Papillary glioneuronal tumor: unexplored entity.

Papillary glioneuronal tumors represent a new and rare entity of an uncommon morphologic subtype of low-grade mixed neuronal-glial neoplasms with an unclear etiology. They are described as benign lesions with extraventricular localization. We report the second case of papillary glioneuronal tumor with recurrent nature after gross-total resection, and the third case of this tumor with intraventricular localization. While conventional magnetic resonance imaging of papillary glioneuronal tumors is well described in literature, there are no data based on advanced magnetic resonance techniques. The present article represents a review of clinicopathological and both conventional and advanced magnetic resonance imaging characteristics of papillary glioneuronal tumors, with focus on 2 cases with atypical course and localization.

Intraventricular textiloma with granuloma formation following third ventricle colloid cyst resection - a case report.

Despite precautions, cotton and gauze pads used for dissection or to achieve haemostasis during neurosurgical procedures can inadvertently be left behind and result in clinically symptomatic or asymptomatic and radiologically apparent mass lesion, sometimes referred to as "textilomas" or "gossypibomas", often mimicking recurrent tumour or abscess on neuroimaging studies. We report the neuroimaging evaluation, including computed tomography (CT), magnetic resonance imaging (MRI) and spectroscopy (H1-MRS), in a case of textiloma developing after the treatment of a third ventricle colloid cyst.

[Diffusion and perfusion magnetic resonance imaging in evaluation of primary glial brain tumors].

INTRODUCTION: Diffusion (DWI) and perfusion (PWI) imaging can give important data about physiological characteristics of tissue, which complete morphologic findings from conventional MRI. The aim of this study is to estimate the value of these MRI technics in evaluation of primary glial brain tumors. MATERIALS AND METHODS: The significance of DWI and PWI in differentiation of histologically proven low- and high-grade gliomas was estimated in 48 patient with diagnosed brain gliomas. ADC and rCBV values were compared by aplication of Mann-Whitney test, and logistic regression analysis was used to determine which of these two parameters contributed the most in increasing the diagnostic accuracy, ia. its sensitivity, specificity and predictive velues. ROC curves were constructed to determine threshold values for differentiation of low- from high-grade lesions. RESULTS: Statistical significance were showed between mean values of rCBV for low-grade (0.82) and high-grade (5.32) gliomas, which was not found for values of ADC parameters. Threshold rCBV value of 1.23 was determinated for discrimination between low- and high-grade gliomas with a sensitivity of 83.2% and a specificity of 77.5%. CONCLUSION: Conventional MRI combined with PWI increases the accuracy in determination of glioma grade.

[Comparative evaluation of conventinal and dynamic magnetic resonance imaging, of the pituitary microadenomas].

OBJECTIVE: This study tried to determine if there is a difference between standard and dynamic MR examination in detection of pituitary microadenoma. SUBJECTS AND METHODS: We have included twenty seven patients with suspicious pituitary tumor. All patients have been hospitalized for endocrinology examination between June 2007 and May 2008 in Institute for Endocrinology, diabetes and metabolic diseases of Clinical Center of Serbia. MR examinations have been preformed in MR Center of Clinical Center of Serbia. RESULTS: Twenty seven patients were included in our study. Only in four of them pituitary microadenoma was detected using dynamic MR examination. One was somatotrophin secreting adenoma, and three were corticotrophin realizing adenomas. There were no statistically significant differences between conventional and dynamic MR examination. CONCLUSION: Dynamic MR Examination as method can hardly match standard MR examination which remains standard in detection of pituitary microadenomas.

[Comparison of detection of brain lesions in multiple sclerosis in magnetic resonance imaging at magnetic field strength of 1.0 and 3.0 Tesla].

To estimate the relative sensitivity of MR examination for brain lesions in multiple sclerosis at 1.0 Tesla (T) and 3.0 T using identical acquisition conditions. 54 patients with multiple sclerosis were examined both at 1.0T (Siemens Impact Expert) and 3.0T (Philips Intera) using T1-weighted spin echo (T1W-SE) with and without gadolinium contrast injections, T2W SE and fluid attenuated inversion recovery (FLAIR) imaging. Images were examined independently by three experienced neuroradiologists using focal lesion counting. 3.0T scans compared with 1.0T scans demonstrate a 27.3%, increase in the number of detected contrast enhanced lesions and an 22.7% increase in the number of detected lesions on FLAIR MR tomograms. Highfield 3.0T MR imaging demonstrates better sensitivity in the detection of focal brain lesions in multiple sclerosis. This improvement is more apparent in contrast enhanced lesion detection and less noticeable in FLAIR detected lesions.

[Histological variants (subtypes) of differentiated thyroid carcinoma]. / Khistologichni varianti (podtipove) na diferentsiraniia kartsinom na shtitovidnata zhleza.

This is a report on retrospective clinical and pathoanatomical study of seventy-one patients presenting histological diagnosis differentiated carcinoma of the thyroid gland, undertaken with the purpose to identify the histological variants (subtypes) of differentiated thyroid carcinoma. As shown by the obtained results, the follicular variant is the commonest subtype of papillary carcinoma (41.18 per cent) followed by focal papillary carcinoma (25.49 per cent), and encapsulated variant (15.69 per cent). On the other hand, the most frequently met with follicular carcinoma subtype proves to be the least invasive variant (55 per cent).

[The surgical treatment of cervical lymph node metastases in differentiated thyroid carcinoma]. / Khirurgichno lechenie na shiinite limfnovuzlovi metastazi pri diferentsiran kartsinom na shtitovidnata zhleza.

Over the period 1980 through 1994, a total of 297 patients presenting histological evidence of differentiated carcinoma of the thyroid gland are studied. In thirty-two of them (10.8 per cent) palpable metastases in the lymph nodes are found at the time of making the diagnosis. A higher frequency of palpable lymph nodes is established in younger patients with histological diagnosis papillary carcinoma (62.5 per cent). In the 32 patients with palpable metastases in the lymph nodes, discovered during diagnosing of the disease, lymph node dissection is undertaken. The obtained results show that the modified cervical dissection yields favourable results, and at the same time preserves intact the neck structure.

[The correlation between serum thyroglobulin and iodine-131 scanning in detecting metastases in patients with a differentiated thyroid carcinoma]. / Suotnoshenie mezhdu serumniia tireoglobulin i skeniraneto s iod 131 za otkrivane na metastazi pri bolni s diferentsiran kartsinom na shtitovidnata zhleza.

One-hundred seventy-one patients, operated for differentiated thyroid gland carcinoma, are subjected to serum thyroglobulin assessment and whole-body scanning. In twenty-nine of the total of 171 patients there is evidence of relapses and metastases, discovered by either examination. In 27/29 cases with metastases (positive scan finding) a high serum thyroglobulin level is documented. The correlation between serum thyroglobulin level and whole-body scanning finding among patients without residual normal thyroid parenchyma (status post total thyroidectomy) is much more favourable than the one in patients presenting normal residual parenchyma (status post organ-salvaging operation). The conclusion is drawn that serum thyroglobulin contributes greatly to the diagnosis of recurrences and metastases, especially in patients with normal residual parenchyma missing.

[The results after an organ-preserving operation and total thyroidectomy in differentiated thyroid carcinoma]. / Rezultati sled organosukhraniavashta operatsiia i totalna tireoidektomiia pri diferentsiraniia tiroiden kartsinom.

A total of 196 patients with differentiated thyroid gland carcinoma are operated over the period 1980 through 1994, and followed up over periods ranging from 1 to 14 years after the operation. Surgical treatment consists in total thyroidectomy in 39.8 per cent of the cases, and organ salvaging operation--in 60.2 per cent. In 124 instances the histological diagnosis is papillary carcinoma, and in 72--follicular carcinoma. Local relapses and lethality are higher in patients with total thyroidectomy--6.4 per cent local recurrences and 3.8 per cent lethality, whereas in the group of organ-salvaging operations--1.6 and 0.9 per cent, respectively. Analysis of the operative interventions according to risk group, stage of disease and histopathological findings shows that there is no significant difference in lethality, but there is a higher rate of relapses among patients treated with total thyroidectomy.

[An expert system for biopsy diagnosis of lymph node pathology using a personal computer]. / Ekspertnaia sistema biopsiinoi diagnostiki patologii limfaticheskikh uzlov s pomoshch'iu personal'noi EVM.

The program has been developed for biopsy diagnosis in lymph node disease including tumors. The expert knowledge is based on the information about more than 200 morphological symptoms of 37 nosological unities: reactive lymphoid hyperplasia, metastatic tumors, granulomatous disease and others. The decision three consists of three sections: diffuse nontumor processes, inflammatory focal processes and tumor diffuse and focal processes. The system can provide a "second opinion" for pathologists in their professional activity and may useful as a teaching tool for medical students.

[Case of severe hypercalcemic crisis in primary hyperparathyroidism]. / Sluchai na tezhka khiperkaltsiemichna kriza pri purvichen khiperparatireoidizum.

A patient is described, admitted to the clinic with manifested picture of severe hypercalcemic crisis. The clinical, paraclinical and instrumental investigations established the presence of adenoma of parathyroid glands. In spite of the reduction of hypercalcemia, after the conservative treatment, the effect was but only transient and adenectomy was performed as a radical method, which led to permanent normocalcemia.