Luigi Giarelli

Gastric resection. A cause of high frequency of gastric carcinoma

On 10,630 autopsies, 480 cases with a gastric resection for benign conditions, performed more than 5 years previously, were found. Pathologic findings revealed 31 (6.5%) cases of gastric stump carcinoma. On the basis of clinical and pathologic data, the authors could demonstrate that gastric carcinoma occurs with significantly higher frequency in resected patients than in unresected ones. Patients having resection before age 45 years are at increased risk (2.46) in developing gastric stump carcinoma, while patients undergoing operation at age 45 years or later are not (0.65). The distribution of gastric carcinoma according to age classes at death in resected and unresected patients is very similar, with an increasing frequency after age 55 years in both groups.

Schnabel cavernous degeneration: a vascular change of the aging eye.

Abstract Context.—Schnabel cavernous degeneration is a histologic finding originally attributed to glaucoma; however, its cause and significance have been controversial. Objective.—To determine the basic cause of the formation of cavernous spaces in the proximal optic nerve and its clinical significance. Methods.—A retrospective analysis of 4500 autopsy eyes processed for histologic evaluation between 1967 and 1991. Results.—Ninety-three (2.1% of eyes examined) cases of Schnabel cavernous optic atrophy were identified. The majority of the eyes were from women (81%). The mean age of the entire group was 88 years (reference range, 54–103 years). Severe vascular anomalies were present in 75% of the individuals. Cavernous degeneration was unilateral in 82% of the cases. Loss of ganglion cells and nerve fiber layer consistent with glaucoma was found in 23.7% of the individuals. Clinical information was available for 15 individuals (16%). Half of them were thought to have some clinical optic nerve damage; in th...

14 cases of cavernous degeneration of the optic nerve.

After a brief bibliographical introduction the authors report on 14 cases of cavernous degeneration of the optic nerve, based upon the study of 1,831 autoptic cases. All the subjects examined showed lesions of a senile degenerative type in the vessels afferent to the retro-laminar segment of the optic nerve. The pathogenetic mechanism of the lesion under examination seems therefore to be attributable to ischaemic cause of a chronic type. Myopia and glaucoma, if present, would also seem to contribute, as they cause disorders of the blood system in this region.

Atherosclerosis and pancreatic damage

The appearance of diabetes in advanced age may be considered as a part of the involutive processes of aging, and as such, it might have a pathogenesis completely different from that of type 2 diabetes of medium age. As a matter of fact, it has been observed that the pancreas undergoes numerous structural and functional alterations with advancing age, both in exocrine and endocrine parts. The present studies have been performed to reveal the quantity and quality of the pancreatic lesions, which may be attributed to atherosclerosis. We have already studied elderly subjects, therefore, we were now looking for further supports in a population of middle age people, died in complications of malignant hypertension. We investigated the pancreas, kidney and heart of 36 subjects (20 males and 16 females) with mean age of 48.6+/-8.9 years. Of this group, eight subjects (22.2%) became diabetic after the appearance of malignant hypertension. Arteriolar atherosclerosis damage (hyalinosis, thickening and stenosis) of the pancreatic arterioles were found in 92.8% of the non-diabetic, and in 87.5% of the diabetic subjects. Lesions of the pancreatic islets were observed in 32% of the non-diabetics, and in 50% of the diabetic subjects. The pancreas is an organ, which tends particularly to develop atherosclerotic damage. The vascular lesion of atherosclerotic origin, independently from the mechanism of its appearance, causes first only a decrease of the blood flux and hypoxia in the pancreatic islets with a consecutive functional decline of the beta-cells. This is then followed by structural modifications of the islets accompanied by the appearance of hyalinosis, loss of beta-cells, and a further decrease of insulin production.

PREVALENCE OF FEMALE BREAST CANCER OBSERVED IN 517 UNSELECTED NECROPSIES

layer of fluorescein isothiocyanate (FITC) conjugated avidin. Probe fluorescence was then amplified with a biotin-labelled anti-avidin antibody and a second layer of FITC-avidin.2 The probe staining took about 4 h altogether. Nuclear DNA was stained with DAPI. Hybridised nuclei were viewed with a fluorescence microscope tuned on ultraviolet excitation for DAPI detection and 488 nm for FITC. Yellow spots representing hybridised loci were counted in each nucleus by switching from ultraviolet to fluorescein excitation. 200 cells were evaluable for diagnosis from all slides. 5-10% of cells presenting only two spots were detected, but in these the spots were larger or more fluorescent, suggesting that one of the three hybridised loci was too close to another to be discriminated. Diagnosis was confirmed with standard cytogenetic techniques on blood cells by fetal blood sampling under ultrasound guidance.3 We feel that such a technique could, for screening, of numerical chromosome abnormalities, be an improvement on classical karyotyping. The reliability of this new procedure mainly depends on the specificity of the DNA probe. More and more genetic laboratories are producing highly specific clones from human chromosome libraries. This may enlarge rapidly the field of action of this method. Already available are X and Y chromosome specific sequences that are obviously needed for sexual abnormalities. X, Y, and 21 chromosome probes would cover, with the technique described here, about 95% of constitutional chromosomal abnormalities. This method combines the accuracy of an all-ornone response with speed. Fluorescent in-situ hybridisation is also less expensive and easier than its radioactive equivalent. Since the amniocentesis under ultrasound guidance has proved to be safe, we

Primary liver cancer in non‐cirrhotic liver. Epidemiological study based on autopsies performed in Trieste, Italy and Kurume, Japan

This study, aimed at elucidating the epidemiological features of primary liver carcinoma developing in non‐cirrhotic livers, was based on 25 103 autopsies performed between 1975 and 1984 in Trieste, Italy. These autopsies correspond to approximately 70% of all deaths that occurred in this area. Various factors allegedly related to carcinomas were analysed in reference to our previous study on cirrhotic livers and in comparison with 5603 autopsies in Kurume, Japan. There were 28 cases of hepatocellular carcinoma (HCC), 16 of cholangiocellular carcinoma (CCC) not associated with cirrhosis in Trieste, and 48 HCC and 19 CCC in Kurume. On the basis of our findings, it was concluded that cirrhosis, regardless of its cause, is the main pathogenetic factor in HCC; it is responsible for a much higher frequency (14.2:1) than in non‐cirrhotic livers, as well as for early occurrence of tumours (an average of 6 years earlier in cirrhotic liver) in Trieste. Patients in Trieste were older than those in Japan, and the frequency of HCC among all autopsies was much greater in the latter.

Eye Involvement in Waldenström's Macroglobulinaemia

A case of WaldenstrOm macroglobulinaemia with eye involvement is described, with emphasis being given to the histopathology of unusual lesions of sclera, choroid and extraocular tissues due to in

Bilateral Breast Metastases from Oat‐Cell Lung Carcinoma in a Man Treated with Diethylstilbestrol for Prostatic Adenocarcinoma

ABSTRACT: A case report is presented of bilateral breast metastases originating from oat‐cell carcinoma of the lung in a man treated with diethylstilbestrol for carcinoma of the prostate. The metastatic spread to both breasts apparently was related to the estrogen therapy.

Anatomo-clinical correlations in amyloidosis of the islets of langerhans

SummaryAfter discussing previous publications on the subject, the authors describe 25 cases of amyloid disease of the islets of Langerhans. They come to the conclusion that two factors,i.e. diabetes mellitus and aging, are responsible for pancreatic amyloidosis.

Giant-cell pneumonia and lung tumorlets in a leukemic four-year-old child.

The authors report a case of a 4-year-old child whose death resulted from acute lymphoblastic leukemia (ALL) and giant-cell pneumonia. Typical lung tumorlets were occasionally observed. On electron microscopy study it was possible to demonstrate a large number of neurosecretory granules in the tumorlets cells, identical to those present in Kulchitskys cells. These studies suggest the occurrence of an abnormal immunitary process.