Search Results (5)

Background and Clinical Significance: Intravascular large B-cell lymphoma (IVLBCL) is an exceedingly rare and aggressive malignancy characterized by the selective growth of lymphoma cells within blood vessel lumina. This malignancy often presents with non-specific systemic manifestations, making diagnosis challenging. Neurological symptoms and cutaneous findings are typical, whereas thrombotic events are uncommon at the initial presentation. We report a unique case of IVLBCL with MYC and BCL2 rearrangements (“double-hit” genetics), diagnosed following mechanical thrombectomy; Case Presentation: A 79-year-old woman presented with acute right-lower-limb swelling due to extensive iliofemoral deep vein thrombosis. Mechanical thrombectomy was performed, and the histopathological and genetic examination of the retrieved material revealed IVLBCL. Subsequent staging with positron emission tomography-computed tomography (PET-CT) demonstrated an FDG-avid tumor thrombus confined to the right internal iliac vein, without any lymphadenopathy or solid tumor mass. The patient was successfully treated with a combination of systemic chemoimmunotherapy and targeted radiotherapy and remained in complete remission for more than four years after diagnosis; Conclusions: We report a potentially unique case of double-hit IVLBCL diagnosed using endovascular thrombectomy. This underscores the therapeutic and diagnostic potential of mechanical thrombectomy systems in the detection of intravascular malignancies and the critical importance of the routine histopathological examination of all thrombectomy specimens. Despite negative thrombolysis data from the ATTRACT and CAVA trials, mechanical thrombectomy may improve venous hemodynamics and may reduce post-thrombotic syndrome (PTS) in pelvic thrombosis. Here, mechanical thrombectomy followed by right iliac vein stenting achieved excellent technical and clinical outcomes. Full article

Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major cause of sudden death and a frequent finding in forensic practice. Correctly estimating thrombus age is crucial to reconstruct the temporal relationship among clinical events, therapeutic decisions, and death, and also to distinguish unavoidable complications from possible diagnostic or management errors. This narrative review summarizes current macroscopic, histological, immunohistochemical, and molecular criteria for thrombus dating, integrating evidence from autopsy studies, experimental models, and clinical research. Because of the inherent heterogeneity of thrombi and postmortem changes, classical morphology frequently does not provide sufficiently precise timing, although it does allow a broad distinction between acute, subacute, and chronic thrombi. A more precise temporal characterization has recently been made possible by the introduction of immunohistochemical and molecular markers, such as neutrophils and NETs, macrophage markers, fibrinolytic system components, metalloproteinases, inflammatory cytokines, autophagy markers, aquaporins, and pro-resolving pathways. In order to improve diagnostic accuracy, a combined evaluation of these characteristics seems promising in differentiating clinically relevant time windows (within 3 days, 3–10 days, 10–21 days, and >21 days). Molecular profiling combined with advanced histopathology may eventually enable more consistent and repeatable thrombus dating standards and enhance the forensic assessment of VTE-related fatalities. Full article

Objectives: This in vivo study introduces a newly developed spirooxindole derivative that is deemed safe and effective as a potential targeted therapy for various cancers. Methods: Extensive in vivo investigations, including histopathology, immunohistochemistry, and molecular biology, validated its potential for further preclinical and clinical exploration, necessitating comprehensive examinations of its bioavailability, pharmacodynamics, and pharmacokinetics. Additionally, this study involves the development of a commercially viable proniosomal drug delivery system for the compound, facilitating controlled drug release. Results: The data revealed efficacy of spirooxindole derivative in halting the progression of liver cancer, metastasis, and portal vein thrombosis, with potential implications for enhancing regeneration and recovery of early-stage cancer cells in multiple organs, thereby improving recovery rates and remission among cancer patients. The proniosomes, loaded with the compound, exhibited high entrapment efficiency and prolonged drug release rates of up to 12 h in vitro. The optimized formula demonstrated superior drug release percentages and stability compared to conventional niosomes. Further analysis via FTIR and DSC confirmed the absence of chemical interactions and proper entrapment of the compound within the nanovesicles, indicating a stable and effective drug delivery system. Conclusions: This study presents a novel, safe, and effective chemical entity of spirooxindole derivatives for further preclinical and clinical studies. Full article

Background: The Delta variant (Pango lineage B.1.617.2) is one of the most significant and aggressive variants of SARS-CoV-2. To the best of our knowledge, this is the first paper specifically studying pulmonary morphopathology in COVID-19 caused by the B.1.617.2 Delta variant. Methods: The study included 10 deceased patients (40-83 years) with the COVID-19 Delta variant. The necrotic lung fragments were obtained either by biopsy (six cases) or autopsy (four cases). Tissue samples were subjected to virology analysis for identification of the SARS-CoV-2 variant, histopathology, and immunohistochemistry (anti-SARS coronavirus mouse anti-virus antibody). Results: Virology analysis identified B.1.617.2 through genetic sequencing in eight cases, and in two cases, specific mutations of B.1.617.2 were identified. Macroscopically, in all autopsied cases, the lung had a particular appearance, purple in color, with increased consistency on palpation and abolished crepitations. Histopathologically, the most frequently observed lesions were acute pulmonary edema (70%) and diffuse alveolar damage at different stages. The immunohistochemical examination was positive for proteins of SARS-CoV-2 in 60% of cases on alveolocytes and in endothelial cells. Conclusions: The histopathological lung findings in the B.1.617.2 Delta variant are similar to those previously described in COVID-19. Spike protein-binding antibodies were identified immunohistochemically both on alveolocytes and in the endothelial cells, showing the potential of indirect damage from thrombosis. Full article

The aim of this study is to report on the oral lesions detected in 123 patients diagnosed at the University Hospital of Bari from October 2020 to December 2020, focusing on the correlation of clinical and pathological features in order to purpose a new classification. Methods. General and specialistic anamnesis were achieved and oral examination was performed. The following data were collected: age/gender, general symptoms and form of Covid-19, presence and features of taste disorders, day of appearance of the oral lesions, type and features of oral lesions and day of beginning of therapies. If ulcerative lesions did not heal, biopsy was performed. Results. Many types of oral lesions were found and classified into four groups considering the timing of appearance and the start of the therapies. Early lesions in the initial stages of Covid-19 before the start of therapies was observed in 65.9% of the patients. In the histopathological analysis of four early lesions, thrombosis of small and middle size vessels was always noticed with necrosis of superficial tissues. Conclusion. The presence of oral lesions in early stages of Covid-19 could represent an initial sign of peripheral thrombosis, a warning sign of possible evolution to severe illness. This suggests that anticoagulant therapies should start as soon as possible. Full article