See

discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/250615527

Dentinoma: a case report.

Conference Paper · September 2009

DOI: 10.13140/2.1.4481.8886

CITATIONS READS

0 115

5 authors, including:

Gabriele Margiotta Tommaso Cutilli

Università degli Studi di Siena Università degli Studi dell'Aquila
41 PUBLICATIONS 35 CITATIONS 52 PUBLICATIONS 118 CITATIONS

SEE PROFILE SEE PROFILE

All content following this page was uploaded by Gabriele Margiotta on 15 May 2014.

The user has requested enhancement of the downloaded file.

 0spedaliGalliera di Genova crted in ln:dex Medicus/l'iEDLtNE, B/os/s Previews, ffi
ScOpUs
'te"errr'vvv'YvD$*
t

6
i\
!

ffiPATHOLOGI
ffi #il*tftlî,fr,,tiid#il::ffi;lH; .,, E

6
t
a
'É
E

E
.c

È
s
Èq

s
E
ú
I
s
î
-.t

g
È
a
€
E
E
T
5
t
I

4
É-
-q
=t
ÈF
gE
PE
ri
t5
6€ SIAPEC-IAP
8;
aÈ Sod€tù [ollmo dl Ambîio Potologrio e Obpoblogh Dio0rl6fho,
Tr Divlelme lluliom rhlh lnl€rúlixrol Acortemy ot htrotogy
 162
PO28
Phagocytosis of apoptotic neutrophils
by adenocarcinoma cells ancl foveolar cells
of the gastric mucosa with Helicobacter
pylori infection: A histologic,
immunohistochemical ancl ultrastructural
stucly of three cases
R. Caruso, C. Crisafulli, F. Fedele
Dipanimento di Patolog ia Ilmana, polic linico IJ ttit e rsiîario,
Messina
We report 3 cases of an unusual typc of gastric carcinotna that
occurred in elderly patients 62-80 ycars of agc. Histologically,
the tumours were well to nr<xlcratcly differentiated intestinal_
type adenocarcinomas with a tiral micropapillary component.
There was an abunchnt ncr-rtrnphilic infiltration around the
tumour cells both irrtracpirhclial (..cannibalism") and stromal-
At the electron nricroscopy. apoptotic neutrophils were found
within vacuoles ol' urjcnrrar cinonra cells. Immunohistochemi_
cal staining firr c:rspusc-3 corrlirrtred the presence of apoptotic
neutrophils within thc cylrpllsrrr ol' thc tumour celh. Antral
and corporirl non-ncopllr.rtit. nruuosu showed a Helicobacter
pylori-positivc gastritis wirlr lrilrh tlc:lr.cc of neutrophil activify.
NeutrophiI phagoc:yIosis h-y lì rvcolar cclls was also documented
by light and elcctrorr rrritrrrst.opy.'l'lris is rhc lìrst study that pro_
vide morphologicul rvir lt'nr.r. ol :r1rr rptol ic ucrrt nrphils phirgcry_
tosed bath hy r:irstric u(['r'( lr'(:irrr.r eclrs rrrrtl rìrvc,rar ccils of
gastric tnrrcos;r with I le litrrh:rr.tcr
|ykrt.i iulcctiorr.
PD29
Aclenocarcinoma intestinat-type of the nasat
cavity and paranasal sinuses:
report of two cases
A. Colagrande, A. Cimmino, G. Ingravallo, L. Resta,
M.P. Cocca
Dilturtimento di Anatomia patologica, policlinico di Bari
lntestinal-type adenocarcinoma (ITAC) is a primary malignant
glandular tumour of the nasal cavity and paranasalìinusei his_
tologically resembling adenocarcinoma of the intestines (Achen_
son ct al. in 1968). The frequency of ITAC is 4Zo of the malig-
nilnt tuntors ot'nasal and paranasal sinuses, with pronounced
nrale prctkrrrrirrance, possibly because of occupational exposure,
in prrticular in wrxrd workers. ITAC involve the ethmoid sinus,
nasrl clvitics arrd rn:rxillary sinus. Advanced tumors t€nd to
invarjc thc orhil. thc pterygopalatine and infratemporal fossae,
and thc cranial cuvily. Wc have observed t*o cuies of ITAC
in wot-d workers paiicnts. with cvidence in the frst case of the
natural evolution of turnor with cxtcnsion in anterior cranial
cavity miming meningionra. bccitusc thc patient refuses surgical
ex-cision, with neurologic and visual disturbances. Macrosópi_
gally ITAC appears as irregular exophytic pink or white mass
bulging in the nasa.l caviry or paranasal sinus, with a necrotic
friable area. Histopathologically have been proposed two clas_
sification of ITAC. Barnes divided these rumois inro 5 types:
papillary, colonic, solid, mucinous and mixed. Kleinsasser and
Schroder divided ITAC into 4 rypes: papillary tubular cylinder
cgll l-tU, alveolar goblet, signet-ring and transitional type. The
differential diagnosis must be made among ITAC, sinonasal
adenocarcinoma (non-tTAC) and metastatió adenocarcinoma
CONCRESSO NAZIONAIÉ SIAPEC.IAP 2OO9
of intestinal origin. Sinonasal ITAC have a distincitive phe_
notype, with most of all cases expressing CK20, CDX2. Mosr
ITAC also express CK7, although a proportion of tumors are
CK7 negative. ITAC seems to be preceded by intestinal meta_
plasia of the respiratory mucosa, which is accompanied by a
switch to an intestinal phenotype.
PDSO
lmmunocytochemical and molecular hetp
in thyroicl liquid basect cwotogy
G. Simoner, M. Liuzzir, G. Achiller, S. Russor, F. palmar,
G. Giannoner, V. Rubinir, C. Queror, L. Grammaticar
tlstituto Giovanni Paolo
II, IRCCS-Oncologico, Bari
Introduction. Fine needle cytology (FNC) is the mosr im-
portant tool in the diagnosis of thyroid nodules. It has been
demonstrated that Liquid Based Cytology (LBC) improves
the quality of the smears and the diagnostic accuracy 1D.A.y
because of well preserved cellutarity useful to immunocyto_
chemical (ICA) or molecular assays.
Material and method. 106 FNCs were observed: the nodules
occurred in 88 females and 12 males (mean age: 4ó.g: Fem
46.4; Males 43), 69 single and 25 in multi-nodular thyroids.
The material was processed in Thin prep 2000 TM. ICA for
HBME-I were carried out on 48 LBC slides. The presence
of BRAF gene mutation (V600E) was investigated appling
MASA tecnique on remaining 48 parienrs; both FIBME-i and
llfìAF were available in 5 patients. FNCs were classified ac-
cording to SIAPEC classification.
Results. We analyzed cyto-histological correlation and D.A.
On 97 evaluablc cases, D.A. was 88.62o (we considered as
false negative l0 Thy3 thar resulred pC at histology). Con-
sidering HBME-l expression and BRAF mutation as detected
ol tBC, thé prevalence of HBME-l and BRAF muration was
44Vo and 27Vo, respectively; D.A. resulted gAVo and g6.5%o,
respectively. The Positive Predictive Value was 96Vo, l\OVo
and lNVo for cytology, immunocytochemistry and molecular
assay, respectively. The relation between histological diag_
noses and cytological, molecular and ICA findings, were s.s.
(p < 0.001). On the 5 cases, where both HBMEI and BRAF
mutation were investigated, 2 cases were HMBE-l positive
and BRAF mutated whereas, the remaining 3 cases were
negative for both the markers.
Conclusions. Our study showed that ICA and rnolecular
assays can be successfully applied on monolayered smears,
on well preserved cells obtained by LBC and could increase
diagnostic accuracy in thyroid FNC.
PD31
Dentinoma: a case report
G. Margiottar, T. Cutillir, A.R. Vitaler, G. Colettir,
P. Leocatal
t
Analomia Patologica, Chirurg ia M axi I I t t-.ft r ct.itil a, Dipar-
2
timento di Scienze della Salute, IJniver.rirìt dcgli Studi di
L'Aquila, rU.O. di Anatomia Pokiltt,qit.tt. ().rltcdale San Sal-
vatore, L'Aquila
lntroduction. "Dcntirronr:r" lr;rs bcut defìned in 197 I by
WHO as "a vcrv r:tlc rrcopl:rsrrr corrrllrsetl of' odontogcnic
epithclirrrn. inrrrr:rlrrrr.tolrreclivr: lissrrc:rrrtl tlvspltrslic tlcn-

tin". It generally occurs in young adults, without sex predilec_
tion. The mandible represents the most common site bf onset.
Clinically, it generally occurs ar,agymptomoric mass, even
though sometimes associated with uneruped or carious teeth,
lurgical excision represents the gold standard therapy.
Case report. We report on a of a 4l-yoar_oiA.w,ornn
presented to our hospital for an."ise
asymprornatic,. l,J. g_nr.lrrrdi.
ameter, Iesionofthemascellar. '" ' :I :
Results. Afterradicat excision. the lesion pr"reiitrià r,íilnit",
hard consistent mass. Microscopically, thà, bsion csnsisted of
dysplastic dentin without clear tubules, scanty epithelium and
rare fibrous immature elements, stained positive for vimentin,
calretinina and cytocheratine. A diagnoiis of dentinoma was
suggested.
Conclusions. First described by Strairh in 1935, ,.dentinoma"
is. an entity that has not been fully accepted. Some patholo_
glsts assume that this lesion must be regarded as ameloblas_
tic fibroma or. ameloblastic fibro-odontJma. In our case, rhe
presence ofdysplastic dentin seems to preclude the diagnosis
of ameloblastic fìbroma, whereas the ibsence of enamel ex_
cludes the diagnosis of ameloblastic hbroodontoma. Thus, we
hypothesize rhe diagnosis of dentinoma.
Up to now, only 20 cases diagnosed as dentinoma have been
reported in lirerarure. The rarity ofthis entity and the difficul=
ties in the differential diagnosis lead us to róport on this case.
t-Anthony H, et
al. Oral Surg Orat Med Oral pathol 19g9;67:731-3.
2Takeda Y, et
al. J Oral pathol Med 1994:2J:92-6.
PD32
Granular cell tumor of the larinx
and of the esophagus: report of twg cases
G. Palumbieri
U_.O.C. Istopatologia e Citodiagnostica, Ospedale ,,Mons.
Dímiccoli", Barletta
Introduction. Granular cell tumor (GCT) is an uncornmon
an{ nearly aJways benign neoplasm of presumably Schwann
cell origin, with predilection for the skin, the softtissue and
the tongue, while laringeal and esophageal involvement is
fairly rare and.theirdiagnosis is mainly UaseA of histopatho-
i:
logic examination of endoscopic biopsies.
Clinico-pathologic cases. Òase t. A 40-yqar-old white
women presented with a recurrent smooih sessile tumor. of the
right vocal cord-subglottic area causing hoarseness (the fimt
lesion revealed hve years ago). Case l. A 4}-yedr-old white
men_with a flat inegular lesion detected incidJntally near the
esophago-gastric junction during esophagoscopy: the endo-
scopic diagnosis was Barren's Esophagus.
Methods. Tissues were fi xed iii, buff;feó foiinalin, poraflin
embedded; for immunoistochemistry, the avidin-bioiin,pcr-
oxidase complex method was used.
Results. Histologically, the tumor was locatcd in the sub-
epithelial area and consisted of sheets,of large polygonal
and round-oval rumor cells with ample granulai"orinófniU.
cytoplasm and with small round nuclei centrally oreccenri-
cally located, with -in the recurrent tumor of cise l_ nuctear
pleomorphism and a few prominent nucleoli; the overlying
epithelium was thin and unremarkable in the case l;, whitó
pseudoepitheliomatous hyperplasia is seen in the case 2.
The neoplastic cells showed immunoreactivity forS-1fi) pro_
tein and CD68 (KP-1), while ki67-MIBI was unremarcable.
Conclusion. Pseudoepitheliomatous hyperplasia may lead
a
View publication stats
!
t
ló3
to misdiagnosis as squamous cell carcinoma when a shal_
low biopsy is performed. Ki67 proliferative index did not
{l3g,uir! reliably between typical and recurrenr atypical
GCT,,I;astly the endoscopic diffJrential diagnosis of Barrett,s
Esophagur should include GCT.
PD33:
lntran€ural schwannoma..
Anincid€ntalobservation, :
S. Squillacir, C. Spairani', R. Mirrchlonor, F;.Tallarlgo:
S e rv izio di Anatomia patol o g ica-O
t
spetlitle, dl Valle,plqnlgnic- a,
2
S e rv i zio d i Anato mia pat o lo g i c a - O i p ettate, rt í C ivìii e"'' -'
: :
Introduction. peripheral nerve tumors ure neopgsilu,that
includes benign (schwannomas, neurofìbromas ,hO
birl*;:
riomas) and malignanr forms, collectively ddigfutiJ.
malignanr periphera.l nerve shearh tumors
;
itvtpN5tj-,'l{Oit
schwannomas are uninodular, truly encapsufafea, .ecéAntri{:
masses, rlistocating the nerve fibers that U-aàioostraiOtt
"ao but
in the periphery, flattened along the capsule, noi p"n"t .t:
ing the substance of the tumors.
Case reporl A 64-year-old rtan was referred to Hosoital, of
Vallecamonica for excision of a 2 cm wide, nodular,
i;rrr_
tion on the left auricle. The lesion reeunèdili'uiónths laterin
the adjacent soft parts and a 3,6x1,5: crn_i ftrass.iwas:reiaoved
with homolateral cervical lymph node clearance.
Results. Histoparhology revealed a moderately_diffeientiated
squzmous cell carcinoma (G2) in the auriclè and recurrent
nodule without tumor invasion in 33 cervical lymph nodes.
One of the cervical nerve showed a 6 mm. fusifonn expansion
of its súucture. Microscopically the lesion was an encapsu-
lated neoplasm growing inside the nerve. .[t *u,
R. of short fascicles of bland spindle cells with focal "orpòi.d
núclear
palisading and Verocay bodies. The tumor cells expressed
S_
100 protein and were.negative for EMA and,GL[IF,,t which
stained instead the peripheral perineurial cells. These findings
were consiòtent wiîh the diagnosis of intraneural schwai_
noma.
Concluslons;,'lller differcntial diagnosis includes traumatic
and Mbrtou,f i'neun,masi palisaded encapsulated neurom4
nerve sheathignnglion. and intraneural perineurioma.
I n' tho, prcso'n{,case.:schwannoma was ientrally located inside
the ncrve. t'position that, ro the best of our inowledge, has
been reported in.tlie literature only oncer.
I Fellegara C. Int
J Surg pathol 2(M8: 16:57-g.
PD34
Nuchal-type fibroma: a case report
N. Scibetta, L. Marasà
I
Pat ho lo g ical Anatomy IJ nit, pa le rmo
Introduction. Nuchal-type fibroma (NTF) is a rare, tumorlike
proliferation typically located in the subcutaneous tissues of
the posterior neck and interscapular regions of patients be-
tween ages 25 and 60 years. The lesion has a low recurrence
tbllowing excision, not metastatize and has a strong associa_
tion with diabetes and Gardner's syndrome.
Methods. A 72-year old man presented with a mass in the
posterior neck region. It was locally excised. Gardner's syn-