[Poorly cohesive gastric carcinoma. Validity of using the term; translation variants]. / Kartsinoma zheludka iz plokho stseplennykh kletok. Pravomochnost' ispol'zovaniya termina i varianty perevoda.

Gastric cancer is one of the leading causes of cancer morbidity and mortality worldwide. It is common practice to use two classification systems: the Lauren classification system and the WHO classification of tumors in the morphological study of gastric carcinomas. Since 2010, the WHO classifications have included the term "poorly cohesive carcinoma", which refers to all diffuse forms of gastric cancer, including signet ring cell carcinoma and other subtypes. Despite this, the term has not been widely used in the world community, and it is almost not found in Russian literature. Only recently, after the publication of the 5th edition of the WHO classification (2019), there have been review articles where the term is used, but its name can be translated into Russian in different ways: poor-, weak -, low-adhesive, discogesive. The paper analyzes the Pubmed and Elibrary databases in order to find out the frequency of using various designations for diffuse gastric carcinoma, justifies the use of the term «poorly cohesive carcinoma¼, and proposes a variant of the term interpretation in Russian.

[Issues on classification of gastric neuroendocrine tumors].

A comparative analysis of available classifications of gastric neuroendocrine tumors was performed. It was showed that there were many contradictions regarding the issues of termi- nology and, in particular, criteria for determining the degree of differentiation of these tumors that significantly influenced on the choice of methods of treatment. There were unclearly marked symptoms of benign tumors, treatment of which could be conducted by endoscopy removal. There was absent the category of high- and moderately differentiated neuroendocrine tumors that metastasized by lymph and blood. Malignant tumors were represented by just low-differentiated malignancies although now many researchers noted the heterogeneity of this group and a different response to therapeutic agents. Up to now there were no standard methods for determining the pro- liferative level because any discrepancies between a number of mitoses and Ki67 index might be. Proliferative activity in tumor itself was often heterogeneous and it was necessary to select a specific point in tumor to determine its grade. Despite a proof of endodermal origin and the presence of combined tumors with epithelial component (mucocarcinoid, adenoneuroendocrine, amphicrine carcinoma) gastric neuroendocrine tumors were considered as a separate group in contrast to such standard symbols in pathology as adenomas and carcinomas. Thus it is necessary to accumulate further material for the standardization of nomenclature and more accurate determina- tion of malignant potential of tumors with the aim of studying the effect of various methods of treatment.

[Pathomorphological diagnosis of erosive or ulcerative reflux esophagitis from esophageal mucosal biopsies].

The histological features and morphogenesis of acute peptic mucosal lesions in gastroesophageal reflux disease (GERD) were studied using 2220 biopsy specimens obtained from 669 patients. The stages of their development and two variants of their healing, which affected the duration and outcome of the disease, were identified. Acute erosions and ulcers in the laminated squamous and cylindrical epithelial areas were shown to be a natural stage of changes that preceded the development of Barrett esophagus and promoted its progression. All the described changes must be embodied in the histological reports on esophageal mucosal biopsy specimens and taken into consideration when using local and systemic treatments.

[Aspergillosis (mycetoma) of gluteal region]. / Aspergillez (mitsetoma) iagodichnoi oblasti.

Lingering deep gluteal mycosis (mycetoma, aspergillosis) in a 32-year-old woman with secondary immunodeficiency is described. The disease developed after intragluteal injection of vitamins and was characterized by development of multiple dense nodes in the skin and soft tissues, parametral and pararectal fat tissue with repeated fistulas. The diagnosis was established by finding fungi histologically and cytologically.

[Morpho-ecological characteristics of thyroid diseases in various regions of Russia and Belorussia from surgical data]. / Morfoékologicheskaia kharakteristika zabolevanii shchitovidnoi zhelezy v razlichnykh regionakh Rossii i Belorussii po dannym operatsionnogo materiala.

Thyroid lesions were histologically studied on surgical material obtained in 1992-1996 in 12 regions of Russian Federation and Republic of Belarus. Various forms of thyroid pathology were considered with reference to local ecological situation. An increase of thyroid carcinoma incidence and particularly that of papillary carcinoma was observed in regions with radiation pollution (Chelyabinsk and Bryansk regions). A high degree of correlation exists between the incidence of various forms of thyroid pathology and radiation situation. This is also true for pollution of sewage and the presence of ferrous metallurgy factories. No correlation was found with the pollution of atmosphere.

[Dynamic of morphological changes of cerebral hematomas induced by arterial hypertension (analysis of surgical and autopsy materials)]. / Dinamika morfologicheskikh izmenenii vnutrimozgovykh gematom, voznikaiushchikh vsledstvie arterial'noi gipertenzii (analiz operatsionnogo i sektsionnogo materiala).

The pattern of morphological changes in blood clots, brain tissue and vessels of hypertensive hematomas (CH) was studied in 79 surgical and autopsy cases. Brain tissue compression degeneration of cells and fibers, edema were observed during the first 6 hours after the onset of hemorrhage. Necrosis and marked leukocyte infiltration appeared to progress gradually and reach maximum by the disease day 2-3. The degeneration manifested by formation of gliomesodermal capsule surrounding the haemorrhagic lesion from day 3 to 8. Dilatation of small cerebral vessels was followed by an increase in permeability and necrosis of vascular walls predominated within 24-72 hours after initial bleeding. It is suggested that the first 24 hours after CH onset are optimal for surgery.

[C-cells in malignant epithelial tumors of the thyroid gland]. / C-kletki pri zlokachestvennykh épitelial'nykh opukholiakh shchitovidnoi zhelezy.

An original procedure using points to evaluate the degree of tumor cell differentiation was employed in examining patients with papillary (42), follicular (33), medullary (19) and anaplastic (2) thyroid cancer. C-cell hyperplasia was detected in 26 out of the total of 94 cases (27.6%). It was the backdrop for each form of thyroid cancer and increased as tumor cell differentiation decreased. Three grades of C-cell hyperplasia were identified: I--11-20; II--21-49 and III--over 50 cells. According to anaplastic degree, it was typical and atypical; according to spreading pattern--focal, diffuse and nodular. Typical or diffuse hyperplasia was detected in well-differentiated cell tumor, while the atypical pattern prevailed in poorly- and moderately-differentiated ones. Most attention should be given to cases of subcapsular atypical hyperplasia of small C-cells showing initial well-differentiated cells of medullar thyroid cancer (C-cell microcarcinoma).

[Changes in the endocrine apparatus of the gastric mucosa in forms of cancer of varying origin]. / Izmeneniia éndokrinnogo apparata slizistoi obolochki zheludka pri formakh raka razlichnogo geneza.

The authors studied endocrine apparatus of the mucous membrane of 53 stomachs in various forms of carcinoma. Silver impregnation and electron microscopy were used as well as routine histology and histochemistry. All the tumors were divided into endocrine-cell and non-endocrine-cell tumors (ET and NET). Cells of the diffuse endocrine system take an important part in the development of the background and pretumorous processes in the stomach mucous membrane. Endocrinocyte hyperplasia, degree I and II, of the mucous membrane of the antrum and enterolysation foci was the background for all NET. Endocrinocyte hyperplasia was more pronounced (degree II and III) in ET and spread to the fundal glands being combined with endocrinocyte dysplasia and metaplasia. These changes are assessed as precancerous for tumors with high content of endocrinocytes.

[Histogenesis of the giant cells of the osteoclast type in anaplastic thyroid carcinoma]. / K voprosu o gistogeneze gigantskikh kletok tipa osteoklastov v anaplasticheskom rake shchitovidnoi zhelezy.

One case is reported of amphicrin thyroid carcinoma with signs of A- and C-cell differentiation. This tumor at its early stage had a follicular structure with massive deposits of amyloid in the stroma. In the course of progression the tumor transformed into C-cell anaplastic carcinoma with stromal amyloid deposits in the form of thin fibrils and production of polypeptide hormones and their precursors by tumor cells. The distinctive feature of the tumor metastases was the presence of many giant cells which, as was shown, were amyloid-clasts.

[Changes in the gastric mucosa in endocrine-cell cancer]. / Izmeneniia slizistoi obolochki zheludka pri éndokrinnokletochnykh rakakh.

Mucous membrane from different parts of the stomach has been studied in 53 surgical cases of stomach carcinoma. All the tumours were subdivided into endocrine-cell (EC) and non-endocrine-cell. The background in all cases was chronic gastritis which was most pronounced at the border with tumour and in the pyloro-antral part of the stomach. Hyperplasia of the fundal glands with hyperfunction of the chief and lining cells, hypersecretion of foveal epithelium, pseudo-pyloric metaplasia and helicobacteriosis were more frequent in EC-carcinomas. Dysplastic epithelial changes in EC were found in the lower third of the necks and terminal regions of the intermediar and pseudo-pyloric glands and in some cases in the foveolar epithelium and intestinal crypts. These features of the background and precancerous lesions in EC should be taken into consideration in diagnosis.

[Endocrine-cell stomach tumors]. / Endokrinnokletochnye opukholi zheludka.

Screening of the endocrine cell participation in the stomach carcinoma has been performed. Endocrine cells are found in all stomach tumors and those in which these cells occupy more than 75% of the surface are distinguished as endocrine cell carcinomas (ECC). They are subdivided into well (WD), moderately (MD) and poorly differentiated (PD). ECC are more frequently observed in males, their predominant location is cardia and fundus. The growth in the deep parts of mucosa and submucosa (this determines late clinical symptoms) is characteristic for these tumors. Alveolar, trabecular and glandular structural variants are observed in WD ECC and MD ECC, while PD ECC corresponded to small cell carcinoma (iat cell and intermediate types). Prognosis is unfavorable in MD ECC and PD ECC. Apart from this amacrine and combined tumors with an endocrine component are described. The authors emphasize the necessity to single out ECC from whole group of stomach carcinoma.

[Cause of death in patients after surgical treatment of hemorrhagic incidence]. / Prichiny smerti bol'nykh posle khirurgicheskogo lecheniia gemorragicheskogo insul'ta.

38 of 50 patients with hemorrhagic apoplexy were operated on. The most frequent causes of the death were progression of the hemorrhagic syndrome, intraventricular hematomas, thromboembolism of the pulmonary artery and its branches. Frequent complications were diencephalo-catabolic syndrome, polybacterial pneumonia, acute renal failure.

[The morphological characteristics of endocrine-cell cancers of the large intestine]. / Morfologicheskie osobennosti éndokrinnokletochnykh rakov tolstoi kishki.

Histological variants of colon carcinoma depending upon the quantity of endocrine cells are distinguished on the basis of 66 malignant epithelial colon tumours morphological investigation. Special emphasis was made on the characteristics of the endocrine cell carcinoma, combined tumours with a combination of glandular and endocrine components, and amphicrin neoplasms. A trabecular-glandular variant of endocrine cell carcinoma is found to be predominant in the colon. The criteria are suggested for the identification of endocrine-cell tumours.

[Stomach and duodenal ulcer in endocrine tumors]. / Iazvennaia bolezn' zheludka i dvenadtsatisperstnoi kishki pri éndokrinnykh opukholiakh.

Clinico-anatomical analysis was performed in 13 cases of endocrine tumors of various sites with concomitant gastric and duodenal ulcer (Zollinger-Ellison's syndrome). Ulcer tended to recur in these patients; it was associated with pronounced pain and involved a high rate of such complications as perforation, bleeding and gastrointestinal fistula. Endocrine tumors were found to locate in the pancreas (5) and duodenum (5) while, in the other three patients, multiple endocrine adenomatosis (type 1) was identified. Correct diagnosis was made in three cases only and surgery was successful in two of them. Errors are analysed.

[The question of the functional significance and origin of pulmonary "tumorlets"]. / K voprosu o funktsional'nom znachenii i proiskhozhdenii "opukholek" legkikh.

In 1955, the term "tumorlets" was proposed to denote unusual microscopic clusters of epithelial cells occasionally detectable in the lung. The endocrinal nature of these formations has been proved, but there are conflicting opinions on the essence of the process (hyperplasia, dysplasia, and neoplasia). Pulmonary proliferation of endocrinal cells, which was similar to that of tumorlets, was found in 2 of 4 observations. The analysis of the results of the studies performed by the authors and of data available in the literature makes it possible to conclude that the proliferates of pulmonary endocrinal cells are, in terms of their functional significance, heterogeneous. Some of them appear as preneoplastic hyperplasia of endocrinal cells. The individual clusters acquiring independent blood circulation (stroma) may be regarded as true tumor-microcarcinoids. The authors also define the transitional forms between hyperplasia and neoplasia.

[Clinico-anatomical comparisons in duodenal carcinoid tumors]. / Kliniko-anatomicheskie sopostavleniia pri kartsinoidnykh opukholiakh dvenadtsatiperstnoi kishki.

A clinical and anatomic analysis was made of duodenal carcinoid tumors in 5 male patients (mean age 43.2 years). The tumors were present in the areas of the major duodenal papilla (in 3 cases), those of the bulb (1) and horizontal part of the duodenum (1). They were multiple in 2 cases. Clinically, signs of gastrin activity, i. e. recurring ulcers in various segments of the gastrointestinal tract (Zollinger-Ellison syndrome), were most common. Other changes included impairments in the biliary tract and liver. The causes of death were hepatic and renal insufficiencies (2 cases), thrombohemorrhagic events (2). In the closed glands, nesidioblastosis and thyroid C cell hyperplasia were detected, one case having type I multiple endocrinal neoplasia (adrenal corticosteroma, pancreatic apudoma). In three cases, the metastases invaded into the liver and lymph nodes. Direct correlation was not established between the tumor sizes, metastases and hormonal activity signs. All the tumors had not been recognized in the patients' life. The paper discusses if it is possible to make life-time diagnosis.

[Morphological characteristics of carcinoid angio- and cardiopathies]. / Morfologicheskaia kharakteristika kartsinoidnykh angio- i kardiopatii.

Cardiovascular affections due to carcinoids can be divided into two groups: related to impaired vascular tonicity, and resultant from proliferative structural response of the heart and vascular walls. The former changes can be evident from arteriolar spasms and microcirculatory ectasia in the tumor, adjacent and distal tissues (myocardium, kidneys, skin). Proliferation, typical for EC-cell tumors, involved active multiplication of smooth muscle cells as well as of subendothelial and perithelial myofibroblasts with formation of specific mixed connective tissue responsible for vascular stenosis and giving rise to valvular disease.