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Buccoliero AM, Caporalini C, Moscardi S, Cetica V, Mei D, Conti V, Nozzoli F, Bonaudo C, Battista F, Giordano F, Mura R, Spacca B, Mussa F, D'Onofrio V, Guerrini R, Genitori L, Scagnet M. Leat-associated seizures the possible role of EAAT2, pyruvate carboxylase and glutamine synthetase. Epilepsy Res 2024; 199:107258. [PMID: 38086219 DOI: 10.1016/j.eplepsyres.2023.107258] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/27/2023] [Accepted: 11/09/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Drug-resistant epilepsy is a common condition in patients with brain neoplasms. The pathogenesis of tumor-associated seizures is poorly understood. Among the possible pathogenetic mechanisms, the increase in glutamate concentration has been proposed. Glutamate transporters, glutamine synthetase and pyruvate carboxylase are involved in maintaining the physiological concentration of glutamate in the intersynaptic spaces. In our previous research on angiocentric gliomas, we demonstrated that all tumors lacked the expression of the main glutamate transporter EAAT2, while the expression of glutamine synthetase and pyruvate carboxylase was mostly preserved. METHODS In the present study, we evaluated the immunohistochemical expression of EAAT2, glutamine synthetase and pyruvate carboxylase in a heterogeneous series of 25 long-term epilepsy-associated tumors (10 dysembryoplastic neuroepithelial tumors, 7 gangliogliomas, 3 subependymal giant cell astrocytomas, 3 rosette forming glioneuronal tumors, 1 diffuse astrocytoma MYB- or MYBL1-altered and 1 angiocentric glioma). In order to evaluate the incidence of variants in the SLC1A2 gene, encoding EAAT2, in a large number of central nervous system tumors we also queried the PedcBioPortal. RESULTS EAAT2 protein expression was lost in 9 tumors (36 %: 3 dysembryoplastic neuroepithelial tumors, 1 ganglioglioma, 3 subependymal giant cell astrocytomas, 1 diffuse astrocytoma MYB- or MYBL1-altered and 1 angiocentric glioma). Glutamine synthetase protein expression was completely lost in 2 tumors (8 %; 1 ganglioglioma and 1 diffuse astrocytoma MYB- or MYBL1-altered). All tumors of our series but rosette forming glioneuronal tumors (in which neurocytic cells were negative) were diffusely positive for pyruvate carboxylase. Consultation of the PedcBioPortal revealed that of 2307 pediatric brain tumors of different histotype and grade, 20 (< 1%) had variants in the SLC1A2 gene. Among the SLC1A2-mutated tumors, there were no angiocentric gliomas or other LEATs CONCLUSIONS: In conclusion, unlike angiocentric gliomas where the EAAT2 loss is typical and constant, the current study shows the loss of EAAT2 expression only in a fraction of the LEATs. In these cases, we may hypothesize some possible epileptogenic role of the EAAT2 loss. The retained expression of pyruvate carboxylase may contribute to determining a pathological glutamate excess unopposed by glutamine synthetase that resulted expressed to a variable extent in the majority of the tumors. Furthermore, we can assume that the EAAT2 loss in brain tumors in general and in LEATs in particular is more conceivably epigenetic.
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Affiliation(s)
| | | | - Selene Moscardi
- Pathology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Valentina Cetica
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Davide Mei
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Valerio Conti
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Filippo Nozzoli
- Histopathology and Molecular Diagnostics, Careggi University Hospital, Florence, Italy
| | - Camilla Bonaudo
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), Careggi University Hospital, Florence, Italy
| | - Francesca Battista
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), Careggi University Hospital, Florence, Italy
| | - Flavio Giordano
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Regina Mura
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Barbara Spacca
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Federico Mussa
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
| | | | - Renzo Guerrini
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Lorenzo Genitori
- Department of Neurosciences, Psychology, Drug Research, and Child Health (NEUROFARBA), Careggi University Hospital, Florence, Italy
| | - Mirko Scagnet
- Department of Neurosurgery, Meyer Children's Hospital IRCCS, Florence, Italy
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Caporalini C, Scagnet M, Giunti L, Cetica V, Mei D, Conti V, Moscardi S, Macconi L, Giordano F, D'Incerti L, Genitori L, Guerrini R, Buccoliero A. Myxoid glioneuronal tumor: Histopathologic, neuroradiologic, and molecular features in a single center series. Neoplasia 2023; 37:100885. [PMID: 36764090 PMCID: PMC9929589 DOI: 10.1016/j.neo.2023.100885] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/17/2023] [Accepted: 02/01/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Myxoid glioneuronal tumor (MGT) is a benign glioneuronal neoplasm recently introduced in the World Health Organization (WHO) classification of the central nervous system (CNS) tumors. MGTs are typically located in the septum pellucidum, foramen of Monro or periventricular white matter of the lateral ventricle. They were previously diagnosed as dysembryoplastic neuroepithelial tumors (DNT), showing histological features almost indistinguishable from classical cortical DNT. Despite that, MGTs have been associated with a specific dinucleotide substitution at codon 385 in the platelet-derived growth factor receptor alpha (PDGFRA) gene, replacing a lysine residue with either leucine or isoleucine (p. LysK385Leu/Iso). This genetic variation has never been described in any other CNS tumor. MATERIALS AND METHODS Thirty-one consecutive tumors, previously diagnosed as DNTs at the Meyer Children's Hospital IRCCS between January 2010 and June 2021 were collected for a comprehensive study of their clinical, imaging, pathological features, and molecular profile. RESULTS In six out of the thirty-one tumors we had previously diagnosed as DNTs, we identified the recurrent dinucleotide mutation in the PDGFRA. All six tumors were typically located within the periventricular white matter of the lateral ventricle and in the septum pellucidum. We then renamed these lesions as MGT, according to the latest WHO CNS classification. In all patients we observed an indolent clinical course, without recurrence. CONCLUSION MGT represent a rare but distinct group of neoplasm with a typical molecular profiling, a characteristic localization, and a relative indolent clinical course.
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Affiliation(s)
- C. Caporalini
- Pathology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, Florence 50100, Italy,Corresponding author.
| | - M. Scagnet
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - L. Giunti
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children's Hospital IRCCS, Florence, Italy
| | - V. Cetica
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - D. Mei
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - V. Conti
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - S. Moscardi
- Pathology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, Florence 50100, Italy
| | - L. Macconi
- Radiology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - F. Giordano
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - L. D'Incerti
- Radiology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - L. Genitori
- Neurosurgery Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - R. Guerrini
- Neuroscience Department, Meyer Children's Hospital IRCCS, Florence, Italy
| | - A.M. Buccoliero
- Pathology Unit, Meyer Children's Hospital IRCCS, Viale Pieraccini 24, Florence 50100, Italy
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Buccoliero AM, Giunti L, Moscardi S, Castiglione F, Provenzano A, Sardi I, Scagnet M, Genitori L, Caporalini C. Pediatric High Grade Glioma Classification Criteria and Molecular Features of a Case Series. Genes (Basel) 2022; 13:genes13040624. [PMID: 35456430 PMCID: PMC9028123 DOI: 10.3390/genes13040624] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/21/2022] [Accepted: 03/28/2022] [Indexed: 02/04/2023] Open
Abstract
Pediatric high-grade gliomas (pHGGs) encompass a heterogeneous group of tumors. Three main molecular types (H3.3 mutant, IDH mutant, and H3.3/IDH wild-type) and a number of subtypes have been identified. We provide an overview of pHGGs and present a mono-institutional series. We studied eleven non-related pHGG samples through a combined approach of routine diagnostic tools and a gene panel. TP53 and H3F3A were the most mutated genes (six patients each, 54%). The third most mutated gene was EGFR (three patients, 27%), followed by PDGFRA and PTEN (two patients each, 18%). Variants in the EZHIP, MSH2, IDH1, IDH2, TERT, HRAS, NF1, BRAF, ATRX, and PIK3CA genes were relatively infrequent (one patient each, 9%). In one case, gene panel analysis documented the presence of a pathogenic IDH2 variant (c.419G>A, p.Arg140Gln) never described in gliomas. More than one-third of patients carry a variant in a gene associated with tumor-predisposing syndromes. The absence of constitutional DNA did not allow us to identify their constitutional origin.
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Affiliation(s)
- Anna Maria Buccoliero
- Pathology Unit, Meyer Children’s Hospital, 50139 Florence, Italy; (S.M.); (C.C.)
- Correspondence:
| | - Laura Giunti
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children’s Hospital, 50139 Florence, Italy; (L.G.); (I.S.)
| | - Selene Moscardi
- Pathology Unit, Meyer Children’s Hospital, 50139 Florence, Italy; (S.M.); (C.C.)
| | | | - Aldesia Provenzano
- Medical Genetics, Department of Experimental and Clinical Biomedical Sciences Mario Serio, University of Florence, 50139 Florence, Italy;
| | - Iacopo Sardi
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children’s Hospital, 50139 Florence, Italy; (L.G.); (I.S.)
| | - Mirko Scagnet
- Neurosurgery Unit, Meyer Children’s Hospital, 50139 Florence, Italy; (M.S.); (L.G.)
| | - Lorenzo Genitori
- Neurosurgery Unit, Meyer Children’s Hospital, 50139 Florence, Italy; (M.S.); (L.G.)
| | - Chiara Caporalini
- Pathology Unit, Meyer Children’s Hospital, 50139 Florence, Italy; (S.M.); (C.C.)
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Buccoliero AM, Caporalini C, Scagnet M, Mussa F, Giordano F, Sardi I, Migliastro I, Moscardi S, Conti V, Barba C, Antonelli M, Gianno F, Rossi S, Diomedi-Camassei F, Gessi M, Donofrio V, Bertero L, Giangaspero F, Santi M, Aronica E, Genitori L, Guerrini R. Corrigendum to 'Angiocentric glioma-associated seizures: The possible role of EATT2, pyruvate carboxylase and glutamine synthetase [Seizure: European Journal of Epilepsy 86 (2021) 152-154]. Seizure 2021; 91:520. [PMID: 34226122 DOI: 10.1016/j.seizure.2021.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
| | - Chiara Caporalini
- Pathology Unit, Children's Hospital A. Meyer-University of Florence, Italy
| | - Mirko Scagnet
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Italy
| | - Federico Mussa
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Italy
| | - Flavio Giordano
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Italy
| | - Iacopo Sardi
- Neuro-oncology Unit, Children's Hospital A. Meyer-University of Florence, Italy
| | - Irene Migliastro
- Pathology Unit, Children's Hospital A. Meyer-University of Florence, Italy
| | - Selene Moscardi
- Pathology Unit, Children's Hospital A. Meyer-University of Florence, Italy
| | - Valerio Conti
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Italy
| | - Carmen Barba
- Pediatric Neurology, Neuroscience Department, Children's Hospital A. Meyer-University of Florence, Italy
| | - Manila Antonelli
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University, Rome, Italy
| | - Francesca Gianno
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University, Rome, Italy
| | - Sabrina Rossi
- Pathology Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Marco Gessi
- Institute of Pathology, Fondazione Policlinico Universitario 'Agostino Gemelli', Universit`a Cattolica del Sacro Cuore, Rome, Italy
| | | | - Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin, Italy
| | - Felice Giangaspero
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University, Rome, Italy; IRCCS Neuromed, Pozzilli (Is), Italy
| | - Mariarita Santi
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, PA, USA
| | - Eleonora Aronica
- Department of Neuropathology, AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Lorenzo Genitori
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Italy
| | - Renzo Guerrini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Children's Hospital A. Meyer-University of Florence, Italy
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Caporalini C, Scagnet M, Moscardi S, Di Stefano G, Baroni G, Giordano F, Mussa F, Barba C, Sardi I, Genitori L, Buccoliero AM. Dysembryoplastic neuroepithelial tumors: A single-institutional series with special reference to glutamine synthetase expression. Ann Diagn Pathol 2021; 54:151774. [PMID: 34182416 DOI: 10.1016/j.anndiagpath.2021.151774] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 06/04/2021] [Accepted: 06/17/2021] [Indexed: 11/18/2022]
Abstract
Dysembryoplastic neuroepithelial tumors (DNT) is a benign (World Health Organisation, WHO, grade I) glioneuronal tumor and it represent one of the most frequent neoplasm in patient affected by seizures. The epileptic neuronal activity can be determined by abnormal synchronization, excessive glutamate excitation and\or inadequate GABA inhibition. Increasing evidence suggests that the astrocytes might be involved in this process even if neurons play a relevant role. In particular astrocytes promote the clearance of glutamate, a potent excitatory neurotransmitter of the central nervous system. Indeed, elevated concentrations of extracellular glutamate may determine iper-excitability and seizures as well as other neurological disorders. So, astrocytes, converting glutamate into glutamine via the enzyme glutamine synthetase (GS), could play a protective anti-seizures role. In the present study, we analyzed the immunohistochemical expression of GS in 20 DNTs specimens documenting a constant immunoistochemical expression of GS in astrocytes of the lesional tissue and of the cerebral cortex.
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Affiliation(s)
- Chiara Caporalini
- Pathology Unit, Anna Meyer Children's University Hospital, Florence, Italy.
| | - Mirko Scagnet
- Neurosurgery Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - Selene Moscardi
- Pathology Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - Gioia Di Stefano
- Department of Pathology, University of Florence, Florence, Italy
| | - Gianna Baroni
- Department of Pathology, University of Florence, Florence, Italy
| | - Flavio Giordano
- Neurosurgery Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - Federico Mussa
- Neurosurgery Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - Carmen Barba
- Neuroscience Department, Italy, Anna Meyer Children's University Hospital, Florence, Italy
| | - Iacopo Sardi
- Neuro-Oncology Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - Lorenzo Genitori
- Neurosurgery Unit, Anna Meyer Children's University Hospital, Florence, Italy
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Caporalini C, Giordano F, Moscardi S, Di Stefano G, Lenge M, Di Giacomo G, Basile M, Zin A, Mura R, Scagnet M, Alaggio R, Sardi I, Genitori L, Buccoliero AM. Primary Intracerebral Alveolar Soft Part Sarcoma: Report of a Case and Review of the Literature. Int J Surg Pathol 2021; 30:195-199. [PMID: 34142883 DOI: 10.1177/10668969211027293] [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] [Indexed: 11/16/2022]
Abstract
Alveolar soft part sarcomas (ASPSs) are rare malignant tumors representing ∼1% of all soft tissue sarcomas. Most ASPS occurring in the central nervous system are metastases. In contrast, primary intracranial ASPSs are extremely rare and only 8 cases have been previously reported in English literature. Here, we report a case of primary alveolar soft part sarcoma in a 16-year-old female patient with no evidence of primary extracranial tumors. Histologically this case fulfilled the criteria of ASPS, and a molecular confirmation has been archived. To date, only 9 primary intracranial ASPS cases, including ours, have been reported in the literature. This report highlights the clinical and pathological characteristics, differential diagnosis, and molecular analysis of primary ASPS of the central nervous system.
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Affiliation(s)
| | - Flavio Giordano
- 9335Anna Meyer Children's University Hospital, Florence, Italy
| | - Selene Moscardi
- 9335Anna Meyer Children's University Hospital, Florence, Italy
| | | | - Matteo Lenge
- 9335Anna Meyer Children's University Hospital, Florence, Italy
| | | | - Massimo Basile
- 9335Anna Meyer Children's University Hospital, Florence, Italy
| | - Angelica Zin
- Institute of Pediatric Research (IRP), 460888Fondazione Città della Speranza, Padova, Italy
| | - Regina Mura
- 9335Anna Meyer Children's University Hospital, Florence, Italy
| | - Mirko Scagnet
- 9335Anna Meyer Children's University Hospital, Florence, Italy
| | - Rita Alaggio
- 9342Ospedale Pediatrico Bambino Gesù IRCCS, Roma, Italy
| | - Iacopo Sardi
- 9335Anna Meyer Children's University Hospital, Florence, Italy
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Caporalini C, Moscardi S, Tamburini A, Pierossi N, Di Maurizio M, Buccoliero AM. Inflammatory Myofibroblastic Tumor of the Tongue. Report of a Pediatric Case and Review of the Literature. Fetal Pediatr Pathol 2018; 37:117-125. [PMID: 29336647 DOI: 10.1080/15513815.2017.1385667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Inflammatory myofibroblastic tumor (IMT) is an uncommon mesenchymal lesion composed of myofibroblastic and fibroblastic spindle cells, accompanied by inflammatory infiltration. IMT may occur in the tongue. Five cases have been previously reported at this site. CASE REPORT An inflammatory myofibroblastic tumor arose in the tongue of a 10 month old infant, confirmed by anaplastic lymphoma kinase (ALK) immunohistochemical staining and the clinical response to the tyrosine kinase inhibitor. CONCLUSIONS IMT can occur in the tongue. This report highlights the differential diagnosis of IMT. ALK staining is both a helpful diagnostic marker and a predictive marker for targeted therapy in this tumor type.
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Affiliation(s)
- Chiara Caporalini
- a A. Meyer Children's University Hospital, Pathology Unit , Florence , Italy
| | - Selene Moscardi
- a A. Meyer Children's University Hospital, Pathology Unit , Florence , Italy
| | - Angela Tamburini
- b A. Meyer Children's University Hospital, Hematology-Oncology Service , Florence , Italy
| | - Nicola Pierossi
- c A. Meyer Children's University Hospital, Otolaryngology Unit , Florence , Italy
| | - Marco Di Maurizio
- d A. Meyer Children's University Hospital, Pediatric Radiology Unit , Florence , Italy
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Caporalini C, Buccoliero AM, Pansini L, Moscardi S, Novelli L, Baroni G, Bordi L, Ammannati F, Taddei GL. Pituitary adenoma with adipose tissue: A new metaplastic variant. Neuropathology 2017; 37:329-334. [DOI: 10.1111/neup.12361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 11/22/2016] [Accepted: 11/23/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Chiara Caporalini
- Pathology Unit; Anna Meyer Children's University Hospital; Florence Italy
| | | | - Luigi Pansini
- Neurosurgery Unit; Careggi University Hospital; Florence Italy
| | - Selene Moscardi
- Pathology Unit; Anna Meyer Children's University Hospital; Florence Italy
| | - Luca Novelli
- Pathology Unit; Careggi University Hospital; Florence Italy
| | - Gianna Baroni
- Pathology Unit; Careggi University Hospital; Florence Italy
| | - Lorenzo Bordi
- Neurosurgery Unit; Careggi University Hospital; Florence Italy
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