Pathologica 4-07.pdf - Pacini Editore

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Results. The pseudoparasites found in the lumen of the appendix,
in the serosa or submucosa of intestinal tract, in the
peritoneum, omentum, pleura and lung were of vegetal origin.
These elements were referable to plant structures,
plant debris, starch grains, plant spiral fibres, trachaee,
small seeds or pollen grains, They were often isolated, sometimes
grouped in nests or in columns. The vegetal cells
show thin walls and a thin layer of clear transparent cytoplasm
around a large central nucleus. The nuclei were sometimes
oblong, moderately hyperchromatic and homogeneously
coloured. The plant debris, stark grains, or pollen
grains are thought to be some kind of parasite egg. The
plant structures were mistaken with sections of helminthes
or with fragments of arthropod. These elements in histological
sections were often observed inside a granuloma with
the presence of giant multinucleated foreign body type cells.
The elements observed in glandular lumen of the prostate,
in the conjunctiva, in the endometrium were referred
to stratified concretions of mucoid material, partially calcified.
They were often mistaken for eggs of various helminth
worms. Unfortunately it is not always possible to
identify all the nonparasites elements, because of the numerous
range of possibility and of the inadeguate palinological
and botanical knowledgés.
Conclusions. This study can be useful to pathologists because,
by giving findings of non-parasite objects, it can help to
correctly interpret the presence of foreign material in histological
specimens in order to avoid diagnostic errors.
References
1 Ash LR, Orihel TG. Atlas of human parasitology. Am Soc Clin Pathol
Press Singapore 2007.
2 Orihel TG, Ash LR. Parasites in human tissues. Am Soc Clin Pathol
Chigago-Hong Kong 1995.
Medullary thyroid microcarcinoma. A case
report
N. Scibetta, L. Marasà
ARNAS Civico “Di Cristina, Ascoli”, Palermo; Servizio di
Anatomia Patologica, Italy
Introduction. Medullary thyroid microcarcinoma is a thyroid
tumor measuring 1 cm or less.
Papillary microcarcinoma is the most common subtype, often
identified incidentally in a thyroid removed for multinodular
goiter or diffuse processes (eg, thyroiditis), whereas
medullary thyroid microcarcinomas (microMTC), are very
rare.
A number of microMTC are discovered in patients members
of familial-MTC or MEN-II kindred.
The discovery of a microMTC as sporadic tumor is even rarer.
Very little information is available about occult microMTC
pathological features and outcome.
Methods. A 26 years-old woman with a unique subcentimetric
palpable thyroid nodule has been subjected to fine needle
aspiration biopsy (FNAB). The presence of cellularity higher
than that found in the usual hyperplastic nodule and of highly
hyperchromatic nuclei with oncocytic cytoplasm suggested
the presence of oncocytic neoplasm.
A total thyroidectomy was made.
The specimens, constituited by thyroid and by 4 pericapsular
lymph nodes, were fixed in 10% buffered formalin, and
POSTERS
paraffin embedded. Sections were stained with H&E, Congo
red stain and argyrophilic stains. Immunohystochemical
staining for low-molecular-weight keratin, CEA, NSE, chromogranin
A, synapthphysin, thyroglobulin, calcitonin, TTF,
BCL2, MIB 1 (KI 67), S100 was performed.
Results. Grossly the tumor was solid, firm, and non encapsulated
but relatively well-circumscribed, located in the right
upper half of the gland, with maximum diameter of 0.8 cm.
Microscopically showed a prominent central sclerosing area
with calcifications, and a lobular proliferation of polygonal
and splindle shaped cells, separated by varyng amounts of fibrovascular
stroma. Tumor cells contain round to oval regular
nuclei, and mitotic figures are scant. The cytoplasm is
granular, amphophilic.
Several benign thyroid follicles are entrapped in the tumor.
The congo-red stain no showed amyloidosis, and the cells
were only weakly positive for calcitonin, diffusely positive
for keratin, CEA, and pan-endocrine markers such as NSE,
chromogranin A, synapthophysin, TTF and argyrophilic
stains, negative for thyroglobulin.
A lymph node showed a metastasis. This tumor that was devoid
of amyloid, weakly positive for calcitonin and negative
for thyroglobulin and positive for NSE and chromogranin
was viewed as poorly differentiated (“calcitonin free”) variant
of medullary carcinoma.
The patient showed a normal postoperative basal calcitonin,
and family screening showed no sign of MEN II or abnormal
CT level. Two years after the surgery she did not show any
local recurrence or metastasis.
Conclusions. Although specific survival rate and percentage
of biological cure in micro-MTC are significantly better than
for larger tumors, the frequency of lymph-node involvement,
however, justifies an aggressive surgical approach,
and a long-term follow-up that strongly relies on regular CT
measurement.
Sistemi informativi a supporto della gestione
della strumentazione
A. Comi
Servizio di Anatomia Patologica, Azienda Ospedaliera “San
Paolo”, Milano, Polo Universitario, Università di Milano
I servizi di Ingegneria Clinica garantiscono, all’interno delle
strutture sanitarie e ospedaliere l’utilizzo sicuro, appropriato
ed economico delle apparecchiature biomediche. Un
efficace servizio di Ingegneria Clinica è in grado di: effettuare
i collaudi di accettazione, realizzare l’inventario tecnico
ed economico, effettuare gli interventi di manutenzione
preventiva e correttiva, svolgere periodicamente le verifiche
di sicurezza ed i controlli di qualità, ottimizzare il risk
management, fornire consulenza sugli acquisti e contribuire
a definire i piani di rinnovo della strumentazione. Il
sempre maggior livello di complessità e numerosità assunto
dal parco tecnologico all’interno delle strutture sanitarie
comporta la necessità di sistemi informativi che supportino
non solo la gestione inventariale ma costituiscano anche
uno strumento per il mantenimento della sicurezza e dell’efficienza
delle tecnologie. Numerosi sistemi informativi
si sono evoluti negli ultimi anni, attraverso la gestione di un
numero sempre più ampio di informazioni. Molte Aziende
Ospedaliere possiedono oggi sistemi più o meno sofisticati
per l’acquisizione, il controllo e l’analisi dei dati di funzio-