[Synchronous primary multiple cancer: distal cholangiocarcinoma of the intrapancreatic common bile duct and intraductal papillary mucinous tumor associated with ductal adenocarcinoma of the pancreatic tail]. / Sinkhronnyi pervichno-mnozhestvennyi rak: distal'naya kholangiokartsinoma intrapankreaticheskoi chasti obshchego zhelchnogo protoka i vnutriprotokovaya papillyarnaya mutsinoznaya opukhol' v assotsiatsii s protokovoi adenokartsinomoi khvosta podzheludochnoi zhelezy.

We present a combination of distal cholangiocarcinoma of the intrapancreatic common bile duct and intraductal papillary mucinous tumor associated with ductal adenocarcinoma of the pancreatic tail. This clinical case is unique. When analyzing the literature, we found no any case of similar primary multiple malignant tumor. Importantly, final diagnosis of simultaneous malignant pancreatobiliary neoplasia is possible only via intraoperative biopsy after adequate morphological dissection and research of resected organ complex including molecular genetic analysis due to identical histological and immunohistochemical picture of ductal neoplasia.

[The use of digital radiography in the morphological evaluation of tumor response to neoadjuvant treatment of breast cancer]. / Primenenie tsifrovoi rentgenografii pri morfologicheskoi otsenke otveta opukholi na neoad"yuvantnoe lechenie raka molochnoi zhelezy.

OBJECTIVE: To optimize the morphological assessment of tumor response to neoadjuvant therapy in breast cancer. MATERIAL AND METHODS: A retro- and prospective cohort study was conducted. The object of the study was the surgical material. Macroscopic parameters of residual tumor without and with the use of digital radiography (digital X-Ray) are described and analyzed. PathVision Faxitron imaging system was used for digital X-ray samples. An analysis of dynamics of clinical characteristics was carried out. Two methods of tumor bed examination were compared. RESULTS AND DISCUSSION: The study cohort included 32 women, mean age 45.5±14 years. The correlation of the results of instrumental methods was 0.66 ([95% CI: 0.28; 1], p=0.0002). Microcalcinates were detected by digital X-Ray in 29 (90.6%) cases. Tumor bed sizes determined macroscopically (mean maximal size 6.1 (3.3) cm, median 5.2 (3.4-8.0) cm) and by using digital X-ray (mean maximal size 4.8 (2.6) cm, median 4.1 (2.7-6.2) cm), had statistically significant differences (p<0.0001). The agreement between the two methods of studying the tumor bed was 96.9%. The Cohen's kappa value was 0.95 (p<0.0001). CONCLUSION: Morphological study is an integral part of clinical trials of drug efficacy. With the help of digital X-Ray, the identification of metal markers placed in the tumor bed and microcalcinates is facilitated by the morphologist, and the visibility of the boundaries of the tumor bed is also improved. The results obtained showed that the use of digital X-Ray can improve the accuracy of assessing the degree of morphological regression of breast cancer in response to treatment.

[Multiparametric magnetic resonance imaging markers of clinically significant prostate cancer].

Authors aimed to assess the correlation between the apparent diffusion coefficient (ADC of the tumor, ADC ratio) and final grade group (GG) after radical prostatectomy (RP), and to determine the threshold values of ADC for detecting clinically significant prostate cancer (PC) with subsequent evaluation in a prospective group. 118 patients with PC were included in the retrospective group. These patients underwent RP from 2012 to 2017 with preoperative 3 Tesla multiparametric MRI (mpMRT) with contrast enhancement in a single center. After analyzing all the MRI studies, the average values of tumor ADC and benign tissue ADC were calculated using the maps of ADC. The prospective part of the study included 60 patients with completed pre-biopsy mpMRI and subsequent RP from January 2018 to March 2019. The prospective part of the study demonstrated the effectiveness of applying the obtained diffusion coefficient thresholds. When used as a criterion for determining clinically significant prostate cancer (GG > 6), threshold value of ADC ratio had sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 84%, 91%, 87%, 94% and 78% respectively.

[Decellularized cadaveric human artery for substitution of connective tissue and smooth muscle defects on the example of tunica albuginea of penis (experimental work)]. / Ispol'zovanie detselliuliarizirovannoi trupnoi arterii cheloveka dlia zameshcheniia defektov soedinitel'notkannykh i gladkomyshechnykh struktur na primere belochnoi obolochki polovogo chlena (éksperimental'naia rabota).

AIM: To analyze experimentally the outcomes of xenotransplantation (cadaveric artery, decellularized cadaveric artery) for tunica albuginea defects repair. MATERIAL AND METHODS: The study included 60 chinchilla rabbits. Rabbits underwent local replacement of tunica albuginea. Animals were divided into 2 groups (group 1 - human cadaveric artery, group 2 - decellularized cadaveric artery). The result was considered after 7, 14 and 30 days postoperatively. RESULTS: Tendency to stasis, sludge-phenomenon and ultimately development of fibrosis of transplantation area were histologically observed in group 1 after 30 days. In group 2 luminal surface of decellularized artery was smoothed, fibrin and blood elements were absent. In group 1 mean level of C-reactive protein was 3.86±0.43, 1.17±0.2 and 0.73±0.16 mg/L after 7, 14 and 30 days respectively. In group 2 the same values were 0.33±0.03, 0.23±0.03 and 0.11±0.02 mg/L. Differences were significant (t =-46.28, t = -25.95, t = -14.84; p<0.0001).

[Rare forms of the ductal carcinoma of the pancreas].

Clinical cases of patients with rare forms of ductal pancreatic carcinoma are described. Difficulties of preoperative radiologic verification of ostheoclast-like giantcell tumor and cricoids-cell carcinoma of the pancreas are described. Morphologigic and immunohistochemical features of these tumors are highlighted. One of the clinical cases demonstrate the aggressive tumor behavior, led to liver metastases 4 months after the radical operation. Literature review highlights historical aspects and the state-of-art of diagnostics and treatment of rare forms of the ductal carcinoma of the pancreas.

[Functional state of stroma and capillaries by chronic pancreatitis].

The straight correlation between the intensity of stroma inflammatory infiltration and the vessel endothelium growth factor (VEGF) was registered. The progression of the pancreatic tissue fibrosis correlated with the decrease of endothelial and fibroblastic activity, increase of perivascular fibrosis and cellular expression of VEGF, as well as the decrease of compensatory capacity of pancreatic cells.

[The role of matrix metalloproteinases in pancreatic ductal adenocarcinoma].

Matrix metalloproteinases-7, -9 (MMP) are crucial factors for prognosis of pancreatic ductal adenocarcinoma (PDA). The expressions of MMP-2, 7, 9 increased in 60 patients with PDA and depended from stage of disease. Metastasis and invasive growth of tumor correlated with increase of MMP production and decrease of MMP inhibitors' expression, stimulated invasive growth of tumor.

[Hepatoid adenocarcinoma of the lung with multiple metastases to the small bowel].

The authors describe a case of hepatoid adenocarcinoma of the lung with multiple metastases to the small bowel. An immunohistochemical study has been conducted.

[Immunohistochemical study of mucins in chronic pancreatitis and ductal adenocarcinoma of the pancreas].

Based on the results of an immunohistological study of MUC1, MUC2, MUC4, MUC5AC, and MUC6 in pancreatic tissue from 50 patients with chronic pancreatitis (CP) and 50 patients with ductal adenocarcinoma (DAC), the authors showed altered mucin immunological responsiveness in severe forms of CP, in the foci of PanIN and DAC. They also revealed that determination of mucin expression may be used in the differential diagnosis of pancreatic cancer.

[Goblet-cell carcinoid of the colon].

The authors describe a case of goblet-cell carcinoid of the appendix subject to additional immunohistological study. Goblet-cell carcinoid is a rare colonic tumor comprises the morphological signs of adenocarcinoma and carcinoid.