.); (A.T.); (M.R.)
| | - Loredana De Marco
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.B.); (E.Z.); (M.Z.); (M.P.B.); (L.D.M.); (G.S.); (M.C.G.); (A.T.); (M.R.)
| | - Alessandra Soriano
- Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA;
- Gastroenterology Division, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy;
- Haematopathology Unit, CREO, Azienda Ospedaliera di Perugia, University of Perugia, 06129 Perugia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Carolina Castro Ruiz
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy;
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy;
| | - Antonio De Leo
- Molecular Diagnostic Unit, Azienda USL Bologna, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy;
| | - Guido Giordano
- Medical Oncology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (G.G.); (M.L.)
| | - Matteo Landriscina
- Medical Oncology Unit, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (G.G.); (M.L.)
| | - Giuseppe Carrieri
- Department of Urology and Renal Transplantation, University of Foggia, 71122 Foggia, Italy; (G.C.); (L.C.)
| | - Luigi Cormio
- Department of Urology and Renal Transplantation, University of Foggia, 71122 Foggia, Italy; (G.C.); (L.C.)
| | - Daniel M. Berney
- Barts Cancer Institute, Queen Mary University of London, London EC1M 5PZ, UK;
| | - Jatin Gandhi
- Department of Pathology and Laboratory Medicine, University of Washington, Seattle, WA 98195, USA;
| | - Giacomo Santandrea
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.B.); (E.Z.); (M.Z.); (M.P.B.); (L.D.M.); (G.S.); (M.C.G.); (A.T.); (M.R.)
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Maria Carolina Gelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.B.); (E.Z.); (M.Z.); (M.P.B.); (L.D.M.); (G.S.); (M.C.G.); (A.T.); (M.R.)
| | - Alessandro Tafuni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.B.); (E.Z.); (M.Z.); (M.P.B.); (L.D.M.); (G.S.); (M.C.G.); (A.T.); (M.R.)
- Pathology Unit, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
| | - Moira Ragazzi
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.B.); (E.Z.); (M.Z.); (M.P.B.); (L.D.M.); (G.S.); (M.C.G.); (A.T.); (M.R.)
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4
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Zanelli M, Pizzi M, Sanguedolce F, Zizzo M, Palicelli A, Soriano A, Bisagni A, Martino G, Caprera C, Moretti M, Masia F, De Marco L, Froio E, Foroni M, Bernardelli G, Alvarez de Celis MI, Giunta A, Merli F, Ascani S. Gastrointestinal Manifestations in Systemic Mastocytosis: The Need of a Multidisciplinary Approach. Cancers (Basel) 2021; 13:cancers13133316. [PMID: 34282774 PMCID: PMC8269078 DOI: 10.3390/cancers13133316] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/18/2021] [Accepted: 06/27/2021] [Indexed: 12/16/2022] Open
Abstract
Simple Summary Mastocytosis is a group of neoplastic mast cell disorders ranging from a skin-limited disease to a systemic form with multi-organ involvement, including gut involvement. Clinical manifestations and outcome of systemic mastocytosis are variable. Symptoms may result from either release of mast cell mediators or tissue infiltration by mast cell proliferation. Gastrointestinal symptoms are one of the major causes of morbidity in these patients. The diagnosis of gastrointestinal mastocytosis can be tricky, as symptoms often mimic other more common gastrointestinal diseases; the endoscopic appearance is often unremarkable or nonspecific and the infiltrate can be focal and subtle and easily missed unless special stains are used. This review aims to better define the gastrointestinal involvement in systemic mastocytosis, discussing potential diagnostic pitfalls and pointing out the importance of a multidisciplinary approach for a prompt diagnosis and treatment. Abstract Mastocytosis represents a heterogeneous group of neoplastic mast cell disorders. The basic classification into a skin-limited disease and a systemic form with multi-organ involvement remains valid. Systemic mastocytosis is a disease often hard to diagnose, characterized by different symptoms originating from either the release of mast cell mediators or organ damage due to mast cell infiltration. Gastrointestinal symptoms represent one of the major causes of morbidity, being present in 60–80% of patients. A high index of suspicion by clinicians and pathologists is required to reach the diagnosis. Gastrointestinal mastocytosis can be a challenging diagnosis, as symptoms simulate other more common gastrointestinal diseases. The endoscopic appearance is generally unremarkable or nonspecific and gastrointestinal mast cell infiltration can be focal and subtle, requiring an adequate sampling with multiple biopsies by the endoscopists. Special stains, such as CD117, tryptase, and CD25, should be performed in order not to miss the gastrointestinal mast cell infiltrate. A proper patient’s workup requires a multidisciplinary approach including gastroenterologists, endoscopists, hematologists, oncologists, and pathologists. The aim of this review is to analyze the clinicopathological features of gastrointestinal involvement in systemic mastocytosis, focusing on the relevance of a multidisciplinary approach.
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Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (A.B.); (L.D.M.); (E.F.); (M.F.); (G.B.)
- Correspondence: ; Tel.: +39-0522-296532; Fax: +39-0522-296945
| | - Marco Pizzi
- General Pathology and Cytopathology Unit, Department of Medicine-DMED, University of Padova, 35121 Padova, Italy;
| | | | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.Z.); (A.G.)
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (A.B.); (L.D.M.); (E.F.); (M.F.); (G.B.)
| | - Alessandra Soriano
- Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA;
- Gastroenterology Division, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Alessandra Bisagni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (A.B.); (L.D.M.); (E.F.); (M.F.); (G.B.)
| | - Giovanni Martino
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (S.A.)
| | - Cecilia Caprera
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (S.A.)
| | - Marina Moretti
- OncoHematology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (M.M.); (F.M.)
| | - Francesco Masia
- OncoHematology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (M.M.); (F.M.)
| | - Loredana De Marco
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (A.B.); (L.D.M.); (E.F.); (M.F.); (G.B.)
| | - Elisabetta Froio
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (A.B.); (L.D.M.); (E.F.); (M.F.); (G.B.)
| | - Moira Foroni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (A.B.); (L.D.M.); (E.F.); (M.F.); (G.B.)
| | - Giuditta Bernardelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (A.P.); (A.B.); (L.D.M.); (E.F.); (M.F.); (G.B.)
| | | | - Alessandro Giunta
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.Z.); (A.G.)
| | - Francesco Merli
- Hematology Unit, Azienda USL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy; (M.I.A.d.C.); (F.M.)
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, 05100 Terni, Italy; (G.M.); (C.C.); (S.A.)
- Haematopathology Unit, CREO, Azienda Ospedaliera di Perugia, University of Perugia, 06129 Perugia, Italy
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Damato A, De Marco L, Serra S, Larocca M, Arias AG, Rondini E, Pinto C. Persistent Response and Prolonged Survival Following Pembrolizumab Discontinuation Due to Long-Lasting Autoimmune Colitis in Advanced NSCLC: A Case Report. Front Oncol 2021; 11:670415. [PMID: 34221986 PMCID: PMC8248363 DOI: 10.3389/fonc.2021.670415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 05/28/2021] [Indexed: 12/19/2022] Open
Abstract
Pembrolizumab is a programmed death receptor-1 (PD-1) inhibitor that has been approved for treatment of a wide variety of malignancies including non-small-cell lung cancer (NSCLC). Immune-mediated colitis is a known adverse effect of pembrolizumab which can lead to the treatment interruption, although not compromising the control of the oncological disease. Herein, we report the case of a 59-year-old woman on pembrolizumab for advanced NSCLC which developed a severe and persistent colitis treated with infliximab for several months following anti-PD-1 antibody discontinuation. This strategy resulted in an improvement but not complete recovery of the gastrointestinal toxicity despite revealed sustained response and control of the oncological disease with prolonged survival over 24 months.
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Affiliation(s)
- Angela Damato
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Loredana De Marco
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Silvia Serra
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mario Larocca
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alicia Garcia Arias
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Ermanno Rondini
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Carmine Pinto
- Medical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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6
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Palicelli A, Giaccherini L, Zanelli M, Bonasoni MP, Gelli MC, Bisagni A, Zanetti E, De Marco L, Torricelli F, Manzotti G, Gugnoni M, D’Ippolito G, Falbo AI, Sileo FG, Aguzzoli L, Mastrofilippo V, Bonacini M, De Giorgi F, Ricci S, Bernardelli G, Ardighieri L, Zizzo M, De Leo A, Santandrea G, de Biase D, Ragazzi M, Dalla Dea G, Veggiani C, Carpenito L, Sanguedolce F, Asaturova A, Boldorini R, Disanto MG, Goia M, Wong RWC, Singh N, Mandato VD. How Can We Treat Vulvar Carcinoma in Pregnancy? A Systematic Review of the Literature. Cancers (Basel) 2021; 13:836. [PMID: 33671249 PMCID: PMC7921964 DOI: 10.3390/cancers13040836] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/06/2021] [Accepted: 02/11/2021] [Indexed: 02/05/2023] Open
Abstract
According to our systematic literature review (PRISMA guidelines), only 37 vulvar squamous cell carcinomas (VSCCs) were diagnosed during pregnancy (age range: 17-41 years). The tumor size range was 0.3-15 cm. The treatment was performed after (14/37, 38%), before (10/37, 27%), or before-and-after delivery (11/37, 30%). We found that 21/37 (57%) cases were stage I, 2 II (5%), 11 III (30%), and 3 IVB (8%). HPV-related features (condylomas/warts; HPV infection; high-grade squamous intraepithelial lesion) were reported in 11/37 (30%) cases. We also found that 9/37 (24%) patients had inflammatory conditions (lichen sclerosus/planus, psoriasis, chronic dermatitis). The time-to-recurrence/progression (12/37, 32%) ranged from 0 to 36 (mean 9) months. Eight women died of disease (22%) 2.5-48 months after diagnosis, 2 (5%) were alive with disease, and 23 (62%) were disease-free at the end of follow-up. Pregnant patients must be followed-up. Even if they are small, newly arising vulvar lesions should be biopsied, especially in women with risk factors (HPV, dermatosis, etc.). The treatment of VSCCs diagnosed in late third trimester might be delayed until postpartum. Elective cesarean section may prevent vulvar wound dehiscence. In the few reported cases, pregnancy/fetal outcomes seemed to not be affected by invasive treatments during pregnancy. However, clinicians must be careful; larger cohorts should define the best treatment. Definite guidelines are lacking, so a multidisciplinary approach and discussion with patients are mandatory.
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Affiliation(s)
- Andrea Palicelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (M.P.B.); (M.C.G.); (A.B.); (E.Z.); (L.D.M.); (F.D.G.); (S.R.); (G.B.); (G.S.); (M.R.)
| | - Lucia Giaccherini
- Radiation Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Magda Zanelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (M.P.B.); (M.C.G.); (A.B.); (E.Z.); (L.D.M.); (F.D.G.); (S.R.); (G.B.); (G.S.); (M.R.)
| | - Maria Paola Bonasoni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (M.P.B.); (M.C.G.); (A.B.); (E.Z.); (L.D.M.); (F.D.G.); (S.R.); (G.B.); (G.S.); (M.R.)
| | - Maria Carolina Gelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (M.P.B.); (M.C.G.); (A.B.); (E.Z.); (L.D.M.); (F.D.G.); (S.R.); (G.B.); (G.S.); (M.R.)
| | - Alessandra Bisagni
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (M.P.B.); (M.C.G.); (A.B.); (E.Z.); (L.D.M.); (F.D.G.); (S.R.); (G.B.); (G.S.); (M.R.)
| | - Eleonora Zanetti
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (M.P.B.); (M.C.G.); (A.B.); (E.Z.); (L.D.M.); (F.D.G.); (S.R.); (G.B.); (G.S.); (M.R.)
| | - Loredana De Marco
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (M.P.B.); (M.C.G.); (A.B.); (E.Z.); (L.D.M.); (F.D.G.); (S.R.); (G.B.); (G.S.); (M.R.)
| | - Federica Torricelli
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (F.T.); (G.M.); (M.G.)
| | - Gloria Manzotti
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (F.T.); (G.M.); (M.G.)
| | - Mila Gugnoni
- Laboratory of Translational Research, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (F.T.); (G.M.); (M.G.)
| | - Giovanni D’Ippolito
- Unit of Obstetrics and Gynaecology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (G.D.); (A.I.F.); (F.G.S.); (V.D.M.)
| | - Angela Immacolata Falbo
- Unit of Obstetrics and Gynaecology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (G.D.); (A.I.F.); (F.G.S.); (V.D.M.)
| | - Filomena Giulia Sileo
- Unit of Obstetrics and Gynaecology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (G.D.); (A.I.F.); (F.G.S.); (V.D.M.)
| | - Lorenzo Aguzzoli
- Unit of Surgical Gynecol Oncology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (L.A.); (V.M.)
| | - Valentina Mastrofilippo
- Unit of Surgical Gynecol Oncology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (L.A.); (V.M.)
| | - Martina Bonacini
- Clinical Immunology, Allergy and Advanced Biotechnologies Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Federica De Giorgi
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (M.P.B.); (M.C.G.); (A.B.); (E.Z.); (L.D.M.); (F.D.G.); (S.R.); (G.B.); (G.S.); (M.R.)
| | - Stefano Ricci
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (M.P.B.); (M.C.G.); (A.B.); (E.Z.); (L.D.M.); (F.D.G.); (S.R.); (G.B.); (G.S.); (M.R.)
| | - Giuditta Bernardelli
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (M.P.B.); (M.C.G.); (A.B.); (E.Z.); (L.D.M.); (F.D.G.); (S.R.); (G.B.); (G.S.); (M.R.)
| | - Laura Ardighieri
- Pathology Unit, ASST Spedali Civili di Brescia, 25123 Brescia, Italy;
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Antonio De Leo
- Molecular Diagnostic Unit, Azienda USL Bologna, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy;
| | - Giacomo Santandrea
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (M.P.B.); (M.C.G.); (A.B.); (E.Z.); (L.D.M.); (F.D.G.); (S.R.); (G.B.); (G.S.); (M.R.)
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Dario de Biase
- Pharmacology and Biotechnology Department (FaBiT), University of Bologna, 40138 Bologna, Italy;
| | - Moira Ragazzi
- Pathology Unit, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (M.P.B.); (M.C.G.); (A.B.); (E.Z.); (L.D.M.); (F.D.G.); (S.R.); (G.B.); (G.S.); (M.R.)
| | - Giulia Dalla Dea
- Department of Health Science, University of Eastern Piedmont, 28100 Novara, Italy; (G.D.D.); (R.B.)
- Pathology Unit, Maggiore Della Carità Hospital, 28100 Novara, Italy;
| | - Claudia Veggiani
- Pathology Unit, Maggiore Della Carità Hospital, 28100 Novara, Italy;
| | - Laura Carpenito
- School of Pathology, University of Milan, 20122 Milan, Italy;
| | - Francesca Sanguedolce
- Pathology Unit, Azienda Ospedaliero-Universitaria-Ospedali Riuniti di Foggia, 71122 Foggia, Italy;
| | - Aleksandra Asaturova
- 1st Pathology Department, FSBI “National Medical Research Center for Obstetrics, Gynecology and Perinatology Named After Academician V.I. Kulakov”, Ministry of Healthcare of the Russian Federation, 117997 Moscow, Russia;
| | - Renzo Boldorini
- Department of Health Science, University of Eastern Piedmont, 28100 Novara, Italy; (G.D.D.); (R.B.)
- Pathology Unit, Maggiore Della Carità Hospital, 28100 Novara, Italy;
| | | | - Margherita Goia
- Unit of Pathology, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, 10126 Turin, Italy;
| | - Richard Wing-Cheuk Wong
- Department of Clinical Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China;
| | - Naveena Singh
- Department of Cellular Pathology, Barts Health NHS Trust, The Royal London Hospital, Whitechapel, London E1 1BB, UK;
| | - Vincenzo Dario Mandato
- Unit of Obstetrics and Gynaecology, Azienda USL-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (G.D.); (A.I.F.); (F.G.S.); (V.D.M.)
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Abstract
INTRODUCTION Plasmablastic lymphoma (PBL) is an uncommon and aggressive large B-cell lymphoma commonly diagnosed in human immunodeficiency viruses -positive patients. Oral cavity is the most commonly PBL affected site. Most oral PBLs presented as asymptomatic swellings, frequently associated with ulcerations and bleeding. Most cases lacked B-symptoms, suggesting a more local involvement of the disease. No standard treatment is yet for oral PBL. Five-year survival rate recorded no more than 33.5%. PATIENT CONCERNS A 39-year-old male presented to Dental Clinic with 1 month swelling of the oral cavity, in absence of any other symptoms or signs. He followed antibiotic therapy just on suspicion of an oral abscess and later oral surgical treatment on suspicion of bone neoplasm. DIAGNOSIS Surgical specimen analysis highlighted a diffuse infiltrate of large-sized atypical cells with plasmablastic appearance and plasma cell phenotype. Oral cavity PBL was diagnosed. Blood tests recorded mild lymphopenia and positive human immunodeficiency viruses serology. INTERVENTIONS Patient underwent chemotherapy including intrathecal methotrexate prophylaxis, in addition to a highly active antiretroviral therapy. OUTCOMES At 12 months from diagnosis, patient recorded complete hematological remission. CONCLUSIONS Oral PBL diagnosis requires a high level of suspicion and awareness both by physicians and pathologists. They should be aware of the extent of such disease which is often mistaken as oral abscess or infected tooth, thus leading to delay the most appropriate diagnostic evaluation. As PBL is an aggressive non-Hodgkin lymphoma, a delayed diagnosis might negatively impact on both treatment and survival.
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Affiliation(s)
- Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena
| | - Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia
| | - Roberta Martiniani
- Onco-Hematology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, Terni
| | - Francesca Sanguedolce
- Pathology Unit, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Foggia, Foggia
| | - Loredana De Marco
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia
| | - Giovanni Martino
- Hematology Unit, CREO, Azienda Ospedaliera di Perugia, University of Perugia, Perugia
| | - Paola Parente
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia
| | - Valerio Annessi
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia
| | - Lorenzo Manzini
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera Santa Maria di Terni, University of Perugia, Terni, Italy
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Zanelli M, Ciarrocchi A, De Petris G, Zizzo M, Costantini M, Bisagni A, Torricelli F, Nicoli D, Ramundo D, Ricci S, Palicelli A, Sanguedolce F, Ascani S, Ruiz CC, Annessi V, Zamponi R, Bortesi M, Martino V, Marchetti M, De Marco L. Acute Radiation Colitis after Preoperative Short-Course Radiotherapy for Rectal Cancer: A Morphological, Immunohistochemical and Genetic Study. Cancers (Basel) 2020; 12:cancers12092571. [PMID: 32917028 PMCID: PMC7563849 DOI: 10.3390/cancers12092571] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 12/11/2022] Open
Abstract
Preoperative radiotherapy is a widely accepted treatment procedure in rectal cancer. Radiation-induced changes in the tumor are well described, whereas less attention has been given to the non-neoplastic mucosa. Our aim is to provide a detailed analysis of the morphological features present in non-neoplastic mucosa that pathologists need to be familiar with, in order to avoid misdiagnosis, when evaluating rectal cancer specimens of patients preoperatively treated with radiotherapy, especially with short-course regimen. We compared 2 groups of 95 rectal cancer patients treated preoperatively with either short-course (45 patients) or long-course radiotherapy (50 patients). Depending on the type of protocol, different histopathological features, in terms of inflammation, glandular abnormalities and endocrine differentiation were seen in the non-neoplastic mucosa within the irradiated volume. Of note, features mimicking dysplasia, such as crypt distortion, nuclear and cytoplasmic atypia of glandular epithelium, were identified only in the short-course group. DNA mutation analysis, using a panel of 56 genes frequently mutated in cancer, and p53 immunostaining were performed on both tumor and radiation-damaged mucosa in a subset of short course cases. Somatic mutations were identified only in tumors, supporting the concept that tissues with radiation-induced "dysplastic-like" features are not genetically transformed. Pathologists should be aware of the characteristic morphological changes induced by radiation. The presence of features simulating dysplasia in the group treated with short-course radiotherapy may lead to serious diagnostic mistakes, if erroneously interpreted. Next generation sequencing (NGS) analysis further validated the morphological concept that radiation-induced abnormalities do not represent pre-neoplastic lesions.
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Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (S.R.); (A.P.); (M.B.); (V.M.); (M.M.); (L.D.M.)
| | - Alessia Ciarrocchi
- Laboratory of Translational Research, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (A.C.); (F.T.)
| | | | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (C.C.R.); (V.A.)
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
- Correspondence: ; Tel.: +39-0522-296372; Fax: +39-0522-295779
| | - Massimo Costantini
- Scientific Director, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Alessandra Bisagni
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (S.R.); (A.P.); (M.B.); (V.M.); (M.M.); (L.D.M.)
| | - Federica Torricelli
- Laboratory of Translational Research, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (A.C.); (F.T.)
| | - Davide Nicoli
- Laboratory of Molecular Biology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (D.N.); (R.Z.)
| | - Dafne Ramundo
- Radiotherapy Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy;
| | - Stefano Ricci
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (S.R.); (A.P.); (M.B.); (V.M.); (M.M.); (L.D.M.)
| | - Andrea Palicelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (S.R.); (A.P.); (M.B.); (V.M.); (M.M.); (L.D.M.)
| | - Francesca Sanguedolce
- Pathology Unit, Azienda Ospedaliero-Universitaria-Ospedali Riuniti di Foggia, 71122 Foggia, Italy;
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, 05100 Terni, Italy;
| | - Carolina Castro Ruiz
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (C.C.R.); (V.A.)
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Valerio Annessi
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (C.C.R.); (V.A.)
| | - Raffaella Zamponi
- Laboratory of Molecular Biology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (D.N.); (R.Z.)
| | - Mara Bortesi
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (S.R.); (A.P.); (M.B.); (V.M.); (M.M.); (L.D.M.)
| | - Veronica Martino
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (S.R.); (A.P.); (M.B.); (V.M.); (M.M.); (L.D.M.)
| | - Marialisa Marchetti
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (S.R.); (A.P.); (M.B.); (V.M.); (M.M.); (L.D.M.)
| | - Loredana De Marco
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy; (M.Z.); (A.B.); (S.R.); (A.P.); (M.B.); (V.M.); (M.M.); (L.D.M.)
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Zizzo M, Manzini L, Zanelli M, De Marco L, Castro Ruiz C, Manenti A, Annessi V. Prevention of bile spillage during cholecystectomy: current evidences and considerations. Hepatobiliary Surg Nutr 2020; 9:109-111. [PMID: 32140494 DOI: 10.21037/hbsn.2019.11.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Lorenzo Manzini
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy
| | - Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy
| | - Loredana De Marco
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy
| | - Carolina Castro Ruiz
- General Surgery Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Ospedale Civile di Guastalla, Reggio Emilia, Italy
| | - Antonio Manenti
- Department of General Surgery, Azienda Ospedaliero-Universitaria - Policlinico, Modena, Italy
| | - Valerio Annessi
- General Surgery Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Ospedale Civile di Guastalla, Reggio Emilia, Italy
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Zanelli M, Smith M, Zizzo M, Carloni A, Valli R, De Marco L, Foroni M, Palicelli A, Martino G, Ascani S. A tricky and rare cause of pulmonary eosinophilia: myeloid/lymphoid neoplasm with eosinophilia and rearrangement of PDGFRA. BMC Pulm Med 2019; 19:216. [PMID: 31744552 PMCID: PMC6862820 DOI: 10.1186/s12890-019-0967-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 10/18/2019] [Indexed: 01/21/2023] Open
Abstract
Background Eosinophilic lung diseases represent a heterogeneous group of disorders with prominent infiltrate of eosinophils in lung interstitium and alveolar spaces. Peripheral blood eosinophilia is often present. Infections, drugs, allergens, toxic agents have to be evaluated as possible causes of eosinophilic lung infiltrates. The category of myeloid/lymphoid neoplasms with eosinophilia and rearrangement of PDGFRA, PDGFRB, FGFR1 and PCM1-JAK2 represents an uncommon cause of eosinophilic lung infiltrate. Case presentation We report the case of a 70-year old man complaining of dry cough and dyspnea. Ground glass-opacities were seen on imaging studies and peripheral blood eosinophilia was present. A thorough step-wise patient’s evaluation led to identify the clonal nature of eosinophilia and the diagnosis of myeloid/lymphoid neoplasm with eosinophilia and rearrangement of PDGFRA was made. Conclusions Correlation with clinical history, laboratory tests and imaging studies is essential to achieve the correct diagnosis when facing with eosinophilic lung infiltrates. A prolonged eosinophilia can cause life-threatening organ damage. Identification of PDGFRA rearrangement, as in the present case, is particularly critical given the sensitivity and excellent response to imatinib, which has completely changed the natural history of this neoplasm.
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Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maxwell Smith
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Scottsdale, AZ, USA
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy. .,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
| | - Angelo Carloni
- Radiology Unit, Ospedale di Terni, University of Perugia, Perugia, Italy
| | - Riccardo Valli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Loredana De Marco
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Moira Foroni
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Palicelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Stefano Ascani
- Pathology Unit, Ospedale di Terni, University of Perugia, Perugia, Italy
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Zizzo M, Ugoletti L, Manzini L, Ruiz CC, Nita GE, Zanelli M, De Marco L, Besutti G, Scalzone R, Sassatelli R, Annessi V, Manenti A, Pedrazzoli C. Correction to: Management of duodenal stump fistula after gastrectomy for malignant disease: a systematic review of the literature. BMC Surg 2019; 19:151. [PMID: 31651298 PMCID: PMC6813063 DOI: 10.1186/s12893-019-0626-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Maurizio Zizzo
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy. .,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
| | - Lara Ugoletti
- General and Emergency Surgery Unit, Ospedale Civile di Guastalla, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Lorenzo Manzini
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Carolina Castro Ruiz
- General and Emergency Surgery Unit, Ospedale Civile di Guastalla, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Gabriela Elisa Nita
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Magda Zanelli
- Department of Oncology and Advanced Technologies, Pathology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Loredana De Marco
- Department of Oncology and Advanced Technologies, Pathology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Giulia Besutti
- Department of Imaging and Laboratory Medicine, Radiology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Rocco Scalzone
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Romano Sassatelli
- Department of Oncology and Advanced Technologies, Gastrointestinal Endoscopy Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Valerio Annessi
- General and Emergency Surgery Unit, Ospedale Civile di Guastalla, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Antonio Manenti
- Department of General Surgery, Azienda Ospedaliero-Universitaria Policlinico, Del Pozzo Street 71, 41124, Modena, Italy
| | - Claudio Pedrazzoli
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
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12
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Zanelli M, Zizzo M, Montanaro M, Gomes V, Martino G, De Marco L, Fraternali Orcioni G, Martelli MP, Ascani S. Fibrin-associated large B-cell lymphoma: first case report within a cerebral artery aneurysm and literature review. BMC Cancer 2019; 19:916. [PMID: 31519155 PMCID: PMC6743119 DOI: 10.1186/s12885-019-6123-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 09/02/2019] [Indexed: 02/07/2023] Open
Abstract
Background Fibrin-associated diffuse large B-cell lymphoma (FA-DLBCL) is a rare Epstein-Barr virus (EBV) positive lymphoproliferative disorder included in the current World Health Organization (WHO) classification. It arises within fibrinous material in the context of hematomas, pseudocysts, cardiac myxoma or in relation with prosthetic devices. In these clinical settings the diagnosis requires an high index of suspicion, because it does not form a mass itself, being composed of small foci of neoplastic cells. Despite overlapping features with diffuse large B-cell lymphoma associated with chronic inflammation, it deserves a separate classification, being not mass-forming and often following an indolent course. Case presentation A 64-year-old immunocompetent woman required medical care for cerebral hemorrhage. Computed Tomography (CT) angiography identified an aneurysm in the left middle cerebral artery. A FA-DLBCL was incidentally identified within thrombotic material in the context of the arterial aneurysm. After surgical removal, it followed a benign course with no further treatment. Conclusions The current case represents the first report of FA-DLBCL identified in a cerebral artery aneurysm, expanding the clinicopathologic spectrum of this rare entity. A complete literature review is additionally made.
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Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy. .,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
| | | | - Vito Gomes
- Pathology Unit, Ospedale di Belcolle, Viterbo, Italy
| | - Giovanni Martino
- Hematology Unit, CREO, Azienda Ospedaliera di Perugia, University of Perugia, Perugia, Italy
| | - Loredana De Marco
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | - Maria Paola Martelli
- Hematology Unit, CREO, Azienda Ospedaliera di Perugia, University of Perugia, Perugia, Italy
| | - Stefano Ascani
- Pathology Unit, Ospedale di Terni, University of Perugia, Perugia, Italy
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13
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Zizzo M, De Marco L, Zanelli M, Annessi V, Manenti A, Ascani S, Pedrazzoli C. Localized Crystal-Storing Histiocytosis Involving Lower Rectum. Int J Surg Pathol 2019; 28:415-416. [PMID: 31500480 DOI: 10.1177/1066896919874407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Maurizio Zizzo
- Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,University of Modena and Reggio Emilia, Modena, Italy
| | - Loredana De Marco
- Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Magda Zanelli
- Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Valerio Annessi
- Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Claudio Pedrazzoli
- Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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14
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Zanelli M, Fraternali Orcioni G, Zizzo M, De Marco L, Martino G, Cerrone G, Cabras AD, Ascani S. HHV-8- and EBV-positive germinotropic lymphoproliferative disorder. Ann Hematol 2019; 98:2439-2441. [PMID: 31377818 DOI: 10.1007/s00277-019-03773-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 07/29/2019] [Indexed: 01/13/2023]
Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy. .,Department of Oncology and Advanced Technologies, Surgical, Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
| | - Loredana De Marco
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Martino
- Hematology Unit, CREO, Azienda Ospedaliera di Perugia, University of Perugia, Perugia, Italy
| | | | | | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera S. Maria di Terni, University of Perugia, Perugia, Italy
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15
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Zizzo M, Ugoletti L, Castro Ruiz C, Zanelli M, De Marco L, Pedrazzoli C, Annessi V. Laparoscopic liver resection for malignancies confined to Couinaud's segment VII in the robotic surgery era. Hepatobiliary Surg Nutr 2019; 8:439-441. [PMID: 31489327 DOI: 10.21037/hbsn.2019.05.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Lara Ugoletti
- General Surgery Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Ospedale Civile di Guastalla, Reggio Emilia, Italy
| | - Carolina Castro Ruiz
- General Surgery Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Ospedale Civile di Guastalla, Reggio Emilia, Italy
| | - Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy
| | - Loredana De Marco
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy
| | - Claudio Pedrazzoli
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Arcispedale Santa Maria Nuova di Reggio Emilia, Reggio Emilia, Italy
| | - Valerio Annessi
- General Surgery Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Ospedale Civile di Guastalla, Reggio Emilia, Italy
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16
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Zizzo M, Ugoletti L, Manzini L, Castro Ruiz C, Nita GE, Zanelli M, De Marco L, Besutti G, Scalzone R, Sassatelli R, Annessi V, Manenti A, Pedrazzoli C. Management of duodenal stump fistula after gastrectomy for malignant disease: a systematic review of the literature. BMC Surg 2019; 19:55. [PMID: 31138190 PMCID: PMC6540539 DOI: 10.1186/s12893-019-0520-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/21/2019] [Indexed: 02/07/2023] Open
Abstract
Background Duodenal stump fistula (DSF) remains one of the most serious complications following subtotal or total gastrectomy, as it endangers patient’s life. DSF is related to high mortality (16–20%) and morbidity (75%) rates. DSF-related morbidity always leads to longer hospitalization times due to medical and surgical complications such as wound infections, intra-abdominal abscesses, intra-abdominal bleeding, acute pancreatitis, acute cholecystitis, severe malnutrition, fluids and electrolytes disorders, diffuse peritonitis, and pneumonia. Our systematic review aimed at improving our understanding of such surgical complication, focusing on nonsurgical and surgical DSF management in patients undergoing gastric resection for gastric cancer. Methods We performed a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. PubMed/MEDLINE, EMBASE, Scopus, Cochrane Library and Web of Science databases were used to search all related literature. Results The 20 included articles covered an approximately 40 years-study period (1979–2017), with a total 294 patient population. DSF diagnosis occurred between the fifth and tenth postoperative day. Main DSF-related complications were sepsis, abdominal abscess, wound infection, pneumonia, and intra-abdominal bleeding. DSF treatment was divided into four categories: conservative (101 cases), endoscopic (4 cases), percutaneous (82 cases), and surgical (157 cases). Length of hospitalization was 21–39 days, ranging from 1 to 1035 days. Healing time was 19–63 days, ranging from 1 to 1035 days. DSF-related mortality rate recorded 18.7%. Conclusions DSF is a rare but potentially lethal complication after gastrectomy for gastric cancer. Early DSF diagnosis is crucial in reducing DSF-related morbidity and mortality. Conservative and/or endoscopic/percutaneous treatments is/are the first choice. However, if the patient clinical condition worsens, surgery becomes mandatory and duodenostomy appears to be the most effective surgical procedure.
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Affiliation(s)
- Maurizio Zizzo
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, AUSL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy. .,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
| | - Lara Ugoletti
- General and Emergency Surgery Unit, Ospedale Civile di Guastalla, AUSL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Lorenzo Manzini
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, AUSL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Carolina Castro Ruiz
- General and Emergency Surgery Unit, Ospedale Civile di Guastalla, AUSL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Gabriela Elisa Nita
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, AUSL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Magda Zanelli
- Department of Oncology and Advanced Technologies, Pathology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, AUSL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Loredana De Marco
- Department of Oncology and Advanced Technologies, Pathology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, AUSL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Giulia Besutti
- Department of Imaging and Laboratory Medicine, Radiology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, AUSL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Rocco Scalzone
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, AUSL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Romano Sassatelli
- Department of Oncology and Advanced Technologies, Gastrointestinal Endoscopy Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, AUSL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Valerio Annessi
- General and Emergency Surgery Unit, Ospedale Civile di Guastalla, AUSL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
| | - Antonio Manenti
- Department of General Surgery, Azienda Ospedaliero-Universitaria Policlinico, Del Pozzo Street 71, 41124, Modena, Italy
| | - Claudio Pedrazzoli
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, Arcispedale Santa Maria Nuova di Reggio Emilia, AUSL-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy
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17
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Zanelli M, Zizzo M, Foroni M, De Marco L, Martino G, Ascani S. EBV-positive mucocutaneous ulcer within colonic diverticulitis mimicking diffuse large B cell lymphoma. Ann Hematol 2019; 98:1795-1797. [PMID: 31093707 DOI: 10.1007/s00277-019-03712-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 05/05/2019] [Indexed: 11/26/2022]
MESH Headings
- Aged, 80 and over
- Colonic Neoplasms/diagnosis
- Colonic Neoplasms/metabolism
- Colonic Neoplasms/pathology
- Diagnosis, Differential
- Diverticulitis, Colonic/diagnosis
- Diverticulitis, Colonic/metabolism
- Diverticulitis, Colonic/pathology
- Diverticulitis, Colonic/virology
- Epstein-Barr Virus Infections/diagnosis
- Epstein-Barr Virus Infections/metabolism
- Epstein-Barr Virus Infections/pathology
- Female
- Herpesvirus 4, Human/metabolism
- Humans
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/virology
- Neoplasm Proteins/metabolism
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Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy.
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
| | - Moira Foroni
- Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy
| | - Loredana De Marco
- Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy
| | - Giovanni Martino
- Institute of Hematology-CREO, Ospedale Santa Maria della Misericordia, University of Perugia, Piazza Menghini, 1, 06129, Perugia, Italy
| | - Stefano Ascani
- Pathology Unit, Ospedale di Terni, University of Perugia, Viale Tristano di Joannuccio, 05100, Terni, Italy
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18
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Zanelli M, Pai RK, Grazia Zorzi M, Zizzo M, Martino G, Morelli L, Parisi A, De Marco L, Annessi V, Ascani S. Gastrointestinal Mastocytosis: A Potential Diagnostic Pitfall to Be Aware. Int J Surg Pathol 2019; 27:643-646. [PMID: 31046499 DOI: 10.1177/1066896919846648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Mastocytosis is a rare and heterogeneous group of disorders that may be limited to the skin and even spontaneously regress or may have a systemic presentation with multi-organ involvement and poor outcome. Among the extracutaneous sites, gastrointestinal tract is often affected, but nonspecific clinical manifestations combined with subtle histological findings of the disease makes the diagnosis of gastrointestinal mastocytosis rather hard. In absence of a high index of suspicion, gastrointestinal involvement is easily overlooked. We report a challenging case of systemic mastocytosis presenting with isolated gastrointestinal manifestations without skin involvement, in which the diagnosis was missed at first evaluation of intestinal biopsies.
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Affiliation(s)
- Magda Zanelli
- 1 Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Maria Grazia Zorzi
- 3 Azienda Provinciale per i Servizi Sanitari, Santa Chiara Hospital, Trento, Italy
| | - Maurizio Zizzo
- 1 Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy.,4 University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Martino
- 5 Azienda Ospedaliera di Perugia, University of Perugia, Perugia, Italy
| | - Luca Morelli
- 3 Azienda Provinciale per i Servizi Sanitari, Santa Chiara Hospital, Trento, Italy
| | | | - Loredana De Marco
- 1 Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Valerio Annessi
- 1 Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefano Ascani
- 7 Ospedale di Terni, University of Perugia, Terni, Italy
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19
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Zanelli M, Zizzo M, Martino G, Bisagni A, De Marco L, Ascani S. Bone Marrow Biopsy Disclosing a Rare Osteolytic Disorder: Gorham-Stout Syndrome. Int J Surg Pathol 2019; 28:76-77. [PMID: 31018723 DOI: 10.1177/1066896919844319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Magda Zanelli
- Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy.,University of Modena and Reggio Emilia, Modena, Italy
| | | | - Alessandra Bisagni
- Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Loredana De Marco
- Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
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20
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Mandato VD, Mastrofilippo V, De Marco L, Aguzzoli L. Laparoscopic approach to an incidentally found pelvic retroperitoneal liposarcoma: Case report and review. Medicine (Baltimore) 2019; 98:e15184. [PMID: 30985710 PMCID: PMC6485822 DOI: 10.1097/md.0000000000015184] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
RATIONALE Well-differentiated liposarcomas (WDLPS) are rare retroperitoneal tumors that can reach significant size as they can grow without constrains before becoming symptomatic. Laparotomic open radical tumor resection represents the most common surgical approach. PATIENT CONCERNS A mass with "fat fluid level" was found in the right pelvis of an asymptomatic woman undergoing routine transvaginal ultrasound: the preoperative diagnosis was right mature ovarian teratoma. DIAGNOSIS Postoperative histopathology confirmed the diagnosis of WDLPS. INTERVENTIONS A radical laparoscopic excision of the retroperitoneal mass with bilateral salpingectomy was performed. OUTCOMES Patient is free of disease at 18 months after surgery. LESSON Despite computed tomography scan is the gold standard technique to identify WDLPS, such neoplasms can be misdiagnosed for mature ovarian teratomas. When a retroperitoneal mass is incidentally discovered during a surgery, an open core-needle biopsy is usually performed, and appropriate treatment planned only after complete staging and final pathology are available. Instead, when tumor margins are identified, resection of an incidentally diagnosed WDLPS would benefit from laparoscopic magnification that could improve distinguishing the disease from the surrounding tissues. Therefore, laparoscopy could represent a safe and effective technique to diagnose and treat retroperitoneal diseases.
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Affiliation(s)
| | | | - Loredana De Marco
- Unit of Pathology, Azienda USL-IRCCS of Reggio Emilia, Risorgimento, Italy
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21
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Zizzo M, Ugoletti L, Zanelli M, De Marco L, Annessi V, Pedrazzoli C. Pasireotide for the Prevention of Postoperative Pancreatic Fistula: A Debate Not To Close Too Early. J Am Coll Surg 2019; 228:811. [PMID: 30770320 DOI: 10.1016/j.jamcollsurg.2019.01.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 01/10/2019] [Indexed: 11/27/2022]
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22
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Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Loredana De Marco
- Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Bisagni
- Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefano Ascani
- Pathology Unit, Ospedale di Terni, University of Perugia, Terni, Italy
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23
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Zizzo M, Mengoli MC, Zanelli M, Marco LD, Lococo F, Ugoletti L, Pedrazzoli C. Atypical presentation of amniotic fluid embolism in liver and colon. Korean J Intern Med 2019; 34:227-230. [PMID: 29936778 PMCID: PMC6325436 DOI: 10.3904/kjim.2018.150] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 05/16/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Maurizio Zizzo
- Surgical Oncology Unit, Department of Oncology and Advanced Technologies, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
- Correspondence to Maurizio Zizzo, M.D. Surgical Oncology Unit, Department of Oncology and Advanced Technologies, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia 42123, Italy Tel: +39-0522-296372 Fax: +39-0522-295779 E-mail:
| | - Maria Cecilia Mengoli
- Pathology Unit, Department of Oncology and Advanced Technologies, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Magda Zanelli
- Pathology Unit, Department of Oncology and Advanced Technologies, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Loredana De Marco
- Pathology Unit, Department of Oncology and Advanced Technologies, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Filippo Lococo
- Thoracic Surgery Unit, Department of Oncology and Advanced Technologies, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Lara Ugoletti
- Surgical Oncology Unit, Department of Oncology and Advanced Technologies, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Claudio Pedrazzoli
- Surgical Oncology Unit, Department of Oncology and Advanced Technologies, IRCCS Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
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24
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Zanelli M, Mengoli MC, Zizzo M, De Marco L, Menozzi G, Giunta A, Ascani S. Uncommon splenic mass with a distinctive appearance. ANZ J Surg 2018; 89:1511-1513. [PMID: 30497097 DOI: 10.1111/ans.14949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 10/07/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria Cecilia Mengoli
- Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Loredana De Marco
- Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Guido Menozzi
- Infectious Disease Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessandro Giunta
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefano Ascani
- Pathology Unit, Azienda Ospedaliera Terni, University of Perugia, Perugia, Italy
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25
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Zanelli M, Zizzo M, Mengoli MC, Valli R, Martino G, Fenocchio D, De Marco L, Ascani S. Diffuse large B cell lymphoma and schistosomiasis: a rare simultaneous occurrence. Ann Hematol 2018; 98:1511-1512. [PMID: 30456422 DOI: 10.1007/s00277-018-3561-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 11/15/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Magda Zanelli
- Department of Oncology and Advanced Technologies, Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Department of Oncology and Advanced Technologies, Surgical Oncology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy. .,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
| | - Maria Cecilia Mengoli
- Department of Oncology and Advanced Technologies, Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy
| | - Riccardo Valli
- Department of Oncology and Advanced Technologies, Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy
| | - Giovanni Martino
- Institute of Hematology-CREO, Ospedale Santa Maria della Misericordia, University of Perugia, Piazza Menghini, 1, 06129, Perugia, Italy
| | - Daniela Fenocchio
- Pathology Unit, Ospedale Santa Maria della Misericordia, University of Perugia, Piazza Menghini, 1, 06129, Perugia, Italy
| | - Loredana De Marco
- Department of Oncology and Advanced Technologies, Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Viale Risorgimento, 80, 42123, Reggio Emilia, Italy
| | - Stefano Ascani
- Pathology Unit, Ospedale di Terni, University of Perugia, Viale Tristano di Joannuccio, 05100, Terni, Italy
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Zanelli M, Mengoli MC, Del Sordo R, Cagini A, De Marco L, Simonetti E, Martino G, Zizzo M, Ascani S. Intravascular NK/T-cell lymphoma, Epstein-Barr virus positive with multiorgan involvement: a clinical dilemma. BMC Cancer 2018; 18:1115. [PMID: 30442097 PMCID: PMC6238309 DOI: 10.1186/s12885-018-5001-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 10/28/2018] [Indexed: 11/23/2022] Open
Abstract
Background Intravascular lymphoma is a rare type of non-Hodgkin lymphoma mostly of B-cell lineage. A few cases of intravascular lymphoma have been found to be of NK/T-cell origin, mainly affecting the skin and central nervous system. Case presentation A 54-year-old Caucasian man sought care because of a 2 weeks history of jaundice and intermittent fever, not responsive to antibiotics and antipyretics. Laboratory tests showed low blood oxygen concentration and pancytopenia. Serum microbiological tests were negative. Computerized tomography (CT) scan revealed hepatosplenomegaly and diffuse ground-glass opacities in both lungs without interlobular septal thickening. Despite oxygen therapy, the clinical conditions rapidly deteriorated leading to death 3 days after admission. Autopsy revealed a multiorgan involvement by an Epstein-Barr virus positive NK/T-cell lymphoma, strikingly growing within the blood vessel lumina, in absence of skin lesions. Conclusions The current case highlights the pathological features of this rare entity, the protean clinical presentation of which is often misleading, resulting in delayed diagnosis and treatment.
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Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria Cecilia Mengoli
- Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Rachele Del Sordo
- Department of Experimental Medicine, Medical School, Section of Pathological Anatomy and Histology, University of Perugia, Perugia, Italy
| | - Angelo Cagini
- Department of Experimental Medicine, Medical School, Section of Pathological Anatomy and Histology, University of Perugia, Perugia, Italy
| | - Loredana De Marco
- Pathology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Edoardo Simonetti
- Hematology Unit, Università degli Studi di Perugia, CREO Perugia, Perugia, Italy
| | - Giovanni Martino
- Hematology Unit, Università degli Studi di Perugia, CREO Perugia, Perugia, Italy
| | - Maurizio Zizzo
- Surgical Oncology Unit, Azienda Unità Sanitaria Locale/IRCCS di Reggio Emilia, Reggio Emilia, Italy. .,Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy.
| | - Stefano Ascani
- Pathology Unit, Ospedale di Terni, University of Perugia, Perugia, Italy
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Zanelli M, Goteri G, Mengoli MC, Capelli D, De Marco L, Valli R, Zizzo M, Ascani S. Rosai-Dorfman Disease Involving Bone Marrow in Association With Acute Myeloid Leukemia. Int J Surg Pathol 2018; 27:396-398. [DOI: 10.1177/1066896918792617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Magda Zanelli
- Azienda Unità Sanitaria Locale/IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | | | | | - Loredana De Marco
- Azienda Unità Sanitaria Locale/IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Riccardo Valli
- Azienda Unità Sanitaria Locale/IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Maurizio Zizzo
- Azienda Unità Sanitaria Locale/IRCCS Reggio Emilia, Reggio Emilia, Italy
- University of Modena and Reggio Emilia, Modena, Italy
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Iachetta F, Romagnani A, Bonelli C, Bisagni A, De Marco L, Pinto C. Clinical-pathological features in HER2-positive advanced gastric cancer: Italian data of the Reggio Emilia Clinical Cancer Centre. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e16067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Francesco Iachetta
- Medical Oncology Unit, Clinical Cancer Center, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Alessandra Romagnani
- Medical Oncology Unit, Clinical Cancer Center, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Candida Bonelli
- Medical Oncology Unit, Clinical Cancer Center, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Carmine Pinto
- Medical Oncology Unit, Clinical Cancer Center, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
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Zanelli M, Smith M, Mengoli MC, Spaggiari L, De Marco L, Lococo F, Puma F, Ascani S. Erdheim-Chester disease: description of two illustrative cases involving the lung. Histopathology 2018; 73:167-172. [PMID: 29469219 DOI: 10.1111/his.13501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM Erdheim-Chester disease represents a clonal systemic proliferation of histiocytes. Bone is the most common site of involvement, although almost any organ, including the lungs, can be affected. METHODS AND RESULTS The diagnosis of Erdheim-Chester disease can be difficult, owing to its rarity and protean presentation. Correlation between clinical, radiological and histological findings is mandatory for identification of the disease. Foamy histiocytes, lacking Langerhans cell markers, represent the typical histological findings, although their absence does not rule out Erdheim-Chester disease. Identification of BRAF mutation can be helpful in making the diagnosis, and allows for the development and application of targeted therapies in this setting. CONCLUSIONS Herein, we describe two cases presenting with lung involvement and vertebral lesions, lacking the more typical long-bone involvement. One case histologically mimicked Rosai-Dorfman disease. However, both cases harboured the pathognomonic BRAFV600E mutation.
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Affiliation(s)
- Magda Zanelli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Maxwell Smith
- Department of Pathology and Laboratory Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Maria C Mengoli
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Lucia Spaggiari
- Radiology Unit, Azienda Unità Sanitaria Locale-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Loredana De Marco
- Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Filippo Lococo
- Thoracic Surgery, Azienda Unità Sanitaria Locale-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Puma
- Thoracic Surgery, University of Perugia Medical School, Perugia, Italy
| | - Stefano Ascani
- Pathology Unit, Ospedale di Terni, University of Perugia, Perugia, Italy
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Mengoli MC, Zanelli M, Zizzo M, Giunta A, Cerami LB, Cavazza A, Mengoli MC, De Marco L. Placental Tissue in Colon and Liver. Int J Surg Pathol 2018; 26:625-626. [PMID: 29444594 DOI: 10.1177/1066896918757913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Magda Zanelli
- 1 Azienda Unità Sanitaria Locale/IRCCS, Reggio Emilia, Italy
| | - Maurizio Zizzo
- 1 Azienda Unità Sanitaria Locale/IRCCS, Reggio Emilia, Italy.,2 Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | - Alberto Cavazza
- 1 Azienda Unità Sanitaria Locale/IRCCS, Reggio Emilia, Italy
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31
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Soriano A, Smerieri N, Bonilauri S, De Marco L, Cavazza A, Salvarani C. Colonic perforation due to severe cytomegalovirus disease in granulomatosis with polyangiitis after immunosuppression. Clin Rheumatol 2018; 37:1427-1432. [PMID: 29302827 DOI: 10.1007/s10067-017-3945-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/26/2017] [Accepted: 12/04/2017] [Indexed: 12/19/2022]
Abstract
Granulomatosis with polyangiitis (GPA) is a small-vessel necrotizing granulomatous vasculitis typically involving upper airways, lungs, and kidneys, which may lead to end-organ damage and life-threatening complications. Major infections during GPA course represent a considerable concern in the management of the disease. Cytomegalovirus (CMV) infection and disease are rare but significant complications in the course of GPA being associated with high morbidity and mortality rates. Colonic perforation due to CMV colitis is exceedingly rare and has so far almost exclusively been documented in HIV, renal transplant, and systemic lupus erythematosus patients. We reported the case of a patient affected with upper airways-limited GPA who developed acute renal failure from rapidly progressive glomerulonephritis and then experienced colonic perforation due to CMV colitis a few weeks after immunosuppressive treatment with high-dose steroids and cyclophosphamide (CYC) for remission induction of the disease. We also reviewed the literature on CMV-related gastro-intestinal complications in the course of GPA and discussed contributing factors to severe manifestations of CMV infection and its reactivation.
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Affiliation(s)
- Alessandra Soriano
- Rheumatology Unit, Department of Internal Medicine, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Viale Risorgimento 80, 42122, Reggio Emilia, Italy. .,Campus Bio-Medico University, Rome, Italy.
| | - Nazareno Smerieri
- General and Emergency Surgery, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Viale Risorgimento 80, 42122, Reggio Emilia, Italy.
| | - Stefano Bonilauri
- General and Emergency Surgery, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Viale Risorgimento 80, 42122, Reggio Emilia, Italy
| | - Loredana De Marco
- Pathology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Viale Risorgimento 80, 42122, Reggio Emilia, Italy
| | - Alberto Cavazza
- Pathology Unit, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Viale Risorgimento 80, 42122, Reggio Emilia, Italy
| | - Carlo Salvarani
- Rheumatology Unit, Department of Internal Medicine, Arcispedale Santa Maria Nuova, Azienda USL di Reggio Emilia - IRCCS, Viale Risorgimento 80, 42122, Reggio Emilia, Italy
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32
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Zanelli M, Mengoli MC, Fanni D, Froio E, De Marco L, Ascani S. Multiple Myeloma With Multilobated Plasma Cells: An Unusual and Challenging Morphological Variant. Int J Surg Pathol 2017; 26:439. [PMID: 29279032 DOI: 10.1177/1066896917750471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Magda Zanelli
- 1 Azienda Unità Sanitaria Locale/IRCCS, Reggio Emila, Italy
| | | | - Daniela Fanni
- 2 Ospedale S. Giovanni di Dio, University of Cagliari, Cagliari, Italy
| | | | | | - Stefano Ascani
- 3 Ospedale di Terni, University of Perugia, Perugia, Italy
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Zanelli M, Mengoli MC, Puma F, Spaggiari L, Lococo F, De Marco L, Ascani S. Diffuse Alveolar-Septal Amyloidosis Associated With Multiple Myeloma. Int J Surg Pathol 2017; 26:334-335. [PMID: 29183204 DOI: 10.1177/1066896917742200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Magda Zanelli
- 1 Arcispedale Santa Maria Nuova-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Lucia Spaggiari
- 1 Arcispedale Santa Maria Nuova-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Filippo Lococo
- 1 Arcispedale Santa Maria Nuova-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Loredana De Marco
- 1 Arcispedale Santa Maria Nuova-IRCCS Reggio Emilia, Reggio Emilia, Italy
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Negro A, De Marco L, Cesario V, Santi R, Boni MC, Zanelli M. A Case of Moderate Sprue-Like Enteropathy Associated With Telmisartan. J Clin Med Res 2017; 9:1022-1025. [PMID: 29163738 PMCID: PMC5687909 DOI: 10.14740/jocmr3047w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 05/02/2017] [Indexed: 12/22/2022] Open
Abstract
Sprue-like enteropathy associated with olmesartan medoxomil use has been recently reported. Its clinical manifestations include diarrhea, weight loss and malabsorption. Duodenal biopsies show villous atrophy (VA) with or without intraepithelial lymphocytosis and inflammation of the lamina propria. Serology for celiac disease (CD) is negative and gluten-free diet does not result in clinical improvement. Symptoms resolve after olmesartan discontinuation. Follow-up biopsies show recovery/improvement of the duodenum. Whether sprue-like enteropathy is a specific adverse reaction to olmesartan or rather a class effect of angiotensin-receptor blockers (ARBs) remains a controversial issue. We report a case of sprue-like enteropathy associated with telmisartan. A 52-year-old man presented with chronic diarrhea, abdominal discomfort and significant weight loss. In the last 3 years, he had been treated with telmisartan 40 mg/day for hypertension after right adrenalectomy for an aldosterone-producing adenoma. Laboratory investigations showed no significant abnormalities: Hb 13.6 g/dL, serum albumin 3.9 g/dL, total cholesterol 193 mg/dL, serum creatinine 0.99 mg/dL, sodium 143.6 mmol/L, K+ 4.3 mmol/L, calcium 9.3 mg/dL, phosphorus 3.9 mg/dL and 25-OH-D3 27.7 ng/mL. Duodenal histology showed subtotal VA and inflammation of the lamina propria. CD serology was negative. HLA-DQ typing showed absence of the DQ2/DQ8 haplotypes. After telmisartan discontinuation, patient’s symptoms subsided, and his body weight increased despite persistence of a gluten-containing diet. Follow-up biopsies at 3 showed progressive duodenal recovery. Very few cases of sprue-like enteropathy associated with ARBs other than olmesartan have been reported. Our case of telmisartan-associated enteropathy further suggests that sprue-like disease may be a class effect of ARBs.
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Affiliation(s)
- Aurelio Negro
- Internal Medicine, Specialized Center of Secondary Hypertension and Gastroenterology, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Loredana De Marco
- Unit of Pathology, Department of Oncology and Advanced Technologies, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Valentina Cesario
- Internal Medicine, Specialized Center of Secondary Hypertension and Gastroenterology, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Rosaria Santi
- Internal Medicine, Specialized Center of Secondary Hypertension and Gastroenterology, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Maria Chiara Boni
- Internal Medicine, Specialized Center of Secondary Hypertension and Gastroenterology, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | - Magda Zanelli
- Unit of Pathology, Department of Oncology and Advanced Technologies, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
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Zanelli M, Ragazzi M, Marchetti G, Bisagni A, Principi M, Fanni D, Froio E, Serra S, Zanetti E, De Marco L, Giangaspero F, Ascani S. Primary histiocytic sarcoma presenting as diffuse leptomeningeal disease: Case description and review of the literature. Neuropathology 2017; 37:517-525. [PMID: 28548244 DOI: 10.1111/neup.12390] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 04/07/2017] [Accepted: 04/08/2017] [Indexed: 01/24/2023]
Abstract
Histiocytic sarcoma is a rare malignant neoplasm arising most commonly in lymph nodes, intestinal tract, skin and soft tissue. The incidence of primary CNS histiocytic sarcoma is even rarer with a total of just 27 cases reported in the literature so far. Herein we describe the first autopsy case of histiocytic sarcoma presenting as a diffuse leptomeningeal disease in absence of a CNS tumor-forming parenchymal lesion. The clinical, pathological and immunophenotypic features are described and an updated literature review on primary CNS histiocytic sarcoma is included.
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Affiliation(s)
- Magda Zanelli
- Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Moira Ragazzi
- Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | | | - Alessandra Bisagni
- Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Massimo Principi
- Radiology Department, Ospedale di Terni, University of Perugia, Italy
| | - Daniela Fanni
- Pathology Unit, Ospedale S. Giovanni di Dio, University of Cagliari, Italy
| | - Elisabetta Froio
- Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Silvia Serra
- Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Eleonora Zanetti
- Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Loredana De Marco
- Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Felice Giangaspero
- Department of Radiological, Oncological and Anatomo-pathological Sciences University Sapienza of Rome, Rome, Italy.,IRCC Neuromed, Porzilli, Italy
| | - Stefano Ascani
- Institute of Pathology, Ospedale di Terni, University of Perugia, Italy
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Zanelli M, Ragazzi M, Fiorino S, Foroni M, Cecinato P, Del Mar Jordana Sanchez M, Ascani S, De Marco L. An Italian case of intestinal anisakiasis with a presurgical diagnosis: Could this parasite represent an emerging disease? Pathol Res Pract 2017; 213:558-564. [PMID: 28325642 DOI: 10.1016/j.prp.2017.01.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 01/22/2017] [Accepted: 01/23/2017] [Indexed: 12/19/2022]
Abstract
Anisakiasis is a parasitic infection caused by the consumption of raw fish containing larvae of the Anisakis species. Since the first description in 1960 of a patient suffering from this pathogen, in the Netherlands, most of the cases have been reported in Japan, where consumption of raw fish is common, but the number of cases is increasing worldwide. The first case identified in Italy dates back to 1996 and a few cases have been reported since then. In Italy the intestinal form occurs almost as frequently as the gastric form, which is far more frequent in Japan. Intestinal Anisakiasis represents a diagnostic challenge as it is clinically misdiagnosed and most of the patients require surgery due to the occurrence of complications such as bowel occlusion or perforation. Practically no cases of the intestinal form are diagnosed preoperatively. We report the first case, to our knowledge, of intestinal Anisakiasis in which surgery was avoided, due to a prompt diagnosis suspected on intestinal biopsies. A literature review of Anisakiasis cases reported in Italy is also carried out.
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Affiliation(s)
- Magda Zanelli
- Anatomic Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Moira Ragazzi
- Anatomic Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy.
| | - Sirio Fiorino
- Unità Operativa Semplice Dipartimentale di Medicina Interna C, Ospedale Maggiore, Bologna, Italy
| | - Moira Foroni
- Anatomic Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Paolo Cecinato
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | | | - Stefano Ascani
- Institute of Pathology, Ospedale di Terni, University of Perugia, Perugia, Italy
| | - Loredana De Marco
- Anatomic Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
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37
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Zanelli M, Ragazzi M, De Marco L. Chemical gastritis and colitis related to hydrogen peroxide mouthwash. Br J Clin Pharmacol 2016; 83:427-428. [PMID: 27696496 DOI: 10.1111/bcp.13100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 08/11/2016] [Accepted: 08/19/2016] [Indexed: 11/29/2022] Open
Affiliation(s)
- Magda Zanelli
- Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Moira Ragazzi
- Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
| | - Loredana De Marco
- Pathology Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy
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Azzolini F, Cecinato P, Iori V, De Marco L, Sassatelli R. Endoscopic full-thickness resection for suspected residual rectal neuroendocrine tumor and closure of the defect with a new suturing system. Endoscopy 2016; 47 Suppl 1:E556-7. [PMID: 26610082 DOI: 10.1055/s-0034-1393384] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Francesco Azzolini
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Paolo Cecinato
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Veronica Iori
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Loredana De Marco
- Unit of Pathology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Romano Sassatelli
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
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Cavazza A, Paci M, De Marco L, Leporati G, Sartori G, Bigiani N, Rossi G. Alveolar Adenoma of the Lung: A Clinicopathologic, Immunohistochemical, and Molecular Study of an Unusual Case. Int J Surg Pathol 2016; 12:155-9. [PMID: 15173924 DOI: 10.1177/106689690401200212] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe an alveolar adenoma of the lung with 3 previously unreported findings, which expand both the clinical and the morphologic spectrum of this rare tumor: presentation as a cystic nodule, foci of mature adipocytes, and S-100 positivity of the mesenchymal cells. Furthermore, using a laser capture microdissection technique under microscope visualization, we analyzed multiple chromosomal loci in both the epithelial and mesenchymal components of the lesion, showing microsatellite alterations and loss of heterozygosity in the former but not in the latter.
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Affiliation(s)
- Alberto Cavazza
- Department of Pathology, S. Maria Nuova Hospital, Reggio Emilia, Italy
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Rosato S, Syx D, Ivanovski I, Pollazzon M, Santodirocco D, De Marco L, Beltrami M, Callewaert B, Garavelli L, Malfait F. RIN2 syndrome: Expanding the clinical phenotype. Am J Med Genet A 2016; 170:2408-15. [PMID: 27277385 DOI: 10.1002/ajmg.a.37789] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/22/2016] [Indexed: 01/12/2023]
Abstract
Biallelic defects in the RIN2 gene, encoding the Ras and Rab interactor 2 protein, are associated with a rare autosomal recessive connective tissue disorder, with only nine patients from four independent families reported to date. The condition was initially termed MACS syndrome (macrocephaly, alopecia, cutis laxa, and scoliosis), based on the clinical features of the first identified family; however, with the expansion of the clinical phenotype in additional families, it was subsequently coined RIN2 syndrome. Hallmark features of this condition include dysmorphic facial features with striking, progressive facial coarsening, sparse hair, normal to enlarged occipitofrontal circumference, soft redundant and/or hyperextensible skin, and scoliosis. Patients with RIN2 syndrome present phenotypic overlap with other conditions, including EDS (especially the dermatosparaxis and kyphoscoliosis subtypes). Here, we describe a 10th patient, the first patient of Caucasian origin and the oldest reported patient so far, who harbors the previously identified homozygous RIN2 mutation c.1878dupC (p. (Ile627Hisfs*7)). Besides the hallmark features, this patient also presents problems not previously associated with RIN2 syndrome, including cervical vertebral fusion, mild hearing loss, and colonic fibrosis. We provide an overview of the clinical findings in all reported patients with RIN2 mutations and summarize some of the possible pathogenic mechanisms that may underlie this condition. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Simonetta Rosato
- Clinical Genetics Unit, Department of Obstetrics and Pediatrics, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Delfien Syx
- Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Ivan Ivanovski
- Clinical Genetics Unit, Department of Obstetrics and Pediatrics, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.,Department of Surgical, Medical, Dental and Morphological Sciences with Interest in Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Marzia Pollazzon
- Clinical Genetics Unit, Department of Obstetrics and Pediatrics, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Daniela Santodirocco
- Clinical Genetics Unit, Department of Obstetrics and Pediatrics, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Loredana De Marco
- Anatomic Pathology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Marina Beltrami
- Department of Internal Medicine, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Bert Callewaert
- Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - Livia Garavelli
- Clinical Genetics Unit, Department of Obstetrics and Pediatrics, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Fransiska Malfait
- Center for Medical Genetics, Ghent University and Ghent University Hospital, Ghent, Belgium
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Cecinato P, Laterza L, De Marco L, Casali A, Zanelli M, Sassatelli R. Esophageal involvement by pemphigus vulgaris resulting in dysphagia. Endoscopy 2016; 47 Suppl 1 UCTN:E271-2. [PMID: 26099087 DOI: 10.1055/s-0034-1391905] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Paolo Cecinato
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Liboria Laterza
- Unit of Digestive Endoscopy, Ospedale Cesare Magati, Reggio Emilia, Italy
| | - Loredana De Marco
- Unit of Pathology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Annamaria Casali
- Center of Hemostasis and Thrombosis, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Magda Zanelli
- Unit of Pathology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Romano Sassatelli
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
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42
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Zanelli M, Ragazzi M, Serra S, Bellafiore S, Ascani S, De Marco L. Malakoplakia Associated With Multiple Adenomas of the Colon: An Extremely Rare Incidental Finding. Int J Surg Pathol 2016; 24:548-51. [PMID: 26912474 DOI: 10.1177/1066896916633855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Malakoplakia in the colon has been described either as part of a systemic disease with a diffuse presentation or as a rare incidental finding associated usually with an adenocarcinoma. To our knowledge, the association of malakoplakia with colonic adenoma is very rare and only 5 cases, including the present case, have been reported so far. Here, we describe a case of malakoplakia coexisting with multiple sigmoid colonic adenomas in a 67-year-old patient without any underlying inflammatory or infectious disease and with no history of immunosuppressive treatment. As far as we are concerned, this is the first description of malakoplakia associated with multiple colonic adenomas.
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Affiliation(s)
- Magda Zanelli
- Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Moira Ragazzi
- Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Silvia Serra
- Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | | | - Stefano Ascani
- Ospedale di Terni, University of Perugia, Perugia, Italy
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Affiliation(s)
- Francesco Azzolini
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Paolo Cecinato
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Veronica Iori
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Loredana De Marco
- Unit of Pathology, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Ramona Zecchini
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Cristina Fodero
- Cervical Cancer Screening Centre, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Cristiana Tioli
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - Romano Sassatelli
- Unit of Gastroenterology and Digestive Endoscopy, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
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Fornelli A, Cavazza A, Cancellieri A, Rossi G, De Marco L. Bronchioloalveolar carcinoma with nodular ("morule-like") features. Virchows Arch 2003; 442:407-8. [PMID: 12715176 DOI: 10.1007/s00428-003-0767-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2002] [Accepted: 10/29/2002] [Indexed: 11/30/2022]
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Abstract
We report a large cell neuroendocrine carcinoma arising in the ampulla of Vater. The patient, a 74-year-old woman, presented with a 3-cm ulcerated mass located in the ampullary region. She died of disease 8 months after surgery. Microscopically, the tumor was extensively necrotic. It was composed of islands and trabeculae irregularly infiltrating the muscular wall of the duodenum. Neoplastic cells were large and had a high mitotic index. Immunohistochemically, they expressed cytokeratin, chromogranin, synaptophysin, and neuron-specific enolase. Large cell neuroendocrine carcinoma is very rare in the ampulla of Vater, and it shares with its more common pulmonary counterpart the same morphology and probably the same poor prognosis.
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Affiliation(s)
- Alberto Cavazza
- Department of Pathology, S. Maria Nuova Hospital, Reggio Emilia, Italy.
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Cavazza A, Pellegrino S, Putrino I, De Marco L, Rossi G. Sclerosing haemangioma with a predominant sclerotic pattern: an unusual pulmonary lesion which can be misdiagnosed. Adv Clin Path 2002; 6:131-134. [PMID: 19757636] [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: 05/28/2023]
Abstract
AIMS An unusual sclerosing haemangioma of the lung with a predominant sclerotic pattern is described. MAIN RESULTS AND CONCLUSIONS The patient was a 51-year-old male, presenting with a well-circumscribed nodule, 0,6 cm in diameter, located in the lower lobe of the left lung. He is alive and well 9 years after surgical excision of the nodule. Microscopically, the lesion was well demarcated and mostly composed of sclerotic tissue, with numerous irregular entrapped alveolar spaces The characteristic bland, round cells with abundant pale cytoplasm, immunohistochemically positive for TTF-1 and negative for cytokeratin, were limited to small clusters embedded in the stroma at the periphery of the nodule. The most important differential diagnostic considerations of the sclerotic variant of pulmonary sclerosing haemangioma are briefly discussed.
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Affiliation(s)
- Alberto Cavazza
- Unità Operativa di Anatomia Patologica, Ospedale S. Maria Nuova, Viale Risorgimento 80, 42100 Reggio Emilia, Italy.
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47
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Mazzucato M, Marco LD, Masotti A, Pradella P, Bahou WF, Ruggeri ZM. Characterization of the initial alpha-thrombin interaction with glycoprotein Ib alpha in relation to platelet activation. J Biol Chem 1998; 273:1880-7. [PMID: 9442020 DOI: 10.1074/jbc.273.4.1880] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
We have evaluated the properties of alpha-thrombin interaction with platelets within 1 min from exposure to the agonist, a time frame during which most induced activation responses are initiated and completed. Binding at 37 degrees C was rapidly reversible and completely blocked by a monoclonal antibody, LJ-Ib10, previously shown to be directed against the alpha-thrombin interaction site on glycoprotein (GP) Ib alpha. By 2-5 min, however, binding was no longer fully reversible and was only partially inhibited by the anti-GP Ib alpha antibody. Results were similar at room temperature (22-25 degrees C), whereas the initial characteristics of alpha-thrombin interaction with platelets were preserved for at least 20 min at 4 degrees C. Equilibrium binding isotherms obtained at the latter temperature were compatible with a two-site model, but the component ascribed to GP Ib alpha, completely inhibited by LJ-Ib10, had "moderate" affinity (kd on the order of 10(-8) M) and relatively high capacity, rather than "high" affinity (kd on the order of 10(-10) M) and low capacity as currently thought. The parameters of alpha-thrombin binding to intact GP Ib alpha on platelets at 4 degrees C corresponded closely to those measured with isolated GP Ib alpha fragments regardless of temperature. Blocking the alpha-thrombin-GP Ib alpha interaction caused partial inhibition of ATP release and prevented the association with platelets of measurable proteolytic activity. These results support the concept that GP Ib alpha contributes to the thrombogenic potential of alpha-thrombin.
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Affiliation(s)
- M Mazzucato
- Servizio Immunotrasfusionale e Analisi Cliniche, Centro di Riferimento Oncologico, Aviano, Italy
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