Selected morphologic features influencing the prognosis of conventional renal cell carcinomas co-expressing P53 and MDM2.

Renal cell carcinoma is the most deadly of common urologic malignancies. The classical prognostic factors, including tumor type, grade and stage, as well as performance status of the patient, offer important information, but there is a need for new biomarkers which could improve the quality of prognostication. It has been proposed that tumors co-expressing P53 and MDM2 could represent a specific, more aggressive subgroup. The aim of the study was to explore this hypothesis using tissue microarrays, using two different anti-P53 antibodies. The material analyzed consisted of 470 cases of renal clear cell carcinoma. Reaction for P53 was positive in 15.1 or 13.2% of cases, depending on the antibody used. Reaction for MDM2 was positive in 37.9% of cases; 6.5 or 5.3% of cases coexpressed P53 and MDM2. Both P53-positive and double P53/MDM2-positive cases were higher grade and more likely to contain a sarcomatoid component, but their stage was similar to negative cases. PAb1081 P53-positive MDM2-positive cases were larger than the rest of the tumors (7.6 cm vs. 6.1 cm, p < 0.001). Our data support the hypothesis of prognostic significance of P53, and double P53/MDM2 positivity, yet further studies are needed to clarify the issue.

Frequency of ERG-positive prostate carcinoma in Polands.

Prostatic carcinoma (PC) is one of the most frequent cancers in men. Molecular pathogenesis of PC remains poorly understood. Translocations involving ERG were found to be the single most frequent genetic event. A strong correlation exists between this translocation and ERG positivity on immunohistochemistry. The rate of ERG positivity and its relationship with other clinicopathological parameters differ between populations and between studies; in particular, there are few data on ERG-positive PC in Eastern Europeans. In the present study, tissue microarrays of unselected PC cases were constructed and standard immunohistochemistry for ERG performed. The results were compared with the basic pathologic prognostic parameters. The group under study consisted of 113 cases; 52 (46.02%) were positive for ERG. The positive cases showed a slightly higher Gleason score (median 6 vs. 7). The majority of ERG-positive cases showed nerve bundle invasion and were also less likely to be prostate confined than negative ones. In conclusion, the frequency of ERG-positive PC in our series is similar to Western populations, and they show some unfavorable prognostic features.

Brown bowel syndrome (intestinal lipofuscinosis) - a case report and review of the literature.

Brown bowel syndrome (BBS) is a very rare condition occurring in association with malabsorption syndromes. It is characterised by deposition of granular, brown pigment (lipofuscin or ceroid) in intestinal smooth muscles. Rarely BBS can be complicated by distention of any segment of the bowel. We present a case of BBS associated with massive dilation of first loop of the small intestine and moderate dilation of the sigmoid colon with functional intestinal disturbances requiring surgical intervention in an 11-year-old boy.

Karyometric comparison of splenic and gastric marginal zone lymphomas.

BACKGROUND: Marginal zone lymphomas are indolent B-cell lymphomas associated with autoimmunity and chronic inflammation. The two most frequent variants are mucosa associated lymphoid tissues marginal zone lymphomas and splenic marginal zone lymphomas. The aim of the study was to determine if it is possible to classify splenic and gastric lymphomas according to karyometric features. METHODS: The material consisted of 16 splenic and 14 gastric lymphomas. The measurements were done with the AnalySIS image analysis system. In each case at least 100 nuclei were selected, and 19 different geometric parameters were measured. RESULTS: On statistical analysis, the nuclei of splenic and gastric lymphomas showed differences in most parameters, but significant overlap of the values was present. Neural networks were trained and used for classification of the data. By this method, the nuclei were properly classified with a sensitivity of 0.75 and specificity of 0.71. In addition, in all the cases the majority of the nuclei were properly classified, thus allowing correct classification of all the cases into "splenic" or "gastric". CONCLUSION: These results support the view that mucosa-associated lymphoid tissue lymphomas and splenic marginal-zone lymphomas are separate entities.

Sclerosing angiomatoid nodular transformation of the spleen treated by laparoscopic partial splenectomy.

The authors describe a case of sclerosing angiomatoid nodular transformation (SANT) of the spleen treated at the 2(nd) Department of Surgery, Jagiellonian University, Medical College. The patient was a 23-year-old woman. Clinically she presented with 2-year history of recurrent mild fever, diffuse joint pain, abdominal discomfort and iron deficiency anaemia of chronic disease. The laboratory tests revealed a non-characteristic chronic inflammatory response. A splenic solid lesion 9 cm in diameter was found on abdominal computed tomography. The patient underwent uneventful laparoscopic resection of the upper half of the splenic parenchyma. The resected tumour showed characteristic histological and immunophenotypical findings of SANT as previously described in the literature. In long-term follow-up, improvement of preoperative symptoms and abnormalities in the blood tests was documented.

[Actinomycosis in persistent urachus]. / Promienica w przetrwalym moczowniku.

A 70 -year old woman with tumor of urachus confirmed in USG and CT us described in this article. In this tumor we have found during histopathology Gram-positive Actinomyceces. The location of Actinomyces in urachus is very rare.

Correlation of microsatellite status, proliferation, apoptotic and selected immunohistochemical markers in colorectal carcinoma studied with tissue microarray.

Colorectal carcinoma is a frequent malignant tumor, characterized by varying clinical course and response to treatment. At the molecular level, colorectal carcinomas are divided into tumors with chromosomal instability (microsatellite-stable, MSS), microsatellite instability (MSI-H) and low microsatellite instability (MSI-L). The method of tissue microarrays allows for combining materials originating from multiple patients into a single slide, what makes possible to simultaneously investigate large material for the presence of numerous, diversified markers. The study material consisted of 208 cases of colorectal carcinoma. Microsatellite instability was evaluated in frozen material employing the PCR reaction with gel and capillary electrophoresis. Following a standard histopathological assessment, tissue microarrays were prepared using a MTA-1 microarrayer (Beecher) and standard immunohistochemical reactions were performed to detect the presence of bcl-2, CDX-2, Ki67, MLH1, MSH2, MSH6, p16, p53 and survivin. Apoptotic cells were detected using the TUNEL method. The correlations between the reactions were investigated and differences in the expression of the investigated proteins noted in carcinomas with various degrees of microsatellite instability. The agglomeration analysis showed differences in patterns of expression between MSS, MSI-L and MSI-H carcinomas. The discriminant function analysis demonstrated that the MSI-H carcinomas were best differentiated by MLH1, survivin and Ki67 expression, while the MSI-L tumors differed from the remaining colorectal carcinomas by their apoptotic index, local tumor stage (pT), the presence of angioinvasion and mucin production.

Three in one kidney. report of a case.

The case of a 70-year old male in whom imaging studies revealed two separate tumors in the left kidney is presented. In the surgical nephrectomy material two tumors were seen, 4.5 and 4 cm in diameter; one of them was a clear cell carcinoma, and the other--a papillary carcinoma, respectively. In addition, a small, subcapsular nodule was detected, which was classified as an adrenal rest. According to current opinions, the above lesions have different pathogenesis and their coexistence may be regarded as accidental.

The comparison of the agreement in determining the histological grade of uterine endometrial endometrioid carcinoma, using the three-grade FIGO classification and the two-grade system.

The objective of the investigation was to compare the degree of interobserver agreement in determining the histological grade of uterine endometrial endometrioid adenocarcinoma using the criteria proposed by the three-grade FIGO classification (1988) and the new, two-grade system proposed by Lax et al. (2000). In the FIGO system, the assessment is focused on the amount of solid, non-squamous growth pattern and the additional feature is the presence of the so-called "notable nuclear atypia" (nuclear grade), with the latter criterion not having been precisely defined. In the two-grade system, the evaluation concentrates on the amount of the solid component, regardless of its character, type of neoplastic growth pattern (expansive or diffusely infiltrating) and the presence of necrosis within the tumor mass. A total of 133 cases of uterine endometrial carcinoma were evaluated, determining the stage according to the FIGO classification and assessing the histological grade based on the criteria presented by the above two systems. All the cases were separately examined by 5 pathologists with varying degrees of experience in gynecological pathology. A higher degree of interobserver agreement was demonstrated when the two-grade system was employed as compared to the FIGO system, regardless whether the material was evaluated by experienced pathologists (FIGO k - 0.64 - 0.71, binary - 0.91 - 0.92), or by individuals with little experience in gynecological pathology (FIGO k - 0.23 - 0.48, binary - 0.21 - 0.57). The data point to the superior character of the two-grade system as to the agreement of the histological grade assessment, but also suggest a considerable effect of experience on the precision of the evaluation.

Benign clear-cell "sugar" tumor of the lung--a case report.

The authors present a rare case of a surgically treated so-called "sugar" tumor of the lung in a 68-year old male patient.

Asynchronous collecting duct carcinoma of the kidney and pulmonary adenocarcinoma. A case report.

Collecting duct carcinoma (CDC) is a rare renal malignancy accounting for about 0.4-2.6% of cases. We report a case of CDC in a 61-year-old woman previously operated on for pulmonary adenocarcinoma. On histological examination and immunohistochemical research diagnosis of asynchronous primary bronchial carcinoma and renal CDC was made. The authors review the available literature on CDC and differential diagnosis of metastatic versus primary renal carcinomas.