36 research outputs found
COVID-19 i dijagnostika tumora prostate u KBC-u Zagreb
The aim of this study was to compare the number of biopsy and surgical procedures
on prostate, as well as the number of newly diagnosed, histologically confirmed cases of prostate cancer
during the COVID-19 pandemic at Zagreb University Hospital Center (UHC). We retrospectively
collected and processed a total of 1344 histopathologic findings of the prostate at the Zagreb UHC. Our
results show that during the COVID-19 pandemic, there was a statistically significant decrease in the
absolute number of biopsy and surgical procedures on prostate at Zagreb UHC, and so was the number
of newly diagnosed, histologically confirmed cases of prostate cancer. During the observed time of the
pandemic (March 19, 2020 to December 31, 2020), there was a 37.5% decrease in the absolute number
of newly diagnosed prostate cancer cases compared to the same period of the previous year (March 19,
2019 to December 31, 2019). To our knowledge, this is the first study of this kind that is based on the
number of prostate cancer diagnoses in Croatia. By observing the early period of the pandemic, our
results provide important guidelines for monitoring and understanding the long-term consequences of
the pandemic on the prostate cancer morbidity and mortality.Cilj ovoga istraživanja bio je usporediti broj biopsijskih i kirurŔkih zahvata na prostati, kao i broj novodijagnosticiranih,
patohistoloÅ”ki potvrÄenih sluÄajeva karcinoma prostate tijekom pandemije COVID-19 u KliniÄkom bolniÄkom centru
Zagreb. Retrogradno smo prikupili i obradili ukupno 1344 patohistoloÅ”kih nalaza prostate na KliniÄkom zavodu za
patologiju i citologiju KBC-a Zagreb. NaÅ”i rezultati pokazuju da je tijekom pandemije COVID-19 doÅ”lo do statistiÄki
znaÄajnog pada apsolutnog broja biopsijskih i kirurÅ”kih zahvata na prostati, kao i broja novodijagnosticiranih, patohistoloÅ”ki
potvrÄenih sluÄajeva karcinoma prostate. UoÄen je pad apsolutnog broja novodijagnosticiranih karcinoma prostate za 37,5%
u promatranom vremenu pandemije (od 19. ožujka do 31. prosinca 2020. godine) u odnosu na isto razdoblje u prethodnoj
godini (od 19. ožujka do 31. prosinca 2019. godine). Prema naŔim spoznajama ovo je prvo istraživanje ovakvog tipa temeljeno
na broju pretraga karcinoma prostate na podruÄju Republike Hrvatske. PromatrajuÄi rano razdoblje pandemije naÅ”i rezultati
donose važne smjernice u buduÄem praÄenju i dugoroÄnim posljedicama pandemije na pobol i smrtnost karcinoma prostate
Comparison of multidetector-row computed tomography and duplex Doppler ultrasonography in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage [Usporedba viŔeslojne kompjuterizirane tomografije i duplex Doppler ultrazvuka u otkrivanju aterosklerotskih karotidnih plakova kompliciranih krvarenjem u plak ]
This study compared sensitivity and specificity of multidetector-row computed tomography and duplex Doppler ultrasonography in detecting atherosclerotic carotid plaques complicated with intraplaque hemorrhage. Carotid plaques from 50 patients operated for carotid artery stenosis were analyzed. Carotid endarterectomy was performed within one week of diagnostic evaluation. Results of multidetector-row computed tomography and duplex Doppler ultrasonography diagnostic evaluation were compared with results of histological analysis of the same plaque areas. American Heart Association classification of atherosclerotic plaques was applied for histological classification. Median tissue density of carotid plaques complicated with intraplaque hemorrhage was 14.7 Hounsfield units. Median tissue density of noncalcified segments of uncomplicated plaques was 54.3 Hounsfield units (p = 0.00003). The highest tissue density observed for complicated plaques was 31.8 Hounsfield units. Multidetector-row computed tomography detected plaques complicated with hemorrhage with sensitivity of 100% and specificity of 70.4%, with tissue density of 33.8 Hounsfield units as a threshold value. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed sensitivity of 21.7% and specificity of 89.6% in detecting plaques complicated with intraplaque hemorrhage. Multidetector-row computed tomography showed a very high level of sensitivity and a moderate level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage. Duplex Doppler ultrasonography plaque analysis based on visual in-line classification showed a low level of sensitivity and a moderate-high level of specificity in detecting atherosclerotic carotid plaques complicated with hemorrhage
HijalinizirajuÄi tumor vretenastih stanica s gigantskim rozetama naen u uterusu ā prikaz sluÄaja
Hyalinizing spindle cell tumor with giant rosettes (HSCTGR) is unusual, recently recognized entity, histologically characterized by the presence of large rosette-like structures. Apart from these formations, histological features of HSCTGR are indistinguishable from low-grade fibromyxoid sarcoma (LGFMS), and available data suggest that these two tumors present different variants of the same entity.
Herein we report the case of HSTCGR found in the uterus. To our knowledge, the present case is the first description of HSTGR occurring at this location as well as the first HSCTGR described in the Croatian medical literature.
A 38-year-old woman presented to her gynecologist with symptoms of acute pain in the lower abdomen. Gynecological ultrasound examination showed an enlarged uterus with a tumor mass. Total hysterectomy and bilateral adnexectomy with selective pelvic and para-aortal lymphadenectomy were performed. Serial slicing of the enlarged uterus revealed a grayish white tumor mass with 15 cm in maximum length. The margins of the tumor merged with the uterine wall and the tumor infiltrated more than one half of the myometrium. Histologically, the tumor showed typical features of HSTGR.
Postoperatively, no complications occurred.
Twenty-two months after surgery, our patient is alive with no signs of recurrence. She needs to be followed up for a long period because HSTCGR belongs to a low-grade malignancy group with the potential to recur and produce late metastasis.HijalinizirajuÄi tumor vretenastih stanica s gigantskim rozetama (HSCTGR) rijedak je, relativno nedavno opisan entitet, Äija je histoloÅ”ka znaÄajka stvaranje krupnih struktura koje nalikuju rozetama. Osim po prisutnosti ovih tvorbi, histoloÅ”ki ga se ne može razlikovati od fibromiksoidnog sarkoma niskoga gradusa i danas se vjeruje da su oni razliÄite varijante istog entiteta.
Opisujemo hijalinizirajuÄi tumor vretenastih stanica s gigantskim rozetama naÄen u uterusu. Prema naÅ”im spoznajama radi se o prvom sluÄaju opisanom na toj lokalizaciji te takoÄer prvom sluÄaju HSCTGR u hrvatskoj medicinskoj literaturi.
Dotada zdrava 38-godiÅ”nja žena javila se ginekologu zbog akutne boli u donjem dijelu abdomena. GinekoloÅ”kim i ultrazvuÄnim pregledom naÄena je veÄa tumorska tvorba u podruÄju uterusa. UÄinjena je histerektomija s adneksektomijom i selektivnom limfadenektomijom. Serijskim rezovima kroz stijenku poveÄanog uterusa prikazao se sivkastobjelkasti tumor najveÄeg promjera 15 cm, koji je infiltrirao viÅ”e od Ā½ debljine miometrija. PatohistoloÅ”kom analizom postavljena je dijagnoza HSCTGR.
Postoperativni je tijek proÅ”ao bez komplikacija, a 22 mjeseca nakon operacije naÅ”a je pacijentica bez znakova recidiva bolesti. HSCTGR pripada skupini tumora s niskim malignim potencijalom te moguÄnoÅ”Äu recidiviranja i metastaziranja nakon viÅ”e godina, stoga se preporuÄuje dugoroÄno kliniÄko praÄenj
Korelacija izmeÄu Gleasonova stadija u uzorcima dobivenim prijeoperacijskom biopsijom prostate i tijekom prostatektomije
The aim of the study was to compare Gleason scores obtained from sextant preoperative prostate biopsy and radical prostatectomy specimens in patients with localized prostate cancer. Seventy-three patients with prostate biopsy and operated on at our hospital from 2000 till 2002 were included in the study. Definitive postprostatectomy Gleason score was accurately predicted by preoperative biopsy in 43.8% and undergraded by 1 grade in 39.7% of study patients. Although a fairly good concordance was recorded between Gleason scores obtained on biopsy and prostatectomy specimens, the problem of undergrading remains to be improved. The web-based free tutorial can improve the accuracy of Gleason grading by practicing pathologists. It is available at: www.pathology.jhu.edu/prostate.Cilj ove studije bio je usporediti Gleasonov zbroj dobiven prijeoperacijskom sekstant biopsijom i konaÄan nalaz nakon radikalne prostatektomije u bolesnika s lokaliziranim karcinomom prostate. U ispitivanje su bila ukljuÄena 73 bolesnika koji su podvrgnuti biopsiji i radikalnoj prostatektomiji u naÅ”oj ustanovi izmeÄu 2000. i 2002. godine. Prijeoperacijska biopsija prostate toÄno je predvidjela konaÄan Gleasonov zbroj nakon prostatektomije u 43,8% bolesnika, dok je u 39,7% bolesnika Gleasonov zbroj bio podcijenjen za 1. Premda je naÄena priliÄno dobra usuglaÅ”enost nalaza stupnja diferenciranosti tumora na bioptiÄkom i definitivnom materijalu, problem podcjenjivanja stupnja diferenciranosti jo. treba biti rijeÅ”en. ToÄnija procjena Gleasonova zbroja može se postiÄi uporabom i vježbom na besplatnoj Internet stranici: www.pathology.jhu.edu/prostate
KliniÄke karakteristike i lijeÄenje lupusnog nefritisa - preliminarna analiza opservacijskih podataka Nacionalnog referentnog centra
Lupus nephritis (LN) is one of the most severe features of systemic lupus erythematosus
(SLE). Data on LN is scarce in the Croatian population. We analysed the characteristics of
LN patients diagnosed at our tertiary referral centre. In this retrospective study, we analysed the following
features of patients with biopsy-proven LN diagnosed between 2011 and 2020: demographics,
renal laboratory parameters, renal histopathology, and treatment.
A total of 38 patients were included (30 females; mean age 39Ā±15 years). The most common indication
for kidney biopsy was proteinuria (89%). The proportion of LN classes was: class I (2.6%), II
(5.3%), III (18.4%), IV (42.1%), V (13.2%), III+V (10.5%), IV+V (5.3%). The median time from SLE
diagnosis to histologic confirmation of LN was 1.0 year. All patients were treated with methylprednisolone
(MP), 68% received MP pulses. Induction treatment included intravenous (IV) cyclophosphamide
(CYC) (71%) (15 patients treated per Euro-Lupus and 9 per the National Institutes of
Health regimen), oral CYC (3%), or mycophenolate mofetil (11%). 79% of patients received antimalarials.
While there is heterogeneity between different populations, our patient profile was similar to
that from other European studies. Further follow-up of this group is necessary to assess outcomes in
our population.Lupusni nefritis (LN) je Äesta i vrlo ozbiljna manifestacija sustavnog eritemskog lupusa (SLE). JoÅ” uvijek nema dovoljno
podataka o karakteristikama bolesnika s LN u Hrvatskoj. Analizirali smo karakteristike bolesnika s LN koji su lijeÄeni u
referentnom centru naÅ”e tercijarne ustanove. U ovu retrospektivnu studiju ukljuÄili smo bolesnike s biopsijom potvrÄenim
LN u periodu od 2011. do 2020. godine, analizirali smo demografske podatke, parametre bubrežne funkcije, patohistoloŔki
nalaz bioptata bubrega i lijeÄenje. U studiju je ukljuÄeno 38 bolesnika (30 žena, prosjeÄna dob 39Ā±15godina). NajÄeÅ”Äa indikacija
za biopsiju bubrega bila je proteinurija (89%). Raspodjela klasa LN bila je sljedeÄa: klasa I(2,6 %), II(5,3 %), III(18,4 %),
IV(42,1 %), V(13,2 %), III+V(10,5 %), IV+V(5,3 %). ProsjeÄno vrijeme od dijagnoze SLE do histoloÅ”ke potvrde LN bilo je
1,0 godina. Svi bolesnici su lijeÄeni kortikosteroidima, 68 % lijeÄeno je bolusima metilprednizolona. Indukcijska terapija
ukljuÄivala je parenteralnu primjenu ciklofosfamida (CYC) (71 %) (15 bolesnika lijeÄeno je prema Euro-lupus protokolu, 9
bolesnika prema protokolu Nacionalnog instituta za zdravlje (NIH)), peroralni CYC (3 %) ili mikofenolat mofetil (11 %).
Antimalarike je primilo 79 % bolesnika. UnatoÄ heterogenosti izmeÄu razliÄitih populacija s LN, profil bolesnika ukljuÄen u
ovu studiju sliÄan je ostalim europskim studijama. Daljnje praÄenje potrebno je da bi se istražili ishodi u ovoj populaciji
Intraoperacijska analiza limfnih Ävorova kod radikalne prostatektomije: Je li ona doista neophodna?
Radical prostatectomy is a treatment of choice for localized prostatic adenocarcinoma. In most cases, radical prostatectomy is combined with pelvic lymph node dissection. During the last decade, the necessity to perform lymphadenectomy in all patients has been questioned. Lymph node dissection adds the risk of complications, and increases operation time and medical costs. Data of patients with prostatic adenocarcinoma who underwent radical prostatectomy at Department of Urology, Sestre milosrdnice University Hospital, Zagreb during the period from January 1, 1998 till December 31, 2002, were analyzed. There were 110 patients who had complete preoperative data including prostate-specific antigen (PSA)
value, Gleason score, T stage and lymph node status on frozen section analysis. Using predictive nomograms the patients were divided into different risk groups. Positive lymph node(s) were found in one patient with T2 and in five patients with T3, whereby three, two and one of these patients had Gleason score 6, 7 and 8, respectively. There was a correlation between increasing PSA value and positive lymph nodes (p<0.005). A statistically significant correlation between T stage and PSA value (p<0.005) as well as between T stage and Gleason score (p=0.0014) was also observed. The majority of patients belonged to low and intermediate risk groups, known to benefit very little from lymph node dissection and frozen section analysis. Thus, it seems reasonable to reconsider the use of these predictive nomograms on advising and therapy strategy planning for newly diagnosed patients, especially those with clinically organ-confined disease.Radikalna prostatektomija je metoda izbora u lijeÄenju lokaliziranog karcinoma prostate, a najÄeÅ”Äe se izvodi u kombinaciji s disekcijom zdjeliÄnih limfnih Ävorova. Disekcija zdjeliÄnih limfnih Ävorova poveÄava rizik komplikacija, produžava trajanje operacije, povisuje troÅ”kove lijeÄenja i medicinske skrbi, pa se je potreba za njenim provoÄenjem u svih bolesnika s dijagnosticiranim karcinomom prostate tijekom proÅ”loga desetljeÄa viÅ”ekratno preispitivala. Radi boljeg probira bolesnika sa znaÄajnijom koristi od disekcije zdjeliÄnih limfnih Ävorova razliÄiti autori su obraÄivali Äimbenike kojima je moguÄe predvidjeti rizik metastaziranja u regionalne limfne Ävorove. Studijom su obuhvaÄeni svi bolesnici kojima je zbog dijagnoze karcinoma prostate u razdoblju od 1. sijeÄnja 1998. do 31. prosinca 2002. u KliniÄkoj bolnici Sestara milosrdnica uÄinjena radikalna prostatektomija. Uz primjenu prediktivnih nomograma bolesnici su bili podijeljeni u razliÄite riziÄne skupine. VeÄina bolesnika pripadala je skupini niskog i srednjeg rizika metastaziranja, s vrlo ograniÄenom koristi od disekcije zdjeliÄnih limfnih Ävorova i njihove intraoperacijske analize. Od 110 bolesnika za koje su dobiveni svi podaci ukljuÄujuÄi vrijednost antigena specifiÄnog za prostatu (PSA), Gleasonov zbroj, T stadij i stanje limfnih Ävorova analiziranih na intraoperacijskim rezovima, pozitivni limfni Ävorovi su utvrÄeni u 6 sluÄajeva. UtvrÄena je statistiÄki znaÄajna povezanost izmeÄu vrijednosti PSA i pozitivnih limfnih Ävorova (p<0,005). TakoÄer je opažena korelacija izmeÄu T stadija i vrijednosti PSA (p<0,005) odnosno T stadija i Gleasonova zbroja (p=0,0014). ZakljuÄeno je kako bi bilo uputno razmotriti uporabu prediktivnih nomograma kod planiranja terapijskog pristupa bolesnicima s novootkrivenim, a poglavito onima s kliniÄki lokaliziranim karcinomom prostate