Periacinar clefting and p63 immunostaining in prostatic intraepithelial neoplasia and prostatic carcinoma

The aim of the present study was to correlate the presence and extent of retraction clefting and the expression of p63 in neoplastic glands and glands with prostatic intraepithelial neoplasia (PIN) in needle core biopsies. We analyzed needle core biopsies from 28 patients with PIN and 41 patients with adenocarcinoma. Neoplastic glands and those with PIN were analyzed on high power field (400x) and classified in three groups according to the extent of clefting. Immunohistochemical staining was performed following Microwave Streptavidin ImmunoPeroxidase (MSIP) protocol on DAKO TechMate Horizon automated immunostainer. Periacinar retraction clefting was significantly more prominent in prostatic carcinoma compared to PIN (p<0.0001) and nonneoplastic glands (p<0.0001). There was no difference between normal glands and PIN regarding clefting (p=0.8064). p63 was positive around the whole circumference in 12 out of 28 cases with PIN, and discontinuously positive in remaining 16 PIN cases suggesting initial disruption of the basal cell layer. p63 immunostaining was also positive in all nonneoplastic glands, and negative in all carcinomas. We conclude that retraction clefting was associated with cancer and lack of basal cells, but not with PIN. The relationship between clefting and p63 immunostaining in prostatic cancer should be further analyzed

Different types of atrophy in the prostate with and without adenocarcinoma

OBJECTIVES: The purpose of this study was to evaluate, according to a classification proposed by a working group, the extent and type of atrophy lesions in radical prostatectomy specimens obtained from patients with prostatic carcinoma and benign prostatic hyperplasia (BPH), and to compare the prevalence and types of atrophy between two investigated groups. ----- METHODS: Histologic analysis of 1096 slides from 50 patients with carcinoma and 277 slides from 31 patients with BPH was performed to evaluate, according to the new prostatic atrophy classification, the number of foci and type of atrophic lesions. ----- RESULTS: Age, Gleason grade, and TNM showed no significant correlation with the number of proliferative atrophy (PA) and proliferative inflammatory atrophy (PIA) foci (p>0.05). PIA was significantly more frequent in prostates with carcinoma (1.63 vs 1.27 atrophic lesions per slide) (p<0.001), whereas PA displayed an increased frequency in BPH (2.28 vs 0.76 atrophic lesions per slide) (p<0.001). ----- CONCLUSIONS: We confirmed that PA and PIA are common findings in prostates with and without carcinoma, but the question of whether inflammation produces tissue damage and PA or whether some other insult induces the tissue damage and atrophy directly, with inflammation occurring secondarily, is still unresolved

Intraoperacijska biopsija: zahtjevan dijagnostički postupak na odjelu za kiruršku patologiju

Frozen section (intraoperative biopsy) is one of the most important and most difficult procedures that a pathologist performs during his/her practice. It is performed daily at most pathology departments and requires experience, the capacity to make quick decisions under pressure, the knowledge of clinical medicine, and awareness of the limitations of the method. The aim of the study was to determine the number of frozen sections according to surgical departments and diagnoses at Surgical Pathology Division of the Ljudevit Jurak University Department of Pathology, Sestre milosrdnice University Hospital in Zagreb, during the 1998-2004 period. Data were retrieved from the Thanatos program for data archiving, analyzed and divided according to departments (ENT, general surgery, neurosurgery, urology, gynecology, and others) and diagnoses (benign tumor, malignant tumor, other conditions and description). During the 1998-2004 period, the relative frequency of frozen sections rose steadily from 6.25% in 1998 to 7.78% in 2004 (p<0.001). A statistically significant increase was noticed in the number of intraoperative biopsies from the departments of neurosurgery (p<0.001), urology (p<0.001), gynecology (p<0.01) and other departments (p<0.001), while the number of intraoperative biopsies from the surgical department decreased significantly (p<0.001). The difference in the number of intraoperative biopsies from ENT department was not significant. The diagnosis of benign tumors was significantly more frequent in 1998 than in 2004 (p<0.05), and so was the diagnosis of metastases (p<0.001). The number of descriptive answers was significantly higher in 2004 (p<0.001), but the difference in the number of diagnosed malignant tumors and other conditions was not significant. The number of samples examined on frozen section ranged from 1 to 14, the mean number of samples being 1.2 to 1.8. The number of routine, paraffin embedded biopsies that rose through the analyzed period was followed by the increased number of frozen sections. The significant increase in the relative frequency of descriptive diagnoses could mainly be attributed to the intraoperative examination of lymph nodes that proved to be free from tumor.Intraoperacijska biopsija je jedan od najvažnijih i najtežih dijagnostičkih postupaka koje patolozi poduzimaju tijekom svog rada. Na većini odjela za patologiju ona se izvodi svakodnevno. Cilj rada bio je utvrditi broj intraoperacijskih biopsija i na njima postavljenih dijagnoza na Kliničkom zavodu za patologiju «Ljudevit Jurak», Kliničke bolnice «Sestre milosrdnice» u Zagrebu, tijekom razdoblja od 1998. do 2004. godine. Za analizu podataka uporabljen je program za pohranjivanje i obradu podataka iz patologije «Thanatos». Podaci su podijeljeni s obzirom na kirurški odjel (ORL, opća kirurgija, neurokirurgija, urologija, ginekologija i ostali) te s obzirom na postavljenu dijagnozu (dobroćudni tumor, zloćudni tumor, ostala stanja, metastaze i opis). Tijekom razdoblja od 1998. do 2004. broj intraoperacijskih biopsija se neprekidno povećavao, s relativnom učestalošću od 6,25% u 1998. do 7,78% u 2004. godini (p<0,001). Značajan porast broja intraoperacijskih biopsija je opažen s neurokirurgije (p<0,001), urologije (p<0,001), ginekologije (p<0,01) te ostalih odjela (p<0,001), dok se broj intraoperacijskih biopsija s odjela opće kirurgije značajno smanjio (p<0,001). Razlika u broju intraoperacijskih biopsija s odjela ORL između 1998. i 2004. godine nije bila značajna. Dijagnoza dobroćudnog tumora postavljena je 1998. značajno češće nego 2004. (p<0,05), kao i dijagnoza metastaza (p<0,001). Broj opisnih dijagnoza u 2004. je bio značajno veći, no razlika između broja dijagnoza zloćudnog tumora i ostalih stanja nije bila značajna. Broj rutinskih biopsija u proučavanom razdoblju bio je praćen povećanim brojem intraoperacijskih biopsija

Ne-melanomski tumori i predtumorske promjene u periodu od 1996. - 2002. Godine

Non-melanoma skin cancers and precancerous skin lesions have a significant morbidity although with relatively low mortality rates in geriatric population. These lesions developed especially on every day sun exposed skin regions. The aim of this study was to determine the prevalence, age and sex distribution of non-melanoma skin cancers and precancerous skin lesions among biopsy specimens collected during seven years (1996-2002) in the University Department of Pathology "Ljudevit Jurak". Also is analyzed their relationship with sun exposure on different body regions. During observed period there were2486 basal cell carcinoma, 419 squamous cell carcinoma and 468 precancerous skin lesions. Basal cell carcinoma was more common in males then in females with ratio 1:0,9 as well as squamous cell carcinoma with male to female ratio 1:0,8. Precancerous skin lesions were more frequent in the female population with male to female ratio 1:1,3. Maximal incidence for booth types of non-melanoma tumours was between 7and 79 years in both sexes while precancerous skin lesions appeared one-decade earlier. Also is found that analyzed skin lesions appear in 60-70% on skin of the head, which is almost permanently sun exposed body region.Nemelanomski tumori kože i predtumorske kožne promjene imaju značajan pobol iako uz nisku smrtnost u pacijenata treće životne dobi. Ove promjene se posebno razvijaju na dijelovima kože koji su svakodnevno izloženi suncu. Cilj ovog rada je prikazati učestalost, razdiobu po spolu i dobi nemelanomskih kožnih tumora i predtumorskih kožnih promjena u bioptičkom materijalu sedmogodišnjeg razdoblja (1996-2002) na Zavodu za Patologiju "Ljudevit Jurak". Također je proučavan odnos kožnih promjena i izloženosti različitih dijelova tijela suncu. U proučavanom periodu bilo je 2486 karcinoma bazalnih stanica, 419 karcinoma pločastih stanica i 468 predtumorskih kožnih promjena. Karcinom bazalnih stanica češće je bio prisutan u muškaraca nego u žena s omjerom 1:0.9 kao i karcinom pločastih stanica s omjerom 1:0,8. Predtumorske kožne lezije bile su češće prisutne kod žena, omjer muškaraca prema ženama bio je 1:1,3. Najveća učestalost za oba nemelanomska kožna tumora bila je između 70 i 79godina starosti u oba spola dok se predtumorske promjene nalaze desetljeće ranije. Proučavane kožne promjene u 60-70% nađene su na koži glave koja je skoro stalno suncu izloženo područje tijela