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Nucl Med Commun ; 40(10): 1060-1065, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31365492


OBJECTIVES: To identify the clinical relevance of incidentally detected lesions (IDLs) in the gastrointestinal tract (GIT) with 18F-FDG PET/CT and to assess the potential benefit of using semiquantitative PET measures to discern malignant from benign lesions. METHODS: Forty-one patients who underwent F-FDG PET/CT scans during the oncologic follow-up, revealing abnormal incidental 18F-FDG accumulations in the GIT were included in this retrospective analysis. Incidental PET/CT findings were correlated with endoscopic and histological findings. Semiquantitative PET values (SUVmax, SUVmean, SULpeak, and TLG) were evaluated by using a new graph-based method. Two sample t-test analysis has been performed to evaluate the differences of PET parameters between precancerous or cancerous lesions and inflammatory disease. RESULTS: Nine of the 41 patients had an IDL of the GIT on F-FDG PET/CT (detection rate 22%). Endoscopic examination and biopsy have confirmed the presence of precancerous or cancerous lesions as follow: colonic adenoma with high-grade dysplasia (N = 2), colonic adenoma with low-grade dysplasia (N =3), colonic metastatic lesion from primary breast cancer (N =1), gastric carcinoma (N=3). Precancerous or cancerous lesions showed a higher SUVmax, SUVmean, SULpeak, and TLG with a mean value of 10.6 (range, 5.3- 16.7), 6.2 (range, 2.1-10.6), 5.2 (2.7-11), and 66.6 (range, 7.4-164), than patients with inflammatory and endoscopically negative lesions. Two sample t-test analysis showed that SUVmean (P = 0.03), SULpeak (P = 0.05) were statistically different between the two subgroups. CONCLUSION: The use of new semiquantitative PET parameters may increase the diagnostic yield of FDG PET in the case of abnormal incidental F-FDG accumulations.

Endoscopia Gastrointestinal , Fluordesoxiglucose F18 , Neoplasias Gastrointestinais/diagnóstico por imagem , Neoplasias Gastrointestinais/patologia , Processamento de Imagem Assistida por Computador , Achados Incidentais , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Adulto , Feminino , Neoplasias Gastrointestinais/metabolismo , Glicólise , Humanos , Masculino , Estudos Retrospectivos , Carga Tumoral
World J Gastroenterol ; 22(7): 2242-55, 2016 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-26900287


Low-grade intestinal inflammation plays a key role in the pathophysiology of irritable bowel syndrome (IBS), and this role is likely to be multifactorial. The aim of this review was to summarize the evidence on the spectrum of mucosal inflammation in IBS, highlighting the relationship of this inflammation to the pathophysiology of IBS and its connection to clinical practice. We carried out a bibliographic search in Medline and the Cochrane Library for the period of January 1966 to December 2014, focusing on publications describing an interaction between inflammation and IBS. Several evidences demonstrate microscopic and molecular abnormalities in IBS patients. Understanding the mechanisms underlying low-grade inflammation in IBS may help to design clinical trials to test the efficacy and safety of drugs that target this pathophysiologic mechanism.

Enterite/fisiopatologia , Mucosa Intestinal/fisiopatologia , Síndrome do Intestino Irritável/fisiopatologia , Animais , Anti-Inflamatórios/uso terapêutico , Enterite/tratamento farmacológico , Enterite/imunologia , Fármacos Gastrointestinais/uso terapêutico , Humanos , Mediadores da Inflamação/antagonistas & inibidores , Mediadores da Inflamação/imunologia , Mucosa Intestinal/efeitos dos fármacos , Mucosa Intestinal/imunologia , Mucosa Intestinal/inervação , Síndrome do Intestino Irritável/tratamento farmacológico , Síndrome do Intestino Irritável/imunologia , Terapia de Alvo Molecular
Case Rep Gastrointest Med ; 2014: 409283, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25371833


In the setting of the curative oncological surgery, the gastric surgery is exposed to complicated upper gastrointestinal leaks, and consequently the management of this problem has become more critically focused than was previously possible. We report here three cases of placement of a partially silicone-coated SEMS (Evolution Controlled Release Esophageal Stent System, Cook Medical, Winston-Salem, NC, USA) in patients who underwent total gastrectomy with Roux-en-Y end-to-side esophagojejunostomy for a gastric adenocarcinoma. The promising results of our report, despite the small number of patients, suggest that early stenting (through a partially silicone-coated SEMS) is a feasible alternative to surgical treatment in this subset of patients. In fact, in the treatment of leakage after total gastrectomy, plastic stents and totally covered metallic stents may not adhere sufficiently to the esophagojejunal walls and, as a result, migrate beyond the anastomosis. However, prospective studies with a larger number of patients might assess the real effectiveness and safety of this procedure.

Surg Today ; 43(1): 106-9, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22623175


Primary thyroid schwannomas are extremely rare tumors and there are very few reports of such tumors in the literature. This report presents a rare case of schwannoma involving the isthmus of the thyroid in a 47-year-old male, presenting as a symptomatic predominating cold nodule within a multinodular goiter. The patient underwent total thyroidectomy. The histological examination indicated an Antoni A-type schwannoma. The clinical, radiological and pathological findings of the tumor are discussed, emphasizing the difficulty in reaching a correct preoperative diagnosis. Only 18 cases of primary schwannoma of the thyroid gland have so far been described in the literature and, this is only the second report of thyroid schwannoma localized in the isthmus.

Neurilemoma/cirurgia , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Neurilemoma/diagnóstico , Neurilemoma/patologia , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia , Resultado do Tratamento
J Cell Physiol ; 221(2): 343-9, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19585492


It is essential to reach a better understanding of "flat epithelial atypia/columnar cell lesions" (FEA/CCLs) in breast core biopsies. Our aim was to explore their biological nature, in order to predict the likelihood of an upgrade to carcinoma. "Cytological grading" has been specially focused, in view of its possible utility in the choice of management. One hundred thirty of a total of 900 cases core needle (CN)/vacuum-assisted biopsies (VABs), with diagnoses of "hyperplasia" and "atypia" were retrospectively re-evaluated. Pathological findings of further excision biopsies (FEBs) performed in 40/75 patients with follow-up were compared with the previous diagnoses. In all cases, both Ki-67 and c-kit immunoreactivities were explored and compared with both normal breast tissues and subsequently documented cancers, with special reference to the hyperplastic FEA/CCLs, with "mild" atypia (FEA/CCHAm). Sixteen cases were re-diagnosed as "usual ductal hyperplasia" (UDH), 60 as "columnar cell hyperplasia" (CCH), and 54 as FEA/CCHA, 30 of which FEA/CCHAm and 24 FEA/CCHAh (with high atypia). Significantly, the Ki-67 index proved to be on the increase and c-kit expression on the decrease in FEA/CCHA lesions, mainly in the FEA/CCHAh group and in the subsequently observed cancers, compared with either benign tissues or the FEA/CCH cases. It was also significant that most of the carcinomas were found in FEBs within the FEA/CCHAh group. In this study cytological grading, together with Ki-67 and c-kit indices, proved to be helpful in FEA/CCLs evaluation. With regard to FEA/CCHAm lesions, an adequate surveillance appears to be a more appropriate management tool than FEB, as a result of their biological nature and behavior.

Mama/patologia , Células Epiteliais/patologia , Imuno-Histoquímica/métodos , Antígeno Ki-67/metabolismo , Proteínas Proto-Oncogênicas c-kit/metabolismo , Adulto , Idoso , Anticorpos Monoclonais/imunologia , Biópsia , Feminino , Humanos , Pessoa de Meia-Idade
Cancer ; 113(5): 936-44, 2008 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-18615628


BACKGROUND: Patients with small papillary thyroid carcinoma (PTC) may have a high incidence of regional lymph-node (LN) metastases at presentation, and these are considered to be an independent risk factor for tumor recurrence. A mutated transketolase transcript (TKTL1) has been found up-regulated in different human malignancies, and strong TKTL1 protein expression has been associated with aggressiveness and poor patient survival in several epithelial cancers. METHODS: TKTL1 protein expression was analyzed in 256 consecutive cases of PTCs

Carcinoma Papilar/metabolismo , Neoplasias da Glândula Tireoide/metabolismo , Transcetolase/metabolismo , Adolescente , Adulto , Idoso , Progressão da Doença , Feminino , Expressão Gênica , Humanos , Imuno-Histoquímica , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/patologia , Transcetolase/genética