Clinicopathological Analysis of Complicated Colorectal Cancer: A Five-Year Retrospective Study from a Single Surgery Unit.

Patients with primary colorectal cancer can present with obstructions, tumor bleeding, or perforations, which represent acute complications. This paper aimed to analyze and compare the clinical and pathological profiles of two patient groups: one with colorectal cancer and a related complication and another without any specific complication. We performed a five-year retrospective study on colorectal cancer patients admitted to a surgery unit and comparatively explored the main clinical and pathological features of the tumors belonging to the two groups. A total of 250 patients with colorectal cancer were included in the analysis. Of these, 117 (46.8%) had presented a type of complication. The comparative analysis that examined several clinical and pathological parameters showed a statistically significant difference for unfavorable prognosis factors in the group with complications. This was evident for features such as vascular and perineural invasion, lymph node involvement, pathological primary tumor stage, and TNM stage. Colorectal cancers with a related complication belonged to a group of tumors with a more aggressive histopathologic profile and more advanced stages. Furthermore, the comparable incidence of cases in the two groups of patients warrants further efforts to be made in terms of early detection and prognosis prediction of colorectal cancer.

Endometrial polyps.

Endometrial polyps (EPs) are a frequent gynecological condition. EPs often arise in the common womanly patients and are appraised to be about 25%. Advancing age, hyperestrogenism, hypertension, and Tamoxifen use are acknowledged as ordinary risk elements for the development of EP. The etiopathogenesis of EP is not accurately elucidated, but certain considerations such as diabetes mellitus, hormonal factors or arterial hypertension are considered to perform a significant contribution. The diagnosis of EPs is essentially by imaging. Transvaginal ultrasound is the primary investigation in EPs. Hysteroscopic resection is now the "gold standard" to treat to treat this disease. Hysterectomy is the definitive treatment for EPs, but it requires a judicious indication and an adequate counseling of the patient. Currently, a certain histological pattern is found in different sequences in EPs. Even if the vast majority EPs are benign, they may reach hyperplastic, with malignant alteration. The purpose of this pictorial review is the integrated approach to this type of abnormal endometrial proliferation from the perspective of natural history, diagnosis, management, morphological aspects, risk of malignancy, recurrence and last but not least, clinical outcome.

Diagnostic difficulties in giant benign phyllodes tumor.

Phyllodes tumors (PTs) are rare tumors of the breast, which encompass both stromal and epithelial components. The maximum incidence is in the fourth decade of life. Most of these tumors are benign, but about one third can be malignant acting as sarcomas. Due to their rarity and atypical clinical behavior (especially for the giant ones), the management of these tumors is usually difficult. We report a case of a 24-year-old woman who presented in the Department of Oncology for rapid increase in volume of the left breast. She had no personal pathological or family history. Initial clinical exam showed a large irregular mass in the left breast of approximately 30 cm and palpable lymph nodes in the ipsilateral axilla. A core needle biopsy for the tumor was performed with histopathological (HP) result that revealed an aspect suggesting fibroadenoma/PT. Contrast-enhanced computed tomography (CT) scan identified lymph node enlargement in the left axilla and a peripheral nodule in the lung about 5.5/3.4 mm with no specific features. The patient was then transferred to the Department of Surgery, where left mastectomy and axillary lymph node sampling were performed. HP result of the surgical specimens confirmed the presence of both fibroadenoma and PT, with clear margins above 1 cm, but recommended immunohistochemistry (IHC) to clearly specify benign versus borderline type. Five lymph nodes out of six resected presented microscopic reactive changes. We performed a search of literature using the keywords "giant", "benign" and "phyllodes". The results were used to summarize and discuss some of the main features of this type of tumors as well as diagnostic and therapeutic difficulties.

Clinical and Morphological Study of Single and Twin Pregnancies Placenta.

Placental morphology is very important in both single and multiple pregnancies. It can dictate certain aspects such as: fibrin depositions, calcifications, infarctions, type of vascularization, which can be directly related to placental weight and implicitly to foetal weight, both in single and twin pregnancy. Our study highlighted the macroscopic morphological aspects and through the classical and immunohistochemical colours the microscopic placental morphological aspects, both in single and in dichorionic diamniotic twin pregnancy and showed that the placenta of the foetuses from the twin pregnancy has a higher vascular density compared to the single pregnancy, and the areas of placental fusion are poor in blood vessels, but rich in fibrin depositions, calcifications and placental infarctions. We also pointed out that maternal weight can increase with age, foetal weight can be directly proportional to maternal weight, as well as placental weight is directly proportional to foetal weight and implicitly to maternal weight, but in terms of vascularization, we observed that there is an inversely proportional connection between placental, foetal weight and vascular density.

Evaluation of placental vascularization in thrombophilia and intrauterine growth restriction (IUGR).

The placenta is an essential organ in the proper development of pregnancy, and it can present a lot of structural and vascular lesions that can affect fetal development. One of the pathologies associated with pregnancy, which can change the placental structure is thrombophilia (TPh), and this can be correlated with an intrauterine growth restriction (IUGR) of the fetus. Maternal clinical aspects (age, weight) can be correlated with fetal ones (weight, gender), but also with the structural and vascular aspect of the placenta. The placental structure associated with TPh and IUGR shows macroscopic changes, such as fibrin deposition, calcifications and placental infarctions, but microscopic lesions are best highlighted by classical staining techniques: Hematoxylin-Eosin (HE), Masson's trichrome (MT) and Periodic Acid-Schiff (PAS)-Hematoxylin, but also by immunohistochemistry technique with the help of anti-cluster of differentiation 34 (CD34) antibody that could make it possible to quantify vascular density depending on the pathology. Microscopic changes were massive infarcts caused by vascular ischemia, intravenous and extravillous fibrin deposits, calcifications, and vascular thrombosis. All these clinical, morphological and morphopathological data are interconnected and may vary in the presence of TPh and IUGR.

Severe upper gastrointestinal bleeding determined by a gastric lymphoma associated with Helicobacter pylori-positive atrophic gastritis.

The pathogenesis of gastric cancer regardless of histological structure is a classic example of gene-environment interaction, and an important epidemiological aspect was the recognized association with Helicobacter pylori infection. This paper describes a case of gastric mucosa-associated lymphoid tissue (MALT) lymphoma in a young patient whose first sign of the disease was upper gastrointestinal bleeding and associated hemorrhagic shock. The patient is a 31-year-old man, diagnosed by endoscopy 10 years ago with H. pylori-positive chronic atrophic gastritis, who refused treatment to eradicate the bacterium and presents currently in the emergency room for serious upper gastrointestinal bleeding. Emergency upper gastrointestinal tract endoscopy highlights the presence of bleeding gastric tumors. It was a surgical emergency and intra-operatively the presence of invasive gastric cancer into the left hepatic lobe was noted which required total gastrectomy with the purpose of hemostasis. Immediate and remote postoperative evolution was favorable and post-operative follow-up at six months, 12 months, and 24 months showed no signs of local or distance occurrence.