Optimized Photodynamic Therapy with Systemic Photosensitizer Following Debulking Technique for Nonmelanoma Skin Cancers

BACKGROUND: The thickness and depth of invasion of skin tumors may be limiting factors for topical photosensitizer-based photodynamic therapy (PDT). The use of PDT with systemic photosensitizer needs to be further explored as a modality of treatment for nonmelanoma skin cancer (NMSC). OBJECTIVE: The objective was to present six patients with multiple, nodular, and/or pigmented NMSC treated successfully with purified hematoporphyrin derivative (PHD) and PDT using prior debulking. METHODS: After 24 hours of systemic PHD (1.5 mg/kg), 12 lesions of NMSC were selected for PHD-PDT alone and 6 nodular/elevated lesions for PHD-PDT following a debulking procedure. The tumor area was illuminated in one single-dose session of 300 J/cm(2), at an intensity range of 130 to 150 mW/cm(2), with a 630-nm-wavelength diode laser. RESULTS: The prior curettage provided significant reduction in volume and/or pigmentation of lesions. After the session of PHD-PDT with prior curettage and additional topical 20% ALA-PDT in two lesions or PHD-PDT alone, 83% (5/6) of lesions and 58% (7/12) of lesions, respectively, maintained a complete clinical response, 22.2+/-8.9 months of follow-up. CONCLUSIONS: The combination of prior debulking with systemic agents-PDT appears to be a good option for multiple, pigmented, and/or nodular lesions of NMSC and can allow the improvement of clinical results.     

''Organoid'' thymoma: a well-differentiated variant with distinctive clinicopathological features

The present paper describes the clinical, histological and immunohistochemical features of five cases of 'organoid' thymoma. The histological hallmark of this lesion is the prominent and diffuse 'organoid' pattern, defined by the presence of several areas of medullary differentiation. These areas, which are strictly reminiscent of the medullary area of the normal thymus, are scattered within a neoplastic tissue resembling the thymus cortex, the overall appearance mimicking that of normal thymus. All cases shared common clinical features; they were non-invasive or minimally invasive tumours arising in young or middle-aged female patients. Although the incidence of 'organoid' thymoma is low (5.2% in our series), our morphological, immunohistochemical and clinical data suggest that this peculiar tumour may represent a well-differentiated variant of thymoma, with low-grade aggressiveness and a distinct clinicopathological profile.     

Hospital versus population controls in a retrospective study on diet and stomach cancer

The aim of the present study is to evaluate drawbacks and advantagesof the choice of hospital versus population controls in a casecontrol study on diet and cancer through the analysis of a retrospectivestudy on diet and gastric cancer (GC) conducted in Forli, Italy,involving 232 cases, 430 population controls and 252 hospitalizedcontrols. The present paper reports the comparison of resultson diet and GC risk obtained using the 2 types of controls.Population controls tended, in general, to eat all kinds offoods slightly more frequently (bread, pasta, cold cuts, freshfish, seasoned cheeses, legumes, garlic, onions and preservedfruits), with the exception of cooked vegetables, which werereported less frequently by population than by hospital controls.ORs for specific foods adjusted for confounders and other foodswere consistent in the separate models including populationand hospital controls respectively for all food groups, withthe exception of cooked vegetables which represented a protectivefactor only when hospital controls were considered (high consumers,population controls: adjusted, OR=0.9, trend p value 0.54; highconsumers, hospital controls, adjusted OR=0.5, trend p value<0.01). Hospital controls were slightly less often currentsmokers (22.6 versus 30.0%) and more often regular wine drinkers(57.5 versus 47.8%) compared with population controls, but noneof these variables was associated with GC risk. The main resultsin this study were consistent using both types of controls,nevertheless the distribution of some dietary variables notrelated to the disease under study differed between the 2 controlgroups, suggesting some caution in the use of hospital controlswhen studying diseases other than GC.     

Protein A Reactivity of Lymphocytes from Some Patients with Chronic Lymphocytic Leukaemia Mediated by an Interaction with the F(ab')2 Region of Surface Immunoglobulin

Peripheral blood lymphocytes (PBL) from 15 of 38 patients with chronic lymphocytic leukaemia (CLL) were capable of forming rosettes with human erythrocytes coated with staphylococcal protein A (SpA-HRBC). PEL from seven patients also showed a marked proliferafive response after stimulation with Staphylocccus aureus bacteria strain Cowan I (Cowan Staph). The SpA-rosetling of CLL cells was inhibited by incubation with F(ab')₂ fragments of anli-immimoglobuiin (Ig) antibodies. In addition, incubation with these fragments inhibited the proliferative response of leukacmie B cells to Cowan Staph. The Cowan-Siaph-induced proliferation of CLL cells was also impaired by the addition of normal human IgG and human IgG F(ab')₂ fragments to the cultures, whereas non-immune rabbit IgG was not inhibitory, The inhibitory activity of human IgG F(ab')₂ fragments was retained hy a SpA-Sepharose column, and it was found in the material recovered from the same column by acid elution. These data indicate thai an interaction between SpA and a structure located in the F(ab')₂ region of surface Ig of different classes is responsible for either SpA-binding or the Cowan-Staph-induced proliferate response of PBL from some patients with CLL.