[Diagnosis of micrometastases of alveolar rhabdomyosarcoma].

Alveolar rhabgomyosarcoma is a highly malignant, small blue cell pediatric soft tissue tumor. Identification of micrometastases in alveolar rhabdomyosarcoma is important because the poor prognosis associated with this subgroup necessitates a modified therapeutic regimen. Since the obtained lymph node specimen can be very small; rhabdomyosarcoma cells are not easily detected using conventional histological methods. To assess the value of myogenin staining in the diagnosis of micrometastases in alveolar rhabdomyosarcoma, the authors examined 36 lymph nodes from children bearing this tumor. Occult tumor cells were detected in 8 cases. The PAX3/7-FKHR gene fusion that resulted from chromosomal translocation in alveolar rhabdomyosarcoma provided potential molecular diagnostic markers. Reverse-transcriptase polymerase chain reaction (RT-PCR) was used to develop an assay capable of identifying RAX3/7-FKHR positive cells in the fresh lymph nodes. Thirty-six lymph nodes were examined and of them 17 lymph nodes had PAX3/7-FKHR fusion transcripts of alveolar rhadomyosarcoma cells. The study demonstrates that molecular RT-PCR detection of micrometastases is the most sensitive method for diagnosing alveolar rhabdomyosarcoma.

[Gastrointestinal stromal tumor of the esophagus].

The paper describes a rare case of a stromal tumor of the esophagus in a 68-year-old male who was initially diagnosed as having esophageal leiomyoma after biopsy and study of a surgical material. Stromal tumour could be diagnosed by immunohistochemical (positive expression of oncomarkers; CD117, CD34, vimentin, CD99, and GFAP) and molecular genetic (real-time PCR) studies. This case confirms that it is necessary to use an immunohistochemical study in patients with spindle-cell tumors of the gastrointestinal tract.

[Immunohistochemical diagnosis of metastases of small round cell carcinomas with undetected primary focus].

17 small round cell tumors of unkown primary site were studied. The main location was lymph nodes and brain. Immunohistochemical study was performed. One of the following diagnosis was obtained in 14 cases (82.4%): small cell carcinoma, Merkel cell carcinoma, melanoma, Ewing sarcoma family tumor. In other three cases (17.6%) tumor histogenesis was not determined definitively.

[Thymidylate synthase, thymidine phosphorylase and dihydropyrimidine dehydrogenase expression in soft-tissue sarcoma versus capecitabine potential].

Expression of thymidylate synthase (TS), thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) can predict for clinical outcome of fluoropyrimidine-based therapy and there is every likelihood that relevant tumors will respond. High TP expression was observed in 35 (42%) patients with soft-tissue sarcoma. Seven out of 26 (27%) such patients revealed molecular phenotype prognostically favorable for capecitabine therapy. More clinical research is required to assess the efficacy of capecitabine-based therapy.

[Monophasic synovial sarcoma: comparison of immunohistochemical and ultrastructural phenotypes and problems of differential diagnosis].

Diagnostics of monophasic synovial sarcoma is highly complicated mostly due to a wide range of cellular and histologic variation. This calls for use of additional examination techniques such as immunohistochemical and electron microscopic.

[Thermoradiochemotherapy of inoperable soft-tissue sarcoma].

Three groups of patients with inoperable soft-tissue sarcoma received preoperative radiotherapy (57), thermoradiotherapy (102) and thermoradiochemotherapy (16) (n=175). Five year recurrence-free survival in group 1 was 37+/-7%, group 2 48+/-6%, and group 3 - 56+/-1,7%. Patients survived 5 years and more in group 3 (60+/-2%), group 2 - 50+/-7%, and group I 44+/-8% (p>0.05). Local hyperthermia used in conjunction with radio- and chemoradiotherapy was followed by a significant rise in the rate of complete and partial tumor regression.

[Immunohistochemical characterization of biphasic synovial sarcomas].

An immunohistochemical investigation of 12 primary biphasic synovial sarcomas was carried out. Highly frequent expression of vimentin, EMA and pan-cytokeratin (cytokeratin AE1/AE3) and low frequency of collagen type II and VI expression in the extracellular matrix of tumors were estallished.

[Expert system for the diagnosis of thyroid neoplasms]. / Ekspertnaia sistema dlia gistologicheskoi diagnostiki opukholei shchitovidnoi zhelezy.

An original computer program designed to help in histological diagnosis of thyroid tumours is presented. The literature is given on the use of computer technologies in current morphology.

[Molecular-biological markers as prognostic factors in breast cancer of I-IIA stage]. / Molekuliarno-biologicheskie markery kak faktory prognoza pri rake molochnoi zhelezy I-IIA stadii.

The study of molecular-biological markers for prediction of recurrence-free survival in breast cancer stage I-IIA demonstrates that high expression of thymidilate synthetase and high maximal density of microvessels are prognostically effective and that the prognosis is influenced by expression of both Bcl-2 and Bax. Low recurrence-free survival was observed in Bcl-2-/Bax patients (31%, median 44 months) while such survival was high in Bcl-2+/Bax patients (86%, median was not reached). The findings can be used for prognostication of a breast cancer clinical course.

[Formalized macroscopic description and computer analyser of macroscopic image (as illustrated by gastric pathology)]. / Formalizovannoe makroskopicheskoe opisanie i komp'iuternyi analizator makroskopicheskogo izobrazheniia (na primere issledovaniia patolodii zheludka).

A computer analyzer is regularly used in the department of pathology in formalized macrodescription of the stomach. Advantages of this method are described.

[Cranial bone neoplasm in early triassic amphibia]. / Novoobrazovanie pokrovnykh kostei chereepa rannetriasovoi amfibii.

A neoplasm in cranial bone of an early Triassic amphibian has been investigated. Although no tissue has survived, the cranial flat bone is similar to that in living animals of the same class. Evidence is presented in support of a hypothesis that the neoplasm is a skeletal tumor which consists of non-functional bone and looks like an atypical tumorous bone of skeletal origin. It was identified as a parostotic osteosarcoma on the basis of macro- and microscopic and X-ray examination.

[Basic directions in pathologoanatomic diagnosis of human tumors]. / Osnovnye napravleniia v patologoanatomicheskoi diagnostike opukholei cheloveka.

The paper deals with basic lines in the development of oncomorphology, such as electron microscopy, immunohistochemistry, and telepathology. Under the present conditions, a pathologist's capacities to diagnose tumors and to elucidate their histogenesis are shown to be greatly expanded due to advances in genetics, immunology, and a number of other biological disciplines. Introduction of methods of molecular pathology can establish a relationship of multiple primary tumors of the similar histological structure of both nodes, predict a disease, and define drug tumor sensitivity. The above shows an increasing role of pathologists in diagnosis and choice of treatments in cancer patients. The author presents his experience in these areas as a practical cancer pathologist at the Department of Pathology, N. N. Blokhin Russian Cancer Research Center, Russian Academy of Medical Sciences.

Renal angiomyolipoma extending into the right atrium.

Renal angiomyolipomas (AMLs) are benign renal tumors that may possess the features of a malignant neoplasm, such as local and vascular invasion. We describe the diagnosis and management of a rare case of AML associated with tumor thrombus extending into the right atrium.

[Molecular biological and clinical-morphological studies of gastric tumors associated with Epstein-Barr virus]. / Molekuliarno-biologicheskoe i kliniko-morfologicheskoe issledovaniia opukholei zheludka, assotsiirovannykh s virusom Epshteina-Barr.

The paper presents the results of the studies of gastric cancer (GC) associated with Epstein-Barr virus (EBV) among the patients residing in 4 geographical regions. In situ hybridization (ISH) techniques revealed that 49(11.4%) of the 430 examinees were EBV positive (EBV+), the virus-specific marker mRNA-1 of EBV, EBER-1) was found to be present in 80-100) of tumor cells. The proportion of EBV(+)-associated GC cases in different geographic regions ranged from 7.3 to 15%. These tumors were predominant in males (15%) as opposite to females (5.5%). Histological types most common among EBV+ tumors and their location in the stomach are also described. Serological findings indicated that the increased anti-EDV antibody response in 70% of GC cases coincided with the presence of the viral genetic information detected by ISH. In contrast to a humoral response to EBV, a humoral response to Helicobacter pylori was equal both in patients with EBV(+)- and EBV(-)-associated gastric tumors. Further molecular biological analysis of EBV isolates from virus positive and virus negative GC may answer the question whether there are really the so-called tumor and non-tumor variants of EBV.

[Formalized cytological report in oncology]. / Formalizovannoe tsitologicheskoe zakliuchenie v onkologii.

A formalised report (FR) offers a set of standard phrases to be used to state (1) whether findings of a cytologic study contain new information; (2) the degree of certainty in understanding the significance of morphological forms of available international classifications of a pathology said morphological evidence is compatible with. The use of that FR provides a means of evaluating reported cytologic conclusions, and comparing them with relevant postmortem diagnosis. This makes it possible to ascertain with greater or less certainty, with which nosological forms a doctor deals. It is also a means of inspection over the way materials are sampled and processed at a particular cytological laboratory as well as evaluation of its general standards. The main advantage of introduction of FR is that it is unambiguous and can be computer processed.

[Detection and characterization of gastric carcinoma associated with epstein-barr herpes virus]. / Obnaruzhenie i kharakteristika opukholei zheludka, assotsiirovannykh s virusom gerpesa épstein-barr.

The present investigation was carried out to estimate the incidence of Epstein-Barr virus (EBV)-associated cases among gastric carcinoma (GC) patients in Russia. Carcinoma specimens from 184 patients with GC treated at the Cancer Research Center were investigated by EBV encoded RNA-1 (EBER-1) in situ hybridization. Seventeen (9.24%) cases showed uniform EBER-1 expression restricted to the carcinoma cells. Hybridized signals were not detected in the non-neoplastic gastric epithelium. EBV involvement was significantly more frequent among males, especially in the tumors belonging to less differentiated types (moderately differentiated tubular adenocarcinomas and poorly differentiated solid adenocarcinomas) and located in the upper stomach (cardia and middle part). Most EBV-positive GCs were characterized by great lymphoid compartment involvement. The findings of the distribution of EBV-positive. GCs by sex, site, and histology are similar to those in Japan; however, the detection rate of EBV-positive cases in Russia is higher than that in Japan (6.7%) and lower than that in the USA (16%).

[Feasibilities of cytological diagnosis in the static telepathology mode]. / Vozmozhnosti tsitologicheskoi diagnostiki v staticheskom rezhime telepatologii.

Results of cytological diagnosis in the static telepathology mode are analyzed. Three expert cytologists made the diagnosis on the basis of images of cytological preparations obtained from 94 patients with tumors of soft tissues and bones. A total of 113 diagnoses were correct: benign or malignant type of the tumor and its histological type were identified. In general, a total of 152 (88.9%) diagnoses were correct as regards their significance for treatment strategy. Errors classified as groups 3 and 4 were the most significant (erroneous assessment of tumor type--benign or malignant--in 6.4% cases). Analysis of discrepancies between cytological and pathoanatomical diagnoses and data of routine optic microscopy of similar cytological preparations of the same material (bone and soft tissue tumors) showed the same value: 6.8% of cytological and pathoanatomical diagnoses were at disagreement (groups 3 and 4 of errors). Therefore, telepathology can be resorted to for consultations and discussion of obscure cases. It is particularly important for a morphologist to discuss complex cases by means of telepathology at a specialized institution, distant from him or her.