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Article ; Online: Acute and Chronic Alcoholic Pancreatitis, Including Paraduodenal Pancreatitis.

Klöppel, Günter / Zamboni, Giuseppe

Archives of pathology & laboratory medicine

2023 Volume 147, Issue 3, Page(s) 294–303

Abstract: Context.—: In the last 2 decades there has been significant progress in typing and recognition of pancreatitis, a necroinflammatory and fibroinflammatory process of multifactorial origin.: Objective.—: To present the current state of pathology and ... ...

Abstract	Context.—: In the last 2 decades there has been significant progress in typing and recognition of pancreatitis, a necroinflammatory and fibroinflammatory process of multifactorial origin. Objective.—: To present the current state of pathology and pathogenesis of alcohol-associated pancreatitis, including paraduodenal pancreatitis. In the context of the most important epidemiologic, clinical, and radiologic features, the related macroscopic changes and histopathologic characteristics are addressed. Data sources.—: In acute pancreatitis we discuss the pathologic findings that distinguish mild from severe pancreatitis and highlight autodigestive fat necrosis as the initial morphologic damage. In chronic pancreatitis we present a histologic staging system that describes the damage patterns as a necrosis-fibrosis sequence that takes place during the development of early to advanced and end-stage chronic pancreatitis. In paraduodenal pancreatitis the anatomic peculiarities are related to the sequence of morphologic changes that are correlated to the most important imaging findings. Pathogenetically, we discuss the role of alcohol overconsumption in triggering autodigestive fat necrosis in the pancreas, the repair of which results in a pancreas-transforming fibroinflammatory process. Conclusions—: Whereas in acute pancreatitis there are no lesions that are diagnostic for alcohol overconsumption and that exclude other etiologies such as gallstone disease or drugs, the sequence of damage patterns in chronic pancreatitis are strongly related to the effect of alcohol overconsumption and allow in many cases the distinction from hereditary, autoimmune, or obstructive pancreatitis. Paraduodenal pancreatitis can be considered a special manifestation of alcoholic pancreatitis.
MeSH term(s)	Humans ; Pancreatitis, Alcoholic/complications ; Pancreatitis, Alcoholic/pathology ; Fat Necrosis/pathology ; Acute Disease ; Pancreas/diagnostic imaging ; Pancreas/pathology ; Pancreatitis, Chronic/diagnosis ; Pancreatitis, Chronic/etiology ; Pancreatitis, Chronic/pathology
Language	English
Publishing date	2023-02-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	194119-7
ISSN	1543-2165 ; 0363-0153 ; 0096-8528 ; 0003-9985
ISSN (online)	1543-2165
ISSN	0363-0153 ; 0096-8528 ; 0003-9985
DOI	10.5858/arpa.2022-0202-RA
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Article: Left abdominal mass with carcinosis: Unusual presentation of pancreatic acinar cell carcinoma.

Ciardiello, Davide / Urbano, Filomena / Zamboni, Giuseppe / Palladino, Nicola / Bazzocchi, Francesca / Parente, Paola

Hepatobiliary & pancreatic diseases international : HBPD INT

2022 Volume 22, Issue 4, Page(s) 412–414

MeSH term(s)	Humans ; Carcinoma, Acinar Cell/diagnostic imaging ; Carcinoma, Acinar Cell/surgery ; Pancreatic Neoplasms/complications ; Pancreatic Neoplasms/diagnostic imaging ; Pancreatic Neoplasms/surgery ; Pancreatic Neoplasms
Language	English
Publishing date	2022-10-14
Publishing country	Singapore
Document type	Case Reports ; Journal Article
ZDB-ID	2241386-8
ISSN	1499-3872
ISSN	1499-3872
DOI	10.1016/j.hbpd.2022.10.002
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Article: Nrf2 and Her3 co-expression in cholangiocarcinoma: Possible biological pathways for potential therapeutic approach.

Parente, Paola / Angerilli, Valentina / Zamboni, Giuseppe / Sparaneo, Angelo / Fiordelisi, Fabiola / Di Candia, Leonarda / Fassan, Matteo / Graziano, Paolo

Hepatobiliary & pancreatic diseases international : HBPD INT

2023 Volume 23, Issue 3, Page(s) 317–321

MeSH term(s)	Humans ; NF-E2-Related Factor 2/metabolism ; Cholangiocarcinoma/drug therapy ; Bile Ducts, Intrahepatic/metabolism ; Bile Duct Neoplasms/drug therapy ; Cell Line, Tumor
Chemical Substances	NF-E2-Related Factor 2
Language	English
Publishing date	2023-02-24
Publishing country	Singapore
Document type	Letter
ZDB-ID	2241386-8
ISSN	1499-3872
ISSN	1499-3872
DOI	10.1016/j.hbpd.2023.02.010
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Article ; Online: Prognostic performance of microscopic size measurements in small invasive carcinomas arising in intraductal papillary mucinous neoplasms of the pancreas.

Zhang, M Lisa / Omori, Yuko / Hong, Seung-Mo / Ideno, Noboru / Date, Kenjiro / Rocha Castellanos, Dario M / Shroff, Stuti G / Zamboni, Giuseppe / Gonzalez, Raul S / Furukawa, Toru / Fernandez-Del Castillo, Carlos / Mino-Kenudson, Mari

Histopathology

2024

Abstract: Aims: Small invasive carcinomas arising in intraductal papillary mucinous neoplasms (IPMNs) of the pancreas can present as multiple, small foci. In such cases, there is no clear optimal measurement method for determining the invasive size for tumour ... ...

Abstract	Aims: Small invasive carcinomas arising in intraductal papillary mucinous neoplasms (IPMNs) of the pancreas can present as multiple, small foci. In such cases, there is no clear optimal measurement method for determining the invasive size for tumour staging and prognostication. Methods: In all, 117 small invasive IPMNs (size of largest invasive component ≤2 cm) from seven institutions (2000-2016) were reviewed, and all individual foci of invasive carcinoma were measured. T stages (AJCC 8th edition) based on the largest single focus size (LS), average size of all foci (AS), and total sum of all foci (TS) were examined in association with clinicopathologic parameters and patient outcomes. Results: The cohort comprised IPMNs with invasive tubular-type (n = 82, 70%) and colloid-type (n = 35, 30%) carcinomas. The mean LS, AS, and TS were 0.86, 0.71, and 1.32 cm, respectively. Based on the LS, AS, and TS, respectively, 48, 65, and 39 cases were classified as pT1a; 22, 18, and 11 cases as pT1b; and 47, 34, and 50 cases as pT1c. Higher pT stages based on all measurements were significantly associated with small vessel, large vessel, and perineural invasion (P < 0.05). LS-, AS-, and TS-based pT stages were not significantly associated with recurrence-free survival (RFS) or overall survival (OS) by univariate or multivariate analyses. However, among tubular-type carcinomas, higher LS-, AS-, and TS-based pT stages trended with lower RFS (based on 1-, 3-, and 5-year survival rates). All microscopic measurement methods were most predictive of RFS and OS using a 1.5-cm cutoff, with LS significantly associated with both RFS and OS by univariate and multivariate analysis. Conclusions: For invasive tubular-type carcinomas arising in IPMN, microscopic size-based AJCC pT stages were not significant predictors of patient outcomes. However, for LS, a size threshold of 1.5 cm was optimal for stratifying both RFS and OS. The AJCC 8th ed. may not be applicable for stratifying small invasive IPMNs with colloid-type histology that generally portend a more favourable prognosis.
Language	English
Publishing date	2024-04-25
Publishing country	England
Document type	Journal Article
ZDB-ID	131914-0
ISSN	1365-2559 ; 0309-0167
ISSN (online)	1365-2559
ISSN	0309-0167
DOI	10.1111/his.15198
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Article ; Online: Epithelioid angiomyolipoma: a pathological entity discovered in Verona with the endorsement of Doctor Rosai.

Caliò, Anna / Brunelli, Matteo / Marletta, Stefano / Zamboni, Giuseppe / Bonetti, Franco / Pea, Maurizio / Martignoni, Guido

Pathologica

2021 Volume 113, Issue 5, Page(s) 307–315

Abstract: In this manuscript, we summarize the main features of angiomyolipoma highlighting the recognition of epithelioid angiomyolipoma and the discovery of immunohistochemical expression of HMB45 in a group of tumors that now are referred to as as PEComas. In ... ...

Abstract	In this manuscript, we summarize the main features of angiomyolipoma highlighting the recognition of epithelioid angiomyolipoma and the discovery of immunohistochemical expression of HMB45 in a group of tumors that now are referred to as as PEComas. In this scenario, Dr. Rosai believed in our intuition, demonstrating his intellectual honesty and motivated us with his experience ("
MeSH term(s)	Angiomyolipoma/diagnosis ; Humans ; Kidney Neoplasms ; Male ; Perivascular Epithelioid Cell Neoplasms
Language	English
Publishing date	2021-11-26
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	418229-7
ISSN	1591-951X ; 0031-2983
ISSN (online)	1591-951X
ISSN	0031-2983
DOI	10.32074/1591-951X-335
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Article ; Online: A semicentennial of pancreatic pathology: the genetic revolution is here, but don't throw the baby out with the bath water!

Hruban, Ralph H / Klimstra, David S / Zamboni, Giuseppe / Klöppel, Günter

Human pathology

2019 Volume 95, Page(s) 99–112

Abstract: The last 50 years have witnessed an explosion in our understanding of the pathology of pancreatic diseases. Entities known to exist 50 years ago have been defined more precisely and are now better classified. New entities, previously not recognized, have ...

Abstract	The last 50 years have witnessed an explosion in our understanding of the pathology of pancreatic diseases. Entities known to exist 50 years ago have been defined more precisely and are now better classified. New entities, previously not recognized, have been discovered and can now be treated. Importantly, new tools have been developed that have unraveled the fundamental biological drivers of a number of pancreatic diseases. Many of these same tools have also been applied clinically, supplementing the tried and true hematoxylin and eosin stained slide with a plethora of new, highly sensitive and specific tests that improve diagnostic accuracy and delineate best treatments. As exciting as these many advances are, our knowledge of pancreatic pathology remains incomplete, and there is much to be learned.
MeSH term(s)	Diffusion of Innovation ; Genetic Predisposition to Disease ; History, 20th Century ; History, 21st Century ; Humans ; Pancreas/pathology ; Pancreatic Diseases/genetics ; Pancreatic Diseases/history ; Pancreatic Diseases/pathology ; Pathology, Molecular/history ; Pathology, Molecular/trends ; Phenotype ; Predictive Value of Tests
Language	English
Publishing date	2019-09-12
Publishing country	United States
Document type	Historical Article ; Journal Article ; Review
ZDB-ID	207657-3
ISSN	1532-8392 ; 0046-8177
ISSN (online)	1532-8392
ISSN	0046-8177
DOI	10.1016/j.humpath.2019.08.024
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Article: Mucinous cystic neoplasms of the pancreas: update on the surgical pathology and molecular genetics.

Fukushima, Noriyoshi / Zamboni, Giuseppe

Seminars in diagnostic pathology

2014 Volume 31, Issue 6, Page(s) 467–474

Abstract: Mucinous cystic neoplasms (MCNs) of the pancreas are primary pancreatic cyst-forming neoplasms that can be a precursor to invasive adenocarcinoma of the pancreas. MCNs occur almost exclusively in the distal pancreas of middle-aged women. MCNs typically ... ...

Abstract	Mucinous cystic neoplasms (MCNs) of the pancreas are primary pancreatic cyst-forming neoplasms that can be a precursor to invasive adenocarcinoma of the pancreas. MCNs occur almost exclusively in the distal pancreas of middle-aged women. MCNs typically show a "cyst-in-cyst" pattern of growth and are well encapsulated by a thick fibrous wall. MCNs are composed of mucin-producing neoplastic epithelial cells and "ovarian-type" subepithelial stroma. The epithelium is dysplastic and the grade can range from low to high grade; some MCNs have an associated invasive carcinoma. It is this associated invasive carcinoma that determines prognosis. MCNs harbor several characteristic genetic and epigenetic alterations, some of which are shared with conventional invasive pancreatic ductal adenocarcinoma. Furthermore, several studies reveal characteristic patterns of gene expression in the ovarian-type stroma that suggest steroidogenesis in the ovarian-type stroma. Better knowledge of the molecular alterations could help in the management of patients with this type of precursor of invasive carcinoma.
MeSH term(s)	Adenocarcinoma, Mucinous/genetics ; Adenocarcinoma, Mucinous/pathology ; Female ; Humans ; Middle Aged ; Molecular Biology ; Pancreatic Neoplasms/genetics ; Pancreatic Neoplasms/pathology ; Pathology, Surgical
Language	English
Publishing date	2014-09-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	605834-6
ISSN	1930-1111 ; 0740-2570
ISSN (online)	1930-1111
ISSN	0740-2570
DOI	10.1053/j.semdp.2014.08.007
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Article ; Online: Angiomyolipoma of the kidney: from simple hamartoma to complex tumour.

Caliò, Anna / Brunelli, Matteo / Segala, Diego / Zamboni, Giuseppe / Bonetti, Franco / Pea, Maurizio / Martignoni, Guido

Pathology

2020 Volume 53, Issue 1, Page(s) 129–140

Abstract: Angiomyolipoma is the most common mesenchymal tumour of the kidney, even if for a long time it has been viewed as a hamartoma rather than a neoplasm. It belongs to a family of neoplasms, named PEComa, characterised by the constant presence of ... ...

Abstract	Angiomyolipoma is the most common mesenchymal tumour of the kidney, even if for a long time it has been viewed as a hamartoma rather than a neoplasm. It belongs to a family of neoplasms, named PEComa, characterised by the constant presence of perivascular epithelioid cells that co-express smooth muscle and melanogenesis markers. Angiomyolipoma can occur in patients with tuberous sclerosis, a hereditary syndrome due to the alteration of TSC1 or TSC2 genes, or sporadically. Angiomyolipoma and its variants are indolent tumours; however, some epithelioid angiomyolipomas/pure epithelioid PEComas are aggressive, and criteria for malignancy have been proposed to identify those cases. Although typical angiomyolipoma is a straightforward diagnosis, pathologists should be aware of the wide morphological spectrum of its variants which could be tricky in routine clinical practice and could require immunohistochemical analysis for resolution. The differential diagnosis may range from an inflammatory process (for instance xanthogranulomatous pyelonephritis) to the most common renal cancers and sarcomas. The immunoexpression of melanogenesis markers (HMB45 and Melan-A) and cathepsin K is extremely helpful in the majority of cases. Recently, a subset of epithelioid angiomyolipoma/pure epithelioid PEComa harbouring TFE3 gene fusions has been described, raising questions about its relationship with the family of perivascular epithelioid cell tumour. The activation of the mTOR pathway due to genetic alterations of tuberous sclerosis complex in TSC1 or TSC2 genes in angiomyolipoma has also been reported as well as the subsequent therapeutic implications.
MeSH term(s)	Angiomyolipoma/diagnosis ; Angiomyolipoma/pathology ; Diagnosis, Differential ; Hamartoma/diagnosis ; Hamartoma/pathology ; Humans ; Kidney Neoplasms/diagnosis ; Kidney Neoplasms/pathology ; Perivascular Epithelioid Cell Neoplasms/diagnosis ; Perivascular Epithelioid Cell Neoplasms/pathology
Language	English
Publishing date	2020-10-31
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	7085-3
ISSN	1465-3931 ; 0031-3025
ISSN (online)	1465-3931
ISSN	0031-3025
DOI	10.1016/j.pathol.2020.08.008
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Article ; Online: Neuroendocrine neoplasms of the duodenum, ampullary region, jejunum and ileum.

Milione, Massimo / Parente, Paola / Grillo, Federica / Zamboni, Giuseppe / Mastracci, Luca / Capella, Carlo / Fassan, Matteo / Vanoli, Alessandro

Pathologica

2021 Volume 113, Issue 1, Page(s) 12–18

Abstract: Neuroendocrine neoplasms of the small intestine are some of the most frequently occurring along the gastrointestinal tract, even though their incidence is extremely variable according to specific sites. Jejunal-ileal neuroendocrine neoplasms account for ... ...

Abstract	Neuroendocrine neoplasms of the small intestine are some of the most frequently occurring along the gastrointestinal tract, even though their incidence is extremely variable according to specific sites. Jejunal-ileal neuroendocrine neoplasms account for about 27% of gastrointestinal NETs making them the second most frequent NET type. The aim of this review is to classify all tumors following the WHO 2019 classification and to describe their pathologic differences and peculiarities.
MeSH term(s)	Duodenum ; Humans ; Ileum ; Jejunum ; Neuroendocrine Tumors/diagnosis ; Pancreatic Neoplasms
Language	English
Publishing date	2021-03-08
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	418229-7
ISSN	1591-951X ; 0031-2983
ISSN (online)	1591-951X
ISSN	0031-2983
DOI	10.32074/1591-951X-228
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Article ; Online: Recurrence after surgical resection of pancreatic cancer: the importance of postoperative complications beyond tumor biology.

Crippa, Stefano / Belfiori, Giulio / Bissolati, Massimiliano / Partelli, Stefano / Pagnanelli, Michele / Tamburrino, Domenico / Gasparini, Giulia / Rubini, Corrado / Zamboni, Giuseppe / Falconi, Massimo

HPB : the official journal of the International Hepato Pancreato Biliary Association

2021 Volume 23, Issue 11, Page(s) 1666–1673

Abstract: Background: Current treatment of potentially resectable pancreatic ductal adenocarcinoma (PDAC) includes pancreatic resection followed by adjuvant therapy. Aim of this study is to identify factors that are related with overall and early recurrence after ...

Abstract	Background: Current treatment of potentially resectable pancreatic ductal adenocarcinoma (PDAC) includes pancreatic resection followed by adjuvant therapy. Aim of this study is to identify factors that are related with overall and early recurrence after pancreatectomy for PDAC. Methods: Retrospective analysis of patients with histologically confirmed PDAC who underwent pancreatectomy between September 2009 and December 2014. Early relapse was defined as recurrence within 12 months after surgery. Univariate/multivariate analysis was performed to identify prognostic factors for recurrence. Results: 261 patients were included (54% males, mean age 67 years). Neoadjuvant and adjuvant treatments were performed in 55 (21%) and 243 (93%) patients. Overall morbidity was 56% with a rate of grade 3-4 Clavien-Dindo complications of 25%. Median disease-free survival was 18 months. Multivariate analysis identified nodal metastases (OR: 3.6) and perineural invasion (OR: 2.14) as independent predictors of disease recurrence in the entire cohort. 76 patients (29%) had an early recurrence. Poorly differentiated tumors (OR: 3.019) and grade 3-4 Clavien-Dindo complications (OR: 3.05) were independent risk factors for early recurrence. Conclusion: Although overall recurrence is associated with tumor-related factors, severe postoperative complications represent an independent predictor of early recurrence. Patients at increased risk of severe postoperative complications may benefit from neoadjuvant therapy.
MeSH term(s)	Aged ; Biology ; Carcinoma, Pancreatic Ductal/surgery ; Female ; Humans ; Male ; Neoplasm Recurrence, Local/surgery ; Pancreatectomy/adverse effects ; Pancreatic Neoplasms/surgery ; Postoperative Complications ; Prognosis ; Retrospective Studies
Language	English
Publishing date	2021-04-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2131251-5
ISSN	1477-2574 ; 1365-182X
ISSN (online)	1477-2574
ISSN	1365-182X
DOI	10.1016/j.hpb.2021.04.004
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