Publications by authors named "Francesca Baciorri"

11 Publications

  • Page 1 of 1

Pathology of non-alcoholic fatty liver disease.

Pathologica 2021 Jun;113(3):194-202

Department of Pathology, Azienda ULSS 2 Marca Trevigiana, Treviso, Italy.

Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of different conditions which are characterized by hepatic steatosis in the absence of secondary causes. It is currently the most common chronic liver disease worldwide, and its estimated prevalence is about 1.5-6.5%. The only histological finding of steatosis ("simple" steatosis) represents the uncomplicated form of NAFLD, while non-alcoholic steatohepatitis (NASH) is its inflammatory subtype associated with disease progression to cirrhosis and hepatocellular carcinoma (HCC), and represents the major indication for liver transplantation. NASH is still a diagnostic and therapeutic challenge for clinicians and liver biopsy is currently the only accepted method to reliably distinguish NASH from "simple" steatosis. From the histological perspectives, NAFLD and NASH continue to be an area of active interest for pathologists, with a specific focus on better methods of evaluation, morphologic clues to pathogenesis, and predictors of fibrosis progression. This review focuses on histopathology of NAFLD in adults, with the aim to provide a practical diagnostic approach useful in the clinical routine.
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http://dx.doi.org/10.32074/1591-951X-242DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299321PMC
June 2021

Pathology of autoimmune hepatitis.

Pathologica 2021 Jun;113(3):185-193

Pathology Department Azienda ULSS 2 Marca Trevigiana, Treviso, Italy.

Autoimmune hepatitis (AIH) is a relatively rare non-resolving chronic liver disease, which mainly affects women. It is characterized by hypergammaglobulinemia, circulating autoantibodies, interface hepatitis on liver histology and a favourable response to immunosuppression. The putative mechanism for the development of autoimmune hepatitis is thought to be the interaction between genetic predisposition, environmental triggers and failure of the native immune system.

AIH still remains a major diagnostic and therapeutic challenge, mainly because it is a very heterogeneous disease. Prompt and timely diagnosis is crucial since, if left untreated, AIH has a high mortality rate. Histological demonstration of hepatitis is required for the diagnosis of AIH and, therefore, liver biopsy is mandatory in the initial diagnostic work-up, before treatment. In this review, we summarize the histological features of AIH with the main aim of highlighting the most important clinical-pathological hallmarks useful in the routine diagnostic practice.
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http://dx.doi.org/10.32074/1591-951X-241DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299324PMC
June 2021

Cholangiocarcinoma.

Pathologica 2021 Jun;113(3):158-169

Department of Pathology, Azienda ULSS2 Marca Trevigiana, Treviso, Italy.

Liver cancer represents the third leading cause of cancer-related death worldwide. Cholangiocarcinoma (CCA) is the second most common type of liver cancer after hepatocellular carcinoma, accounting for 10-15% of all primary liver malignancies. Both the incidence and mortality of CCA have been steadily increasing during the last decade. Moreover, most CCAs are diagnosed at an advanced stage, when therapeutic options are very limited.

CCA may arise from any tract of the biliary system and it is classified into intrahepatic, perihilar, and distal CCA, according to the anatomical site of origin. This topographical classification also reflects distinct genetic and histological features, risk factors, and clinical outcomes. This review focuses on histopathology of CCA, its differential diagnoses, and its diagnostic pitfalls.
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http://dx.doi.org/10.32074/1591-951X-252DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299326PMC
June 2021

Effectiveness of a cosmetic device containing a combination of alpha- and beta-hydroxy acids, urea, and thuja for the treatment of seborrheic keratoses.

J Cosmet Dermatol 2021 Jul 15. Epub 2021 Jul 15.

Dermatologic Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.

Background: Seborrheic keratosis is a benign epidermal tumor of cosmetic concern-as it progressively increases in size, thickness, and pigmentation-on which topical treatments are poorly effective. Considering its keratotic component, effective products may include active principles with keratolytic action.

Aims: Evaluate the efficacy and tolerability of a topical cosmetic product with urea and hydroxy acids, in the treatment of seborrheic keratoses.

Patients And Methods: Twenty patients were enrolled in an observational, prospective, open-label study. The topical device was applied on seborrheic keratoses twice daily for 30 days. We evaluated the progression of the treatment by clinical examination-using Daily Life Quality Index-and epiluminescence microscopy at baseline and day 30.

Results: After 30 days of treatment, we documented a significant reduction in seborrheic keratosis thickness and number, which was confirmed also by epiluminescence microscopy. On day 30, global Daily Life Quality Index improved by 99.95%. The tolerability of the cosmetic device was considered excellent, according to 19/20 subjects (95%).

Conclusions: The results of our study showed the efficacy and tolerability of this cosmetic device. Its active compounds favor gradual removal of seborrheic keratoses, even in case of pigmented variants. This non-invasive treatment represents an alternative to surgical procedures, mainly for fragile patients and delicate skin areas. It is possible to speculate its usefulness in the topical treatment of circumscribed hyperkeratosis, palmoplantar keratoderma, and thick psoriatic plaques.
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http://dx.doi.org/10.1111/jocd.14346DOI Listing
July 2021

Histopathology of the temporomandibular joint disc: Findings in 30 samples from joints with degenerative disease.

J Oral Rehabil 2021 Sep 9;48(9):1025-1034. Epub 2021 Jul 9.

School of Dentistry, University of Siena, Siena, Italy.

Aim: The aim of this study is to show the anatomical and histological features of the displaced temporomandibular joint (TMJ) disc in joints with degenerative disease.

Methods: This study was performed on a total of 30 TMJ discs extracted from 22 patients, who underwent surgical discectomy after failure of conservative non-surgical treatment regimens to control pain and/or limited range of motion. All joints had imaging signs of an anteriorized disc position and degenerative joint disease. Samples of the extracted discs were stored in formalin, cut into 3 micron-thick sections imbedded in paraffin and processed with hematoxylin-eosin.

Result: All the samples present irreversible morphologic and histological alterations. The macroscopical evaluation showed that 14 discs were worn and fragmented in several parts, and one disc was perforated. Morphological alterations with deformation and degenerative signs were shown in all discs, which were all severely worn and compromised. Histologically, various alterations were found, such as pre-fibrous sclerosis with myxoid degeneration and collagen deposits (N = 25), an increase in fibro-hyaline and fibrous tissues, with loss of elasticity (N = 25), scattered calcifications (N = 15), and synovial inflammation with microvascular proliferation and increased cellularity, presence of lymphocytes, histiocytes and plasma cells (N = 18). After the intervention, all patients reported decreased pain levels and showed improved function at 6 months.

Conclusion: These observations suggest that degenerative joint disease is accompanied by a anteriorized discs featuring abnormal macroscopical and histological changes. From a clinical viewpoint, this may suggest that, when treatment escalation leads to consider TMJ surgery, total discectomy is the most reasonable approach.
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http://dx.doi.org/10.1111/joor.13218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8456827PMC
September 2021

Adenosquamous carcinoma of the right colon with diffuse signet-ring mucinous component.

Clin J Gastroenterol 2020 Aug 5;13(4):555-559. Epub 2020 Feb 5.

Anatomic Pathology, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy.

Colorectal carcinoma is one of the most frequent human malignant neoplasms. Besides the most common histological types, colorectal adenosquamous carcinoma is very rare, being microscopically constituted by tumoural glandular and squamous components. The diagnosis of primary colon adenosquamous carcinoma requires the exclusion of a metastatic squamous cell carcinoma and the extension of a primary squamous cell carcinoma from the anal-rectum junction. We report a case of primary adenosquamous carcinoma of the ascending colon in a 62-year-old Caucasian man affected by long-standing ulcerative colitis. Peritumoural lymph nodes and distant metastasis were present. We reported also a diffuse signet-ring mucinous component, which has not been previously observed. Moreover, we investigated microsatellite and all-RAS/B-RAF status, p16 and p53 protein expression, and the molecular presence of human papillomavirus DNA in all the morphologically distinct components, in order to suggest pathogenetic factors influencing the aggressive prognosis of colon adenosquamous carcinoma.
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http://dx.doi.org/10.1007/s12328-020-01101-yDOI Listing
August 2020

Oral manifestation of indolent T-cell lymphoproliferative disorder of the gastrointestinal tract: A potential diagnostic pitfall.

J Cutan Pathol 2020 May 11;47(5):494-496. Epub 2020 Feb 11.

Anatomic Pathology, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.

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http://dx.doi.org/10.1111/cup.13658DOI Listing
May 2020

Inflammatory bowel disease versus Chlamydia trachomatis infection: a case report and revision of the literature.

Eur J Gastroenterol Hepatol 2020 03;32(3):454-457

Department of Systems Medicine, Unit of Gastroenterology, University 'Tor Vergata' of Rome.

Infectious proctitis may mimic inflammatory bowel disease, particularly when limited to the rectum. The present case report includes findings from a 50-year-old man, soldier, referring to our Inflammatory Bowel Disease Unit with a diagnosis of rectal Crohn's disease, refractory to conventional treatments. Mild anemia, hypergammaglobulinemia and HIV-antibodies seronegativity were detected. Entero-MRI and stool examinations were negative. Ileocolonoscopy detected few rectal ulcers with irregular edges. Endosonography showed marked thickening of the rectal wall and enlarged perirectal lymphnodes. Nodal and rectal fine needle aspirate did not show atypia (PAN CK-). Rectal biopsies showed flogistic granular tissue (PAN CK-): Warthin-Starry stain was negative. Previous Treponema pallidum infection was detected. Clinical history revealed habits at risk for sexually transmitted infection. Rectal swabs for RT-PCR for Chlamydia trachomatis, Neisseria gonorrhoeae, and Herpes Simplex Virus 1-2 lead to a diagnosis of lymphogranuloma venereum. Doxycycline 100 mg and Azitromicyn 500 mg t.i.d. were given for 21 days, followed by negativity for RT-PCR for Chlamydia trachomatis at rectal swabs. Complete disappearance of symptoms and mucosal healing occurred. Due to the increased frequency of infectious diseases, sexually transmitted infection (including lymphogranuloma venereum) should be considered as possible differential diagnosis when assessing patients with inflammatory bowel disease limited to the rectum.
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http://dx.doi.org/10.1097/MEG.0000000000001605DOI Listing
March 2020

The differential diagnosis between sclerotic fibroma and sclerosing perineurioma: An unresolved challenge.

J Cutan Pathol 2020 02 9;47(2):195-196. Epub 2019 Dec 9.

Division of Anatomic Pathology, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.

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http://dx.doi.org/10.1111/cup.13620DOI Listing
February 2020

Primary intrafascial desmoplastic melanoma with pseudoglandular differentiation and aberrant cytokeratins expression: An exceptional presentation.

Pathol Res Pract 2019 Dec 25;215(12):152668. Epub 2019 Sep 25.

Department of Dermatology, IRCCS INRCA, Ancona, 60121, Italy.

Desmoplastic melanoma (DM) is an uncommon variant of malignant melanoma (MM), histologically characterized by a mainly dermal proliferation of spindled cells within a desmoplastic stroma. Normally, involvement of deeper tissues by DM is the result of direct extension down from the overlying dermis. MM is widely known to harbor a striking potential for morphological and phenotypic variability; among MM morphological variants, pseudoglandular MM is characterized by extensive discohesion within cords and nests of malignant cells and ensuing formation of so-called pseudolumina, thus mimicking adenocarcinoma. We present an exceptional case of DM characterized by intrafascial origin, partly pseudoglandular differentiation, and aberrant experession of cytokeratins in the pseudoglandular component; genetic data from next-generation sequencing supported the final diagnosis of DM, as well as the ontogenetic identity of the pseudoglandular component. Prior to this report, pseudoglandular features had never been described in DM. Additionally, our case is unusual because of the deep origin of the tumor, arising below the subcutaneous fat of the scalp, as well as the aberrant experession of cytokeratins in the pseudoglandular component, thus posing a challenging differential diagnosis with several soft tissue tumors.
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http://dx.doi.org/10.1016/j.prp.2019.152668DOI Listing
December 2019

Contrast-enhanced endoscopic ultrasound diagnosis of the intraductal papillary mucinous neoplasm.

Clin J Gastroenterol 2020 Feb 6;13(1):120-126. Epub 2019 Jul 6.

Gastroenterology Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133, Rome, Italy.

Pancreatic cystic neoplasms (PCNs) are a frequent incidental finding during an ultrasound or other radiological investigations. As PCNs may have a potential of malignancy, a precise differential diagnosis between a malignant and benign lesion is crucial to define appropriate management of patients with this kind of lesions. Radiology, with computed tomography (CT) and magnetic resonance imaging, may not be conclusive in the diagnostic assessment of PCNs. Endoscopic ultrasound (EUS), a simple and relatively low invasive technique, is able to identify intra-cystic worrisome features suggesting malignancy. Fine-needle aspiration (FNA) of the cystic fluid or of intra-cystic tissue nodule during EUS is an adjunctive procedure for reaching a conclusive diagnosis. As EUS-FNA is burdened by complications, the use of intravenous contrast may increase the diagnostic accuracy of EUS allowing in many cases a correct diagnosis of PCN at high risk of malignancy, without additional risk of complication during the procedure. The present report deals with the case of a cystic lesion found by CT scan in the pancreatic head of a 59-year-old woman suffering from mild epigastric pain. Once submitted to EUS, malignant nature of PCN was suspected due to the finding of a typical worrisome feature, the presence of a mural nodule. The intravenous administration of contrast medium during the EUS confirmed malignancy and the patient was immediately sent to the surgeon for pancreatic resection. Histology revealed an intraductal papillary mucinous neoplasm, with areas of high-grade dysplasia in the main and secondary ducts, progressed toward an invasive carcinoma.
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http://dx.doi.org/10.1007/s12328-019-01008-3DOI Listing
February 2020
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