bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical Treatment for Carcinoma of the Gastric Cardia: A Modified Proximal Esophagogastrectomy
Authors: Valente Maurizio , Pastorino Ugo , Cataldo Ignazio , Bertario Lucio , Alloisio Marco , Muscolino Giuseppe , Ravasi Gianni
Published: April 2018

Proximal esophagogastrectomy saving only the distal half of the greater curvature of the stomach was retrospectively evaluated in 91 consecutive patients with resectable carcinoma of the gastric cardia. Division of the right gastric artery at its beginning provided a free nodal margin if N1 diffusion was observed. Operative mortality was 6.5% and fatal leak rate 3.8%. Survival without dysphagia occurred in all but stage I tumors; for larger tumors recurrence and reflux esophagitis were not able to produce dysphagia because distant metastases were faster to kill the patients. Five-year survival was 0% for stage IV (i.e. incomplete macroscopic resection), 8% for stage III, 12% for stage II and 53% for stage I. Local recurrence occurred only at esophageal anastomosis and for every stage, whereas regional recurrence occurred only for tumors with nodal diffusion. The results of this study are not suitable for a comparison with total esophagogastrectomy by inductive logic, nevertheless deductive arguments are possible if patterns of recurrence are considered. The possibility of regional recurrence for N1 and not for N0 tumors means that the volume of nodal resection has diagnostic specificity for N0 but not for N1 tumors. If N2 nodal diffusion is really a sistemic disease, as indicated by current reports, than greater nodal resection by total esophagogastrectomy can only improve the diagnostic specificity of N1 assessment but not survival.
Inhibition of Human Melanoma Growth in Nude Mice by Autologous, Alloactivated Peripheral Blood Lymphocytes
Authors: Balsari Andrea , Fossati Giuseppe , Taramelli Donatella , Nava Maurizio , Ravagnani Fabrizio , Parmiani Giorgio
Published: April 2018

Peripheral blood lymphocytes of melanoma patients were stimulated in vitro by a pool of allogeneic lymphocytes and shown to be cytotoxic against autologous melanoma cells. To evaluate the in vivo antitumor activity of the cytotoxic alloactivated autologous peripheral blood lymphocytes, tumor neutralization (Winn) assay was carried out by injecting such lymphocytes admixed with autologous melanoma cells in athymic BALB/c nude mice. In 3 of 6 cases, complete inhibition of tumor growth was obtained at lymphocytes to tumor cells ratio of 10:1 and in one case also of 5:1. In all cases the appearance of tumors was delayed and the growth rate was significantly reduced in a dose-dependent fashion as compared to control mice injected with tumor cells alone. We conclude that in vitro alloactivated peripheral blood lymphocytes can inhibit and/or impair the growth of autologous melanoma cells in nude mice.
FAM2 Regimen in Disseminated Gastric Cancer
Authors: Fornasiero Adriano , Cartei Giuseppe , Daniele Otello , Fosser Vinicio , Fiorentino Mario V.
Published: April 2018

Forty-four previously untreated patients with advanced inoperable and/or disseminated gastric carcinoma were given an i.v. combination (FAM2) chemotherapy of 5-fluorouracil, 400 mg/m2 on days 1, 2 and 3, and 21, 22 and 23; adriamycin, 40 mg/m2 on days 2 and 22; and mitomycin C, 10 mg/m2 on day 1, with a recycle on day 42 (1 cycle = 41 days). Forty patients have completed 2 cycles and are evaluable (median number of cycles 5; range 3 to 8): 26 of these achieved a partial remission, with a response rate of 65 %; 4 (10 %) gained a stable situation for 3 to 6 months, and 10 (25 %) showed progression of disease. Median duration of partial remissions was 10 months, and median survival was 15 months for responders and 5 months for nonresponders. A fall in WBC (< 2500/μl) occurred in 7 % and of platelets (< 80,000/μl) in 4.5 %. Total alopecia occurred in 20 of 40 patients and nausea and or weakness were common findings. No drug-related infection, bleeding or death was observed. Patients with advanced gastric carcinoma can derive useful palliation from FAM2 chemotherapy.
Chronic Neutrophilic Leukemia and Myeloma. Report on Long Survival
Authors: Franchi Fabrizio , Seminara Patrizia , Giunchi Giuseppe
Published: April 2018

A case of chronic neutrophilic leukemia associated with multiple myeloma is described. The patient appears to be the longest surviving case reported in the literature. Since myeloma developed several years after leukemia, the possible precancerous role of myeloproliferative syndromes is proposed.
Influence of ICRF-159 or ICRF-186 on Cytotoxicity of Daunorubicin and Doxorubicin
Authors: Supino Rosanna
Published: April 2018

It has been shown that ICRF-159 [1,2-bis(3,5-dioxopiperazine-1-yl)propane] and its more water soluble d-enantiomer, ICRF-186, antagonize the toxicity of daunorubicin and the cardiac toxicity of daunorubicin and doxorubicin and potentiate the antitumor effect of both substances in experimental animals. In particular, the antagonism against general toxicity was observed in combination with daunorubicin but not with doxorubicin. In this study, we evaluated the activity of ICRF-159 and ICRF-186 on the colony inhibition test of HeLa cells in vitro in combination with daunorubicin or doxorubicin. ICRF-159 and ICRF-186 similarly antagonize the cytotoxicity of daunorubicin but not of doxorubicin. There were no differences between ICRF-159 and ICRF-186, dissolved in DMSO and in physiological solution, respectively. The different activity of ICRF-159 and ICRF-186 against daunorubicin and doxorubicin is not explained by a different uptake of the anthracyclines by HeLa cells in vitro. In the present paper we report findings from our in vitro colony forming assay with HeLa cells, which has been used to evaluate the cytotoxicity of ICRF-159 and ICRF-186 in the presence of daunorubicin and doxorubicin.
Independent Submacroscopic Foci of Infiltrating Carcinoma in Breasts Removed for Clinical Cancer
Authors: Sarnelli Roberta , Squartini Francesco
Published: April 2018

The aim of our study was the detection and the characterization of submacroscopic foci of infiltrating carcinoma in the human female mammary glandular tree collateral to clinical cancer. Accordingly, we analyzed 100 breasts surgically removed by radical mastectomy. Five thin slices per case were analyzed under a dissecting microscope by subgross method of observation. Submacroscopic foci of invasive cancer, well separated and apparently independent of the primary tumor, were found in 19 % of the cases and were confirmed by histologic examination. Foci of submacroscopic cancer were either single (79 %) or multiple (21 %), and were located in slices including or not the main tumor mass (31 % and 69 % of cases, respectively). Their size ranged from 1 to 4 mm. Four histologic types were represented: 1) invasive ductal NOS with productive fibrosis, scirrhous type (36 % of cases); 2) invasive ductal NOS without productive fibrosis, simplex type (32 % of cases); 3) invasive ductal with tubular component (16 % of cases); 4) medullary (16 % of cases). Concordance between histology of clinical and submacroscopic cancers was assessed in 42 % of cases. A significant association of the tubular type (invasive ductal carcinoma with a consistent tubular component) of primary tumor was demonstrated (P < 0.05), as well as with the presence of ductal and lobular proliferative changes in the collateral glandular tree (intraductal papillomas, P < 0.01; atypical lobules, P < 0.02). No relationship was found between submacroscopic foci of infiltrating carcinoma and neoplastic familiarity, patients’ age by decades, axillary lymph node metastases, size of clinical tumor or profile of the collateral mammary glandular tree. These data support the hypothesis of a multicentric origin of human breast cancer and suggest a systemic nature of the neoplastic mammary disease. Prognostic and therapeutic implications of this concept are discussed.
Unilateral Seizures following Vincristine Intravenous Injection
Authors: Dallera Francesco , Gamoletti Roberto , Costa Paolo
Published: April 2018

A case of acute central nervous system toxicity following the intravenous injection of vincristine was observed in a patient treated with a chemotherapy regimen including cyclophosphamide, doxorubicin and prednisone for non-Hodgkin lymphoma. The neurological symptoms consisted of right-sided epileptiform jacksonian seizures limited to the face, that lasted about 10 min, followed by spontaneous recovery. A cerebrospinal fluid study and computed tomographic scan of the brain failed to reveal any central nervous system lymphomatous involvement.
Results of EN Bloc Resections for Lung Cancer
Authors: Janni Alberto , Santini Paolo , Mussi Alfredo , Menconi Gian Franco , Miniati Massimo , Angeletti Carlo Alberto
Published: April 2018

The results of en bloc resection carried out in 33 patients with lung cancer involving the chest wall are described. Microscopic examination of the lung specimen revealed large cell anaplastic carcinoma in 14 cases, squamous carcinoma in 10, adenocarcinoma in 5, microcytoma and fibrosarcoma in 2 cases respectively. The 5 year survival, calculated according to the actuarial method, was 32 %, only slightly lower than the 5 year overall survival observed in our survey. The long-term prognosis was essentially related to the presence of lymphnodal metastases, which were found to occur at a late stage of the clinical evolution.
Reliability of Aspiration Biopsy in Thyroid Nodes: Study of 2190 Operated Patients
Authors: Radetić Miljenko , Kralj Zvonimir , Padovan Ivo
Published: April 2018

The cytologic finding was negative in 1841 patients; accurate in 1763 (95.8 %). Suspicious cytology proved malignant in 82 of 252 patients (32.5 %). Positive cytology was accurate in 88 out of 97 cases (90.7 %). In 1942 benign goiters, cytology was accurate in 90.8 % of patients, false suspicious in 8.7 % and false positive in 0.5 %; the highest percentage of misdiagnosis was in adenomas (15.8 %) and thyroiditis (19.0 %). In 248 malignant goiters, cytology was accurate in 35.5 % of patients, suspicious in 33.1 %, and false negative in 31.4 %. False-negative cytology was found in 44 % of follicular cancers, 22.2 % of papillary and medullary, and 12.9 % anaplastic. The most frequent false-negative cytologic diagnosis was the adenomatous goiter. The accuracy of cytology was statistically higher in papillary cancers than in follicular (77.8 % vs 56.0 %), in undifferentiated tumors than in differentiated (83.7 % vs 65.0 %), and in adenomatous nontoxic goiters than in adenomas, thyroiditis and toxic goiters (80.3 % vs 42.7 %), 20.1 % and 13.4 %). Positive preoperative fine needle aspiration biopsy cytology is a worthwhile and reliable finding; it fails in less than 10 % of patients. Negative cytology, however, does not exclude malignancy in thyroid nodes; it is false negative in more than 30 % of cancers.
Laser Phototherapy following HpD Administration in Superficial Neoplastic Lesions
Authors: Bandieramonte Gaetano , Marchesini Renato , Melloni Elsa , Andreoli Claudio , di Pietro Sergio , Spinelli Pasquale , Fava Giannino , Zunino Franco , Emanuelli Hermes
Published: April 2018

We report our preliminary clinical experience with hematoporphyrin derivative (HpD) injection and argon or dye laser irradiation for the treatment of 61 surface neoplastic lesions in 7 patients. Forty-three sites were multiple basal cell carcinoma in 5 patients, and the remaining 18 were cutaneous and subcutaneous recurrent breast carcinoma after mastectomy in the thoracic wall. The patients were selected on the basis of the lack of indication for conventional therapeutic modalities. The selection of irradiation procedures and laser source was based on the thickness of the lesion and extension of the disease. The photochemical reaction between HpD injected i.v. at a dose of 3 mg/kg body weight and the laser beam at a dose of 60 to 120 J/cm2 resulted in 75 % favorable responses at the treated sites. Optimal therapeutic effects appeared to be critically dependent on total light dose and tumor infiltration patterns. The phototherapeutic technique proved to be effective in selected cases of neoplastic lesions, especially when conventional treatment modalities were poorly indicated or contraindicated.
Lymphoblastic Lymphoma in Adults: A Study on 30 Patients Treated with Two Different Programs According to Bone Marrow Findings
Authors: Bernasconi Carlo , Brusamolino Ercole , Lazzarino Mario , Salvaneschi Laura , Isernia Paola , Magrini Umberto
Published: April 2018

Thirty adult patients with lymphoblastic lymphoma were treated with two different programs according to bone marrow findings. Bone marrow positive patients were given an ALL-like program: vincristine, daunorubicin, cyclophosphamide and prednisone for induction of remission, CNS prophylaxis, continuous maintenance for three years and monthly reinductions. Bone marrow negative patients were given a conventional lymphoma program with CHOP-Bleo and limited RT on bulky mediastinum without CNS prophylaxis. The CR rate of the whole group was 54 % (62 % for ALL-treated versus 47 % for lymphoma-treated patients; not significantly different), with a median survival for remitters of 28.5 mos. Relapse-free survival of the whole group was 65 % at 12 and 25 % at 24 mos. Stage IV ALL-treated patients had a median survival of 16.5 versus 10 mos for stage IV lymphoma-treated ones (p = 0.05); the three-years survival was 24 and 10 %, respectively. No patients undergoing CNS prophylaxis (ALL-therapy) had neurological complications or late meningeal relapse. The better prognosis of ALL-treated patients, in spite of bone marrow positivity, argues in favor of an ALL-like therapy in all adult lymphoblastic lymphomas, in terms of CR rate, overall survival, and absence of CNS relapse. This therapy must be adopted irrespective of bone marrow findings, and regardless of how localized the lymphoma appears to be.
Metastatic Medullary and Undifferentiated Thyroid Cancers are not Associated with Elevated Levels of Serum Thyroglobulin
Authors: Pacini Furio , Lari Riccardo , Taddei Donatella , Grasso Lucia , Martino Enio , Baschieri Lidio , Pinchera Aldo
Published: April 2018

It is now well accepted that serum thyroglobulin (Tg) determination is a specific marker of disease activity in well-differentiated thyroid cancer after total thyroidectomy. In this study we examined 15 thyroidectomized patients with metastases from medullary thyroid cancer and 10 patients with metastases from undifferentiated thyroid cancer, to determine whether serum Tg measurement could be useful also in these types of thyroid tumors. In contrast with differentiated thyroid cancer, which had high levels of circulating serum Tg, patients with medullary and undifferentiated thyroid cancer had undetectable or low levels of serum Tg. Thus, serum Tg measurements are not useful in the diagnosis of metastatic disease in these patients.
Platelet Activation in Patients with Benign and Malignant Ovarian Diseases
Authors: Landolfi Raffaele , Storti Sergio , Sacco Francesco , Scribano Donata , Cudillo Laura , Leone Giuseppe
Published: April 2018

Plasma concentration of beta-thromboglobulin (beta-TG) and platelet factor 4 (PF4) were measured by radioimmunoassay in 45 patients with benign and malignant ovarian diseases. All patients with ovarian carcinoma showed increased beta-TG and PF4 levels. Among benign ovarian diseases the patients with serous cystadenoma more frequently showed signs of platelet activation, whereas those with endometriotic cyst and mucinous cystadenoma generally had normal beta-TG and PF4 values. These results indicate that an increased platelet activation is consistently associated with malignant tumors of the ovary, whereas benign tumors show a different capacity to induce platelet activation.
Local Morphologic Changes Related to Laryngeal Carcinoma
Authors: Resta Leonardo , Santangelo Antonio , Caruso Gilda , Buonomo Carmela
Published: April 2018

In a series of 178 patients who underwent partial or total laryngectomy for laryngeal carcinoma, the morphologic changes at a distance from the neoplasm were investigated with whole organ serial sections. We found 60 cases with extensive squamous metaplasia of the epithelium outside of the vocal cords, 24 case with hyperplastic epithelium of the vocal cords, 29 cases with mild or moderate dysplasia, 5 cases with foci of in situ carcinoma, 3 cases with a second carcinoma with minimal stromal invasion, and 4 cases with a double synchronous primary carcinoma. In 55 cases we observed the contemporary presence of a carcinoma and a mono-or bilateral laryngocele. In the excretory ducts of the salivary glands present in the laryngeal mucosa we found a reserve cell hyperplasia in 100 % of the cases, a mature squamous metaplasia in 25%, and an oncocytic metaplasia in 14 %. These observations led us to consider the laryngeal cancer as an organ disease, in which the oncogenic stimulus operates on all the laryngeal structures and determines lesions of different severity up to neoplasm.
Cutaneous Carcinomas and Soft Tissue Sarcomas Induced by Ionizing Radiation Therapy. Presentation of a Series of 42 Cases
Authors: Basso-Ricci Sante , Bartoli Cesare
Published: April 2018

Forty-two cases of tumors of the skin and of the soft tissues immediately beneath the skin, presumably induced by ionizing radiotherapy, are reported: 35 were carcinomas, 2 angiosarcomas, 2 leiomyosarcomas of the dermis and 3 fibrosarcomas. In 31 of the 35 cases of carcinomas, multiple neoplastic foci were found in the skin area exposed to the ionizing radiation. The median age of the patients at the time of exposure to ionizing radiation was 32.5 years for those with carcinomas and 30 years for the others. The relatively young age at exposure to the ionizing radiation may have influenced onset of the tumor. The median interval between exposure to ionizing radiation and clinical finding of the tumor was 18.1 years for the carcinomas and 16 for the other tumor types. The radiation dose to which the patients had been subjected varied for the carcinomas from 12 to 25 Gy and for the other tumors from 40 to 50 Gy, administered over 1 to 4 years in the cases of carcinomas and 4 to 5 weeks in the other cases. The dose administered to the cases with cutaneous carcinomas was rather low, since almost all these patients had benign disease; however, it is in this dose range (12-25 Gy) that, according to Gray, a relatively high incidence of induced tumors is verified. In the opinion of the author of the present paper, the multiplicity of neoplastic carcinomatous foci in the skin area exposed to radiation confirms Gray's hypothesis; also, the time over which the dose was administered was presumably important in determining such multiplicity. The soft tissue sarcomas occurred only in patients previously subjected to radiotherapy, according to traditional modalities, for malignant neoplasms. The carcinomas were observed almost always in the trunk, and like spontaneous carcinomas at this site they were almost exclusively of basal cell type.
Pharmacologic Data and Technical Feasibility of Intraperitoneal Doxorubicin Administration
Authors: Demicheli Romano , Bonciarelli Giorgio , Jirillo Antonio , Foroni Roberto , Petrosino Luigi , Targa Lino , Garusi Gianfranco
Published: April 2018

Seventy intraperitoneal administrations of doxorubicin were performed in 12 patients with malignant disease in the abdominopelvic space. Peritoneal and hematologic drug levels were measured by fluorimetric assay. A first-order decline in the peritoneal level was determined (T1/2 96 ± 18 min), with a mean drug absorption of 84 % in 4 h (range 40-96 %) and a mean ratio of a peak dialysate/peak serum level of 111 (range 12-390). Gastrointestinal toxicity was common and peritoneal phlogosis occurred twice. The doxorubicin level and the time of peritoneal exposure seem to be critical factors for major local toxicity. At a moderate concentration doxorubicin can be intraperitoneally administered, but its usefullness is probably confined to patients with minimal abdominal disease.
Genetic Unresponsiveness to a Murine Fibrosarcoma Determined by the Host Genetic Environment but not by Lymphocyte Precursor Genotype
Authors: Colombo Mario P. , Rodolfo Monica , Parmiani Giorgio
Published: April 2018

(BALB/c × C3Hf) (H-2d × H-2k)F1 hybrid mice but not parental BALB/c or other BALB/c × H-2k F1 hybrids, were unresponsive in transplantation and in neutralization (Winn) assay against a 3-methylcholanthrene-induced BALB/c fibrosarcoma. In BALB/c mice the antitumor activity revealed by Winn assay with antitumor immune lymphoid cells was shown to be tumor specific and mediated by Thy 1+ cells. Mouse chimeras were constructed by injecting fetal liver cells into irradiated recipients. BALB/c → (BALB/c × C3Hf)F1 and control (BALB/c × C3Hf)F1 → (BALB/c × C3Hf)F1 chimeras were unable to develop a transplantation immunity against the immunizing tumor, whereas (BALB/c × C3Hf)F1 → BALB/c chimeras were able to respond to the immunizing tumor. Thus, unresponsiveness was shown to be due to a defect in the maturation of precursor stem cells both of parental and F1 hybrid origin in the body of the (BALB/c × C3Hf)F1 animals.
Abo Blood-Groups and the Risk of Gestational Trophoblastic Disease
Authors: Parazzini Fabio , La Vecchia Carlo , Franceschi Silvia , Pampallona Sandro , Decarli Adriano , Mangili Giorgia , Belloni Carlo
Published: April 2018

The relation between ABO blood group, mating patterns of patient/husband blood group, and the risk of gestational trophoblastic disease was investigated in a case-control study conducted in Milan on 286 women with histologically confirmed trophoblastic disease (245 benign hydatidiform moles and 41 persistent trophoblastic disease) and 433 control subjects admitted for normal delivery to the same hospitals where cases had been identified. ABO blood groups were associated with the risk of gestational trophoblastic disease ( x26 for heterogeneity = 14.46, p = 0.02). Compared to women of group O or B, women of group A and AB had an elevated relative risk (RR) of benign mole (RR = 1.4 and 2.3, respectively). The risk estimates were higher for persistent trophoblastic disease, i.e., 2.2 for women of group A and 4.8 of group AB. The tests for linear trend in risk from benign to persistent disease were statistically significant in both A and AB groups. There was a significant interaction between blood group and age, since the ABO-related risk was elevated only for women over the age of 35. When mating combinations of maternal/paternal blood groups were considered, women of group A married to males of group O had a risk estimate not substantially different than those married to group A males.
Oral Contraceptives and Cervical Neoplasia: Pooled Information from Retrospective and Prospective Epidemiologic Studies
Authors: Franceschi Silvia , La Vecchia Carlo , Talamini Renato
Published: April 2018

A positive association between the use of oral contraceptives and the risk of cervical neoplasia has been suggested by different sources. This paper examines epidemiologic evidence on this issue through pooled computation of relative risks emerging from 21 studies, subdivided into three main categories: studies based on routine cytologic screening programs, case-control investigations and prospective studies. The pooled estimates of the relative risks for ever vs never use of oral contraceptives were broadly similar and slightly above unity (1.4 from cytologic screening programs, 1.1 from case-control and 1.4 from prospective studies). The risk increased with duration of use and, generally, lower relative risk estimates derived from the older studies, necessarily based on short-term use of oral contraceptives. A particularly limited increase in risk was apparent from case-control investigations. Furthermore, when allowance was made for the major covariates (mostly indicators of sexual habits), a noticeable decrease in the excess risk was evident. In conclusion, although statistical significance of moderate differences in risk can be obtained by pooling data from several studies, a risk of the magnitude of that for the association between oral contraceptives and cervical neoplasia may well be due to bias and confounding. In addition, since sexual behavior only indicates the probability of having been exposed to some sexually transmitted agent (most likely human papilloma virus), the greatest additional contribution may come from a case-control study in which adjustment for such exposure is possible.
Polyamine Oxidase Activity in Carcinoma-Bearing Human Breast: Significant Decreased Activity in Carcinomatous Tissue
Authors: Romano Marta , Bonelli Patrizia
Published: April 2018

The paper reports a comparative study of the activity and distribution of polyamine oxidase (PAO) in carcinomatous human breast tissue and in the healthy uninvolved tissue of the same breast. The results indicated that in the carcinomatous tissue the PAO activity is lower than in the healthy uninvolved tissue.
Correlation of Histologic Grade and Lymph Node Status with Some Histopathologic Discriminants in Breast Cancer
Authors: Urdiales-Viedma Mariano , Nogales-Fernandez Francisco , Martos-Padilla Sebastian , Sanchez-Cantalejo Emilio
Published: April 2018

In fifty non selected ductal carcinomas of the breast we found that a marked tumoral inflammatory infiltrate (P < 0.025), perinodal tumoral infiltrate (P < 0.01), sinus catarrh (P < 0.05), follicular hyperplasia (P < 0.025), mixed pattern in lymph nodes (P < 0.01) and with 54 years of age or younger (P < 0.01) correlated significantly with lymph node metastases and/or high histologic grade. On the contrary, elastosis (P < 0.05), scanty or absent inflammatory infiltrate (P < 0.01), sinus histiocytosis (P < 0.001) and endothelial hyperplasia were statistically related to low histologic grade and/or lack of metastases. Elastosis is considered a defensive host response. Groups of lymphocytes in the perinodal fat is usually found in metastasized lymph nodes and may indicate metastasis should be sought in a lymph node which otherwise seems to be tumor-free.
Pigmented Papillary Carcinoma of the Male Breast
Authors: Romanelli Romano , Toncini Carlo
Published: April 2018

A case of highly pigmented papillary carcinoma originating in the breast of a 70-year-old man is presented. The tumor was located in the subareolar region and did not affect the overlying skin, which was normally pigmented. The significance of the presence of melanocytes in the tumor and of melanin pigment in the cytoplasm of its cells is discussed.
Follicular Lymphomas with Predominant Splenic Involvement: Report of Two Cases
Authors: De Pasquale Andrea , Paterlini Patrizia , Di Francesco Anna , Vecchio Luciano , Quaglino Dennis
Published: April 2018

The authors describe the results of histological, cytomorphological, cytochemical and immunological studies carried out in two cases of follicular lymphoma characterized at onset by an exceptional degree of splenomegaly. Although several different histological types seem to be capable of giving rise to prominent splenic involvement, the authors, on the basis of the reported findings, suggest the possibility that some cases of follicular lymphoma presenting with conspicuous splenomegaly and which at present are classified in the group of the so-called intermediate lymphocytic lymphoma, might be an expression of proliferation of a cell type normally recognizable in the marginal zone of the splenic follicles.
Primary Brain Malignant Non-Hodgkin Lymphoma: Report of a Case Treated with Chemotherapy in Combination with Radiotherapy
Authors: Grosso Enzo , Geda Claudio , Büchi Gualtiero , Ferrari Giancarlo , Termine Giuseppe
Published: April 2018

Primary brain lymphomas are usually treated with surgery in combination with radiotherapy, whereas only a few cases have been treated with chemotherapy. We describe a case of a 68-year-old man with an immunoblastic primary cerebral lymphoma first treated with surgery and radiotherapy and subsequently with chemotherapy consisting of cyclophosphamide, adriamycin, vincristine and prednisone (CHOP). In this case immunological study of the peripheral blood and cerebrospinal fluid (CSF) lymphocytes confirmed that a primary brain lymphoma may be an intrinsic cerebral neoplasm with different forms of spreading within the central nervous system (CNS). The period of survival of our patient is equivalent to that of patients treated with radiotherapy alone or in combination with surgery. This suggests the need for further investigation in this field.
Cardiac Toxicity of 5-Fluorouracil Report of a Case of Spontaneous Angina
Authors: Mancuso Luigi , Bondì Francesco , Marchì Salvatore , Iacona Maria Aurora , Di Gregorio Luigi
Published: April 2018

We report a case of a patient with colon carcinoma and liver metastasis who presented chest pain after 5-fluorouracil (5-FU) administration. Clinical electrocardiographic evolution was similar to that observed in Prinzmetal's angina, and chest pain promptly resolved with nifedipine. These data suggest that coronary spasm may be the cause of cardiotoxicity due to 5-FU, and that calcium antagonists may probably be used in the prevention or treatment of 5-FU cardiotoxicity.
Peripheral Blood Lymphocyte Response to Exogenous Interleukin 2 by PHA-Prestimulated and Non-PHA-Prestimulated Cells in Patients with Cancer
Authors: Mantovani Giovanni , Coiana Alessandra , Cossu Francesco , Floris Carlo , Proto Ernesto , Macciò Antonio , Pisano Giuseppe , Taglieri Guglielmo , Puxeddu Guido , Del Giacco Gennaro S.
Published: April 2018

The study aims were 1) to assess the response of peripheral blood lymphocytes (PBL) of cancer patients to exogenous Interleukin 2 (IL 2) either by PHA-prestimulated or non PHA-prestimulated PBL, and 2) to carry out preliminary experiments for a direct quantitative evaluation of endogenous IL 2 production by PBL cultures of cancer patients in order to define the actual role of IL 2 in the disease. Analysis of PBL subsets was also carried out with monoclonal antibodies in a selected group of patients. A total of 134 patients entered the study. Cancer sites were: larynx 32, breast 36, lung (NSC) 24, colorectal 17 and gynecologic 25. In the former 3 cancer sites staging showed localized or only locally advanced disease, and in the last 2 sites disseminated disease. Our results provided evidence that cancer patients exhibit a T-cell functional immunodepression, which progresses during tumor growth, so that the localized disease shows a low-grade defect, and advanced disease a high-grade defect. Our data also clearly suggested that the factor involved with a primary role in this functional immune impairment is the IL 2 deficiency. A perspective may be drawn on the therapeutic administration in vivo of IL 2 and IL 2-activated lymphokine-activated killer cells in controlled clinical trials of selected groups of cancer patients.
Cost-Effectiveness of Chest X-Ray Follow-Up of Patients Treated for Seminoma of the Testis
Authors: Ciatto Stefano , Cionini Luca , Pacini Paolo
Published: April 2018

The authors report on a consecutive series of 253 cases of seminoma of the testis followed with periodic chest X-ray examinations from a minimum of three to a maximum of 27 years. The detection rate of asymptomatic intrathoracic metastases (ITM) was considered together with the costs of the follow-up procedure. Chest X-ray follow-up is not advisable beyond one year from primary treatment, since most (14 of 18) ITM occur in the first year, the detection rate of ITM beyond this date is too low (0.11% patients/year), and the related costs are too high (over $ 130,000 per ITM detected). Chest X-ray follow-up is questionable even in the first year after primary treatment for Stage I cases because of the low detection rate (1.38% patients/year) and the high costs (over $ 14,000 per ITM detected), whereas it appears to be opportune in Stages IIA and IIB.
Multiple Gastric Carcinoids and Pernicious Anemia: Report of a Case
Authors: Ranaldi Renzo , Lorenzini Ivano , Montesi Alfeo , Bearzi Italo
Published: April 2018

A case of pernicious anemia associated with multiple gastric carcinoids is reported. The neoplastic growth was composed of enterochromaffin-like (ECL) cells, and ECL cell hyperplasia was observed also in hyperplastic polyps, inside the fundic glands and in small nests lying in the lamina propria (microcarcinoidosis). The possible relation between pernicious anemia and ECL cell hyperplasia is discussed.
Is the Carcinoembryonic Antigen Test a Valid Predictor of Response to Medical Therapy in Disseminated Breast Cancer?
Authors: Palazzo Salvatore , Liguori Virginia , Molinari Benedetto
Published: April 2018

In 30 of 63 patients with disseminated breast cancer, CEA became positive before medical therapy. Treatment response was obtained in 63.3% of CEA-positive patients compared to 15.2% of CEA-negative patients. The CEA-positive patients also had a longer relapse-free survival, a longer survival from diagnosis of metastases, and a longer overall survival from primary surgery than CEA-negative patients. CEA production appears to be an important and favorable prognostic factor in disseminated breast cancer and determinant of treatment response.
The Value of Immunohistological Techniques in Undifferentiated Cancers
Authors: Coindre J.M. , Tanguy F. , Merlío J.P. , De Mascarel I. , De Mascarel A. , Trojani M.
Published: April 2018

From 1980 to 1984, we observed 144 undifferentiated cancers, of which 116 (0.9% of all cancers treated during this period) were treated in our center. Immunohistochemical study classified 130 tumors (90%), which comprised 82 non-Hodgkin's lymphomas (57%), 32 carcinomas (22%), 7 melanomas (5%), 7 sarcomas (5%) and 2 others (1%). Sixty-nine patients, with the diagnostic problem of non-Hodgkin's lymphoma versus carcinoma, which was solved by immunohistology, were followed up for 44 ± 20 months. Lymphomas (57 cases) had a better clinical course than carcinomas (11 cases), and a clinical course similar to high-grade lymphomas identified by conventional histology. For 66 patients with the same problem, the treatment was started before the immunohistochemical diagnosis. This treatment was inappropriate in the light of the correct diagnosis in 16 of 66 cases (24% of all cases).
Prognostic Value of « Total Tumor Mass Score » (TTM): A Retrospective Analysis of 130 Patients with Chronic Lymphocytic Leukemia
Authors: Molica Stefano , Alberti Antonio
Published: April 2018

The validity of the clinical staging of Jaksic and Vitale for chronic lymphocytic leukemia (CLL), designated total tumor mass score (TTM), was tested in 130 consecutive and previously untreated patients followed at our institution over a 15-year period. The analysis, extended to the whole population, confirmed the prognostic value of the TTM score. Patients with a high TTM (> 9.0) had an expected median survival (EMS) of 30 months; those with a low TTM (< 8.9) had an EMS of 129 months (P < 0.001). The prognostic value of TTM remained even after adjustment was made for age, sex, lymphocyte count, TTM distribution pattern, bone marrow failure, and response to therapy. Taking into account the value of the TTM score, patients of the intermediate risk group (stage II of Rai et al.) could be divided into two subgroups with a different prognosis (EMS 200 vs. 32 months; P < 0.005). When used as a continuous quantitative parameter the TTM score may help to define response to therapy. In this study TTM response to therapy was significant for prognosis (P < 0.001), and there seems to be relationship between the degree of response and survival probability.
Breast Tumors: Immunoglobulins in Axillary Lymph Nodes
Authors: Urdiales-Viedma Mariano , Nogales-Fernandez Francisco , Martos-Padilla Sebastian , Sanchez-Cantalejo Emilio
Published: April 2018

The immnuohistochemical determination of immunoglobulins IgA, IgG and IgM in axillary lymph nodes from 50 unselected breast ductal carcinomas disclosed that lymph nodes with IgG-positive lymphoid follicles and/or metastasized lymph nodes with IgM-positive lymphoid cells are statistically related to breast tumors with a high histologic grade and more than 3 lymph node metastases.
Antitumoral Activity of the Oxazaphosphorine Derivative, Mafosfamide-Cyclohexylamine Salt (ASTA 7557) on a Murine Ovarian Reticular Cell Sarcoma and its Subline Resistant to Cyclophosphamide
Authors: Colombo Tina , Paolini Angela , Finazzi Mario , Scanziani Eugenio , Mandelli Giancarlo , Donelli Maria Grazia
Published: April 2018

The antitumor activity of mafosfamide (MFA), and its parent compound cyclophosphamide (CTX), was investigated against an ovarian reticular cell sarcoma growing i.m. in C57BI/6 mice (M5), which is very sensitive to CTX, and against a subline of this tumor (R16) resistant to CTX. MFA is the prototype of a class of oxazaphosphorines which do not require metabolic activation since under physiologic conditions they undergo rapid spontaneous hydrolyzation to the activated 4-hydroxyoxazaphosphorine and retain a spectrum of activity very similar to the parent compound. After a single dose (300 mg/kg × 1) or repeated low doses (100 mg/kg × 6) the antitumoral activity of MFA on the M5 tumor appeared comparable to or only slightly lower than CTX; the highest T/C value for median survival times was 167% in MFA-treated mice vs. 176% in the CTX group. MFA showed no activity against the R16 subline, thus indicating cross-resistance between the two drugs. Marked thickening of the glissonian capsule with compression of the lobular area of the liver, observed on i.p. administration of MFA, did not result in histopathologic abnormalities of the hepatic parenchyma. The therapeutic efficacy of MFA was similar with the i.p. and the i.v. route. MFA may represent a good candidate to replace CTX in cases in which a compound acting per se, and not through metabolites, is preferred.
Adenine and Pyridine Nucleotides in the Red Blood Cells of Subjects with Solid Tumors
Authors: Stocchi Vilberto , Canestrari Franco , Giacchi Remo , Sebastiani Maurizio , Lungarotti Ferdinando , Dachà Ugo , Dachà Marina
Published: April 2018

The concentration of adenine (ATP, ADP, AMP) and pyridine (NADP+, NADPH, NAD+, NADH) nucleotides in the erythrocytes of subjects affected by solid tumors was evaluated using a method which allows their simultaneous extraction and reverse-phase high-performance liquid chromatographic analysis. The results showed a lower level of ATP in the erythrocytes of subjects affected by solid tumors, whereas no significant modifications were observed in the other compounds. In fact, the mean value of ATP in these subjects was 27 % lower than that of normal adults. This fact is discussed in relation to other enzymatic and metabolic modifications previously observed in red blood cells.
Turmeric and Curcumin as Topical Agents in Cancer Therapy
Authors: Kuttan Ramadasan , Sudheeran P.C. , Josph C.D.
Published: April 2018

An ethanol extract of turmeric (« Curcuma longa ») as well as an ointment of curcumin (its active ingredient) were found to produce remarkable symptomatic relief in patients with external cancerous lesions. Reduction in smell were noted in 90 % of the cases and reduction in itching in almost all cases. Dry lesions were observed in 70 % of the cases, and a small number of patients (10 %) had a reduction in lesion size and pain. In many patients the effect continued for several months. An adverse reaction was noticed in only one of the 62 patients evaluated.
Hyperplasia and Metaplasia of Ovarian Surface Epithelium in Women with Endometrial Carcinoma. Suggestion for a Hormonal Influence in Ovarian Carcinogenesis
Authors: Resta Leonardo , De Benedictis Giuseppe , Scordari Maria Dolores , Orlando Eleonora , Borraccino Vittoria , Milillo Francesco
Published: April 2018

Surface ovarian epithelium and that of related inclusion cysts were comparatively studied in two groups of patients: one group of 50 non-pregnant women without myometrial, endometrial, or cervical hyperplasia and/or neoplasia; a second group of 50 women surgically treated for endometrial cancer and without evidence of ovarian pathology. Papillomatosis, hyperplasia and tubaric, squamoid, endometrioid and mucinous metaplasia were more frequently present in ovarian surface epithelium or in related inclusion cysts in patients with endometrial carcinoma. These findings may be correlated with a hormonal oncogenic stimulus involved in the genesis of endometrial cancer and suggests a new « hormonal » hypothesis in the pathogenesis of common epithelial tumors of the ovary.
Diminished Production of Interleukin 2 and Gamma-Interferon by Cloned «T» Cells from Patients with the Acquired Immunodeficiency Syndrome (AIDS)
Authors: Maggi Enrico , Macchia Donatella , Parronchi Paola , Milo Domenico , Romagnani Sergio
Published: April 2018

A total of 76 T-cell clones established from peripheral blood (PB) of 2 patients with the acquired immune deficiency syndrome (AIDS) and of 141 T-cell clones established from PB of 3 normal donors were compared for their ability to produce interleukin 2 (IL-2) and gamma-interferon (γ-IFN). Twenty-seven clones from AIDS patients and 85 clones from controls expressed the CD4 phenotype, whereas 49 clones from AIDS patients and 56 clones from controls expressed the CD8 phenotype. There were no significant differences in the proportions of IL-2-producing CD4 T-cell clones established from PB of patients with AIDS and controls, but the mean concentration of IL-2 produced by CD4 clones from AIDS patients was significantly lower than that produced by CD4 clones from controls. Both the proportion of γ-IFN-producing CD4 clones and the mean concentration of γ-IFN produced by CD4 clones were significantly lower in AIDS patients than in controls. In contrast, there were no differences between AIDS patients and normal individuals in the proportion of IL-2- or Y-IFN-producing CD8 clones, or in the mean concentration of IL-2 and v-IFN produced by CD8 clones. These data suggest that the reduced ability of PB T-cells from patients with AIDS to produce IL-2 and v-IFN is not simply due to altered proportions or numbers of T-cell sub-populations, but also reflects intrinsic abnormalities of individual CD4 T lymphocytes.
The Determination of Urinary Oxypurines as Markers of Gastrointestinal Tumors
Authors: Lorenzi Marco , Vannoni Daniela , Leoncini Roberto , Caldarone Ranieri , Marinello Enrico
Published: April 2018

Plasma levels and urinary excretion of oxypurines – hypoxanthine and xanthine – were evaluated by reverse-phase high-pressure liquid chromatography in 13 patients affected by gastric tumors and in 19 colorectal tumor-bearing patients. Preliminary results indicate higher values of urinary xanthine and an increase in the xanthine/hypoxanthine ratio in cancer patients. The increase was not generalized to all subjects, and did not appear related either to the stage of the disease or to CEA values. The limits within which the determination of urinary oxypurines can be employed as a tumor marker are discussed.
Case Report of a Burkitt-Like Lymphoma in a Bisexual Hiv-Positive Man
Authors: Parrinello Antonino E. , Legnami Franco A. , Fiorilli Massimo , Zecchinato Fabrizio , Papetti Claudia , Aiuti Fernando
Published: April 2018

The clinical and pathologic features of a Burkitt-like lymphoma in a bisexual HIV-seropositive man are reported. Emphasis is placed on some histologic characteristics present in a hyperplastic lymph node removed 2 years before the development of the B-cell lymphoma.
Anal Squamous Cell Carcinoma Arising on Radio-Dermatitis Cured with Chemotherapy Alone: Case Report
Authors: Barni Sandro , Frigerio Franco , Lissoni Paolo , Crispino Sergio , Paolorossi Franco
Published: April 2018

A squamous cell carcinoma of the anal canal appeared 10 years and 6 months after ionizing radiation therapy (58 Gy) for a previous squamous cell carcinoma in the same region. The patient was treated with chemotherapy alone, which produced a complete remission for 17+ months without relevant acute toxicity.
Adjuvant Chemotherapy with Adriamycin, Fluorouracil, Cyclophosphamide, Methotrexate, with or without Tamoxifen in Operable Breast Cancer
Authors: Lluch-Hernandez Ana , Cervantes-Ruiperez Andres , Anton-Torres Antonio , Aviño-Viguer Jose , Martinez-Agullo Angel , Mengual-Colomer Francisco , Ciudad-Platero Juan , Alberola-Candel Vicente , Garcia-Conde Javier
Published: April 2018

Between January 1982 and February 1985, 70 breast cancer patients with histologically confirmed axillary node involvement and T1–3a were treated following surgery with a combination of adriamycin, fluorouracil, cyclophosphamide, methotrexate, with or without tamoxifen according to the estrogen and progesterone receptors state. At 60 months of study (median follow-up, 41 months), the estimated proportion remaining disease-free was 62%. The estimated survival rate was 81%. A comparison of the actuarial disease-free and overall survival with data reported in the literature indicates a similar positive effect of adjuvant systemic therapy as described in adjuvant studies using polychemotherapy regimens. Patient acception of chemotherapy regimen was generally good. This can be accounted for because of an adequate emesis control and real compliance of the patients with the oncologist.
Cisplatin and Low-Dose Cytosine Arabinoside in Advanced Cancer
Authors: Di Costanzo Francesco , Brugia Mauro , Padalino Domenico , Maragoni Mauro , Proietti Maria Grazia , Bartolucci Roberta , Buzzi Franco
Published: April 2018

Twenty-two patients with advanced malignancies were treated with low-dose cytosine arabinoside (ara-C) (45 mg/m2 sc every 12 h for 3 days) and cisplatin (DDP) (100 mg/m2 ev on day 2, 2 h after ara-C. Patients received 61 cycles of ara-C + DDP with a median number per patient of 2.7 cycles (range, 1–5). All patients were evaluable for toxicity and response. Overall, 6 of 22 patients (27%) obtained an objective response (2 CR + 4 PR) with a median response duration of 20 weeks. Hematologic and gastrointestinal toxicities were moderate. Our results show a low response rate with the ara-C and DDP combination compared to the interesting results obtained in vitro.
Syndrome of Inappropriate Antidiuretic Hormone Secretion Associated with Hepatic Arterial Infusion of Vinblastine in Three Patients with Breast Cancer
Authors: Fraschini Giuseppe , Recchia Francesco , Holmes Frankie A.
Published: April 2018

We report the occurrence of the syndrome of inappropriate antidiuretic hormone secretion in 3 patients with breast carcinoma metastatic to the liver who received hepatic arterial infusion of vinblastine at lower doses than those previously associated with this effect. Leukopenia was severe in all patients, who additionally experienced hypokalemia with excessive kaliuresis. The etiology of the observed hypokalemia is unclear. We suspect that vinblastine may induce renal tubular dysfunction. These toxicities appear dose-related.
Non-Hodgkin's Lymphoma Associated with Sickle Cell Disease: A Case Report
Authors: Morabito Fortunato , Callea Vincenzo , Brugiatelli Maura , D'Ascola Domenico , Palazzolo Alfio , Neri Alberto
Published: April 2018

A case of non-Hodgkin's lymphoma with leukemic spread in a patient affected with homozygous sickle cell disease is reported. This association has not been previously described. A correlation between the malignancy and the hemoglobinopathy could not be etiologically ascertained; therefore, an alternative explanation to a chance event cannot be offered.
Sebaceous Carcinoma Arising from the Eyelid and from Extra-Ocular Sites
Authors: Audisio Riccardo A. , Lodeville Daniela , Quagliuolo Vittorio , Clemente Claudio
Published: April 2018

Sebaceous carcinoma is slow growing, locally aggressive and capable of metastatic spread. The natural history of sebaceous carcinoma arising from the eyelid is well known, but less than 100 cases arising from other cutaneous sites have been reported. Five cases of sebaceous carcinoma, 3 of which originated from the eyelid and 2 from extraocular sites are here reported. The patients (3 men and 2 women; median age, 69 years) were treated at the Istituto Nazionale Tumori of Milan between 1974 and 1984. Pathologic features, complete follow-up and natural history are reported.