The mysterious case of spontaneous disappearance of hepatocellular carcinoma.

We describe the case of a 77-year-old woman with chronic hepatitis C and well compensated cirrhosis in whom a single encapsulated 5.5 cm hepatocellular carcinoma was found in the right liver lobe. The patient was symptomatic with left upper quadrant pain and had elevated alfa-fetoprotein levels (3133 ng/ml). While she was waiting for liver resection and 2 months after the initial diagnosis the pain improved and alfa-fetoprotein levels normalized. A computerized tomography scan showed reduction in size of the lesion to 2.5 cm, with no central arterial enhancement, but with the demonstration of a peripheral rim enhancing in all dynamic phases. Follow up computerized tomography and magnetic resonance imaging examinations showed further reduction in size of the lesion to 1.3 cm with persistence of the enhancing rim 20 months after the initial diagnosis. The spontaneous and durable regression of the HCC and the persistent peripheral enhancing rim could be explained by a strong and persistent activation of the immune system directed against the neoplastic cells.

Use of differential fluorescence induction and optical trapping to isolate environmentally induced genes.

The techniques of differential fluorescence induction (DFI) and optical trapping (OT) have been combined to allow the identification of environmentally induced genes in single bacterial cells. Designated DFI-OT, this technique allows the in situ isolation of genes driving the expression of green fluorescent protein (Gfp) using temporal and spatial criteria. A series of plasmid-based promoter probe vectors (pOT) was developed for the construction of random genomic libraries that are linked to gfpUV or egfp. Bacteria that do not express Gfp on laboratory medium (i.e. non-fluorescent) were inoculated into the environment, and induced genes were detected with a combined fluorescence/optical trapping microscope. Using this selection strategy, rhizosphere-induced genes with homology to thiamine pyrophosphorylase (thiE) and cyclic glucan synthase (ndvB) were isolated. Other genes were expressed late in the stationary phase or as a consequence of surface-dependent growth, including fixND and metX, and a putative ABC transporter of putrescine. This strategy provides a unique ability to combine spatial, temporal and physical information to identify environmental regulation of bacterial gene expression.

[Xeroradiography of axillary lymph nodes in patients with tumors of the breast]. / La xeroradiografia dei linfonodi ascellari nelle pazienti con tumore della mammella.

The use of axillary xeroradiography for the detection of lymph node metastases from breast cancer was evaluated on 125 consecutive patients submitted to surgery and to axillary dissection. The clinical and xeroradiographic aspect of lymph nodes was related to their histological diagnosis. Axillary xeroradiography was useful in predicting the metastatic involvement of lymph nodes in a fair good percent of cases, but it gave sometimes unpredictable results due to the superimposition of superficial soft tissues and to the lack of reliable diagnostic criteria. For these reasons, axillary xeroradiography cannot be used as a primary procedure before surgery is performed, and the xeroradiographic diagnosis cannot be assumed as the unique prognostic factor in predicting the metastatic spread of the tumour. This technique may prove useful, however, for the study of the axilla in obese patients and for the evaluation of the size and of the relationships of an axillary mass.

Lack of efficacy of xeroradiography to preoperatively detect axillary lymph node metastases in breast cancer.

Xeroradiography of the axilla was performed in 132 patients with operable breast cancer to investigate the status of the axillary lymph nodes. Pathologic findings were correlated with the results of clinical examination and xeroradiographic findings. Xeroradiography does not appear to have improved our ability to identify axillary lymph node metastases in patients with breast cancer.

[Vascular tumors of somatic soft tissues: a xerographic evaluation]. / Tumori vascolari delle parti molli: apporto della xeroradiografia.

The xeroradiographic features of 34 soft tissue vascular tumors, either benign and malignant, were retrospectively evaluated and analyzed. The incidence of the main semeiologic landmarks in benign and malignant lesions was submitted to statistical evaluation. Benign vascular tumors (hemangiomas, lymphangiomas and mixed forms) often appear as irregular nodes with granular or worm-like structure due to the dilatation of small vessels. Lymphangiomas may contain also rounded or ovoid opacities due to the presence of lymphatic cysts. Vascular malignancies (angiosarcomas) are always radiopaque masses, with irregular borders and infiltration of the surrounding structures. Xeroradiography is proposed as a first-line technique for the diagnosis of soft tissue vascular tumors, before more complex and expensive procedures, like CT or arteriography, are undertaken.