Rare case of Richter's syndrome localization in liver and thyroid of a patient with a chronic lymphocytic leukemia (CLL) - Case report and literature.

Richter's syndrome (RS) is a rare complication in which chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL) transforms into a more aggressive type of lymphoma - diffuse large B cell lymphoma (DLBCL), or Hodgkin's lymphoma (HL). The review describes the clinical case of a patient with CLL and RS diagnosis. A computed tomography (CT) scan of the abdominal cavity detected numerous normodense areas in the liver. Simultaneously, ultrasound examination (USG) of the thyroid revealed the presence of a solid hypoechogenic lump. The material sampled from closed biopsies of liver and thyroid in both cases allowed the diagnosis of diffuse large B cell lymphoma (DLBCL). The liver and the thyroid are particularly rare locations of RS. However, those cases allowed the conclusion that RS may occur even in a very unexpected and less probable location.

Anterolateral thigh free flap in reconstruction of lateral skull base defects after oncological resection.

PURPOSE: Evaluation of the utility of the free anterolateral thigh flap reconstruction of the defects resulting from radical temporal bone resection in the management of lateral skull base malignancies in a single institution. METHODS: An analysis of 17 en bloc subtotal petrosectomies for removal of malignant tumours was performed. There were 12 squamous cell carcinomas, 4 basal cell carcinomas and 1 adenoid cystic carcinoma. The tumours were staged with the University of Pittsburgh TNM system. In all patients, the lateral temporal bone with the preservation of the petrous apex and carotid artery was performed. All patients had parotid gland resection. The post-resection defect was reconstructed with an ALT free flap. RESULTS: Tumour radical resection and defect reconstruction with an ALT flap was achieved in all patients without intraoperative complications. The transplants were harvested as fasciocutaneous flaps, 11 perfused by musculocutaneous and 6 by septocutaneous perforators. The ALT flaps had a mean pedicle length of 8 cm (6-12 cm), and the flap size ranged between 6 × 15 cm and 15 × 30 cm. The flaps were supplied by nine facial, five occipital and three maxillary arteries. Recipient-site veins included eight internal jugular, seven facial, one retromandibular and one external jugular vein. All arterial pedicles were anastomosed in an end-to-end manner. The veins were anastomosed with interrupted sutures and in 11 cases with Synovis-Coupler® devices. All the flap transfers were performed successfully. Three patients experienced postoperative complications. CONCLUSIONS: The ALT flap proved to be effective for covering large temporal skull base defects resulting from the radical removal of temporal bone malignancies. The functional and cosmetic results were acceptable with a low complication rate.

The diagnostic quality of needle brain biopsy specimens obtained with different sampling methods - Experimental study.

The aim is to examine whether brain tissue samples obtained through needle biopsy are better for histopathological evaluation when obtained with defined vacuum pressure, a novel needle rotation method, and using different needle type - Laitinen or Nashold. Moreover the paper aims to answer the question: Does vacuum and mechanical injury resulting from different sampling methods damage the tissue specimen challenging the diagnosis?. Eight hundred biopsy specimens from fresh swine brains were obtained using Nashold and Laitinen brain biopsy needles through inner cannula cutting or needle rotation sampling at vacuum pressure, from 0 to 0.06 MPa. The specimen weight and tissue quality for microscopic assessment were evaluated using the Mair score. Rising aspiration pressure increased the biopsy sample weight. Needle rotation delivered larger biopsy samples than the standard method. Laitinen provided larger samples than the Nashold needle, with the same sampling method or vacuum pressure. A higher histopathological diagnostic quality of tissue was obtained with the Laitinen needle than with Nashold, with higher vacuum pressure than lower pressure and finally with needle rotation than the standard method. No tissue damage caused by higher suction pressure or method of tissue separation was documented. Brain tissue samples obtained through needle biopsy are better for histopathological evaluation when obtained with higher vacuum pressure, a novel needle rotation method and with Laitinen needle. Higher suction pressure and sampling methods did not cause tissue damage.

Management of Radiation Induced Carotid Stenosis in Head and Neck Cancer.

OBJECTIVES: Presentation of radiation-induced lesions in carotid arteries of patients with head and neck squamous cell carcinoma (HNSCC) and the evaluation of the effectiveness of endovascular treatment of symptomatic stenoses. MATERIALS AND METHODS: We retrospectively analyzed 26 patients who underwent surgery and subsequently cervical radiotherapy (RT) for HNSCC, focusing on radiation-induced vascular disease in neck arteries-from the latency period to the occurrence of neurological events-and the endovascular treatment of the internal carotid artery (ICA) and/or of common carotid artery (CCA) stenoses. The vascular lesions were diagnosed with Doppler ultrasonography and selective digital angiography. Patients with >70% stenoses of ICA and/or CCA were scheduled for carotid artery stenting (CAS). They were followed-up with neurological examinations and Doppler ultrasonography at 6, 12, and 24 months after stenting. RESULTS: Radiation-induced vascular diseases occurred in the ICA in 22 patients (85%), CCA in 15 (58%), and in ECA in 15 (58%). The stents were implanted in 25 ICA and 17 CCA. Thirteen patients (50%) had one stent, eight (30%) had two stents, four (15%) had three stents, and one patient had five stents. Overall, 46 stents were implanted. Technical success was achieved in all patients. No cerebrovascular events occurred in the 24-months follow-up. CONCLUSION: RT in patients with HNSCC holds a significant risk factor of developing carotid artery stenosis and cerebrovascular events. Carotid stenting is preferable mode of treatment for radiation-induced stenosis. A screening program with doppler ultrasonography enables pre-stroke detection of carotid stenosis.

Subpopulations of natural killer-T-like cells before and after surgical treatment of laryngeal cancer.

INTRODUCTION: Tumours connected with head and neck comprise about 5% of all tumours. The most frequent histological type of laryngeal carcinoma is squamous cell carcinoma. Different research projects suggest that the role of T lymphocytes might be significant in tumour development. iNKT cells are a new subpopulation of T cells and show cytotoxic activity against tumours. iNKT cells participate in modulating the function of other cells which have anti-tumour properties and secrete cytokines, which have pro-inflammatory and anti-inflammatory effects. In animal models the significance of iNKT cells in various diseases including cancer was shown. AIM OF THE STUDY: The aim of this study was to determine the percentages of iNKT cells, CD161+ cells, CD161- cells, iNKT CD4+ cells, and iNKT CD8+ cells, NK cells, NKT-like cells, and T cells subsets present in peripheral blood of patients with laryngeal cancer before and two months after the tumour resection, in comparison to healthy volunteers. MATERIALS AND METHODS: This study included material from laryngeal patients who were treated at the Department of Otolaryngology and Laryngological Oncology (Medical University of Lublin) between 2012 and 2013. A total of 50 patients (40 men and 10 women) aged between 45 and 77 years (median age: 60 years) were enrolled. Based on the TNM classification, the patients were classified as having stage I-IV laryngeal cancer. The control group was composed of 15 healthy volunteers (12 men and three women) aged between 43 and 82 years (median age: 61 years). The protocol of the study was approved by the Local Bioethical Committee at the Medical University of Lublin.Peripheral blood samples (15 ml) from the basilic vein were collected by venipuncture using sterile, sodium heparin-treated tubes (20 units per ml of blood) and used for cytometric analyses. RESULTS: iNKT cells were analysed among T CD3+ cells. The percentage of CD3+ and CD3+CD4+ T cells before tumour resection was higher than in the control group, but the increase of CD3+ T cells was not significant. The T CD3+CD4+ / T CD3+CD8+ cell ratio was significantly higher than in healthy donors. After tumour resection a decreased percentage of CD3+CD4+ T cells but an increased percentage of CD8+CD3+T cells was noted. The T CD3+CD4+ / T CD3+CD8+ cell ratio was significantly higher in patients before and after the surgery than in the control group. The amount of NKT-like cells increased after resection and was significantly higher than in the control group. CONCLUSIONS: Our study exhibited the change in percentage of iNKT, NK, NKT-like cells, and T lymphocytes after tumour resection in patients with laryngeal cancer. The research explains the contribution of those cells in immunological response against tumour.

The percentage of iNKT cells among other immune cells at various clinical stages of laryngeal cancer.

INTRODUCTION: Invariant natural killer T (iNKT) cells constitute a small population of immune cells that share functional and phenotypic characteristics of T lymphocytes and NK cells. Due to their involvement in specific and non-specific immune responses, iNKT cells may represent an important component of antitumor and anti-infectious immunity. MATERIAL AND METHODS: Using flow cytometry, we analyzed the percentages of iNKT cells as well as T and B lymphocytes in peripheral blood of 50 laryngeal cancer patients at various clinical stages in comparison to healthy controls (n=15). Moreover, we determined the expression of CD25, CD69 and CD95 antigens on T lymphocytes. RESULTS: The percentage of CD4+/CD3+ T lymphocytes in the controls was higher than in laryngeal cancer patients, both with early and late stages of the disease. The percentage of CD8+/CD3+ T lymphocytes in healthy controls was lower than in patients with early and late clinical stages of laryngeal cancer. Patients with advanced laryngeal cancer showed a lower percentage of iNKT cells and higher frequencies of T regulatory cells (Tregs) than the controls. Advanced clinical stages of laryngeal cancer are associated with impaired activation of lymphocytes. CONCLUSIONS: Our study confirmed that laryngeal cancer cells exert a strong suppressor effect on the immune system of the host. This is reflected by a decrease in the percentage of iNKT cells that are capable of cancer cell elimination, and a concomitant increase in the percentage of Tregs. However, further studies are needed in order to explain the underlying mechanisms of immunosuppression and understand interactions between immune and cancer cells.

[Retroperitoneal perforation of duodenum - surgical approach]. / Zaotrzewnowa perforacja dwunastnicy - postEpowanie chirurgiczne.

Retroperitoneal perforation of the duodenum, caused by abdominal trauma, endoscopic examination or diverticulitis, is a serious clinical problem, because of it's lack of specific symptoms. Surgical treatment is often performed in sepsis. That is why the knowledge of adequate techniques is crucial for surgeons. We would like to present our model of surgical approach, based on several trauma center's cases. Among the methods and techniques presented we emphasize the duodenal by-pass with bile duct drainage. Post-op cases of gastrojejunal anastomosis' bleeding prompt to implement a selective vagotomy, which however requires further studies.

[Importance of donor site vascular imaging in free fibula flap reconstruction]. / Znaczenie diagnostyki obrazowej unaczynienia miejsca pobrania w planowaniu rekonstrukcji wolnym platem strzalkowym.

INTRODUCTION: Free fibula flap is widely used in head and neck reconstruction. Imaging studies of the donor site can reveal vascular abnormalities and therefore prevent acute leg ischemia. AIM: Evaluation of the role of donor site vascular imaging studies for free fibula flap planing. MATERIAL AND METHODS: Out of 35 free flap reconstructions performed in Otolaryngology Head and Neck Surgery Department in Medical University in Lublin in 2011-2012, there were 10 fibula flaps. Each patient had preoperative lower leg subtraction angiography performed. RESULTS: Lower leg angiography revealed vascular abnormalities in two out of 10 patients scheduled for free fibula flap transfer. One had dominant peroneal artery and second occlusion of anterior tibial artery. In both cases fibula was harvested from the other leg. CONCLUSIONS: Imaging studies reveal lower leg vascular abnormalities in 20% of cases thus facilitate surgical plans alternations and prevent serious complications in free fibula flap patients.

External and middle ear diseases: radiological diagnosis based on clinical signs and symptoms.

OBJECTIVE: Pathology of the external and middle ear is the most frequent reason to prescribe antibiotics and perform surgery in children and young adults. In the majority of cases imaging studies are not performed; the need for imaging comes when complications are suspected or when treatment is not effective. This paper discusses indications for temporal bone imaging studies and presents the most frequent pathological conditions, together with differential diagnosis, clinical symptoms and methods of treatment. METHODS AND RESULTS: This pictorial review describes major external and middle ear diseases, with special regard to clinical findings and appropriate reporting. CONCLUSIONS: Apprehension of the complete clinical picture, together with imaging clues, narrows differential diagnosis and helps avoid mistakes. Evaluation of temporal bone pathologies requires close cooperation between the clinician and radiologist.

Head and neck cancer: value of perfusion CT in depicting primary tumor spread.

BACKGROUND: The aim of this study was to assess head and neck squamous cell cancer and surrounding tissue in computed tomography contrast enhanced and perfusion studies, and to examine the role of perfusion imaging in depiction of tissue infiltration. MATERIAL/METHODS: We prospectively evaluated 43 primary malignant head and neck tumors, using standard CT followed by perfusion. Blood flow, blood volume, mean transit time, and permeability values were obtained using regions of interest (ROIs) over lesions and surrounding tissue. Results were compared with histological analysis of resected tissue. Sensitivity, specificity, accuracy, positive and negative predictive values were calculated for both methods. RESULTS: We found significant differences between infiltrated and non-infiltrated tissue, especially with regard to muscles. In case of bone and salivary gland infiltration, change in perfusion parameters did not allow proper diagnosis. CONCLUSIONS: CTP shows promise in depicting malignant infiltration. The combined use of CECT plus CTP results in correct staging of the majority of head and neck tumors.

[Epistaxis in Rendu-Osler-Weber disease treated with selective embolization--case report]. / Leczenie krwawienia z nosa w przebiegu choroby Rendu-Oslera-Webera za pomoca wybiórczego zamkniecia naczyn metoda embolizacji--opis przypadku.

Hereditary hemorrhagic telangiectasia (HHT), known as well as Osler-Weber-Rendu syndrome (ORW disease) is autosomal dominant inheritance disease with the worldwide prevalence of 1 case per 5000-10000 population. The pathophysiology of the disease consists of disorders in the growth and migration of endothelial cells, which leads to telangiectasias and arterio-venous malformations (AVM) development. Vascular abnormalities can form in various organs. The most frequent locations are nose and mouth mucous membranes, as well as the rest of GI tract, skin, lungs, urinary system and central nervous system. The most common symptom is reccurent epistaxis (80-90% of patients). Advanced stage disease can result in extensive bleeding with dicrease in hemoglobin levels. Unfortunately, the only available treatment options for Osler-Weber-Rendu syndrom fight the symptoms, not the essential cause, and because of the rarity of the disease there are no guidelines for effective therapy. We are presenting a case of a patient suffering from recurrent episodes of nose bleeding due to hereditary hemorrhagic telangiectasia, who was successfully treated using low-invasive, intravascular arterial embolisation in interventional radiology department.

Epistaxis in patients with hereditary hemorrhagic telangiectasia treated with selective arterial embolization.

BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is a rare systemic fibrovascular dysplasia also known as Rendu-Osler-Weber disease. Epistaxis is often the first and foremost symptom of the disease and recurrent epistaxis is the main complaint. PURPOSE: Evaluation of effectiveness and safety of endovascular treatment of epistaxis in HHT patients. MATERIAL AND METHODS: Between June 2004 and January 2008, 14 patients with HHT underwent embolization of external carotid artery (ECA) branches due to severe epistaxis. There were eight men and six women aged 27-42 years. Patients were referred for endovascular treatment when primary management with electrocautery and nasal packing was ineffective. Arteries suspected of bleeding were catheterized super-selectively with micro-catheters to perform embolization. Polyvinyl alcohol particles (PVA) or embospheres in diameter of 500-700-µm were used as an embolic material. RESULTS: Embolization was technically successful in 11 (78.5%) patients. Immediate, complete control of bleeding was achieved in 12 (85%) patients. During long-term follow-up recurrent nasal bleeding occurred in six (43%) patients 6-24 months after treatment. There were no severe complications after embolization. Nine patients experienced mild facial pain which resolved within three days after the treatment. Three patients in whom arterial spasm was observed, suffered from facial paraesthesia lasting for 3-5 days after embolization. Out of 14 patients, 12 were available for 24-month follow-up evaluation. All except one claimed reduction in frequency and severity of epistaxis which had a positive impact on their quality of life. CONCLUSION: Endovascular embolization of epistaxis in patients with HHT is an effective and safe procedure although it cannot provide a long-term cure in most cases. Embolization reduces the frequency, severity and duration of nasal bleeding in patients with HHT, improving patients' quality of life.

Evaluation of cervical lymph nodes with CT perfusion in patients with hypopharyngeal and laryngeal squamous cell cancer.

BACKGROUND: In patients with head and neck squamous cell cancer, metastases in cervical lymph nodes still remain the single most important negative predicting factor. Their presence reduces overall 5-year survival by 50%. The aim of the study was to evaluate the role of computed tomography perfusion (CTP) for differentiation between metastatic and non-metastatic cervical lymph nodes in patients with squamous cell cancer of hypopharynx and larynx. MATERIAL/METHODS: This was a prospective single center study of 18 consecutive patients. Eleven patients with squamous cell cancer of the hypopharynx and seven patients with laryngeal cancer underwent CT examination of the neck followed by CTP. Group II, III, and V of lymph nodes were evaluated. Perfusion maps of basic parameters (blood flow [BF], blood volume [BV], mean transit time [MTT] and permeability surface [PS]) were reconstructed for all patients. In all patients resection of primary tumour along with neck dissection was performed. Lymph nodes underwent histopathological examinations for presence of metastases. CTP parameters were related with histological analysis of resected nodes. RESULTS: CTP and histological findings of 65 nodes were correlated. 24 of them were metastatic and 41 were non-metastatic. Metastatic nodes showed significant hyperperfusion, comparing to non-metastatic ones. An average value of BF in metastatic nodes was 136.4 ml/100 g/min, BV was 7.7 ml/100 g, MTT was 4.4 s and PS was 19.4 ml/100 g/min. The average values for non-metastatic nodes were: BF was 80.7 ml/100 g/min, BV was 4.7 ml/100 g, MTT was 5.6 s and PS was 12.8 ml/100 g/min. The differences were significantly higher for BF, BV and PS values (p<0.05). CONCLUSIONS: CTP may be useful in differentiation between metastatic and non-metastatic lymph nodes, based on evaluation of the value of BF, BV and PS.

Computed tomography perfusion examination is helpful in evaluating the extent of oropharyngeal and oral cavity cancer.

BACKGROUND: Squamous cell cancer (SCC) of the head and neck, like other malignancies, should be reported with regard to TNM classification and treated accordingly. Sole anatomic imaging has its drawbacks, as early lesion detection often remains challenging, non-neoplastic processes can mimic malignancies and there are doubts concerning the extent of tumour. The purpose of this study was to perform assessment of head and neck squamous cell cancer and surrounding tissue, in order to examine the relationship between perfusion measurements derived from CT perfusion imaging (CTP) and histologic evaluation of resected tissue. MATERIAL/METHODS: We prospectively evaluated 21 primary SCC of the oral cavity and oropharynx, using contrast enhanced CT of the head and neck followed by CTP examination at the level of tumour. Blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability (PS) values were calculated with use of manually drawn regions of interest (ROIs) over the lesions and on the contralateral side. Results were compared with histologic analysis of resected tissue. RESULTS: CTP was possible in all twenty one patients, but one did not undergo surgery. Of the remaining twenty, four had retromolar trigone cancer, nine had tongue cancer and seven had tonsil cancer. We found significant differences between infiltrated and healthy tissue. Differentiation was most reliable by using blood flow (BF), permeability surface (PS) and blood volume (BV). CONCLUSIONS: CTP shows promise in distinguishing benign and malignant processes, primarily by means of BF, BV and PS.

Late caecal fistula after laparoscopic appendectomy managed mini-invasively - case report.

Laparoscopic appendectomy is being performed increasingly, worldwide. The laparoscopic approach is associated with a lower complication rate and a shorter period of disability but some major complications still occur. We present a case of a 22-year-old woman who underwent laparoscopic appendectomy for acute appendicitis. In 3 weeks time after surgery, after physical activity the patient presented acute abdomen. Exploratory laparoscopy revealed peritonitis caused by caecal fistula. Laparoscopic lavage and drainage of the peritoneal cavity with formal caecostomy was performed. The postoperative course was uneventful. The stoma was closed in 6 months' time without other complications. In our opinion laparoscopy is proven to be a safe and good option for diagnostics and treatment of some complications of appendectomy.

Evaluation of tracheal stenosis: comparison between computed tomography virtual tracheobronchoscopy with multiplanar reformatting, flexible tracheofiberoscopy and intra-operative findings.

The aim of the study was to evaluate and compare various helical CT display modes [virtual endoscopy (VE)] and multiplanar reformations (MPR), conventional flexible tracheobronchoscopy (FT) and intra-operative (IO) findings in patients with tracheal stenosis and to analyze the advantage of MPR and VE in diagnosis and treatment planning and in postoperative follow-up. Thirty-seven patients with tracheal stenosis underwent standard neck and chest CT followed by MPR and VE. Results were correlated with the results of FT and IO findings. Thirty-three of the 37 stenoses were correctly graded and measured adequately using VE. Complete correlation among CT, fiberoptic tracheoscopy, and surgery of stenosis grading, stenosis length and length of planned resection segment of the trachea was noted between 33 of 37 patients with tracheal stenosis. Correlation between VE and IO was noted in 35 of 37 patients and between FT and VE was noted in 33 of 37 patients with tracheal stenosis. The sensitivity of VE was 94-97%, specificity was 100% with comparison to IO findings. The sensitivity and accuracy of MPR was 86-89% and specificity was 100% with comparison to FT findings. The results of the study indicate that VE is an excellent, consistent, and objective technique. VE with MPR is very useful in diagnostic evaluation and treatment planning in patients with tracheal stenosis.

[Evolution of views on surgical treatment of gastroesophageal reflux disease and hiatal hernia]. / Ewolucja pogladów na chirurgiczne leczenie choroby refluksowej przelyku i przepuklin rozworu przelykowego.

This year it has been 90 years since the first hiatal hernia repair was performed (Soresi, 1919). Nowadays surgeons' approach to operational treatment has changed as a result of development of more precise imaging techniques, better understanding of physiology and pathology of gastroesophageal reflux disease (GERD), invention of effective medicines and alternative endoscopic procedures. Complications and discomfort in patients during a follow-up resulted in evolution of surgical methods. Close co-operation between surgeons and gastroenterologists and interchange of experiences among surgeons have allowed establishing general algorithm for therapeutic and preoperational management. It seems crucial for further defining of surgical management of hiatal hernia and reflux disease to have at least basic knowledge on previous medical views on GERD. Another reason for taking the subject is epidemiology, oncological prophylaxis and quality of life improvement in patients with reflux disease. It has been proven that the most effective way of operational treatment of GERD is creating with the liberated gastric fundus a full "floppy" wrap around the lower esophagus. The procedure is completed with narrowing of esophageal hiatus. In cases of impaired esophageal motor activity the partial (180 degrees) posterior fundoplication is widely used. In hiatal hernias, particularly of type II or paraesophageal hernias, the diaphragmatic defect can be repaired with surrounding tissues or, when large, with a synthetic mesh.

[Current methods of ventral hernias repair]. / Wspólczesne metody leczenia przepuklin brzusznych.

Hernioplasty is the most common procedure performed on surgical wards. The golden standard among the different techniques of hernia repair is the usage of mesh. It resulted in the reduction of recurrences below 1% of primary repairs. Usage of the artificial material results in less numbers of recurrences which is 1% less than primary repairs. The aim of this article was to review contemporary opinions on repair operations of an abdominal hernia. Appropriate documentation and publications were reviewed in this area. We presented the usage of new techniques in ventral hernioplasty including laparoscopic approach and the intraperitoneal usage of mesh. The presentation was based on references and our experience. Conclusions regarding the lack of treatment standards and superiority of usage of the artificial materials method were formulated accordingly.

[Transpalatal approach for juvenile angiofibroma]. / Dojscie przez podniebienie do naczyniakowlókniaka mlodzienczego.

INTRODUCTION: Juvenile nasopharyngeal angiofibromas (JNA) are highly vascular, locally invasive tumours which originate in the sphenopalatine foramen. Several surgical approaches are described for this tumour. The aim of this study was to evaluate the transpalatal approach for juvenile angiofibroma. MATERIAL AND METHODS: In a group of 22 patients with JNA transpalatal approach was employed. A retrospective patients notes review was done. Extension of tumour, complications of surgery and recurrences were analyzed. RESULTS: In 17 patients the tumour was confined to the nasal cavity and the nasopharynx. In 5 patients the tumour invaded the sphenoid sinus. No complications were observed after surgery. Two (9%) patients had recurrence. CONCLUSION: Transpalatal approach is best suited to small tumours (Andrews grade I and II) limited to the nasopharynx, nasal cavity and sphenoid sinus.

Application of primary cell cultures of laryngeal carcinoma and laser scanning cytometry in the evaluation of tumor reactivity to cisplatinum.

Unsatisfactory effects of treatment of laryngeal carcinoma patients stimulate the clinicians as well as researchers to develop new more effective treatment models and to find new reliable prognostic factors. The aim of the present study was the evaluation of the use of primary cell cultures of the laryngeal carcinoma and laser scanning cytometry (LSC) in the assessment of tumor reactivity to cisplatinum. Nineteen primary cultures of laryngeal carcinoma cells established from fragments of laryngeal carcinoma infiltrations were cultured with or without cisplatin, stained with monoclonal antibodies against P53 and BCL-2 proteins and analyzed by LSC. Cisplatin added to the culture medium leads to the significant increase of P53 expression and decrease of BCL-2 expression. Moreover, changes of P53 and BCL-2 expressions were significantly correlated. Our findings of apoptosis regulatory mechanisms could be useful in patient qualification for the chemotherapeutic follow-up treatment.