Fallopian tube pathology – review with emphasis on the radiological features

A trompa de Falópio é uma estrutura ginecológica visível em ecografia, tomografia computorizada ou ressonância magnética unicamente quando comporta alterações patológicas. Técnicas de imagem semi-invasivas como a histerossalpingografia e histerossonografia permitem também evidenciá-la, sendo particularmente empregues no esclarecimento de situações de infertilidade. O objectivo deste nosso trabalho é rever a patologia da trompa de Falópio com tradução radiológica nas correntes técnicas de imagem seccionais.The Fallopian tube is a gynecological structure depicted on ultrasonography, computed tomography or magnetic resonance only when pathological processes are present. Semi-invasive techniques such as hysterosalpingography and hysterosonography also allow to disclose it, being particularly employed in the evaluation of infertility. The purpose of this work is to review the Fallopian tube pathology with radiological manifestation on cross-sectional imaging techniques

Langerhans cell histiocitosis: a study of 20 cases

Objectivo: Descrever os aspectos clínico-radiológicos da Histiocitose de Células de Langerhans (HCL) numa série de doentes. Material e Métodos: Reviram-se 20 casos de HCL, nove com diagnóstico segundo os actuais critérios anátomo-patológicos (positividade para CD1a e/ou presença de grânulos de Birbeck em microscopia electrónica), outros nove apenas com critérios morfológicos, e dois casos com diagnóstico patológico estabelecido fora da instituição, não susceptível de aferição anátomo- patológica. Resultados: A razão sexo masculino:feminino foi 4:1 e a média de idades de apresentação da doença 8 anos (variação: 2 meses - 44 anos). Os quatro órgãos mais frequentemente envolvidos foram, por ordem decrescente: osso, gânglios linfáticos, pele e hipófise. Dois doentes tinham doença unifocal óssea, oito apresentavam doença multifocal-unissistémica, em sede óssea ou ganglionar, e dez doença multissistémica. As lesões líticas foram o achado radiológico mais frequente, distribuindo-se predominantemente na calote craniana, ossos ilíacos e fémures. As alterações pulmonares constituiram achado minoritário. Conclusão: A série em estudo incluiu uma proporção grande de casos com gravidade clínica (10 doentes com HCL multissistémica), tendo-se observado em número relativamente restrito a forma menos grave da doença, correspondente ao clássico granuloma eosinófilo. A aparência das alterações radiológicas foi contudo similar à descrita na literatura.Objective: To describe the clinical and radiological features of Langerhans Cell Histiocytosis (LCH) in a series of patients. Material And Methods: We reviewed 20 cases of LCH, nine with diagnosis by the current pathological criteria (positivity for CD1a and/or presence of Birbeck granules identified at ultrastructural examination), and nine only with morphological criteria. In the other two cases, the pathological diagnosis was made outside our institution and could not be reviewed. Results: Male:female ratio was 4:1 and the average age of presentation of the disease was 8 years (range: 2 months - 44 years). The four most affected organs were, in decreasing order: bone, lymph nodes, skin and hypophysis. Two patients had unifocal bone disease, eight multifocal unisystem involvement in the bone or lymph nodes, and ten presented multisystem LCH. Lytic lesions were the most common radiological finding, affecting mainly the skull, iliac bones and femurs. Pulmonary lesions were rather infrequent. Conclusion: This series included a large proportion of severe cases (10 patients with multisystem LCH), while the mildest form of the disease, classically designated as eosinophilic granuloma, was observed only in a few patients. The appearance of the radiological findings was however similar to the described in the literature

Propranolol therapy for cerebral cavernous malformations

Funding Information: The present study was funded by IPOLFG EPE and by iNOVA4Health (UID/Multi/04462/2019) a program finan‑ cially supported by Fundação para a Ciência e Tecnologia (FCT)/Ministério da Educação e Ciência, through national funds. The PhD fellowship of FLC was funded by FCT (PD/BD/128337/2017).Cerebral cavernous malformations (CCMs) are vascular malformations characterized by the abnormal growth of vascular structures in the central nervous system. However, the precise mechanism(s) responsible for the development of CCM vascular abnormalities remain poorly understood. Although the mechanisms of action of propranolol in CCM have not yet been fully explored it is not commonly prescribed, it has been shown to be effective in children and appears to play a protective role in the prevention of CCM-derived hemorrhage in adults. The present study performed in vitro and ex vivo assays in order to examine the effects of propranolol on endothelial cells (ECs). The percentage of CD14+/CD31+ cells and the levels of VEGF in the peripheral blood (PB) of a child patient with CCM, with recurrent seizures and hemorrhages, who was maintained under propranolol therapy, were also analyzed. In addition to the effects of propranolol on differentiated ECs, and the decrease angiogenic-related features in vitro and ex vivo, it was observed that in the PB of this patient, propranolol administration decreased the percentage of circulating cells sharing monocytic and EC features (CD14+/CD31+ cells), as well as the VEGF levels; this was concomitant with a good prognosis and with the reversion of CCM lesions. A decrease in VEGF levels by propranolol may also be involved in the impairment of the recruitment of CD14+/CD31+ monocytes functioning as endothelial progenitor cells to sustain the vascular lesion. On the whole, the present study demonstrates that propranolol impairs angiogenesis in vitro and may thus be a useful tool for the clinical management of CCM. Moreover, the present study highlights the monitorization of the levels of CD14+/CD31+ monocytes and VEGF levels as a useful tool for predicting the clinical efficacy of propranolol in patients with CCM.publishersversionepub_ahead_of_prin

EPN-29THE ROLE OF RADIOTHERAPY IN PEDIATRIC EPENDYMOMAS - BEYOND ADJUVANT TREATMENT

Un’analisi del trattamento del tema della prostituzione nelle opere di Dacia Maraini pubblicate tra il 1962 e il 1999 (romanzi, racconti, opere teatrali, poesia e saggi). Sono state prese in considerazione le seguenti opere: La vacanza; L’età del malessere; Le mani; Il manifesto; Memorie di una ladra; Dialogo di una prostituta con un suo cliente; L’arte di amare; Prostituzione pubblica o privata?; Una casa di donne; Pazza d’amore; Prefazione a “Ritratto a tinte forti” di Carla Corso; Veronica, meretrice e scrittora; Voci; Corpo in vetrina; Viollca la bambina albanese

Selumetinib for plexiform neurofibromas in neurofibromatosis type 1: a single-institution experience

Background Plexiform neurofibromas (PN) are the most frequent tumors associated with Neurofibromatosis type 1 (NF-1). PN can cause significant complications, including pain, functional impairment, and disfigurement. There is no efficient medical treatment and, surgical resection of large PN is frequently infeasible. Selumetinib (AZD6244/ARRY-142886) is a mitogen-activated protein kinase enzyme (MEK1/2) inhibitor and works by targeting the MAPK pathway. It is an investigational treatment option for inoperable symptomatic PN associated with NF-1. Herein, we describe a single institutional experience with selumetinib for inoperable PN in NF-1. Methods Case series study of demographics, clinical, baseline characteristics, treatment effect, and follow-up of consecutive genetically confirmed NF1 patients with inoperable PN associated with significant or potential significant morbidity treated with selumetinib (April 2018 to April 2019). Results Nineteen patients were treated with selumetinib. Predominant target locations were head and neck (31.6%, 6/19), chest (26.3%, 5/19) and pelvis (21%, 4/19) and the most important comorbidities were disfigurement (47.4%, 9/19) and pain (26.3%, 5/19). The mean follow-up time was 223 days (range 35-420 days). All but one had sustained clinical improvement, mainly in the first 60-90 days of treatment. In one patient, the treatment was suspended after 168 days (lack of clear benefit and left ventricular ejection fraction drop). There were no adverse effects leading to treatment suspension. Conclusions In the first observational study of selumetinib for NF-1 associated PN we showed that the drug was associated with clinical and radiological improvement. Our study also confirms the safety described in the clinical trials