Sensitivity and specificity of ex vivo dermatoscopy: a case series.

BACKGROUND: Sensitivity and specificity of ex vivo dermatoscopy (EVD) for malignancy detection of skin tumors is unknown. We sought to assess whether the use of EVD could be a useful adjunct to histopathological diagnosis of pigmented skin tumors, including cases where complete clinical information is inadequate or missing. MATERIALS AND METHODS: EVD was performed on 195 excised, formalin-fixed pigmented skin tumors. RESULTS: Of 183 eligible lesions, 104 (56.8%) were melanocytic and 79 (43.2%) nonmelanocytic. Overall, 54 (29.5%) were malignant: 10 melanomas, 39 basal cell carcinomas, and five squamous cell carcinomas. Ex vivo images were devoid of red color. The following colors were seen: light and dark brown, grey, blue, black, and white. All structures typical for pigmented melanocytic and nonmelanocytic lesions were observed. In malignant nonmelanocytic lesions, diagnostic accuracy and sensitivity for malignant/benign decision was not better when combining visual assessment and EVD but diagnostic specificity improved by 3.0%. For melanoma, combined diagnostics improved diagnostic accuracy, sensitivity, and specificity for 9.6, 30.0, and 7.5%, respectively. CONCLUSION: For dermatopathologists, EVD offers increased specificity for all categories of tumors and increased diagnostic accuracy, sensitivity, and specificity for melanoma. With EVD view, the dermatopathologist can instantly find areas of interest, thus minimizing the possibility for missing a malignant lesion.

Tissue kidney injury molecule-1 expression in the prediction of renal function for several years after kidney biopsy.

OBJECTIVES: Retrospective study was designed to examine the importance of tissue kidney injury molecule-1 (KIM-1) expression in predicting kidney function in sixty patients (27 males) aged 34.15 ± 12.23 years with different kidney diseases over three years after kidney biopsy. MATERIALS AND METHODS: Tissue KIM-1 expression was determined immunohistochemically and KIM-1 staining was scored semiquantitatively, as well as tubulointerstitialis (TIN), inflammation, atrophy, and fibrosis. Kidney function (MDRD formula) and proteinuria/day were evaluated at the time of biopsy (GFR0) and 6, 12, 24, and 36 months later. RESULTS: Significantly positive correlations between tissue KIM-1 expression and age (r = 0.313), TIN inflammation (r = 0.456), fibrosis (r = 0.317), and proteinuria at 6 months (r = 0.394) as well as negative correlations with GFR0 (r = -0.572), GFR6 (r = -0.442), GFR24 (r = -0.398), and GFR36 (r = -0.412) were found. Meanwhile, TIN inflammation was the best predictor of all measured kidney functions during three years, while tissue KIM-1 expression (P = 0.016) was a predictor only at 6 months after biopsy. CONCLUSION: Tissue KIM-1 expression significantly predicts kidney function solely at 6 months after biopsy, when the effects of immune and nonimmune treatments are the strongest.

Expression of Bcl-2 and Bax proteins in thyroid glands of rats in experimental thyroiditis.

In the recent years, iodine was associated to the development of apoptosis in thyroid diseases. The aim of the present study is to determine the expression of pro-apoptotic and anti-apoptotic proteins, Bax and Bcl-2, in a Wistar rat experimental model of thyroiditis induced by administration of different doses of potassium iodide. Immunohistochemical staining was done with chromogen diaminobenzidine on avidin-biotin peroxidase using the Animal Research Kit (ARK), stained with antibodies to Bcl-2 and Bax proteins. The intensity and distribution of positive staining were evaluated by light microscopy on a scale of 0 to 4. Bax protein was expressed in the area of regenerating follicular cells in high percent in potassium iodide treated rats, but was not expressed in thyrocytes from control rats. Bcl-2 expression was constantly observed in thyrocytes of the control group and in the mantle-zone of lymphoid follicular infiltrates. Our results show that Bax expression is significantly higher in the Wistar rat experimental model of thyroiditis than in the control group. These data suggest that the increased expression of Bax may contribute to the role of apoptosis in the pathogenesis of experimental thyroiditis.

Primary non-hodgkin lymphoma of urinary bladder with nine years later renal involvement and absence of systemic lymphoma: a case report.

AIMS: Primary bladder non-Hodgkin lymphoma (PBNHL) is very rare, especially as extranodal B-small lymphocytic lymphoma (B-SLL). Also, late isolated renal manifestation of PBNHL is extremely unusual. We report a very rare type of extranodal B-SLL of bladder wall with extremely unusual late isolated renal involvement, clinically manifested by nephrotic syndrome and incipient renal failure. A CASE REPORT: A 56-year-old woman was presented with a solitary tumor of bladder wall, with history of dysuria and night sweating. A transvaginal needle biopsy of the tumor was performed, and diagnosis of primary extranodal B-SLL was made in the absence of bone marrow, lymph node, or blood involvement. She was treated with chemotherapy until the achievement of complete remission. Nine years later, she developed nephrotic syndrome. The renal biopsy revealed parenchymal lymphoma's involvement associated with glomerular lesion. Immunohistochemical analysis confirmed the same imunophenotype of lymphoma cells like in bladder wall nine years ago. Restaging procedure showed no evidence of disease elsewhere. CONCLUSION: To our knowledge, it is the first case of association of very rare primary bladder B-SLL with late isolated renal involvement.

[HIV infection and the kidneys (Part II): Morphologic changes and their diagnostic significance].

HIV-infected patients may be faced with a variety of renal problem patterns. HIV-associated nephropathy is a unique pattern of sclerosing glomerulopathy and represents the most rapidly progressive form of focal segmental glomerulosclerosis. This study involved the examination of 32 renal biopsies: by light, immunofluorescence, and electron microscopy, in order to determine the most accurate and reliable diagnostic procedure. The findings show that the most sensitive and accurate procedure is electron microscopy, capable of detecting specific EM changes very early on, which is sufficient for the diagnosis of HIV-associated nephropathy.

[IgA nephropathy: clinico-morphologic correlations]. / IgA nefropatija: klinicko-morfoloska korelacija.

IgA nephropathy is glomerular disease characterized by the presence of IgA dominant or codominant immunoglobuline deposits in glomerular mesangium which can be demonstrated by immunofluorescence. Clinical manifestations of IgA nephropathy in the majority of cases is hematuria which can be macro or microscopic, isolated or combined with proteinuria, which can be of nephrotic range. The prognosis of the disease is better if presented with haematuria. Intensity of morphologic changes as well as the prognosis is in correlation with the amount of proteinuria. The prognosis is better in children.

[Adhesion molecules in Wilm's tumor (part I)]. / Adhezioni molekuli u Vilmsovom tumoru (I deo).

Adhesion molecules are glicoprotees which have extracellular, transmembranous and intracytoplasmatic part. They show their basic role is in cell interaction in the tissue on one side and between cells and matrix on the other side. They have an important role in stabile integrity of tumor tissue, as well as in differentiation, proliferation, apoptosis and metastatic spread of tumorous cells. Since there is very little known facts about adhesion molecule detection and about its significance in Wilms tumor, our intention was to collect all known achievements which could be of importance for better understanding of tumors nature and successful treatment. Especially because of well known fact that in 15% Wilms tumors there are b-catenin mutations, which indicates that there is a disorder in Wnt signal path that plays an important role in Wilms tumor genesis.

[Adhesion molecules in Wilm's tumor: expression and significance of beta-catenin (part II)]. / Adhezioni molekuli u Wilms-ovom tumoru: ekspresija i znacaj beta-katenina (II deo).

Beta-catenin is a glicoprotein which has an important role in cell-cell adhesion, as well as in cell signal transmission, in u regulation of gen expression and in interaction with axin and APC (adenomatous poliposis coli). Its oncogenic role in several types of carcinomas in human population is well known. It is very likely that beta-catenin as an protooncogen plays an important role in genesis of Wilms tumor. It is well known that in 15% Wilms tumors there are beta-catenin mutations, which indicates that there is a disorder in Wnt signal path that plays an important role in Wilms tumor genesis. The aim of our study was to investigate b-catenin expression in Wilms tumor, to compare it with the expression in normal renal tissue as well as to see if there is a positive correlation between b-catenin expression in Wilms tumor with tumor stage, histologic type and/or prognostic group.

Steric Control of the Electronic Ground State in Six-Coordinate Copper(II) Complexes.

Replacing the 3- and 3''-protons of the ligand 2,6-di(pyrazol-1-yl)pyridine L by mesityl groups changes the electronic ground state of [Cu(L)2 ]2+ complexes from {d x 2-y 2}1 to {d z 2}1 . This is the best example so far for a "homoleptic" Jahn-Teller-compressed six-coordinate CuII complex.