Daniela Moncini - Academia.edu (original) (raw)

Papers by Daniela Moncini

The Ochsner journal, 2015

Endometriosis can be intrapelvic or, rarely, extrapelvic. Endometriosis involving the rectus abdo... more Endometriosis can be intrapelvic or, rarely, extrapelvic. Endometriosis involving the rectus abdominis muscle on the trocar port site is a rare event; until now, only 16 cases have been reported in the literature. The majority of cases were associated with previous abdominal surgery such as diagnostic laparoscopy, cyst excision, appendectomy, myomectomy, or cholecystectomy. We review all the reported cases of this unusual form of extrapelvic endometriosis. We report a new case of abdominal wall endometriosis at the trocar port site in the rectus abdominis muscle in a woman who had undergone 2 laparoscopies for endometriosis in the 3 years before coming to our attention. The diagnosis was made by sonography. We performed a surgical resection of the lesion with a free macroscopic margin of 5-10 mm. Endometriosis should be considered in the differential diagnosis of any abdominal swelling. In our experience, surgery is the treatment of choice.

Investigative Ophthalmology & Visual Science, 2008

To determine whether infliximab may be used safely as an intraocular drug, the ocular safety of i... more To determine whether infliximab may be used safely as an intraocular drug, the ocular safety of intravitreal infliximab in rabbits was studied by clinical examination, electroretinography (ERG), and histology in rabbits. METHODS. Twelve New Zealand albino rabbits were selected for this study. Different infliximab doses, namely 1.0 mg, 1.7 mg, and 3.3 mg in 0.1 mL, were injected intravitreally into one eye each of three rabbits. As a control, the vehicle solution was injected into the fellow eye of each animal. Eye clinical examination and ERG recordings were made before and 2, 6, and 12 weeks after injection. Eventually, the rabbits were humanely killed, and the retinas were examined by light microscopy. In addition, the elimination half-life of the drug in the vitreous was assessed. RESULTS. Slit lamp biomicroscopy, indirect funduscopy, and ERG evidenced no significant differences between control and infliximab-injected eyes in this rabbit model, at any of the tested doses. Histologic examination revealed no retinal abnormality in the rabbits injected with 1 mg and 1.7 mg intravitreal infliximab. In two of three eyes injected with 3.3 mg infliximab, significant edema of the nerve fibers was detected compared with the control group. The half-life of the drug was estimated to be 8.5 days.

Archives of Gynecology and Obstetrics, 2014

Human papillomavirus (HPV), especially HPV 16, is associated with the development of both cervica... more Human papillomavirus (HPV), especially HPV 16, is associated with the development of both cervical and oral cancer. We show the case of a woman affected by HPV-related cervical disease and oropharyngeal squamous cell carcinoma (OPSCC). A 41-year-old woman arrived at our Colposcopy Center following an abnormal Pap smear result (ASC-H) and a diagnosis of moderate cervical dysplasia obtained by a cervical biopsy. She underwent a colposcopy that showed a cervical abnormal transformation zone grade 2. A laser conization was performed in November 2010. Histology reported a moderate/severe dysplasia. The cone resection margins were free. Follow-up colposcopy and cytology were negative. The HPV testing showed an infection by HPV 16. In October 2012, the patient presented to the Head-Neck ER after episodes of hemoptysis; a lesion was found in the left tonsillar lodge. A biopsy was performed with a result of squamous cell carcinoma with low-grade differentiation. The HPV testing detected a high-risk HPV and the immunohistochemical analysis was positive for p16. She was treated by chemotherapy and brachytherapy. She was followed at the head-neck center with monthly visits with oral visual inspection that showed complete absence of mucosal abnormalities. HPV-related OPSCC and cervical precancerous/cancerous lesions have significant similarities in terms of pathogenesis. They are both caused largely by HPV 16, as in the present case. In conclusion, because of this association found in literature and in our case, we think that women with HPV cervical lesions should have regular surveillance for oropharyngeal cancer, whereas women with OPSCC should be encouraged to have diligent cervical screening.

Neuropathology, 2010

Lipoastrocytoma is an extremely rare tumor, with only six cases described. We report the case of ... more Lipoastrocytoma is an extremely rare tumor, with only six cases described. We report the case of an astrocytoma involving the upper part of the cerebellar-pontine angle and the right portion of the clivus starting from the brainstem with a diffuse lipomatous component in a 39 year-old man. The patient was admitted with headache of 1 year's duration and diplopia over the previous 3 months. MRI revealed a ponto-cerebellar lesion that showed irregular enhancement after contrast administration. Subtotal excision of the tumor was accomplished. Adjuvant chemotherapy and radiation therapy were not administered. Histologically the tumor showed the classical histology of low-grade astrocytoma and a portion of the lesion was composed of lipid-laden cells. Immunohistochemistry for glial fibrillary acid and S-100 proteins clearly demonstrated the glial nature of these cells. Ki-67/Mib-1 labeling index was low (2%). The patient remains in good neurological conditions after 10 months. Our case has a benign postoperative behavior, also after subtotal excision, with restrictions due to the short follow-up. It is important to record each new case of this rare tumor to produce a better characterization of this lesion.

Diagnostic Cytopathology, 2008

... Francesca Garbini MD 1,* ,; Anna Maria Buccoliero MD 1 ,; Francesca Castiglione MD 1 ,; Chiar... more ... Francesca Garbini MD 1,* ,; Anna Maria Buccoliero MD 1 ,; Francesca Castiglione MD 1 ,; Chiara Francesca Gheri MD 1 ,; Daniela Moncini MD 1 ,; Duccio Rossi Degl'Innocenti B.Sc. 1 ,; Alfredo Barbetti B.Sc. 1 ,; Alessandro Villanucci MD 2 ,; Gian Luigi Taddei MD 1. ...

The European Journal of Contraception Reproductive Health Care the Official Journal of the European Society of Contraception, Dec 1, 1997

Endometrial hyperplasias, which occur in the premenopausal age and are often induced by anovulato... more Endometrial hyperplasias, which occur in the premenopausal age and are often induced by anovulatory cycles, are kept under control by progestin therapy. The good results with natural and synthetic progestins suggest that this treatment can be used both in premenopause and postmenopause hyperplasia. The progestin effect on the endometrium appears through a marked pseudodecidual reaction of the stroma and functional atrophy of the glands. These events are reported in the literature as inactive or suppressed endometrium and there is no physiological equivalent.

Obstetrical & Gynecological Survey, 2008

The European Journal of Contraception and Reproductive Health Care, 1997

Endometrial hyperplasias, which occur in the premenopausal age and are often induced by anovulato... more Endometrial hyperplasias, which occur in the premenopausal age and are often induced by anovulatory cycles, are kept under control by progestin therapy. The good results with natural and synthetic progestins suggest that this treatment can be used both in premenopause and postmenopause hyperplasia. The progestin effect on the endometrium appears through a marked pseudodecidual reaction of the stroma and functional atrophy of the glands. These events are reported in the literature as inactive or suppressed endometrium and there is no physiological equivalent.

Tumors of the Central Nervous System, 2013

Journal of Pediatric Hematology/Oncology, 2011

Herein, we describe an intracerebral primary low-grade myxofibrosarcoma occurring in a 9-year-old... more Herein, we describe an intracerebral primary low-grade myxofibrosarcoma occurring in a 9-year-old boy. The lesion measured 7 cm and occupied the left parieto-occipital region. A gross-total removal of the tumor was performed. Nine months later, radiologic follow-up revealed a local recurrence which was again surgically removed. The patient then underwent radiotherapy and chemotherapy. He was well and disease-free at 6 months follow-up. The tumor was composed of spindle, stellated, and multinucleated cells embedded in a myxoid background. Foci of increased cellularity, pleomorphism, and high mitotic rate were present. The tumor borders were sharply demarcated from the non-neoplastic nervous parenchyma. Immunohistochemical staining showed that the neoplastic cells were vimentine and CD34 positive. Fluorescence in-situ hybridization analyses did not show FUS and EWSR1 gene rearrangements. Primary intracranial myxofibrosarcomas are very rare (to the best of our knowledge, less than 10 published cases in the international literature). We believe each new case should be recorded to produce a better clinical, pathologic, molecular, prognostic, and therapeutic characterization of this lesion.

Gynecologic and Obstetric Investigation, 2008

The aim of this study was to evaluate the utility of liquid-based cytology for endometrial survei... more The aim of this study was to evaluate the utility of liquid-based cytology for endometrial surveillance in patients receiving tamoxifen. One hundred and sixty-eight women scheduled for hysteroscopy were enrolled in the study. The women sequentially underwent hysteroscopy, endometrial cytology and biopsy. Endometrial biopsy only was inadequate in 112 (67%) patients, both endometrial biopsy and cytology were inadequate in 19 (11%) patients, endometrial cytology only was inadequate in 4 (2%) patients, and both endometrial biopsy and cytology were adequate in 33 (20%) patients. Overall, endometrial biopsy was inadequate in 131 (78%) patients and endometrial cytology in 23 (14%) patients. Endometrial cytology provided sufficient material for diagnosis more often than endometrial biopsy (p < 0.05). In the series of 33 patients (20%) in whom both endometrial cytology and biopsy were adequate, there was a 100% correlation between the endometrial cytology and biopsy results. For the first time, this study shows the diagnostic efficacy of liquid-based endometrial cytology in the follow-up of women receiving tamoxifen. It could be applied solely or in conjunction with ultrasonography.

Gynecologic and Obstetric Investigation, 1996

First-trimester chorion villosum plays the key role in the development of human placenta and secr... more First-trimester chorion villosum plays the key role in the development of human placenta and secretes a large number of hormones and hormone-related substances. To test whether progesterone and estrogen could have regulatory effects on first-trimester chorion villosum functions, we investigated the presence of progesterone receptor (PR) and estrogen receptor (ER) in 47 chorion villosum samples from patients who underwent abortion during the first trimester of pregnancy. The study was carried out using immunohistochemical methods. No ER and PR positivity was evidenced in the 47 chorion villosum samples examined. The possibility that progesterone and estrogen play a role in the regulation of chorion villosum functions should therefore be excluded.

Fetal & Pediatric Pathology, 2008

We present the case of a Middle Eastern child, diagnosed and treated at 8 months of age for a hep... more We present the case of a Middle Eastern child, diagnosed and treated at 8 months of age for a hepatic neuroblastoma. After surgical removal of a 7 cm mass of the left liver lobe at our institution when the child was 15 months of age, the tumor was reclassified as a teratoid hepatoblastoma. The tumor was composed of fetal and embryonal hepatic tissue, undifferentiated tissue, and a teratoid background of loose mesenchymal tissue containing osteoid, squamous, and mucinous epithelium. We speculate on the histogenesis of teratoid hepatoblastoma and discuss its association with chemotherapy.

European Journal of Obstetrics & Gynecology and Reproductive Biology, 1997

Objective: The purpose of this contribution is to investigate the pathophysiology of the abnormal... more Objective: The purpose of this contribution is to investigate the pathophysiology of the abnormal endometrial development in hyperstimulated IVF cycles. Study design: In 12 IVF-patients who did not have embryo transfer because of failure of oocyte fertilization, serum values of 17b-estradiol, progesterone, FSH, LH, total and free testosterone, and androstenedione were measured on the pick-up day and were evaluated with respect to the values normally expressed in the day of ovulation; in the endometrial specimens collected 2 days later, at the time of embryo replacement, estrogen and progesterone receptors were immunohistochemically determined and dating by the Noyes method was performed. Results: 17b-Estradiol values are constantly higher, and progesterone levels are, only in four cases, higher than expected for the day of ovulation in a natural cycle. These hormonal patterns can only partially explain the pattern of steroid receptors: progesterone receptors are expressed sparsely both in glands and stroma, while estrogen receptors are abundant in the glands and absent in the stroma. In 11 of 12 patients an abnormal endometrial development with stromal advancement was observed: this morphological picture of the endometrium could partially be explained only in the four cases presenting high progesterone levels by serum values and endometrial receptor content of estrogen and progesterone. Conclusions: The abnormal endometrial development in hyperstimulated IVF cycles could only in part be explained by estrogen and progesterone, and other factors have to be considered.

European Journal of Obstetrics & Gynecology and Reproductive Biology, 1995

Objective: To evaluate if human endometrium presents morphological variations suggestive of an ag... more Objective: To evaluate if human endometrium presents morphological variations suggestive of an age-related decline in endometrial receptivity. Study design: Peri-implantation endometrium of younger (< 30 years of age: n = 13) and older (> 40 years of age: n = 17) normally menstruating women was studied. Endometrial specimens were routinely fixed in buffered formalin and embedded in paraffin. Sections (5 /~m) were stained with hematoxylin-eosin, periodic acid-Schiff (PAS) and Trichrome conforming to Masson according to conventional histologic examination. Several consecutive sections were used for the following immunohistochemical study: vascular localization (CD34), cellular proliferation index (PCNA), progesterone and estrogen receptors. Results: Using both the traditional morphological evaluation and monoclonal antibodies, no significant differences were found between the endometria of women < 30 years of age and those of women > 40. Conclusions: Our results suggest that human endometrium does not age, at least while cyclic hormonal stimulation and menstruation are present.

Clinical Neuropathology, 2012

Angiocentric glioma is a rare slow growing tumor. It is associated to seizures and is mainly diag... more Angiocentric glioma is a rare slow growing tumor. It is associated to seizures and is mainly diagnosed in children and young adults. We describe the clinical, histo-pathological and molecular (IDH1, IDH2 and BRAFV600E mutational status) features in 3 children, 2 girls (2- and 11-years old) and 1 boy (10-years old). The tumors were located at the left temporo-parietalinsular, left parieto-occipital and left subcortical paramedian region respectively. All 3 patients were operated. Two patients are well at 2 and 16 months of follow-up while the third still suffers from seizures at 7 years of follow-up. Histologically, all tumors were composed of spindle-shaped cells showing a prominent tendency to align around the blood vessels and to grow in the subpia space creating palisade-like structures. In one case the tumoral cells were embedded in a mucoid matrix and some microcalcifications were observed. In all the cases the neoplastic cells diffusely immunostained for GFAP and S-100. Punctate dot-like intracytoplasmic staining for EMA was also observed. All tumors resulted in wild type for the mutations investigated. Owing to the rarity of angiocentric glioma, we believe that each new case should be recorded to produce a better clinical, pathological and molecular characterization of this lesion.

Annals of the New York Academy of Sciences, 1994

There is much anatomo-clinical data which must be evaluated for a therapeutic choice and which in... more There is much anatomo-clinical data which must be evaluated for a therapeutic choice and which influences the survival rate of endometrial carcinoma patients (stage, histologic subtype, grading, myometrial infiltration, lymphonodal extension, e t~. ) . ' -~ A correct clinical staging of endometrial carcinoma is therefore an indispensable premise. The distinction between stages I and 11, according to the model proposed by the International Federation of Gynaecologists and Obstetricians (FIGO, 1991),'0,11 is tied to the neoplasia's extension to the cervical canal. In the past the presence of the endometrial carcinoma's diffusion to the cervical canal was entrusted to the fractioned curretage, but the data obtained were never quite trustworthy. The possibility of visualizing the cervical canal, given by Hamou's hysteroscope, should allow, by means of a guided biopsy, greater certainty during the preoperatory stage.I2-l6 The wide angle view of the endometrial cavity allows the evaluation of the tumor's dimensions. The aim of our study is to correlate the tumoral mass, present in the uterine cavity, to the neoplasia's myometrial infiltration and to evaluate the capability of the hysteroscopic test to document the tumor's presence in the cervical canal. A correct preoperatory evaluation of the neoplasia's extension could lead to a personalized therapeutic programming and could intervene positively in survival rates.

The American Journal of Surgical Pathology, 2007

Glioneuronal tumor with neuropil-like islands (GTNI) is a rare neoplasm harboring circumscribed l... more Glioneuronal tumor with neuropil-like islands (GTNI) is a rare neoplasm harboring circumscribed loci of neuronal differentiation and diffusely infiltrating astroglial and oligodendrocytelike components. We report 8 previously unpublished examples of GTNI, specifically studied for chromosome 1p and 19q allelic losses. All tumors showed characteristic histologic features and immunoprofile. One primary tumor displayed frankly malignant histology with frequent mitoses, microvascular proliferation, and necrosis. This tumor progressed within months of the initial resection. Three other tumors (2 low-grade and 1 showing only focal microvascular proliferation) recurred at 2 years, 3 years, and 1 year, respectively. All cases were evaluated for 1p/19q allelic losses by standard polymerase chain reaction-based loss of heterozygosity assays. No evidence of 1p/19q losses was found in 7 of 8 tumors. One tumor demonstrated small interstitial deletions at 1p36 (at D1S1612 and D1S513, but not at D1S548 or D1S1592) and a small interstitial deletion at 19q13 (at D19S219 and D19S412, but not at PLA2G4C). The lack of large, whole-arm 1p/19q losses (such as those found in oligodendroglial tumors), aberrant p53 expression, and the predominance of astroglial components may indicate a biologic relationship of the GTNI to diffuse astrocytoma. Although GTNI shares some morphologic features with recently reported cases of oligodendroglioma with neurocytic differentiation, the 2 tumors appear different at the molecular genetic level.

American Journal of Obstetrics and Gynecology, 2007

The aim of this study was to determine whether the premalignant change in lichen sclerosus (LS) c... more The aim of this study was to determine whether the premalignant change in lichen sclerosus (LS) could be identified with immunohistochemical analyses.

European Journal of Obstetrics & Gynecology and Reproductive Biology, 1996

Objective: To evaluate if the peri-implantation endometrium shows age variations in lectin patter... more Objective: To evaluate if the peri-implantation endometrium shows age variations in lectin patterns, which suggest possible age variations in embryo-maternal recognition. Study design: Peri-implantation endometria of younger (< 30 years of age: n = 13) and older ( > 40 years of age: n = 17) normally menstruating women was studied. Endometrial specimens were routinely fixed in buffered formaline and embedded in paraffin. Sections (5 /tm) were studied using seven lectins: DBA (Dolicus biflorus, binding specificity ~-D-GalNAc), PNA (Arachis hypogea, binding specificity D-Gal (ill ~3)-D-GalNAc), SBA (Glycine max binding specificity ~/fl-D-GalNAc > D-Gal), WGA (Triticum vulgate binding specificity (c~-D-GlcNAc)n and sialic acid), ConA (Canavalia ensiformis binding specificity a-D-Man > ~-D-Glc), LTA (Lotus tetragonolobus binding specificity ~-L-fucose) and UEA I (Ulex europaeus binding specificity ~-L-fucose). Results: No significant differences were found in the glycoconjugates sugar residue content and distribution between the endometria of women < 30 years of age and those of women > 40. Conclusions: Our results suggest that human endometrium does not age, at least while cyclic hormonal stimulation and menstruation are present.

The Ochsner journal, 2015

Endometriosis can be intrapelvic or, rarely, extrapelvic. Endometriosis involving the rectus abdo... more Endometriosis can be intrapelvic or, rarely, extrapelvic. Endometriosis involving the rectus abdominis muscle on the trocar port site is a rare event; until now, only 16 cases have been reported in the literature. The majority of cases were associated with previous abdominal surgery such as diagnostic laparoscopy, cyst excision, appendectomy, myomectomy, or cholecystectomy. We review all the reported cases of this unusual form of extrapelvic endometriosis. We report a new case of abdominal wall endometriosis at the trocar port site in the rectus abdominis muscle in a woman who had undergone 2 laparoscopies for endometriosis in the 3 years before coming to our attention. The diagnosis was made by sonography. We performed a surgical resection of the lesion with a free macroscopic margin of 5-10 mm. Endometriosis should be considered in the differential diagnosis of any abdominal swelling. In our experience, surgery is the treatment of choice.

Investigative Ophthalmology & Visual Science, 2008

To determine whether infliximab may be used safely as an intraocular drug, the ocular safety of i... more To determine whether infliximab may be used safely as an intraocular drug, the ocular safety of intravitreal infliximab in rabbits was studied by clinical examination, electroretinography (ERG), and histology in rabbits. METHODS. Twelve New Zealand albino rabbits were selected for this study. Different infliximab doses, namely 1.0 mg, 1.7 mg, and 3.3 mg in 0.1 mL, were injected intravitreally into one eye each of three rabbits. As a control, the vehicle solution was injected into the fellow eye of each animal. Eye clinical examination and ERG recordings were made before and 2, 6, and 12 weeks after injection. Eventually, the rabbits were humanely killed, and the retinas were examined by light microscopy. In addition, the elimination half-life of the drug in the vitreous was assessed. RESULTS. Slit lamp biomicroscopy, indirect funduscopy, and ERG evidenced no significant differences between control and infliximab-injected eyes in this rabbit model, at any of the tested doses. Histologic examination revealed no retinal abnormality in the rabbits injected with 1 mg and 1.7 mg intravitreal infliximab. In two of three eyes injected with 3.3 mg infliximab, significant edema of the nerve fibers was detected compared with the control group. The half-life of the drug was estimated to be 8.5 days.

Archives of Gynecology and Obstetrics, 2014

Human papillomavirus (HPV), especially HPV 16, is associated with the development of both cervica... more Human papillomavirus (HPV), especially HPV 16, is associated with the development of both cervical and oral cancer. We show the case of a woman affected by HPV-related cervical disease and oropharyngeal squamous cell carcinoma (OPSCC). A 41-year-old woman arrived at our Colposcopy Center following an abnormal Pap smear result (ASC-H) and a diagnosis of moderate cervical dysplasia obtained by a cervical biopsy. She underwent a colposcopy that showed a cervical abnormal transformation zone grade 2. A laser conization was performed in November 2010. Histology reported a moderate/severe dysplasia. The cone resection margins were free. Follow-up colposcopy and cytology were negative. The HPV testing showed an infection by HPV 16. In October 2012, the patient presented to the Head-Neck ER after episodes of hemoptysis; a lesion was found in the left tonsillar lodge. A biopsy was performed with a result of squamous cell carcinoma with low-grade differentiation. The HPV testing detected a high-risk HPV and the immunohistochemical analysis was positive for p16. She was treated by chemotherapy and brachytherapy. She was followed at the head-neck center with monthly visits with oral visual inspection that showed complete absence of mucosal abnormalities. HPV-related OPSCC and cervical precancerous/cancerous lesions have significant similarities in terms of pathogenesis. They are both caused largely by HPV 16, as in the present case. In conclusion, because of this association found in literature and in our case, we think that women with HPV cervical lesions should have regular surveillance for oropharyngeal cancer, whereas women with OPSCC should be encouraged to have diligent cervical screening.

Neuropathology, 2010

Lipoastrocytoma is an extremely rare tumor, with only six cases described. We report the case of ... more Lipoastrocytoma is an extremely rare tumor, with only six cases described. We report the case of an astrocytoma involving the upper part of the cerebellar-pontine angle and the right portion of the clivus starting from the brainstem with a diffuse lipomatous component in a 39 year-old man. The patient was admitted with headache of 1 year&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s duration and diplopia over the previous 3 months. MRI revealed a ponto-cerebellar lesion that showed irregular enhancement after contrast administration. Subtotal excision of the tumor was accomplished. Adjuvant chemotherapy and radiation therapy were not administered. Histologically the tumor showed the classical histology of low-grade astrocytoma and a portion of the lesion was composed of lipid-laden cells. Immunohistochemistry for glial fibrillary acid and S-100 proteins clearly demonstrated the glial nature of these cells. Ki-67/Mib-1 labeling index was low (2%). The patient remains in good neurological conditions after 10 months. Our case has a benign postoperative behavior, also after subtotal excision, with restrictions due to the short follow-up. It is important to record each new case of this rare tumor to produce a better characterization of this lesion.

Diagnostic Cytopathology, 2008

... Francesca Garbini MD 1,* ,; Anna Maria Buccoliero MD 1 ,; Francesca Castiglione MD 1 ,; Chiar... more ... Francesca Garbini MD 1,* ,; Anna Maria Buccoliero MD 1 ,; Francesca Castiglione MD 1 ,; Chiara Francesca Gheri MD 1 ,; Daniela Moncini MD 1 ,; Duccio Rossi Degl'Innocenti B.Sc. 1 ,; Alfredo Barbetti B.Sc. 1 ,; Alessandro Villanucci MD 2 ,; Gian Luigi Taddei MD 1. ...

The European Journal of Contraception Reproductive Health Care the Official Journal of the European Society of Contraception, Dec 1, 1997

Endometrial hyperplasias, which occur in the premenopausal age and are often induced by anovulato... more Endometrial hyperplasias, which occur in the premenopausal age and are often induced by anovulatory cycles, are kept under control by progestin therapy. The good results with natural and synthetic progestins suggest that this treatment can be used both in premenopause and postmenopause hyperplasia. The progestin effect on the endometrium appears through a marked pseudodecidual reaction of the stroma and functional atrophy of the glands. These events are reported in the literature as inactive or suppressed endometrium and there is no physiological equivalent.

Obstetrical & Gynecological Survey, 2008

The European Journal of Contraception and Reproductive Health Care, 1997

Endometrial hyperplasias, which occur in the premenopausal age and are often induced by anovulato... more Endometrial hyperplasias, which occur in the premenopausal age and are often induced by anovulatory cycles, are kept under control by progestin therapy. The good results with natural and synthetic progestins suggest that this treatment can be used both in premenopause and postmenopause hyperplasia. The progestin effect on the endometrium appears through a marked pseudodecidual reaction of the stroma and functional atrophy of the glands. These events are reported in the literature as inactive or suppressed endometrium and there is no physiological equivalent.

Tumors of the Central Nervous System, 2013

Journal of Pediatric Hematology/Oncology, 2011

Herein, we describe an intracerebral primary low-grade myxofibrosarcoma occurring in a 9-year-old... more Herein, we describe an intracerebral primary low-grade myxofibrosarcoma occurring in a 9-year-old boy. The lesion measured 7 cm and occupied the left parieto-occipital region. A gross-total removal of the tumor was performed. Nine months later, radiologic follow-up revealed a local recurrence which was again surgically removed. The patient then underwent radiotherapy and chemotherapy. He was well and disease-free at 6 months follow-up. The tumor was composed of spindle, stellated, and multinucleated cells embedded in a myxoid background. Foci of increased cellularity, pleomorphism, and high mitotic rate were present. The tumor borders were sharply demarcated from the non-neoplastic nervous parenchyma. Immunohistochemical staining showed that the neoplastic cells were vimentine and CD34 positive. Fluorescence in-situ hybridization analyses did not show FUS and EWSR1 gene rearrangements. Primary intracranial myxofibrosarcomas are very rare (to the best of our knowledge, less than 10 published cases in the international literature). We believe each new case should be recorded to produce a better clinical, pathologic, molecular, prognostic, and therapeutic characterization of this lesion.

Gynecologic and Obstetric Investigation, 2008

The aim of this study was to evaluate the utility of liquid-based cytology for endometrial survei... more The aim of this study was to evaluate the utility of liquid-based cytology for endometrial surveillance in patients receiving tamoxifen. One hundred and sixty-eight women scheduled for hysteroscopy were enrolled in the study. The women sequentially underwent hysteroscopy, endometrial cytology and biopsy. Endometrial biopsy only was inadequate in 112 (67%) patients, both endometrial biopsy and cytology were inadequate in 19 (11%) patients, endometrial cytology only was inadequate in 4 (2%) patients, and both endometrial biopsy and cytology were adequate in 33 (20%) patients. Overall, endometrial biopsy was inadequate in 131 (78%) patients and endometrial cytology in 23 (14%) patients. Endometrial cytology provided sufficient material for diagnosis more often than endometrial biopsy (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). In the series of 33 patients (20%) in whom both endometrial cytology and biopsy were adequate, there was a 100% correlation between the endometrial cytology and biopsy results. For the first time, this study shows the diagnostic efficacy of liquid-based endometrial cytology in the follow-up of women receiving tamoxifen. It could be applied solely or in conjunction with ultrasonography.

Gynecologic and Obstetric Investigation, 1996

First-trimester chorion villosum plays the key role in the development of human placenta and secr... more First-trimester chorion villosum plays the key role in the development of human placenta and secretes a large number of hormones and hormone-related substances. To test whether progesterone and estrogen could have regulatory effects on first-trimester chorion villosum functions, we investigated the presence of progesterone receptor (PR) and estrogen receptor (ER) in 47 chorion villosum samples from patients who underwent abortion during the first trimester of pregnancy. The study was carried out using immunohistochemical methods. No ER and PR positivity was evidenced in the 47 chorion villosum samples examined. The possibility that progesterone and estrogen play a role in the regulation of chorion villosum functions should therefore be excluded.

Fetal & Pediatric Pathology, 2008

We present the case of a Middle Eastern child, diagnosed and treated at 8 months of age for a hep... more We present the case of a Middle Eastern child, diagnosed and treated at 8 months of age for a hepatic neuroblastoma. After surgical removal of a 7 cm mass of the left liver lobe at our institution when the child was 15 months of age, the tumor was reclassified as a teratoid hepatoblastoma. The tumor was composed of fetal and embryonal hepatic tissue, undifferentiated tissue, and a teratoid background of loose mesenchymal tissue containing osteoid, squamous, and mucinous epithelium. We speculate on the histogenesis of teratoid hepatoblastoma and discuss its association with chemotherapy.

European Journal of Obstetrics & Gynecology and Reproductive Biology, 1997

Objective: The purpose of this contribution is to investigate the pathophysiology of the abnormal... more Objective: The purpose of this contribution is to investigate the pathophysiology of the abnormal endometrial development in hyperstimulated IVF cycles. Study design: In 12 IVF-patients who did not have embryo transfer because of failure of oocyte fertilization, serum values of 17b-estradiol, progesterone, FSH, LH, total and free testosterone, and androstenedione were measured on the pick-up day and were evaluated with respect to the values normally expressed in the day of ovulation; in the endometrial specimens collected 2 days later, at the time of embryo replacement, estrogen and progesterone receptors were immunohistochemically determined and dating by the Noyes method was performed. Results: 17b-Estradiol values are constantly higher, and progesterone levels are, only in four cases, higher than expected for the day of ovulation in a natural cycle. These hormonal patterns can only partially explain the pattern of steroid receptors: progesterone receptors are expressed sparsely both in glands and stroma, while estrogen receptors are abundant in the glands and absent in the stroma. In 11 of 12 patients an abnormal endometrial development with stromal advancement was observed: this morphological picture of the endometrium could partially be explained only in the four cases presenting high progesterone levels by serum values and endometrial receptor content of estrogen and progesterone. Conclusions: The abnormal endometrial development in hyperstimulated IVF cycles could only in part be explained by estrogen and progesterone, and other factors have to be considered.

European Journal of Obstetrics & Gynecology and Reproductive Biology, 1995

Objective: To evaluate if human endometrium presents morphological variations suggestive of an ag... more Objective: To evaluate if human endometrium presents morphological variations suggestive of an age-related decline in endometrial receptivity. Study design: Peri-implantation endometrium of younger (< 30 years of age: n = 13) and older (> 40 years of age: n = 17) normally menstruating women was studied. Endometrial specimens were routinely fixed in buffered formalin and embedded in paraffin. Sections (5 /~m) were stained with hematoxylin-eosin, periodic acid-Schiff (PAS) and Trichrome conforming to Masson according to conventional histologic examination. Several consecutive sections were used for the following immunohistochemical study: vascular localization (CD34), cellular proliferation index (PCNA), progesterone and estrogen receptors. Results: Using both the traditional morphological evaluation and monoclonal antibodies, no significant differences were found between the endometria of women < 30 years of age and those of women > 40. Conclusions: Our results suggest that human endometrium does not age, at least while cyclic hormonal stimulation and menstruation are present.

Clinical Neuropathology, 2012

Angiocentric glioma is a rare slow growing tumor. It is associated to seizures and is mainly diag... more Angiocentric glioma is a rare slow growing tumor. It is associated to seizures and is mainly diagnosed in children and young adults. We describe the clinical, histo-pathological and molecular (IDH1, IDH2 and BRAFV600E mutational status) features in 3 children, 2 girls (2- and 11-years old) and 1 boy (10-years old). The tumors were located at the left temporo-parietalinsular, left parieto-occipital and left subcortical paramedian region respectively. All 3 patients were operated. Two patients are well at 2 and 16 months of follow-up while the third still suffers from seizures at 7 years of follow-up. Histologically, all tumors were composed of spindle-shaped cells showing a prominent tendency to align around the blood vessels and to grow in the subpia space creating palisade-like structures. In one case the tumoral cells were embedded in a mucoid matrix and some microcalcifications were observed. In all the cases the neoplastic cells diffusely immunostained for GFAP and S-100. Punctate dot-like intracytoplasmic staining for EMA was also observed. All tumors resulted in wild type for the mutations investigated. Owing to the rarity of angiocentric glioma, we believe that each new case should be recorded to produce a better clinical, pathological and molecular characterization of this lesion.

Annals of the New York Academy of Sciences, 1994

There is much anatomo-clinical data which must be evaluated for a therapeutic choice and which in... more There is much anatomo-clinical data which must be evaluated for a therapeutic choice and which influences the survival rate of endometrial carcinoma patients (stage, histologic subtype, grading, myometrial infiltration, lymphonodal extension, e t~. ) . ' -~ A correct clinical staging of endometrial carcinoma is therefore an indispensable premise. The distinction between stages I and 11, according to the model proposed by the International Federation of Gynaecologists and Obstetricians (FIGO, 1991),'0,11 is tied to the neoplasia's extension to the cervical canal. In the past the presence of the endometrial carcinoma's diffusion to the cervical canal was entrusted to the fractioned curretage, but the data obtained were never quite trustworthy. The possibility of visualizing the cervical canal, given by Hamou's hysteroscope, should allow, by means of a guided biopsy, greater certainty during the preoperatory stage.I2-l6 The wide angle view of the endometrial cavity allows the evaluation of the tumor's dimensions. The aim of our study is to correlate the tumoral mass, present in the uterine cavity, to the neoplasia's myometrial infiltration and to evaluate the capability of the hysteroscopic test to document the tumor's presence in the cervical canal. A correct preoperatory evaluation of the neoplasia's extension could lead to a personalized therapeutic programming and could intervene positively in survival rates.

The American Journal of Surgical Pathology, 2007

Glioneuronal tumor with neuropil-like islands (GTNI) is a rare neoplasm harboring circumscribed l... more Glioneuronal tumor with neuropil-like islands (GTNI) is a rare neoplasm harboring circumscribed loci of neuronal differentiation and diffusely infiltrating astroglial and oligodendrocytelike components. We report 8 previously unpublished examples of GTNI, specifically studied for chromosome 1p and 19q allelic losses. All tumors showed characteristic histologic features and immunoprofile. One primary tumor displayed frankly malignant histology with frequent mitoses, microvascular proliferation, and necrosis. This tumor progressed within months of the initial resection. Three other tumors (2 low-grade and 1 showing only focal microvascular proliferation) recurred at 2 years, 3 years, and 1 year, respectively. All cases were evaluated for 1p/19q allelic losses by standard polymerase chain reaction-based loss of heterozygosity assays. No evidence of 1p/19q losses was found in 7 of 8 tumors. One tumor demonstrated small interstitial deletions at 1p36 (at D1S1612 and D1S513, but not at D1S548 or D1S1592) and a small interstitial deletion at 19q13 (at D19S219 and D19S412, but not at PLA2G4C). The lack of large, whole-arm 1p/19q losses (such as those found in oligodendroglial tumors), aberrant p53 expression, and the predominance of astroglial components may indicate a biologic relationship of the GTNI to diffuse astrocytoma. Although GTNI shares some morphologic features with recently reported cases of oligodendroglioma with neurocytic differentiation, the 2 tumors appear different at the molecular genetic level.

American Journal of Obstetrics and Gynecology, 2007

The aim of this study was to determine whether the premalignant change in lichen sclerosus (LS) c... more The aim of this study was to determine whether the premalignant change in lichen sclerosus (LS) could be identified with immunohistochemical analyses.

European Journal of Obstetrics & Gynecology and Reproductive Biology, 1996

Objective: To evaluate if the peri-implantation endometrium shows age variations in lectin patter... more Objective: To evaluate if the peri-implantation endometrium shows age variations in lectin patterns, which suggest possible age variations in embryo-maternal recognition. Study design: Peri-implantation endometria of younger (< 30 years of age: n = 13) and older ( > 40 years of age: n = 17) normally menstruating women was studied. Endometrial specimens were routinely fixed in buffered formaline and embedded in paraffin. Sections (5 /tm) were studied using seven lectins: DBA (Dolicus biflorus, binding specificity ~-D-GalNAc), PNA (Arachis hypogea, binding specificity D-Gal (ill ~3)-D-GalNAc), SBA (Glycine max binding specificity ~/fl-D-GalNAc > D-Gal), WGA (Triticum vulgate binding specificity (c~-D-GlcNAc)n and sialic acid), ConA (Canavalia ensiformis binding specificity a-D-Man > ~-D-Glc), LTA (Lotus tetragonolobus binding specificity ~-L-fucose) and UEA I (Ulex europaeus binding specificity ~-L-fucose). Results: No significant differences were found in the glycoconjugates sugar residue content and distribution between the endometria of women < 30 years of age and those of women > 40. Conclusions: Our results suggest that human endometrium does not age, at least while cyclic hormonal stimulation and menstruation are present.