Ultrasound Examination of Unilateral Seminoma in a Salernitano Stallion.

An 18-year-old Salernitano stallion developed a progressive enlargement of the left testicle over eight months. An ultrasound evaluation was performed, along with a hormonal profile. A histopathological evaluation of the testis was performed after unilateral orchiectomy. On B-mode ultrasound examination, testicular parenchyma was characterized by the loss of internal structure, with the presence of multiple coalescing, nodular, well-defined and heterogeneous lesions with capsule deformity, appearing with an irregular profile. On dissection, the testicular parenchyma bulged over the cut section, confirming the increase in size. Microscopically, the lesion consisted mainly of large, densely packed, polygonal-to-round-shaped neoplastic cells. Mitotic figures were plentiful and frequently atypical; further microscopic features included apoptosis and necrosis. At immunohistochemistry, the entire neoplasm showed strong and diffuse immunolabeling for vimentin, while CD117-specific immunoreactivity was only observed in scattered clusters of neoplastic cells. Based on the gross, microscopic and IHC findings, a diagnosis of diffuse seminoma was made. Three months later, a follow-up examination showed no evidence of recurrence and the preservation of reproductive abilities. The case presented shows an unusual ultrasonographic pattern for seminoma and the basis of the correlation between the characteristics of the sonoelastographic examination and histological diagnosis.

Pleural empyema associated with alveolar-pleural fistulas in severe acute respiratory syndrome coronavirus 2.

Surgery in COVID-19 disease complicated by APF represents the last life-saving treatment option. The choice of the therapeutic period to indicate this approach is fundamental. In fact, the clinical stability of patient is necessary in order to allow single-lung ventilation and to minimize postoperative sequelae.

Invasive Ductal Breast Cancer with Osteoclast-Like Giant Cells: A Case Report Based on the Gene Expression Profile for Changes in Management.

We report the case of a 49-year-old woman diagnosed with a rare histotype of early breast cancer (BC), invasive ductal carcinoma with osteoclast-like giant cells (OGCs), from the perspective of gene profile analysis tests. The patient underwent a quadrantectomy of the right breast with removal of 2 cm neoplastic nodule and three ipsilateral sentinel lymph nodes. The Oncotype Dx gave a recurrence score (RS) of 23, and taking into account the patient's age, an RS of 23 corresponds to a chemotherapy benefit of 6.5%. After a multidisciplinary collegial discussion, and in consideration of the patient's age, the absence of comorbidity, the premenopausal state, the rare histotype and the Oncotype Dx report, the patient was offered adjuvant chemotherapy treatment followed by hormone therapy. This case may be an example of the utility of integrating gene expression profiling tests into clinical practice in the adjuvant treatment decision of a rare histotype BC. The Oncotype Dx test required to supplement the histological examination made us opt for the proposal of a combined treatment of adjuvant chemotherapy followed by adjuvant hormone therapy. It demonstrates the importance of considering molecular tests and, in particular, the Oncotype Dx, in estimating the risk of disease recovery at 10 years in order to identify patients who benefit from hormone therapy alone versus those who benefit from the addition of chemotherapy, all with a view toward patient-centered oncology. Here, we discuss the possible validity and limitations of the Oncotype Dx in a rare luminal A-like histotype with high infiltrate of stromal/inflammatory cells.

A Case of Adenocarcinoma of Uterus Masculinus in a Pomeranian Dog.

Introduction: Persistent Müllerian duct syndrome (PMDS), or uterus masculinus, is a rare autosomal recessive form of male pseudohermaphroditism due to the failure of paracrine anti-Müllerian hormone (AMH) secretion by Sertoli cells or failure of the Müllerian ducts to respond to AMH secretion. The malignant degeneration of persistent Müllerian remnants is rare. In human medicine, few related reports exist. In veterinary medicine, this is the first report describing adenocarcinoma of the uterus masculinus involving the prostate in a dog. Clinical history: An 11-year-old, male, neutered Pomeranian dog was referred for computed tomography due to the suspicion of prostatic carcinoma based on ultrasound and cytological examinations. The computed tomography findings were consistent with a uterus masculinus mass with possible prostatic infiltration. Uterus masculinus removal and total prostatectomy were performed; termino-terminal urethral anastomosis was carried out. Dehiscence of the anastomosis was observed 3 days after surgery. The owner declined any further procedures, and the dog was euthanized 5 days after surgery. Histopathological evaluation revealed adenocarcinoma of the uterus masculinus. Conclusion: Adenocarcinoma of the uterus masculinus may occur, suggesting that patients with PMDS should be evaluated for malignant changes of Müllerian remnants.

Tumor⁻Microenvironment Interaction: Analysis of Mast Cell Populations in Normal Tissue and Proliferative Disorders of the Canine Prostate.

Mast cells (MCs) are involved in angiogenesis, tissue remodeling and immunomodulation in several human and animal tumors, although their exact role is still controversial. Since no information is available in canine prostate carcinoma (PC) and normal prostate tissues, the aims of this study were to evaluate the possible correlations between MC distribution, molecular expression and microvessel density (MVD) in normal prostatic tissue and proliferative disorders of the canine prostate. All samples (6 normal, 15 benign prostate hyperplasia-BPH, 8 PC) were stained with Toluidine Blue and immunohistochemically evaluated for tryptase, c-Kit (CD117) and CD31. Mast cell density (MCD) and MVD were quantified by the hot-spot method. MCD was significantly increased in periglandular/peritumoral areas, when compared with intraglandular/intratumoral areas, in all groups (p = 0.03). C-Kit expression was strongly associated with PC (ρ = 0.75 p = 0.03), whereas positive correlation between tryptase and c-Kit expression (ρ = 0.64 p = 0.01) was observed in periglandular areas of BPH. MVD showed a correlation with MCD in BPH (ρ = 0.54 p = 0.04). Our data support the importance of c-Kit in regulating MC proliferation. The predominant location of MCs in peritumoral areas of canine PC was similar to the human counterpart, in which PC cells are supposed to produce substances attracting MCs to the tumor microenvironment.

Low HtrA1 expression in patients with long­standing ulcerative colitis and colorectal cancer.

The association between inflammatory bowel disease (IBD) and colorectal cancer (CRC) is being increasingly investigated. HtrA1 overexpression inhibits cell growth and proliferation by influencing apoptosis, invasiveness and migration of tumour cells. In the present study, HtrA1 expression was analysed in 228 colon tissue samples from patients with CRC, adenoma with high-grade dysplasia (AHD), adenoma with low-grade dysplasia (ALD), ulcerative colitis of >10 year duration (UCL), ulcerative colitis of <5 year duration (UCS) and colonic diverticulitis (D), and was compared with its expression in normal colon tissues (NCTs) collected 5 cm from the CRC lesion and in healthy colon mucosa (HC), to establish whether HtrA1 can serve as a biomarker for these conditions. All tissue specimens came from Italian Caucasian subjects. The main finding of the present study was that HtrA1 expression was significantly reduced in CRC and UCL tissues compared with that observed in both NCT and HC samples and with tissues from the other patients. In particular, a similar HtrA1 expression was detected in the stromal compartment of UCL and CRC samples. In contrast, the HtrA1 level was significantly lower (p=0.0008) in UCL compared with UCS tissues, suggesting an inverse relationship between HtrA1 expression and ulcerative colitis duration. HtrA1 immunostaining in the stromal compartment of AHD and ALD tissues showed no differences compared with the HC tissues. No data are available on the immunohistochemical localization of HtrA1 in CRC or IBD. The present findings suggest that HtrA1 could serve as a marker to identify UCL patients at high risk of developing CRC.

Modulating the inflammatory response to provide the best environment for healing in the pelvic organ prolapse (POP) repair. A preliminary study using coated medical devices.

AIM: We studied the inflammatory response in Phosphorylcholine (PC)-coated and uncoated meshes after 4 weeks of implantation in the subcutaneous tissue of the hypogastric region in six patients. MATERIAL AND METHODS: Six patients underwent POP surgery using two different types of mesh. In three of them a PC-coated mesh was implanted and an uncoated one was implanted in the last three. A small part of the mesh has previously been cut with a standard size decided by the authors and was subsequently implanted in the same time of the pop repair in the subcutaneous fascia of the hypogastric region. After 4 weeks the small part of the mesh was explanted and tissue growth in the fishnet-like mesh was analyzed. RESULTS: A typical foreign body response formed around the uncoated meshes. On the other hand there was a lack in the inflammatory response around the PC-coated mesh identifying less histiocytes, less giant cells and a thinner fibrous capsule formation. DISCUSSION: PC polymers have demonstrated excellent biocompatibility and hemocompatibility. The adsorption of protein onto materials' surface and the trauma involved in surgery necessary for device implantation determines an inflammatory response. The ability of the PC coating to reduce the extent of nonspecific proteins, modulates the specific environment around the implant. CONCLUSION: This preliminary study showed that modulating the inflammatory response we attempt to provide the best environment for healing.