1,720,967 research outputs found

    Cytomegalovirus infection of endocrine system in a patient with diffuse large B-cell lymphoma. Report of a case

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    Cytomegalovirus (CMV) is an opportunistic pathogen causing different diseases in immunocompromised patients and leading to death in a high percentage of cases. CMV infection is also relatively frequent among patients with hematological malignancies, especially when treated with immunosuppressive agents. We describe the clinical history of a patientwith stage IV diffuse large B-cell lymphoma (DLBCL) treated with eight courses of R-CHOP every two weeks, who presented clinical remission of the disease at the end of therapy. However, two months later he developed neurological symptoms due to cerebellar involvement and a subcutaneous dorsal lymphomatous infiltration. He had a partial response after chemotherapy and brain radiotherapy, but his clinical course was complicated by fever and hypotension. Although the fever resolved with broad-spectrum antibiotics, he presented progressive endocrine failure and died three weeks later. Autopsy confirmed disseminated multiorgan involvement by DLBCL associated with an unexpected CMV infection of the lungs and several endocrine organs including the pituitary gland, pancreatic islets and adrenals, a clinical association not previously reported in the English literatur

    Dynamic Identification of the Collapse Mechanisms of a Masonry Arch

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    The preservation, the safeguard and the valorization of the existing architectural heritage requires the development of theoretical and experimental approaches that can effectively identify any damage of the structures that could lead to their collapse. In the case of masonry constructions, the methodology becomes complex both due to the uncertainties deriving from the mechanical behavior of the masonry material, and due to the necessity to use contactless experimental approaches, which do not lead to the damage of the structure and can also be performed during the service life phase. In this article, we propose a damage identification method for masonry arches and vaults, based on the analysis of the dynamic tests results. In particular, our approach is able to identify the collapse mechanism of masonry curved structures in terms of position of hinges and depths of cracks. The case study consists of a clay-brick masonry arch subjected to an eccentric load on extrados. The experimental values of frequencies were used to calibrate a numerical model of the undamaged arch. A comparison between numerical and experimental frequencies values related to damaged and undamaged configuration was allowed to develop an effective approach to identify the collapse mechanism of arch

    Primary small cell neuroendocrine carcinoma of the kidney: morphological, immunohistochemical, ultrastructural, and cytogenetic study of a case and review of the literature

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    Poorly differentiated neuroendocrine carcinomas (PDNECs) of the kidney are extremely rare high-grade cancers accounting for only 42 cases reported in the literature. In this paper, we describe the morphological, immunohistochemical, ultrastructural, and for the first time, cytogenetic features of a renal PDNEC. In addition, we have reviewed the literature and compared the published clinicopathological data with our morphological and genetic results. The tumor arose within the kidney parenchyma and showed the typical histological features of a pure small cell PDNEC. Fluorescence in situ hybridization study demonstrated a complex chromosomal assessment indicative of a high degree of chromosome instability with gain of multiple chromosomes, loss of p53, and amplification of myc gene. These results suggest that renal PDNEC has a different genetic background to renal clear cell carcinoma, mainly characterized by the loss of the short arm of chromosome 3. Conversely, genetic alterations seem to resemble those of type 2 papillary renal cell carcinoma. The review of the literature demonstrated that PDNECs are associated with poor prognosis and that parenchymal tumors show some differences from those arising in the pelvis, in that parenchymal tumors are purely neuroendocrine while pelvic tumors are mostly mixed neuroendocrine-exocrine neoplasms
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