Echinococcus granulosus cyst fluid(EgCF) inhibits the migration and phagocytic function of mouse macrophages induced by LPS via inducing cytoskeletal rearrangement / 细胞与分子免疫学杂志

Objective To investigate the effect of Echinococcus granulosus cyst fluid(EgCF) on the cytoskeletal rearrangement and phagocytosis and the migration of macrophages induced by lipopolysaccharide(LPS). Methods Peritoneal macrophages of C57BL/6 mice were isolated and cultured in vitro, and divided into control group and LPS group and LPS combined with EgCF group. After 48 hours of treatment, filamentous actin (F-actin) changes were observed with rhodamine-labelled phalloidin staining and fluorescence microscopy; TranswellTM chamber was used to test cell migration ability and flow cytometry to test cell phagocytosis. After 1 hour of treatment, PI3K and AKT, phosphorylated AKT (p-AKT), Rac1, guanosine triphospho-Rac1 (GTP-Rac1), WASP and Arp2 protein expressions were detected with Western blot analysis. Results Compared with the control group, after LPS stimulation, macrophages were deformed significantly; pseudopodia increased; actin cytoskeleton increased and was more distributed in pseudopodia; the ability of migration and phagocytosis were significantly improved, and the expression of PI3K, p-AKT, GTP-Rac1, WASP and Arp2 proteins significantly increased. EgCF treatment caused cell shrinkage and disappearance of pseudopodia protrusions of LPS-activated cells, and led to the reduced phagocytic and migratory of cells; the protein expression of PI3K, p-AKT, GTP-Rac1, WASP and Arp2 decreased significantly compared with the LPS group. Conclusion LPS induces the migration and enhances phagocytosis of macrophages while EgCF inhibits these effects, which is related to actin cytoskeleton rearrangement.

Advances in Serological Diagnosis of Taenia solium Neurocysticercosis in Korea

Cysticercosis, a parasitic disease caused by Taenia solium metacestode (TsM), has a major global public health impact in terms of disability-adjusted life years. The parasite preferentially infects subcutaneous tissue, but may invade the central nervous system, resulting in neurocysticercosis (NC). NC is an important neglected tropical disease and an emerging disease in industrialized countries due to immigration from endemic areas. The prevalence of taeniasis in Korea declined from 0.3%–12.7% during the 1970s to below 0.02% since the 2000s. A survey conducted from 1993 to 2006 revealed that the percentage of tested samples with high levels of specific anti-TsM antibody declined from 8.3% to 2.2%, suggesting the continuing occurrence of NC in Korea. Modern imaging modalities have substantially improved the diagnostic accuracy of NC, and recent advances in the molecular biochemical characterization of the TsM cyst fluid proteome also significantly strengthened NC serodiagnosis. Two glycoproteins of 150 and 120 kDa that induce strong antibody responses against sera from patients with active-stage NC have been elucidated. The 150 kDa protein showed hydrophobic-ligand binding activities and might be critically involved in the acquisition of host-derived lipid molecules. Fasciclin and endophilin B1, both of which play roles in the homeostatic functions of TsM, showed fairly high antibody responses against calcified NC cases. NC is now controllable and manageable. Further studies should focus on controlling late-onset intractable seizures and serological diagnosis of NC patients infected with few worms. This article briefly overviews diagnostic approaches and discusses current issues relating to NC serodiagnosis.

Quiste óseo aneurismático: Presentación de un caso / Aneurysmal Bone Cyst: Case Report

El quiste óseo aneurismático es una lesión expansiva, de pared fina, de contenido quístico, y con niveles líquido-líquido. Su etiología es incierta, suele asociarse a traumatismo, probablemente debido a obstrucción venosa o a la formación de fístulas que se producen tras la contusión. Los pacientes refieren dolor, que puede ser de comienzo insidioso o abrupto debido a una fractura patológica. Los quistes óseos aneurismáticos se clasifican, según su etiología, en primarios o secundarios a una lesión subyacente, como displasia fibrosa, condroblastoma, tumor de células gigantes u osteosarcoma. Se presenta el caso de una paciente que consulta por dolor localizado en la región plantar izquierda, no asociado a traumas, a quien se le diagnosticó un quiste óseo aneurismático, con hallazgos definitivos en resonancia magnética (RM) y comprobación histológica.

The aneurysmal bone cyst is an expansive, thin-wall lesion with cystic content, and with the presence of liquid-liquid levels. Its etiology is uncertain, usually associated with trauma, probably due to a venous obstruction or the formation of fistulas that are produced by contusion. Patients report pain, which may be of insidious onset or abrupt onset due to a pathological fracture. Aneurysmal bone cysts are classified according to their etiology in primary, or secondary to an underlying lesion, such as fibrous dysplasia, chondroblastoma, giant cell tumor or osteosarcoma. We present the case of a patient who consulted for pain located in left plantar region, not associated with trauma, who was diagnosed with an aneurysmal bone cyst, with definitive magnetic resonance findings and histological verification.

An appraisal of pancreatic cyst fluid molecular markers

Pancreatic malignancy is the third leading cause of cancer related death in the United States with limited viable screening options. By the end of this decade, cancers are poised to become the leading cause of death with pancreatic cancer projected to be the second leading cause of cancer related mortality. Pancreatic cystic lesions (PCLs) are found in approximately 5%–14% of patients due to the increased utilization of cross-sectional imaging, with approximately 8%–10% of pancreatic cancers originating as PCLs. Current screening guidelines have shown discrepancies between morphologic characteristics of PCLs and identifying advanced pancreatic disease. Molecular analysis has emerged as a novel technology to aid in adequate diagnosis and management decisions of PCLs. Mucinous cysts including intraductal papillary mucinous neoplasms (IPMNs) or mucinous cystic neoplasms have similar oncogenic mutations including KRAS, TP53, SMAD4, PIK3CA, PTEN, or CKDN2A, while GNAS and RNF43 mutations are specific only to IPMNs. Serous cystadenomas have been associated with a loss of tumor suppressor gene VHL, while solid-psuedopapillary neoplasms have an oncogenic mutation CTNNB1. A specific molecular marker to diagnose existing high-grade dysplasia or impending malignant transformation is yet to be identified. Moving forward it is important to advance technology in isolating and identifying high-risk molecular markers from cyst fluid while considering their increased utilization in the evaluation of PCLs.

Recent developments in endoscopic ultrasound-guided diagnosis and therapy of pancreatic cystic neoplasms

This review highlights new developments in the field of endoscopic ultrasound (EUS)-guided diagnosis and therapy of pancreatic cystic neoplasms. Studies pertinent to pancreatic cyst diagnosis by morphology, namely diagnostic accuracies of various criteria such as pancreatic cyst size, pancreatic duct size, mural nodules and use of EUS contrast agent are discussed. Tissue acquisition during EUS using a novel brush for cytology as well as microforceps is explored further. The role of multiple emerging molecular markers such as CEA, BRAF, KRAS, and GNAS, to name a few, is covered in detail. Recent developments relating to the utility of micro-RNAs in the analysis of cyst fluid is explored. Needle based confocal laser endomicroscopy for pancreatic cyst imaging is a recent development, and findings from recent trials are discussed. Furthermore, recent data regarding the role of ablative therapies using alcohol, paclitaxel and radiofrequency ablation of cyst is covered. Also, given the multiplicity of guidelines regarding management of pancreatic cystic neoplasms, we discuss the merits and shortcoming of these guidelines.

The Combination of Cyst Fluid Carcinoembryonic Antigen, Cytology and Viscosity Increases the Diagnostic Accuracy of Mucinous Pancreatic Cysts

BACKGROUND/AIMS: The objective of this study was to investigate the value of cyst fluid carcinoembryonic antigen (CEA) in combination with cytology and viscosity for the differential diagnosis of pancreatic cysts. METHODS: We retrospectively reviewed our data for patients who underwent endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and cyst fluid analysis. We investigated the sensitivity, specificity and accuracy of the combination of cyst fluid CEA, cytology and viscosity testing. RESULTS: A total of 177 patients underwent EUS-FNA and cyst fluid analysis. Of these, 48 subjects were histologically and clinically confirmed to have pancreatic cysts and were therefore included in the analysis. Receiver operator curve analysis demonstrated that the optimal cutoff value of cyst fluid CEA for differentiating mucinous versus nonmucinous cystic lesions was 48.6 ng/mL. The accuracy of cyst fluid CEA (39/48, 81.3%) was greater than the accuracy of cytology (23/45, 51.1%) or the string sign (33/47, 70.2%). Cyst fluid CEA in combination with cytology and string sign assessment exhibited the highest accuracy (45/48, 93.8%). CONCLUSIONS: Cyst fluid CEA was the most useful single test for identifying mucinous pancreatic cysts. The addition of cytology and string sign assessment to cyst fluid CEA increased the overall accuracy for the diagnosis of mucinous pancreatic cysts.

A Case of Sclerocorneal Cyst in a 4-Year-Old Female

PURPOSE: To report a case of sclerocorneal cyst found in a 4-year-old female following strabismus surgery treated with cyst wall excision and scleral graft. CASE SUMMARY: A 4-year-old female with a history of strabismus surgery performed 1.5 year prior presented with a whitish lesion in cornea and sclera which developed 1 month ago. Slit-lamp examination revealed a 4.2 x 3.5 mm-sized cyst at the superotemporal part of the cornea, extending into the sclera at 3-o'clock. Cyst fluid, precipitate aspiration, and cyst wall excision were performed. Scleral patch graft was used to cover the scleral defects after excision. Upon histopathological examination, the cyst wall was lined with nonkeratinized stratified squamous epithelium and numerous degenerated epithelial cells were present in the cyst aspirate. CONCLUSIONS: Sclerocorneal cyst can rarely develop following trauma or surgery. In this report, the sclerocorneal cyst, possibly induced by previous strabismus surgery, was treated successfully without recurrence using cyst wall resection.

Clinical Features and Prognosis of Intraductal Papillary Mucinous Neoplasm of the Pancreas / 대한내과학회지

Intraductal papillary mucinous neoplasm is frequently found recently and have recognized as precancerous lesions to pancreatic cancer that characterized by papillary growth of the ductal epithelium with rich mucin production and cystic dilatation of the main pancreatic duct and/or its branches. These tumors are asymptomatic and often multifocal. Preoperative differentiation between benign and malignant lesions is important to select the most appropriate treatment and to improve prognosis. Surgical resection is the treatment of choice to avoid malignant transformation when predictive factors for malignancy are present. These factors include mural nodule in the cyst, main pancreatic duct dilation, thick septum, cyst greater than 3 cm, atypias in the cyst fluid and the presence of symptoms. The follow-up of these patients who do not undergo surgical resection, is of great importance, since patients with IPMN appear to be at risk for pancreatic cancer. Patients who retain a portion of their pancreas following resection of an IPMN need to be followed up with periodic imaging to detect recurrences and metachronous lesions.

Clinical Features and Prognosis of Intraductal Papillary Mucinous Neoplasm of the Pancreas / 대한내과학회지

Intraductal papillary mucinous neoplasm is frequently found recently and have recognized as precancerous lesions to pancreatic cancer that characterized by papillary growth of the ductal epithelium with rich mucin production and cystic dilatation of the main pancreatic duct and/or its branches. These tumors are asymptomatic and often multifocal. Preoperative differentiation between benign and malignant lesions is important to select the most appropriate treatment and to improve prognosis. Surgical resection is the treatment of choice to avoid malignant transformation when predictive factors for malignancy are present. These factors include mural nodule in the cyst, main pancreatic duct dilation, thick septum, cyst greater than 3 cm, atypias in the cyst fluid and the presence of symptoms. The follow-up of these patients who do not undergo surgical resection, is of great importance, since patients with IPMN appear to be at risk for pancreatic cancer. Patients who retain a portion of their pancreas following resection of an IPMN need to be followed up with periodic imaging to detect recurrences and metachronous lesions.

Analysis of the chemical components of hydatid fluid from Echinococcus granulosus

Introduction The aim of this study was to explore the environment of Echinococcus granulosus (E. granulosus) protoscolices and their relationship with their host. Methods Proteins from the hydatid-cyst fluid (HCF) from E. granulosus were identified by proteomics. An inductively coupled plasma atomic emission spectrometer (ICP-AES) was used to determine the elements, an automatic biochemical analyzer was used to detect the types and levels of biochemical indices, and an automatic amino acid analyzer was used to detect the types and levels of amino acids in the E. granulosus HCF. Results I) Approximately 30 protein spots and 21 peptide mass fingerprints (PMF) were acquired in the two-dimensional gel electrophoresis (2-DE) pattern of hydatid fluid; II) We detected 10 chemical elements in the cyst fluid, including sodium, potassium, calcium, magnesium, copper, and zinc; III) We measured 19 biochemical metabolites in the cyst fluid, and the amount of most of these metabolites was lower than that in normal human serum; IV) We detected 17 free amino acids and measured some of these, including alanine, glycine, and valine. Conclusions We identified and measured many chemical components of the cyst fluid, providing a theoretical basis for developing new drugs to prevent and treat hydatid disease by inhibiting or blocking nutrition, metabolism, and other functions of the pathogen. .

Cholesterol detection and assay in radicular cyst fluid, the correlation between its existence and concentration and the inflammatory features

It is known that radicular cyst is one of the most important odontogenic inflammatory cysts and the existence of cholesterol needles in the wall of radicular cyst, raises the question about the probability of its existence in the cyst fluid and the relationship between the presence and concentration and the degree of inflammation occurring in the cyst. 20 radicular cysts from 20 patients were obtained, histological study was conducted for each tissue sample and study standardized testing and dosage of cholesterol in the fluid. After evaluating the results, cholesterol was found in 65% of the cysts and its concentration in the fluid was medium [m = 188 mg/dl] to high [m = 297 mg/dl] in 55% of them. The correlation between the cholesterol concentration in the cyst fluid and all of the presence of cholesterol needles and haemosiderin granules in the wall of the same cyst and also the degree of inflammation in the same cyst was positive [p=0.002], [p < 0.001] and [p=0.002] respectively. There was not a significant correlation between the presence of cholesterol needles and the degree of inflammation in the cyst [p=0.716]. The cholesterol concentration in the radicular cyst fluid can be used as an indicator for the presence of cholesterol needles and haemosiderin granules in the cyst, and it might be a feature of the degree of inflammation in the cyst

Effect of Echinococcus granulosus cyst fluid on the proliferation of HepG2 cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate whether Echinococcus granulosus cyst fluid-infected host liver cells had differential expression of mitogen-activated protein kinases (MAPKs) or differential cell cycle activity.</p><p><b>METHODS</b>Human liver cells cultured with different concentrations of hydatid cyst fluid (HCF) were tested by the MTT method to determine effects on proliferation. The cell cycle was assessed by flow cytometry. Western blotting was used to detect changes in protein expressions of p-ERK, PCNA, cyclin-A, cyclin-B1, cyclin-D1, and cyclin-E.</p><p><b>RESULTS</b>Forty-eight, 72 and 96 h of HCF at 15%, 30% and 60% concentrations in the cell media significantly promoted cell proliferation (F=67.845, P less than 0.01) and compared to controls (P less than 0.05). Cells exposed to 15% HCF for 48 h showed significantly induced expression of p-ERK (F=1.916, P less than 0.01), higher than controls (P less than 0.01). Cells exposed to 15% HCF for 24 h showed significantly induced expression of cyclin-Dl (F=3.901, P less than 0.01), higher than controls (P less than 0.01). Cells exposed to 15% HCF for 48 h or 30% HCF for 72 h showed significantly induced expression of PCNA (F=91.140, P less than 0.01), higher than controls (P less than 0.01). Cells exposed to 15% HCF for 48 h or 30% HCF for 72 h shed significantly induced expression of cyclin-A (F=18.587, P=0.002), higher than controls (P less than 0.01). Cells exposed to 15% HCF for either 48 h or 72 h showed significantly induced expression of cyclin-B1 (F=2.064, P less than 0.01), higher than controls (P less than 0.01). Cells exposed to 30% HCF for 96 h showed significantly induced expression of cyclin-E (F=1.068, P less than 0.01), higher than controls (P less than 0.01).</p><p><b>CONCLUSION</b>Hydatid cyst fluid exerts no inhibitory effect on primary cultured host liver cells, but may promote cellular proliferation.</p>

Pancreatic Pseudocyst after Endoscopic Ultrasound-Guided Fine Needle Aspiration of Pancreatic Mass

Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is well known as a safe diagnostic procedure. We report the first case of pancreatic pseudocyst after EUS-FNA of the pancreatic body mass. A 60-year-old male underwent EUS-FNA for incidentally detected pancreatic solid mass which was suspected as neuroendocrine tumor. Two weeks later, the patient visited emergency room with acute abdominal pain and right upper quadrant tenderness; leukocytosis and elevated C-reactive protein, amylase, and lipase levels were noted. Computed tomography discovered newly developed 11.5x9.5 cm sized cystic mass communicating with the main pancreatic duct. Cyst fluid analysis revealed amylase level of 3,423 U/L and fluid culture isolated Streptococcus parasanguinis. The cystic mass corresponds with pancreatic pseudocyst. FNA induced main pancreatic duct injury and fluid leakage may cause it. Endoscopists who perform EUS-FNA must remember that pancreatic main duct injury can occur as one of severe complications and that it could be treated successfully with endoscopic internal drainage.

Evaluation of two Taenia solium cysticercal antigenic preparations (vesicular fluid and a glycoprotein fraction with affinity for lentil lectin) for the immunodiagnosis of neurocysticercosis by enzyme-linked immunosorbent assay (ELISA) / Avaliação de duas preparações antigênicas de cisticercos de Taenia solium (líquido vesicular e uma fração glicoprotéica com afinidade para lentil lectina) para o imunodiagnóstico da neurocisticercose usando uma técnica imunoenzimática (ELISA)

OBJECTIVE: To evaluate the performance of two antigenic preparations (vesicular fluid - VF and a glycoprotein fraction, LLa-Gp fraction, purified from a whole parasite extract by lentil lectin affinity chromatography) from Taenia solium cysticerci for the immunodiagnosis of neurocysticercosis. METHOD: Fifty-six cerebrospinal fluid (CSF) samples (22 from patients with neurocysticercosis and 34 from patients with other neurological disorders) and 57 serum samples (22 from patients with neurocysticercosis, 18 from patients with other infections and 17 from presumably healthy persons) were assayed for anticysticercal IgG antibodies with an enzyme-linked immunosorbent assay (ELISA). RESULTS: The VF ELISA showed 100 percent sensitivity and specificity in CSF and serum samples, whereas the sensitivity and specificity of the LLa-Gp ELISA were, respectively, 90.9 percent and 97.1 percent, with the CSF samples and 95.5 percent and 100 percent with serum samples. There was no significant difference in the sensitivity and specificity of the two antigenic preparations used to screen CSF and serum samples. CONCLUSION: Considering the complexity and high cost of obtaining the LLa-Gp fraction, VF could be more suitable for screening specific antibodies by ELISA in CSF and serum samples from patients with neurocysticercosis.

OBJETIVO: Avaliar o desempenho de duas preparações antigênicas (líquido vesicular - LV e uma fração glicoprotéica, fração LL a-Gp, purificada do extrato total dos parasitas por cromatografia de afinidade com lentil lectina) de cisticercos de Taenia solium para o imunodiagnóstico da neurocisticercose. MÉTODO: Cinquenta e seis amostras de líquido cefalorraquidiano (LCR) (22 de pacientes com neurocisticercose e 34 de pacientes com outras doenças neurológicas) e 57 amostras de soro (22 de pacientes com neurocisticercose, 18 de pacientes com outras infecções e 17 de pessoas presumivelmente sadias) foram analisadas quanto à presença de anticorpos IgG anti-cisticercos com uma reação imunoenzimática (ELISA). RESULTADOS: A reação ELISA LV apresentou 100 por cento de sensibilidade e especificidade em amostras de LCR e soro, enquanto a sensibilidade e a especificidade da reação ELISA LLa-Gp em amostras de LCR e soro foram de 90,9 por cento e 97,1 por cento e 95,5 por cento e 100 por cento, respectivamente. Não foram encontradas diferenças significativas na sensibilidade e especificidade das duas preparações antigênicas utilizadas, tanto para amostras de LCR como para amostras de soro. CONCLUSÃO: Considerando a complexidade e o alto custo de obtenção da fração LLa-Gp, o LV pode ser mais adequado para a pesquisa de anticorpos específicos por ELISA em amostras de LCR e soro de pacientes com neurocisticercose.

Evaluation of ELISA and IHAT in serological diagnosis of proven cases of human hydatidosis

Cystic hydatid disease [Hydatidosis] is the most serious tape-worm infection prevalent in the cattle and sheep raising area of the world. Hydatidosis in man [as an accidental host] is caused by infection with the ova containing larval stage of Echinococcus granulosus. In the last decade, different techniques have been employed for sero-diagnosis of hydatidosis; as IHA, IFA, ELISA, CCLE [Counter Current Immuno-electrophoresis]. This paper evaluated the validity of ELISA and IHA. Since whole hydatid cyst fluid was used as a source of antigen for serodiagnosis. Thirty surgical and pathological hydatidosis proven patients were examined. The sensitivity and specificity of ELISA were 96.7% and 97.5% respectively, and that of IRA were 86.7%, and 95% respectively

MR Images and 1H MR Spectroscopy of Enteric Duplication Cyst of the Pancreas in an Adult

Enteric duplications associated with the pancreas are especially uncommon, and the differential diagnosis of pancreatic duplication cysts is often difficult, and may be confused with various cystic lesions of the pancreas. We report a case of pancreatic duplication cyst; present the images and laboratory findings including cyst fluid tumor markers. MR and MRS findings enabled the detection of the location, contour, characteristics of cystic fluid and definition of tissue planes between the lesion and adjacent structures, providing useful information for an accurate surgical approach.

Detection of G1 genotype of human cystic echinococcosis in Egypt

The first trial to detect G1 genotype in Egyptian human isolates of hydatid cysts [HC] and serum samples to approach diagnosis of cystic echinococcosis [CE] using human sera by PCR. Using strain specific primers, 27/36 confirmed CE patients [75%] showed G1 specific band in their sera at 254 bp. Specificity was 100% without detecting bands for either other parasitosis, or mass occupying lesions. Using PCR, G1 genotype was detected in 83.3% of HC samples, without significant difference between types of human isolates [pulmonary, hepatic, or multi-organ]. G1 genotype detection in human sera was in 75% of CE patients compared to 83.3% in HC samples of the same group of patients proved satisfactory, simple and safer than HCF sampling. IHAT gave sensitivity of 58.3% compared to histopathological examination of surgically removed cysts or examination of hydatid cyst fluid [HCF] for pro-toscolices [gold standards]. The specificity was 70% with false positive reactions with other parasitic infections and mass occupying lesions. PCR detection of G1 genotype in Egyptian animal hydatid cysts showed 90% in camel isolates and 80%; in sheep isolates, but pig isolates were negative. The presence of this genotype in a high percentage in camel isolates incriminated sheep strain as the source of CE camel infection. The results may give an explanation to the contradicting results of other studies that did not relay upon molecular aspects

Apresentação das lesões mamárias císticas à ultra-sonografia utilizando a elastografia / Features of cystic breast lesions at ultrasound elastography

OBJETIVO: Demonstrar a apresentação mais freqüente das lesões mamárias císticas utilizando a elastografia e discutir a sua aplicabilidade. MATERIAIS E MÉTODOS: A casuística compôs-se de 150 pacientes encaminhadas para realização de biópsia mamária percutânea com 175 lesões. Foram excluídas as lesões com diagnóstico histológico de lesões sólidas (153 lesões) e incluídas as lesões com características císticas à histologia (22 lesões), incluindo cistos complicados, lesões papilíferas, lesões inflamatórias, hiperplasia de células colunares típica e ectasia ductal. Estas lesões foram classificadas de forma retrospectiva por meio da elastografia, conforme escores criados pelos autores, variando de 1 a 4. RESULTADOS: Das 22 lesões encaminhadas, 13 (59 por cento) correspondiam a cistos, uma (4,6 por cento) a ectasia ductal, duas (9,2 por cento) a lesões inflamatórias, cinco (22,6 por cento) a lesões papilíferas e uma (4,6 por cento) a hiperplasia de células colunares. Foram encontrados 17 escores 2, quatro escores 3, um escore 4 e nenhum escore 1, com especificidade de 95 por cento. CONCLUSÃO: As lesões císticas mamárias têm diferentes apresentações à elastografia, conforme o resultado histológico, sendo este um método útil para a sua diferenciação e de fácil aplicabilidade na clínica diária.

OBJECTIVE: To demonstrate the most frequent features of cystic breast lesions at ultrasound elastography, discussing the applicability of this method. MATERIALS AND METHODS: The present casuistic included 150 patients referred for percutaneous breast biopsy of 175 lesions. Histologically diagnosed solid lesions (153 lesions) were excluded; lesions histologically diagnosed as cystic (22 lesions), including complicated cysts, papillary lesions, inflammatory lesions, typical columnar cell hyperplasia and duct ectasia were retrospectively classified by means of elastography, according to a scoring system developed by the authors, with categories ranging between 1 and 4. RESULTS: Thirteen (59 percent) of the 22 lesions evaluated corresponded to cysts, one (4.6 percent) to duct ectasia, two (9.2 percent) to inflammatory lesions, five (22.6 percent) to papillary lesions, and one (4.6 percent) to columnar cell hyperplasia. The scoring system was applied with the following results: 17 category 2 lesions, four category 3 lesions, one category 4 lesion, and none category 1 lesion, with a 95 percent specificity. CONCLUSION: Different features of cystic breast lesions are demonstrated by elastography according to histological results, representing a useful and easily applicable method for differentiating benign from malignant breast lesions.

estimation of erythropoietin levels in the blood serum and cystic fluid in patients with solitary renal cysts

Renal cysts are common among people older than 50 years. A hypothesis that erythropoietin may be produced in renal cysts as a defense mechanism to prevent anemia was put forwards, thus erythropoietin concentration in cystic fluid should be higher than the serum level. Our study aimed to explain this phenomenon. Levels of erythropoietin were estimated in serum and cystic fluid of 33 patients with renal cysts and were compared to results from 33 controls. Results showed a 35 times higher level of erythropoietin in cystic fluid compared to serum. Serum levels of erythropoietin from renal cyst patients were comparable to those from control group. Thus we concluded that there is no erythropoietin penetration from the cystic fluid into the blood serum; and the role of high erythropoietin concentration in renal cystic fluid is not clear yet