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Fox SB, Webster F, Chen CJ, Chua B, Collins LC, Foschini MP, Mann GB, Millar EKA, Pinder SE, Rakha E, Shaaban AM, Tan BY, Tse GM, Watson PH, Tan PH. Dataset for pathology reporting of ductal carcinoma in situ, variants of lobular carcinoma in situ and low grade lesions: recommendations from the International Collaboration on Cancer Reporting (ICCR). Histopathology 2022; 81:467-476. [DOI: 10.1111/his.14725] [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: 06/10/2022] [Revised: 07/05/2022] [Accepted: 07/05/2022] [Indexed: 11/28/2022]
Affiliation(s)
- SB Fox
- Department of Pathology, Peter MacCallum Cancer Centre, Level 4 Victorian Comprehensive Cancer Centre Melbourne VIC 3000 Australia
| | - F Webster
- International Collaboration on Cancer Reporting, Albion St, Surry Hills NSW 2010 Australia
| | - CJ Chen
- Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4 Taichung 40705 Taiwan
| | - B Chua
- Prince of Wales Clinical School, UNSW Sydney The University of New South Wales Randwick NSW 2031 Australia
| | - LC Collins
- Department of Pathology, Beth Israel Deaconess Medical Center, 330 Brookline Ave and Harvard Medical School Boston MA 02215 USA
| | - MP Foschini
- Department Anatomic Pathology University of Bologna Department of Biomedical and Neuromotor Sciences Unit of Anatomic Pathology at Bellaria Hospital, Via Altura 3 40139 Bologna Italy
| | - GB Mann
- The Breast Service, The Royal Melbourne Hospital, Grattan St Parkville VIC 3050 Australia
| | - EKA Millar
- Department of Anatomical Pathology Heath Pathology St George Hospital, Kogarah NSW 2217 & St George & Sutherland Clinical School, UNSW NSW Sydney Australia
| | - SE Pinder
- School of Cancer & Pharmaceutical Sciences King's College London, 9th Floor, Innovation Hub, Comprehensive Cancer Centre at Guy's Hospital, Great Maze Pond. London SE1 9RT United Kingdom
| | - E Rakha
- Department of Histopathology The University of Nottingham Nottingham City Hospital, Hucknall Road Nottingham NG5 1PB United Kingdom
| | - AM Shaaban
- Department of Cellular Pathology, Queen Elizabeth Hospital Birmingham and Cancer and Genomic Sciences University of Birmingham, Mindelsohn Way Birmingham B15 2GW United Kingdom
| | - BY Tan
- Department of Anatomical Pathology, Singapore General Hospital College Rd Singapore 169856
| | - GM Tse
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital The Chinese University of Hong Kong, Ngan Shing Street Shatin Hong Kong
| | - PH Watson
- Department of Pathology, Biobanking and Biospecimen Research Services, Deeley Research Centre, BC Cancer Agency, 2410 Lee Ave Victoria BC V8R 6V5 Canada Victoria British Columbia Canada
| | - PH Tan
- Division of Pathology Singapore General Hospital Singapore
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2
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Muscatello LV, Avallone G, Brunetti B, Bacci B, Foschini MP, Sarli G. Standardized approach for evaluating tumor infiltrating lymphocytes in canine mammary carcinoma: Spatial distribution and score as relevant features of tumor malignancy. Vet J 2022; 283-284:105833. [PMID: 35489672 DOI: 10.1016/j.tvjl.2022.105833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 04/22/2022] [Accepted: 04/24/2022] [Indexed: 12/09/2022]
Abstract
Neoplastic cells, through immunoediting mechanisms, can establish a state of immunosuppression to evade host immune defenses. The aims of this study were: (1) to validate a standard method for assessing tumor infiltrating lymphocytes (TILs) in canine mammary carcinoma by applying international human breast cancer guidelines; (2) to investigate if the TIL population was composed of a subset of regulatory T lymphocytes (Tregs); and (3) to evaluate the relationship between the number of TILs and Tregs and the biological behavior of the tumors. One hundred and twenty-nine canine mammary tumors were retrospectively selected for this study. Histological diagnosis, grading and histological evaluation of TILs was performed on hematoxylin and eosin-stained sections. TILs were evaluated using a three-tier semiquantitative method, previously validated in human medicine, based on the percentage of TILs (0-10%, 11-40% and 41-90%). Lymphocyte immunophenotype was confirmed by CD3 and CD79, while an anti-FoxP3 antibody was used to determine the presence of Tregs. The number of stromal TILs and invasive front TILs significantly correlated with each other (P<0.0001) and increased with increasing histological grade (P=0.002 and P=0.004, respectively). A subset of TILs was composed of FOXP3+ Tregs. Stromal Tregs and invasive front Tregs were associated with stromal TILs and invasive front TILs (P=0.03; P=0.01 and P=0.003; P=0.007, respectively). In conclusion, in canine mammary carcinomas, an increased number of stromal and invasive front TILs is associated with increased malignancy and significant increase of Tregs that could lead to immunosuppression and evasion of the host immune system.
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Affiliation(s)
- L V Muscatello
- Department of Veterinary Medical Sciences, University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - G Avallone
- Department of Veterinary Medical Sciences, University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - B Brunetti
- Department of Veterinary Medical Sciences, University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy.
| | - B Bacci
- Department of Veterinary Medical Sciences, University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
| | - M P Foschini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, via Altura 3, 40139, Bologna, Italy
| | - G Sarli
- Department of Veterinary Medical Sciences, University of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, Italy
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3
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Fabbri VP, Valluzzi A, Acciarri N, Foschini MP. Peripheral nerve mucoid degeneration involving the sciatic nerve. Pathologica 2019; 111:67-69. [PMID: 31388198 DOI: 10.32074/1591-951x-9-19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/20/2019] [Indexed: 11/30/2022] Open
Abstract
Peripheral nerve mucoid degeneration (PNMD) is a rare non-neoplastic degenerative condition characterized by endoneural deposit of mucoid matrix. Herein, we report a case of PNMD involving the sciatic nerve with preoperative features, surgical treatment and pathological findings.
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Affiliation(s)
- V P Fabbri
- Unit of Anatomic Pathology, Department of Biomedical and Neuromotor Sciences, University of Bologna at Bellaria Hospital, Bologna, Italy
| | - A Valluzzi
- Department of Neurosurgery, IRCCS, Bellaria Hospital, Bologna, Italy
| | - N Acciarri
- Department of Neurosurgery, IRCCS, Bellaria Hospital, Bologna, Italy
| | - M P Foschini
- Unit of Anatomic Pathology, Department of Biomedical and Neuromotor Sciences, University of Bologna at Bellaria Hospital, Bologna, Italy
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4
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Asioli S, Righi A, Iommi M, Baldovini C, Ambrosi F, Guaraldi F, Zoli M, Mazzatenta D, Faustini-Fustini M, Rucci P, Giannini C, Foschini MP. Validation of a clinicopathological score for the prediction of post-surgical evolution of pituitary adenoma: retrospective analysis on 566 patients from a tertiary care centre. Eur J Endocrinol 2019; 180:127-134. [PMID: 30481158 DOI: 10.1530/eje-18-0749] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/26/2018] [Indexed: 11/08/2022]
Abstract
Objective and design A clinicopathological score has been proposed by Trouillas et al. to predict the evolution of pituitary adenomas. Aim of our study was to perform an independent external validation of this score and identify other potential predictor of post-surgical outcome. Methods The study sample included 566 patients with pituitary adenomas, specifically 253 FSH/LH-secreting, 147 GH-secreting, 85 PRL-secreting, 72 ACTH-secreting and 9 TSH-secreting tumours with at least 3-year post-surgical follow-up. Results In 437 cases, pituitary adenomas were non-invasive, with low (grade 1a: 378 cases) or high (grade 1b: 59 cases) proliferative activity. In 129 cases, tumours were invasive, with low (grade 2a: 87 cases) or high (grade 2b: 42 cases) proliferative activity. During the follow-up (mean: 5.8 years), 60 patients developed disease recurrence or progression, with a total of 130 patients with pituitary disease at last follow-up. Univariate analysis demonstrated a significantly higher risk of disease persistence and recurrence/progression in patients with PRL-, ACTH- and FSH/LH-secreting tumours as compared to those with somatotroph tumours, and in those with high proliferative activity (grade 1b and 2b) or >1 cm diameter. Multivariate analysis confirmed tumour type and grade to be independent predictors of disease-free-survival. Tumour invasion, Ki-67 and tumour type were the only independent prognostic factors of disease-free survival. Conclusions Our data confirmed the validity of Trouillas' score, being tumour type and grade independent predictors of disease evolution. Therefore, we recommend to always consider both features, together with tumour histological subtype, in the clinical setting to early identify patients at higher risk of recurrence.
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Affiliation(s)
- S Asioli
- Department of Biomedical and Neuromuscular Sciences, Section of Anatomic Pathology 'M. Malpighi' at Bellaria Hospital, University of Bologna
- Pituitary Unit - Center for the Diagnosis and Treatment of Hypothalamic and Pituitary Diseases, IRCCS Istituto delle Scienze Neurologiche di Bologna
| | - A Righi
- Department of Pathology, IRCCS Rizzoli Institute
| | - M Iommi
- University of Bologna, Unit of Hygiene and Biostatistics
| | - C Baldovini
- Department of Biomedical and Neuromuscular Sciences, Section of Anatomic Pathology 'M. Malpighi' at Bellaria Hospital, University of Bologna
| | - F Ambrosi
- Department of Biomedical and Neuromuscular Sciences, Section of Anatomic Pathology 'M. Malpighi' at Bellaria Hospital, University of Bologna
| | - F Guaraldi
- Pituitary Unit - Center for the Diagnosis and Treatment of Hypothalamic and Pituitary Diseases, IRCCS Istituto delle Scienze Neurologiche di Bologna
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - M Zoli
- Pituitary Unit - Center for the Diagnosis and Treatment of Hypothalamic and Pituitary Diseases, IRCCS Istituto delle Scienze Neurologiche di Bologna
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - D Mazzatenta
- Pituitary Unit - Center for the Diagnosis and Treatment of Hypothalamic and Pituitary Diseases, IRCCS Istituto delle Scienze Neurologiche di Bologna
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - M Faustini-Fustini
- Pituitary Unit - Center for the Diagnosis and Treatment of Hypothalamic and Pituitary Diseases, IRCCS Istituto delle Scienze Neurologiche di Bologna
| | - P Rucci
- University of Bologna, Unit of Hygiene and Biostatistics
| | - C Giannini
- Department of Pathology & Laboratory Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - M P Foschini
- Department of Biomedical and Neuromuscular Sciences, Section of Anatomic Pathology 'M. Malpighi' at Bellaria Hospital, University of Bologna
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Abstract
A 73-year-old man developed an enlarged cystic lesion located in the soft tissues surrounding the left hip. The lesion was surgically removed. The patient was well 1 year after surgery. The lesion was histologically identical to an aneurysmal bone cyst, therefore it was diagnosed as an extraosseous aneurysmal bone cyst. The differential diagnoses and a review of the literature are presented.
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Affiliation(s)
- L Riccioni
- Department of Radiology and Anatomic Pathology, University of Bologna, Italy
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6
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Mazzocchi A, Foschini MP, Marconi F, Eusebi V. Kasabach-Merritt Syndrome Associated to Angiosarcoma of the Breast. A Case Report and Review of the Literature. Tumori 2018; 79:137-40. [PMID: 8346567 DOI: 10.1177/030089169307900212] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Kasabach-Merritt syndrome is characterized by the association of a consumptive thrombohemorrhagic disorder and angioma occurring usually in children. In the present study, a case of Kasabach-Merritt syndrome associated to an angiosarcoma of the breast is reported. Clinical History The tumor together with the thrombohemorrhagic disorder manifested in a 28-year-old woman. The patient underwent mastectomy. The tumor recurred in the same site 2 years later. The patient died of severe anemia 8 years after the first appearance of the angiosarcoma. Material and Methods Tissues were formalin fixed and paraffin embedded; in addition, selected sections were immunohistochemically stained. Results and Conclusions A well-differentiated angiosarcoma was visible throughout the removed organ. A review of the literature showed that only 6 cases of Kasabach-Merritt syndrome associated to malignant vascular tumors have been previously reported. All these 6 cases occurred in adult patients. On the contrary, Kasabach-Merritt syndrome associated to benign vascular tumors affects children. This is the first case occurring in the breast.
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Affiliation(s)
- A Mazzocchi
- Department of Pathology, University of Bologna, Italy
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7
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Abstract
Three cases of connective tissue tumors causing hypophosphatemic osteomalacia are reported and the literature is reviewed. In two of our patients the tumors were completely excised with total disappearance of the symptoms. In one case a total excision was not possible and the symptoms of this patient have not completely disappeared. The substance responsible for the syndrome has not been identified yet, but probably interferes with vitamin D renal hy-droxylation, thus causing osteomalacia. As more than 30 per cent of cases of this condition have been reported in the last 5 years, it is suggested that these tumors are more frequent than previously believed.
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Affiliation(s)
- M Papotti
- Dipartimento di Scienze Biomediche e Oncologia Umana, Università di Torino, Italia
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8
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Geyer FC, Li A, Papanastasiou AD, Smith A, Selenica P, Burke KA, Edelweiss M, Wen HC, Piscuoglio S, Schultheis AM, Martelotto LG, Pareja F, Kumar R, Brandes A, Lozada J, Macedo GS, Muenst S, Terracciano LM, Jungbluth A, Foschini MP, Wen HY, Brogi E, Palazzo J, Rubin BP, Ng CKY, Norton L, Varga Z, Ellis IO, Rakha E, Chandarlapatty S, Weigelt B, Reis-Filho JS. Abstract PD4-13: Estrogen receptor-negative breast adenomyoepitheliomas are driven by co-occurring HRAS hotspot and PI3K pathway gene mutations: A genetic and functional analysis. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd4-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction:Adenomyoepithelioma (AME) of the breast is a rare biphasic tumor, characterized by epithelial and myoepithelial differentiation. Although AMEs have an indolent clinical course, a subset may progress to carcinoma and metastasize. We sought to define the mutational landscape of AMEs and investigate the functional impact of recurrent pathogenic mutations identified in these tumors.
Methods: Thirty-one AMEs were subjected to whole-exome sequencing (WES, n=8) or massively parallel sequencing targeting all coding regions of 410 key cancer genes and intronic and regulatory regions of selected genes (n=23). Somatic genetic alterations were defined using state-of-the-art bioinformatics algorithms. In an additional set of 12 AMEs, Sanger sequencing analysis of HRAS, PIK3CA and AKT1 was performed. Non-tumorigenic estrogen receptor (ER)-negative mammary epithelial cells (i.e. MCF10A, MCF10A with a PIK3CA H1047R mutation knock-in and MCF12A) were utilized for functional studies using both conventional monolayer and three-dimensional (3D) culture assays.
Results: 27 (63%) and 16 (37%) AMEs were ER-positive and ER-negative, respectively. ER-negativity was significantly associated with histologic features predictive of a more aggressive behavior, with a higher number of mutations and copy number alterations, and with a distinct mutational profile as compared to ER-positive AMEs. Of the 27 ER-positive AMEs, 12 cases (44%) harbored PIK3CA hotspot mutations, and 5 PIK3CA wild-type cases displayed E17K AKT1 hotspot mutations. By contrast, of the 16 ER-negative AMEs, 9 (56%), 9 (56%) and 3 (19%) harbored HRAS, PIK3CA (mostly E545K and H1047R hotspots) and PIK3R1 mutations, respectively. Strikingly, all HRAS mutations were restricted to ER-negative AMEs, affected the hotspot codon Q61 (Q61R/K), and all but one co-occurred with PIK3CA or PIK3R1 mutations. In addition, HRAS Q61 hotspot mutations were significantly associated with necrosis (p=0.01) and high mitotic rates (p=0.03). CDKN2A homozygous deletions were also detected only in ER-negative AMEs (19%) and found to be significantly associated with progression to carcinoma (p=0.001). Forced expression of HRAS Q61R in MCF10A and MCF12A cells resulted in i) increased proliferation and transformation, ii) an irregular growth pattern in 3D organotypic cell cultures, iii) partial loss of the epithelial phenotype, and iv) acquisition of myoepithelial differentiation, which was more overt in PIK3CA-mutant MCF10A cells. HRAS Q61Rinduced hyperactivation of the PI3K pathway, but both PI3K and MAPK pathways likely contributed to the RAS-mediated proliferation, which was completely arrested by combined AKT and MEK inhibition.
Conclusion: AMEs are phenotypically and genetically heterogeneous. Whilst pathogenic mutations in PI3K pathway-related genes occur across the spectrum of lesions, HRAS Q61 hotspot mutations are restricted to ER-negative AMEs. Our genomic and functional analyses indicate that HRAS Q61 mutations are driver events in the pathogenesis of ER-negative AMEs and, in conjunction with mutant PIK3CA, may lead to the acquisition of myoepithelial differentiation in breast epithelial cells.
Citation Format: Geyer FC, Li A, Papanastasiou AD, Smith A, Selenica P, Burke KA, Edelweiss M, Wen H-C, Piscuoglio S, Schultheis AM, Martelotto LG, Pareja F, Kumar R, Brandes A, Lozada J, Macedo GS, Muenst S, Terracciano LM, Jungbluth A, Foschini MP, Wen HY, Brogi E, Palazzo J, Rubin BP, Ng CKY, Norton L, Varga Z, Ellis IO, Rakha E, Chandarlapatty S, Weigelt B, Reis-Filho JS. Estrogen receptor-negative breast adenomyoepitheliomas are driven by co-occurring HRAS hotspot and PI3K pathway gene mutations: A genetic and functional analysis [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD4-13.
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Affiliation(s)
- FC Geyer
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - A Li
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - AD Papanastasiou
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - A Smith
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - P Selenica
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - KA Burke
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - M Edelweiss
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - H-C Wen
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - S Piscuoglio
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - AM Schultheis
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - LG Martelotto
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - F Pareja
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - R Kumar
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - A Brandes
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - J Lozada
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - GS Macedo
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - S Muenst
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - LM Terracciano
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - A Jungbluth
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - MP Foschini
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - HY Wen
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - E Brogi
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - J Palazzo
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - BP Rubin
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - CKY Ng
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - L Norton
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - Z Varga
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - IO Ellis
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - E Rakha
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - S Chandarlapatty
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - B Weigelt
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
| | - JS Reis-Filho
- Memorial Sloan Kettering Cancer Center, New York, NY; University of Basel, Basel, Switzerland; Bellaria Hospital, University of Bologna, Bologna, Italy; Thomas Jefferson University Hospital, Philadelphia, PA; Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH; Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland; University of Nottingham, Nottingham, United Kingdom
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Cserni G, Wells CA, Kaya H, Regitnig P, Sapino A, Floris G, Decker T, Foschini MP, van Diest PJ, Grabau D, Reiner A, DeGaetano J, Chmielik E, Cordoba A, Andreu X, Zolota V, Charafe-Jauffret E, Ryska A, Varga Z, Weingertner N, Bellocq JP, Liepniece-Karele I, Callagy G, Kulka J, Bürger H, Figueiredo P, Wesseling J, Amendoeira I, Faverly D, Quinn CM, Bianchi S. Consistency in recognizing microinvasion in breast carcinomas is improved by immunohistochemistry for myoepithelial markers. Virchows Arch 2016; 468:473-81. [DOI: 10.1007/s00428-016-1909-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Revised: 08/24/2015] [Accepted: 01/14/2016] [Indexed: 11/29/2022]
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10
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Marucci G, Fabbri PV, Morandi L, De Biase D, Di Oto E, Tallini G, Sturiale C, Franceschi E, Frezza GP, Foschini MP. Pathological spectrum in recurrences of glioblastoma multiforme. Pathologica 2015; 107:1-8. [PMID: 26591624 DOI: pmid/26591624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Glioblastoma (GBM) is the most frequent primary malignant brain tumour. Despite advances in treatment its prognosis remains poor. Histological features of GBM are well known. On the contrary histological description of recurrences is still not available. The aim of this study was to describe the morphological, immunohistochemical and molecular features of recurrent GBMs. METHODS 25 recurrent GBMs, diagnosed after 2005, were collected. All patients had undergone an adjuvant treatment regimen (temozolomide and/or radiotherapy). All cases were immunostained using anti-GFAP, Olig2 and Nogo-A antisera. MGMT and IDH1 status was reassessed. Features of the recurrences were compared with those of primary GBMs, time of recurrence and survival. RESULTS Recurrences were divided morphologically into three groups: 1) recurrences displaying the same features of primary GBM, were highly cellular, had the fastest progression and the worst prognosis; 2) recurrences changing dramatically morphological appearance, had a slightly longer survival, 3) poorly cellular recurrences, with sparse neoplastic cells intermingled with reactive and necrotic tissue, displayed the slowest progression and longer survival. MGMT and IDH1 status remained unchanged between primary tumours and recurrences. DISCUSSION GBM histological subtypes display different reactions to adjuvant treatments, offering a possible role in predicting different recurrence and survival time.
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11
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Del Corso G, Righi A, Bombardi M, Rossi B, Dallera V, Pelliccioni GA, Marchetti C, Foschini MP. Jaw cysts diagnosed in an Italian population over a 20-year period. Int J Surg Pathol 2014; 22:699-706. [PMID: 25015670 DOI: 10.1177/1066896914541000] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cysts of the jaws (JCs) are an important topic of oral pathology, but few epidemiological data are present in the literature, in particular about the potential of recurrence. The aim of this study was to describe a case series of JCs from a single institution, evaluating the frequency, the site, the age distribution, and the percentage of recurrence of all types of JCs. METHODS All JCs present in the histological records of the Section of Anatomic Pathology of the University of Bologna at Bellaria Hospital from 1992 to 2012 were retrieved. RESULTS A total of 1136 jaws cysts were obtained, of which 1117 (98.3%) were odontogenic and 19 (1.7%) were nonodontogenic. About odontogenic cysts (OCs), the most frequent was the radicular cyst (538 cases), followed by parakeratinized keratocystic odontogenic tumor (pKOT, 193 cases) and dentigerous cyst (120 cases). Among pKOT, 21 out of 193 cases (10.89%) showed a recurrence after a mean time of 4.5 years (range, 1-12 years). During follow-up (mean 11 years, range 1-19 years), all 3 cases of botrioid cysts, 12 out of 46 cases of unicystic ameloblastoma (26.09%), 2 out of 20 cases of calcifying OCs (10%) and 2 out of 538 cases of radicular cyst (0.37%) showed a recurrence. CONCLUSION Our study confirms that the distribution pattern of JCs in Italy is relatively similar to other studies worldwide and emphasizes the importance of recognizing the different histological types of JCs for their potential local aggressive behavior.
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Affiliation(s)
| | - A Righi
- Rizzoli Hospital, Bologna, Italy
| | - M Bombardi
- Bellaria Hospital, University of Bologna, Bologna, Italy
| | - B Rossi
- Bellaria Hospital, University of Bologna, Bologna, Italy
| | - V Dallera
- Bellaria Hospital, University of Bologna, Bologna, Italy
| | | | - C Marchetti
- Policlinico S. Orsola, University of Bologna, Bologna, Italy
| | - M P Foschini
- Bellaria Hospital, University of Bologna, Bologna, Italy
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12
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Cinocca S, Rosini F, Asioli S, Del Vecchio M, Cucchi MC, Saguatti G, Betts CM, Foschini MP. Cytological features of nipple adenoma in scraping smears. Pathologica 2014; 106:41-44. [PMID: 25291865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
INTRODUCTION Nipple adenoma (NA) is a benign epithelial lesion of the breast that can clinically simulate Paget's disease or invasive ductal carcinoma. Therefore, correct pre-operative diagnosis is important for appropriate management. METHODS Cytological samples may be obtained by different methods such as fine needle aspiration, nipple discharge or nipple scraping. Herein, the cytological features of three cases of NA are described in which samples were derived from nipple scraping. RESULTS In all three cases, patients were adult females presenting with a sub-areolar nodule, showing skin ulceration in 2 of 3 cases. The nipple scraping cytological smears were characterised by a bloody background with epithelial cells arranged in clusters or singularly, showing an irregular nuclei profile. These features could simulate a malignant process. However, at higher magnification, fine nuclear chromatin with inconspicuous nucleoli and presence of myoepithelial cells were helpful to exclude malignancy. DISCUSSION NA may present "worrisome" cytological features on smears derived from nipple scraping. Therefore, knowledge of the cytological spectrum of this lesion is important to avoid misdiagnosis.
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D'Andrea M, Reggiani C, Fasano D, Betts CM, Montanari F, Lanzoni A, Reggiani M, Foschini MP. Tumours of the skin adnexa: a case series with focus on multiple segmental forms. Pathologica 2013; 105:337-341. [PMID: 24730337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE Skin adnexal tumours (SAT) as a whole are rare tumours, and most of our current knowledge on SAT is from single case reports or small series focused on single histotypes. The purpose of this paper is to review a series of benign and malignant SAT diagnosed in a 20-year period. METHODS All consecutive cases of SAT diagnosed between January 1992 and Dicember 2011 were retrieved. All slides were reviewed and diagnosed according to currently accepted criteria. RESULTS 281 consecutive cases of SAT were found. The majority of cases (94.3%) were benign, the most frequent histotypes were eccrine spiradenoma, hidrocystoma, eccrine poroma, syringoma, sebaceous adenoma and trichofolliculoma. Benign SAT affected adult males more frequently (M/F = 153/112) (mean age 59 years). Recurrences were rare (2/265). Three cases of multiple segmental spiroadenoma were observed. Malignant SAT consituted only 5.7% of all cases comprising sebaceous carcinoma, extramammary Paget disease and apocrine carcinoma. There was a slight female predilection (M/F = 7/9) (mean age 72 years), although patients were older than those affected by benign SAT. All neoplasms were small and no recurrences were recorded. CONCLUSION SAT are rare and most frequently benign. Correct diagnosis and complete surgical removal are important.
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Meretoja TJ, Audisio RA, Heikkilä PS, Bori R, Sejben I, Regitnig P, Luschin-Ebengreuth G, Zgajnar J, Perhavec A, Gazic B, Lázár G, Takács T, Kővári B, Saidan ZA, Nadeem RM, Castellano I, Sapino A, Bianchi S, Vezzosi V, Barranger E, Lousquy R, Arisio R, Foschini MP, Imoto S, Kamma H, Tvedskov TF, Jensen MB, Cserni G, Leidenius MHK. International multicenter tool to predict the risk of four or more tumor-positive axillary lymph nodes in breast cancer patients with sentinel node macrometastases. Breast Cancer Res Treat 2013; 138:817-27. [DOI: 10.1007/s10549-013-2468-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2013] [Accepted: 02/25/2013] [Indexed: 01/06/2023]
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15
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Montebugnoli L, Venturi M, Gissi DB, Flamminio F, Foschini MP. Low-grade myofibroblastic sarcoma of the gingiva. BMJ Case Rep 2010; 2010:2010/nov22_1/bcr0720103166. [PMID: 22797208 DOI: 10.1136/bcr.07.2010.3166] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Low-grade myofibroblastic sarcoma is a malignant tumour from myofibroblasts, which has only recently become clearly defined. It represents a rare entity developing in the soft tissues of the head and neck. About 20 cases have been reported in the oral cavity, especially in the tongue and bone, while gingiva as the primary site has been described only once to date. Diagnostic methods include histology and immunohistochemistry. The present report concerns a case of a 37-year-old man who presented with a persistent gingival ulcerated swelling that was interpreted for a long time as a gingival epulis. A low-grade myofibrosarcoma was diagnosed and the patient underwent a segmental osteotomy of the mandibular symphisys for complete excision. There was no sign of recurrence or metastatic disease during the 18-month postoperative period.
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Affiliation(s)
- L Montebugnoli
- Department of Oral Science, University of Bologna, Bologna, Italy.
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Montebugnoli L, Felicetti L, Cervellati F, Foschini MP. Glycogenic acanthosis presenting as leukoplakia on the tongue. BMJ Case Rep 2010; 2010:2010/oct05_1/bcr0120102634. [PMID: 22778105 DOI: 10.1136/bcr.01.2010.2634] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
This report describes a rare case of glycogenic acanthosis (GA) located on the tongue of a 72-year-old man. The patient presented with a white plaque that had been on the right side of the tongue for 5 years. Histologically, the lesion was characterised by thickened squamous epithelium with abundant intracellular glycogen deposits. No epithelial dysplasia was noted. This is the first report of GA involving the tongue. This benign condition should be added to the large number of lesions responsible for leukoplakia in this anatomical location.
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Affiliation(s)
- L Montebugnoli
- Department of Oral Science, University of Bologna, Bologna, Italy.
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Panzacchi R, Gallo C, Fois F, Dalpiaz G, Cucchi MC, Degli Esposti R, Foschini MP. Primary sarcoidosis of the breast: case description and review of the literature. Pathologica 2010; 102:104-107. [PMID: 21171514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Sarcoidosis is a systemic granulomatous disease of unknown aetiology. The breast is involved in less than 1% of cases. Breast can be either a primary or a secondary site of presentation. Breast sarcoidosis often mimics carcinomas at clinical examination. We report a case of breast sarcoidosis detected during screening mammography in a 57-year-old woman. The lesion presented as a 1.4 cm nodule located in the right breast. On histology, it was characterized by non-caseating giant cell granulomas. Differential diagnoses included idiopathic granulomatous mastitis, tuberculosis, fungal infection, cat-scratch disease and sarcoid-like reactions to cancer. Further clinical and laboratory investigations were consistent with a diagnosis of sarcoidosis. Specifically, serum levels of angiotensin-converting enzyme (ACE) were elevated and a CT scan showed small bilateral pulmonary nodules distributed along the pleura and bronchovascular bundles (perilymphatic pattern), as well as enlarged bilateral hilar and mediastinal lymph nodes. The patient received corticosteroid treatment, and is presently asymptomatic. Breast involvement by sarcoidosis, although rare, should be considered when dealing with granulomatous lesions of the breast.
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Affiliation(s)
- R Panzacchi
- Department of Hematology and Oncology, "L. and A. Seragnoli" University of Bologna, Section of Anatomic Pathology at Bellaria Hospital, Bologna, Italy
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Steri V, Farnedi A, Montinari E, Foschini MP. Fast track biopsy method: a rapid approach to preoperative diagnoses. Pathologica 2010; 102:41-45. [PMID: 23596755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
INTRODUCTION It is well known that the use of a microwave oven greatly reduces the time for histoprocessing. OBJECTIVE Apply the microwave-based histoprocessing method "Fast Track Biopsy" (FTB), previously described for breast needle-core biopsies, to samples of other organs. METHODS From 01/09/2008 to 31/12/2008, 125 normal and neoplastic tissue samples (thickness from 0.2 and 1.2 cm) were collected, processed according to the FTB technique, stained with haematoxylin/eosin (H/E) and analysed with tissue-specific immunohistochemical (IHC) markers. RESULTS The quality of both H/E and IHC stained sections was comparable to that obtained with standard methods. Sample thickness less than 0.5 cm gave better results. DISCUSSION the FTB method is suitable for most tissue types, and is thus useful for preoperatory diagnoses.
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Affiliation(s)
- V Steri
- Section of Anatomic Pathology, Department of Haematology and Oncology "L. e A. Seragnoli", University of Bologna, Bellaria Hospital, Bologna, Italy
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Marucci G, Faustini-Fustini M, Righi A, Pasquini E, Frank G, Agati R, Foschini MP. Thyrotropin-secreting pituitary tumours: significance of “atypical adenomas” in a series of 10 patients and association with Hashimoto thyroiditis as a cause of delay in diagnosis. J Clin Pathol 2008; 62:455-9. [DOI: 10.1136/jcp.2008.061523] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Thyrotropin-secreting adenomas (TSH-As) are rare and, according to the World Health Organization criteria (WHO 2004), a significant proportion of them present features of atypical adenomas at the time of diagnosis.Aims:To determine the frequency of “atypical adenomas” and the significance of this definition as regards follow-up. To investigate their possible association with Hashimoto thyroiditis, leading to a delay in diagnosis.Methods:Case notes for patients who underwent trans-sphenoidal surgery between 1992 and 2006 were retrieved. Follow-up ranged from 6 to 180 months.Results:Ten cases of TSH-As out of 908 pituitary adenomas were selected. Before surgery, eight patients had hyperthyroidism, one was euthyroid and another one showed hypothyroidism associated with Hashimoto thyroiditis. All cases were macroadenomas; six of them were invasive. Three cases met the criteria for classification as atypical. In none of the cases, including the three “atypical adenomas”, were clinical or radiological signs of recurrence observed.Conclusions:The three cases with features of atypical adenoma did not recur or metastasise, suggesting that, at least in the present series, a strict relationship between the morphological criteria for diagnosing atypical adenomas and biological behaviour may be sometimes lacking. Furthermore, the casual association of TSH-As with Hashimoto thyroiditis may led to an adjunctive delay in diagnosis, because of low thyroid hormone levels.
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Montebugnoli L, Felicetti L, Gissi DB, Cervellati F, Servidio D, Marchetti C, Prati C, Flamminio F, Foschini MP. Predictive Role of p53 Protein as a Single Marker or Associated to Ki67 Antigen in Oral Carcinogenesis. Open Dent J 2008; 2:24-9. [PMID: 19088879 PMCID: PMC2581531 DOI: 10.2174/1874210600802010024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2007] [Accepted: 01/09/2008] [Indexed: 11/22/2022] Open
Abstract
p53 over-expression has been proposed as a reliable marker associated to oral carcinogenesis, although only about 50% of oral carcinomas (OSCC) are associated with p53 over-expression and even p53-negative lesions can progress to OSCC. The aim of the study was to determine whether the combination of p53 over-expression and p53 low-expression associated with Ki67 over-expression (high Ki67/p53 ratio) could lead to a more sensitive parameter. Immunohistochemical expression of Ki67 and p53 was measured in 54 specimens from OSCC; 27 specimens from moderate/severe epithelial dysplasia; 32 specimens from oral leukoplakias without epithelial dysplasia, and 13 specimens with normal epithelium. p53 over-expression was found in 31 (53%) samples from OSCC, in 10 (37%) samples from severe dysplasias, and in 5 (15%) samples from non-dysplastic lesions, while the combination of high p53 values with high Ki67/p53 ratio was observed in 93% of OSCC, in 81% of dysplastic lesions, and in 50% of non-dysplastic lesions. This parameter may have a clinical implication to detect early lesions with an impairment of p53 pathway, and probably at risk of progress to OSCC.
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Farneti P, Balbi M, Foschini MP. Neuroglial choristoma of the middle ear. Acta Otorhinolaryngol Ital 2007; 27:94-7. [PMID: 17608139 PMCID: PMC2640011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Neuroglial choristoma is a rare cerebral heterotopia which can involve various locations. Even if its occurrence is more frequent in midline structures, it can also be found in the non-midline structure such as, for example, even if only rarely, the middle ear. The described case is that of a 74-year-old male who had been operated on for a neuroglial choristoma located in the tympanic cavity and in the mastoid bone. High resolution computed tomography and intra-operative findings did not reveal any connection with the upper cerebral structures, thus excluding the hypothesis of an encephalocele. After careful histopathological examination, the aetiopathogenetic hypothesis are analysed. Only 8 similar cases have been reported in the literature.
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Affiliation(s)
- P Farneti
- Department of Otolaryngology, General Hospital, Budrio, Azienda USL Bologna, Italy.
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22
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Righi A, Foschini MP. [Values and limits in fine needle aspiration in the diagnosis of Warthin tumour of the parotid gland]. Pathologica 2006; 98:635-9. [PMID: 17285840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
UNLABELLED Recent paper state that cytological diagnosis of Warthin Tumour of the parotid gland is poorly reproducible and that aspiration procedures damage the tumoral tissue as to make difficult the histological diagnosis. Aim of the present study is to review cytological sampling performed with fine needle sampling without aspiration and to compare them with the relative surgical specimens in order to determine the value of fine needle aspiration in the diagnosis of Warthin Tumour and to quantify' the damage in histological tissue. MATERIALS AND METHOD All cases with cytological and/or histological diagnosis of Warthin Tumour during the period 1/1/98 to 30/6/04 were retrieved. In all cases both cytological and histological slides were reviewed and compared. In all cases fine needle aspiration (FNA) was performed according to the technique described by Zajdela et al. in 1987. A cytologic sample was considered diagnostic when there were in the same sample mucoid substance, lymphocytes scattered with a range of maturation and oncocytes organized in flat sheets of cells. RESULTS 38 cases were selected corresponding to 37 patients (1 case of Warthin Tumour bilateral): all tumors were localized in the parotid gland. Fine needle sampling were 43. Nine cytological sample (20.9%) were inadequate. Sensitivity and specificity, in the preent series, had the same value, being 97.1%. A spectrum of histologic alterations were observed in 30/38 cases (79%). These alterations were squamous metaplasia (7 cases), acute and chronic hemorrhage and inflammation with multinucleated giant cells (26 cases) and granulation tissue with subsequent fibrosis (24 cases). In all cases the histologic alterations from fine needle were focal, limited to less than 20% of the tumoral area (first category of Batsakis 'classification), and did not prevent the histologic diagnosis of Warthin Tumour. CONCLUSIONS These data suggest that fine needle aspiration without aspiration is a valuable tool for the per-operative diagnosis of Warthin Tumour. In addition it creates only minor histological changes, that always allow the histological diagnosis.
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Affiliation(s)
- A Righi
- Dipartimento di Scienze Oncologiche, Sezione di Anatomia Patologica, Università di Bologna, Ospedale Bellaria, Bologna
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Foschini MP, Cocchi R, Marucci G, Pennesi MG, Magrini E, Ligorio C, Lombardini F, Tosi AL, Marchetti C. High DeltaN p63 isoform expression favours recurrences in odontogenic keratocyst--odontogenic keratocystic tumour. Int J Oral Maxillofac Surg 2006; 35:673-5. [PMID: 16687239 DOI: 10.1016/j.ijom.2006.02.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2006] [Revised: 02/20/2006] [Accepted: 02/28/2006] [Indexed: 10/24/2022]
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Marucci G, Betts CM, Michal M, Foschini MP. Peripheral ameloblastoma with Merkel cells. Virchows Arch 2004; 446:204-5. [PMID: 15735981 DOI: 10.1007/s00428-004-1159-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2004] [Accepted: 09/30/2004] [Indexed: 11/29/2022]
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Di Tommaso L, Macchia S, Morandi L, Leoncini S, Pession A, Dal Monte PR, Foschini MP. Correlation between histologic staging, hepatitis C virus genotypes and clinical features in HCV chronic hepatitis: evidence of a new pattern. Int J Surg Pathol 2003; 11:197-204. [PMID: 12894351 DOI: 10.1177/106689690301100306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Genome heterogeneity may be related to the wide variability of clinical and pathological features in hepatitis C virus (HCV)-related chronic liver disease. This paper addresses the possible association between HCV subtypes and clinical and histological features of chronically infected patients. Sixty-eight consecutive liver biopsies of chronic hepatitis constituted the basis of the study. HCV genotyping was performed on frozen tissue. Grading of necroinflammatory activity and staging of fibrosis were histologically assessed. Serologic HCV-RNA and liver function were assessed at the same time. All information was compared with clinical data including age, sex, HCV serology, and probable data and route of infection. Two cases were excluded as inadequate tissue was available. Five cases were negative to HCV-RNA in both serum and tissue. In 61 cases HCV RNA was present at the same time in serum and liver tissue. Forty-four patients were men (72%) and 17 (28%) were women. Two peaks of age were observed: 1 in the 4th decade of life, the 2nd in the 7th. The 2 groups had different HCV genotypes. Patients with genotypes 1b (mean age 50.7 years), 2c (mean age 61.3 years), and a subgroup of coinfections (mean age 60 years) were older than patients with genotypes 1a (mean age 35.5 years), 3 (mean age 36 years), and a subgroup of coinfections (mean age 33 years). Patients with genotypes 1b, 2, or 2c and a subgroup of coinfections more frequently had a history of blood transfusion and or surgical intervention dating up to 49 years previously. Patients with HCV 1a, 3, and a subgroup of coinfections frequently admitted a period of intravenous drug abuse. Patients with advanced liver disease, i.e., severe fibrosis and cirrhosis, showed the same 2 peaks of incidence: in the 4th and 7th decades of life, the first group mainly comprising patients with HCV types 1a and 3, the second, patients with HCV types 1b and 2c. Both these groups shared a clinical history of a long-standing infection. Two profiles of patients emerged. The largest group was composed of elderly patients, infected by HCV genotypes 1b or 2c, with a history of blood transfusion and/or surgery, presenting an advanced stage of liver disease (namely, severe fibrosis or cirrhosis). The second group was composed of younger patients, mainly in the 4th decade of life, infected by HCV types 3 or 1a, often presenting with chronic hepatitis in the stage of severe fibrosis or cirrhosis. The latter could be the profile of HCV infection in the near future.
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Affiliation(s)
- L Di Tommaso
- Department of Oncology, Section of Anatomic Pathology Marcello Malpighi, University of Bologna, Italy
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Marucci G, Morandi L, Macchia S, Betts CM, Tardio ML, Dal Monte PR, Pession A, Foschini MP. Fibrinogen storage disease without hypofibrinogenaemia associated with acute infection. Histopathology 2003; 42:22-5. [PMID: 12493021 DOI: 10.1046/j.1365-2559.2003.01551.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS The presence of ground glass hepatocytes in a liver biopsy may be related to different conditions, including fibrinogen storage disease. Three types of fibrinogen storage disease have been described, namely types I, II and III. Type I is an hereditary hypofibrinogenaemia genetically characterized by a mutant variant of the fibrinogen molecule designated as fibrinogen Brescia, consistent with a gamma284 Gly-->Arg mutation. Only rare cases of types II and III fibrinogen storage disease have been described. The purpose of the present paper is to describe two cases of fibrinogen storage disease without associated hypofibrinogenaemia, which appeared during acute infectious diseases. METHODS AND RESULTS Both patients were female, aged 77 and 73 years, who developed high transaminases during an infectious disease. In each case blood coagulation tests were within the normal range, and despite clinical and laboratory investigations no possible cause for liver disease could be found. Liver biopsies were performed; in both cases weakly eosinophilic cytoplasmic inclusions were observed. Using immunohistochemistry the inclusions were found to be due to fibrinogen accumulation. At ultrastructural level features corresponding to type II inclusions were observed. Molecular studies, performed in case 2, excluded the mutation typical of type I fibrinogen storage disease. Both patients also presented features of chronic hepatitis. In case 1, giant cell granulomas were additionally present. No close relatives of the patients presented any clinical or laboratory features of liver disease. In both patients altered liver function test values gradually, spontaneously, returned to within normal ranges after infectious disease was resolved. CONCLUSIONS These cases suggest that, on rare occasions, hepatocytes may accumulate fibrinogen during an infectious disease.
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Affiliation(s)
- G Marucci
- Section of Pathology, Department of Oncology, University of Bologna, Bellaria Hospital, Bologna, Italy
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27
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Di Tommaso L, Tolomelli B, Mezzini R, Marchetti M, Cenacchi G, Foschini MP, Mancini AM. Renal calcium phosphate and oxalate deposition in prolonged vitamin B6 deficiency: studies on a rat model of urolithiasis. BJU Int 2002; 89:571-5. [PMID: 11942967 DOI: 10.1046/j.1464-410x.2002.02670.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effect on kidney oxalate-salt deposition of a prolonged diet which induced vitamin B6 deficiency in adult rats, as there are reports of the pathogenic involvement of vitamin B6 deficiency in the formation of renal calcium oxalate calculi. MATERIALS AND METHODS The study comprised 24 6-month-old male albino Wistar rats; 12 were fed with a purified vitamin B6-deficient diet and the others provided with the same diet but supplemented with 6 mg/kg of vitamin B6. After 12 weeks, all rats were killed, and their kidneys fixed in formalin and routinely processed to paraffin for morphological examination; some fragments were fixed in glutaraldehyde and prepared for ultrastructural examination. From each rat consecutive sections of both kidneys were cut and stained with haematoxylin and eosin, periodic-acid Schiff, Sirius red and the Von Kossa method for calcium. Sections were examined in polarized light and by electron microscopy. RESULTS The histopathological and ultrastructural features of the kidney of vitamin B6-deficient rats were those of tubular-interstitial nephritis, characterized by tubular atrophy, interstitial fibrosis and chronic inflammatory infiltration. Oxalate and phosphate crystals were present in the papillary and parenchymal connective tissue. Ultrastructural features confirmed severe tubular epithelial lesions and the presence of an interstitial and intraepithelial inflammatory infiltrate; there was mild interstitial fibrosis. None of these features were apparent in the kidney of control rats. CONCLUSIONS Histopathological and ultrastructural data indicate that a prolonged vitamin B6-deficient diet may contribute to the formation and deposition of calcium phosphate and oxalate crystals, which lead to severe damage of the renal parenchyma. This phenomenon may occur not only in growing rats, which have more active protein metabolism and consequently higher vitamin B6 requirements, but also in adult rats.
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Affiliation(s)
- L Di Tommaso
- Section of Anatomic Pathology, Department of Oncology, University of Bologna, Bologna, Italy
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28
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Scarpellini F, Marucci G, Foschini MP. [Myoepithelial differentiation markers in salivary gland neoplasia]. Pathologica 2001; 93:662-7. [PMID: 11785118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Salivary gland tumors frequently present myoepithelial cell differentiation that is not always easily identified on routinely stained sections. Recently novel markers of myoepithelium have been studied, such as calponin (CALP), caldesmon (CALD), and smooth muscle myosin heavy chain. These markers, together with smooth muscle actin may be useful tools for identifying myoepithelial cells. We immunohistochemically studied a series of 23 benign and malignant salivary gland tumors using antibodies to these four markers. The tumors were classified as follows: pleomorphic adenoma (n = 8), basal cell adenoma (n = 3), myoepithelioma with plasmacytoid cells (n = 2), epithelial-myoepithelial cell carcinoma (n = 6) and adenoid cystic carcinoma (n = 4). All tumors were positive for at least one of the four markers. CALP and smooth muscle actin were the markers more frequently expressed. Positivity was mostly located in the myoepithelial cells that constitute the external layer of the glandular or tubular neoplastic structures. In poorly differentiated epithelial myoepithelial carcinomas, composed of solid sheets of neoplastic cells and sometimes of clear cells, immunohistochemical staining for myoepithelial markers evidenced rudimentary glandular structures. CALP and smooth muscle actin were positive in the two cases of myoepithelioma with plasmacytoid cells. In conclusion, the combined staining with four markers helps to disclose myoepithelial cell differentiation and can be a useful tool for the correct histopathological diagnosis of salivary gland tumors. Among the four markers studied, CALP and smooth muscle actin were the most useful to identify myoepithelial cell differentiation.
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MESH Headings
- Actins/analysis
- Adenocarcinoma, Clear Cell/chemistry
- Adenocarcinoma, Clear Cell/pathology
- Adenoma/chemistry
- Adenoma/pathology
- Adenoma, Pleomorphic/chemistry
- Adenoma, Pleomorphic/pathology
- Adult
- Aged
- Aged, 80 and over
- Antigens, Differentiation/analysis
- Antigens, Neoplasm/analysis
- Calcium-Binding Proteins/analysis
- Calmodulin-Binding Proteins/analysis
- Carcinoma/chemistry
- Carcinoma/pathology
- Carcinoma, Adenoid Cystic/chemistry
- Carcinoma, Adenoid Cystic/pathology
- Cell Differentiation
- Epithelial Cells/chemistry
- Female
- Humans
- Male
- Microfilament Proteins
- Middle Aged
- Muscle, Smooth/pathology
- Myoepithelioma/chemistry
- Myoepithelioma/pathology
- Myosin Heavy Chains/analysis
- Neoplasm Proteins/analysis
- Neoplastic Stem Cells/chemistry
- Protein Isoforms/analysis
- Salivary Gland Neoplasms/chemistry
- Salivary Gland Neoplasms/pathology
- Calponins
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Affiliation(s)
- F Scarpellini
- Dipartimento di Oncologia, Università di Bologna, Ospedale Bellaria, Via Altura 3, I-40139 Bologna, Italia
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29
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Foschini MP, Morandi L, Macchia S, DalMonte PR, Pession A. TT virus-related acute recurrent hepatitis. Histological features of a case and review of the literature. Virchows Arch 2001; 439:752-5. [PMID: 11787846 DOI: 10.1007/s004280100467] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
TT virus is a recently discovered virus, of which the pathogenetic potential is still uncertain. The present paper describes the histopathological features of a case of TT virus-related acute recurrent hepatitis. The patient is a 28-year-old woman with no history of drug or alcohol abuse, presenting with repeated episodes of hypertransaminasemia evidenced during the last 4 years. No other markers of viral or autoimmune disease were found. On histological analysis, the liver parenchyma showed a preserved architecture. The histological features were those of a mild acute hepatitis. The clinicopathological findings suggest th
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Affiliation(s)
- M P Foschini
- Department of Oncology, Section of Pathology, University of Bologna, Italy.
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30
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Foschini MP, Morandi L, Macchia S, Dal Monte PR, Pession A. [Demonstration of TT virus in liver tissue fixed in formalin and embedded in paraffin]. Pathologica 2001; 93:112-7. [PMID: 11428287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
INTRODUCTION TT virus has been recently isolated in Japan in patients with acute and chronic non-A/non-G hepatitis. Its possible etiopathogenetic role in causing hepatitis has been initially taken in consideration. On the contrary, more recent studies deny the importance of TT virus in causing liver damage. Most of the studies are based on serological data or on viral detection from frozen liver tissue. AIM OF THE STUDY In the present paper we describe a method to detect viral genome from formalin-fixed and paraffin-embedded liver tissue. MATERIALS AND METHODS Twelve needle biopsies from liver were studied. Six cases were selected on the basis of serological negativity for HBV and HCV markers. Five cases of HCV-related chronic hepatitis and one HCV- and HIV-positive intravenous drug abuser were also included. All patients underwent liver biopsy, performed with a 14-G needle. Liver specimens were formalin-fixed and paraffin-embedded as routine. From each block, sections were cut and stained for histopathologic examination. Additional 5 microns sections were employed to extract DNA for nested PCR. RESULTS In 2 of 12 cases studied, TT virus genome was found. In both cases the presence of viral DNA was confirmed by sequencing. Both patients were male. The first patient was a 39-year-old HIV- and HCV-positive intravenous drug abuser. The second patient was a 60-year-old heavy alcohol drinker. In both cases the presence of TT virus apparently did not affect the histological picture. CONCLUSION It is possible to detect TT virus genome from formalin-fixed and paraffin-embedded tissue. This method offers the possibility to perform retrospective studies.
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Affiliation(s)
- M P Foschini
- Sezione di Anatomia Patologica, Istologia e Citologia Patologica M. Malpighi, Dipartimento di Oncologia, Ospedale Bellaria, Via Altura 3, I-40139 Bologna.
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31
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Foschini MP. [Radicality criteria in head and neck tumors. Histopathologic presuppositions]. Acta Otorhinolaryngol Ital 2000; 20:376-9. [PMID: 11398671] [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] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Affiliation(s)
- M P Foschini
- Dipartimento di Oncologia, Sezione di Anatomia Patologica, Università di Bologna, Ospedale Bellaria
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32
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Carlinfante G, Foschini MP, Pasquinelli G, Scotti R, Cavazza A. Hepatoid carcinoma of the lung: a case report with immunohistochemical, ultrastructural and in-situ hybridization findings. Histopathology 2000; 37:88-9. [PMID: 10931226 DOI: 10.1046/j.1365-2559.2000.00955-5.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Jones C, Foschini MP, Chaggar R, Lu YJ, Wells D, Shipley JM, Eusebi V, Lakhani SR. Comparative genomic hybridization analysis of myoepithelial carcinoma of the breast. J Transl Med 2000; 80:831-6. [PMID: 10879734 DOI: 10.1038/labinvest.3780087] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Although there seems to be a common stem cell for the two epithelial cell types in the breast, the vast majority of breast cancers exhibit a luminal phenotype. Pure myoepithelial carcinomas are rare. We report our findings of genetic alterations in these tumors. We have analyzed 10 cases of pure myoepithelial cell carcinomas using laser capture microdissection and comparative genomic hybridization. The mean number of changes was 2.1 (range 0-4), compared with a mean of 8.6 (range 3.6-13.8) in unselected ductal carcinomas. Common alterations included loss at 16q (3/10 cases), 17p (3/10), 11q (2/10), and 16p (2/10), regions also commonly deleted in ductal carcinomas. The single case in which both pure myoepithelial carcinoma and invasive ductal carcinoma was present showed 2 alterations in the myoepithelial tumor (losses at 17p and 17q), whereas the invasive ductal component showed 15 alterations (5 gains and 9 losses), including loss at 17p. The sharing of 17p loss in myoepithelial and ductal carcinoma is consistent with a common stem cell model in the breast. The relatively few genetic alterations in otherwise aggressive neoplasms suggests that myoepithelial tumors may be a good model for the delineation of genes important in breast tumorigenesis.
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Affiliation(s)
- C Jones
- Department of Histopathology, Royal Free and University College Medical School, University College, London, United Kingdom
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34
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Foschini MP, Eusebi V. Divergent differentiation in endocrine and nonendocrine tumors of the skin. Semin Diagn Pathol 2000; 17:162-8. [PMID: 10839616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
In the skin, endocrine tumors showing areas with nonendocrine features and nonendocrine tumors showing endocrine differentiation are present. (1) Neuroendocrine carcinomas with nonendocrine differentiation: Merkel cell carcinoma (MCC) of the skin has been frequently described in association with squamous cells carcinoma (SCC) which can arise separately (as synchronous or metachronous lesions) from MCC as well as closely intermixed. In the first event the possibility that the lesions are sustained by same causative factors (among which sun exposure is the most probable) is suggested. In cases of lesions closely intermixed the possibility of an origin from a common precursor is suggested. Furthermore, cases of MCC have been described to contain glandular, melanocytic, striated muscle, and lymphoepithelioma-like features. These latter findings further support the hypothesis of tumors showing divergent differentiations. (2) Nonendocrine tumors showing endocrine differentiation: Basal cell carcinoma (BCC) was the first cutaneous nonendocrine tumor described to contain neuroendocrine granules. Presence of endocrine features were subsequently confirmed with immunohistochemical studies. Endocrine features were then described in sweat gland apocrine and eccrine carcinomas. Endocrine elements present in BCC and in sweat gland carcinomas do not show morphological and immunohistochemical features of Merkel cells. Thus the possibility that these tumors develop an immature Merkel cell or a new type of endocrine cell of the skin is suggested. Tumors with follicular differentiation such as trichoblastomas and trichofolliculomas contain a high number of Merkel cells. As Merkel cells are numerous in hair follicles of human fetal skin, the possibility that these tumors recapitulate the human skin embryogenesis is suggested.
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MESH Headings
- Aged
- Biomarkers, Tumor/analysis
- Carcinoma, Basal Cell/chemistry
- Carcinoma, Basal Cell/diagnosis
- Carcinoma, Merkel Cell/chemistry
- Carcinoma, Merkel Cell/diagnosis
- Carcinoma, Merkel Cell/secondary
- Carcinoma, Squamous Cell/chemistry
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/secondary
- Cell Differentiation
- Eccrine Glands/pathology
- Humans
- Immunohistochemistry
- Male
- Neoplasm Proteins/analysis
- Neoplasms, Complex and Mixed/chemistry
- Neoplasms, Complex and Mixed/diagnosis
- Neoplasms, Complex and Mixed/secondary
- Skin Neoplasms/chemistry
- Skin Neoplasms/diagnosis
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Affiliation(s)
- M P Foschini
- Department of Oncology, University of Bologna, Bellaria Hospital, Italy
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35
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Jones C, Foschini MP, Chaggar R, Lu YJ, Wells D, Shipley JM, Eusebi V, Lakhani SR. Comparative genomic hybridisation analysis of myoepithelial carcinoma of the breast. Breast Cancer Res 2000. [PMCID: PMC3300876 DOI: 10.1186/bcr178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
Orbital cavernous hemangiomas (OCH) have thick and highly cellular vascular walls. Ultrastructural studies have demonstrated the smooth muscle nature of these cells. Vascular neoplasms can modify their morphological and clinical features under hormonal stimulation. The purpose of the present study was to investigate the presence of smooth muscle markers and sex steroid receptors in 12 cases of OCH. Orbital cases were compared with cutaneous hemangiomas and subcutaneous angioleiomyomas. Smooth muscle actin (SMA) and desmin were localized in spindle cells of the vascular walls of all 12 cases studied. OCH showed immunohistochemical positivity with progesterone receptor (PR) antibody both in smooth muscular and in endothelial cells. For comparison, sex steroid receptors were studied in 10 cases of cutaneous cavernous hemangioma and in 10 cases of subcutaneous angioleiomyoma. PR was found in smooth muscle and endothelial cells of 6 out of 10 cases of subcutaneous angioleiomyoma and in none of the cases of cutaneous cavernous hemangioma. No positivity was obtained with estrogen receptor (ER) antibody in any of the cases tested. The present data suggest that OCH share morphological and immunohistochemical features with subcutaneous angioleiomyomas. Furthermore, immunohistochemical positivity with PR antibody indicates that OCH have to be added to the list of mesenchymal lesions that express sex steroid receptors.
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Affiliation(s)
- L Di Tommaso
- Department of Oncology, Ospedale Bellaria, University of Bologna, Italy
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37
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Marucci G, Galliani E, Marrocolo F, Foschini MP. [Orbital embryonal rhabdomyosarcoma in adults. Report of 2 cases]. Pathologica 1999; 91:459-65. [PMID: 10783642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Rhabdomyosarcoma (RMS) is the most frequent sarcoma of infancy. Embryonal RMS is generally correlated with a better response to chemotherapy. In the present paper two cases of embryonal RMS of the orbit affecting adult patients are reported. Both patients are male, aged 22 and 24 years respectively. In Case 1 the lesion arose primitively in the orbit, in Case 2 the orbit was affected by secondary involvement. Both patients presented a rapid response to chemotherapy, with reduction of the neoplastic mass and regression of symptoms.
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Affiliation(s)
- G Marucci
- Dipartimento di Oncologia, Università di Bologna, Ospedale Bellaria
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38
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Stumpo M, Foschini MP, Poppi M, Cenacchi G, Martinelli P. Hypertrophic inflammatory neuropathy involving bilateral brachial plexus. Surg Neurol 1999; 52:458-64; discussion 464-5. [PMID: 10595765 DOI: 10.1016/s0090-3019(99)00142-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The present case is an example of hypertrophic inflammatory neuropathy (HIN). This entity is a rare tumor-like, chronic inflammatory, focal or multifocal, mainly demyelinating neuropathy of unknown origin, most frequently involving the brachial plexus. CASE DESCRIPTION The authors describe a 67-year-old man presenting with a nodular mass in his right supraclavicular fossa. A nodular mass grossly resembling a schwannoma originating from a single nerve fascicle was surgically removed from the right C6 spinal nerve. Histologically, endoneurial edema, fibrosis, focal chronic inflammation, and extensive "onion bulb" formation were seen. Electron microscopy studies and immunohistochemistry proved that the onion bulb-forming cells were schwannian in nature and that the whorls of onion bulbs surrounded a generally demyelinated axon. Three months following surgery the patient developed acute painless paralysis of his right biceps brachii muscle that rapidly reversed; after that he remained neurologically asymptomatic. MRI revealed multiple fusiform mass lesions involving the brachial plexus bilaterally. Electrophysiologic studies demonstrated a bilateral, asymmetrical, mainly demyelinating neuropathy involving the brachial plexus; they failed to reveal any abnormality suggestive of generalized neuropathy. CONCLUSION HIN is different from other focal tumor-like neuropathies and in particular from localized hypertrophic neuropathy (LHN).
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Affiliation(s)
- M Stumpo
- Institute of Neurology, University of Bologna, Italy
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39
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Foschini MP, Macchia S, Baccarini P, Milandri GL, Losi L, Spongano P, Panarelli M, Dal Monte PR, Eusebi V. [Albumin mRNA and pCEA in the histopathologic diagnosis of hepatocellular carcinoma]. Pathologica 1999; 91:260-7. [PMID: 10630075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
Extrahepatic neoplasms metastatic to the liver histologically are often indistinguishable from hepatocellular carcinoma (HCC). The differential diagnosis between HCC and metastatic liver tumours can be even more difficult in ultrasound guided fine-needle biopsies. Purpose of the present study was to investigate the utility of immunohistochemical staining with polyclonal anticarcinoembryonic antigen (pCEA) antibody and of in situ hybridization (ISH) revealing human albumin mRNA, with emphasis on tissues obtained via fine-needle procedure. Cases consisted of 52 primary HCC; 2 HCC metastatic to vertebral bones; 18 tumours metastatic to the liver; 24 non-hepatocellular tumours metastatic to the skin, lymph nodes and brain; 2 immature teratomas with areas of hepatoid differentiation. Forty-seven HCC (90%) and 7 liver metastases (38%) were obtained by ultrasound guided fine-needle biopsies (21 g needle was used). All the remaining cases were surgical specimens. All the cases were studied with immunohistochemistry for pCEA and ISH using a cRNA probe for human albumin mRNA. The immunohistochemical staining using pCEA showed a canalicular type of positivity in 37 cases of HCC (71%), in one HCC metastatic to vertebral bone and in the hepatoid areas of one immature teratoma. No canalicular type of positivity was obtained in non-hepatocellular neoplasms metastatic to the skin, brain, lymph-nodes and liver. Albumin mRNA was detected in 51 (98%) primary HCC, in both HCC bone metastases, and in the hepatoid areas of both immature teratomas. No positivity was obtained in non-hepatocellular tumours. The data here obtained indicate that immunostaining with pCEA and ISH revealing human albumin mRNA are markers of hepatocellular differentiation and confirm their diagnostic utility. Detection of albumin mRNA showed a higher sensitivity. In addition the cRNA probe here used seems more sensitive that the oligonucleotide probes employed in previous studies.
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Affiliation(s)
- M P Foschini
- Dipartimento di Oncologia, Ospedale Bellaria, Università di Bologna.
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40
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Marucci G, Collina G, Damiani S, Dina R, Foschini MP, Losi L, Roncaroli F, Eusebi V. [Quality control of the "M. Malpighi" Anatomy, Histology, and Pathologic Cytology Section, Oncology Department, University of Bologna, Bellaria Hospital]. Pathologica 1999; 91:268-75. [PMID: 10630076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Abstract
The quality control scheme in use at the Department of Anatomic Pathology of the University of Bologna-Bellaria Hospital Since 1993 a quality assurance (QA) scheme has been set up in our Department, modified from the protocol in use at the Department of Pathology of Yale University and published by J. Rosai in his textbook. A QA committee has been appointed and each member is responsible for a specific branch of the total workload; the areas involved are: 1. review of frozen section diagnoses with the final diagnoses 2. randomized review of biopsies (1:25) 3. quality control of cytological cases 4. quality control of specimen adequacy 5. quality control of immunohistochemistry and in situ Hybridization 6. quality control of the cytogenetics laboratory 7. quality control of autopsies All data collected from january 1996 to february 1999 have been reviewed and analyzed in order to provide references for other laboratories and for the purpose of monitoring our laboratory' performance.
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Affiliation(s)
- G Marucci
- Dipartimento di Oncologia, AUSL Città di Bologna
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Foschini MP, Corti B, DaCol M, Cenzi M, Zanella F, Barbazza R. Angiomyolipoma of the parotid gland: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 87:738-41. [PMID: 10397669 DOI: 10.1016/s1079-2104(99)70172-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Angiomyolipoma is a hamartomatous process that most frequently occurs as a single lesion or multiple foci in the kidneys of patients affected by tuberous sclerosis. Angiomyolipoma can also arise in extrarenal sites, among which the liver is the most frequently recorded. Only rare cases of angiomyolipoma located in the head and neck region (ear and oral and nasal cavity) have been described. The purpose of the present article is to report a case of angiomyolipoma of the parotid gland. A 68-year-old woman appeared for treatment with a slow-growing nodule located in her right parotid gland. Ultrasound examination revealed a heterogeneous nodule with well-defined margins. The nodule was surgically removed by total parotidectomy and showed the characteristic appearance of angiomyolipoma, with an admixture of fat smooth muscle cells, and tortuous, thick-walled blood vessels. Careful physical examination of the patient failed to reveal features of tuberous sclerosis. Angiomyolipoma should be considered in the differential diagnosis of mesenchymal lesions involving the salivary gland.
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Affiliation(s)
- M P Foschini
- Department of Oncology, Ospedale Bellaria, University of Bologna, Italy
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42
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Foschini MP, Pieri F, Cerasoli S, Accardo P, Formica G, Biasiucci A, Donzelli C, Villanacci V. [Helicobacter heilmannii: anatomo-clinical study of 14 new cases]. Pathologica 1999; 91:18-24. [PMID: 10396946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023] Open
Abstract
INTRODUCTION Helicobacter pylori is one of the most common causes of human gastritis. Recently, a new agent has been isolated, which also causes a gastritis. It has been initially named Gastrospirillum hominis and renamed Helicobacter heilmannii (Hh). Hh is extremely rare. In spite of the rarity it is important to recognize and diagnose it, as it requires a proper therapy, different from Hp therapy. Clinical presentation and serological results of Hh are superimposable to those of HP. Therefore differential diagnosis resides on histological grounds. PURPOSE of the present paper is to report 14 new cases of Hh gastritis, which constitutes the first italian series. RESULTS Cases constituted 0.01% of all gastric biopsies seen in the period 1994-1998. Nine patients were male and five were female; age ranged from 32 to 76 years (50 years on average). All patients presented a mild to moderate gastritis. Hh is a spiral bacterium, being about 10 micra in length, localized in single or small groups in the glandular mucus. Two cases were associated with Hp. One case was associated with gastric adenocarcinoma. Two cases were diagnosed during the follow-up of duodenal ulcer. In CONCLUSION, the incidence of Hh gastritis in the present series seems consistent with that from other European countries. In all cases the presence of Hh was associated with features of gastritis. This confirms the pathogenetic role of Hh.
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Affiliation(s)
- M P Foschini
- Dipartimento di Oncologia Ospedale Bellaria, Università di Bologna
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Foschini MP, Baccarini P, Dal Monte PR, Sinard J, Eusebi V, Rosai J. Albumin gene expression in adenocarcinomas with hepatoid differentiation. Virchows Arch 1998; 433:537-41. [PMID: 9870687 DOI: 10.1007/s004280050286] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Two cases of hepatoid adenocarcinomas were studied with an in situ hybridization technique (ISH) using a RNA probe for human albumin mRNA. In case 1 the urinary bladder of a 67-year-old woman was affected; in case 2 the tumour was located in the gastric antrum of an 80-year-old woman. In neither case had alpha fetoprotein (AFP) been determined preoperatively. Histologically these cases showed adenocarcinomatous features intermingled with hepatoid areas. These latter areas were characterized by cords of polygonal cells, each with an oval nucleus and prominent nucleoli, separated by a fine network of sinusoids. In the hepatoid areas the immunohistochemical profile was similar to that observed in hepatocellular carcinomas, in that the tumour cells were positive with AFP, alpha-1-antitrypsin (A1AAT) and albumin antisera and there was a canalicular type of reactivity with polyclonal anti-CEA (pCEA) antibody. ISH revealed albumin mRNA in virtually all hepatoid cells in case 1, and in about 50% of those in case 2. In addition, in case 2 occasional cells in the adenocarcinomatous areas showed albumin transcripts of ISH. Our findings confirm that ISH for albumin mRNA probe is a valuable method of establishing hepatocellular differentiation, and that hepatoid adenocarcinomas are tumours with true extrahepatic hepatocellular differentiation.
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Affiliation(s)
- M P Foschini
- Department of Oncology, M. Malpighi, Ospedale Bellaria, University of Bologna, Italy
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Foschini MP, Macchia S, Losi L, Dei Tos AP, Pasquinelli G, Di Tommaso L, Del Duca S, Roncaroli F, Dal Monte PR. Identification of mitochondria in liver biopsies. A study by immunohistochemistry, immunogold and Western blot analysis. Virchows Arch 1998; 433:267-73. [PMID: 9769131 DOI: 10.1007/s004280050246] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Hepatocytes are rich in mitochondria, which play an important role in hepatic metabolism. In certain pathologic conditions (most often alcoholic liver disease) mitochondria became enlarged; nevertheless, even in these conditions they are hardly detectable on light microscopy. Recently an antimitochondrial antibody (mAM), which recognizes a 60-kDa protein, has been characterized. The purpose of the present study was to study immunoreactivity of this antibody in a series of liver biopsies. We studied 146 liver biopsies using an mAM. In 8 cases an ultrastructural study was also done, and in 2 cases Western blot analysis was performed. Cases were divided as follows: alcoholic liver disease (ALD, 31); steatosis (8); nonalcoholic steatohepatitis (NASH, 1); hepatitis C virus (HCV)-related hepatitis (83); hepatitis B virus (HBV)-related hepatitis (6); primary biliary cirrhosis (1); sclerosing cholangitis (1); haemosiderosis (1); sarcoidosis (1); alpha-1-antitrypsin deficiency (1); nonspecific findings (12). All the patients were investigated for alcohol or drug abuse, pharmacological treatment, hyperlipidaemia, hypercholesterolaemia and diabetes. Immunoreactivity was diffuse in cases of ALD, NASH and steatosis, and in patients with drug abuse. Electron microscopic immunogold and Western blot analysis confirmed that in the conditions examined the protein recognized by the mAM showed greater expression. Immunohistochemical staining was helpful in demonstrating a toxic or a metabolic insult even in cases in which the histological picture was blurred by viral infection.
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Affiliation(s)
- M P Foschini
- Department of Radiology and Anatomic Pathology, Ospedale Bellaria, University of Bologna, Italy
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45
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Putrino I, Baccarini P, Bracko M, Foschini MP, Collina G. [Malignant melanoma with pseudoepitheliomatous reaction marker. A case report]. Pathologica 1998; 90:397-402. [PMID: 9793402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Pseudoepitheliomatous hyperplasia or pseudocarcinomatous hyperplasia (PEH) is characterized by a downward expansion of the epidermis, which can simulate a squamous cell carcinoma (SC). It is usually associated to chronic inflammatory conditions, but rarely it can hide a tumour. In the present paper a case of melanoma (M) associated with a prominent PEH is described. The patient is a 79-year old woman who presented a polypoid, ulcerated lesion of the left thigh. The lesion was entirely removed. The patient is free of disease 5-years after surgery. On histology, the malignant melanomatous proliferation was closely admixed to sheets of squamous cells. The possibility of SC was excluded as the squamous component did not show architectural disarray, prominent nucleoli and atypical mitoses. Siringomatous metaplasia was observed in the deeper portion of the lesion. On the basis of these findings the diagnosis of melanoma (M) associated to prominent PEH was considered the most likely.
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Affiliation(s)
- I Putrino
- Sezione di Anatomia Patologica dell'Università di Bologna, Italia
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46
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Abstract
Myoepithelial cells are normally located between the epithelial cells and the basal lamina of secretory elements of exocrine glands. Their role in the histogenesis of breast tumours has been studied extensively, and a definite differentiation towards myoepithelial cells has been demonstrated in adenoid cystic carcinoma, adenomyoepithelioma, low-grade adenosquamous (syringomatous) carcinoma, pure malignant myoepithelioma and poorly differentiated myoepithelial-rich breast carcinoma. All these tumours are of low malignancy, with the exception of malignant myoepithelioma and poorly differentiated myoepithelial-rich carcinoma. When a low-grade tumour is associated with a spindle cell component, distant metastases must be expected. Pure malignant myoepithelioma shows morphological and clinical features similar to those of monophasic sarcomatoid carcinomas, and it is possible that this last tumour is linked histogenetically to sarcomatoid carcinomas.
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Affiliation(s)
- M P Foschini
- Department of Onkology, Ospedale Bellaria, University of Bologna, Italy
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47
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Scarpellini F, Borsari A, Foschini MP. [Sarcoid-like hepatic granulomas, associated with gastric neoplasia. Description of a case]. Pathologica 1997; 89:742-6. [PMID: 9549383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Giant cell granulomas in liver biopsies is a relative common finding. Among the many causes of granulomatous lesions of the liver primary biliary cirrhosis and sarcoidosis are the most frequently diagnosed. On the other hand sarcoid-like granulomatous reaction can be encountered associated to malignant tumours. Purpose of the present paper is to describe a case of a sarcoid-like reaction of the liver associated to gastric adenocarcinoma. The patient was a 66 yr old man who underwent gastrectomy for a signet-ring cell adenocarcinoma. Pathological anamnesis was unremarkable. Liver function tests were within normal limits. Chest x ray was normal. A liver biopsy was performed during surgery as the liver presented an irregular surface. On histology giant cell granulomas with sarcoid-like features were seen in the hepatic parenchyma. Same reaction was present in the perigastric lymph nodes. The patient died immediately after surgery due to massive pulmonary embolism. No autopsy was performed. Among the possible diagnoses primary biliary cirrhosis, sarcoidosis and paraneoplastic sarcoid-like granulomatous reaction were considered. Primary biliary cirrhosis and sarcoidosis were excluded on the basis of the past clinical history of the patient, that was unremarkable; furthermore liver function tests performed preoperatively were within normal ranges. Thus paraneoplastic sarcoid-like reaction involving the liver was regarded as the most likely diagnosis.
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Affiliation(s)
- F Scarpellini
- Sezione di Anatomia, Istologia e Citologia Patologica M. Malpighi Università di Bologna, Ospedale Bellaria
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Padovani R, Acciarri N, Giulioni M, Pantieri R, Foschini MP. Cavernous angiomas of the spinal district: surgical treatment of 11 patients. Eur Spine J 1997; 6:298-303. [PMID: 9391798 PMCID: PMC3454601 DOI: 10.1007/bf01142674] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Cavernous angiomas, also called cavernous malformations or cavernomas, are vascular hamartomas accounting for 3-16% of all angiomatous lesions of the spinal district. Although histologically identical, these vascular anomalies may exhibit different clinical behavior and radiological features, depending on their location, hinting at different managements and therapeutic approaches. The authors report 11 cases of symptomatic spinal cavernous angiomas diagnosed and surgically treated over the past 18 years. Age of patients ranged from 15-75 years; males outnumbered females. Three patients had vertebral cavernous malformations, secondarily invading the epidural space; two had pure epidural lesions; two patients had intradural extramedullary lesions, and four intramedullary lesions. Surgical removal was completely achieved in four patients with intramedullary lesions, in two with subdural extramedullary lesions, and in one with a pure epidural lesion. Subtotal excision of another one epidural and three vertebral cavernous angiomas was followed by radiotherapy. There was no morbidity related to surgery; the mean follow-up was 2 years. The outcome was excellent in two cases, good in six, and unchanged in the other three. The authors discuss the different modalities of treatment of these vascular lesions variously placed along the spine.
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Affiliation(s)
- R Padovani
- Department of Neurosurgery, Bellaria Hospital, Bologna, Italy
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49
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Scarpellini F, Usellini L, Foschini MP. [Malignant myoepithelioma associated with in situ and invasive ductal carcinoma. Description of a case and review of the literature]. Pathologica 1997; 89:420-4. [PMID: 9471611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A case of malignant myoepithelioma of the breast, associated with in situ and invasive carcinoma NOS is described. Myoepithelial differentiation was demonstrated with immunohistochemistry and electron microscopy. The tumour affected the left breast of a 72 year old lady. The patient had been treated with quadrantectomy with axillary dissection, followed by radiotherapy. At the time of diagnosis no local or distant metastases were found. Bone, pulmonary and cerebral metastases appeared 28 months after treatment. Malignant myoepitheliomas share histological and immunohistochemical features with monophasic sarcomatoid carcinomas. Comparison and and possible relationship with monophasic sarcomatoid carcinomas is discussed.
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Affiliation(s)
- F Scarpellini
- Sezione di Anatomia, Istologia e Citopatologia M. Malpighi, Università di Bologna, Ospedale Bellaria
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50
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Bisulli F, Foschini MP, Dallera P, Gaist G. [Expanding lesions of the orbit: Multicase review]. Pathologica 1997; 89:256-63. [PMID: 9380419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Different types of neoplastic and non neoplastic lesions can affect the orbit causing ocular damage. Aim of the present study was that to review a series of endoorbital neoplastic and non neoplastic space occupying lesions. All the cases of endoorbital lesions, seen during the period January 1980-September 1996, were retrieved from the files of the Department of Pathology of the Ospedale Bellaria of Bologna (Italy). All the cases were reviewed and reclassified according to the WHO criteria. One hundred-twenty-six cases of orbital lesions were selected; of these 88 were benign, 36 malignant and 2 borderline. The cases were then subdivided into the following categories: benign lesions of soft tissues (37 cases), malignant lesions of soft tissues (5 cases), lymphoid tumors and pseudotumors (12 cases), other primitive endoorbital tumors (18 cases), secondary and metastatic tumors (43 cases), tumors of the optic nerve (6 cases) and non neoplastic lesions (3 cases). A great variety of lesions can affect the orbit, most of which are benign in nature. Thus a correct diagnosis followed by a correct treatment of the patients can avoid severe ocular damage.
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Affiliation(s)
- F Bisulli
- Dipartimento Clinico di Radiologia e Anatomia Patologica, M. Malpighi, Sede Distaccata
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