[Spontaneous rupture of kidney tumor. Successful surgical treatment].

A clinical case of spontaneous rupture of the kidney lesion that occurred after physical exercise is presented in the article. During the examination (ultrasound, multi-slice computed tomography of the kidneys), the diagnosis was unclear, and therefore, the patient underwent surgical treatment. Given the risks of complications and impossibility to exclude the malignancy, a decision was made to perform nephrectomy. The diagnosis was clear cell adenocarcinoma. We consider the prompt nephrectomy in this clinical situation as a success.

Stress protein Hsp27 expression predicts the outcome in operated small cell lung carcinoma and large cell neuroendocrine carcinoma patients.

PURPOSE: Heat shock protein (Hsp)27 is overexpressed in a range of human cancers and is implicated in tumor cell proliferation, differentiation, invasion, metastasis, and survival. The aim of the present study was to determine the prognostic significance of Hsp27 expression in small cell lung carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC). METHODS: Surgically resected SCLCs (N=51) and LCNECs (N=15) were studied. The Hsp27 expression was detected immunohistochemically. RESULTS: Hsp27 positive immunoreaction in the cytoplasm was observed in 45 (88%) SCLCs and 14 (93%) LCNECs. A combination of cytoplasmic with nuclear Hsp27 expression was observed in 28 (62%) SCLCs and 14 (100%) LCNECs. There was a correlation between Hsp27 cytoplasmic overexpression and Hsp27 nuclear expression with patient survival confirmed by Cox multivariate analysis. CONCLUSION: We conclude that the higher Hsp27 cytoplasmic expression and nuclear expression may represent favorable prognostic factors in SCLC and LCNEC.

Contrast-enhanced Chest Ultrasound in the Control of Transthoracic Tru-cut Needle Biopsies: A Case Report.

INTRODUCTION: The current article presents a clinical case of ultrasound controlled transthoracic tru-cut needle biopsy of a small metastatic lesion in the left lung, performed with contrast-enhanced ultrasonography (CEUS). The following case demonstrates a real-time interventional manipulation of a very small lesion, which was done under local anesthesia, with a minimal invasion to the patient. CASE PRESENTATION: A 72-year-old woman is presented, hospitalized for a left-sided pleural effusion with bilateral, multiple nodulеs of different sizes in the lungs. Thoracentesis revealed data for atypical cells in the pleural fluid. The CT scan suspected a probable neoplastic process, but the subsequently performed fiberbronchoscopy couldn't prove the existence of the same. The final diagnosis was established after ultrasound controlled transthoracic tru-cut needle biopsy of a pulmonary lesion with the application of a contrast medium. CONCLUSION: The CEUS allows precise detection of the metastatic area because of its unique perfusion characteristics and ability to remain hypocontrasted after the application of the contrast medium sulfur hexafluoride. The persistence of a concomitant left-sided pleural effusion is used as an ultrasound window during the performance of the manipulation, with the successful verification of the pathology as primary pulmonary adenocarcinoma. By the application of this minimally invasive manipulation, an accurate final histological result was obtained.