The prognostic significance of tumour infiltrating lymphocytes in oral squamous cell carcinoma.

Currently there is being conducted an extensive search to find new prognostic factors in oral squamous cell carcinoma which would assist in better patient management. One of the most promising prognostic markers is the density of tumour infiltrating lymphocytes. 100 cases of patients with oral squamous cell carcinoma that underwent surgical resection between 2006 and June 2016 at our institution were included in this study. From each case the most representative HE stained slide was identified and the density of tumour infiltrating lymphocytes were classified as non-brisk or brisk, which was included in the survival analysis. Upon analysis there was a strong correlation between non-brisk (n = 28) and brisk (n = 72) tumour infiltrating lymphocytes and the primary clinical outcomes: overall survival (p = 0.0472) and local recurrence-free survival (p = 0.00037). Univariate and multivariate Cox regression model confirmed the high prognostic value of tumour infiltrating lymphocytes as the independent prognostic indicator of better survival, being even superior, in our study, to the traditional pTNM system. This study provides robust evidence that the density of tumour infiltrating lymphocytes demonstrates a high prognostic significance in oral squamous cell carcinoma.

Benign metastasizing leiomyoma in triple location: lungs, parametria and appendix.

Benign metastasizing leiomyoma (BML) usually are situated in one organ, most often in lungs. BML patients typically have a history of uterine leiomyoma treated with hysterectomy, myomectomy or subtotal hysterectomy. The aim of the study was to present the case of a 53-year-old woman with triple location in the lungs, parametria and appendix. She had undergone a myomectomy 26 years earlier. In 2015, she was admitted to the surgical department because of abdominal pain, whereupon a cholecystectomy was performed. CT scans showed pelvic mass with pulmonary metastasis. Upon discharge the patient was referred to the Gynecology Clinic, where a laparotomy was performed. The intraoperative findings were: 1) uterus with multiple leiomyomas, 2) four tumors in the parametria, 3) tumor connected to the appendix. A subtotal hysterectomy, with a bilateral salpingo-oophorectomy, removal of the tumors from the parametria and appendectomy was performed. Pathology confirmed the diagnosis based on morphology and immunohistochemical staining (strongly positive for estrogen receptors and SMA, while Ki67 was very low, below 1%). Upon postoperative recovery, the patient was referred to the Thoracic Surgery Department. During the thoracotomy, multiple nodes, surrounded by lung parenchyma, were revealed. Wedge resection was performed, for localized pulmonary lesions, and sent for pathological examination. The final pathological diagnosis was benign metastasizing leiomyomatosis. In conclusion, the triple location of BML could possibly be a result of a parallel different metastasizing mechanism, although it is impossible to exclude one mechanism, which may be the cause of the metastases in three locations.

RCAS1 decidual immunoreactivity during cesarean section in scar deciduosis: immune cell presence and activity.

INTRODUCTION: Scar deciduosis provides a research model that enables us to assess the impact of decidua on the activity and quality of the immune cells infiltrating this scar tissue. This unique model allows us to examine these processes under conditions excluding the impact of placental cells which, along with decidual cells, control the activity of immune cells under physiological conditions. RCAS1 is a protein responsible for the suppression of the cytotoxic immune response during gestation. The present study evaluates the immunoreactivity level of RCAS1 with respect to immune cell status in the decidua and scar deciduosis. MATERIAL AND METHODS: Immunohistochemical analysis of RCAS1, CD3, CD56, CD25, and CD69 antigen immunoreactivity levels was performed in tissue samples derived from scar deciduosis that developed after a previous cesarean section and were excised during a subsequent cesarean section. The control group consisted of decidua samples derived from cesarean section at term. RESULTS: A statistically significantly higher RCAS1 immunoreactivity level was identified in scar deciduosis tissue samples than in decidua derived from a cesarean section at term. The number of CD56+ cells and immunoreactivity of the CD25 antigen level were observed to be statistically significantly higher in scar deciduosis than in the control group. CONCLUSION: The presence of an enhanced number of immune cells of higher activity in ectopic decidua during the final step of decidualization seems to be associated with an increase in the immunoreactivity level of RCAS1.