Francesca Riboni

Serological evidence of vertical transmission of JC and BK Polyomaviruses in humans

Vertical transmission of JC virus and BK virus has been investigated by few authors, with conflicting results. We performed a combined serological and genomic study of 19 unselected pregnant women and their newborns. Blood and urine samples were collected during each gestational trimester from the pregnant women. Umbilical cord blood, peripheral blood, urine and nasopharyngeal secretion samples were taken from newborns at delivery and after 1 week and 1 month of life. Polyomavirus DNA was detected by nested PCR. Polyomavirus IgG-, IgM- and IgA-specific antibodies were measured in maternal and newborn serum samples using a virus-like-particle-based ELISA method. BKV and JCV DNA were detected in urine from 4 (21 %) and 5 (26 %) women, respectively. BKV and JCV seroprevalences in the pregnant women were 84 % and 42 %, respectively. Using a rise in the IgG level or the transient appearance of an IgA or IgM response as evidence of infection in the newborn, we detected BKV and JCV infections in four (21 %) and three (16 %) newborns, respectively. Three infants had serological evidence of infection with both BKV and JCV. In two of the four possible BKV-infected newborns, the mothers seroconverted during pregnancy, while another mother was viruric and IgA seropositive. The mother of one of the three possible JCV-infected newborns was viruric and IgA seropositive; another mother was viruric. These results suggest JC virus and BK virus can be transmitted from mother to newborn during pregnancy or soon after birth.

Diacylglycerol kinase α mediates 17-β-estradiol-induced proliferation, motility, and anchorage-independent growth of Hec-1A endometrial cancer cell line through the G protein-coupled estrogen receptor GPR30

Increased levels of endogenous and/or exogenous estrogens are one of the well known risk factors of endometrial cancer. Diacylglycerol kinases (DGKs) are a family of enzymes which phosphorylate diacylglycerol (DAG) to produce phosphatidic acid (PA), thus turning off and on DAG-mediated and PA-mediated signaling pathways, respectively. DGK α activity is stimulated by growth factors and oncogenes and is required for chemotactic, proliferative, and angiogenic signaling in vitro. Herein, using either specific siRNAs or the pharmacological inhibitor R59949, we demonstrate that DGK α activity is required for 17-β-estradiol (E2)-induced proliferation, motility, and anchorage-independent growth of Hec-1A endometrial cancer cell line. Impairment of DGK α activity also influences basal cell proliferation and growth in soft agar of Hec-1A, while it has no effects on basal cell motility. Moreover, we show that DGK α activity induced by E2, as well as its observed effects, are mediated by the G protein-coupled estrogen receptor GPR30 (GPER). These findings suggest that DGK α may be a potential target in endometrial cancer therapy.

Primary vulvar Ewing's sarcoma/primitive neuroectodermal tumor in a post-menopausal woman: A case report

Ewings sarcomas/peripheral primitive neuroectodermal tumors (ES/pPNETs) are high-grade malignant neoplasms rarely found outside the skeletal system. Only 12 cases of vulvar ES/pPNET have so far been reported, all involving children or women of child-bearing age. We describe the case of a 52-year-old woman who was admitted to our hospital for the local excision of a 4cm vulvar mass, originally thought to be a Bartholins gland cyst. It was subsequently found to consist of small round cells positive for anti-CD99 antibody, thus suggesting a diagnosis of ES/pPNET. The demonstration of EWSR1 gene translocations by means of fluorescent in situ hybridization excluded small-cell carcinoma, squamous cell carcinoma of the small type, Merkel cell carcinoma, and lymphoblastic lymphoma. After surgery, the patient received six cycles of polychemotherapy and radiotherapy; she is still alive and well after 1 year of follow-up. Our findings underline the crucial role of molecular biology techniques in the differential diagnosis of small round cell tumors in these unusual locations.

Accuracy of a new diagnostic tool in deep infiltrating endometriosis: Positron emission tomography–computed tomography with 16α‐[18F]fluoro‐17β‐estradiol

Preoperative workup of deep infiltrating endometriosis is limited in the evaluation of extragenital and extrapelvic disease and in distinguishing between the previous surgical scar and active lesion. Histological verification remains the gold standard for diagnosis. The aim of this study was therefore to evaluate positron emission tomography–computed tomography (PET/CT) with an experimental estrogen receptor tracer (16α‐[18F]fluoro‐17β‐estradiol; [18F]FES) for accurate staging and non‐invasive diagnosis of the disease. The primary endpoint was the feasibility of this tool on comparison with histology. The secondary endpoint was the accuracy of PET/CT in comparison with magnetic resonance imaging (MRI).

Peritoneal Psammocarcinoma Diagnosed by a Papanicolau Smear

BACKGROUND: Serous psammocarcinoma is a rare variant of epithelial neoplasia that can arise from the ovaries or peritoneum. It is characterized by massive psammoma body formation, invasiveness and low grade cytologic features. CASE: A 70-year-old woman was admitted to our hospital; a bimanual examination with cervicovaginal smear was performed. The smears revealed neoplastic cells with psammoma bodies; afterward, endocervical curettage revealed microaggregates of epithelial neoplastic cells with psammoma bodies. Computed tomography of the abdomen showed a diffuse peritoneal carcinosis with left ovarian calcification. An exploratory laparotomy was carried out. Final pathologic findings showed peritoneal serous psammocarcinoma with ovarian implants. CONCLUSION: Our report suggests that a Pap smear can play a role in the detection of peritoneal psammocarcinoma and underlines the significance of psammoma bodies as a cytologic marker of this rare tumor.

Thrombophilias in pregnancy and their role in preeclampsia

Thrombophilias are inherited or acquired conditions that predispose the affected individual to thromboembolism. Several studies have demonstrated that the presence of thrombophilic defects is a risk factor for adverse pregnancy outcome. Preeclampsia (PE) is associated with vascular and endothelial damage and thrombophilias may play an important role in this pathology. Most studies have found an association between early-onset PE and thrombophilia. Early recognition of PE is essential for optimal treatment but, at present, specific markers of the disease are lacking. Therapy must address the prevention of maternal complications and improvement of neonatal outcome. There is no clear evidence to support the use of heparin prophylaxis for PE. A high dose of antithrombin concentrate may represent a possible therapy in early-onset PE. Preventive and conservative treatment of PE with early diagnosis and a new therapeutic approach will allow the prolongation of pregnancy with fewer maternal and fetal complications.