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1. AB1329 COMPARATIVE EFFICACY AND SAFETY OF GLUCOCORTICOIDS, METHOTREXATE AND TOCILIZUMAB IN THE TREATMENT OF NEW-ONSET LARGE VESSEL GIANT CELL ARTERITIS

Author

Davanzo, F., primary, Iorio, L., additional, Delvino, P., additional, Fiorin, E., additional, Codirenzi, M., additional, Sorace, D., additional, Campochiaro, C., additional, Nannipieri, S., additional, Dagna, L., additional, Doria, A., additional, Monti, S., additional, Tomelleri, A., additional, and Padoan, R., additional

Published
2024
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5. Trattato di Diritto dell'Ambiente - Vol. II: I procedimenti Amministrativi per la tutela dell'ambiente - Capitolo 10: L'accertamento del danno ambientale

Author

Crosetti, A, Ferrara, R, Grassi, S, S. a. n. d. u. l. l. i., . M. A., Acquarone, Giovanni, Agnoletto, R, Andronio, A, Borzì, A, C. a. f. a. g. n. o., . M. M., Carapellucci, A, Cecchetti, M, Cimini, S, Crepaldi, G, D. e., Giorgi, G, ., D. e. v. i. l. l. e. r., . M. J., Dipace, R, Foà, S, Fonderico, F, G. a. l. l. o., . C. E., G. e. n. e. s. i. n., . M. P., G. i. r. a. c. c. a., . M. P., Giuffrida, A, Lombardi, P, Lombardi, R, Marchetti, F, Marzuoli, C, Massone, A, Milone, A, Montanaro, R, Mostacci, E, Oddenino, A, O. l. i. v. e. t. t. i., Rason, N, ., Paire, A, Pajno, S, Pineschi, L, Pizzanelli, G, Porchia, O, P. o. r. p. o. r. a. t. o., . A. M., P. o. r. t. a. l. u. r. i., . P. L., Rissolio, A, Sartoretti, C, S. c. h. i. a. v. a. n. o., . M. L., Siclari, D, Sorace, D, S. t. i. c. c. h. i., Damiani, S, ., Videtta, C, and V. i. v. a. n. i., . C.

Subjects
Capitolo 10, Volume II, I procedimenti amministrativi per la tutela dell'ambiente, Trattato di diritto dell'ambiente, Volume II, I procedimenti amministrativi per la tutela dell'ambiente, Capitolo 10, Trattato di diritto dell'ambiente
Published
2014

6. A 150 anni dall’unificazione amministrativa italiana. Vol. II

Author

Portaluri, Pier Luigi, Ferrara, Leonardo, Sorace, Domenico, and DE GIORGI CEZZI, Gabriella

Abstract

In 1865, there was the enactment of the laws of administrative unification for the Kingdom of Italy. On the occasion of the 150th anniversary, the Department of Legal Sciences of the University of Florence organized a study project on the transformations which over the last fifty years have affected the Italian Republic’s administrative apparatus and activities. They analysed in its articulated local government and its EU membership. Over nearly two years, the researches have involved more than one hundred and fifty scholars from Italian universities. The results were presented on 15th and 16th October 2015 in Florence, the Italian capital city a hundred and fifty years before, which in 1965 had hosted the conference celebrating the 100th anniversary of the same administrative unification laws. The conducted studies are now published in definitive form and organized into eight volumes. Table of contents I. The organization of public administrations between national state and European integration, edited by Roberto Cavallo Perin, Aristide Police, Fabio Saitta II. Political and territorial cohesion, edited by Gabriella De Giorgi Cezzi, Pier Luigi Portaluri III. Legalization, edited by Barbara Marchetti, Mauro Renna IV. Technification, edited by Stefano Civitarese Matteucci, Luisa Torchia V. Public intervention in the economy, edited by Maurizio Cafagno, Francesco Manganaro VI. Unification and cultural pluralism, edited by Edoardo Chiti, Gianluca Gardini, Aldo Sandulli VII. Administrative justice as a service (between effectiveness and efficiency), edited by Gian Domenico Comporti VIII. Administrative citizenships, edited by Antonio Bartolini, Alessandra Pioggia

Published
2022
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7. A 150 anni dall’unificazione amministrativa italiana. Vol. IV

Author

Civitarese Matteucci, Stefano, Torchia, Luisa, Ferrara, Leonardo, and Sorace, Domenico

Abstract

In 1865, there was the enactment of the laws of administrative unification for the Kingdom of Italy. On the occasion of the 150th anniversary, the Department of Legal Sciences of the University of Florence organized a study project on the transformations which over the last fifty years have affected the Italian Republic’s administrative apparatus and activities. They analysed in its articulated local government and its EU membership. Over nearly two years, the researches have involved more than one hundred and fifty scholars from Italian universities. The results were presented on 15th and 16th October 2015 in Florence, the Italian capital city a hundred and fifty years before, which in 1965 had hosted the conference celebrating the 100th anniversary of the same administrative unification laws. The conducted studies are now published in definitive form and organized into eight volumes. Table of contents I. The organization of public administrations between national state and European integration, edited by Roberto Cavallo Perin, Aristide Police, Fabio Saitta II. Political and territorial cohesion, edited by Gabriella De Giorgi Cezzi, Pier Luigi Portaluri III. Legalization, edited by Barbara Marchetti, Mauro Renna IV. Technification, edited by Stefano Civitarese Matteucci, Luisa Torchia V. Public intervention in the economy, edited by Maurizio Cafagno, Francesco Manganaro VI. Unification and cultural pluralism, edited by Edoardo Chiti, Gianluca Gardini, Aldo Sandulli VII. Administrative justice as a service (between effectiveness and efficiency), edited by Gian Domenico Comporti VIII. Administrative citizenships, edited by Antonio Bartolini, Alessandra Pioggia

Published
2022
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8. Discipline processuali differenziate nei diritti amministrativi europei

Author

SORACE, DOMENICO

Subjects
Diritto, Diritto amministrativo
Abstract

Discipline processuali differenziate nei diritti amministrativi europei. Anyone in Europe who considers that they have suffered an abuse of power on the part of a public body can apply to a judge for justice. But this role is not restricted to a single judge. Not only is there a plurality of judges corresponding to the plurality of States in which they exercise their functions, but also (in the majority of cases) within each State there is more than one type of judge appointed to impose respect of the law even on public bodies, just as the procedures and manner in which the judicial action may materialise are also different. The protection of the citizens is differentiated, and this can be explained by the varying requirements or the different motivations which cannot always justify the deriving complications. The book explores this phenomenon, considering some of the principal European State systems, as well as the system of the European Union itself.

Published
2022
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9. A 150 anni dall’unificazione amministrativa italiana. Vol. VII

Author

Comporti, Gian Domenico, Ferrara, Leonardo, and Sorace, Domenico

Abstract

In 1865, there was the enactment of the laws of administrative unification for the Kingdom of Italy. On the occasion of the 150th anniversary, the Department of Legal Sciences of the University of Florence organized a study project on the transformations which over the last fifty years have affected the Italian Republic’s administrative apparatus and activities. They analysed in its articulated local government and its EU membership. Over nearly two years, the researches have involved more than one hundred and fifty scholars from Italian universities. The results were presented on 15th and 16th October 2015 in Florence, the Italian capital city a hundred and fifty years before, which in 1965 had hosted the conference celebrating the 100th anniversary of the same administrative unification laws. The conducted studies are now published in definitive form and organized into eight volumes. Table of contents I. The organization of public administrations between national state and European integration, edited by Roberto Cavallo Perin, Aristide Police, Fabio Saitta II. Political and territorial cohesion, edited by Gabriella De Giorgi Cezzi, Pier Luigi Portaluri III. Legalization, edited by Barbara Marchetti, Mauro Renna IV. Technification, edited by Stefano Civitarese Matteucci, Luisa Torchia V. Public intervention in the economy, edited by Maurizio Cafagno, Francesco Manganaro VI. Unification and cultural pluralism, edited by Edoardo Chiti, Gianluca Gardini, Aldo Sandulli VII. Administrative justice as a service (between effectiveness and efficiency), edited by Gian Domenico Comporti VIII. Administrative citizenships, edited by Antonio Bartolini, Alessandra Pioggia

Published
2022
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10. A 150 anni dall’unificazione amministrativa italiana. Vol. VIII

Author

FERRARA, LEONARDO, Sorace, Domenico, BARTOLINI, Antonio, and PIOGGIA, Alessandra

Abstract

In 1865, there was the enactment of the laws of administrative unification for the Kingdom of Italy. On the occasion of the 150th anniversary, the Department of Legal Sciences of the University of Florence organized a study project on the transformations which over the last fifty years have affected the Italian Republic’s administrative apparatus and activities. They analysed in its articulated local government and its EU membership. Over nearly two years, the researches have involved more than one hundred and fifty scholars from Italian universities. The results were presented on 15th and 16th October 2015 in Florence, the Italian capital city a hundred and fifty years before, which in 1965 had hosted the conference celebrating the 100th anniversary of the same administrative unification laws. The conducted studies are now published in definitive form and organized into eight volumes. Table of contents I. The organization of public administrations between national state and European integration, edited by Roberto Cavallo Perin, Aristide Police, Fabio Saitta II. Political and territorial cohesion, edited by Gabriella De Giorgi Cezzi, Pier Luigi Portaluri III. Legalization, edited by Barbara Marchetti, Mauro Renna IV. Technification, edited by Stefano Civitarese Matteucci, Luisa Torchia V. Public intervention in the economy, edited by Maurizio Cafagno, Francesco Manganaro VI. Unification and cultural pluralism, edited by Edoardo Chiti, Gianluca Gardini, Aldo Sandulli VII. Administrative justice as a service (between effectiveness and efficiency), edited by Gian Domenico Comporti VIII. Administrative citizenships, edited by Antonio Bartolini, Alessandra Pioggia

Published
2022
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11. A 150 anni dall’unificazione amministrativa italiana. Vol. V

Author

Cafagno, Maurizio, Manganaro, Francesco, Ferrara, Leonardo, and Sorace, Domenico

Abstract

In 1865, there was the enactment of the laws of administrative unification for the Kingdom of Italy. On the occasion of the 150th anniversary, the Department of Legal Sciences of the University of Florence organized a study project on the transformations which over the last fifty years have affected the Italian Republic’s administrative apparatus and activities. They analysed in its articulated local government and its EU membership. Over nearly two years, the researches have involved more than one hundred and fifty scholars from Italian universities. The results were presented on 15th and 16th October 2015 in Florence, the Italian capital city a hundred and fifty years before, which in 1965 had hosted the conference celebrating the 100th anniversary of the same administrative unification laws. The conducted studies are now published in definitive form and organized into eight volumes. Table of contents I. The organization of public administrations between national state and European integration, edited by Roberto Cavallo Perin, Aristide Police, Fabio Saitta II. Political and territorial cohesion, edited by Gabriella De Giorgi Cezzi, Pier Luigi Portaluri III. Legalization, edited by Barbara Marchetti, Mauro Renna IV. Technification, edited by Stefano Civitarese Matteucci, Luisa Torchia V. Public intervention in the economy, edited by Maurizio Cafagno, Francesco Manganaro VI. Unification and cultural pluralism, edited by Edoardo Chiti, Gianluca Gardini, Aldo Sandulli VII. Administrative justice as a service (between effectiveness and efficiency), edited by Gian Domenico Comporti VIII. Administrative citizenships, edited by Antonio Bartolini, Alessandra Pioggia

Published
2022
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12. A 150 anni dell’unificazione amministrativa italiana. Vol. I

Author

Ferrara, Leonardo, Sorace, Domenico, CAVALLO PERIN, Roberto, POLICE, ARISTIDE, and SAITTA, Fabio

Abstract

In 1865, there was the enactment of the laws of administrative unification for the Kingdom of Italy. On the occasion of the 150th anniversary, the Department of Legal Sciences of the University of Florence organized a study project on the transformations which over the last fifty years have affected the Italian Republic’s administrative apparatus and activities. They analysed in its articulated local government and its EU membership. Over nearly two years, the researches have involved more than one hundred and fifty scholars from Italian universities. The results were presented on 15th and 16th October 2015 in Florence, the Italian capital city a hundred and fifty years before, which in 1965 had hosted the conference celebrating the 100th anniversary of the same administrative unification laws. The conducted studies are now published in definitive form and organized into eight volumes. Table of contents I. The organization of public administrations between national state and European integration, edited by Roberto Cavallo Perin, Aristide Police, Fabio Saitta II. Political and territorial cohesion, edited by Gabriella De Giorgi Cezzi, Pier Luigi Portaluri III. Legalization, edited by Barbara Marchetti, Mauro Renna IV. Technification, edited by Stefano Civitarese Matteucci, Luisa Torchia V. Public intervention in the economy, edited by Maurizio Cafagno, Francesco Manganaro VI. Unification and cultural pluralism, edited by Edoardo Chiti, Gianluca Gardini, Aldo Sandulli VII. Administrative justice as a service (between effectiveness and efficiency), edited by Gian Domenico Comporti VIII. Administrative citizenships, edited by Antonio Bartolini, Alessandra Pioggia

Published
2022
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13. A 150 anni dall’unificazione amministrativa italiana. Vol. VI

Author

Chiti, Edoardo, Gardini, Gianluca, Sandulli, Aldo, Ferrara, Leonardo, and Sorace, Domenico

Abstract

In 1865, there was the enactment of the laws of administrative unification for the Kingdom of Italy. On the occasion of the 150th anniversary, the Department of Legal Sciences of the University of Florence organized a study project on the transformations which over the last fifty years have affected the Italian Republic’s administrative apparatus and activities. They analysed in its articulated local government and its EU membership. Over nearly two years, the researches have involved more than one hundred and fifty scholars from Italian universities. The results were presented on 15th and 16th October 2015 in Florence, the Italian capital city a hundred and fifty years before, which in 1965 had hosted the conference celebrating the 100th anniversary of the same administrative unification laws. The conducted studies are now published in definitive form and organized into eight volumes. Table of contents I. The organization of public administrations between national state and European integration, edited by Roberto Cavallo Perin, Aristide Police, Fabio Saitta II. Political and territorial cohesion, edited by Gabriella De Giorgi Cezzi, Pier Luigi Portaluri III. Legalization, edited by Barbara Marchetti, Mauro Renna IV. Technification, edited by Stefano Civitarese Matteucci, Luisa Torchia V. Public intervention in the economy, edited by Maurizio Cafagno, Francesco Manganaro VI. Unification and cultural pluralism, edited by Edoardo Chiti, Gianluca Gardini, Aldo Sandulli VII. Administrative justice as a service (between effectiveness and efficiency), edited by Gian Domenico Comporti VIII. Administrative citizenships, edited by Antonio Bartolini, Alessandra Pioggia

Published
2022
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14. A 150 anni dall’unificazione amministrativa italiana. Vol. III

Author

Marchetti, Barbara, Renna, Mauro, Ferrara, Leonardo, and Sorace, Domenico

Abstract

In 1865, there was the enactment of the laws of administrative unification for the Kingdom of Italy. On the occasion of the 150th anniversary, the Department of Legal Sciences of the University of Florence organized a study project on the transformations which over the last fifty years have affected the Italian Republic’s administrative apparatus and activities. They analysed in its articulated local government and its EU membership. Over nearly two years, the researches have involved more than one hundred and fifty scholars from Italian universities. The results were presented on 15th and 16th October 2015 in Florence, the Italian capital city a hundred and fifty years before, which in 1965 had hosted the conference celebrating the 100th anniversary of the same administrative unification laws. The conducted studies are now published in definitive form and organized into eight volumes. Table of contents I. The organization of public administrations between national state and European integration, edited by Roberto Cavallo Perin, Aristide Police, Fabio Saitta II. Political and territorial cohesion, edited by Gabriella De Giorgi Cezzi, Pier Luigi Portaluri III. Legalization, edited by Barbara Marchetti, Mauro Renna IV. Technification, edited by Stefano Civitarese Matteucci, Luisa Torchia V. Public intervention in the economy, edited by Maurizio Cafagno, Francesco Manganaro VI. Unification and cultural pluralism, edited by Edoardo Chiti, Gianluca Gardini, Aldo Sandulli VII. Administrative justice as a service (between effectiveness and efficiency), edited by Gian Domenico Comporti VIII. Administrative citizenships, edited by Antonio Bartolini, Alessandra Pioggia

Published
2022
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20. Legalità, interpretazione adeguatrice e risultato amministrativo nell'attività di regolazione dell'Autorità per la vigilanza sui lavori pubblici

Author

Celone, C., Immordino, M, Police, A, Romano Tassone, A, Merusi, F, Perongini, S, Picozza, E, D'Orsogna, M, Cerulli Irelli, V, Bartolini, A, Zito, A, Corso, G, Sorace, D, La Barbera, R, Marino, IM, De Leonardis, F, Bassi, ML, Caputi Jambrenghi, V, Figorilli, F, Sandulli, MA, Cognetti, S, Ferrara, R, Contieri, A, D'Orsogna, D, Follieri, E, Cammelli, M, Giani, L, Celone, C, Ragusa, M, Spasiano, MR, Olmedo Gaya, A, Paolantonio, N, Marzuoli, C, Modica, C, Raimondi, S, Pensabene Lionti, S, Iannotta, L, and CELONE C

Subjects
Legalità, interpretazione, risultato, regolazione, autorità, vigilanza, lavori pubblici, Settore IUS/10 - Diritto Amministrativo
Abstract

Il lavoro si concentra sul percorso ermeneutico seguito dall’Autorità per la vigilanza sui lavori pubblici per potere esercitare competenze di natura regolatoria, al fine di dimostrare come una interpretazione dei documenti normativi, da parte dei soggetti pubblici, adeguata alle finalità della legge, sia, non solo utile, ma talvolta indispensabile, proprio per consentire alla stessa amministrazione di perseguire nel modo più efficace ed efficiente gli obiettivi che la medesima legge ha affidato alle sue cure.

Published
2004

21. Institutionalizing Sex Education in Diverse U.S. School Districts.

Author

Saul Butler R, Sorace D, and Hentz Beach K

Subjects
Adolescent, Child, Health Services Accessibility organization & administration, Humans, Program Evaluation, Qualitative Research, Sex Education standards, United States, Schools statistics & numerical data, Sex Education organization & administration
Abstract

Purpose: This paper describes the Working to Institutionalize Sex Education (WISE) Initiative, a privately funded effort to support ready public school districts to advance and sustain comprehensive sexuality programs, and examines the degree to which WISE has been successful in increasing access to sex education, removing barriers, and highlighting best practices., Methods: The data for this study come from a set of performance indicators, guidance documents, and tools designed for the WISE Initiative to capture changes in sex education institutionalization at WISE school districts. The evaluation includes the analysis of 186 school districts across 12 states in the U.S., Results: As a result of the WISE Initiative, 788,865 unique students received new or enhanced sex education in school classrooms and 88 school districts reached their sex education institutionalization goals. In addition to these school district successes, WISE codified the WISE Method and toolkit-a practical guide to help schools implement sex education., Conclusions: Barriers to implementing sexuality education can be overcome with administrative support and focused technical assistance and training, resulting in significant student reach in diverse school districts nationwide., (Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Published
2018
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22. Microglandular carcinoma of the pancreas: immunohistochemical and ultrastructural study of an unusual variant of pancreatic carcinoma that may closely resemble a neuroendocrine neoplasm.

Author

Berho M, Blaustein A, Willis I, Sorace D, and Suster S

Subjects
Adenocarcinoma secondary, Aged, Diagnosis, Differential, Follow-Up Studies, Humans, Immunohistochemistry, Liver Neoplasms secondary, Male, Middle Aged, Neuroendocrine Tumors pathology, Pancreatic Neoplasms pathology, Adenocarcinoma chemistry, Adenocarcinoma ultrastructure, Neuroendocrine Tumors chemistry, Neuroendocrine Tumors ultrastructure, Pancreatic Neoplasms chemistry, Pancreatic Neoplasms ultrastructure
Abstract

Two cases are described of an unusual form of primary adenocarcinoma of the pancreas characterized histologically by their striking resemblance with a neuroendocrine neoplasm. The tumors were composed of a population of relatively small, uniform cells arranged in sheets admixed with small microglandular structures resulting in a cribriform pattern of growth. The tumor cells displayed scant cytoplasm with indistinct cell borders and round to oval nuclei with irregular clumping of chromatin and small, inconspicuous nucleoli. Immunohistochemical studies in both cases showed positivity of the neoplastic cells with CAM 5.2 antibodies and negative staining with a battery of neuroendocrine-related markers including chromogranin, NSE and synaptophysin, as well as with a variety of peptide hormones including insulin, glucagon, vasoactive intestinal polypeptide, gastrin and serotonin. Ultrastructural examination revealed a cohesive population of cells forming abortive glandular lumens lined by imperfectly formed microvilli and showing well-developed junctional complexes. No dense core neurosecretory granules or zymogen granules could be identified in any of the cells, supporting a ductal type of differentiation for these tumors. The main importance of recognizing this rare variant of pancreatic adenocarcinoma lies in avoiding misdiagnosis with other primary and metastatic neuroendocrine neoplasms of this organ. Immunohistochemical and ultrastructural examination will be of value in such cases for differential diagnosis.

Published
1996
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23. Morphometric estimation of superoxide generation in allergen-induced airway hyperresponsiveness.

Author

Liberman H, Mariassy AT, Sorace D, Suster S, and Abraham WM

Subjects
3,3'-Diaminobenzidine, Animals, Bronchial Hyperreactivity immunology, Bronchial Hyperreactivity pathology, Female, Inflammation immunology, Respiratory Hypersensitivity pathology, Sheep, Bronchial Hyperreactivity metabolism, Respiratory Hypersensitivity metabolism, Superoxides metabolism
Abstract

Background: We previously reported that the airway hyperresponsiveness (AHR) that follows antigen challenge is mediated, in part, by the generation of reactive oxygen species. The purpose of this study was to provide quantitative morphologic evidence of oxygen radical production in the airways during antigen-induced AHR., Experimental Design: Allergic sheep with a history of early and late bronchial responses to inhaled Ascaris suum antigen were used. The sheep were either challenged with antigen (N = 5) or saline (N = 5) and then euthanized 24 hours later when AHR had been documented to occur. Complete transverse sections of the right cranial lobar bronchus were obtained from the animals and were washed three times in Tris buffer and then incubated for 20 minutes in an oxygenated solution of diaminobenzidine which, in the presence of superoxide and manganese, forms an insoluble amber reaction product. Superoxide dismutase (SOD, 2250 units/ml) and phorbol ester (phorbol myristate acetate, 0.5 microgram/ml) were added to some tissues and used as negative and positive controls, respectively. The bronchial samples were then fixed and embedded in paraffin for light microscopy. The diaminobenzidine reaction product was quantified by determining the volume fraction of reaction product by point counting with a differential interference contrast microscope without counterstain., Results: Diaminobenzidine reaction product increased 5-fold (p < 0.05) in challenged animals, and this response was blocked by SOD. The reaction product was localized in and around the airway epithelium. Antigen challenge also resulted in a 2.4- and 2.0-fold increase in eosinophils and metachromatic cells in the airway wall. There were no differences in the number of neutrophils between groups. Pretreatment of animals (N = 2) with the combination of the 5-lipoxygenase inhibitor (zileuton, 10 mg/kg, po) and the platelet-activating factor antagonist (WEB-2086, 3 mg/kg, i.v.) agents, which have been shown to block AHR and antigen-induced inflammation in the sheep model, also blocked the antigen-induced superoxide formation., Conclusions: These data suggest that superoxide and increased numbers of mediator-containing inflammatory cells are present in sheep airways 24 hours after antigen challenge. The interaction of this reactive oxygen species with these cells could contribute to the AHR seen at this time.

Published
1995

24. Gastrointestinal stromal tumors with prominent myxoid matrix. Clinicopathologic, immunohistochemical, and ultrastructural study of nine cases of a distinctive morphologic variant of myogenic stromal tumor.

Author

Suster S, Sorace D, and Moran CA

Subjects
Actins metabolism, Adult, Aged, Aged, 80 and over, Female, Gastrointestinal Neoplasms metabolism, Gastrointestinal Neoplasms ultrastructure, Humans, Immunoenzyme Techniques, Intermediate Filament Proteins metabolism, Male, Gastrointestinal Neoplasms pathology
Abstract

Nine cases are presented of a distinctive morphologic variant of myogenic gastrointestinal stromal tumor characterized by an unusually prominent myxoid stromal background reminiscent of a neural neoplasm but lacking the immunohistochemical or ultrastructural features of peripheral nerve sheath or ganglionic differentiation. The patients included six women and three men aged 42 to 86 years (mean, 70). The lesions occurred in the stomach (seven cases) and small intestine (two cases) and ranged in size from 2.5 to 9.5 cm. They were described grossly as well circumscribed, unencapsulated, with a prominently myxoid and often cystic cut surface. Histologically, the lesions were composed of a proliferation of round, spindle, or stellate cells embedded in an abundant myxoid stroma. Histochemical stains showed strong positive reaction of the myxoid stromal background with alcian blue at pH 2.5; this staining reaction was abolished by treatment with hyaluronidase, indicating an abundance of connective tissue mucosubstances rich in hyaluronic acid. Immunohistochemical stains showed strong positivity of the tumor cells with vimentin antibodies in all cases and focal weak to moderate positive staining with muscle actin (HHF35) in eight cases and with desmin in two. Stains for keratin, S-100; epithelial membrane antigen, and collagen type IV were uniformly negative. Ultrastructural examination carried out in all cases showed features consistent with those previously described for myogenic gastrointestinal stromal tumors, namely, scattered mitochondria and prominent Golgi apparati, strands of rough endoplasmic reticulum, focal accumulation of intracytoplasmic microfilaments with occasional focal condensations, subplasmalemmal attachment plaques and immature cell junctions, focal extracellular basal lamina material, and surface-oriented micropinocytotic activity. The myxoid changes observed in these tumors may represent a secondary, nonspecific reaction pattern of the tumor cells to some noxious stimulus, or they may be a form of degenerative phenomenon such as that commonly observed in smooth-muscle tumors of the uterus and other sites. Myogenic gastrointestinal stromal tumors with prominent myxoid stroma should be distinguished from benign schwannoma of the stomach and gastrointestinal autonomic nerve tumors. Because of the differences in prognosis for these entities, immunohistochemical and ultrastructural examinations are recommended for the evaluation of gastrointestinal stromal neoplasms with prominent myxoid features.

Published
1995

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