Section of Pathological Anatomy

Siena, Italy

Section of Pathological Anatomy

Siena, Italy
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Primary lymphoma of the breast is extremely rare accounting for 0.04-0.5% of all breast malignancies. Up to 50% (56-84%) are diffuse large B-cell lymphomas, and indolent histological types such as extranodal marginal zone lymphomas of mucosa-associated lymphoid tissue (MALT lymphoma) occur rarely with a reported incidence variable between 0 and 64%, corresponding to less than 0.5% of overall malignant neoplasms of the breast. A 38-year-old Caucasian woman was admitted to the surgery unit nine months after the excision of a pre-existing inflammatory pseudotumor of the breast because mammography investigation revealed asymmetrical, ill-defined parenchymal accumulation located in the right axillary prolongation. The final diagnosis was obtained after surgical excision and pathological evaluation of the mass. Histological features and the immunohistochemical profile, characterized by positive expression of the lymphoid tumor cells for CD20, BCL-2, and CD5 together with lambda light chain monoclonality and negativity for Cyclin D1, supported the diagnosis of a CD5 positive extranodal marginal zone lymphoma of MALT. © Mattioli 1885.

Catanzariti F.,Amurri Hospital | Servi L.,Macerata Hospital | Fabiani A.,Macerata Hospital | Filosa A.,Section of Pathological Anatomy | Mammana G.,Macerata Hospital
Archivio Italiano di Urologia e Andrologia | Year: 2016

Introduction: Testicular cancer is one of the most frequent in young men and its incidence is increasing in recent years because of incidental finding during routine ultrasound exams. Adenomatous hyperplasia of the rete testis is one of the benign and rare pathological types incidentally detected and very few cases are described in the literature. Case report: A 40 years old man come to our attention for a balanoposthitis without testicular pain. During andrological examination we performed palpation of the testes and we noticed a palpable nodule of hard consistency in the left testicle. We then performed an ultrasound exam of the testis which highlighted the presence of an intra-didymus neoformation with diameters of 1.2 x 1.6 cm and with the presence of cysts inside. We also performed blood tests to check tumor markers alpha fetoprotein, beta hCG and LDH which resulted inside the normal range. We then conducted a chest and abdomen CT scan that showed no pathological elements. Therefore, as we suspected that this tumor was benign, we performed an enucleation of the neoplasm. The definitive histological examination revealed the presence of dilated ducts lined with epithelial cubic-columnar cells with clear cytoplasm rich in glycogen and the pathologist so concluded that the tumor could be classified as adenomatous hyperplasia of the rete testis. At three months of follow up, the patient doesn't have any recurrent lesion to either testicles. Discussion: Adenomatous hyperplasia of the rete testis is a very rare intrascrotal lesion. This histological type is the most frequent between benign lesion of the ovary, but few works in literature reported this histological type in the male gonad and, in most of these works, authors described these lesion at epididymis. Conclusion: We believe that a conservative approach must be considered mandatory in case of testicular lesions 1.5 cm in diameter. A radical approach might have alterate fertility of the patient and also have caused psychological trauma more than an enucleation. However a longer follow up is needed to understand if this was the right decision for the oncological point of view. © 2016, Edizioni Scripta Manent s.n.c. All rights reserved.

PubMed | Section of Pathological Anatomy, University of Foggia, Section of Pathological Anatomy Ospedale di Ascoli, University of Naples Federico II and 3 more.
Type: Journal Article | Journal: Infectious agents and cancer | Year: 2014

The exact worldwide incidence of Burkitts lymphoma is not known. There are three distinct clinical variants of Burkitts lymphoma, each manifesting differences in epidemiology, clinical presentation, morphology, biology and genetic features: the endemic (African), the sporadic (non-endemic), and the immunodeficiency-associated form. In particular, we reported data regarding Burkitts lymphoma incidence in the world and across different European countries. Finally, we described clinic-pathological data of 48 Burkitts lymphomas occurred in Italy from 2003 to 2013, in 4 different hospitals, two of which located in east side, and the other ones located in the west-coast. Forty Burkitts lymphomas occurs in children (age range 3-12), and 8 were adulthood Burkitts lymphomas (age range 18-87). In the pediatric group the Male:Female ratio (M:F) was of 4:1, whereas the group of the adult patients has a M:F of 1:1.67. Immunohistochemical detection of Latent Membrane Protein 1 (LMP1) expression and Epstein-Barr virus Encoded RNA (EBER) In Situ Hybridization (ISH) procedures have been performed. Lymphocyte B monoclonal spread has been demonstrated using a Polymerase Chain Reaction (PCR) based method to amplify Fragment Restriction FR1, FR2 and FR3 immunoglobulin heavy chains DNA fragments. Only 38 cases out of 48 were analyzed for LMP-1 showing various percentage of stained cells in 47.4% of the patients. Considering ISH for EBER detection results: 1 out 2 (50%) adult analyzed cases was positive, with 50% of stained tumor cells (this patient was a 22years old female, coming from Napoli);15 out 24 (62.5%) children analyzed Burkitts lymphomas resulted as positive for EBER;the overall positivity has been observed in 16/26 Burkitts lymphomas (61.53%).Finally, EBV has been detected in children and adult patients, one of them with deregulation of the oncogene c-MYC by chromosomal translocation.

Santoni M.,Marche Polytechnic University | Santini D.,Biomedical University of Rome | Massari F.,University of Verona | Conti A.,Marche Polytechnic University | And 6 more authors.
Cancer and Metastasis Reviews | Year: 2014

Metastatic disease occurs in a significant percentage of patients with renal cell carcinoma (RCC) and is usually associated with an overall poor prognosis. However, not all of the sites of metastases seem to have the same prognostic significance in patients receiving targeted agents. Indeed, patients with lung-only metastases seem to present a better survival than patients with other sites, whereas liver and bone metastases are associated with a worst prognosis. Some clinical studies suggest that metastatic sites are more responsive than primary tumors. This event may be due to intratumor heterogeneity in terms of somatic mutations, chromosome aberrations, and tumor gene expression, primarily centered around Von Hippel-Lindau (VHL) pathway, such as VHL mutations, HIF levels, vascular endothelial growth factor (VEGF) isoforms, and VEGF receptor levels. Nevertheless, these data do not completely explain the discordant biological behavior between primary tumor and metastatic sites. Understanding the causes of this discordance will have profound consequences on translational research and clinical trials in RCC. In this review, we overview current data on the differences between primary RCC and metastases in terms of drug target expression and clinical/radiological response to targeted agents, thus describing the prognostic role of different metastatic sites in RCC patients. © 2013 Springer Science+Business Media New York.

Morgado J.M.,Institute Estudios Of Mastocitosis Of Castilla La Mancha | Perbellini O.,Section of Haematology | Johnson R.C.,Stanford University | Teodosio C.,Red Espanola de Mastocitosis | And 20 more authors.
Histopathology | Year: 2013

Aims: CD30 expression by bone marrow (BM) mast cells (MC) has been reported recently in systemic mastocytosis (SM) patients. The aim of this study was to investigate the potential diagnostic and prognostic value of CD30 expression in SM as assessed by multiparameter flow cytometry. Methods and results: A total of 163 consecutive BM samples corresponding to 142 SM patients and 21 non-mastocytosis cases were studied. CD30 was positive in most SM patients (80%), but in only one non-mastocytosis case (4.8%). When combined with CD25, CD30 contributed to an improved accuracy over that of CD25 alone (98% versus 93%) mainly because most (eight of nine) of the well-differentiated SM (WDSM), who lacked CD25, were CD30+. Similar levels of expression of CD30 were observed among all different subgroups of SM except mast cell leukaemia; among indolent SM (ISM) patients, no significant association was observed between the levels of CD30 expression and other clinical and biological features of the disease. Conclusions: The increased expression of CD30 associated with absence of CD25 contributes to the diagnosis of WDSM and its distinction from other subtypes of SM. By contrast, CD30 expression did not contribute either to prognostic stratification of ISM or to the differential diagnosis between ISM and aggressive SM cases. © 2013 John Wiley & Sons Ltd.

Giuffre G.,Section of Pathological Anatomy | Ieni A.,Section of Pathological Anatomy | Barresi V.,Section of Pathological Anatomy | Caruso R.A.,Section of Pathological Anatomy | Tuccari G.,Section of Pathological Anatomy
Journal of Clinical Pathology | Year: 2012

Aim: To investigate HER2 status in a cohort of 109 gastric adenocarcinomas also including unusual variants, such as 14 hepatoid (HAS) and 9 mitochondrion-rich (MRC), characterised by an opposing clinical behaviour. Methods and Results: Using HercepTest (DAKO) and FISH test (pharmDx DAKO), HER2 overexpression/ amplification was encountered in 23 of 109 (21.10%) of all gastric adenocarcinomas. A progressive increase in HER2 overexpression was observed moving from the poorly cohesive histotype to MRC, tubular adenocarcinomas and HAS. A statistically significant difference was found between poorly cohesive carcinomas and the others; a similar significant difference was encountered between HAS and all other variants of adenocarcinoma. HER2 overexpression was significantly associated with high grade, advanced stage, high Ki-67 labelling index value and death from gastric cancer. Multivariate analysis identified HER2 overexpression as an independent unfavourable prognostic variable for adenocarcinomas as a whole and also for the HAS variant. Conclusions: Trastuzumab has been confirmed as an additional useful therapeutic standard option for patients with HER2-positive advanced gastric cancers, and also in aggressive variants of adenocarcinomas such as HAS.

Roviello G.,University of Siena | Petrioli R.,University of Siena | Cerase A.,Unit NINT Neuroimaging and Neurointervention | Marsili S.,University of Siena | And 3 more authors.
Case Reports in Oncology | Year: 2013

Glioblastoma multiforme (GBM) is the most lethal subtype of glioma, classified as a WHO grade 4 infiltrative glioma. The etiology of GBM remains unknown and risk factors can be identified only in a small minority. We report the synchronous occurrence of GBM in an otherwise unrelated married couple, i.e. a husband and his wife, who developed GBM within an interval of 1 month. No specific causative environmental factors were identified for both patients, and the genetic screens were negative for hereditary syndromes. Family history was negative for tumors, and no other incidence of cancer in either siblings, parents or other children was reported. An analysis of the couple's exposure to nonionizing electromagnetic fields and ionizing radiations revealed values within the normal ranges usually found in homes. Overall, conjugal tumors are rarely reported. However, the case reported herein raises important questions about possible etiologic factors. © 2013 S. Karger AG, Basel.

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