Citološka analiza urina i popratni pregled za interpretaciju i praćenje urinarnih tumora

Microscopic appearance of cells in urine cytological samples is the formal diagnostic approach adjunct to cystoscopy for the detection and follow-up of urinary tumors. However, cystoscopy is a surgical method and cytology may miss low-grade papillary tumors. Several assays and markers have been developed to assist in this. When combined with conventional cytology, uro-oncological diagnostic performance is improved. We review the value of these non-invasive modalities in comparison with urine cytomorphology in the work-up of urothelial malignancies.Pregled stanica urinarinih citoloških uzoraka mikroskopom je formalni dijagnostički pristup koji se, uz citologiju, koristi za otkrivanje i praćenje urinarnih tumora. No citoskopija je kirurška metoda, a citologiji mogu promaknuti papilarni tumori niskog stupnja. Razvijeno je nekoliko analiza i biljega koji u tome pomažu. Kada se koriste uz konvencionalnu citologiju, poboljšava se uspješnost uro-onkološke dijagnostike. Pružamo pregled korisnosti ovih ne-invazivnih modaliteta u usporedi s urinarnom citomorfologijom u analizi malignih tumora mokraćnog mjehura

Invasive Aspergillus tracheobronchitis in a patient with hairy cell leukemia and previous Plasmodium falciparum infection

Invasive Aspergillus tracheobronchitis is a relatively rare form of invasive pulmonary aspergillosis characterized by invasion of the tracheobronchial tree by Aspergillus spp. Invasive pulmonary aspergillosis is predominantly detected in severely immunocompromised patients. Notably however, pulmonary and tracheobronchial cases of invasive aspergillosis have also been reported, particularly in the context of severe malaria caused by Plasmodium falciparum. Herein, we present a case of invasive Aspergillus tracheobronchitis in a patient with hairy cell leukemia and previous Plasmodium falciparum infection

Cytological differencial diagnostic problems in ulcerative cervicitis

Ulcerative cervicitis is, like all inflammatory processes, a reaction of the cervical epithelium against damaging factors (with the formation of an exudate, protein-, WBC-, and fibrin-rich), which is accompanied by ulceration. Damaging factors can be micro-organisms (trichomonas vaginalis, herpes simplex, candida species, neisseria), iatrogenic or anatomic (biopsy, intrauterine contraceptive device-IUD-, prolapse of the uterus, cysteorthocele ) and chemical (chemotherapy). Additional causative factors are eostrogen depletion (hypoestrogenism), increased flow and alkalinity of cervical mucus, cervical ectopy and obstruction from pessaries or tampons. It may be either acute or chronic. Chronic cervicitis is of more clinicopathologic interest because it causes sterility due to abnormalities of the os, involvement of the endometrium or tubes by inflammation conveyed up from the cervix, and it is partly a risk factor for cervical intraepithelial neoplasia. Our aim is to increase the detection rate in the determination of features consistent with ulcerative cervicitis against features of Cervical Intraepithelial Neoplasia in cervicovaginal smears. We investigated the frequency of establishing a diagnosis of a simple ulcerative cervicitis by histology in a cohort of 58 females with cervical cytology suggestive of intraepithelial neoplasia. There was found a detection rate of 81,58% in the determination of ulcerative cervicitis by cytology and a rate of 100% in the determination of HPV-infection, and Cervical Intraepithelial Neoplasia grades respectively. There was no statistically significant difference between cytology and histology in the diagnosis of ulcerative cervicitis (p>0,5 chi-square). There is an overestimation of the cytological signs in the diagnosis of ulcerative cervicitis. Some of the reasons of discrepancies between cytology and histology depend on factors such as the skill of taking and interpreting the smear, the size of the lesions, the location of the lesions high up within the endocervical canal and the failure of a few lesions to shed abnormal cells. Nowadays there must be stressed the attempt of the assessment of cervicography and telecolposcopy as triage methods with the application of new parameters such as HPV DNA typing and liquid cytology in order to achieve a very high accuracy rate in cervical screening.Η ελκώδης τραχηλίτιδα είναι όπως όλες οι φλεγμονώδεις εξεργασίες μια αντίδραση του τραχηλικού επιθηλίου σε βλαπτικούς παράγοντες με τον σχηματισμό εξιδρώματος πλούσιου σε πρωτεΐνες, λευκοκύτταρα και ινική, που συνοδεύεται από εξέλκωση. Βλαπτικοί παράγοντες δυνατόν να είναι μικροοργανισμοί όπως η τριχομονάδα, ο έρπητας, οι μύκητες, η ναισσέρεια, ιατρογενείς ή ανατομικοί (λήψη βιοψίας, ενδομητρικό σπείραμα, πρόπτωση μήτρας, κυστεοορθοκήλη) και χημικοί (χημειοθεραπεία). Επιπλέον η οιστρογονοπενία, η αυξημένη ροή και η αλκαλικότητα της βλέννης, η εκτοπία του τραχήλου και η απόφραξη από κολπικά υπόθετα, αντισυλληπτικό διάφραγμα ή επίπωμα (ταμπόν). Μπορεί να είναι χρόνια ή οξεία. Η χρόνια έχει κλινικοπαθολογικό ενδιαφέρον από το γεγονός ότι προκαλεί στείρωση λόγω ανωμαλιών του στομίου, εμπλοκής του ενδομητρίου ή των σαλπίγγων στη φλεγμονώδη εξεργασία από επέκταση της φλεγμονής από τον τράχηλο, και ότι αποτελεί εν δυνάμει προδιαθεσικό παράγοντα για την ανάπτυξη ενδοεπιθηλιακής τραχηλικής νεοπλασίας. Σκοπός της μελέτης είναι η αύξηση της διαγνωστικής ακρίβειας προσέγγισης της ελκώδους τραχηλίτιδας έναντι των ενδοεπιθηλιακών τραχηλικών νεοπλασιών. Διερευνήθηκε η συχνότητα διαπίστωσης ιστολογικά της ελκώδους τραχηλίτιδας σε 58 γυναίκες με κυτταρολογικά ευρήματα ενδεικτικά ενδοεπιθηλιακής νεοπλασίας. Βρέθηκε ότι σε ποσοστό 81.58% η κυτταρολογική και ιστολογική διαπίστωση της τραχηλίτιδας συνέπιπταν, ενώ η σύμπτωση κυτταρολογικής και ιστολογικής απάντησης έφτασε το απόλυτο (100%) στις περιπτώσεις ιογενούς προσβολής του τραχηλικού επιθηλίου και ενδοεπιθηλιακής νεοπλασίας. Δεν υπήρξε στατιστικά σημαντική διαφορά μεταξύ κυτταρολογίας και ιστολογίας στη διαγνωστική προσέγγιση της ελκώδους τραχηλίτιδας (ρ>0.5, χ2 τεστ). Διαπιστώνεται μια υπερεκτίμηση των κυτταρολογικών ευρημάτων στην διαγνωστική προσέγγιση της ελκώδους τραχηλίτιδας και διαφωνία με την ιστολογική προσέγγιση σε ποσοστό 18.41%. Ως λόγοι της διαφωνίας μεταξύ κυτταρολογίας και ιστολογίας μπορούν να θεωρηθούν η επάρκεια του δείγματος, η ερμηνεία των ευρημάτων, το μέγεθος της αλλοίωσης, η εντόπιση της αλλοίωσης ψηλά στον ενδοτράχηλο και η αποτυχία κάποιων βλαβών να αποφολιδώνουν ανώματα κύτταρα. Σήμερα πρέπει να τονιστεί πως η εφαρμογή της τραχηλογραφίας και της τηλεκολποσκόπησης συνοδευόμενων από νέες τεχνολογίες, όπως η τυποποίηση DNA του ιού των θηλωμάτων (HPV), και της κυτταρολογίας υγρής φάσης επιτυγχάνεται η επίτευξη υψηλού ποσοστού διαγνωστικής ακρίβειας στην κυτταρολογική ανίχνευση των παθήσεων του τραχήλου της μήτρας

Reduction of Nitroarenes into Aryl Amines and N-Aryl hydroxylamines via Activation of NaBH4 and Ammonia-Borane Complexes by Ag/TiO2 Catalyst

In this study, we report the fabrication of mesoporous assemblies of silver and TiO2 nanoparticles (Ag/MTA) and demonstrate their catalytic efficiency for the selective reduction of nitroarenes. The Ag/TiO2 assemblies, which show large surface areas (119–128 m2·g−1) and narrow-sized mesopores (ca. 7.1–7.4 nm), perform as highly active catalysts for the reduction of nitroarenes, giving the corresponding aryl amines and N-aryl hydroxylamines with NaBH4 and ammonia-borane (NH3BH3), respectively, in moderate to high yields, even in large scale reactions (up to 5 mmol). Kinetic studies indicate that nitroarenes substituted with electron-withdrawing groups reduced faster than those with electron-donating groups. The measured positive ρ values from the formal Hammett-type kinetic analysis of X-substituted nitroarenes are consistent with the proposed mechanism that include the formation of possible [Ag]-H hybrid species, which are responsible for the reduction process. Because of the high observed chemo selectivities and the clean reaction processes, the present catalytic systems, i.e., Ag/MTA-NaBH4 and Ag/MTA-NH3BH3, show promise for the efficient synthesis of aryl amines and N-aryl hydroxylamines at industrial levels

Recurrent Cerebellar Desmoplastic/Nodular Medulloblastoma in Cerebrospinal Fluid (CSF) in the Elderly. A Cytologic Diagnosis

Desmoplastic medulloblastoma is a rare subtype of medulloblastoma in childhood and more rare in adults. Cerebrospinal fluid (CSF) occurrence is frequent and important for treatment and prognosis. We report the CSF cytologic features of recurrent desmoplastic/nodular medulloblastoma in a 30-aged male

EUS – Fine- Needle Aspiration Biopsy (FNAB) in the Diagnosis of Pancreatic Adenocarcinoma: A Review

Solid masses of the pancreas represent a variety of benign and malignant neoplasms of the exocrine and endocrine tissues of the pancreas. A tissue diagnosis is often required to direct therapy in the face of uncertain diagnosis or if the patient is not a surgical candidate either due to advanced disease or comorbidities. Endoscopic ultrasound (EUS) is a relatively new technology that employs endoscopy and high-frequency ultrasound (US). EUS involves imaging of the pancreatic head and the uncinate from the duodenum and imaging of the body and tail from the stomach. It has been shown to be a highly sensitive method for the detection of pancreatic masses. It is superior to extracorporeal US and computed tomographic (CT) scans, especially when the pancreatic tumor is smaller than 2-3 cm. Although EUS is highly sensitive in detecting pancreatic solid masses, its ability to differentiate between inflammatory masses and malignant disease is limited. Endoscopic retrograde cholangiopancreatography (ERCP) brushing, CT-guided biopsies, and transabdominal ultrasound (US) have been the standard nonsurgical methods for obtaining a tissue diagnosis of pancreatic lesions, but a substantial false-negative rate has been reported. Transabdominal US-guided fine-needle aspiration biopsy (US-FNAB) has been used for tissue diagnosis in patients with suspected pancreatic carcinoma. It has been shown to be highly specific, with no false-positive diagnoses. With the advent of curvilinear echoendoscopes, transgastric and transduodenal EUS-FNAB of the pancreas have become a reality EUS with FNAB has revolutionized the ability to diagnose and stage cancers of the gastrointestinal tract and assess the pancreas. Gastrointestinal cancers can be looked at with EUS and their depth of penetration into the intestinal wall can be determined. Any suspicious appearing lymph nodes can be biopsied using EUS/FNAB. The pancreas is another organ that is well visualized with EUS. Abnormalities such as tumors and cysts of the pancreas can be carefully evaluated using EUS and then biopsied with FNAB. There are many new applications of EUS using FNAB. Researchers are looking to deliver chemotherapeutics into small pancreatic cancers and cysts. Nerve blocks using EUS/FNAB to inject numbing medicines into the celiac ganglia, a major nerve cluster, are now routinely performed in patients with pain due to pancreatic cancer. The aim of this study is to perform a review of the literature regarding the usefulness of EUS/FNAB in the diagnosis of pancreatic adenocarcinoma

Cytology of Pericardial Effusion due to Malignancy

Background. Malignant pericardial effusion occurs in one tenth of all cancers. It is a very serious disorder that is mainly a secondary process due to metastasis because primary neoplasms of the pericardium such as mesotheliomas, sarcomas being exceedingly rare