Cell-block procedure in endoscopic ultrasound-guided-fine-needle-aspiration of gastrointestinal solid neoplastic lesions

In the present review we have analyzed the clinical applications of endoscopic ultrasound-guided-fineneedle-aspiration(EUS-FNA) and the methodological aspects obtained by cell-block procedure(CBP) in the diagnostic approach to the gastrointestinal neoplastic pathology. CBP showed numerous advantages in comparison to the cytologic routine smears; in particular, better preservation of cell architecture, achievement of routine haematoxylin-eosin staining equivalent to histological slides and possibility to perform immunohistochemistry or molecular analyses represented the most evident reasons to choose this method. Moreover, by this approach, the differential diagnosis of solid gastrointestinal neoplasias may be more easily achieved and the background of contaminant nonneoplastic gastrointestinal avoided. Finally, biological samples collected by EUS-FNA CBP-assisted should be investigated in order to identify and quantify further potential molecular markers.

Rectal perforation by inadvertent ingestion of a blister pack: A case report and review of literature

The accidental ingestion of a foreign body(FB) is a relatively common condition. In the present study, we report a peculiar case of rectal perforation, the first to our knowledge, caused by the inadvertent ingestion of a blister pill pack. The aim of this report is to illustrate the difficulties of the case from a diagnostic and therapeutic viewpoint as well as its unusual presentation. A 75-year-old woman, mentally impaired, arrived at our emergency department in critical condition. The computed tomography scan revealed a substantial abdominopelvic peritoneal effusion and free perigastric air. The patient was therefore submitted to an urgent exploratory laparotomy; a 2-cm long, full-thickness lesion was identified in the anterior distal part of the intraperitoneal rectum. Hence, we performed a Hartmann's procedure. Because of her critical condition, the patient was eventually transferred to the Intensive Care Unit, where she died after 10 d, showing no surgical complication. The ingestion of FBs is usually treated with observation or endoscopic removal. Less than 1% of FBs are likely to cause an intestinal perforation. The intestinal perforation resulting from the unintentional ingestion of an FB is often a difficult challenge when it comes to treatment, due to its late diagnosis and the patients' deteriorated clinical condition.

Benign intratesticular schwannoma:a rare finding

Schwannoma is a peripheral nerve tumour, occasionally located in the genitourinary tract. We described an extremely rare case of intratesticular neurinoma in a 79-year-old patient. （Asian JAndrol 2006 Jan; 8： 101-103）

PathVisio Analysis:An Application Targeting the miRNA Network Associated with the p53 Signaling Pathway in Osteosarcoma

MicroRNAs(miRNAs)are small single-stranded,non-coding RNA molecules involved in the pathogenesis and progression of cancer,including osteosarcoma.We aimed to clarify the pathways involving miRNAs using new bioinformatics tools.We applied WikiPathways and PathVisio,two open-source platforms,to analyze miRNAs in osteosarcoma using miRTar and ONCO.IO as integration tools.We found 1298 records of osteosarcoma papers associated with the word“miRNA”.In osteosarcoma patients with good response to chemotherapy,miR-92a,miR-99b,miR-193a-5p,and miR-422a expression is increased,while miR-132 is decreased.All identified miRNAs seem to be centered on the TP53 network.This is the first application of PathVisio to determine miRNA pathways in osteosarcoma.MiRNAs have the potential to become a useful diagnostic and prognostic tool in the management of osteosarcoma.PathVisio is a full pathway editor with the potentiality to illustrate the biological events,augment graphical elements,and elucidate all the physical structures and interactions with standard external database identifiers.

An unexpected urinary bladder xanthoma:Case report

In spite of the fact that xanthomas of the skin,tendons and mucosae are relatively common conditions,urinary bladder xanthoma is a rare benign lesion,only occasionally reported in literature.It usually appears as an exophytic mass into the bladder cavity,which often worries the clinicians,because it is considered as a neoplasm that need both an excision and follow-up.We herein describe the 32nd case,accidentally identified in a 63-year-old man with a right urinary bladder mass on follow-up abdominal ultrasound scan for a previous open pyeloplasty.He also referred mild obstructive lower urinary tract symptoms.Consequently,a cystoscopy with biopsies was performed and the subsequent histopathological examination was consistent with the diagnosis of urinary bladder xanthoma.Therefore,no additional therapeutics interventions were needed,and the patient currently presents nor symptoms,recurrences,or other pathologies.Although its rarity,it is important to correctly identify urinary bladder xanthoma,differentiating it from other pathological entities which present similar histopathological characteristics,but which sometimes could be associated with a patients’dismal prognosis.Moreover,an accurate diagnosis of urinary bladder xanthoma can avoid both additional treatments and follow up,but also allows to recognize some potential detrimental pathologies which could be associated with it,such as either an altered lipid metabolism or urothelial neoplasms.Proper and prompt recognition and treatment of these last can notably improve patient’s outcome.

Uterine large cell neuroendocrine carcinoma with unusual colonic metastasis

A 78-year-old female patient arrived at our practice complaining of progressive abdominal increase and presenting a clinical picture of intestinal obstruction.At physical examination,the abdomen appeared distended,moderately painful with the presence of a mass of hard consistency.Abdominal computed tomography scan showed a large hypodense pelvic mass that indicated a compression and lateral deviation of the uterus and bladder.Microscopically,the mass showed a uniform solid pattern,composed of medium and large-sized cells with hyperchromatic and pleomorphic nuclei demonstrating high mitotic activity and diffuse immunoreactivity for estrogen receptors and synaptophysin.A diagnosis of uterine poorly differentiated large cell neuroendocrine carcinoma,arising in the endometrium with an unusual colonic metastatic localization,was made.

Microsurgical tunica albuginea transplantation in an animal model

Several andrological diseases require surgical repair or reconstruction of tunica albuginea, which envelops the corpora cavernosa penis. Despite intense research efforts involving a variety of biological materials, such as skin, muscle aponeurosis, human dura mater, tunica vaginalis, and pericardium, engineered tunica albuginea suitable for graft use is yet to be obtained. The study investigates microsurgical tunica albuginea allotransplantation in an animal model with the purpose of creation of an organ-specific tissue bank to store penile tissue, from cadaveric donors and male-to-female trans-sexual surgery, for allogeneic transplantation. Materials were tunica albuginea tissue explanted from 15 donor rats, cryopreserved at -80~C, gamma-irradiated, and implanted in 15 recipient rats, of which three rats were used as controls. Penile grafts were explanted at different time intervals; after macroscopic evaluation of the organ, the grafts were processed to morphological, histochemical, and immunohistochemical examinations by light microscopy. Detection of pro-inflammatory cytokines was also performed. Examination of the tunica albuginea allografts collected 1, 3, or 6 months after surgery and of control tunica albuginea fragments showed that tunica albuginea implants achieved biointegration with adjacent tissue at all-time points. The integration of cryopreserved rat tunica albuginea allografts, documented by our study, encourages the exploration of tunica albuginea allotransplantation in humans. In conclusion, the effectiveness and reliability of the tunica albuginea conditioning protocol described here suggest the feasibility of setting up a tunica albuginea bank as a further tissue bank.