Purpose: To evaluate the role of 18 F-flurodeoxiglucose positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) in predicting malignancy of thyroid nodules with indeterminate cytology. Patients and methods:We analysed 87 patients who have been scheduled to undergo surgery for thyroid nodule with indeterminate cytology. All patients underwent 18 F-FDG-PET/CT, multiparametric neck ultrasonography (MPUS), and 99m Tc-methoxyisobutylisonitrile scintigraphy ( 99m Tc-MIBI-scan). Histopathology was the standard of reference.We compared the sensitivity (SE), specificity (SP), accuracy (AC), positive (PPV) and negative predictive (

Cutaneous lesions related to chronic active Epstein-Barr virus (EBV) infection have been rarely documented in immunocompetent patients. A 30-year-old woman, fulfilling the diagnostic criteria for the chronic fatigue syndrome, had a 10-year history of pruritic brownish macules and papules on her chest and back. Her EBV serology was abnormal; the EBV genome was present in the epidermis of lesions, in oral secretions, and in peripheral mononuclear cells (PMC). Her blood lymphocytes spontaneously outgrew in culture. Histology revealed deposits of amyloid in the papillary dermis. Treatment with acyclovir and interferon-alpha rapidly improved her condition, stopped the lymphocyte outgrowth in culture, and reduced the EBV DNA content in oral secretions and in PMC. These data support an endogenous reactivation of EBV infection and suggest a causal relationship with primary amyloidosis.

We read with interest the paper recently published on your journal by Magaña-Contreras et al. [2015] examining the prevalence and the role of sexually transmitted pathogens associated with Human papillomavirus (HPV) infection in cervical samples. However, since the authors were unable to differentiate Ureaplasma parvum (UP) from Ureaplasma urealyticum (UU) in their study, we would like to supplement their observations with the data we collected about HPV-UP co-infection.In a series of 46 asymptomatic patients, who gave written informed consent, examined at the Dermatology Department of the University of Genoa, as part of a screening program on sexually transmitted infections (STIs), we have collected cervical samples, testing them for HPV and UP infection. A cytological evaluation of the samples was also performed.To collect the samples we used the ThinPrep liquidbased cytology preparation system and polymerase chain reaction (PCR) to detect HPV types 6, 11, 16, 18, 31, 33, 35, 39, 40, 42, 43, 44, 45, 51, 52, 53, 58; liquidbased cytology slides were examined by a cytologist at the Galliera Hospital. Furthermore, we collected a second cervical swab that was analyzed with a multiplex-PCR for DNA detection of seven sexually transmitted bacterial pathogens, including UP.Overall, HPV infection was detected in 31 patients, 11 of them had high-risk HPV (HR-HPV). UU infection was detected in three patients: one of them had normal cytology, HPV infection, and no UP infection, two had CIN1 and UP-HPV co-infection.Chlamydia trachomatis (CT) infection was detected in three patients: one of them had normal cytology and UP-HPV co-infection, two had CIN1 and UP-HPV co-infection.Twenty-one patients were positive for UP: three of them (14%) were negative for HPV and eighteen (86%) were co-infected by UP and HPV. Of the 18 patients with UP and HPV co-infection only 2 (11%) had normal cytology whereas 16 (89%) had abnormal cytology, showing cervical intraepithelial neoplasia of grade 1 (CIN1) ( Table I).As a control group, we selected seven age-matched patients that had HPV infection but were negative for UP infection: four of them (57%) had normal cytology whereas three (43%) had abnormal cytology (CIN1).The age-matched control group was selected among the 25 UP negative patients. Excluding the 7 patients mentioned above, forming the control group, of the remaining 18, 12 were HPV negative and with normal cytology, 4 were HPV positive with a normal cytology, and 2 were HPV positive with CIN 1.Sixteen (89%) of the co-infected patients had CIN1 lesions while only 43% of the patients without UP co-infection had CIN1 lesions. We assessed the statistical significance between the two groups with the Fisher's exact test (two-tailed P-value ¼ 0.0324).HPV infection is a definite human carcinogen, but only few of the HPV infected population develop cancer, suggesting that other risk factors may play a promoting role. Other STIs can be significant in the carcinogenic pathway of HPV, increasing the risk of cancer and cervical intraepithelia...

Background: Though rarely reported, mucin deposition may be observed in scleroderma. Objective: To verify the frequency of significant amounts of mucin in the biopsy specimens. Methods: Biopsies from 20 patients with scleroderma were reviewed and stained to verify the presence of mucin. Results: Mucin deposits were found in all of the 20 specimens. Conclusion: Mucin deposition is probably a constant feature in both morphea and systemic scleroderma. Its relevance in differential diagnosis between scleredema and scleroderma is debatable.

Tumor vascularity has been reported to be a prognostic factor in solid tumors. We studied the prognostic value of tumor vascularity in 19 primary stage I skin melanomas. Only intermediate-thickness melanomas (0.76-4.00-mm thick) were studied. They were treated surgically to provide two groups of patients. The first group of 11 patients had no evidence of metastases after a follow-up of a mean period of 72.36 months, whereas the second one developed metastases in a mean period of 46.87 months. The two groups were matched for important prognostic factors including tumor thickness, sex, and age. Vascularity was quantified by a morphometric stereological analysis on paraffin sections stained with anti CD31 monoclonal antibody. The percentage of vascular area was significantly higher in the metastasizing group than in the nonmetastasizing one. Our study suggests that increased vascularity may have a prognostic significance in intermediate-thickness melanoma.