[Clinically non-palpable lesions of the breast: radiologic features, biologic factors, and surgical strategy]. / Le lesioni clinicamente non palpabili della mammella: aspetti radiologici, fattori biologici e strategia chirurgica.

The use of mammography for early detection of breast cancer showed an increased detection of non-palpable breast-lesions (NPBL). The authors evaluate the radiologic findings, the biological factors and the surgical approach, trough the personal experience and the literature, for a correct treatment of these lesions.

US and CT findings of secondary neoplasms of the thyroid--a pictorial essay.

Although clinical series report a low (3%) incidence of metastases to the thyroid gland, autoptic studies have showed occurrences as high as 17%, probably because of the high vascularization of the thyroid. We selected 9 patients who had pathologically proven thyroid metastases at CT and US, during follow-up for a known primary neoplasm. The most common originating neoplastic primaries include mostly those that generally give rise to blood-borne metastases such as breast and lung cancers, mucoid adenocarcinoma of the stomach, colon cancer and renal cancer, as well as melanoma and leiomyosarcoma. Because of its diffusion, sensitivity, and noninvasiveness, ultrasonography can justifiably be introduced in the staging protocols of those neoplasm that more frequently give blood-borne metastases to the thyroid, but a US-guided biopsy is warranted for hypoechoic or otherwise suspicious nodules. This holds particularly true in disease-free patients or previously diagnosed with generally slow-growing malignancies (breast or kidney), since the secondary localization, often metachronous in our experience, may be effectively managed surgically. CT features, on the other hand, are extremely variable and are directly dependent on the histology of the primary lesion, as well as the size of the secondary lesions.

Synthesis, DNA interaction and antineoplastic activity of semicarbazone derivatives.

A number of antineoplastic agents including procarbazine and bisantrene derive from hydrazine, but so far none have been developed from semicarbazide. In order to assay active minimal structures, thirteen new compounds were prepared by replacing hydrogen atoms in semicarbazone amine group by alkylamine moieties, employing an improved procedure. DNA binding was evaluated by treatment of a drug solution with DNA-cellulose complex and further measurement of remaining drug by UV spectroscopy and the affinity observed to range from medium to weak. On testing these compounds against human neoplastic cell lines, only a nitroderivative proved active on CNS and Breast cell lines at 10(-4) M. This member was studied by cyclic voltammetry.

[Stereotactic fine-needle aspiration biopsy (FNAB) of nonpalpable breast lesions: cyto-histological correlations]. / Agoaspirazione (FNAB) mediante centratura stereotassica di lesioni mammarie non palpabili: correlazioni cito-istologiche.

There are not complete consensus if mammographically guided FNABs of nonpalpable breast lesions can replace open biopsy. To elucidate this problem, we have reviewed the efficacy of stereotactic FNAB in a series of 502 cases of nonpalpable lesions observed in a period from 1990 to 1994, with a immediate cytologic control of adequacy of material. In 144 patients of the lesion is achieved with 4% sterile coal localisation and an open biopsy of the area performed. In each case cytologic findings, with a brief description of probable histotype of the lesion, are correlate with surgical pathologic diagnosis, with a comparison between two time period (1990-92; 1993-94). In our study particularly ductal and lobular hyperplasia (with or without atypia) restrict the efficiency of the FNAB. In fact the specificity varies from 83.3% to 90.3%, the sensitivity from 78.7% to 77.8%, positive predictive value from 86.0% to 90.3%, negative predictive value from 75.6% to 70% and diagnostic accuracy from 80.0 to 82.4%, considering ductal and lobular hyperplasias as true negatives or true suspects. Cytologically we have 2 false positive in the first period of time, 3 false suspects in the second period of time and 7 false negatives. However benign/malign biopsy ratio is well (0.97). Moreover histopathologic informations of cytological diagnosis is variable according the histotype of the lesion. In conclusion our study confirm that FNAB is an reliable method that avoid unnecessary biopsy but is insufficiently sensitive to replace open biopsy of nonpalpable breast lesions, also with an immediate cytological control of adequacy of aspirate.

[Quality control of stereotaxic cytologic test of non-palpable lesions of the breast]. / Controllo della qualità dell'esame citologico stereotassico delle lesioni non palpabili della mammella.

The authors compare the accuracy and other indicators of efficiency of ten centers (1,784 total cases) performing stereotaxic cytology and adhering to a multicentric study aimed at validating a quality control system for this diagnostic procedure. The results from single centers were compared with average results. No significant differences were observed for most centers from the average sensitivity (86%), specificity (91%), positive predictive value of a dubious (57%) or positive (96%) cytologic report, inadequacy rate on malignant (6%) or benign (11%) lesions, and benign/malignant biopsy ratio (0.63). Some significant differences from the average values indicated the need for some centers to review different phases of the diagnostic process, namely to verify the accuracy of sampling sites (low sensitivity with good specificity and predictivity), to review the criteria for cytologic diagnosis (specificity less than 90%, low predictive value or higher predictive value for dubious compared with positive reports), to optimize the impact of cytology on the final decision (lack of reduction of benign/malignant biopsy ratio). Periodic check of the above parameters is proposed as a routine quality control of this diagnostic procedure.

[Xerography of diseases caused by microcrystalline deposits]. / La xerografia nelle malattie da depositi microcristallini.

In this work, the authors have pointed out the role of xeroradiography in the diagnostic assessment of joint disorders associated to dystrophic microcalcifications (gout, pseudogout, acute calcific periarthritis). Within this class of pathology, the physical and technical characteristics of xeroradiography imaging (side-effect; showing of details; wide range of x-ray exposition; small density differences) are capable to depict all the joints and related structures involved. In addition particular attention was paid to drew out the joint disorders associated to dystrophic microcalcifications from the vague and non specific term of "arthropathy".