RESUMO
Anaplastic thyroid carcinoma is a high-grade aggressive tumor with a tendency for early metastasis. The paper describes a rare case of Stage IVB anaplastic thyroid carcinoma, including its clinical, instrumental, morphological, and autopsy findings, in a 66-year-old woman.
Assuntos
Carcinoma Anaplásico da Tireoide , Neoplasias da Glândula Tireoide , Idoso , Autopsia , Feminino , HumanosRESUMO
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.
Assuntos
Imageamento por Ressonância Magnética Multiparamétrica , Neoplasias da Próstata , Humanos , Imageamento por Ressonância Magnética , Masculino , Estudos Prospectivos , Prostatectomia , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/cirurgia , Estudos RetrospectivosRESUMO
AIM: Structural and functional analysis of cells from purulent-necrotic wounds in patients with diabetic foot syndrome undergoing ultrasonic treatment with 0.2% Lavasept solution. MATERIAL AND METHODS: It is presented morphological/ultrastructural analysis of wound specimens in 90 (DFS) patients aged 27-80 years with diabetic foot syndrome and purulent-necrotic complications who were hospitalized in the department of wounds and wound infections of the Vishnevsky Institute of Surgery in 2013-2016. Main group consisted of 75 patients, control group - 15 patients. Mean age was 58.4±8.2 years. All patients had diabetes mellitus type II for previous 13±4.5 years. Severity of foot tissue damage was assessed according to Wagner classification (F. Wagner, 1981). 46 (51.1%) patients had Wagner III-IV, 44 (48.9%) patients - Wagner II. Complex treatment included radical surgical management of purulent lesion, surgical revascularization for critical limb ischemia and foot reconstruction at the final stage. Additional measures were complete unloading of the foot, correction of carbohydrate metabolism and concomitant diseases. Topical treatment between surgical stages included dressing with 1.0% betadine solution (once a day). Ultrasonic cavitation was additionally applied in the main group. Electron microscopic examination of specimens was used before treatment, after 3-5 and 7-10 days in order to assess effectiveness of ultrasound cavitation for purulent-necrotic complications of DFS. RESULTS: Ultrasound cavitation with 0.2% Lavasept solution effectively cleans wounds from microbial and cellular detritus, destroys cellular membranes of biofilm-forming microorganisms, prevents their redo development and reinfection of the wound. Effective management of the wounds accelerates reparative processes that allows to perform foot reconstruction early.
Assuntos
Anti-Infecciosos Locais/administração & dosagem , Biguanidas/administração & dosagem , Pé Diabético/cirurgia , Necrose/cirurgia , Procedimentos Cirúrgicos Ultrassônicos , Administração Tópica , Adulto , Idoso , Idoso de 80 Anos ou mais , Diabetes Mellitus Tipo 2/complicações , Pé Diabético/tratamento farmacológico , Pé Diabético/patologia , Humanos , Pessoa de Meia-Idade , Necrose/tratamento farmacológico , Necrose/patologia , Soluções/administração & dosagemRESUMO
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).
Assuntos
Artérias/transplante , Pênis/cirurgia , Transplante Heterólogo , Ferimentos e Lesões/cirurgia , Animais , Cadáver , Tecido Conjuntivo/lesões , Tecido Conjuntivo/cirurgia , Humanos , Masculino , Músculo Liso/lesões , Músculo Liso/cirurgia , Pênis/irrigação sanguínea , Pênis/patologia , Coelhos , Transplante Heterólogo/efeitos adversos , Transplante Heterólogo/métodosRESUMO
AIM: To define the optimal treatment of postoperative ventral hernias. MATERIAL AND METHODS: It was performed microscopic examination of intraoperative specimens which were obtained from 40 patients with medium, large and giant hernia. The aim was to reveal ultrastructural changes and morphological features which are associated with abdominal wall weakness in case of postoperative ventral hernia. There were 28 (70%) cases of primary postoperative hernia and 12 (30%) cases of recurrent and multiple-recurrent hernia. In 4 patients polypropylene mesh implants were implanted prior to recurrence. Tissue specimens were obtained from the top of herniation, hernial ring and in 6 cm from the hernial ring. RESULTS AND DISCUSSION: Electron microscopy showed that postoperative ventral hernias are accompanied by ultrastructural destructive changes in cells of the skin, aponeurosis and muscles that indicates on morphofunctional failure of abdominal wall tissues. Swelling and degradation of collagen, fibroblasts vacuolization, capillary sludge of erythrocytes, development of vacuum zones with the fragments of altered collagen fibrils, red blood cells and mast cells are morphological signs of micronecrosis followed by abdominal wall weakness and postoperative ventral hernias. CONCLUSION: Postoperative ventral hernias are associated with morphological and functional failure of abdominal wall due to tissue destructive changes. Therefore, this obviously defective tissue can not be used per se and especially with tension. Mesh implants should be applied.
Assuntos
Parede Abdominal/patologia , Hérnia Ventral/patologia , Hérnia Incisional/patologia , Parede Abdominal/cirurgia , Materiais Biocompatíveis , Hérnia Ventral/etiologia , Humanos , Hérnia Incisional/etiologia , Microscopia Eletrônica , Polipropilenos , Recidiva , Telas CirúrgicasAssuntos
Carcinoma Papilar , Pancreatectomia/métodos , Neoplasias Pancreáticas , Carcinoma Papilar/metabolismo , Carcinoma Papilar/patologia , Carcinoma Papilar/fisiopatologia , Carcinoma Papilar/cirurgia , Humanos , Imuno-Histoquímica , Invasividade Neoplásica , Pâncreas , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/fisiopatologia , Neoplasias Pancreáticas/cirurgia , Prognóstico , Proteínas Wnt/metabolismo , Via de Sinalização WntRESUMO
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.
Assuntos
Carcinoma Ductal Pancreático , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Pâncreas/cirurgia , Neoplasias Pancreáticas , Carcinoma Ductal Pancreático/diagnóstico , Carcinoma Ductal Pancreático/metabolismo , Carcinoma Ductal Pancreático/fisiopatologia , Carcinoma Ductal Pancreático/terapia , Terapia Combinada , Diagnóstico Diferencial , Tratamento Farmacológico/métodos , Feminino , Humanos , Imuno-Histoquímica , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias/métodos , Pâncreas/patologia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/fisiopatologia , Neoplasias Pancreáticas/terapia , Prognóstico , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ultrassonografia/métodosRESUMO
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.
Assuntos
Capilares/patologia , Pâncreas/irrigação sanguínea , Pancreatite Crônica/patologia , Fator A de Crescimento do Endotélio Vascular/biossíntese , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/metabolismo , Pâncreas/patologia , Pancreatite Crônica/metabolismoRESUMO
Brain metastases (BM) are the most frequent intracranial SOL and extremely heterogeneous group of tumours from morphological point of view. Nevertheless, studies devoted to BM up to now paid little attention to the histogenesis of the primary tumour. Lung carcinoma is the most common source of BM; morpologically this is a very heterogeneous group of tumors, and they demostrate different clinical pathway and outcome. The aim of present study was to evaluate clinical and morphological prognostic factors in 126 patients with lung carcinoma metastases to the brain, operated in 2004-2010 at Burdenko Neurosurgical Institute. Statistical analysis demonstrated that age, gender, amount and location of BM, primary operation and even histological tumour type were not significant prognostic factors, meanwhile absence of extracranial metastases and Karnofsky index above 70 were significant factors of the favorable prognosis.
Assuntos
Neoplasias Encefálicas/secundário , Neoplasias Pulmonares/patologia , Adulto , Idoso , Biomarcadores Tumorais/análise , Neoplasias Encefálicas/mortalidade , Neoplasias Encefálicas/cirurgia , Proteínas de Ligação a DNA/biossíntese , Feminino , Humanos , Imuno-Histoquímica , Estimativa de Kaplan-Meier , Avaliação de Estado de Karnofsky , Queratina-5/biossíntese , Queratina-6/biossíntese , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Fatores de TranscriçãoRESUMO
4 clinical cases of metastatic invasion of pancreas by renal cancer were analyzed. The main features were the late metastatic revealance and the absence of specific clinical picture. The radiodiagnostics showed signs similar to neuroendocrine tumors of the pancreas, which complicated the diagnosis. All the patients were operated on - the resection of the pancreas was performed.
Assuntos
Carcinoma de Células Renais/secundário , Neoplasias Renais/patologia , Neoplasias Pancreáticas/secundário , Biópsia por Agulha , Carcinoma de Células Renais/diagnóstico , Carcinoma de Células Renais/cirurgia , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Neoplasias Renais/diagnóstico por imagem , Pessoa de Meia-Idade , Pancreatectomia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/cirurgia , Tomografia Computadorizada Espiral , UltrassonografiaRESUMO
Morphology of hormonally inactivated pituitary adenoma can be different types of tumors. Morphological immunohistochemical and electron-microscopic researches of 23 hormonally inactivated pituitary adenomas has been carried out. We shown that more frequent morphological substrate was gonadotropinoma or "zero-cells" adenoma. According to our results, gonadotropinomas, "zero-cells" adenomas and oncocytomas have similar features and can be put into the same group of tumor Pathomorphologist has to differentiate this group of tumors from others "silent" pituitary adenomas because they have different prognosis for a disease. A research of somatostatin and dopamine receptors expression would be new area for differential diagnosis of these types of adenomas.
Assuntos
Adenoma/metabolismo , Adenoma/ultraestrutura , Proteínas de Neoplasias/metabolismo , Neoplasias Hipofisárias/metabolismo , Neoplasias Hipofisárias/ultraestrutura , Receptores Dopaminérgicos/metabolismo , Somatostatina/metabolismo , Adenoma/diagnóstico , Adulto , Feminino , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias Hipofisárias/diagnóstico , PrognósticoRESUMO
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.
Assuntos
Carcinoma Ductal Pancreático/enzimologia , Colagenases/biossíntese , Regulação Enzimológica da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Proteínas de Neoplasias/biossíntese , Neoplasias Pancreáticas/enzimologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Ductal Pancreático/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Metástase Neoplásica , Neoplasias Pancreáticas/patologiaRESUMO
The authors describe a case of hepatoid adenocarcinoma of the lung with multiple metastases to the small bowel. An immunohistochemical study has been conducted.
Assuntos
Adenocarcinoma/secundário , Neoplasias do Jejuno/secundário , Neoplasias Pulmonares/patologia , Adenocarcinoma/cirurgia , Idoso , Humanos , Imuno-Histoquímica , Neoplasias do Jejuno/cirurgia , Neoplasias Pulmonares/cirurgia , Masculino , Recidiva , alfa-Fetoproteínas/análiseRESUMO
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.
Assuntos
Carcinoma Ductal Pancreático/metabolismo , Mucinas/metabolismo , Proteínas de Neoplasias/metabolismo , Neoplasias Pancreáticas/metabolismo , Pancreatite Crônica/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Ductal Pancreático/diagnóstico , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/diagnóstico , Pancreatite Crônica/diagnóstico , Estudos RetrospectivosRESUMO
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.
Assuntos
Adenocarcinoma/patologia , Tumor Carcinoide/patologia , Neoplasias do Colo/patologia , Adenocarcinoma/imunologia , Idoso , Tumor Carcinoide/imunologia , Neoplasias do Colo/imunologia , Humanos , MasculinoRESUMO
The authors describe one case of squamouscell carcinoma of the liver, which developed in a 54-year-old male. The gross tumor was a cyst, 10 cm in diameter, with the brown contents. A histological study revealed high-grade differentiated squamous-cell carcinoma without keratinization. An immunohistochemical study showed a positive reaction with cytokeratin 19 and PCNA expression in single nuclei of tumor cells.
Assuntos
Carcinoma de Células Escamosas/patologia , Neoplasias Hepáticas/patologia , Carcinoma de Células Escamosas/diagnóstico , Núcleo Celular/química , Humanos , Queratinas/análise , Neoplasias Hepáticas/diagnóstico , Masculino , Pessoa de Meia-Idade , Antígeno Nuclear de Célula em Proliferação/análiseAssuntos
Angiomiolipoma/complicações , Hemangiopericitoma/complicações , Neoplasias Renais/complicações , Neoplasias Pulmonares/complicações , Idoso , Angiomiolipoma/diagnóstico , Biópsia , Broncoscopia , Diagnóstico Diferencial , Feminino , Hemangiopericitoma/diagnóstico , Hemangiopericitoma/cirurgia , Humanos , Neoplasias Renais/diagnóstico , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , Pneumonectomia , Tomografia Computadorizada por Raios XRESUMO
Current international histologic classification of exocrine pancreatic tumours is presented. Macro- and microscopic characteristics of benign and malignant tumors are described. The role of immunohistochemistry in differential diagnosis is shown.
Assuntos
Neoplasias Pancreáticas/classificação , Neoplasias Pancreáticas/diagnóstico , Diagnóstico Diferencial , HumanosRESUMO
A rare case of hepatoblastoma is reported in a female of 47 years of age with literature review of these tumors in the adults. Microscopically the tumor was represented by the cells of embryonal and fetal types. Immunohistochemically expression of low-molecular cytokeratins as well as that of S-100 protein and hepatocyte antigen was observed.