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One-step nucleic acid amplification (OSNA) detects and quantifies, with the use of a polymerase chain reaction, the presence of cytokeratin 19 mRNA in sentinel lymph nodes. The main advantage of the OSNA assay is the avoidance of second surgery in case of positive sentinel lymph node diagnosis. The objective of this study was to evaluate the significance of matrix metalloproteinase 9 expression by immunohistochemistry as supporting marker to cytokeratin 19 mRNA in sentinel lymph nodes in breast cancer patients and to relate this expression with clinicopathological data. This study was conducted on fresh sentinel lymph nodes obtained from 40 patients with tumors classified as carcinoma of no special type. The presence of metastatic cells in the slices of lymph nodes was evaluated by immunohistochemistry using antibodies for CK19 and MMP-9. Expression of CK19 and MMP-9 in lymph nodes was also confirmed by means of Western blot analysis. Results indicated that the strongest correlation with CK19 mRNA was displayed by MMP-9, CK19 (by immunohistochemistry, IHC), and nodal metastases (p < 0.001). Higher histological grading also positively correlated with CK19 mRNA, however that correlation was less significant. Since MMP-9 shows very strong correlation with CK19 mRNA in breast carcinoma of no special type metastases, expression of MMP-9 in sentinel lymph nodes should be considered as useful method whenever OSNA analysis is not available.
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Biomarcadores Tumorais/metabolismo , Neoplasias da Mama/diagnóstico , Carcinoma/diagnóstico , Queratina-19/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Linfonodo Sentinela/metabolismo , Adulto , Idoso , Western Blotting , Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Carcinoma/metabolismo , Carcinoma/patologia , Feminino , Humanos , Imuno-Histoquímica , Queratina-19/genética , Pessoa de Meia-Idade , Invasividade Neoplásica , Reação em Cadeia da Polimerase , RNA Mensageiro/metabolismoRESUMO
OBJECTIVE: Neck nodular lesions may derive from several different tissues, often mimicking thyroid tumor in the preoperative examination. METHODS: We described three patients admitted in 2012 to the Department of Endocrine Surgery in Wroclaw with nodular lesion in the neck area mimicking tumor of the thyroid gland. RESULTS: In the first patient with a tumor in projection on the isthmus and the left thyroid lobe, neurilemmoma was discovered in the histopathological exams. In the second one with the suspicion of papillary thyroid carcinoma, adenoid cyst carcinoma was identified in the pathological examination. In the third case, suspected to being a recurrent or split goiter, non-specific, chronic lymphonodulitis was recognized in the final histology. CONCLUSIONS: Appropriate and careful diagnostics of a nodular lesion in the neck before surgery has crucial significance for choosing optimal method of surgical treatment which has great influence on mortality rate and reducing complications.
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Carcinoma Adenoide Cístico/diagnóstico , Carcinoma/diagnóstico , Bócio/diagnóstico , Neurilemoma/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Adulto , Idoso , Carcinoma/patologia , Carcinoma Adenoide Cístico/patologia , Carcinoma Papilar , Diagnóstico Diferencial , Feminino , Bócio/patologia , Humanos , Pescoço/patologia , Neurilemoma/patologia , Câncer Papilífero da Tireoide , Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/patologiaRESUMO
Thyroid-stimulating hormone (TSH) is a growth factor associated with the initiation and progression of well-differentiated thyroid cancer (WDTC). Atypia of undetermined significance and follicular lesion of undetermined significance (AUS/FLUS) are the most uncertain cytological diagnoses of thyroid nodules. The aim of the study was to determine the association of histopathological diagnosis with preoperative serum TSH levels in patients with AUS/FLUS thyroid nodule diagnosis. Among 5028 individuals with thyroid nodules, 342 (6.8%) with AUS/FLUS diagnoses were analyzed. The frequency of all histopathology diagnoses was assessed for associations with preoperative serum TSH levels. The median TSH concentration was significantly higher in patients with AUS/FLUS diagnosis and histopathology of WDTC than in patients with the same cytology result and histopathology of a benign tumor (p < 0.0001). The diagnostic potential of serum TSH level was determined to evaluate risk of malignancy in patients with thyroid nodules classified into the Bethesda III category. ROC analysis showed the TSH concentration at a cutoff point of 2.5 mIU/L to be an acceptable prognostic factor for WDTC. For this optimal cutoff point, the AUC was 0.877, the sensitivity was 0.830, and the specificity was 0.902. Preoperative serum TSH levels in patients with AUS/FLUS thyroid tumor diagnosis should be taken into consideration in the decision-making process and clinical management.
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Epidemiological studies have shown a strong association between high body mass index (BMI) and papillary thyroid cancer (PTC). We assessed the clinical and histopathological features of PTC in patients with a higher BMI and compared them to analogous parameters in PTC patients with a normal BMI. We retrospectively analyzed 5021 medical records of patients admitted and surgically treated for thyroid tumors in one center between 2008 and 2018. Finally, we extracted data from 523 adult patients with PTC and stratified patients into two groups according to BMI: Group 1 with BMI < 25 kg/m2 and Group 2 with BMI ≥ 25 kg/m2. Data stratification was performed to estimate the association of overweight and obesity with clinical and histopathological features of PTC in both univariable and multivariable binary logistic regression analyses. Overall, compared to patients with a normal BMI, overweight and obese patients had a greater risk of minimal extrathyroidal extension (minimal ETE), multifocality and bilaterality of PTC (p < 0.001 for all). Analysis did not show that BMI was significantly associated with the more advanced tumor-node-metastasis (TNM) stage (p = 0.894). Obesity and overweight were significantly associated with higher aggressiveness of PTC. When considering various management options for PTC patients, these findings regarding overweight and obesity should be taken into consideration during the decision-making process.
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PURPOSE: Although some prognostic variables and risk factors for thyroid cancer (TC) are age-related, the association between age and the risk of TC in patients with thyroid nodules (TNs) assigned to atypia of undetermined significance (AUS) and follicular lesion of undetermined significance (FLUS) is poorly estimated. The aim of this study was to assess the histopathology of AUS/FLUS and the risk of TC according to the age of the patients at the time of AUS/FLUS diagnosis. PATIENTS AND METHODS: Among 5021 individuals treated for TNs at one institution from 2008 to 2018, 161 (3.2%) patients with 161 TNs assigned to the AUS/FLUS category (1 nodule per patient) were selected and stratified by age at initial diagnosis: <55 years, 55-75 years and >75 years. Logistic regression analysis was used to estimate the association of age with the risk of TC diagnosis. RESULTS: Ninety-one (56.52%) patients <55 years old, 58 (36.02%) patients 55-75 years old, and 12 (7.45%) individuals >75 years old were identified. There were 130 (80.7%) females and 31 (19.3%) males with a mean age of 50.6 ± 16.12 years. Among the evaluated TNs, 142 (88.2%) were ultimately diagnosed as benign, and 19 (11.8%) were diagnosed as malignant. Younger age in patients was significantly related to malignancy outcome (p=0.024 for age <55 years). Patients aged 55-75 years had a significantly lower risk of TC than the other age categories (p=0.040). The risks of high vascularity and fast tumor growth were significantly higher in the youngest category than in the other categories (age <55 years old: p=0.045 and p=0.002, respectively). CONCLUSION: Although patients with TNs classified as AUS/FLUS by ultrasound-guided fine needle aspiration biopsy (UG-FNAB) are not typically qualified for surgery, it is worth noting that younger patients with an AUS/FLUS diagnosis might be at a higher risk of TC.
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Atypia and follicular lesions of undetermined significance (AUS/FLUS) is the most controversial category of The Bethesda System. The risk of malignancy (ROM) in this group is estimated as 5-15%, however, the occurrence of two or more subsequent biopsy results with AUS/FLUS diagnosis makes these clinical situations more complex. We evaluated the ROM and prognostic value of aggressive ultrasound (US) features in 342 patients with thyroid nodules (TNs) with subsequent biopsy results of AUS/FLUS. We assessed US features and compared them with the final histopathological diagnosis. Overall, 121 (35.4%) individuals after first AUS/FLUS diagnosis underwent surgery and 221 (64.6%) patients had repeated biopsies. The ROM after first, second, and third biopsies with subsequent AUS/FLUS diagnosis were 7.4%, 18.5%, and 38.4% respectively. We demonstrated significantly higher rates of occurrence of aggressive US features in patients with malignancy (p < 0.0001). The age <55 years old was also a significant risk factor for TC (p = 0.044). Significant associations were found between aggressive US features and malignancy in patients after first diagnosis of AUS/FLUS (p < 0.05). The juxtaposition of US features with the number of biopsy repetitions of TN with consecutive AUS/FLUS diagnoses may simplify the decision-making process in surgical management. Two or three consecutive biopsy results with AUS/FLUS diagnosis increases the ROM.
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BACKGROUND/AIMS: Primary retroperitoneal tumours and retroperitoneal organs' tumours represent a variety of lesions that require different treatments and have various prognoses. The aim of this study was to present the author's observations of the histological tumors types occurrence and their surgical treatment. METHODOLOGY: One hundred twenty-three cases of retroperitoneal tumours were studied retrospectively in a 6-year period. All cases were investigated for haematological and biochemical parameters. Abdominal ultrasonography, computed tomography or magnetic resonance imaging of abdominal cavity and pelvis were done in the all cases. All cases were subjected to laparotomy with an aim to resect the tumour completely. RESULTS: In the present study we observed primary retroperitoneal tumours like malignant neuroblastoma, paraganglioma, primitive neuroectodermal tumour, cavernous haemangioma and mucinous cystadenoma. Among retroperitoneal organs' tumours pancreatic lesions present the majority of them. There were 6 cases of neuroendocrine pancreatic tumours. We had two cases of retroperitoneal fibrosis in patients with ulcerative colitis. In adrenal glands we observed benign and malignant lesions like pheochromocytoma and fibrosarcoma. All primary retroperitoneal tumours, except two cases of retroperitoneal fibrosis, were an bloc removed. CONCLUSIONS: Primary retroperitoneal tumours in contrast to retroperitoneal organs' tumours occur very rare. Their anatomical location makes early detection difficult and as a result they are usually quite extensive when first detected. The clinical manifestations of all retroperitoneal tumours are not specific, so it causes a lot of difficulties in early diagnosis. This is the main reason that contributes to treatment failure.
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Neoplasias Retroperitoneais/patologia , Neoplasias Retroperitoneais/cirurgia , Adulto , Idoso , Estudos de Coortes , Diagnóstico por Imagem , Procedimentos Cirúrgicos do Sistema Digestório , Feminino , Humanos , Laparotomia , Masculino , Pessoa de Meia-Idade , Radioterapia Adjuvante , Neoplasias Retroperitoneais/epidemiologia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
We present a case of widespread cutaneous telangiectasias in a patient with a B-cell intravascular lymphoma most likely representing tumor-induced angiogenesis. The patient presented with a rapid onset of large cutaneous telangiectasias and skin edema, followed by the development of multiorgan failure. We describe difficulties with the ante-mortem diagnosis in the patient with predominant, clinically observed, skin lesions. The patient had disseminated disease involving many organs with a rapidly fatal outcome. The final diagnosis of intravascular malignant lymphoma (IVL) was established post-mortem after morphological and immunohistochemical studies of the autopsy material.
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Linfoma Difuso de Grandes Células B/diagnóstico , Neovascularização Patológica/diagnóstico , Neoplasias Cutâneas/irrigação sanguínea , Neoplasias Cutâneas/diagnóstico , Telangiectasia/diagnóstico , Neoplasias Vasculares/diagnóstico , Idoso , Antígenos CD20/análise , Antígenos CD79/análise , Evolução Fatal , Feminino , Humanos , Linfoma Difuso de Grandes Células B/patologia , Insuficiência de Múltiplos Órgãos/diagnóstico , Insuficiência de Múltiplos Órgãos/patologia , Neovascularização Patológica/patologia , Neoplasias Cutâneas/patologia , Telangiectasia/patologia , Neoplasias Vasculares/patologiaRESUMO
BACKGROUND: Currently, less aggressive treatment or even active surveillance of papillary thyroid microcarcinoma (PTMC) is widely accepted and recommended as a therapeutic management option. However, there are some concerns about these approaches. We investigated whether there are any demographic, clinical and ultrasound characteristics of PTMC patients that are easy to obtain and clinically available before surgery to help clinicians make proper therapeutic decisions. METHODS: We performed a retrospective chart review of 5,021 patients with thyroid tumors surgically treated in one center in 2008-2018. Finally, 182 (3.62%) PTMC patients were selected (158 (86.8%) females and 24 (13.2%) males, mean age 48.8±15.4 years). We analyzed the disease-free survival (DFS) time of the PTMC patients according to demographic and histopathological parameters. Univariate and multivariate logistic regression analyses were used to assess the relationships of demographic, clinical and ultrasound characteristics with aggressive histopathological features. RESULTS: Age ≥55 years, hypoechogenicity, microcalcifications, irregular tumor shape, smooth margins and high vascularity significantly increased the risk for minimal extrathyroidal extension (minETE), lymph node metastasis (LNM), and capsular and vascular invasion (p<0.0001). Multivariate logistic regression analysis demonstrated a statistically significant risk of LNM (OR = 5.98, 95% CI: 2.32-15.38, p = 0.0002) and trends toward significantly higher rates of minETE and capsular and vascular invasion (OR = 2.24, 95% CI: 0.97-5.19, p = 0.056) in patients ≥55 years than in their younger counterparts. The DFS time was significantly shorter in patients ≥55 years (p = 0.015), patients with minETE and capsular and vascular invasion (p = 0.001 for all), patients with tumor size >5 mm (p = 0.021), and patients with LNM (p = 0.002). CONCLUSIONS: The absence of microcalcifications, irregular tumor shape, blunt margins, hypoechogenicity and high vascularity in PTMC patients below 55 years and with tumor diameters below 5 mm may allow clinicians to select individuals with a low risk of local recurrence so that they can receive less aggressive management.
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Carcinoma Papilar/patologia , Recidiva Local de Neoplasia/patologia , Neoplasias da Glândula Tireoide/patologia , Adulto , Fatores Etários , Carcinoma Papilar/diagnóstico por imagem , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico por imagem , Estudos Retrospectivos , Fatores de Risco , Neoplasias da Glândula Tireoide/diagnóstico por imagem , UltrassonografiaRESUMO
BACKGROUND: The relationship of diffusely adherent Escherichia coli (DAEC) with pediatric inflammatory bowel disease (IBD) has not been previously studied. Diffusely adherent E. coli are a common cause of long-lasting childhood diarrhea and we postulated that they may induce inflammation of the intestinal mucosa, contributing to the development of IBD in susceptible children. OBJECTIVES: The aim of the study was to investigate the relationship between DAEC and pediatric IBD, including Crohn's disease (CD) and ulcerative colitis (UC). Diffusely adherent E. coli isolates were also assessed regarding their pathogenicity. MATERIAL AND METHODS: Diffusely adherent E. coli were screened among 130 E. coli strains isolated from intestinal biopsy specimens from 26 children with IBD using polymerase chain reaction (PCR) with primers specific to the pathotype and adherence assays to HEp-2 cells. Diffusely adherent E. coli were further analyzed for their ability to adhere to and invade polarized Caco-2 cells. The immunomodulatory effect of DAEC on the secretion of tumor necrosis factor α (TNF-α) by human monocyte-derived macrophages (MDM) was assessed using an immunoenzymatic assay. RESULTS: Diffusely adherent E. coli were recovered from 18 (69.2%) of the 26 intestinal biopsy specimens from both CD and UC patients. Most DAEC isolates carried AfaE3 adhesin, adhered to and were internalized by Caco-2 cells, and induced secretion of elevated levels of TNF-α. CONCLUSIONS: The study demonstrated the internalization of DAEC by intestinal epithelial cells and their ability to induce secretion of increased level of TNF-α in a Caco-2/macrophage compartmentalized culture. This indicated that the pathovar should be considered a pathobiont inducing inflammation of the intestinal mucosa in pediatric patients with IBD.
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Aderência Bacteriana , Moléculas de Adesão Celular/metabolismo , Colite Ulcerativa/microbiologia , Doença de Crohn/microbiologia , Infecções por Escherichia coli/epidemiologia , Escherichia coli/isolamento & purificação , Doenças Inflamatórias Intestinais/microbiologia , Mucosa Intestinal/microbiologia , Adesinas de Escherichia coli , Células CACO-2 , Moléculas de Adesão Celular/genética , Criança , Colite Ulcerativa/epidemiologia , Colite Ulcerativa/imunologia , Doença de Crohn/epidemiologia , Doença de Crohn/imunologia , Escherichia coli/genética , Infecções por Escherichia coli/imunologia , Infecções por Escherichia coli/microbiologia , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/imunologia , Mucosa Intestinal/imunologia , Polônia/epidemiologia , PrevalênciaRESUMO
THE AIM OF THIS STUDY: To evaluate the frequency and type of endoscopic and histopathological changes in upper gastrointestinal tract in children with inflammatory bowel diseases. MATERIAL AND METHODS: The study included 97 patients aged from 3 to 18 years (mean age 12.8 years, 45 girls and 52 boys) with inflammatory bowel diseases (IBD), treated in the 2nd Chair and Department of Pediatrics, Gastroenterology and Feeding of Children from 2005 to 2007. These children were divided into 3 groups depending on the clinical diagnosis: group 1: 38 children with ulcerative colitis (UC), group 2: 26 children with Crohn's disease (CD), and group 3: 33 children with indeterminate colitis (IC). In all patients upper gastrointestinal endoscopy was performed. During endoscopy biopsies were routinely taken from the stomach (antral region), the duodenum and all mucosal changes. H. pylori infection was detected by a positive culture. The obtained results were analyzed using 2 test (p<0.05). RESULTS: Esophageal changes were observed in 27.8% children with IBD, most frequently in CD and IC groups, respectively in 34.6% and 36.3% of children. No endoscopic abnormalities in the esophagus were noted in 72.2% of IBD children and the figure rises to 84.3% in UC children (p<0.05). Endoscopic examination of the stomach revealed no changes in 23.7% of IBD children, in 76.3% of these patients inflammatory lesions were observed. Only in 11.5% of the CD patient were no abnormalities in the stomach observed (p<0.05). In the CD group children mild endoscopic changes were observed in 53.8%, and severe in 34.6% of these patients. Ulceration of the duodenum, often in the descending part was revealed in 23.1% of CD children. Helicobacter pylori infection was found in 10.3% of the IBD children, most frequently in the IC group (12.1%). Histopathological examination confirmed esophageal changes in 31.9% of IBD patients, in the stomach and duodenum respectively in 77.3% and 48.4% of these children. Noncaseating granulomas were noted in 3.1% of the CD patients, partial villus atrophy was noted in 1 child with CD. CONCLUSIONS: In the group of IBD children, various inflammatory changes during the upper endoscopy were observed. Endoscopic examination most frequently revealed inflammatory changes of the stomach, less frequently of the duodenum and of the esophagus. Histopathological examination of IBD patients most frequently confirmed stomach changes. Less frequently histopathological changes were observed of the duodenum and of the esophagus, particularly in CD children. In the group of IBD children H. pylori infection was noted in few of the patients. Upper endoscopy in the IBD children is an important diagnostic tool and should be a part of monitoring the activity of the disease and results of the therapy.
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Endoscopia Gastrointestinal , Infecções por Helicobacter/diagnóstico , Doenças Inflamatórias Intestinais/diagnóstico , Doenças Inflamatórias Intestinais/patologia , Adolescente , Biópsia , Causalidade , Criança , Pré-Escolar , Comorbidade , Diagnóstico Diferencial , Úlcera Duodenal/diagnóstico , Úlcera Duodenal/epidemiologia , Esofagite/diagnóstico , Esofagite/epidemiologia , Feminino , Gastrite/diagnóstico , Gastrite/epidemiologia , Gastrite/patologia , Gastroscopia , Granuloma/diagnóstico , Granuloma/epidemiologia , Granuloma/patologia , Infecções por Helicobacter/epidemiologia , Infecções por Helicobacter/microbiologia , Helicobacter pylori/isolamento & purificação , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/microbiologia , Masculino , Polônia/epidemiologiaRESUMO
Using immunohistochemistry, Fas/Apo-1 protein expression was investigated in thyroid cancers of 67 patients. Thyroid biopsies from twenty eight patients with benign thyroid diseases were also examined. The patients with thyroid cancer manifested a variable histology of the cancer, including 14 patients with follicular carcinoma, 48 with papillary carcinoma, 5 patients with medullary carcinoma. The benign thyroid disease involved nodular goitre in 11 patients and follicular adenoma in other 17 patients. The study aimed at examining immunohistochemical expression of Fas protein in order to determine whether the level of its expression correlated with histological diagnosis. In individual patients Fas expression was more prevalent in thyroid carcinomas as compared to benign tumors (p=0.001). A marked increase in Fas expression was found in papillary carcinoma, as compared to follicular and medullary carcinomas (p=0.02). In conclusion, Fas was significantly more frequently overexpressed in thyroid cancer, indicating its role in thyroid tumorigenesis.
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Neoplasias da Glândula Tireoide/metabolismo , Receptor fas/metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Bócio Nodular/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Glândula Tireoide/patologiaRESUMO
UNLABELLED: Eosinophilic esophsgitis (EE) is a chronic inflammatory disease of the esophagus which is characterized by isolated eosinophilic infiltrations within squamous esophageal epithelium and by macroscopic lesions which lead to clinical symptoms of the disease. The aim of the work is presentation of the case of EE in a boy, together with discussion of epidemiology, pathophysiology, clinical symptoms and treatment basing on current literature. A case of a 18-years old boy with a allergy and dysphagia lasting since 6 months in whom eosinophilic esophagitis was recognized is presented. CONCLUSIONS: The authors emphasize necessity of extensive diagnostic, including histopatological study of esophagus mucosa specimens in pediatric patients in whom dysphagia is observed. It seems that there is a need for prospective studies in children, which would allow for determination of esinophilic esophagitis in Polish population.
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Transtornos de Deglutição/etiologia , Eosinofilia/complicações , Estenose Esofágica/complicações , Estenose Esofágica/diagnóstico por imagem , Esofagite/complicações , Adolescente , Transtornos de Deglutição/diagnóstico , Diagnóstico Diferencial , Endoscopia Gastrointestinal , Eosinofilia/diagnóstico , Eosinófilos/patologia , Esôfago/diagnóstico por imagem , Humanos , Masculino , Estudos Prospectivos , UltrassonografiaRESUMO
BACKGROUND: Postmenopausal osteoporosis and osteoporotic fractures constitute an increasing problem in developing countries. Kaempferol, isolated from seeds of Cuscuta chinensis, is an active flavonoid inhibiting in vitro osteoclast activity. The aim of the presented research was an assessment of kaempferol effect on estrogen-deficiency-induced bone structure disturbances in rats. METHODS: The study was performed on 24 Wistar female rats divided into 3 groups: SHAM - rats undergoing a "sham" surgery, OVX-C - control group of animals that underwent ovariectomy, OVX-K - rats undergoing ovariectomy and receiving kaempferol for 8 weeks (from day 56 to day 112). RESULTS: In the OVX-K group, contrary to the OVX-C one, there was no significant decrease in femoral bone mineral density (BMD). A significant increase in Young's modulus was observed in the OVX-K group compared to the OVX-C (15.33±2.51GPa vs. 11.14±1.93GPa, p<0.05). A decreased bone turnover was detected in the OVX-K group. Tissue volume ratio (BV/TV) and trabecular bone perimeter were increased in the OVX-K group compared to the OVX-C one (0.241±0.037 vs. 0.170±0.022, p<0.05 and 15.52±2.78mm vs. 9.67±3.07mm, p<0.05, respectively). CONCLUSION: Kaempferol has a beneficial influence on estrogen-deficiency-induced disturbances of bone structure in rats.
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Doenças Ósseas Metabólicas/prevenção & controle , Quempferóis/farmacologia , Ovariectomia/efeitos adversos , Animais , Fenômenos Biomecânicos , Densidade Óssea/efeitos dos fármacos , Doenças Ósseas Metabólicas/etiologia , Feminino , Ratos , Ratos WistarRESUMO
Testicular cancer is broadly divided into seminoma and non-seminoma types for treatment planning because seminomas are more sensitive to radiation therapy. Non-seminomatous germ-cell testis tumors represent a majority of all testicular neoplasms and include yolk sac tumor, embryonal carcinoma, choriocarcinoma, teratoma and undifferentiated tumors. Malignant neoplasms account for approximately 25% of neoplasms of the paratesticular tissues and most of them are sarcomas. We report a case of completely undifferentiated germ cell tumor of spermatic cord and discuss its diagnosis.
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Germinoma/patologia , Neoplasias Testiculares/patologia , Biomarcadores Tumorais/análise , Intervalo Livre de Doença , Germinoma/cirurgia , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Cordão Espermático/química , Cordão Espermático/patologia , Neoplasias Testiculares/química , Neoplasias Testiculares/cirurgiaRESUMO
A case of small-cell lung cancer with prompt worsening of the clinical course was observed in a patient with significant immune restoration after receiving effective highly active antiretroviral therapy (HAART) for seven months. Rapid and enormous enlargement of metastatic liver was the main symptom. Chest x-ray showed an enlargement of the left hilus. The patient died 22 days after the onset of the fulminant disease. We suggest that the occurrence and aggressive course of the lung cancer resulted from the development of immune reconstitution syndrome.
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Carcinoma de Células Pequenas/imunologia , Carcinoma de Células Pequenas/secundário , Soropositividade para HIV/complicações , Soropositividade para HIV/tratamento farmacológico , Neoplasias Pulmonares/imunologia , Adulto , Terapia Antirretroviral de Alta Atividade , Carcinoma de Células Pequenas/tratamento farmacológico , Evolução Fatal , Soropositividade para HIV/imunologia , Humanos , Lamivudina/administração & dosagem , Neoplasias Hepáticas/secundário , Metástase Linfática , Masculino , Ritonavir/administração & dosagem , Saquinavir/administração & dosagem , Zidovudina/administração & dosagemRESUMO
Acromegaly is usually caused by excess GH (growth hormone) secretion by pituitary adenoma. Extremely rare (< 1% of cases) acromegaly can be a result of ectopic GHRH (growth hormone releasing hormone) secretion by bronchial tubes, lung, pancreatic or intestinal tumor. The aim of this description is to present the case of successfully treated acromegaly caused by ectopic GHRH secretion by bronchial neuroendocrine tumor and the usefulness of chromogranin A assay in the disease monitoring. The diagnosis of acromegaly in 61-year old woman was based on typical clinical picture and elevated GH and IGF-1(insulin-like growth factor-1) levels. MRI (magnetic resonance imaging) images revealed no tumor in the pituitary but only the pituitary enlargement. Moreover, the right lung tumor (10 cm size) and elevated GHRH level were documented. The secretion of GH, IGF-1 and GHRH were normalized and progression of acromegaly was stopped after the carcinoid tumor surgery. Currently, 5 year after surgery, acromegaly is still in the remission, as the normal levels of GH, IGF-1, chromogranin A and normal chest and pituitary images confirm. The authors emphasize usefulness of measurement of chromogranin A concentration for the evaluation of the tumor remission in case the routine GHRH assay is not accessible.
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Biomarcadores Tumorais/sangue , Neoplasias Brônquicas/metabolismo , Neoplasias Brônquicas/cirurgia , Tumor Carcinoide/metabolismo , Tumor Carcinoide/cirurgia , Cromogranina A/sangue , Hormônio Liberador de Hormônio do Crescimento/metabolismo , Acromegalia/diagnóstico , Acromegalia/etiologia , Neoplasias Brônquicas/complicações , Tumor Carcinoide/complicações , Progressão da Doença , Intervalo Livre de Doença , Feminino , Seguimentos , Hormônio do Crescimento/sangue , Hormônios Ectópicos/sangue , Humanos , Pessoa de Meia-Idade , Monitorização Fisiológica , Indução de RemissãoRESUMO
INTRODUCTION: Cytokeratin-19 (CK19) is recognized as a reliable tumor marker of papillary thyroid carcinoma (PTC). The general prognosis in the classical subtype of PTC (CSTPTC) remains favorable, but some cases can be very aggressive. The aim of this study was to evaluate the localization and intensity of immunohistochemical CK19 expression in CSTPTC and its associations with the clinical and pathological characteristics of patients with CSTPTC in the Silesian region. MATERIAL AND METHODS: All the available clinical and histopathological data for 149 patients with CSTPTC from the Silesian region were retrospectively analyzed. The group consisted of 135 (90.6%) women and 14 (9.4%) men (mean age and SD: 52.3 ± 15.0). All these patients with CSTPTC underwent surgery at the same center between 2008 and 2013; the follow-up period was 24 to 90 months (mean and SD: 47 ± 20). RESULTS: In 142 (95.3%) of the patients with CSTPTC, positive cytoplasmic staining of CK19 was found. A higher expression of CK19 was observed in the group of patients without the recurrence of the disease (p = 0.015). CK19 expression was not associated with age, gender, tumor focality, disease stage, tumor size (pT), lymph node involvement (pN), or distant metastases (pM). CONCLUSIONS: Decreased CK19 expression in CSTPTC cases with relapse suggests that it plays a role in the carcinoma progression of CSTPTC. The association between lower CK19 expression and patients' unfavorable postoperative course could suggest its possible role as a marker of CSTPTC poor prognosis.
Assuntos
Carcinoma/metabolismo , Queratina-19/biossíntese , Neoplasias da Glândula Tireoide/metabolismo , Adulto , Idoso , Biomarcadores Tumorais/biossíntese , Carcinoma/diagnóstico , Carcinoma/patologia , Carcinoma Papilar , Diagnóstico Diferencial , Feminino , Humanos , Imuno-Histoquímica , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/patologiaRESUMO
BACKGROUND: Epidemiological studies suggest that long-term administration of proton pump inhibitors (PPIs) may decrease bone mineral density (BMD) and increase the risk of osteoporotic fractures. The aim of the study was to assess the influence of pantoprazole on bone metabolism in growing rats. METHODS: The experiment was carried out on twenty-four young male Wistar rats divided into two groups receiving either pantoprazole at the dose of 3mg/kg or vehicle for 12 weeks. Femoral bone mineral density (BMD) and bone histomorphometry were assessed. Serum total calcium, inorganic phosphate and markers of bone turnover were measured. RESULTS: In pantoprazole-treated rats a decreased BMD was detected (0.2618±0.0133g/cm(2)vs. 0.2715±0.0073g/cm(2), p<0.05). Bone histomorphometry revealed a decrease in growth plate thickness (G.Pl.RTh.) (161.0±27.8µm vs. 195.0±20.8, p<0.05) in pantoprazole-treated animals. Serum total calcium level and osteocalcin concentrations were decreased in the pantoprazole-treated group (9.62±0.55mg/dl vs. 10.15±0.38mg/dl, p<0.05 and 242.7±44.4pg/ml vs. 342.5±123.3pg/ml, p<0.05, respectively). CONCLUSION: We observed that PPIs might have a negative impact on bone formation in growing rats mainly due to their inhibitory effects on the gastric proton pump, with probable deterioration of calcium absorption and decrease in growth plate thickness.
Assuntos
2-Piridinilmetilsulfinilbenzimidazóis/administração & dosagem , Densidade Óssea/efeitos dos fármacos , Fêmur/efeitos dos fármacos , Animais , Doenças Ósseas Metabólicas/tratamento farmacológico , Doenças Ósseas Metabólicas/metabolismo , Remodelação Óssea/efeitos dos fármacos , Cálcio/metabolismo , Fêmur/metabolismo , Masculino , Osteocalcina/efeitos dos fármacos , Ovariectomia/métodos , Pantoprazol , Inibidores da Bomba de Prótons/farmacologia , Ratos , Ratos WistarRESUMO
BACKGROUND: Ideal pouch created during restorative proctocolectomy is a new gastrointestinal organ--"neorectum". Although it is made from the ileum, it takes over function of the removed rectum. This new function results in significant morphological changes in pouch's mucous membrane, which becomes similar to the large bowel mucosa. The most common pathology of the ileal pouch is its inflammation--pouchitis. One of the suspected causes of pouchitis is bacterial flora disturbance. OBJECTIVES: The aim of the study was to analyze the morphological and microbiological changes in ileal pouches in different time periods after ileostomy closure and to evaluate the influence of certain bacterial strains on the degree of inflammation. MATERIAL AND METHODS: The study involved 47 patients who had been treated surgically; they were investigated before and at different stages after ileostomy closure. They underwent repeated rectoscopies with biopsies of pouch mucosa and swabs for microbiological examination. In total 89 rectoscopies were performed, which provided 70 histopathological results according to the Heidelberg Pouchitis Activity Score and 87 microbiological test results. RESULTS: The assessment of the morphology of intestinal pouches showed increased signs of chronic inflammation as the length of time after the closure of a protective ileostomy increased. There was no correlation between the signs of acute inflammation and the length of time after surgery; there were more signs of acute inflammation in cases of pouchitis. The composition of the bacterial flora of intestinal pouches changed as the length of time after ileostomy closure increased, with significant increases in the number of enterobacteriaceae species. The presence of Staphylococcus aureus significantly correlates with a higher degree of chronic inflammation; this bacterium may be a potential infectious factor in pouchitis. CONCLUSIONS: Microbiological analysis of intestinal pouch lumen is a useful tool that can be used in routine follow-up assessment of intestinal pouches as well as in diagnosing pouchitis.