[Inflammatory myofibroblastic tumor of the lung: problems in differential diagnosis].

Inflammatory myofibroblastic tumor is a neoplasm of intermediate biological potential, a marked inflammatory component, and characteristic genetic changes. Once it was identified as an independent nosological entity from a rather heterogeneous group of inflammatory pseudotumors. This paper describes a case of inflammatory myofibroblastic tumor of the chest in a child, by discussing the criteria for differential diagnosis in the use of up-to-date radiology techniques. When thoracic neoplasms are detected, it is necessary to determine their site and the most likely origin organ as exactly as possible and to assess the X-ray pattern of the pathological process. By applying the state-of-the-art radiodiagnostic techniques, the clarification of the pattern of the disease makes it possible to choose an optimal treatment policy and a surgical procedure and scope, to avoid anesthesia overload, and to decrease the probability of resurgery. Our observation is to demonstrate possible problems in the diagnosis of inflammatory myofibroblastic tumor of the lung in childhood and to recall again the algorithm of radiological approaches to detecting mediastinal and lung masses.

[Differential diagnosis of persistent interstitial emphysema and other cystic lesions of the lung].

Neonatal interstitial emphysema (IE) may develop as a complication of the respiratory distress syndrome. IE is classified as acute and persistent and as diffuse and local forms. The differential diagnosis of persistent IE and congenital cystic malformations from clinical and imaging data may present problems. The histological pattern of persistent IE has specific features that permit the morphological diagnosis of this condition.

[Primitive neuroectodermal tumor of the kidney in children; its differential diagnosis with Wilms tumor].

There may be a number of tumors made up by small round blue cells in the kidneys of children. One of them is primitive neuroectodermal tumor (PNET). The differences in therapeutic approaches determine the need to establish an accurate diagnosis. The differential diagnosis of PNET and the blastemal component of Wilms tumor can be difficult due to the similar histological pattern. There is a need for a close analysis of morphological manifestations, by keeping in mind the age of patients, and supplementary studies. A strong CD99 membrane expression and nuclear FLI1 expression in tumor cells are the signs of PNET. Reverse transcriptase-polymerase chain reaction and fluorescence in situ hybridization can determine PNET-specific translocations [t(11;22)(q24;q12), by involving the EWS gene.

[Solitary orbital fibrous tumor in a 12-year-old child].

Solitary orbital fibrous tumor was diagnosed in a 12-year old boy admitted to hospital for right-sided exophthalmos. MRI revealed orbital mass and surgical resection was performed. Histologically the tumor was composed of round or spindle cells with a lot of multinucleate giant cells and pseudovascular spaces. The neoplasm was regarded as a mixoid type of a solitary giant cell-rich fibrous tumor. Immunohistochemical analysis revealed coexpression of CD34, CD99, bcl-2, and CD99 (mic-2). The most important clinical, morphological, and immunohistochemical manifestations are presented in the paper. Major criteria for the differential diagnosis of solitary orbital fibrous tumor and the similar soft tissue tumors are discussed.

[Wilms' tumor: current classification and the basic principles of a morphological study].

A morphological study of renal tumors in children requires the accurate diagnosis of the histological type and stage of a tumor and the evaluation of its risk in accordance with the SIOP protocol standards. Pathological findings may provide the most adequate therapeutic approach in every specific case. It is necessary to correctly analyze the results of studies and to elaborate the most effective and adequate treatment

[Solitary fibrous tumor: a clinico-morphological and immunohistochemical study].

Solitary fibrous tumor is a rare neoplasm which may occur at any site although it is more frequent in the pleura, mediastinum and lung. The study used 4 cases of tumor localization in the pleura and orbit. Three cases presented as a "hemangiopericytic" variety of spindle cells; there were numerous giant cells in orbit tumor. Solitary fibrous tumor revealed enhanced expression of vimentin, CD34, bel-2 and CD99. Expression of S-100, desmine and non-striated muscle actin was found in few cells in some cases. Such features as large size (over 10 cm), necrosis, high cellularity, nuclear polymorphism and high mitotic index (more than 4 mitoses within 4 visual fields, at high magnification) were used as malignancy criteria:. Tumor histological pattern of "hemangiopericytic" variety could be reliably identified thanks to immunohistochemical procedure.

[Inflammatory pseudotumor of the stomach in a 12-year old child].

A 12 year old boy was admitted to the hospital with complaints of stomachache, weight loss, weakness. The first symptoms appeared 6 months ago after intake of the mixture of vinegar, soda and gasoline. The endoscopy showed polypoid mass in the angle of the stomach and malignancy was suspected. Partial resection of the stomach was performed and the boy was discharged from the hospital if satisfactory condition. Microscopic investigation detected spread of fibroblast-like cells containing lengthened nuclei with distinct nucleoli in some of them. There was prominent inflammatory reaction with the presence of neutrophils, macrophages, lymphocytes and many plasma cells. Immunohistochemical analysis showed positive reactions with smooth muscle actin and vimentin. The mass was considered to be an inflammatory pseudotumor. The fact that the lesion developed after the action of the aggressive fluid on the stomach wall permits to consider this event as a possible etiologic factor.

[Ways to improve the transfusion support of surgical hospitals under current conditions]. / Nekotorye puti sovershenstvovaniia transfuziologicheskogo obespecheniia khirurgicheskikh statsionarov v sovremennykh usloviiakh.

The article touches upon problems of the improvement of transfusiological maintenance of surgical departments with new tendencies in the donor movement taken into account. Specific methods to gain this aim are proposed.

[Anastomoses of the extrahepatic bile ducts with the duodenal stump (duodenocholecystostomy)]. / Ob anastomozakh vnepechenochnykh zhelchnykh putei s kul'tei dvenadtsatiperstnoi kishki (biliokul'toduodenostomiia).

The article generalizes the experience of 11 anastomoses between the bile ducts and the duodenal stump in patients previously operated for ulcer or cancer. These operations were performed in obstruction of the hepatocholedochus resulting from an accidental lesion of bile ducts during resection of the stomach or less frequently by choledocholithiasis, sclerosis of the pancreas head.