Tumor growth fraction, expression of estrogen and progesterone receptors, p53, bcl-2 and cathepsin D activity in primary ductal invasive breast carcinoma and their axillary lymph node metastases.

The aim of this paper is to determine similarities and differences between tumor cell subclones in cases of ductal invasive breast carcinoma, and which occupy primary tumor and local axillary lymph metastases. The tumor growth fraction evaluated by Ki-67 was analyzed along with the expression level of estrogen and progesterone receptors, protein p53, proto-oncogene protein bcl-2 and cathepsin D in 60 patients. Metastatic lymph node in axilla has a higher growth fraction of the tumor cells than the primary tumor (p = 0.045), as well as the higher level of bcl-2 overexpression (p = 0.014). No statistically significant difference was found in the presence of immunohistochemically identified estrogen receptors (p = 0.161) and progesterone receptors (p = 0.081) between the primary tumor and the metastatic lymph node in axilla. Likewise, no difference was found between the immunohistochemical evaluation of p53 (p = 0.356) and cathepsin D activity (p = 0.928). A higher growth fraction of the tumor cells and the higher level of bcl-2 overexpression in metastatic tumor cells indicate the more aggressive cell subclones. This study does not support the routine testing of both primary tumor and locoregional metastasis to evaluate the breast cancer hormone receptor status.

[Lung lesions in penetrating war injuries of the chest]. / Ozljede pluca kod ratnih penetrantnih trauma prsnog kosa.

Presentation is made of 157 patients with lung parenchymal lesions due to penetrating war injuries of the chest, 50.3% civilians and 49.3% soldiers. The wounds were mostly inflicted by cluster projectiles (71.4%), followed by firearms (25.5%) and sharp instruments (3.1%). The injuries were characterized as a combination of laceration and lung contusion. In case of lung laceration, a moderate to massive hemopneumothorax develops. Clinically, the manifestation of lung contusion may range from hardly observable dyspnea and hemophthisis through tachypnea, tachycardia and cyanosis. Most lesions of pulmonary parenchyma can be managed by thoracic drainage, whereas in case of massive bleeding and air loss thoracotomy and appropriate operative procedures are recommended. We used anterolateral thoracotomy as a sparing procedure, which involves minimal thoracic wall disintegration. When deciding on the choice of surgical procedures for the lesions of pulmonary parenchyma, care was taken to ensure to maximally spare the intact parenchyma. Minor resections (sutures, atypical resection, segmentectomies) were performed in 92%, whereas major resection (lobectomy, pulmectomy) had to be performed in 8% of thoracotomized patients. Rethoracotomy was done in two patients due to postoperative hemorrhage. The patient submitted to pulmectomy because of the hilus vasculature lesion died after the surgery. Early resuscitation, volume and blood replacement, rapid diagnosis, and early surgical intervention are the crucial factors that influence survival in patients with lung lesions due to penetrating injuries of the thorax.

Trichinella spiralis and breast carcinoma--a case report.

Authors report about a patient with recurrent ductal invasive breast carcinoma and trichinosis. The patient underwent mastectomy of the left breast with evacuation of the axilla because of the cancer. Radiation therapy was received. An infestation with Trichinella spiralis was diagnosed two years after The patient was treated with mebendazole. A local recurrence of the tumor was found on the chest wall six years after the surgery. Tumor excision was performed. Histological analysis pointed at a ductal invasive carcinoma with numerous parasites of Trichinella spiralis present within both the muscle and the tumor tissue. The finding of parasites in the tumor tissue witnesses in favor of infestation, and the parasite morphology preserved in the tumor shows at the protective effects of the cysts, i.e. preventing parasite necrosis.

"Signet-ring" cell invasive lobular carcinoma of the breast - accidental finding associated with intraductal papilloma: a case report.

BACKGROUND: A 57-year old woman had only unilateral milky dischardge of the right breast. Clinical and mammography findings were normal. CASE PRESENTATION: Cytological diagnosis of intraductal papilloma was established which was galactographically confitmed and patient underwent to surgery. Ductulolobular segmentectomy was made. Histopathologically beside intraductal papilloma numerous single dispread malignant "signet ring" cells in the fibrous retromammilary stroma were found. Imunohistochemically findings were: cytokeratin 8 positive, ER H-score 80, PR H-score 50, HER-2/neu negative. Diagnosis of "signet ring" cell lobular invasive carcinoma was made, followed by mastectomy, axillary limphadectomy and contra lateral breast biopsy. CONCLUSION: Residual tumor were found only in the breast tissue, while axillary lymph nodes and contra lateral breast biopsy were negative. Patient underwent to oncology therapy.