Neurotensin localization in adenomatoid cystic malformation versus normal lung: Preliminary report of six consecutive cases

Neuropeptides are considered a new class of neurotransmitters, several of which interact with the immune system as well as the macrophagic activity. Among these, neurotensin (NT) enhances the phagocitic response of macrophages and is the only neuropeptide that can enhance the cytolytic effects of activated macrophages. In this way, it may play a role as an inflammatory mediator. In order to investigate the possible relationship between NT and the defence mechanisms of the lung, we started to localize the presence of NT in pulmonary adenomatoid cystic malformation (CCAM). This series consists of 6 children affected by CCAM. In every case, at operation, we obtained specimens of both normal and pathological lung. Tissue sections from the pathological lung showed a significant increase of NT-like immunoreactivity in respect to sections of normal lung. NT influences and activates the macrophages, thus suggesting that it could represent a defence mechanism in children's lung activated in some malformative conditions. Finally, the increasing evidence of NT immunoreactivity in CCAM could explicate an in utero infectious pathogenesis of this malformation

SURGERY IN PATIENTS WITH TESTICULAR MALIGNANT GERM CELL TUMORS: COMPLIANCE TO SURGICAL GUIDELINES AND RESULTS IN THE ITALIAN COOPERATIVE STUDY

Purpose: Surgery represents a main and often the only treatment in patients with testicular Malignant Germ Cell Tumors (MGCT). We analyzed the compliance to surgical guidelines and the results in a series of patients with testicular MGCT -/+ retroperitoneal node involvement, without distant metastases. Method: 42 patients, observed in 15 Centers were enrolled in the Italian Cooperative Study on MGCT (January2004–December2010). 14/42 were younger than 2 y. of age, 28/42 between 13–18 y. Treatment was delivered according to COG-Staging-System: St.I patients (complete excision with inguinal orchifunicolectomy+decrease of markers, +hemiscrotectomy if scrotal involvement) did not receive further treatment; St.II patients (scrotal involvement after hemiscrotectomy and/or retroperitoneal node (RPN) enlargement:2 cm) had RPN Dissection if residuals were suspected after PEBx3or4. Results: St.I: 26 patients. 3/26 had a scrotal approach due to suspected testicular torsion: 1/3 underwent hemiscrotectomy, 2 did not receive further therapy after decrease of alphaFP, due to patient’s or physician’s decision respectively. 3/26 were successfully treated for RPN relapse, occurred at 3,6,9 months after adequate surgery (2 adolescents, 1 infant). St.II: in 4 patients CTwas delivered due to slight enlargement of RPN (+persistent alphaFP in 1). St.III: 12 patients received CT and RPND (bilateral in 1). Histology was negative in 11/12. All patients are alive without disease, 39 in 1stCR, 3 in 2ndCR (f.u 9–86 m.:med.48). 1 St.1 patient suffered from postoperative scrotal hematoma. Among patients younger than 2 y, 10/14 had a pure YST, 12/14 had St.I disease; among those between 13–18 y, 27/28 had a mixed histology, 14/28 were St.II or St.III. In 3 adolescents a testicular prosthesis was positioned during primary operation. Conclusion: Outcome was excellent. Regional relapses, observed only in St.I patients, were cured. Surgical guidelines were followed in 40/42 cases. Scrotal approach did not worsen the outcome of patients who did not receive further treatment

SURGERY IN MALIGNANT GERM CELL TUMORS OF CHILDHOOD. RESULTS OF THE SECOND ITALIAN COOPERATIVE STUDY TCG 98

Analysis of treatment and results of the patientsenrolled in the Italian TCG-98 Study, still open and comparison of data with those of the previous Studt TCG-9