1,720,964 research outputs found
Breast citology
No full textFine needle aspiration (FNA) has traditionally been regarded as the simplest, less invasive and less expensive diagnostic procedure for the definition of breast lesions. In expert hands, it allows obtaining an accurate diagnosis in most breast lesions.
The introduction of widespread mammographic screeningprogrammes and the consequent detection of a large number of small, non-palpable lesions have increasingly brought to the routine use of other minimally invasive biopsy methods using heavier gauge cutting needles – the so-called core biopsies (CB) and other automatic, imaging-guideddevices, such as vacuum assisted biopsies (VAB) – partially obscuring the central role of FNA. Recently, new recommendations propose to definitively abandon FNA, restricting all morphological investigations to CB.Has FNA completely lost its role as to let us to remove it from the routine diagnostic practice? In our personal experience from the breast unit of Trieste, where there systematic use of FNA is available, it is proved that this method may bring to a definitive diagnosis 2/3 of the lesions investigated. The unjustified abandonment of the technique by breast healthcare centres must be avoided, since it could only have negative repercussions on the whole preoperative diagnostics.it is necessary for the pathologists to guarantee the maintenance of their professional expertise in this field, and to transmit it to the young
Thyroid Metastases From Renal Cell Carcinoma Presenting as Thyroid Nodules With Involvement of an Adjacent Vein
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BREAST CYTOLOGY: AN EXAMPLE OF STRONG SYNERGY BETWEEN MORFOLOGY AND CLINICAL NEEDS
No full textBreast Fine Needle Aspiration Cytology (FNAC) represents first choice diagnostic tool to determine mammographic lesions and clinically palpable breast nodules. FNAC is affected anyway by a certain degree of subjectiveness, that is more evident with the so- called “grey zone” cases (the ones not clearly benign or not clearly malignant) and when there are some doubts about material adequacy. These situations may create some misunderstandings between clinicians and pathologists with possible over or undertreatment for patients. The need for clear communication is extremely important, but it becomes a priority in senology because of the multidisciplinary aspects of the field. For this reasons a breast cytology reporting system has been proposed since 1993 within a U.K. mammographic breast screening programme. From our experience we think only a cytological exam with well demonstrated and well documented quality which satisfies those criteria suggested by guidelines will be able to play a key role in patients’ clinical management. It will allow reducing as much as possible diagnostic biopsies on benign lesions and frozen sections to confirm malignant lesions.We believe that a good quality cytology can provide an important and relevant contribution to define breast lesions’ nature without using other invasive procedures and to obtain in most cases good material for subsequent molecular investigations.
Cytological approach to breast lesions was also validated in Breast Unit of Trieste during EUSOMA certification visit
HSV respiratory tract infections in immunocompromised patients not undergoing mechanical ventilation
No full textUnveiling tumor invasiveness: enhancing cancer diagnosis with phase-contrast microtomography for 3D virtual histology
Full text linkMalignant diseases are characterized by a critical trait known as invasiveness, where tumor cells tend to spread from the primary tissue layer into surrounding healthy tissues and distant organs. Presently, histopathology offers essential insights for diagnosing, classifying, predicting outcomes, and guiding patient-specific treatments. However, histology offers two-dimensional data from chosen cutting planes. Although 3D histological volumes can be generated through serial sectioning or whole slide imaging, this method is laborious, may introduce processing artefacts, and lacks isotropic spatial resolution. These limitations pose a considerable challenge to accurate diagnoses, particularly when dealing with micro-infiltrating carcinomas. These lesions, characterized by minute infiltrations, demand a three-dimensional representation for comprehensive visualization, essential for precise identification and assessment. Emerging X-ray-based virtual histology technology offers three-dimensional visualization of soft-tissue specimens, enabling virtual slicing in any direction or at any point. This approach can assist in guiding tissue sectioning for optimal representation of tumor cross sections during histological analysis.Micro-infiltrating carcinomas from the breast, cervix, and thyroid were imaged using X-ray phase-contrast microtomography (PhC-μCT) at the Elettra synchrotron facility in Trieste, Italy. Comparative assessment of histological and CT slices by pathologists revealed that PhC-μCT aids in classifying lesions by highlighting distinct tissue components and, notably, identifying tissue invasion. Reviewing a volume image allows pathologists to trace the entire lesion, identifying invasion sites that might be overlooked in individual or serial histological sections. Consequently, this proposed method could complement pathologists’ tools, potentially enhancing diagnoses by minimizing under-staging and reducing false negative results
How Porcine Acellular Dermal Matrix Influences the Development of the Breast Capsule 1 Year after Implantation: A Histopathological Analysis
Full text linkBackground: In prepectoral breast reconstruction (PPBR) the acellular dermal matrix (ADM)'s integration capacity into the tissue is known. The aim of this study was to analyze the effect of the ADM on development and composition of the peri-implant breast capsule in a dynamic setting of breast tissue expansion during two-stage prepectoral breast reconstruction.Methods: This is a prospective single-center study in which 50 patients who underwent mastectomy and breast reconstruction with prepectoral tissue expander and Braxon ADM (group A) and submuscular tissue expander (group B) were enrolled. One-year post implantation hematoxylin & eosin (H&E) staining and immunohistochemistry analyses were done on capsule tissue samples.Results: The analysis conducted on H&E-stained samples showed a significant reduction of cellular density and a decrease of the cellular infiltration in capsules of ADM-covered expanders compared with naked expander capsules (P < 0.05). The immunohistochemical analyses showed that group A capsules presented significantly less M1 CD68+ macrophages (P < 0.05), lower alfa-SMA expression levels, and a lower number of myofibroblasts (P < 0.05) compared with group B capsules. Presence of lymphatic vessels was minimally detected in both groups.Conclusions: The ADM presence around the prepectoral tissue expander influences the development of the peri-implant capsule, causing a significant reduction of the number of cells and inflammatory infiltrate, especially M1 macrophages and myofibroblasts. The ADM Braxon is therefore effective in creating a noninflamed capsule around the implant and in dynamic tissue conditions, and such an environment is maintained in time
NEODUCTGENESIS AS A PROGNOSTIC MARKER IN “DUCTAL” CARCINOMA IN SITU OF THE BREAST
No full textObjective. Ductal carcinoma in situ (DCIS) of the breast is
becoming more and more frequent in women after the introduction
of breast screening programmes. Once the diagnosis
is confirmed on the surgical specimen, its prognosis is excellent,
but still some tumours recur as in situ or even invasive
neoplasms in the same or contralateral breast.
Neoductgenesis (NGD), defined by László Tabár and Tibor
Tot as the presence of “casting type” calcifications on mammography,
an abnormal number of ducts, periductal desmoplastic
reaction and lymphocytic infiltrate, has been proposed
as a marker of aggressiveness in “early” breast carcinoma
(1 2). We analysed this phenomenon in pure DCIS by correlating
its presence with clinical and instrumental findings,
morphological and immunohistochemical features, and with
patients’ prognosis.
Materials and Methods. We selected 199 cases of breast
DCIS undergone surgery between 2004 and 2016, available
at the Unit of Pathology of the Academic Hospital of Trieste,
and performed a re-evaluation of the histological slides in
order to define the presence or absence of NDG, based on the
morphological features previously described2. Furthermore,
a subgroup of 64 cases underwent radiological review by
two expert radiologists (AF, MT) in order to re-classify the
mammographic findings according to specific types of calcifications1.
The correlation between morphological NDG,
casting type calcifications and prognostic markers of breast
DCIS, such as extension, grade and expression of hormonal
receptors and HER2-neu, as well as with disease recurrence,
was evaluated through Chi-Square independence test or Fisher
test as appropriate.
Results. NDG was identified in 33 cases (16.6%) and was
found to be positively associated with the larger size of lesions
on mammography (p=0.008), histological high grade
(p<0.001), presence of necrosis (p<0.001), low expression
of hormonal receptors (p<0.001), HER2-neu overexpression
(p=0.005) and high proliferative index (p<0.001). Casting
type calcifications were present in 54% of DCIS with NDG
and 44% of DCIS without NDG (p=0.70). They were also
found in 63% of DCIS with comedo type necrosis versus 35%
of DCIS without comedo necrosis (p=0.07). Nine patients
(4.64%) developed disease recurrences during the follow-up
and among them 5 had tumours with the morphological features
of NDG.
Conclusions. Consistent with literature, the morphological
features of NDG were able to identify lesions with an “aggressive”
biological phenotype. Interestingly, NDG was found to
positively correlate with disease recurrences in patients with
pure DCIS
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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