[Cystic renal tumours in children]. / Cisticni tumori bubrega kod dece.

AIM: To present clinico-pathological features of cystic renal tumours of childhood and to discuss criteria for their diagnosis and classification. MATERIAL AND METHOD: Renal tumours of childhood diagnosed at the Department of Pathology, Mother and Child Health Institute, New Belgrade, in the 1976-1990 period. In the analysys and classification of these tumours criteria of the International Society for Paediatric Oncology and the National Wilms' Tumor Study were used. RESULTS: There were 133 renal tumours diagnosed, and five of them were cystic. Further histological examination revealed that 3 of them were cystic partially differentiated nephroblastomas (CPDN), one cystic nephroma (CN), and one Wilms' tumour (WT) with cystic areas. All children were treated according to the SIOP protocol and showed no evidence of the tumour at follow-up (at least 6 years). CONCLUSION: Cystic renal tumours of childhood represent the spectrum of lesions that include CN, CPDN and WT with multicystic areas. CN is a bening multilocular tumour composed of non-communicating cysts separated by septa containing mature elements only. CPDN is a low risk malignant tumour characterised by the presence of the poorly differentiated elements (blastema) within the septa. WT with multicystic areas contains both cystic and solid areas composed of the same elements as classical WT. CN and CPDN follow a favourable course and they are treated with surgery only while WT with multicystic areas requires the same therapy as the classical WT including surgery, hemio- and radiotherapy. Since other renal tumours in children, such as clear cell sarcoma of kidney and mesoblastic nephroma, can be cystic too, the precise diagnosis of the cystic renal lesions is mandatory for their appropriate treatment.

[Ultrastructural changes in transplantation glomerulopathy]. / Ultrastrukturne promene transplantacione glomerulpatije.

Twenty-eight biopsy specimens were obtained from patients 3-95 months after kidney transplantation and studied by light, electron and in some cases also by immunofluorescence microscopy. Electron microscopic studies showed that the most frequent glomerular lesion was widening of lamina rata interna which is accompanied with subendothelial accumulation of finely granular material, formation of new subendothelial basement membrane and deposition of microfibrils and fine filaments. The mesangial changes were mainly those of mesangiolysis and mesangial sclerosis with deposition of mesangial matrix and microfibrils, but little cellular proliferation. Fragmented red blood cells were seen in nearly half of the patients. Arterial intimal thickening and occasionally also thrombosis produced ischaemic changes in the kidney and in the glomeruli and contributed to the process of transplant rejection.

[Electron microscopic analysis of eosinophilic renal cell carcinoma]. / Elektronosko-mikrospopska analiza eosinofilnog karcinoma celija bubrega.

Renal cell carcinoma with cytoplasmic eosinophilic globules visualized on routine histologic preparations was analyzed. Eosinophilic globules in cytoplasm of the cells in renal cell carcinoma are very rate and till today we have not heard or found in the literature an attempt to analyze and describe them and that was the aim of our study. By electron microscopy, the globules most closely resembled non-membrane bound filamentous material that normally constitutes the cytoskeleton of normal and neoplastic renal epithelium.

Ménétrier's disease in a child.

A case of Ménétrier's disease in a 3 year old child presenting with subtotal pyloric stenosis and fatal outcome due to postoperative complications is reported. It is emphasized that although radiographic and gastroscopic studies are helpful, a full-thickness mucosal biopsy is essential for the diagnosis of Ménétrièr's disease.

[Clear cell sarcoma of the kidney in children]. / Sarkom "svelih celija" (clear cell) bubrega kod dece.

Clear cell sarcoma of the kidney (CCSK) is a distinct, highly malignant renal tumour of childhood which was diagnosed in 5 (3.9%) of 133 primary renal tumours in children under 15 years of age in the period from 1976 to 1990. The clinical and pathological features of these patients are presented. The most common clinical features were abdominal mass and haematuria. The male to female ratio was 1: 1.5 and there was predilection for the left side (4:1). The age of patients varied from 5 months to 4 years (average age 23 months). In four children the tumour was in Stage I, and in one child in Stage II. Three tumours showed classical microscopic pattern of CCSK. The treatment for all patients consisted of preoperative chemotherapy, radical surgery and additional aggressive chemotherapy. Four patients developed metastases: three of them to bones and one to the liver. Three patients died of the tumour, one is alive but with the tumour (3 years follow-up), and one child is alive and without any evidence of disease (3-years follow-up). Although relatively uncommon, these tumours are responsible for 50% of all children's deaths from renal tumours and, so, their precise classification is essential for proper treatment.

[Hodgkin's lymphoma in children--histopathological and clinical features a 10-year experience (1978-1987)]. / Hockinov (Hodgkin) limfom kod dece--histopatoloske i klinicke karakteristike. Analiza za desetogodisnji period (1978-1987).

Hodgkin's lymphoma (HL) is a common neoplasm in children. In a 10-year period HL was found in 41% of all malignant lymphomas. Clinical and morphological features of 22 cases of HL are presented. HL was clinically manifested as an painless unilateral cervical lymphadenopathy. Males were slightly more affected, and the majority of the patients were from 5 to 15 years old. The most frequent histological types of HL were nodular sclerosis (45%) and mixed cellularity (40%). Although modern chemotherapy altered prognosis of HL and contributed to a favourable outcome of the disease in children, 36% of our patients died.