34 results on '"Maccio L."'
Search Results
2. L’analisi delle Best Practice internazionali
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Maccio', L. and Ricciuti, Elisa
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IMPRESE ,ECCELLENZA ,ANALISI ,PROSPETTIVE ,BEST PRACTICE ,ANALISI, BEST PRACTICE, PROSPETTIVE, IMPRESE, ECCELLENZA - Published
- 2009
3. The GHB analogue n-(4-trifluoromethyl)-4-methoxybutanamide prevents the behavioral and neurodegenerative consequences of repeated episodes of alcohol withdrawal, in rats
- Author
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Tacchi, R., Spaccapelo, L., Maccio, L., Ferrari, Anna, Rivasi, F., and Bertolini, A.
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GHB analogue n-(4-trifluoromethyl)-4-methoxybutanamide ,alcohol ,withdrawal - Published
- 2009
4. P.06.17 ANTI-TNF-ALPHA-INDUCED PSORIASIS IN INFLAMMATORY BOWEL DISEASE (IBD) PATIENTS: IS IT A PARADOX OR A SIDE EFFECT TO BE EXPECTED?
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Sartini, A., primary, Di Girolamo, M., additional, Scarcelli, A., additional, Bertani, A., additional, Marzi, L., additional, Maccio, L., additional, Lasagni, C., additional, Merighi, A., additional, and Villa, E., additional
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- 2014
- Full Text
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5. P.10.17 CAN KI-67 CYTOLOGICAL INDEX DISTINGUISH LOW GRADE FROM HIGH GRADE GEP-NETs?
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Carlinfante, G., primary, Camellini, L., additional, Baccarini, P., additional, Fabbri, C., additional, Losi, L., additional, Conigliaro, R., additional, Manta, R., additional, Fornelli, A., additional, Sassatelli, R., additional, Maccio, L., additional, Pagano, N., additional, Federico, D., additional, and Di Tommaso, L., additional
- Published
- 2013
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6. P.14.3 SPYGLASS SINGLE OPERATOR PER-ORAL CHOLANGIOSCOPY IN THE EVALUATION OF INDETERMINATE BILIARY LESIONS – A SINGLE-CENTER, PROSPECTIVE COHORT STUDY
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Manta, R., primary, Cellini, C., additional, Frazzoni, M., additional, Conigliaro, R., additional, Maccio, L., additional, Melotti, G., additional, Dabizzi, E., additional, Bertani, H., additional, Manno, M., additional, Castellani, D., additional, Villanacci, V., additional, and Bassotti, G., additional
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- 2013
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7. The role of fetal autopsy and placental examination in the causes of fetal death: a retrospective study of 132 cases of stillbirths
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Bonetti, L. Reggiani, primary, Ferrari, P., additional, Trani, N., additional, Maccio, L., additional, Laura, Schirosi, additional, Giuliana, Sartori, additional, Facchinetti, F., additional, and Rivasi, F., additional
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- 2010
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8. Congenital tracheal atresia in newborn-case report and review of the literature
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Lupi, M., Luca Reggiani Bonetti, Trani, N., Maccio, L., and Maiorana, A.
9. Public network leadership and the ties that lead
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Alessandro Sancino, Benedetta Trivellato, Daniela Cristofoli, Laura Macciò, Josip Markovic, Cristofoli, D, Trivellato, B, Sancino, A, Maccio', L, and Markovic, J
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LEADERSHIP, NETWORK MANAGEMENT, PUBLIC MANAGEMENT, PUBLIC NETWORKS, PUBLIC SERVICES ,media_common.quotation_subject ,Network management ,Network structure ,Public network ,PUBLIC SERVICES ,Lead (geology) ,Order (exchange) ,0502 economics and business ,050602 political science & public administration ,Public service ,Network performance ,Business and International Management ,Industrial organization ,media_common ,Government ,PUBLIC NETWORKS ,business.industry ,05 social sciences ,Public management ,0506 political science ,Leadership ,business ,050203 business & management ,Autonomy - Abstract
This study explores how certain characteristics of the network structure, such as autonomization and connectivity, differently combine with individual leadership in order to produce high network performance. Data gathered through a survey of 265 networks for homecare assistance shed light on three different paths simultaneously leading to network success. First, the presence of autonomy from government (autonomization) appears to be able to ensure network success, irrespective of the other conditions. Secondly, the presence (or absence) of an individual network leader combines differently with the network’s connectivity. Sparsely connected networks seem to require a network leader, forging agreements and leading partners towards a common objective. On the contrary, in highly connected networks, it is the intensity of network ties that appears to lead the network (the network leader seems to be not important). These networks seem to be leaderless, but not necessarily leadershipless.
- Published
- 2020
10. Microsurgical Testis-sparing Surgery in Small Testicular Masses: Seven Years Retrospective Management and Results.
- Author
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De Stefani S, Isgrò G, Varca V, Pecchi A, Bianchi G, Carmignani G, Derchi LE, Micali S, Maccio L, and Simonato A
- Published
- 2012
11. Neoangiogenesis-related genes are hallmarks of fast-growing hepatocellular carcinomas and worst survival. Results from a prospective study
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Mariagrazia Del Buono, Paola Loria, Teresa Pollicino, Stefano Colopi, Elena Bertolini, Guido Marzocchi, Stefano Ballestri, Cristian Caporali, Calogero Cammà, Barbara Lei, Aimilia Karampatou, Gianluigi Giannelli, Fabiola Milosa, Erica Villa, Giuseppe Cabibbo, Marco Enea, Elena Turola, Rosina Maria Critelli, Umberto Cillo, Giorgio Enrico Gerunda, Patrizia Pontisso, Nicola De Maria, María L. Martínez-Chantar, Paola Todesca, Luisa Losi, Livia Maccio, Filippo Schepis, Villa E., Critelli R., Lei B., Marzocchi G., Camma C., Giannelli G., Pontisso P., Cabibbo G., Enea M., Colopi S., Caporali C., Pollicino T., Milosa F., Karampatou A., Todesca P., Bertolini E., Maccio L., Martinez-Chantar M.L., Turola E., Dal Buono M., De Maria N., Ballestri S., Schepis F., Loria P., Gerunda G.E., Losi L., and Cillo U.
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Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Time Factors ,Carcinoma, Hepatocellular ,Time Factor ,Microarray ,Hepatocellular carcinoma ,molecular carcinogenesis ,Gastroenterology ,liver imaging ,HEPATOCELLULAR CARCINOMA ,LIVER IMAGING ,MOLECULAR CARCINOGENESIS ,MOLECULAR ONCOLOGY ,Aged ,Aged, 80 and over ,Disease Progression ,Female ,Humans ,Liver Neoplasms ,Middle Aged ,Neovascularization, Pathologic ,Prospective Studies ,Survival Rate ,Tumor Burden ,Medicine (all) ,03 medical and health sciences ,molecular oncology ,0302 clinical medicine ,Hepatocellular carcinoma, liver imaging, molecular carcinogenesis, molecular oncology ,Internal medicine ,medicine ,Carcinoma ,Doubling time ,Prospective cohort study ,Survival rate ,business.industry ,Proportional hazards model ,medicine.disease ,Prospective Studie ,030104 developmental biology ,Quartile ,Liver Neoplasm ,030220 oncology & carcinogenesis ,business ,Human - Abstract
Objective The biological heterogeneity of hepatocellular carcinoma (HCC) makes prognosis difficult. We translate the results of a genome-wide high-throughput analysis into a tool that accurately predicts at presentation tumour growth and survival of patients with HCC.Design Ultrasound surveillance identified HCC in 78 (training set) and 54 (validation set) consecutive patients with cirrhosis. Patients underwent two CT scans 6 weeks apart (no treatment in-between) to determine tumour volumes (V-0 and V-1) and calculate HCC doubling time. Baseline-paired HCC and surrounding tissue biopsies for microarray study (Agilent Whole Human Genome Oligo Microarrays) were also obtained. Predictors of survival were assessed by multivariate Cox model.Results Calculated tumour doubling times ranged from 30 to 621 days (mean, 107 +/- 91 days; median, 83 days) and were divided into quartiles: = 111 days (n= 19). Median survival according to doubling time was significantly lower for the first quartile versus the others (11 vs 41 months, 42, and 47 months, respectively) (p< 0.0001). A five-gene transcriptomic hepatic signature including angiopoietin-2 (ANGPT2), delta-like ligand 4 (DLL4), neuropilin (NRP)/tolloid (TLL)-like 2 (NETO2), endothelial cell-specific molecule-1 (ESM1), and nuclear receptor subfamily 4, group A, member 1 (NR4A1) was found to accurately identify rapidly growing HCCs of the first quartile (ROC AUC: 0.961; 95% CI 0.919 to 1.000; p< 0.0001) and to be an independent factor for mortality (HR: 3.987; 95% CI 1.941 to 8.193, p< 0.0001).Conclusions The hepatic five-gene signature was able to predict HCC growth in individual patient and the consequent risk of death. This implies a role of this molecular tool in the future therapeutic management of patients with HCC.
- Published
- 2015
12. Ovarian senescence increases liver fibrosis in humans and zebrafish with steatosis
- Author
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Antonio Craxì, Antonio Grieco, Marisa Di Giovanni, Elena Turola, Luca Valenti, Luca Miele, Anna Ludovica Fracanzani, Calogero Cammà, Franco Cotelli, Fabiola Milosa, Nazarena Raos, Vincenza Calvaruso, Elisabetta Bugianesi, Livia Maccio, Silvia Fargion, Serena Mercorella, Rosina Maria Critelli, Marcello Bianchini, Erica Villa, Salvatore Petta, Ester Vanni, Turola, E., Petta, S., Vanni, E., Milosa, F., Valenti, L., Critelli, R., Miele, L., Maccio, L., Calvaruso, V., Fracanzani, A., Bianchini, M., Raos, N., Bugianesi, E., Mercorella, S., Di Giovanni, M., Craxì, A., Fargion, S., Grieco, A., Cammà, C., Cotelli, F., and Villa, E.
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Liver Cirrhosis ,Male ,Fibrosi ,Biopsy ,Physiology ,lcsh:Medicine ,Medicine (miscellaneous) ,Body Mass Index ,Cohort Studies ,Immunology and Microbiology (miscellaneous) ,Fibrosis ,Non-alcoholic Fatty Liver Disease ,Risk Factors ,Odds Ratio ,Zebrafish ,Cellular Senescence ,medicine.diagnostic_test ,Anthropometry ,Fatty liver ,Middle Aged ,Ovarian senescence ,Menopause ,Liver biopsy ,Models, Animal ,Disease Progression ,Female ,lcsh:RB1-214 ,Research Article ,Senescence ,Adult ,medicine.medical_specialty ,Fibrosis, Menopause, Non-alcoholic fatty liver disease, Ovarian senescence, Zebrafish ,Neuroscience (miscellaneous) ,Non-alcoholic fatty liver disease ,Biochemistry, Genetics and Molecular Biology (all) ,Biology ,Real-Time Polymerase Chain Reaction ,General Biochemistry, Genetics and Molecular Biology ,Internal medicine ,medicine ,lcsh:Pathology ,Animals ,Humans ,Aged ,lcsh:R ,Settore MED/09 - MEDICINA INTERNA ,Ovary ,Odds ratio ,medicine.disease ,Endocrinology ,Steatosis ,Body mass index - Abstract
Contrasting data exist on the effect of gender and menopause on the susceptibility, development and liver damage progression in non-alcoholic fatty liver disease (NAFLD). Our aim was to assess whether menopause is associated with the severity of liver fibrosis in individuals with NAFLD and to explore the issue of ovarian senescence in experimental liver steatosis in zebrafish. In 244 females and age-matched males with biopsy-proven NAFLD, we assessed anthropometric, biochemical and metabolic features, including menopausal status (self-reported); liver biopsy was scored according to ‘The Pathology Committee of the NASH Clinical Research Network’. Young and old male and female zebrafish were fed for 24 weeks with a high-calorie diet. Weekly body mass index (BMI), histopathological examination and quantitative real-time PCR analysis on genes involved in lipid metabolism, inflammation and fibrosis were performed. In the entire cohort, at multivariate logistic regression, male gender [odds ratio (OR): 1.408, 95% confidence interval (95% CI): 0.779-2.542, P=0.25] vs women at reproductive age was not associated with F2-F4 fibrosis, whereas a trend was observed for menopause (OR: 1.752, 95% CI: 0.956-3.208, P=0.06). In women, menopause (OR: 2.717, 95% CI: 1.020-7.237, P=0.04) was independently associated with F2-F4 fibrosis. Similarly, in overfed zebrafish, old female fish with failing ovarian function [as demonstrated by extremely low circulating estradiol levels (1.4±0.1 pg/µl) and prevailing presence of atretic follicles in the ovaries] developed massive steatosis and substantial fibrosis (comparable with that occurring in males), whereas young female fish developed less steatosis and were totally protected from the development of fibrosis. Ovarian senescence significantly increases the risk of fibrosis severity both in humans with NAFLD and in zebrafish with experimental steatosis., Summary: This study provides clinical and experimental evidence for the different roles played by excess calorie intake in the development of NAFLD and fibrosis; these diseases are dependent on age and reproductive status.
- Published
- 2015
13. Ki-67 cytological index can distinguish well-differentiated from poorly differentiated pancreatic neuroendocrine tumors: A comparative cytohistological study of 53 cases
- Author
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Carlo Fabbri, Luca Di Tommaso, Adele Fornelli, Silvia Serra, Lorenzo Camellini, Luisa Losi, Paola Baccarini, Rita Conigliaro, Raffaele Manta, Nico Pagano, Tiziana Cassetti, Debora Berretti, Romano Sassatelli, Giorgio Gardini, Gabriele Carlinfante, Andrea Frasoldati, M. Cavina, Alessandro De Pellegrin, Livia Maccio, Carlinfante G., Baccarini P., Berretti D., Cassetti T., Cavina M., Conigliaro R., De Pellegrin A., Di Tommaso L., Fabbri C., Fornelli A., Frasoldati A., Gardini G., Losi L., Maccio L., Manta R., Pagano N., Sassatelli R., Serra S., and Camellini L.
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Concordance ,Neuroendocrine tumors ,Gastroenterology ,Sensitivity and Specificity ,Pathology and Forensic Medicine ,Cytological grading ,Internal medicine ,Cytology ,Carcinoma ,medicine ,Biomarkers, Tumor ,Mitotic Index ,Humans ,Molecular Biology ,Grading (tumors) ,Pancreatic neuroendocrine tumors ,Aged ,Retrospective Studies ,Aged, 80 and over ,Neoplasm Grading ,Endoscopic ultrasound-guided fine needle aspiration ,biology ,business.industry ,Histocytochemistry ,Cell Differentiation ,Cell Biology ,General Medicine ,Middle Aged ,medicine.disease ,Prognosis ,Confidence interval ,Carcinoma, Neuroendocrine ,Pancreatic Neoplasms ,Neuroendocrine Tumors ,Ki-67 Antigen ,Ki-67 ,biology.protein ,Female ,business - Abstract
The Ki-67 labeling index has been found to bear prognostic significance in gastrointestinal neuroendocrine tumors (NETs), and it was recently incorporated in NET histological grading. Nevertheless, a reliable preoperative determination of NET grading could be useful in clinical practice. The aim of this study is to compare the results of Ki-67 labeling index, as measured on cytological samples and on surgical specimens of patients with pancreatic NETs (P-NETs). We also investigated whether concordance might be improved, using a 5 % (instead of 2 %) cutoff value for defining G2 tumors. We retrospectively identified 48 consecutive patients with 53 P-NETs, from our five institutions, and we measured Ki-67 labeling index on their cytological samples and surgical specimens. The traditional 2 % and the alternative 5 % cutoff values were used to classify G2 tumors. The concordance rate between cytological and histological grading was 46/53 (86.8 %; weighted κ statistic 0.77; 95 % confidence interval (95 % CI) 0.60-0.94). No cases of cytological G1-G2 NETs were upgraded to G3 neuroendocrine carcinoma (NEC) at histological grading. Cytology was found to be highly specific in the diagnosis of both G2 (94.1 %; 95 % CI 80.3-99.3) and G3 tumors (100.0 %; 95 % CI 92.8-100), but the sensitivity was poor for G2 NETs (66.7 %; 95 % CI 38.4-88.2) and high for the prediction of G3 NECs (100 %; 95 % CI 39.8-100.0). When the 5 % cutoff value was adopted, concordance rate was 49/53 (92.4 %; weighted κ 0.82; 95 % CI 0.64-1.00). In conclusion, Ki-67 cytological expression can distinguish well-differentiated (both G1 and G2) from poorly differentiated P-NETs, and it may be useful for their preoperative classification. © 2014 Springer-Verlag.
- Published
- 2014
14. Ewing Sarcoma of the Female Genital Tract: Clinicopathologic Analysis of 21 Cases With an Emphasis on the Differential Diagnosis of Gynecologic Round Cell, Spindle, and Epithelioid Neoplasms.
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Sharma AE, Wepy CB, Chapel DB, Maccio L, Irshaid L, Al-Ibraheemi A, Dickson BC, Nucci MR, Crum CP, Fletcher CDM, and Kolin DL
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- Humans, Female, Adult, Diagnosis, Differential, Adolescent, Young Adult, Middle Aged, Child, Retrospective Studies, Immunohistochemistry, In Situ Hybridization, Fluorescence, Homeobox Protein Nkx-2.2, Transcription Factors genetics, Homeodomain Proteins genetics, Predictive Value of Tests, Gene Rearrangement, 12E7 Antigen metabolism, Epithelioid Cells pathology, Epithelioid Cells chemistry, Nuclear Proteins, Sarcoma, Ewing genetics, Sarcoma, Ewing pathology, Sarcoma, Ewing diagnosis, Sarcoma, Ewing chemistry, Genital Neoplasms, Female pathology, Genital Neoplasms, Female genetics, Genital Neoplasms, Female diagnosis, Biomarkers, Tumor genetics, Biomarkers, Tumor analysis, RNA-Binding Protein EWS genetics
- Abstract
Ewing sarcoma is an uncommon neoplasm considered in the differential diagnosis of tumors with "small round cell" morphology, but its occurrence in the gynecologic tract has only been sporadically documented. Herein, we describe the largest cohort of Ewing sarcoma localized to the female genital tract to date, and emphasize their clinicopathologic resemblance to more common gynecologic neoplasms. Ewing sarcoma (n=21) was retrospectively identified from 5 institutions. The average patient age was 35 (range 6-61) years. Tumor sites included uterus (n=8), cervix (n=4), vulva (n=5), vagina (n=1), broad ligament (n=1), inguinal area (n=1), and pelvis (n=1). Nine of 18 cases in which slides were available for review demonstrated only classic round cell morphology, with the remainder showing a variable combination and prominence of variant ovoid/spindle or epithelioid appearance. Tumors showed diffuse membranous reactivity for CD99 (20/20) and were positive for NKX2.2 (8/8, diffuse) and cyclin D1 (7/7, of which 3/7 were patchy/multifocal and 4/7 were diffuse). They were negative for ER (0/6) and CD10 (0/6). Three cases were initially diagnosed as endometrial stromal sarcomas. EWSR1 rearrangement was confirmed in 20/21 by fluorescence in situ hybridization (n=15) and/or sequencing (n=8). Of the eight tumors that underwent sequencing, 6 harbored FLI1 , 1 ERG, and 1 FEV as the fusion partner. Of 11 patients with available follow-up, 5 died of disease, 1 developed lung metastases and 5 are alive with no evidence of disease. Ewing sarcoma of the gynecologic tract is a rare, aggressive entity that shares some morphologic and immunohistochemical features with other more common gynecologic neoplasms. In addition to the typical round cell appearance, variant spindled/ovoid to epithelioid morphology may also be observed and should prompt consideration of this entity with appropriate immunohistochemical and/or molecular studies., Competing Interests: Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2024
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15. Gastric (gastrointestinal)-type endometrial adenocarcinoma presenting as a solitary endometrial polyp: a case report and literature review on a novel and potentially aggressive endometrial cancer histotype.
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Bragantini E, Angelico G, Disanto MG, Magri E, Maccio L, and Barbareschi M
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- Female, Humans, Middle Aged, Endometrium, Endometrial Neoplasms diagnosis, Stomach Neoplasms diagnosis, Adenocarcinoma diagnosis, Carcinoma
- Abstract
Gastric-type carcinoma of the endometrium is a rare endometrial cancer histotype, recently introduced in the 2020 WHO classification of the female genital tract tumors. Clinico-pathological features, as well as treatment strategies for this rare histotype, are not fully defined. We herein present an unusual case of endometrial carcinoma with mucinous features arising in a 58-year-old menopausal woman. Morphological features of the present case as well as immunohistochemical profile were consistent with gastrointestinal differentiation. Therefore, after clinical and imaging studies ruled out the possibility of a metastatic origin, a final diagnosis of gastric-type carcinoma of the endometrium was rendered., (Copyright © 2023 Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.)
- Published
- 2023
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16. Dedifferentiated leiomyosarcoma of the uterus: a clinicopathologic and immunohistochemical analysis of 23 cases.
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Chapel DB, Maccio L, Bragantini E, Zannoni GF, Quade BJ, Parra-Herran C, and Nucci MR
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- Female, Humans, Prospective Studies, Uterus pathology, Biomarkers, Tumor analysis, Leiomyosarcoma diagnosis, Smooth Muscle Tumor, Leiomyoma, Uterine Neoplasms pathology
- Abstract
Aims: To morphologically and immunophenotypically characterize dedifferentiated uterine leiomyosarcoma (LMS)., Methods and Results: We identified 23 dedifferentiated uterine LMS, defined as a malignant uterine smooth muscle tumour containing discrete differentiated and dedifferentiated components (i.e. with and without morphologic and immunophenotypic evidence of smooth muscle differentiation, respectively). The differentiated component was leiomyosarcoma in most cases (17/23), though some arose from a leiomyoma (n = 4) or smooth muscle tumour of uncertain malignant potential (n = 2). The dedifferentiated tumour component showed noncohesive polygonal cells with moderate to abundant cytoplasm, pleomorphic nuclei with coarse vesicular to smudged chromatin, one or more macronucleoli, frequent multinucleation, and atypical mitoses. Three cases showed heterologous osteosarcomatous or chondrosarcomatous differentiation. Immunohistochemistry revealed alterations characteristic of uterine LMS, including Rb loss (18/19); strong diffuse p16 (17/19); strong diffuse (9/19) or complete absence of (5/19) p53; and ATRX loss (6/16). Compared to a control cohort of uterine LMS without dedifferentiation, dedifferentiated uterine LMS showed significantly shorter disease-specific (median, 54 versus 20 months; 5-year DSS, 46% versus 36%; P = 0.04) and disease-free (median, 31 versus 8 months; 5-year DFS, 42% versus 8%; P = 0.002) survival. Of 19 dedifferentiated uterine LMS with follow-up, 12 had died of disease at median 14 (range, 2-73) months; four were alive with disease at 4, 12, 44, and 50 months; and three were alive with no evidence of disease at 56, 109, and 114 months., Conclusion: Routine prospective recognition of dedifferentiated uterine LMS and distinction from mimics is advocated for accurate prognostication and for further characterisation of these tumours., (© 2023 The Authors. Histopathology published by John Wiley & Sons Ltd.)
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- 2023
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17. Fumarate Hydratase and S-(2-Succinyl)-Cysteine Immunohistochemistry Shows Evidence of Fumarate Hydratase Deficiency in 2% of Uterine Leiomyosarcomas: A Cohort Study of 348 Tumors.
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Chapel DB, Sharma A, Maccio L, Bragantini E, Zannoni GF, Yuan L, Quade BJ, Parra-Herran C, and Nucci MR
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- Female, Humans, Fumarate Hydratase genetics, Cysteine, Cohort Studies, Immunohistochemistry, Leiomyosarcoma, Uterine Neoplasms pathology, Pelvic Neoplasms, Leiomyomatosis genetics, Kidney Neoplasms pathology, Carcinoma, Renal Cell pathology
- Abstract
Approximately 1% to 1.5% of uterine leiomyomas are fumarate hydratase (FH)-deficient (FHd). A subset of these are associated with germline FH mutations. However, the prevalence and clinicopathologic characteristics of FHd uterine leiomyosarcoma (uLMS) remain unknown. Clinicopathologic data were collected for 348 uLMS. Morphologic features associated with FH deficiency (staghorn-type vessels, alveolar-pattern edema, macronucleoli with perinucleolar clearing, eosinophilic cytoplasmic inclusions, and chain-like nuclear arrangement) were documented. All 348 tumors were studied by FH immunohistochemistry. Eighty-nine were also studied by S-(2-succinyl)-cysteine (2SC) immunohistochemistry. Seven (2%) FHd uLMS were identified. Five showed uniformly negative FH and diffusely positive 2SC immunostaining; 1 showed variably negative to weak to strong FH and diffusely positive 2SC immunostaining; and 1 showed retained FH staining alongside positive 2SC confined to a morphologically distinct subclone. Three of 7 patients had extrauterine disease at presentation, and 3 of 6 had persistent disease or died from disease. Macronucleoli with perinucleolar clearing were significantly more common in FHd uLMS (7/7) than in uLMS with retained FH (182/341; P =0.017). Disease-specific survival, disease-free survival, and other morphologic features of FH deficiency did not differ significantly between FHd and FH-retained tumors. Our data emphasize that immunohistochemical FH deficiency does not preclude malignancy in uterine smooth muscle tumors. However, the biological significance and molecular basis of FH deficiency in uLMS, including any relationship to germline FH mutation, remain unknown, and a larger multi-institutional effort is necessary to gather sufficient FHd uLMS for more robustly powered clinicopathologic and for molecular characterization., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 by the International Society of Gynecological Pathologists.)
- Published
- 2023
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18. A novel morphology-based risk stratification model for stage I uterine leiomyosarcoma: an analysis of 203 cases.
- Author
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Chapel DB, Sharma A, Lastra RR, Maccio L, Bragantini E, Zannoni GF, George S, Quade BJ, Parra-Herran C, and Nucci MR
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- Female, Humans, Necrosis pathology, Neoplasm Staging, Prognosis, Risk Assessment, Leiomyosarcoma pathology, Uterine Neoplasms pathology
- Abstract
Uterine leiomyosarcoma is the most common uterine mesenchymal malignancy. The majority present at stage I, and clinical outcomes vary widely. However, no widely accepted risk stratification system for stage I uterine leiomyosarcoma is currently available. We studied 17 routinely evaluated clinicopathologic parameters in 203 stage I uterine leiomyosarcoma from three institutions to generate a novel risk stratification model for these tumors. Mitoses >25 per 2.4 mm
2 (10 high-power fields), atypical mitoses, coagulative necrosis, lymphovascular invasion, and serosal abutment were significantly associated with disease-free and disease-specific survival in univariate and multivariate analyses. These prognostic parameters were each scored as binary ("yes" or "no") variables and fitted to a single optimized algebraic risk model:Risk score = (coagulative necrosis)(1) + (mitoses > 25 per 2.4 mm2 )(2) + (atypical mitoses)(2) + (lymphovascular invasion)(3) + (serosal abutment)(5)By logistic regression, the risk model was significantly associated with 5-year disease-free (AUC = 0.9270) and 5-year disease-specific survival (AUC = 0.8517). Internal and external validation substantiated the model. The continuous score (range, 0-13) was optimally divided into 3 risk groups with distinct 5-year disease-free and disease-specific survival: low risk (0-2 points), intermediate risk (3-5 points), and high risk (6-13 points) groups. Our novel risk model performed significantly better than alternative uterine leiomyosarcoma risk stratification systems in predicting 5-year disease-free and disease-specific survival in stage I tumors. A simplified risk model, omitting terms for serosal abutment and lymphovascular invasion, can be accurately applied to myomectomy or morcellated specimens. We advocate routine application of this novel risk model in stage I uterine leiomyosarcoma to facilitate patient counseling and proper risk stratification for clinical trials., (© 2022. The Author(s), under exclusive licence to United States & Canadian Academy of Pathology.)- Published
- 2022
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19. Neoangiogenesis-related genes are hallmarks of fast-growing hepatocellular carcinomas and worst survival. Results from a prospective study.
- Author
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Villa E, Critelli R, Lei B, Marzocchi G, Cammà C, Giannelli G, Pontisso P, Cabibbo G, Enea M, Colopi S, Caporali C, Pollicino T, Milosa F, Karampatou A, Todesca P, Bertolini E, Maccio L, Martinez-Chantar ML, Turola E, Del Buono M, De Maria N, Ballestri S, Schepis F, Loria P, Enrico Gerunda G, Losi L, and Cillo U
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Hepatocellular mortality, Disease Progression, Female, Humans, Liver Neoplasms mortality, Male, Middle Aged, Neovascularization, Pathologic genetics, Prospective Studies, Survival Rate, Time Factors, Tumor Burden, Carcinoma, Hepatocellular genetics, Carcinoma, Hepatocellular pathology, Liver Neoplasms genetics, Liver Neoplasms pathology
- Abstract
Objective: The biological heterogeneity of hepatocellular carcinoma (HCC) makes prognosis difficult. We translate the results of a genome-wide high-throughput analysis into a tool that accurately predicts at presentation tumour growth and survival of patients with HCC., Design: Ultrasound surveillance identified HCC in 78 (training set) and 54 (validation set) consecutive patients with cirrhosis. Patients underwent two CT scans 6 weeks apart (no treatment in-between) to determine tumour volumes (V0 and V1) and calculate HCC doubling time. Baseline-paired HCC and surrounding tissue biopsies for microarray study (Agilent Whole Human Genome Oligo Microarrays) were also obtained. Predictors of survival were assessed by multivariate Cox model., Results: Calculated tumour doubling times ranged from 30 to 621 days (mean, 107±91 days; median, 83 days) and were divided into quartiles: ≤53 days (n=19), 54-82 days (n=20), 83-110 days (n=20) and ≥111 days (n=19). Median survival according to doubling time was significantly lower for the first quartile versus the others (11 vs 41 months, 42, and 47 months, respectively) (p<0.0001). A five-gene transcriptomic hepatic signature including angiopoietin-2 (ANGPT2), delta-like ligand 4 (DLL4), neuropilin (NRP)/tolloid (TLL)-like 2 (NETO2), endothelial cell-specific molecule-1 (ESM1), and nuclear receptor subfamily 4, group A, member 1 (NR4A1) was found to accurately identify rapidly growing HCCs of the first quartile (ROC AUC: 0.961; 95% CI 0.919 to 1.000; p<0.0001) and to be an independent factor for mortality (HR: 3.987; 95% CI 1.941 to 8.193, p<0.0001)., Conclusions: The hepatic five-gene signature was able to predict HCC growth in individual patient and the consequent risk of death. This implies a role of this molecular tool in the future therapeutic management of patients with HCC., Trial Registration Number: ClinicalTrials.gov Identifier: NCT01657695., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
- Published
- 2016
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20. Clinical significance of pelvic lymph node status in prostate cancer: review of 1690 cases.
- Author
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Maccio L, Barresi V, Domati F, Martorana E, Cesinaro AM, Migaldi M, Iachetta F, Ieni A, and Bonetti LR
- Subjects
- Aged, Aged, 80 and over, Biopsy, Needle, Cohort Studies, Databases, Factual, Disease-Free Survival, Humans, Immunohistochemistry, Kaplan-Meier Estimate, Lymph Node Excision methods, Lymph Nodes surgery, Male, Middle Aged, Neoplasm Invasiveness pathology, Neoplasm Staging, Pelvis, Prognosis, Proportional Hazards Models, Prostate-Specific Antigen blood, Prostatic Neoplasms surgery, ROC Curve, Retrospective Studies, Survival Rate, Lymph Nodes pathology, Prostatectomy methods, Prostatic Neoplasms mortality, Prostatic Neoplasms pathology
- Abstract
To assess whether any relationship exists between the number of histologically examined lymph nodes and the detection of metastases in pelvic lymph node dissection (PLND) specimens taken from patients with radical prostatectomy (RP) for prostatic adenocarcinoma. 1690 cases of RP with PNLD were included in the study; 54 % of the patients were submitted to extended PLND (ePLND). Kaplan-Meier curves confirm the negative prognostic significance of nodal metastases on the overall patients' survival (P < 0.0001). Nodal metastases are significantly associated with older age of patients (P = 0.0466), higher pT status (P < 0.0001), higher Gleason score (P < 0.0001) and positive surgical margin (P < 0.0001). The frequency of nodal metastases is significantly increased in cases submitted to ePLND (P < 0.0001), presumably due to the significantly higher number of lymphnodes retrieved using this procedure (P < 0.0001). In addition, regardless of the extent of PLND procedure, entire histological examination of PLND specimens is significantly associated with a higher frequency of nodal metastases (P < 0.0001). When we considered only pN0 cases, 21 display adverse prognosis and died of disease during the follow-up. The number of pelvic lymphnodes examined is significantly lower in the group of patients who die of the disease compared to that of survivors (P = 0.0448). In addition, Kaplan-Meier analysis shows that patients with 10 or fewer examined lymphnodes have significantly shorter disease-specific survival (P = 0.0151). Our findings confirm the negative prognostic significance of N status in prostate cancer. We suggest the examination of a minimum number of 10 lymphnodes, together with entire PLND processing, for accurate assessment of N status.
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- 2016
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21. Epithelioid hemangioendothelioma of the mandibular gingiva: A rare case of metastasis 4 years after radical excision and literature review.
- Author
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Salgarelli AC, Bellini P, Maccio L, and Setti G
- Abstract
Malignant epithelioid hemangioendothelioma (MEH), or high-risk epithelioid hemangioendothelioma, is a low- to intermediate-grade vascular malignancy. A few cases of MEH have been documented in the head and neck region, including the neck, thyroid gland, larynx and scalp. MEHs are extremely rare in the oral cavity. Only 31 cases of MEH in the oral cavity were described in English literature between 1975 and 2014. Further, only eleven cases were referred to MEH of the maxillary or mandibular gingiva. No gingival MEH metastases have been described in literature. We report a literature review and a case of MEH with a metastatic occurrence 4 years after surgical excision.
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- 2016
- Full Text
- View/download PDF
22. Ovarian senescence increases liver fibrosis in humans and zebrafish with steatosis.
- Author
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Turola E, Petta S, Vanni E, Milosa F, Valenti L, Critelli R, Miele L, Maccio L, Calvaruso V, Fracanzani AL, Bianchini M, Raos N, Bugianesi E, Mercorella S, Di Giovanni M, Craxì A, Fargion S, Grieco A, Cammà C, Cotelli F, and Villa E
- Subjects
- Adult, Aged, Animals, Anthropometry, Biopsy, Body Mass Index, Cohort Studies, Disease Progression, Female, Humans, Male, Middle Aged, Models, Animal, Odds Ratio, Real-Time Polymerase Chain Reaction, Risk Factors, Zebrafish, Cellular Senescence, Liver Cirrhosis pathology, Menopause, Non-alcoholic Fatty Liver Disease pathology, Ovary pathology
- Abstract
Contrasting data exist on the effect of gender and menopause on the susceptibility, development and liver damage progression in non-alcoholic fatty liver disease (NAFLD). Our aim was to assess whether menopause is associated with the severity of liver fibrosis in individuals with NAFLD and to explore the issue of ovarian senescence in experimental liver steatosis in zebrafish. In 244 females and age-matched males with biopsy-proven NAFLD, we assessed anthropometric, biochemical and metabolic features, including menopausal status (self-reported); liver biopsy was scored according to 'The Pathology Committee of the NASH Clinical Research Network'. Young and old male and female zebrafish were fed for 24 weeks with a high-calorie diet. Weekly body mass index (BMI), histopathological examination and quantitative real-time PCR analysis on genes involved in lipid metabolism, inflammation and fibrosis were performed. In the entire cohort, at multivariate logistic regression, male gender [odds ratio (OR): 1.408, 95% confidence interval (95% CI): 0.779-2.542, P=0.25] vs women at reproductive age was not associated with F2-F4 fibrosis, whereas a trend was observed for menopause (OR: 1.752, 95% CI: 0.956-3.208, P=0.06). In women, menopause (OR: 2.717, 95% CI: 1.020-7.237, P=0.04) was independently associated with F2-F4 fibrosis. Similarly, in overfed zebrafish, old female fish with failing ovarian function [as demonstrated by extremely low circulating estradiol levels (1.4±0.1 pg/µl) and prevailing presence of atretic follicles in the ovaries] developed massive steatosis and substantial fibrosis (comparable with that occurring in males), whereas young female fish developed less steatosis and were totally protected from the development of fibrosis. Ovarian senescence significantly increases the risk of fibrosis severity both in humans with NAFLD and in zebrafish with experimental steatosis., (© 2015. Published by The Company of Biologists Ltd.)
- Published
- 2015
- Full Text
- View/download PDF
23. Human cytomegalovirus induced pseudotumor of upper gastrointestinal tract mucosa: effects of long-term chronic disease?
- Author
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Reggiani Bonetti L, Barresi V, Bertani A, Maccio L, and Palmiere C
- Subjects
- Adult, Aged, Antibodies, Viral blood, Chronic Disease, Cytomegalovirus immunology, Cytomegalovirus Infections immunology, Cytomegalovirus Infections virology, Diagnostic Errors, Female, Gastric Mucosa ultrastructure, Gastric Mucosa virology, Gastrointestinal Neoplasms pathology, Humans, Inclusion Bodies, Viral, Male, Middle Aged, Stomach Ulcer virology, Time Factors, Cytomegalovirus physiology, Cytomegalovirus Infections pathology, Gastric Mucosa pathology, Gastrointestinal Neoplasms diagnosis, Stomach Ulcer pathology
- Abstract
Human cytomegalovirus-induced lesions resembling malignancies have been described in the gastrointestinal tract and include ulcerated or exophytic large masses. The aim of this study was to review the cases registered in the databases of two academic hospitals and formulate a hypothesis concerning the pathogenic mechanisms responsible for cytomegalovirus-induced pseudotumor development. All the diagnoses of human cytomegalovirus infections of the upper gastrointestinal tract recorded from 1991 to 2013 were reviewed. Cases of mucosal alterations misdiagnosed endoscopically as malignancies were selected. Large ulcers occurring in the stomach (three cases) and an irregular exophytic mass at the gastro-jejunal anastomosis were misdiagnosed endoscopically as malignancies (4 cases out of 53). Histologically, all lesions reflected hyperplastic mucosal changes with a prevalence of epithelial and stroma infected cells, without signs of cell atypia. The hypothesis presented is that the development of human cytomegalovirus-induced pseudotumors may be the morphological expression of chronic mucosa damage underlying long-term infection., (© 2015 Wiley Periodicals, Inc.)
- Published
- 2015
- Full Text
- View/download PDF
24. Malignant metastasizing solitary fibrous tumors of the liver: a report of three cases.
- Author
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Maccio L, Bonetti LR, Siopis E, and Palmiere C
- Subjects
- Abdominal Neoplasms chemistry, Abdominal Neoplasms therapy, Aged, Aged, 80 and over, Biomarkers, Tumor analysis, Biopsy, Disease Progression, Fatal Outcome, Female, Humans, Immunohistochemistry, Liver Neoplasms chemistry, Liver Neoplasms therapy, Lung Neoplasms chemistry, Lung Neoplasms therapy, Male, Mitosis, Necrosis, Solitary Fibrous Tumors chemistry, Solitary Fibrous Tumors therapy, Time Factors, Tomography, X-Ray Computed, Tumor Burden, Abdominal Neoplasms secondary, Liver Neoplasms pathology, Lung Neoplasms secondary, Solitary Fibrous Tumors secondary
- Abstract
Solitary fibrous tumors are rare neoplasms of mesenchymal origin that have been reported in various other extrathoracic sites, including the liver. We present a case series of three malignant solitary fibrous tumors of the liver, occurring in two women 74 and 80 years old and one 65-year-old man. No clinical features were predictive of malignancy except the large sizes and synchronous presence of lung metastases in two of the three cases. Histological examinations revealed the presence of high pleomorphic cellularity with nuclear atypia, necrosis and high mitotic ratios. All patients died of disease progression.
- Published
- 2015
- Full Text
- View/download PDF
25. Splenic hypereosinophilia in anaphylaxis-related death: different assessments depending on different types of allergens?
- Author
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Reggiani Bonetti L, Maccio L, Trani N, Radheshi E, and Palmiere C
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Animals, Anti-Bacterial Agents adverse effects, Case-Control Studies, Cell Count, Cell Degranulation, Contrast Media adverse effects, Female, Forensic Pathology, Humans, Immunoglobulin E metabolism, Immunohistochemistry, Insect Bites and Stings complications, Male, Mast Cells metabolism, Mast Cells pathology, Middle Aged, Organ Size, Organic Chemicals, Prospective Studies, Spleen metabolism, Staining and Labeling, Tryptases metabolism, Young Adult, Allergens, Anaphylaxis pathology, Eosinophils pathology, Spleen pathology
- Abstract
The aim of this study was to evaluate splenic eosinophil and mast cell accumulation using pagoda red stain in a series of anaphylaxis-related deaths that underwent medico-legal investigations. Our goal was to assess whether fatal reactions to insect stings, intramuscularly administered antibiotics and intravenously injected contrast media are responsible for specific patterns of eosinophil and mast cell accumulation. Two study groups were prospectively formed, an anaphylaxis-related death group and a control group. Autopsy, histology (haematoxylin-eosin stain, pagoda red stain and immunohistochemistry using anti-tryptase antibodies), toxicology and postmortem biochemistry (beta-tryptase, total IgE and specific IgE) were performed in all cases. All tested parameters (spleen weight, beta-tryptase and total IgE levels as well as eosinophil, mast cell and degranulated mast cell numbers in the spleen) were significantly higher in the anaphylaxis-related death group. No statistically significant differences were observed among the various groups (intramuscular antibiotic injection, intravenous contrast medium administration and stinging insects) in any combination, suggesting that mast cell and eosinophil accumulation in the spleen during anaphylaxis does not have any specific pattern related to the triggering allergen. Despite a lower sensitivity than immunohistochemical staining in discriminating eosinophil and mast cells, pagoda red stain allowed these cells to be identified and could therefore be proposed as a low-cost, first-line diagnostic procedure in those situations where immunohistochemistry is not systematically performed or cannot be carried out.
- Published
- 2015
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26. Fatal pneumonia following maternal HSV-1 viraemia in late pregnancy.
- Author
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Berardi A, Gallo C, Lugli L, Guidotti I, Gargano G, Maccio L, Pietrosemoli P, and Ferrari F
- Subjects
- Adult, Fatal Outcome, Female, Humans, Infant, Newborn, Pregnancy, Herpes Simplex diagnosis, Herpesvirus 1, Human isolation & purification, Pneumonia, Viral diagnosis, Pregnancy Complications, Infectious diagnosis, Viremia diagnosis
- Abstract
Neonatal Herpes simplex virus (HSV) pneumonia without apparent accompanying disseminated infection is a rare condition. We describe a case of neonatal pneumonia following maternal HSV type 1 viraemia in late pregnancy. A review of the literature shows that cases of HSV presenting as pneumonia in the first week of life are the most severe form of neonatal HSV.
- Published
- 2015
- Full Text
- View/download PDF
27. Ki-67 cytological index can distinguish well-differentiated from poorly differentiated pancreatic neuroendocrine tumors: a comparative cytohistological study of 53 cases.
- Author
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Carlinfante G, Baccarini P, Berretti D, Cassetti T, Cavina M, Conigliaro R, De Pellegrin A, Di Tommaso L, Fabbri C, Fornelli A, Frasoldati A, Gardini G, Losi L, Maccio L, Manta R, Pagano N, Sassatelli R, Serra S, and Camellini L
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Neuroendocrine pathology, Cell Differentiation, Female, Histocytochemistry, Humans, Male, Middle Aged, Mitotic Index, Neoplasm Grading, Prognosis, Retrospective Studies, Sensitivity and Specificity, Biomarkers, Tumor metabolism, Ki-67 Antigen metabolism, Neuroendocrine Tumors pathology, Pancreatic Neoplasms pathology
- Abstract
The Ki-67 labeling index has been found to bear prognostic significance in gastrointestinal neuroendocrine tumors (NETs), and it was recently incorporated in NET histological grading. Nevertheless, a reliable preoperative determination of NET grading could be useful in clinical practice. The aim of this study is to compare the results of Ki-67 labeling index, as measured on cytological samples and on surgical specimens of patients with pancreatic NETs (P-NETs). We also investigated whether concordance might be improved, using a 5 % (instead of 2 %) cutoff value for defining G2 tumors. We retrospectively identified 48 consecutive patients with 53 P-NETs, from our five institutions, and we measured Ki-67 labeling index on their cytological samples and surgical specimens. The traditional 2 % and the alternative 5 % cutoff values were used to classify G2 tumors. The concordance rate between cytological and histological grading was 46/53 (86.8 %; weighted κ statistic 0.77; 95 % confidence interval (95 % CI) 0.60-0.94). No cases of cytological G1-G2 NETs were upgraded to G3 neuroendocrine carcinoma (NEC) at histological grading. Cytology was found to be highly specific in the diagnosis of both G2 (94.1 %; 95 % CI 80.3-99.3) and G3 tumors (100.0 %; 95 % CI 92.8-100), but the sensitivity was poor for G2 NETs (66.7 %; 95 % CI 38.4-88.2) and high for the prediction of G3 NECs (100 %; 95 % CI 39.8-100.0). When the 5 % cutoff value was adopted, concordance rate was 49/53 (92.4 %; weighted κ 0.82; 95 % CI 0.64-1.00). In conclusion, Ki-67 cytological expression can distinguish well-differentiated (both G1 and G2) from poorly differentiated P-NETs, and it may be useful for their preoperative classification.
- Published
- 2014
- Full Text
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28. NF1 truncating mutations associated to aggressive clinical phenotype with elephantiasis neuromatosa and solid malignancies.
- Author
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Ponti G, Martorana D, Pellacani G, Ruini C, Loschi P, Baccarani A, De Santis G, Pollio A, Neri TM, Mandel VD, Maiorana A, Maccio L, Maccaferri M, and Tomasi A
- Subjects
- Adult, Aged, Cohort Studies, Family, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasms complications, Neoplasms pathology, Neurofibroma, Plexiform complications, Neurofibroma, Plexiform pathology, Neurofibromatosis 1 complications, Neurofibromatosis 1 pathology, Pedigree, Phenotype, Prognosis, Mutation genetics, Neoplasms genetics, Neurofibroma, Plexiform genetics, Neurofibromatosis 1 genetics, Neurofibromin 1 genetics
- Abstract
Background/aim: Von Recklinghausen disease is a syndrome characterized by a wide phenotypic variability giving rise to both, cutaneous and visceral benign and malignant neoplasms. The first include cutaneous neurofibromas, subcutaneous and plexiform neurofibromas. The latter can undergo malignant transformation and/or determine elephantiasis neuromatosa. Visceral tumors may include malignant peripheral nerve sheet tumors, gastrointestinal stromal tumors, cerebral gliomas and abdominal neurofibromas. In the present study, the authors discuss the clinical and biomolecular characterization of a cohort of 20 families with a diagnosis of type 1 neurofibromatosis., Patients and Methods: Clinically, the cohort includes three probands with elephantiasis neuromatosa and a peculiarly high incidence of breast and gastrointestinal cancer., Results: Among the 14 NF1 mutations documented, 10 encoding for a truncated protein have been associated to particularly aggressive clinical phenotypes including elephantiasis neuromatosa, malignant peripheral nerve sheet tumors, breast cancer, gastrointestinal stromal tumors., Conclusion: This effect on protein synthesis, rather than the type of NF1 mutation, is the key to the explanation of the genotype-phenotype correlations in the context of neurofibromatosis type 1., (Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.)
- Published
- 2014
29. Primary cutaneous mantle cell lymphoma of the leg with blastoid morphology and aberrant immunophenotype: a diagnostic challenge.
- Author
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Cesinaro AM, Bettelli S, Maccio L, and Milani M
- Subjects
- Aged, Biomarkers, Tumor analysis, Biopsy, DNA-Binding Proteins analysis, DNA-Binding Proteins biosynthesis, Female, Humans, Immunohistochemistry, Immunophenotyping, Leg pathology, Lymphoma, Mantle-Cell genetics, Lymphoma, Mantle-Cell metabolism, Neprilysin analysis, Neprilysin biosynthesis, Proto-Oncogene Proteins c-bcl-6, Skin Neoplasms genetics, Skin Neoplasms metabolism, Translocation, Genetic, Diagnostic Errors, Lymphoma, Large B-Cell, Diffuse diagnosis, Lymphoma, Mantle-Cell diagnosis, Skin Neoplasms diagnosis
- Abstract
Mantle cell lymphoma rarely affects the skin and is usually a secondary involvement. The present case illustrates a primary cutaneous mantle cell lymphoma of the leg, with blastoid morphology and aberrant expression of CD10 and bcl-6, which was misinterpreted at the beginning as diffuse large B-cell lymphoma. A larger panel of immunohistochemical markers, including cyclin-D1, and molecular investigation showing the typical translocation (t11;14), pointed toward the correct diagnosis. Cutaneous diffuse B-cell lymphomas with unusual morphology should be interpreted cautiously, and the diagnosis made on the basis of an appropriate panel of antibodies and molecular studies.
- Published
- 2014
- Full Text
- View/download PDF
30. Parathyroid gland involvement by thyroid cancer: results from a large series of thyroidectomies performed in two italian university hospitals and review of the literature.
- Author
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Papi G, Corrado S, Fadda G, Maiorana A, Maccio L, Corsello SM, and Pontecorvi A
- Abstract
Objectives.Parathyroid involvement by thyroid cancer (TC) has not been frequently investigated in thyroidectomy-based studies. We aimed to detect cases of parathyroid invasion by TC in a large series of thyroidectomies and to review the literature on this topic. Study Design. A 10-yr period database research was made from the files of the Section of Pathology of two Italian University Hospitals. Out of 22,310 thyroidectomies, 10 patients with parathyroid involvement by TC were found. Results. The 10 patients, 7 females and 3 males, aged 55 ± 14 years (range 34-76, median 56) had papillary thyroid carcinoma and accounted for 0.4% of subjects affected by all TCs and submitted to thyroidectomy. The tumor invaded perithyroid soft tissues in 6 patients and central neck (level VI) lymph nodes in 3. Parathyroid involvement by TC occurred by infiltration in 6 cases, extension through an intervening pseudocapsule in 1, and both patterns in 3. All patients are alive and disease free at 5.6 ± 3-yr follow-up. Conclusion. Limited to thyroidectomy series, our results and literature data suggest that parathyroid involvement by TC has a 0.4-3.9% incidence rate; mainly affects women in their sixth-seventh decade of life; is associated to a good prognosis, unless massive extrathyroid extension of TC occurs.
- Published
- 2014
- Full Text
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31. SpyGlass single-operator peroral cholangioscopy in the evaluation of indeterminate biliary lesions: a single-center, prospective, cohort study.
- Author
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Manta R, Frazzoni M, Conigliaro R, Maccio L, Melotti G, Dabizzi E, Bertani H, Manno M, Castellani D, Villanacci V, and Bassotti G
- Subjects
- Adult, Aged, Aged, 80 and over, Biliary Tract Diseases pathology, Biliary Tract Diseases surgery, Biliary Tract Neoplasms diagnosis, Biliary Tract Neoplasms pathology, Biliary Tract Neoplasms surgery, Biopsy instrumentation, Cholangiocarcinoma diagnosis, Cholangiocarcinoma pathology, Cholangiocarcinoma surgery, Cholangiopancreatography, Endoscopic Retrograde, Cholangitis etiology, Endoscopy, Digestive System adverse effects, Female, Gallbladder Neoplasms diagnosis, Gallbladder Neoplasms pathology, Gallbladder Neoplasms surgery, Humans, Male, Middle Aged, Neoplasm Invasiveness, Pancreatic Neoplasms pathology, Pancreatitis etiology, Predictive Value of Tests, Prospective Studies, Sensitivity and Specificity, Stents, Biliary Tract Diseases diagnosis, Endoscopes, Endoscopy, Digestive System instrumentation
- Abstract
Background: SpyGlass single-operator peroral cholangioscopy appears to be a promising technique to overcome some limitations of conventional peroral cholangioscopy. We aimed to prospectively evaluate the SpyGlass system in a cohort of patients with indeterminate biliary lesions., Methods: Patients with indeterminate strictures or filling defects at endoscopic retrograde cholangiopancreatography (ERCP) were consecutively enrolled. After SpyGlass visual evaluation, targeted biopsies were taken with the SpyBite and histopathological assessment was made by two experienced gastrointestinal pathologists. SpyBite-targeted biopsy results were evaluated by assessing agreement with surgical specimens and by evaluation of final, clinical follow-up-based diagnosis., Results: Fifty-two patients participated in the study. In 7 cases, definite diagnosis (stones, varices) was made by SpyGlass endoscopic evaluation. In 42 of the remaining 45 cases, material suitable for histopathology assessment was provided by the SpyBite. Overall, a definite diagnosis was made in 49 (7 + 42; 94 %) cases. Agreement of SpyBite biopsy results with surgical specimen diagnosis was found in 38/42 (90 %) cases; sensitivity, specificity, and positive and negative predictive values were 88, 94, 96, and 85 %, respectively. Procedure-related complications consisted of one case of mild cholangitis and one case of mild pancreatitis., Conclusions: In our series, the SpyGlass system allowed adequate biopsy sampling and definite diagnosis with high accuracy in the vast majority of patients with indeterminate biliary lesions. Its use was associated with a low complication rate. Further refinements of the technique are warranted, but the SpyGlass system has the potential to become a diagnostic standard for the assessment of indeterminate biliary lesions.
- Published
- 2013
- Full Text
- View/download PDF
32. EGFR polysomy in squamous cell carcinoma of the thyroid. Report of two cases and review of the literature.
- Author
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Bonetti LR, Lupi M, Trani M, Trani N, Sartori G, Schirosi L, Bettelli S, Zanelli G, Maccio L, and Maiorana A
- Subjects
- Aged, Aged, 80 and over, Aneuploidy, Cell Proliferation, Female, Gene Expression Regulation, Neoplastic, Humans, Immunohistochemistry, In Situ Hybridization, Fluorescence, Up-Regulation, Carcinoma, Squamous Cell genetics, Carcinoma, Squamous Cell pathology, ErbB Receptors genetics, Thyroid Neoplasms genetics, Thyroid Neoplasms pathology
- Abstract
Aims and Background: Primary squamous cell carcinoma of the thyroid gland (PSCCT) is an uncommon malignancy characterized by a poor prognosis. A radical surgical approach combined with radiotherapy or chemotherapy is the generally accepted treatment for this tumor. The epidermal growth factor receptor (EGFR) is a transmembrane tyrosine kinase receptor modulating the cell proliferation and biological progression of many human epithelial tumors. The EGFR overexpression in PSCCT suggests an additional therapeutic option for the treatment of this tumor., Methods and Study Design: The clinicopathological features and immunohistochemical profiles of two cases of primary squamous cell carcinoma of the thyroid in a 66-year-old and an 83-year-old woman are presented. EGFR status was valued in both cases., Results: Overexpression of EGFR protein was detected in 50% and 75% of the tumor cell membranes. EGRF gene polysomy was detected in both tumors., Conclusions: Pharmaceuticals targeting EGFR may help to provide the rationale for an additional, novel therapeutic option for this rare tumor, especially when other therapeutic options have been exhausted.
- Published
- 2010
- Full Text
- View/download PDF
33. Mesothelial cell clusters in endometrial biopsy: another possible source of diagnostic pitfall.
- Author
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Rossi G, Nannini N, Maccio L, and Cavazza A
- Subjects
- Adipose Tissue pathology, Aged, Diagnosis, Differential, Epithelium pathology, Female, Humans, Artifacts, Biopsy, Hysteroscopy, Uterine Diseases diagnosis
- Published
- 2010
- Full Text
- View/download PDF
34. Congenital tracheal atresia in newborn: case report and review of the literature.
- Author
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Lupi M, Bonetti LR, Trani N, Maccio L, and Maiorana A
- Subjects
- Abnormalities, Multiple pathology, Humans, Infant, Newborn, Male, Infant, Newborn, Diseases pathology, Trachea abnormalities, Tracheal Diseases congenital
- Abstract
Tracheal atresia is an uncommon congenital malformation with a high mortality rate. Clinical symptoms occur suddenly after birth. The diagnosis is suspected in any infant in whom improved ventilation is obtained despite aggressive attempts at resuscitation. We describe a small gestational week 34 male newborn affected by tracheal atresia without esophageal fistula with associated fetal growth restriction, ascites and polyhydramnios. Post mortem examination revealed a diffuse cyanotic status, abdominal ascites and a low birth weight. A 3 cm tract of trachea was documented that distantly ended in a blind pouch and without tracheoesophageal fistulae and enlarged bulky lungs connected to each other by a common thin-walled bronchus. Histological examination showed a normal conformed larynx and scratchily cartilaginous disks in the proximal tract of the short trachea. Vascular space referred to small arteries and veins, thin bands of fibrous tissue and adipose tissue were detected under the blind pouch. Lung distal airspaces were lined by premature cubic epithelium separated by a broad poorly vascularized interstitium. A striking interstitial and alveolar edema was remarkable.
- Published
- 2009
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