Postać podskórna ziarniniaka obrączkowatego – opis przypadku i przegląd piśmiennictwa

Granuloma annulare (GA) is a chronic, idiopathic dermatosis with tendency to spontaneous resolution. GA has distinct histopathological features including collagen degeneration associated with granulomatous inflammation. It is estimated that condition affects 0.1–0.4% of dermatology patients. Subcutaneous GA is a rare variant of the disease. The authors present a case of a 3-year-old boy diagnosed with subcutaneous GA, successfully treated with local cryotherapy. Ziarniniak obrączkowaty (GA, granuloma annulare) jest przewlekłą, idiopatyczną dermatozą z tendencją do spontanicznego ustępowania. Schorzenie charakteryzuje się specyficznymi cechami histopatologicznymi, obejmującymi zwyrodnienie kolagenu ze współistniejącym ziarniniakowym stanem zapalnym. Ocenia się, że GA dotyczy 0,1–0,4% pacjentów dermatologicznych. Podskórna postać GA występuje niezwykle rzadko. Autorzy przedstawiają przypadek 3-letniego chłopca, u którego rozpoznano podskórną postać GA leczonego z powodzeniemmiejscową krioterapią

Zlokalizowana postać choroby Dariera

Localized Darier’s disease is a rare variant of the disorder, charaterized by limited extent of the skin lesions as well as the absence of ungual and mucosal changes. We present a case of an 83-year-old man with cutaneous plaques and papules in the sacral area diagnosed as a localized Darier’s disease.Zlokalizowana postać choroby Dariera jest rzadko występującym, miejscowym wariantem klasycznej postaci choroby. Charakteryzuje się ograniczeniem zmian skórnych oraz brakiem współwystępowania objawów paznokciowych i śluzówkowych. Przedstawiono przypadek 83-letniego mężczyzny, u którego obserwowane od kilkunastu lat blaszki i grudki umiejscowione w okolicy krzyżowej okazały się zlokalizowaną postacią choroby Dariera

HPV-pozytywny rak jamy ustnej - etiologia i czynniki ryzyka.

HPV oral infection is one of a etiological risk factors of oral and pharyngeal squamous cell carcinoma development. HPV-positive OSCC seems to have better prognostics and to be more susceptible to treatment than cancer with major a etiological factors being alcohol or tobacco. Therefore, qualifying a patient to an appropriate OSCC group is vital. The aim of this work is to present HPV infection risk factors, as well as the implications of such infection. This should facilitate creating awareness in this matter among the patients.Zakażenie wirusem HPV w jamie ustnej jest jednym z czynników etiologicznych rozwoju raka płaskonabłonkowego jamy ustnej (OSCC) oraz gardła środkowego. HPV (+) OSCC związany z obecnością zakażenia wirusem HPV w jamie ustnej wydaje się wiązać z lepszym rokowaniem i odpowiedzią na leczenie niż rak, którego głównymi czynnikami etiologicznymi są alkohol czy tytoń. Dlatego też bardzo istotna jest kwalifikacja pacjenta do odpowiedniej grupy. Celem tej pracy jest przedstawienie czynników ryzyka infekcji wirusem HPV oraz implikacji, jakie niesie ze sobą zakażenie. Wiedza ta ułatwi lekarzom zwiększanie świadomości pacjentów

Neural Component of the Tumor Microenvironment in Pancreatic Ductal Adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive primary malignancy of the pancreas, with a dismal prognosis and limited treatment options. It possesses a unique tumor microenvironment (TME), generating dense stroma with complex elements cross-talking with each other to promote tumor growth and progression. Diversified neural components makes for not having a full understanding of their influence on its aggressive behavior. The aim of the study was to summarize and integrate the role of nerves in the pancreatic tumor microenvironment. The role of autonomic nerve fibers on PDAC development has been recently studied, which resulted in considering the targeting of sympathetic and parasympathetic pathways as a novel treatment opportunity. Perineural invasion (PNI) is commonly found in PDAC. As the severity of the PNI correlates with a poorer prognosis, new quantification of this phenomenon, distinguishing between perineural and endoneural invasion, could feature in routine pathological examination. The concepts of cancer-related neurogenesis and axonogenesis in PDAC are understudied; so, further research in this field may be warranted. A better understanding of the interdependence between the neural component and cancer cells in the PDAC microenvironment could bring new nerve-oriented treatment options into clinical practice and improve outcomes in patients with pancreatic cancer. In this review, we aim to summarize and integrate the current state of knowledge and future challenges concerning nerve–cancer interactions in PDAC

Significance of the PIK3CA mutations in the differential diagnosis of ovarian epithelial carcinoma

Background: Ovarian carcinoma, one of the most common gynecological malignancies in Central and Eastern Europe, is characterized by a clinical and genetic heterogeneity with a distinct molecular signature for each histologic subtype. Material and methods: Here, we established the frequency of the PIK3CA mutations and amplifications in 100 FFPE tissues with the initial diagnosis of serous ovarian carcinoma. Accordingly, the diagnostic value of combining morphology with genetic and immunohistochemical testing was estimated in this cohort. Results: The PIK3CA mutations and amplifications were found in 4.1% (4/97) and 7.2% (7/97) of samples, respectively with a higher prevalence in low-grade tumors (p=0.0121). All identified variants were classified as pathogenic missense mutations, located within the PIK3CA mutational hotspots. In the light of the molecular and immunohistochemical results, two tumors with the somatic PIK3CA mutations and strongly positive expression for PI3K and hNF1β were eventually re-classified from serous to clear cell carcinomas after pathological re-evaluation. Conclusions: These findings demonstrate that the PIK3CA mutational screening facilitated establishing an accurate diagnosis of ovarian carcinomas and, more importantly, might allow for personalized treatment optimization. As the PIK3CA mutations result in the PI3K/AKT pathway deregulation, the individuals with the somatic PIK3CA variants may be eligible for personalized targeted therapies with PI3K inhibitors

Coexistence of sarcoidosis with seminoma — a case report

A 30-year-old patient, with diagnosis of seminoma (T1 Nx Mx) was treated radically with orchidectomy. In chest CT performed postoperatively numerous diffuse nodules were revealed in both lungs. Lesions were situated particularly in the upper and middle pulmonary zones. In order to verify the nature of pulmonary abnormalities videothoracoscopy of the right pleural cavity was performed with specimen collection. Histopathological examination excluded the possibility of cancer metastases to pulmonary parenchyma and revealed the presence of sarcoid-like granulomas. Coexistence of seminoma and diffuse sarcoid-like abnormalities is only sporadically described. Up till now it has not been unequivocally explained whether the pulmonary abnormalities develop in the course of idiopathic sarcoidosis or only reflect a sarcoid-like reaction to cancer antigens.Celem pracy jest przedstawienie przypadku 30-letniego chorego na nasieniaka jądra (T1 Nx Mx) leczonego operacyjnie, u którego w przebiegu choroby wystąpiły zmiany rozsiane w płucach. W badaniu tomografii komputerowej o wysokiej rozdzielczości klatki piersiowej wykonanym po zabiegu orchidektomii stwierdzono obecność licznych, rozsianych zmian drobnoguzkowych w obu płucach. W celu diagnostyki zmian płucnych wykonano wideotorakoskopię prawej jamy opłucnej. Na podstawie wyniku badania histopatologicznego pobranych wycinków wykluczono rozsiew nowotworu do miąższu płuc. Stwierdzono natomiast ziarniniaki nabłonkowato-komórkowe typu sarkoidalnego. Jednoczasowe współistnienie raka jądra oraz zmian rozsianych o typie sarkoidalnym jest opisywane sporadycznie. Rozpoznanie nie jest jednoznaczne. Nie w pełni wyjaśniono, czy tego typu zmiany w miąższu płuc powstały w przebiegu sarkoidozy, czy odzwierciedlają jedynie odczyn sarkoidalny przeciwko antygenom nowotworowym

Central nervous system autopsy — a neuropathological procedure based on multidisciplinary pathoclinical cooperation

Introduction: Neuropathological brain and spinal cord post mortem examination is a distinct procedure that still plays an important role in modern medicine. In front of increasing amounts of clinical and genetic data, together with important developments in the field of neuroimaging, the Polish Association of Neuropathologists have updated their recommendations regarding central nervous system (CNS) examination. These guidelines are aimed at neuropathologists, pathologists and clinicians.Aim of the study: Presentation of the outlined recommendations as their goal is to improve the quality, informativity, and cost effectiveness of CNS post mortem examinations. A comprehensive study of the literature was conducted to provide a clinical background of neuropathological autopsy. There are numerous open questions in neuroscience, and new strategies are required to foster research in CNS diseases. These include the challenge of organizing brain banks tasked with managing and protecting detailed multidisciplinary information about their resources. Complex neuropathological analyses of post mortem series are also important to assess the effectiveness of diagnostics and therapy, identify environmental impact on the development of neurological disorders, and improve public health policy. The recommendations outline the need for collaboration between multiple specialists to establish the proper diagnosis and to broaden knowledge of neurological disorders

Recommendations of the Polish Association of Neuropathologists on performing post-mortem examination of the brain and spinal cord

Neuropathological central nervous system (CNS) post-mortem examination is a highly specialistic element of the autopsy procedure with methodological specificity. Herein we propose updated recommendations for CNS autopsy for pathologists and neuropathologists. The protocol includes the compendium of neuroanatomy with current nomenclature, consecutive steps of gross examination, as well as appropriate sampling algorithms in different clinical and pathological settings. The significance of pathoclinical cooperation in differential diagnosis is exposed. We believe it is essential to create and promote the guidelines to improve the quality of CNS post-mortem examination at the national level