Giuseppe Troccoli

Epidermal growth factor receptor serum levels and prognostic value in malignant gliomas.

Aims and background The epidermal growth factor receptor (EGFR) is a member of a family of cell membrane receptors that use tyrosine kinase activity as the signal transduction mechanism. It is commonly expressed or overexpressed by many solid tumors and correlates with disease progression and a poor clinical prognosis. Increased EGFR expression might therefore be a strong prognostic feature in multiple tumor types, and inhibition of its cellular actions may have substantial therapeutic benefit. The aim of this study was to estimate the EGFR serum concentration for potential use as a biological marker of brain cancer to predict prognosis and follow-up after treatment. Methods and study design Serum samples obtained from 50 healthy individuals and 65 brain cancer patients (35 glioblastoma multiforme and 30 anaplastic astrocytomas) were collected before and after treatment and assayed for EGFR extracellular domain serum concentrations by a sandwich ELISA. Results EGFR was elevated in 47 of 65 brain cancer patients, with mean serum values of 84 ± 18 ng/ml, compared with that of healthy controls (43.6 ± 11 ng/ml, P = 0.001). There was a significant difference in the mean serum levels of EGFR between glioblastoma multiforme patients (96.2 ± 12 ng/ml) and anaplastic astrocytoma patients (71.6 ± 18 ng/ml, P = 0.04). Sixty brain cancer patients underwent surgery; EGFR serum levels did not show significant differences from those observed before surgery. For all patients, median overall survival was 13 months (anaplastic astrocytoma, 18 months; glioblastoma multiforme, 12.5 months). In 47 patients with high EGFR serum levels, overall survival was reduced (P = 0. 01), with a median survival time corresponding to 11.5 months (anaplastic astrocytoma, 14.5 months; glioblastoma multiforme, 10.5 months). Conclusions Although a prospective study with large sample size is warranted, serum EGFR extracellular domain may be potentially useful as a biological marker of gliomas for prediction of prognosis and follow-up after treatment.

Cytochemical study of acute promyelocytic leukaemia.

SummaryFive cases of acute promyclocytic leukaemia (A.P.L.) are investigated for peroxidase, PAS, toluidine blue, astra blue, α-naphthyl esterase, double esterase incubation (naphthol-AS + naphthol-AS-D chloroesterase), and cellular lysozyme activity.These cytochemical investigations may contribute further characterizations of the morphologic type.ZusammenfassungVerfasser berichten über 5 Fälle von akuter promyelozytärer Leukämie (APL) bei Frauen zwischen 22 bis 43 Jahren. Die zytochemischen Methoden (Peroxydase, PAS, Toluidinblau, Astrablau, α-Naphthyl-Esterase, Doppel-Esterase-Inkubation, Lysozym) zeigen charakteristische Differenzen der Zellen von APL, auch wenn sie morphologisch identisch sein mögen.

Association of a Wide Invasive Malignant Thymoma with Myastenia Gravis and Primary Hyperparathyroidism Due to Parathyroid Adenoma: Case Report and Review of the Literature

There are few cases described in the world literature reporting an association of thymoma (with myasthenia gravis or not) with hyperparathyroidism. In these cases the hyperparathyroidism was due to the presence of an adenoma or hyperplasic parathyroid tissue either in the cervical region or in an ectopic intrathymic location.() In other cases the syndrome of hypercalcemia was due to the secretion of parathyroid-related protein (PTHRP) () or parathyroid hormone (PTH) () by the thymoma itself. We report the first case, at the best of our knowledge, of a wide invasive malignant thymoma (type B3), associated with myasthenia gravis and hyperparathyroidism caused by parathyroid adenoma.

Evaluation of non-stimulated nitroblue-tetrazolium test in patients with malignant lymphomas

ZusammenfassungDer Nitroblau-Tetrazolium-Test (NBT) wurde bei 54 Patienten mit malignen Lymphomen durchgeführt. Diese Patienten hatten mit einer Ausnahme keine erkennbaren Infektionen. Bei 18 Patienten war vorder Erkrankung die Zahl der NBT-reduzierenden Granulozyten über die Norm erhöht.Verlaufsuntersuchungen wÄhrend einer Polychemotherapie bei 17 Patienten zeigten, da\ die Zytostatika-Therapie als solche die Zahl der NBT-reduzierten Granulozyten nicht vermindert.Die Ergebnisse zeigen, da\ der NBT-Test bei malignen Lyphomen zum Nachweis bakterieller Infektionen nicht geeignet ist.SummaryThe NBT-test was performed in 54 patients with Hodgkin and nonHodgkin lymphoma showing no bacterial infection exept for one case. 18 patients presented, at onset of the disease, a number of neutrophilic NBT-reducing granulocytes at pathological levels (> 12%).In order to evaluate the influence of cytostatic drugs on NBT-test serial blood samples were taken during polychemotherapy in 17 patients with lymphoma. In our experience, cytostatics (COPP) do not necessarily lessen NBT-reducing activity of granulocytes.The results suggest that the NBT in malignant lymphomas could not be used as an indication of bacterial infection.

Leucemia acuta a promielociti cosiddetti basofili

SummaryAcute leukaemia with so-called basophilic promyelocytes is a form of myelogenous leukaemia with peculiar cytoenzymatic patterns. The abundant metachromatic substance and the particular esterase activities (double naphthol-AS and chloroesterase incubation) of these promyelocytes differ from other promyelocytic leukaemias. It is interesting to note that chloroesterase-positive Auer bodies are present in both leukaemic cells with mixed esterase activity and in leukaemic cells with naphthol-AS esterase activity. We believe that this consideration is pointed out here for the first time. Some rare elements, morphologically similar to promyelocytes, displayMicrococcus lysodeicticus lytic activity. These are usually monocytes mistaken for promyelocytes. The characteristics of promyelocytic, so-called basophilic leukaemia described in this paper differentiate it from other myelogenous leukaemias.RiassuntoLa leucemia acuta a promielociti cosiddetti basofili è una forma di leucemia mielogena che presenta particolaripatterns citochimici, rappresentati principalmente da una notevole quantità di sostanza metacromatica negli elementi leucemici e da un particolare comportamento delle attività esterasiche (doppia incubazione naftol-AS e cloroesterasica) diverso da quello di altre leucemie a promielociti. È interessante sottolineare il fatto che i corpi di Auer, con esclusiva attività cloroesterasica, sono presenti in cellule leucemiche con attività esterasica mista ed in cellule con esclusiva attività naftol-AS esterasica, osservazione questa segnalata per la prima volta a nostra conoscenza. Inoltre alcuni rari elementi, morfologicamente simili ad elementi promielocitari, mostrano attività litica nei conftonti delMicrococcus lysodeicticus: sarebbero quindi elementi monocitari scambiati per promielociti. Le caratteristiche descritte in questa leucemia a promielociti cosiddetti basofili tendono a differenziare questa forma leucemica da altre leucemie mielogene.