17 research outputs found
UÄinak terapije metimazolom na patohistoloÅ”ki izgled tkiva Å”titnjaÄe koji može oponaÅ”ati maligne promjene
Diffuse toxic goiter, as the most common cause of hyperthyroidism, is usually
initially treated with thyrostatic drugs such as methimazole, followed by radioiodine therapy or surgery
which may be indicated as definitive treatment. Radioactive iodine therapy has a known association
with various histopathologic features including cytologic atypia, but herein we present a rare example
of morphological thyrocyte changes induced by long-term pharmacological treatment with
methimazole that mimicked thyroid malignancy in a pathohistological sample.Difuzna toksiÄna struma, kao najuÄestaliji uzrok hipertireoze, se uglavnom lijeÄi tireostaticima kao Å”to je metimazol a
nakon poÄetne farmakoloÅ”ke terapije, ukoliko ne doÄe do spontane remisije bolesti, lijeÄenje se nastavlja primjenom radioaktivnog
joda (I-131) ili kirurŔkim zahvatom.
Primjena radioaktivnog joda dovodi do brojnih histopatoloÅ”kih izmjena u parenhimu Å”titnjaÄe, ukljuÄujuÄi i staniÄnu
atipiju, no u naÅ”em radu prikazujemo rijedak sluÄaj utjecaja dugotrajne farmakoloÅ”ke terapije metimazolom na izmjenu
morfologije tireocita koja može oponaÅ”ati izgled malignih stanica na histoloÅ”kom uzorku tkiva Å”titnjaÄe
Postoperative Morbidity and Histopathologic Characteristics of Tonsillar Tissue Following Coblation Tonsillectomy in Children: A Prospective Randomized Single-Blind Study
The aim of this prospective randomized single blind study was to determine the depth of thermal damage to tonsillar tissue due to coblation, and to compare it with thermal damage to tonsillar tissue following conventional tonsillectomy; to correlate the depth of thermal damage to tonsillar tissue with the parameters of postoperative morbidity, to compare intraoperative blood loss, postoperative pain severity, time to resuming normal physical activity, and incidence of postoperative bleeding between two groups of tonsillectomized children aged up to 16 years. 72 children aged 3ā16 years scheduled for tonsillectomy randomly assigned into two groups submitted either to conventional tonsillectomy with bipolar diathermy coagulation or to coblation tonsillectomy, with a 14-day follow up.Statistically significant differences were observed in the depth of thermal damage to tonsillar tissue (p<0.001), intraoperative blood loss (p<0.004), in postoperative pain severity (p<0.05) and in time to resuming normal physical activity between the two groups (p<0.001). There was no case of reactionary or secondary bleeding in either group. In this paper for the first time we have correlated postoperative morbidity and thermal tissue damage: less thermal damage is associated with less postoperative morbidity
The Epidemiology of Non-Traumatic Prehospital Sudden Death in Split-Dalmatia County
The aim of this study was to determine epidemiology of non-traumatic prehospital sudden adult deaths in Split- -Dalmatia County from 2000. to 2005. The following information were collected from autopsy reports in the archives of University Hospital Split: gender of deceased, birth date, date of death, location of death, immediate cause of death, previously diagnosed diseases that might lead to terminal outcome. There were 160 non-traumatic prehospital sudden adult deaths in the observed period, with 104 (65%) male and 56 (35%) female autopsies performed. Diseases of cardio- vascular system were the main cause of death, responsible for 95 (59.37%) sudden deaths, followed by diseases of respira- tory system (14.37%) and central nervous system (8.12%). The most frequent cause of non-traumatic sudden death was myocardial infarction, found in 50 cases. July and September were the months of the most frequent occurrence of sudden death. In this study it was confirmed that sudden death incidence increases with age, with almost half of all deaths occurring in people between ages of 61ā80. The result that a fifth of all sudden deaths occurred in people aged 51ā60 is troubling and potentially preventable. The most frequent location of death was deceasedās place of residence (N=29), followed by the ambulance vehicle (N=17). In conclusion, this is the first publication describing the incidence of pre- hospital sudden non-traumatic adult death in Split-Dalmatia County. Causes of sudden death and its incidence are in accordance with World Health Organizationās information on general causes of death in Croatia and Western Europe
ANAPLASTIC THYROID CARCINOMA IN A 17-YEAR-OLD FEMALE PATIENT
AnaplastiÄni karcinom Å”titnjaÄe je jedan od Äetiri najmalignija tumora u Äovjeka. Pojavljuje se u jednog do dva bolesnika na milijun ljudi u godini dana. U djece je iznimno rijedak. 17-godiÅ”nja bolesnica primljena je u Kliniku za bolesti uha, nosa i grla i kirurgiju glave i vrata u KBC-u Split zbog operacije Å”titnjaÄe. Ranije joj je naÄen nagli porast Ävora lijevog režnja Å”titnjaÄe. Preoperacijska obrada je upuÄivala na benigan karakter promjena. Napravljena je operacija thyreoidectomia totalis cum dissectione colli regionis VI et VII. Intraoperacijski preparat lijevog režnja Å”titnjaÄe je bio maligan. Potom se napravio i PET/CT. Nalaz je bio uredan. Bolesnica je upuÄena otorinolaringoloÅ”ko-onkoloÅ”kom timu gdje se odreÄuje adjuvantna radioterapija. Stadij bolesti prema TNM klasifi kaciji bio je IVa. Godinu dana nakon operacije bolesnica je dobro, nema znakova bolesti. Ovaj prikaz sluÄaja je prilog dosadaÅ”njim rijetkim spoznajama o anaplastiÄnom karcinomu Å”titnjaÄe u osoba mlaÄe životne dobi u svijetu.Anaplastic carcinoma of thyroid gland is one of the four most malignant tumors in humans. It appears in one or two patients per million per year. It is very rare in children. A 17-year-old female patient was admitted to the Clinical Department of ENT and Head and Neck Surgery, Split University Hospital Center, for thyroid gland surgery due to rapid growth of a node in the thyroid gland left lobe. Preoperative examination indicated benign nature of changes. Total thyroidectomy with levels VI and VII neck dissection was done. Intraoperative slide of the left lobe was malignant. Positron emission tomography and computed tomography were also done. The finding was negative. The patient was examined by an ENT-oncology team and juvenile radiotherapy was administered. It was found to be carcinoma stage IVa according to TNM classification. One year after the operation, the patient was well and had no signs of illness. This case report is a contribution to the existing but scarce knowledge of anaplastic carcinoma of thyroid gland in young patients in the world
PrognostiÄka vrijednost kliniÄkih i patohistoloÅ”kih osobitosti melanoma srednje oÄne ovojnice: retrospektivna studija
The aim of the study was to determine clinical and histopathologic prognostic factors for tumor related survival of patients with uveal melanoma. Clinical and histopathologic records of 20 patients with histologically verified uveal melanomas were retrospectively analyzed. Patients were operated on at University Department of Ophthalmology, Split University Hospital in Split, January 1, 1991 and December 31, 2000. Histopathologic confirmation was obtained from the Hospital Department of Pathology, Forensic Medicine and Cytology, Split University Hospital. Standard histological staining with hemalaun and immunohistochemical staining with primary antibody against melanoma antigen and S-100 protein were performed. Data on the cause of death were collected from death certificates obtained from Hospital Department of Pathology, Forensic Medicine and Cytology and from Split Population Registry, Split-Dalmatia County government. The overall annual incidence of uveal melanoma in Split-Dalmatian County was 0.44 per 100,000. Out of 20 intraocular melanomas, 4 (20%) were located at the ciliary body, 13 (65%) at the choroid, and 3 (15%) at the ciliary body and at the choroid. There was no statistically significant survival difference between groups with different tumor localization (cĀ²=2.747; df=3; p=0.253). The largest tumor diameter was 35 mm and the smallest 9 mm (median 12 mm), and there was no statistically significant correlation between tumor diameter and survival (Spearman\u27s correlation 0.21). Histological study revealed pure spindle A type melanoma in one (5%) case, pure spindle B type melanoma and pure epithelioid type melanoma in 4 (20%) cases each, and mixed type melanoma in 11 (55%) cases. There was no statistically significant survival difference between groups of patients with different histopathologic types of melanoma (ĻĀ²=5.312; df=4; p=0.150). Study results indicated that none of the study parameters (localization, tumor diameter and histopathology finding) could be considered a valid prognostic factor of uveal melanoma survival.Cilj studije bio je ustanoviti kliniÄke i patohistoloÅ”ke prognostiÄke Äimbenike preživljenja od melanoma srednje oÄne ovojnice kod bolesnika s tom boleÅ”Äu. Provedena je retrospektivna analiza kliniÄkih i patohistoloÅ”kih podataka 20 bolesnika s histoloÅ”ki dokazanim melanomom srednje oÄne ovojnice. Bolesnici su operirani u Klinici za oÄne bolesti KB Split u razdoblju od 1. sijeÄnja 1991. do 31. prosinca 2000. godine. Melanomi su patohistoloÅ”ki verificirani u Zavodu za patologiju, sudsku medicinu i citologiju KB Split. Primijenjeno je standardno HE (hemalaun-eozin) bojenje i imunohistokemijsko bojenje na melanoma antigen i S-100 protein. Uzrok smrti utvrÄen je uvidom u mrtvozorniÄke prijave o uzroku smrti u Zavodu za patologiju, sudsku medicinu i citologiju KB Split i u MatiÄnom uredu Split, Uredu državne uprave Splitsko-dalmatinske županije. GodiÅ”nja incidencija melanoma srednje oÄne ovojnice u Splitsko-dalmatinskoj županiji bila je 0,44 na 100.000 stanovnika. Od 20 intraokularnih melanoma, 4 (20%) su imala polaziÅ”te iz zrakastog tijela, 13 (65%) iz žilnice, a 3 (15%) su bila smjeÅ”tena u zrakastom tijelu i žilnici. Nije naÄena statistiÄki znaÄajna razlika u preživljenju prema lokalizaciji tumora (ĻĀ²=2,747; df=3; p=0,253). NajveÄi promjer tumora iznosio je 35 mm, najmanji 9 mm (medijan 12 mm). Nije utvrÄena statistiÄki znaÄajna korelacija izmeÄu preživljenja i veliÄine tumora (Spermanova rang korelacija 0,21). HistoloÅ”ka analiza utvrdila je 1 (5%) melanom vretenastog tipa A, 4 (20%) vretenastog tipa B, 4 (20%) epiteloidnog tipa i 11 (55%) mijeÅ”anog tipa. Nije dokazana statistiÄki znaÄajna razlika u preživljenju ovisno o patohistoloÅ”kom tipu tumora (ĻĀ²=5,312; df=4; p=0,15). Na temelju dobivenih rezultata može se zakljuÄiti kako niti jedan od ispitivanih parametara (lokalizacija, veliÄina i patohistoloÅ”ki tip tumora) nije valjan prognostiÄki Äimbenik preživljenja kod melanoma srednje oÄne ovojnice
Glomus tumor of the lingual base: a case report
Glomus tumori su pretežito benigni neuroendokrini tumori nastali od ekstraadrenalnih paraganglija autonomnog živÄanoga sustava. Iako su vrlo rijetki, problemi vezani za njihovu pravodobnu dijagnozu i lijeÄenje, Äine ih zanimljivim i zahtjevnim. U radu je prikazan bolesnik u dobi od 24 godine s glomus tumorom baze jezika. Tumor je dokazan radioloÅ”kim metodama (kompjutorizirana tomografija i angiografija).
Terapija je bila iskljuÄivo kirurÅ”ka. Do sada je u literaturi opisan samo jedan sluÄaj paraganglioma orofarinksa.Glomus tumors generally are benign neuroendocrine tumors originating from extra-adrenal paraganglia of the autonomic nervous system. Although very rare, the problems associated with timely diagnosis and treatment of glomus tumors make them rather intriguing and demanding. A case is presented of a 24-yearold man with glomus tumor of the lingual base. The tumor was verified by radiological methods
(computerized tomography and angiography) and treated exclusively by surgical approach. To our knowledge, a single case of oropharyngeal paraganglioma has been reported in literature
Izražajnost ciklina D1, RET i p27 u papilarnom mikrokarcinomu Ŕtitne žlijezde
The aim of the study was to determine the influence of RET, p27 and cyclin D1 on regional lymph node metastases in papillary microcarcinoma. The analysis included 70 patients with papillary thyroid microcarcinoma that underwent surgery at Split University Hospital Center between 1999 and 2001. Immunohistochemistry was performed on formalin-fixed, paraffi n-embedded tissue by the RET, p27 and cyclin D1 antibodies. Quantification was based on the intensity and distribution of nuclear staining, dividing tumors into those that showed expression (expressors) and those that showed no expression (non-expressors). Univariate analysis using ĻĀ²-test and Fisher exact test was performed with the level of statistical significance set at p<0.05. Th ere was no statistically significant difference in the incidence of metastases according to the expression or non-expression of RET mutation (ĻĀ²-test: p=0.459; Fisher exact test: p=0.672). Among 25 cases with cyclin D1 expression, 6 had metastases, whereas only 2 of 45 cases with no cyclin D expression had metastases (ĻĀ²-test: p=0.014; Fisher exact test: p=0.021), indicating that the expression of cyclin D1 is not crucial for the development of metastases in lymph nodes. In contrast,analysis of p27 expression showed it to be significantly associated with lymph node metastasis because 3 of 45 patients with p27 expression had metastases, indicating a statistically significant correlation between p27 expression and lymph node metastases (ĻĀ²-test: p=0.093; Fisher exact test: p=0.124). This study confirmed the importance of the evaluation of RET, p27 and cyclin D1 expression and demonstrated the validity of their application in the assessment of microcarcinoma behavior.Cilj istraživanja bio je odrediti utjecaj izražajnosti RET, p27 i ciklina D1 na pojavu metastaza u regionalnim limfnim Ävorovima kod papilarnog mikrokarcinoma Å”titnjaÄe. U analizu su ukljuÄeni histoloÅ”ki uzorci 70 bolesnika podvrgnutih operativnom zahvatu zbog papilarnog mikrokarcinoma Å”titnjaÄe u KliniÄkom bolniÄkom centru Split od 1999. do 2001. godine. HistoloÅ”ki uzorci papilarnog mikrokarcinoma pohranjeni u parafinu i fiksirani formalinom imunohistokemijski su obojani pomoÄu tri monoklonska protutijela: RET, protein p27 i ciklin D1. Izražajnost je opisana prema intenzitetu i raspodjeli staniÄne obojenosti, dijeleÄi tumore na one koji imaju izražajnost (ekspresori) i one koji ne pokazuju izražajnost (ne-ekspresori). StatistiÄka obrada podataka uÄinjena je pomoÄu ĻĀ²-testa i Fisherova egzaktnog testa, uz razinu statistiÄke znaÄajnosti od p<0,05. Nije uoÄena statistiÄki znaÄajna razlika u uÄestalosti metastaza u odnosu na izražajnost RET mutacije (ĻĀ²-test: p=0,459; Fisherov egzaktni test: p=0,672). U 25 uzoraka bila je prisutna izražajnost ciklina D1, od kojih su metastaze bile prisutne u 6 sluÄajeva, a od 45 uzoraka bez izražajnosti ciklina D1 metastaze su bile prisutne u samo 2 uzorka (ĻĀ²-test: p=0,014; Fisherov egzaktni test: p=0,021), iz Äega proizlazi da ekspresija ciklina D1 nije presudna za razvoj metastaza u limfne Ävorove. Nasuprot tome, ekspresija p27 znaÄajno je povezana s metastaziranjem, jer su metastaze bile prisutne u 3 od 45 ispitanika koji su imali poveÄanu izraažajnost p27 (ĻĀ²-test: p=0,093; Fisherov egzaktni test: p=0,124). Ovim istraživanjem potvrdili smo važnost evaluacije izražajnosti p27, ciklina D1 i RET kao i vrijednost njihove primjene u procjeni ponaÅ”anja mikrokarcinoma
UÄestalost RET mutacije u papilarnom karcinomu Å”titnjaÄe i korelacija s kliniÄko-patoloÅ”kim karakteristikama
The purpose of this study was to analyze the possible prognostic value of RET mutation in papillary thyroid carcinoma and its incidence in the past few decades in our population, due to the increasing incidence of papillary thyroid carcinoma. The present study included 180 patients operated for papillary thyroid carcinoma. The clinical and histopathologic characteristics were analyzed. Paraffin sections of the selected histologic slides were cut again and immunohistochemically stained by the Clone 3F8 P (HIER) from Novocastra (Vision Bio Systems Europe, Newcastle upon Tyne, UK) monoclonal antibody to RET oncoprotein. Univariate analysis indicated sex (p=0.01), histologic subtype (p=0.075) and capsular invasion (p=0.010) to be statistically significant predictors of lymph node metastases, whereas age (p=0.796), tumor size (p=0.556) and intraglandular dissemination (p=0.131) showed no such correlation. The presence of RET mutation (p=0.704) was not a statistically significant predictor of the tumor metastasizing potential. RET mutation (p=0.500) showed no statistically significant correlation with papillary thyroid carcinoma classifed into prognostic groups according to clinicopathologic features either. RET mutation was detected in 30% of 180 papillary thyroid carcinomas. This is the first large study demonstrating that RET mutation incidence in papillary thyroid carcinoma in Croatian population is consistent with the classic distribution of sporadic cases, despite the increased prevalence of papillary thyroid carcinoma in the past few decades.Cilj ovoga rada bio je ispitati moguÄe prognostiÄko znaÄenje RET mutacije u papilarnom karcinomu Å”titnjaÄe i uÄestalost mutacije u odnosu na porast uÄestalosti papilarnog karcinoma Å”titnjaÄe u posljednjih nekoliko desetljeÄa. U istraživanje je bilo ukljuÄeno 180 bolesnika operiranih zbog papilarnog karcinoma Å”titnjaÄe. Analizirane su kliniÄke i patohistoloÅ”ke osobitosti. HistoloÅ”ki rezovi iz parafinskih blokova odabranih uzoraka imunohistokemijski su obojani monoklonskim protutijelom na RET onkoprotein Clone 3F8 P (HIER) proizvoÄaÄa Novocastra (Vision Bio Systems Europe, Newcastle upon Tyne, UK). Univarijatnom analizom utvrÄena je statistiÄki znaÄajna povezanost spola (p=0,01), histoloÅ”kog podtipa (p=0,075) i kapsularne invazije (p=0,010) kao prediktora pojave metastaza u limfne Ävorove vrata, dok takva povezanost nije zabilježena za dob (p=0,796), veliÄinu tumora (p=0,556) i intraglandularnu diseminaciju tumora (p=0,131). Prisutnost RET mutacije nije bila statistiÄki znaÄajan prediktor metastatskog potencijala tumora (p=0,704). TakoÄer, RET mutacija nije bila statistiÄki znaÄajno povezana s prognostiÄkim skupinama papilarnog karcinoma koje su sastavljene na temelju kliniÄko-patoloÅ”kh osobitosti (p=0,500). RET mutacija bila je prisutna u 30% od 180 papilarnih karcinoma Å”titnjaÄe. Ovo je prvo veÄe istraživanje kojim je dokazano da je RET mutacija u papilarnom karcinomu Å”titnjaÄe u Hrvatskoj u skladu s uÄestaloÅ”Äu pojave spontane mutacije, iako se bilježi porast uÄestalosti papilarnog karcinoma Å”titnjaÄe tijekom posljednjih desetljeÄa