Publications by authors named "Pio Zeppa"

Introduction: The aim of this project is to assess interobserver agreement for programmed death-ligand 1 (PD-L1) scoring on of non-small cell lung cancer (NSCLC) on cytological specimens in a large-scale multicenter study, by exploiting the cell block-derived tissue microarray (cbTMA) approach.

Methods: A total of 65 cell blocks (CB) diagnosed as NSCLC were retrospectively collected and selected for TMA preparation. Hematoxylin-eosin and PD-L1 stained slides were digitized and uploaded on a free web sharing platform.

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Introduction: Around 85% of non-small cell lung cancers (NSCLCs) are diagnosed at an advanced stage (IIIB to IV), where therapeutic options depend on molecular analysis. However, diagnostic material for molecular testing is often represented by cytological samples which are generally scarce and span a wide range of preparation types. Thus, the primary objective is to efficiently manage materials for molecular profiling.

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Objective: ALK, ROS1, NTRK, and RET gene fusions and MET exon 14 skipping alterations represent fundamental predictive biomarkers for advanced non-small cell lung cancer (NSCLC) patients to ensure the best treatment choice. In this scenario, RNA-based NGS approach has emerged as an extremely useful tool for detecting these alterations. In this study, we report our NGS molecular records on ALK, ROS1, NTRK, and RET gene fusions and MET exon 14 skipping alterations detected by using a narrow RNA-based NGS panel, namely SiRe fusion.

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Introduction: Multiple myeloma (MM) with pulmonary extramedullary disease is rare and usually associated with poor prognosis, and no data on daratumumab-based regimens have been reported yet.

Case Presentation: Here, a 64-year-old man with pulmonary plasmacytoma received daratumumab-based regimens and has achieved a very good partial response with lung mass disappearance and overall survival of 16 months. He did not receive autologous stem cell transplantation because of several comorbidities, such as severe drug-induced neuropathy and JAK2-mutated myeloproliferative neoplasm with marked splenomegaly.

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Background: Kidney transplant recipients (KTRs) rely on immunosuppressants like mycophenolate to prevent organ rejection. However, mycophenolate often causes intestinal symptoms and inflammation in various organs, including the skin and the colon. While KTRs have an increased risk for skin cancer, the risk of colorectal cancer is not increased.

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Lymph node (LN) fine-needle aspiration cytology (FNAC) is a common diagnostic procedure for lymphadenopathies. Despite the qualities and potentialities of LN-FNAC, the number of possible pathologies and the variety of clinical contexts represent a challenge and require a continuous upgrading of the procedure according to the emerging clinical requests and new technologies. This study presents an overview of the current and future impact of LN-FNAC on the care of patients with lymphadenopathy.

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Background: The Sydney system for fine-needle aspiration biopsy of lymph nodes has five categories, stressing the role of correlation of cytopathology with clinical, ultrasound, and ancillary findings to achieve diagnosis. The five categories constitute a hierarchical system with increasing risk of malignancy from benign to atypical, suspicious, and malignant categories, which informs recommendations for further workup to achieve a final diagnosis as possible. This article analyzes 10 publications using the Sydney system and a meta-analysis of nine of these studies.

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Introduction: Mandibular osteosarcoma (MOS) is a rare malignant bone tumour known for its rapid and aggressive behaviour, particularly in cases of relapse. Early and accurate diagnosis is crucial for effective treatment.

Case Presentation: We report the case of a 48-year-old woman with recurrent MOS.

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Objectives: BAG3 (Bcl2-associated athanogene3) is able to induce the transformation of cancer-associated fibroblasts to alpha smooth muscle actin (a-SMA) positive (+) myofibroblasts. In systemic sclerosis (SSc), a-SMA+ myofibroblasts also play an important role in the progression of fibrosis in the skin and involved internal organs. The aim of the study was to investigate whether BAG3 is overexpressed in SSc and may be a biomarker of fibrogenesis.

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Recent advancements in computer-assisted diagnosis (CAD) have catalysed significant progress in pathology, particularly in the realm of urine cytopathology. This review synthesizes the latest developments and challenges in CAD for diagnosing urothelial carcinomas, addressing the limitations of traditional urinary cytology. Through a literature review, we identify and analyse CAD models and algorithms developed for urine cytopathology, highlighting their methodologies and performance metrics.

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Following the introduction of RNA-based vaccines, COVID-19 vaccine-associated clinical lymphadenopathy (C19-LAP) has been reported as a side effect. Moreover, subclinical lymphadenopathy detected on imaging (SLDI) has also been observed, mainly as incidental findings while performing screening tests on oncological patients. In these cases, surgical lymphadenectomy, fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) have been used as a valuable diagnostic tool for SLDI and C19-LAP.

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Article Synopsis
  • A study assessed the role of abnormal p53 expression in 370 patients with low-risk endometrial cancer (EC), discovering that 4.9% had p53 abnormalities, which could indicate a higher recurrence risk.
  • Among the patients, 3.6% experienced recurrences, with those exhibiting abnormal p53 expression having a 5.23 times higher odds of recurrence compared to those with normal p53.
  • Although there was no significant difference in overall survival between the two groups, the findings suggest that molecular classification for p53 abnormalities may help tailor treatment in future studies of low-risk EC patients.
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Article Synopsis
  • Efficient predictive biomarkers are essential for the success of immune checkpoint inhibitors (ICIs) in treating non-small cell lung cancer (NSCLC), with specific focus on evaluating single nucleotide polymorphisms (SNPs) in PD-L1.
  • The SNP rs822336 shows a strong correlation with positive responses to anti-PD-1/PD-L1 therapy in NSCLC patients, outperforming other SNPs like rs2282055 and rs4143815.
  • The study reveals that rs822336 influences PD-L1 expression through its location in the gene’s promoter/enhancer region, controlled by specific transcription factors (C/EBPβ and NFIC), highlighting its potential as a novel biomarker
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Introduction: Fine needle aspiration cytology (FNAC) combined with rapid on-site evaluation (ROSE) and ancillary techniques is an accurate diagnostic tool for many pathologies. However, in some cases, it may not be sufficient for actionable diagnoses or molecular testing, especially for cases that require large immunohistochemical panels or cases in which histological features are mandatory for the diagnosis. Core needle biopsy (CNB), on the contrary, provides samples that are suitable for histological features and sufficient for all ancillary studies.

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Leptomeningeal metastasis is the spread of cancer to the leptomeninges and subarachnoid space and represents a dreadful complication of cancer. The most commonly responsible neoplasms are high-grade lymphomas, leukemias, and some solid tumors, chiefly breast and lung cancer as well as melanoma. Herein we report our ten-year retrospective experience on 715 cases of cerebrospinal fluid cytology, 21 (2.

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Article Synopsis
  • The Sydney system was developed to improve standardization and reproducibility in lymph node cytopathology, with previous studies focusing on its risk of malignancy but not on how consistently different pathologists can interpret it.
  • A study involving 15 cytopathologists from 12 institutions globally evaluated 85 cases using digital whole-slide images, resulting in over 1200 diagnoses.
  • The findings indicated nearly perfect agreement with a ground truth for most diagnoses, but varying levels of concordance across categories, with the inadequate and malignant categories showing the most agreement, while suspicious and atypical categories had very slight agreement.
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The reliability and safety of front-line ultrasonography guided core needle biopsy (UG-CNB) performed with specific uniform approach have never been evaluated in a large series of patients with lymphadenopathies suspected of lymphoma. The aim of this study was to assess the overall accuracy of UG-CNB in the lymph node histological diagnosis, using a standard reference based on pathologist consensus, molecular biology, and/or surgery. We retrospectively checked the findings concerning the application of lymph node UG-CNB from four Italian clinical units that routinely utilized 16-gauge diameter modified Menghini needle under power-Doppler ultrasonographic guidance.

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Fine-needle aspiration cytology (FNAC) is commonly used to obtain a pre-surgical pathological diagnosis in many organs, but its cost-effectiveness in lymphadenopathy has not been studied yet. We calculated the cost and diagnostic accuracy of a diagnostic algorithm that uses FNAC as a first-line procedure and compared it to a purely surgical approach in 545 consecutive lymphadenopathies. In 74% of the cases, FNAC alone can obtain a sufficiently detailed diagnosis, avoiding the surgical biopsy.

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Article Synopsis
  • A 31-year-old man had problems with urination and was found to have a rare type of prostate cancer called prostatic stromal sarcoma after undergoing tests.
  • Although doctors tried to help him with chemotherapy, he sadly passed away 8 months later because he didn't want surgery.
  • This case is important because it shows how unusual cancers can be tricky to diagnose and treat, and doctors need to remember these rare types when dealing with prostate problems.
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