A mini-review regarding the carcinogenesis and morphology of serous tumors of the ovary, fallopian tube and peritoneum

Similar to the already well-recognized adenoma-carcinoma sequence in colorectal cancer pathogenesis, it has been believed for many decades that the progression of ovarian epithelial tumors occurs from benign serous cystadenomas to borderline tumors, to well-differentiated carcinomas, and ultimately, to poorly differentiated carcinomas. However, it is currently accepted that low-grade serous carcinoma (LGSC) and high-grade serous carcinoma (HGSC) are fundamentally different tumor types and, consequently, different diseases. In fact, whereas the benign-borderline-malignant sequence seems to apply quite well to low-grade serous carcinoma, the sequence of genetic alterations in high-grade serous carcinoma is substantially different. In this mini-review, we included the current consensus regarding the morphological and etiopathogenic results regarding serous tumors of the ovary, fallopian tube and peritoneum. It also briefly describes the history of benign, borderline and malignant serous tumors, discussing multiple types of dichotomies in serous carcinomas of the female genital tract and summarizing the current molecular classification

Intra et parasellar chordoma: Case report

A rare case of giant intra and parasellar chordoma, mimicking a pituitary prolactinoma is presented. The tumor involving pituitary fossa and surrounding structures was removed via a bifrontal approach. The pathology exhibited the typical histological patterns of a chordoma. The authors present a rare case of a giant sellar and parasellar chordoma and review the literature on that

Rezultate preliminare privind depistarea infecţiilor hemotransmisibile la utilizatorii de droguri injectabile

Articolul de faţă este dedicat evaluării nivelului de infectare cu HVB, HVC, HTLV 1/2, HSV 1/2, EBV şi CMV în rândul narcomanilor ce practică consumul de droguri intravenoase. S-a utilizat metoda descriptivă de studiu pe perioadă 2015-2016. Prin metoda ELISA au fost diagnosticaţi serurile a 141 de utilizatori de droguri la markerii HVB, HVC, HTLV 1/2, HSV 1/2, EBV şi CMV. Toţi aceşti markeri au fost identificaţi în mod individual şi în asociere. S-a constatat, că 56,0% sunt pozitivi pentru markerii hepatitei virale, 13,5% pentru anti-HTLV 1/2, 91,7% au avut un rezultat pozitiv pentru anti-HSV 1 IgG şi 19,1% pentru anti-HSV 2 IgG, EBV a fost găsit în 92,6%, anti-CMV în 100,0%. Aşadar, rezultatele obţinute arată concordanţa situaţiei din Republica Moldova cu alte ţări şi sugerează necesitatea continuării acestui studiu, în scopul de a dezvolta metode eficiente de monitorizare a acestei infecţii

High-grade versus low-grade serous carcinoma of the ovary – current differential diagnosis and perspectives

Introduction. Serous carcinoma is responsible for 47% of all ovarian cancers, and from these cases, only 5% are represented by low-grade serous carcinoma, the rest of them accounting for high-grade serous carcinoma. Objective. The aim of this study is an observational approach of the differences and similarities of the two types of serous carcinoma of the ovary, that must be seen as different forms of cancer and rendered with care. Methods. We performed a retrospective study using three cases of ovarian high-grade serous carcinoma and three cases of ovarian low-grade serous carcinoma, diagnosed at the University Emergency Hospital Bucharest. We analyzed patients’ age, clinical symptoms, macroscopic and microscopic features together with immunohistochemistry tests. Results. Mean age for HG carcinoma was 71.3 years old and for LG carcinoma 47.6 years old. Average tumor diameter was with 5.67 cm higher for LG carcinoma. The most encountered stage for HG tumors was pT2a and for LG tumors was pT1a. Mean value for Ki67 was with 36.33% higher for HG carcinoma. AR expressed diffuse positivity in two cases of LG and only focal positivity in two cases of HG. CD44 expressed focal positivity in all cases of LG and had different patterns in HG. Conclusions. We found considerable differences between patients’ mean age, macroscopic and microscopic features, together with immunohistochemistry expression for Ki67, AR, CD44

Hepatita virală B la lucrătorii medicali din Republica Moldova

În studiul realizat s-a demonstrat, că seroprevalenţa markerului AgHBs la lucrătorii medicali în Republica Moldova constituie 11,8%, iar la anti-HBcor (sum) – 19,5%. Nivelul protector de anti-HBs (≥10 UI/ml) s-a demonstrat la 58,6% din numărul total de lucrători medicali investigaţi, cea mai mică valoare s-a înregistrat la vârsta de 61 ani şi mai mult (16,7±15,2%). Aceste date justifică faptul, că personalul medical necesită o doză booster de vaccin contra hepatitei virale B la 10 ani după vaccinarea primară. Totodată, seroprevalenţa markerilor anti-HBs concomitent cu anti-HBcor s-a demonstrat în 31,3±5,0% cazuri.

Bilateral breast carcinoma – a study of patients admitted in a university emergency hospital

Introduction. Breast carcinoma represents the leading cause of oncologic mortality among women worldwide. Bilateral breast carcinoma is a distinct pathologic entity, with particular prognostic and therapeutic implications. Objective. The objective of the study was to determine the histologic and immunohistochemical characteristics of patients with bilateral breast carcinoma admitted in a university emergency hospital from Bucharest, Romania. Materials and methods. We analyzed breast carcinoma specimens registered as bilateral in the Department of Pathology of the University Emergency Hospital, Bucharest, Romania, between 2015‑2017, and studied their histologic and molecular features in the clinical context obtained from our hospital database. Results. All the analyzed patients were postmenopausal women. The extent of time between the diagnosis of the first and second tumor varied in metachronous cases from 8 months to 7 years. In the majority of cases, the bilateral breast lesions shared histologic, grading and hormone expression similarities. Conclusions. Bilateral breast carcinoma is a rare entity that needs more histologic parameters to be defined as primary or metastatic

Seroprevalence of viral hepatitis B, C and E in TB patients from the Republic of Moldova

Introduction. For the first time, in the Republic of Moldova, there was established the seroprevalence of viral hepatitis B, C and E markers in patients with tuberculosis depending on gender, age and geographical areas. Material and methods. 200 blood samples were collected from patients with tuberculosis and tested by the immuno-fermentative method for presence of viral hepatitis B, C and E markers. Results. Following the investigations, it was established that the seroprevalence of the anti-HEV Ig marker in patients with tuberculosis is 12.0±2.3%. The seroprevalence of viral hepatitis B marker HBsAg in patients with tuberculosis was 13.5±2.4%, and that of viral hepatitis C anti-HCV – 9.0±2.0%. The study of investigations results for the presence of nominated markers depending on the geographical areas showed a significant statistically difference in the seroprevalence of the anti-HEV IgG marker in TB patients in the Central area of the country compared to the Southern area(p<0.05). Conclusions. Patients with tuberculosis have a higher risk of developing viral hepatitis B, C and E, mainly affecting people aged 40-49 and > 60 years, including males

Clinico‑morphological aspects and new immunohistochemistry characteristics of ovarian high‑grade serous carcinoma

Introduction. High‑grade serous carcinoma of the ovary is an aggressive form of cancer, with unknown precursor lesions and often delayed diagnosis because of non‑specific, mild symptoms. Objective. We performed a clinical‑pathological study of ovarian high‑grade serous carcinomas, in order to evaluate morphological and new immunohistochemistry characteristics of this malignancy. Methods. This is a retrospective study of 10 cases of ovarian high‑grade serous carcinoma. We evaluated patients’ age, symptoms at presentation, macroscopic aspects, bilateral involvement, microscopic features: papillary/solid areas, mitotic index, psammoma bodies, tumoral extension, lymph node metastasis, immunohistochemistry markers: CD44, ER, AR, Ki67 index. Results. Mean age was 56.9 years old. Tumors were bilateral in 50% of cases. Only 30% were limited to the ovary. Maximum tumor diameter was 16 cm. Solid component in a proportion of 50‑95% was more characteristic. Most tumors had a mitotic index of 30‑50 mitosis/10HPF (70% of cases). 20% of cases contained psammoma bodies. 2 cases out of 7 had lymph node metastasis. We noticed one case with pleural metastasis (M1). We observed AR80% was noticed in 30% of cases. CD44 was positive in 50% of cases and one case had diffuse positivity of CD44 in corpus luteum cells near the tumoral bed. Conclusions. The majority of patients with ovarian high‑grade serous carcinomas presented with extraovarian extension and were characterized by high mitotic index, rare presence of psammoma bodies, AR expression <10%, novel marker CD44 positive in 50% of cases and curious positivity in corpus luteum cells associated with the tumor

The clinical importance of PD‑L1 and PD‑1 expression in diffuse large B cell lymphoma

Introduction. The target pathway programmed cell death‑1 (PD‑1)/ programmed death‑ligand 1 (PD‑L1) shows clinical efficacy in solid tumors, but also in Hodgkin’s and non‑Hodgkin’s lymphoma. PD‑L1 expression most often correlates with a poor prognosis and a PD‑1 regulatory factor that mediates immunosuppression. The presence of an increased number of tumor‑infiltrating lymphocytes (TILs) PD‑1 + is a favorable prognostic factor in patients with diffuse large B cell lymphomas (DLBCLs) and follicular lymphomas, while the low number of TILs PD‑1 + is associated with an increased risk of histological transformation. In DLBCLs, TILs PD‑1 + may not reflect the depletion of T‑mediated tumor cells but may be an indicator of lymphoid cell origin. Objectives. The objective of this study was to describe the correlation between PD‑1 and PDL‑1 with survival in patients with the diagnosis of diffuse large B cell lymphoma. Material and methods. We have studied 80 patients and we have analyzed DLBCLs according to the Hans algorithm; in addition, we analyzed PD‑1 and PD‑L1 in tumor cells and in immune cells and we correlated this data with patient’s survival. Results. We found that there is a tendency of decreased survival and therapeutic response in DLBCL patients, with both an intense and weak PD‑L1 positivity in tumor cells. PD‑1 low positivity was associated in higher percentage with relapse and treatment unresponsiveness. Conclusions: Our data suggested that PD‑L1 expression correlates with a poor clinical response although it is not an independent prognostic marker and PD‑1 represents a favorable prediction factor for survival

BETA-CATENIN – AN IMPORTANT IMMUNOHISTOCHEMICAL TOOL IN STRATIFYING ENDOMETRIAL CARCINOMAS?

Introduction. Recent research has demonstrated that the immunohistochemical nuclear -catenin expression is a valid surrogate for CTNNB1 exon 3 mutation in endometrial carcinomas (ECs). This mutation is an independent prognostic factor which identifies a subgroup of low-grade endometrial carcinomas that have a tendency for recurrence and worse prognosis. The objective of the study was to evaluate nuclear -catenin expression in different molecular subgroups of E Cs. Material and methods. We tested immunohistochemical nuclear -catenin expression in 50 cases of endometrial carcinomas diagnosed in two clinical institutions. Statistical analysis was performed between -catenin expression and various clinical, demographic, pathological and immunohistochemical parameters (age, myometrial invasion, FIGO grade, histopathological subtype, hormone receptors – ER, PR etc). Additionally, we analysed what molecular subgroup of ECs (MSS, MSI, p53wt, p53abn) revealed the most frequent cases with -catenin expression. Results. Our study indicated that ECs with nuclear -catenin positivity were observed in cases with higher FIGO grade (p=0.02), in endometrioid carcinomas (p=0.04) and in cases with lympho-vascular invasion (p=0.05). ER and PR were frequently expressed in the positive -catenin subgroup (p=0.03, p=0 .02). Our results show that ECs which express nuclear -catenin correlate with parameters that are already considered unfavourable. Conclusions. mmunohistochemical -catenin nuclear expression is an excellent replacement for the CTNNB1 exon 3 mutation in ECs and helps to stratify and predict prognosis in certain cases of ECs. We believe that future research will include this marker as part of the routine immunohistochemical panel for ECs