[Pathology of the kidneys in malignant tumors of various localizations and antitumor therapy]. / Patologiya pochek pri zlokachestvennykh opukholyakh razlichnoi lokalizatsii i protivoopukholevoi terapii.

Non-tumorlesions of the kidneys in malignant neoplasms are very diverse. They can alter the results of chemotherapy and lead to death in the long term. In this regard, the related discipline of onconephrology has increasingly begun to be identified, which emphasizes the importance of diagnosing non-tumor kidney lesions in this category of patients. This review is devoted to the classification, diagnosis, course, prevention and treatment of non-tumor kidney lesions in patients with malignant neoplasms. There are four groups of lesions: mechanical damage; nephropathy due to anticancer therapy; paraneoplastic nephropathy; lesions associated with metabolic disorders. Kidney lesions in patients with malignant neoplasms are characterized by a variable course. In some cases, acute renal failure develops. Others are characterized by an asymptomatic course with an outcome in nephrosclerosis. Timely diagnosis and treatment of kidney lesions in malignant neoplasms can improve the quality of life and prognosis of patients with malignant neoplasms.

[Amplifiation of the c-MYC gene in acinar prostate adenocarcinoma. Morphogenic comparisons]. / Amplifikatsiya gena c-MYC pri atsinarnoi adenokartsinome prostaty. Morfogeneticheskie sopostavleniya.

OBJECTIVE: The purpose of this work was to evaluate c-MYC gene amplification in the substrate of prostate acinar adenocarcinoma at various Gleason scores and various stages of the disease, taking into account the morphological characteristics of the tumor. MATERIAL AND METHODS: The number of cases in the study was 82, including the control group - 12 cases. Morphological assessment included: determination of the total Gleason score, grading group, assessment of lymphovascular/perineural invasion, and architectural characteristics of the tumor. Gene amplification was assessed by FISH using the c-MYC (8q24)/SE8 probe. RESULTS: In all cases of the study group, amplification of the c-MYC gene was detected in the tumor, with a significant difference from the control group (p<0.05). When assessing cases with 4-6 fold copies of the gene, significant differences were established between patients with stages II and III of the disease and stage IV (10.0 and 13.5 versus 30.0) (p<0.05). Cluster amplification of the c-MYC gene was detected with equal frequency in groups of patients with stages III and IV of the disease, while in stage II of the disease, the event almost did not occur (p<0.05). A significant increase in the level of c-MYC gene amplification was found in groups with advanced stages of the disease (p<0.02). Non-cluster amplification significantly distinguishes T4M0 and T4M1 stage patients from the rest with a significant increase in the score (p<0.05). In the metastatic stage of the disease, there was an increase c-MYC gene amplification compared to the non-metastatic stage (p<0.02). The copy number of the c-MYC gene was significantly higher in cases with perineural and lymphovascular invasion, as well as in cases of cribriform tumor organization (p<0.05). CONCLUSION: Amplification of the c-MYC gene in prostate tumor cells is associated with advanced stages of the disease (T4M0 and T4M1) with an increase in the copy number of the gene during the metastatic stage of the process. It was found that increased amplification of the c-MYC gene distinguishes groups of patients whose tumors exhibit perineural and lymphovascular invasion, as well as a cribriform pattern of tumor organization.

[Glomerulopathy in kidney neoplasms: frequency of occurrence, structure of morbidity]. / Glomerulopatii pri novoobrazovaniyakh pochek: chastota vstrechaemosti, struktura zabolevaemosti.

BACKGROUND: Malignant neoplasms of the kidneys are among the 10 most common oncological diseases in Russia, in which various kidney lesions can occur, including glomerulopathy. Glomerular pathology can be an independent nosology, a manifestation of paraneoplastic syndrome or metabolic disturbances. OBJECTIVE: Evaluation of the incidence and structure of glomerulopathies in patients with kidney neoplasms. MATERIAL AND METHODS: We analyzed 141 samples with a tumor obtained during nephrectomy. To diagnose glomerular pathology, a fragment of the kidney parenchyma was examined at a distance of at least 4 cm from the tumor border. Histological slides were stained with hematoxylin and eosin, methenamine silver, trichrome Masson, Congo red, PAS reaction was performed. Immunofluorescent microscopy was performed with antibodies to IgA, IgG, IgM, C3c, C1q, Kappa light chain and Lambda light chain. Samples for electron microscopy were contrasted with a solution of 0.1% lead citrate. RESULTS: Malignant neoplasms were diagnosed in 130 (92.2%) patients, benign ones - in 11 (7.8%) patients. In 59 patients with kidney tumors, glomerulopathies were detected, which amounted to 41.8%. All cases of glomerulopathies were diagnosed in combination with carcinomas of the kidneys and renal pelvis. Among 59 cases of glomerulopathy, diabetic nephropathy was diagnosed in 44 (74.6%) cases, IgA nephropathy - in 7 (11.9%) cases, membranous nephropathy - in 1 (1.6%), minimal change disease - in 2 (3.4%), focal segmental glomerulosclerosis - in 5 (8.5%). CONCLUSION: The study demonstrates a high incidence of glomerulopathies in patients with malignant kidney tumors. The performed work emphasizes the importance of an in-depth morphological study of the kidneys in the presence of a tumor with an integrated approach to the treatment of patients.

[Microglandular adenosis of the breast]. / Mikroglandulyarnyi adenoz molochnoi zhelezy.

The presented case describes the difficulties of diagnosis of the breast microglandular adenosis (MGA), taken by clinicians for a malignant process due to the nature of growth and large size. Criteria for histological and immunohistochemical diagnosis and differentiation of MGA with malignant neoplasms, in particular, with tubular breast carcinoma, are presented. Taking into account the rarity of the pathology and the absence of described cases in the Russian-language literature, the observation is of interest to pathologists and clinicians.

[Metastatic lesion of the bone marrow caused by primary angiosarcoma of the spleen]. / Metastaticheskoe porazhenie kostnogo mozga pri pervichnoi angiosarkome selezenki.

The article presents a rare case of bone marrow metastasis of the spleen angiosarcoma. The observation is of particular interest due to the fact that secondary bone marrow damage in angiosarcoma in the vast majority of cases is due by primary tumor growth in the spleen. Clinically, such cases may resemble the course of blood diseases with hematological disorders and splenomegaly. Patients come into the field of view of a hematologist, and the final diagnosis is unexpected to the attending physician. Detection of angiosarcoma growth in a bone marrow trephine biopsy during morphological examination can be a rare finding for a pathologist. In this regard, the presented case is of interest not only for pathologists, but also for doctors of clinical specialties.

[Rare kidney tumor - thyroid-like follicular carcinoma]. / Redkaya opukhol' pochki ­ tireoidopodobnaya follikulyarnaya kartsinoma.

The literature review provides an analysis of a rare malignant tumor of the kidney: thyroid-like follicular carcinoma of the kidney (TLFCK). In morphology, this tumor is extremely similar to thyroid follicular carcinoma, but the immunophenotype of tumor cells is different. TLFCK has an indolent clinical course, rarely metastasizes, and even the development of metastases does not mean an unfavorable prognosis for the patient. The literature review presents the features of the clinical course of the disease, macroscopic, microscopic, immunohistochemical characteristics of the tumor and typical cytogenetic breakdowns. Particular attention is paid to the issues of differential diagnosis of the tumor with other pathological processes that may microscopically resemble TLFCK.

[Thyroid-like follicular carcinoma of the kidney]. / Tireoidopodobnaya follikulyarnaya kartsinoma pochki.

Thyroid-like follicular carcinoma of the kidney (TLFCK) is an extremely rare histological variant of renal cell carcinoma, not yet included in the WHO list of tumors. This tumor has a characteristic morphological structure strikingly resembling follicular carcinoma of the thyroid gland, but differing from itby the immunophenotype of tumor cells. TLFCK is characterized by an indolent clinical course, rarely metastases, and even the presence of metastases does not lead to a worsening of the prognosis for the patient. Described a case of TLFCK diagnosed in a 38-year-old patient, observed clinically for 8 years, without metastases during this time, and removed by focal kidney resection. The paper presents the macroscopic and microscopic characteristics of the tumor, immunohistochemical profile, and discusses the issues of differential diagnosis.

[Gene expression profiling in melanoma diagnostics: problems and future application in clinical practice]. / Profilirovanie ekspressii genov v diagnostike melanomy: problemy i perspektivy.

Difficulties in the diagnosis and differential diagnosis of melanoma in the work of a pathologist include not only conflicting structural and morphological features, but also the insufficient effectiveness of biochemical and some molecular markers in immunohistochemical studies. The review presents modern alternative methods for diagnosing malignant tumors based on the assessment of gene expression, the performance, objectivity and reliability of the determination of which may in the future have clinical application as an addition to histopathological methods in the diagnosis and differential diagnosis of various malignant neoplasms, including melanocytic neoplasms, which is changing the paradigm of routine medical practice, introducing diagnostic tests that carry molecular information into it.

[Endometrial vasculature in women with hydrosalpinx].

OBJECTIVE: To study the endometrial vasculature in women with hydrosalpinx and to determine a possible correlation between its state and the morphometric parameters of other structural components of the uterine mucosa. SUBJECTS AND METHODS: The endometrium was studied in 20 patients with primary tubal infertility in hydrosalpinx. A control group included 20 women with established fertility and a regular menstrual cycle with a good obstetric and gynecological history. The spectrum of morphometric parameters included the relative volumes occupied by the endometrial glands and glandular epithelium; the height of the integumentary epithelium; and the number of stromal cells per mm2. Stereometric (glandular-stromal, epithelial-stromal) indices and epithelium/glandular lumen ratio were calculated. The endometrial vasculature was estimated by immunohistochemical assay of CD31- and CD34-expressing cells. RESULTS: There was a decrease in the specific volume occupied by positively stained vascular endotheliocytes and a predominance of the stromal component of the endometrium over its epithelial one. Correlations were found between the degree of development of the endometrial vasculature and endometrial glands, which reflects their normal relationships in the proliferation phase. In the study group, the correlation between the height of the integumentary epithelium and the development of the endometrial vasculature was moderately positive, which was absent in the control group where this correlation was strong and positive. The findings are evidence in favor of the negative impact of hydrosalpinx on the uterine mucosa. The found changes in the main endometrial structural components (vessels, glands, and stromal cells) reflect impaired mucosal maturation processes during the proliferation phase. The substantial negative impact of hydrosalpinx has an effect on the height of the integumentary epithelium of the endometrium. CONCLUSION: The given data suggest that there are significant and complex endometrial changes in hydrosalpinx. Suppressed angiogenesis is one of the key moments in the chain of impairments in the preparation of the uterine mucosa for implantation.

[Web-ring of sites for pathologists in the internet: a computer-mediated communication environment].

The recently developed Web-ring of pathology-related Web-sites has transformed computer-mediated communications for Russian-speaking pathologists. Though the pathologists may be geographically dispersed, the network provides a complex of asynchronous and synchronous conferences for the purposes of diagnosis, consultations, education, communication, and collaboration in the field of pathology. This paper describes approaches to be used by participants of the pathology-related Web-ring. The approaches are analogous to the tools employed in telepathology and digital microscopy. One of the novel methodologies is the use of Web-based conferencing systems, in which the whole slide digital images of tissue microarrays were jointly reviewed online by pathologists at distant locations. By using ImageScope (Aperio Technologies) and WebEx connect desktop management technology, they shared presentations and images and communicated in realtime. In this manner, the Web-based forums and conferences will be a powerful addition to a telepathology.