Venous invasion detection in colorectal cancer: which approach, which technique?

Colorectal cancer is one of the most commonly diagnosed human malignancies and is a major cause of death worldwide. A high-quality macroscopic examination and histopathology report enables correct tumour staging, affects patient prognosis, and provides indications for further therapy. Although venous invasion is a stage-independent indicator of poor prognosis that identifies high-risk patients for visceral metastases, it is not a stage-influencing factor. Accordingly the use of special stains to facilitate the detection of venous invasion is not universally recommended and therefore not widely used in routine histopathological analysis. In this report based on a case presentation, the different approaches and techniques for detecting venous invasion are presented and discussed.

Aspiration biopsy cytology of pleuro-pulmonary metastasis from a recurrent meningioma.

A transthoracic fine-needle aspiration biopsy, sampled under echographic guidance from a pleuro-pulmonary mass, proved to be a metastatic meningioma. The meningioma had been operated on from the left parietal lobe, twelve years previously. Cytologic specimens showed nests of round-to-spindle-shaped tumor cells with whorl formation; the cells were immunoreactive for vimentin and epithelial-membrane antigen. The cytological appearance of the tumor cells was diagnostic of meningioma. In the course of the clinical staging, a recurrent cerebral meningioma was found and was judged to be inoperable, because of extensive growth and brain infiltration.

[Diagnostic reliability of radiography in shoulder trauma. Considerations on the use and choice of more radiographic projections]. / Attendibilità diagnostica dell' esame radiografico nei traumi della spalla. Considerazioni sull'impiego e la scelta di più proiezioni radiografiche.

The radiographic examination of the shoulder, one of the most common studies performed in the emergency department of examine trauma patients, very often yields poor and incorrect results. A radiographic study of the shoulder requires at least two radiographs, and different projections-namely, a frontal anteroposterior view and some additional projections, at right angles to one another. The shoulder radiographs of 126 patients examined for acute trauma were retrospectively reviewed to investigate the adequacy of lateral and oblique apical views in detecting shoulder injuries missed on anteroposterior view. The antero-posterior view was the most effective one, showing 88% of the injuries. Even though the oblique apical and the lateral views were less sensitive than the antero-posterior view, detecting 82% and 60% of the injuries, respectively, they were more sensitive for some specific injuries missed by the other views. Thus, glenohumeral dislocations with or without fracture and some clavicular fractures were best depicted by the oblique apical view, while the fractures of the body and coracoid process of the scapula were best detected by the lateral view. However, the two views had a complementary role and, in our series of patients, both of them showed four injuries missed by the anteroposterior view. Therefore, we conclude that the radiologist should collaborate with the orthopedist to choose which projections to use in each patient on the basis of physical and clinical examinations.

[Leydig cell tumor of the testis]. / Il tumore del testicolo a cellule di Leydig.

It represents a rare and mostly unilateral pathology with benign istological patterns. However, since the biological behaviour of the tumor is not foreseable from the istological characteristics, the follow-up must be prolonged. The treatment of this cancer is orchidofuniculectomy, sometimes associated, in selected cases, with retroperitoneal lymphadenectomy. In presence of tumor of small dimensions, above all if bilateral ones, it may be indicated a conservative treatment. Authors report six cases of Leydig cell tumors of the testis observed in sixteen years. All patients had orchidofuniculectomy by inguinal approach. In only one case has been associated retroperitoneal lymphadenectomy for the suspect of lymphatic metastasis. Follow-up of 3 months to 15 years is available for all patients: no one has died for the tumor and all are without signs of disease.

[Pulmonary carcinoid tumors]. / I tumori carcinoidi polmonari.

27 patients suffering from carcinoid of the lung (18 females and 9 males, middle age 52 years, range 26-68) underwent surgery in our department. The neoplasms were located at the pulmonary hilum in 21 cases. The diagnosis was occasional in 6 cases, cough (51.8%) and recurrent bronchitis (37%) were the most frequent symptoms. No instances of carcinoid syndrome were detected. Preoperative staging ruled out pathologic mediastinal lymph nodes or hematogenous metastases. 26 patients underwent complete excision of the neoplasm (11 lobectomies, 9 pneumonectomies, 4 bilobectomies, 1 segmental resection, 1 bronchial wedge resection). Histologically, 4 cases were categorized as atypical carcinoids. Two patients died within 1 year, one suffering from atypical carcinoid because of disease progression, and an other one (suffering from atypical carcinoid) who underwent only at exploratory thoracotomy followed by chemotherapy. A patient suffering from typical carcinoid died within 1.5 years because of gallbladder carcinoma. From our experience and from the literature review it appears that carcinoids has to be considered as malignant neoplasms and treated according to.

Breast solitary schwannoma: fine-needle aspiration biopsy and immunocytochemical analysis.

A case of intramammary solitary schwannoma (SS) (benign neurilemoma) diagnosed by fine-needle aspiration biopsy (FNAB) and supported by immunocytochemical study is reported. The tumor arose in the right breast of an 18-yr-old woman and was clinically and radiologically considered a fibroadenoma. The smears obtained by FNAB of the lump showed clusters of spindle-shaped cells and suggested a benign mesenchymal neoplasm. The presence of some structures reminiscent of Verocay bodies and the immunocytochemical reactivity for S-100 protein antiserum demonstrated the schwannian nature of the tumor and suggested the diagnosis of SS. The final histologic examination confirmed the cytologic diagnosis.

Platelet imipramine binding in intensive care unit suicidal patients.

3H-Imipramine binding in relation to serotonergic function was studied in patients hospitalized following a suicide attempt. Comparison with a control group showed a highly significant difference in Bmax values. The results suggest, at least a posteriori, a biological alteration as the basis of suicidal behaviour. Although it is impossible to attribute a suicidal attempt to the alteration or to a predisposing pre-existent condition, this biological marker may be useful in evaluating suicidal risk and also short- and long-term prognosis.

[Reaction to mourning in elderly subjects]. / La reazione al lutto nei soggetti anziani.

Although in most cases mourning is characterised by phenomena of adaptation with development towards a new balance on a course that can be considered "normal" it is certainly for many people an event capable of involving and altering the psychophysical make-up with more or less serious and variously reversible consequences. The possibility, therefore, of a course definable as "pathological", with an increase in risks of morbosity and morbidity means that every situation must be considered specifically, focusing attention on personal, social and biological variables that can determine a "risk" course. The loss experience is also to be considered with particular attention as regards the problems of the elderly who are more exposed and more vulnerable to these events and to the difficulties directly or indirectly related to them. From this point of view an attempt has therefore been made to identify certain interpretative hypotheses on the interconnections between deprivation reaction and psycho-physical consequences for the individual, especially in relation to the elderly subject who frequently already lives a situation of psychophysical precariousness.