Radiotherapy-induced changes of peripheral blood lymphocyte subpopulations in cervical cancer patients: relationship to clinical response.

PURPOSE: To determine the absolute number and percentage of peripheral blood lymphocyte subpopulations positive (+) cells CD8(+), CD8(+)NKG2D(+), CD8(+), Granzyme B(+) (GrB), CD16(+), CD16(+)NKG2D(+), CD56(+) and CD56(+)NKG2D(+) in cervical cancer patients before and after radiotherapy (RT), and to analyze whether their changes are related to the clinical response. MATERIALS AND METHODS: Stage IIB - IVA cervical cancer patients received external irradiation and concomitant intracavitary brachytherapy. Blood samples for immunophenotypic analysis by flow cytometry were collected from each patient one day before starting RT and one day after completing RT. Fifteen healthy volunteers served as controls. Surface marker expression and granzyme B positivity were quantified on FACSCalibur flow cytometer. RESULTS: Unlike their absolute numbers, the percentages of all analyzed lymphocyte subsets of all patients, including those with complete response (CR), were significantly increased (p <0.05) after RT. Only in patients with progressive disease (PD), CD8(+), CD8(+)NKG2D(+), CD16(+) and CD56(+)NKG2D(+) lymphocytes were not significantly increased. In healthy volunteers, the percentage of CD8(+)GrB(+) lymphocytes was lower than in patients after RT, while the percentages of CD56(+) and CD56(+)NKG2D(+) cells were higher than in patients before RT (p <0.05). CONCLUSION: Our data indicate that RT, besides its direct cytoreductive effect on tumor cells, may contribute to better immunological control of cervical cancer.

[Imaging capabilities in upper urothelial malignancies differentiation].

UNLABELLED: Aim of our study is to analyze sensitivity and specificity of imaging procedures in characterization upper urothelial malignancies, according to algorithm suggested by American Urology Association. MATERIAL AND METHODS: We analyzed 242 patients with kidney tumor masses who had been operated during 2006/2007 at Urological clinic in Belgrade. Due to pathohistological exam 210 patients had kidney parenchyma and 32 patients upper urothelial kidney tumor. RESULTS: According to tumor stage, computed tomography was sufficient and definitive diagnostic tool concerning both renal epithelial and upper urothelial malignancy. Only in four cases 1.60% (4/242; CT in 3/4, MRI 1/4) preoperative site of origin was different from histopathology findings. This mislead to inappropriate surgery plan. CONCLUSION: Familiarity with limitations and capabilities of imaging modalities is crucial for appropriate diagnosis. It should respect algorithm but has to be individual adapted.

[Diagnosis of pericardial cysts: significance of cardiac magnetic resonance and literature review].

Pericardial cysts are uncommon and caused by an incomplete coalescence of fetal lacunae forming the pericardium. The paper presents two cases of pericardial cyst and literature review. The first is a case of a female patient with progressive dispnoa and spherical mass located in the right cardiophrenic angle on a chest x-ray. A pericardial cyst with low signal intensity was noted on T1w, high signal intensity on T2w in TSE (turbo spin echo) sequence on magnetic resonance images (MRI) which was suggestive of serous content. The patient underwent pericardial puncture and was thereafter free of symptoms. Histologic study of the cyst confirmed hydatid cyst diagnosis. Another patient is with echocardiographic evidence of cystic formation which was confirmed on MRI, with high signal intensity on SSFP (steady state free precession) sequence. The cyst was without septa and without communication with pericardial space. Since there were no significant hemodynamic changes, the patient is on regular follow up.

[CT endoscopy in urinary bladder lesions detection].

AIM: To evaluate applicability and efficacy CT virtual cystoscopy in detection of urinary bladder tumors. MATERIAL AND METHODS: During the period of 14 months, 17 patients with suspicion or present of some urinary bladder lesions has undergone CT virtual and conventional cystoscopy. After examination, all data were moved to the workstation for interactive endoluminal navigation. After that, radiologist analyzed transversal and virtual images without results of conventional cystoscopy and made conclusion. RESULTS: Results were divided according to their basic clinical application. By using this method, all lesions over 5 mm in size were revealed. In the group of patients that were followed up for urinary bladder tumors, three patients with carcinomatous lesion were revealed. Two tumors of bladder vault that were missed on transversal scan were visualized by virtual cystoscopy. Useful additional information about tumor spread was given in two patient. One tumor inside the bladder diverticulum was detected, that was not seen by conventional cystoscopy. In two patients, endoluminal origin of mass that could not be confirmed by conventional radiologic methods, was determined. CONCLUSION: CT virtual cystoscopy is useful method and technics that promise a lot, especially in following situations: a) follow up of bladder tumors; b) supplemental estimation of endoscopically hardly accessible regions; c) differential diagnosis between intravesical and exravesical lesions. Optimal estimation offers adequate bladder distension with patient positioned on the back and on the belly and interpretation as well as on transversal and virtual images.