RESUMO
BACKGROUND: The detectability of adrenal incidentalomas (incidentally found adrenal tumours) in the whole population is estimated at 0.1%; 0.42% in non-endocrine patients and at 4.3% in oncologically diagnosed ones. Even up to 16% of incidentalomas of adrenal glands can be malignant lesions. The issue of crucial importance is the histopathological differentiation between benign lesions and malignant tumours of the adrenal cortex and medulla. OBJECTIVES: To evaluate whether the immunohistochemical analysis of the expression of p53, p21, PCNA and Ki67 in the tumour's tissue can be useful in the histopathological diagnostics of adrenal incidentalomas and whether it is important for prognosis. MATERIAL AND METHODS: Our series consisted of 74 tumour samples from 164 patients operated for incidentalomas. There were 43 cortical adenomas, 11 cortical adrenocarcinomas and 20 PHEOs (including 5 malignant lesions). Using monoclonal antibodies, the expression of p53, p21, PCNA and Ki67 was evaluated. RESULTS: We found a statistically significant correlation between the expression of p53, p21, Ki67 and the differential diagnosis of adrenal cortical adenoma and adrenocortical carcinoma (for proteins: p53 p=0.010, for p21 p=0.010, for Ki67 p<0.001). The statistical significant correlation between PCNA protein and diagnosis of adrenal cortical adenoma and adrenocortical carcinoma was not found. The statistically significant correlation between p21, PCNA proteins and the diagnosis of benign and malignant PHEOs was not estimated. There was no expression of Ki67 or p53 protein above the assumed level in benign and malignant pheochromocytomas. The statistically significant correlation between p53, p21, PCNA or Ki67 and the occurrence of metastases in adrenocarcinoma and malignant PHEOs was not found.
Assuntos
Adenoma/patologia , Neoplasias das Glândulas Suprarrenais/patologia , Feocromocitoma/patologia , Adenoma/genética , Neoplasias das Glândulas Suprarrenais/genética , Regulação Neoplásica da Expressão Gênica , Humanos , Imuno-Histoquímica , Antígeno Ki-67/genética , Feocromocitoma/genética , Antígeno Nuclear de Célula em Proliferação/genética , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteína Supressora de Tumor p53/genética , Quinases Ativadas por p21/genéticaRESUMO
Autoimmune chronic hepatitis is a clinical syndrome of unknown aetiology with serious prognosis. The disease poses also important problems. During 4 years 11 children with autoimmune chronic hepatitis were observed, among them 10 girls and 1 boy aged from 8 to 16 years. The diagnosis was based on histological examinations, clinical symptoms and biochemical investigations. In all cases the level of gamma-globulin was raised over 20 g/l, with increased concentrations of immunoglobulin G and bile acids, and increased A1AT activity. Abnormal results of the antipyrin test were found in 4 children, and presence of tissue antibodies was demonstrated in 8 children. All children were treated with prednisone. After 2 years of treatment control histological examinations were done in 5 cases. Despite the use of glycocorticosteroids full remission was not obtained in any case. This observation agrees with literature data indicating that autoimmune chronic hepatitis is a long-standing process leading to cirrhosis.
Assuntos
Doenças Autoimunes/diagnóstico , Hepatite/diagnóstico , Adolescente , Autoanticorpos/análise , Doenças Autoimunes/tratamento farmacológico , Criança , Doença Crônica , Feminino , Hepatite/tratamento farmacológico , Hepatite/imunologia , Humanos , Fígado/imunologia , Testes de Função Hepática , Masculino , Prednisona/uso terapêuticoRESUMO
In this paper we present a 10-year-boy with viral giant-cell hepatitis with a immune component. We observed clinical, biochemical and histological improvement after treatment.
Assuntos
Hepatite/diagnóstico , Bilirrubina/sangue , Criança , Hepatite/fisiopatologia , Humanos , Imunoglobulina G/sangue , Fígado/fisiopatologia , Masculino , Tempo de Protrombina , gama-GlobulinasRESUMO
In this paper we describe liver-related Wilson's disease in two sisters. The elder died of liver failure. Our patient, a 13-year old girl has hepatitis C coinfection. Gradual improvement was observed after Cuprenil, Zincteral and interferon (Intron A).
Assuntos
Hepatite C/complicações , Degeneração Hepatolenticular/complicações , Adjuvantes Imunológicos/uso terapêutico , Adolescente , Feminino , Hepatite C/tratamento farmacológico , Degeneração Hepatolenticular/fisiopatologia , Humanos , Interferon-alfa/uso terapêutico , Fígado/fisiopatologia , Penicilamina/uso terapêutico , Sulfatos/uso terapêutico , Compostos de Zinco/uso terapêutico , Sulfato de ZincoAssuntos
Aberrações dos Cromossomos Sexuais/diagnóstico , Trissomia , Feminino , Humanos , Lactente , Cariotipagem , Cromossomo XRESUMO
In the light of a retrospective analysis of 213 case records of infants with urinary tract infections, hyperbilirubinemia was disclosed in 19 cases. In 7 cases jaundice was the main cause of admission of these children to the hospital. It was observed mainly in the youngest age group up to 3 months. Jaundice was hemolytic in some cases and hepatic in others. Urinary tract malformations had no effect on the frequency of jaundice in urinary tract infection or on its intensity.