[Prevalence of the intestinal variant in multiorgan atherosclerosis: difficulties of the clinical diagnosis]. / Preobladanie kishechnoi formy pri poliorgannom ateroskleroze: trudnosti klinicheskoi diagnostiki.

One case of multiorgan atherosclerosis with prevalence of atherosclerotic clinical manifestations of the mesenteric arteries with their thrombosis and intestinal infarct is reported. The diagnosis was established only in the final stage of the disease.

[Xanthogranulomatous pyelonephritis]. / Ksantogranulematoznyi pielonefrit.

Based on the evidence obtained on 28 cases of xanthogranulomatous pyelonephritis (XP), the authors suggest to distinguish two XP clinical forms: obstructive and nonobstructive. The former may occur in noticeable destruction of renal tissue and urine retention secondary, most frequently, to long-standing nephrolithiasis. The latter simulates by symptoms and examination results renal carcinoma. In suspicion of nonobstructive XP, the surgeon should consider fast-made intraoperative biopsy to decide on feasibility of sparing intervention.

[Morphologic characteristics of nephrosclerosis: electron microscopic, immunohistochemical and histospectrophotometric study]. / Morfologicheskaia kharakteristika nefroskleroza: élektronno-mikroskopicheskoe, immunogistokhimicheskoe i histospektrofotometricheskoe issledovanie.

Combined study of nephrosclerosis revealed profound alterations of both extracellular matrix (ECM) and tubular epithelium. ECM alterations manifested in the accumulation in the stroma of I and III types of collagen, fibronectin, considerable increase of collagen IV and laminin.

[Sclerosis and carcinogenesis]. / Skleroz i kantserogenez.

Morphological analysis of the sclerotic changes in peripheral lung carcinoma (PLC) and nephrosclerosis in renal-cell carcinoma (RCC) established a promoting role of sclerosis in carcinoma development. The pneumosclerosis role as a background process in the PLC development is proved by the following facts: high proportion (83%) of the carcinoma in the scar among PLC; identity of the scar collagen composition in PLC and that in metatuberculosis and metapneumonic pneumosclerosis foci; detection of metatuberculosis foci in 75% of PLC; the presence of the precancerous changes in the epithelium entrapped in the pneumosclerotic foci, not only with signs of morphological atypia, but with the disturbance of nuclear DNA and cellular oncogene expression as well. The association of RCC with nephrosclerosis is shown by a high proportion (82.7%) of the RCC development against the background of nephrosclerosis; the dependence of the so-called cortical adenoma development on the degree of nephrosclerosis; epithelial proliferation in the nephrosclerotic foci with the appearance of undifferentiated cells with the altered DNA content and the expression of cytokeratins and vimentine. Carcinoma morphogenesis against the background of sclerosis may be described as follows: development of sclerosis (focal and/or diffuse), the appearance of the focal epithelial hyperplasia in the scar, dysplasia or adenoma and finally carcinoma.

[Kidney adenoma]. / Adenomy pochek.

Morphological, electron microscopic, histospectrophotometric and morphometric (mean nuclear surface and ellipticity coefficient) studies of small cortical adenomas were performed. Surgical (kidneys removed because of renal cell carcinoma and shrinkage) and autopsy (atrophic kidney) materials were used. Total 142 adenomas were found in 93 out of 592 observations. The incidence of adenomas in kidneys with renal cell carcinoma was 12%, in contracted kidneys 19.2 and 19.44% (surgical and autopsy material). Electron microscopic examination was performed in 15 adenoma cases. Comparative quantitative DNA determination was performed in sections stained by Feulgen using plug-method on the microscope spectrum analyzers in 20 cases of adenoma and 15 cases of renal cell carcinoma identical histologically to adenocarcinoma. This combined study revealed the adenomas heterogeneity. Only part of them (well differentiated with diploid DNA-histograms and nuclei up to 32 mm2 may be referred to adenomas. All the others morphologically and morphometrically are close to adenocarcinomas. The type of DNA distribution and mean nuclear surface are most important for differential diagnosis between renal adenoma and carcinoma.

[Background and precancerous processes in renal cell carcinoma]. / Fonovye i predrakovye protsessy pri pochechnokletochnom rake.

150 patients dying from renal cell carcinoma are studied in order to reveal the background disease, incidence and character of the nephrosclerosis and the possible morphogenetic link between nephrosclerosis and carcinoma. Renal cell carcinoma is found to develop in 82.7% of cases in the kidneys with signs of nephrosclerosis. The diffuse nephrosclerosis developing in connection with the hypertension disease, atherosclerosis, diabetes mellitus, chronic pyelonephritis, nephrolithiasis is the most important. Proliferation of the canaliculi epithelium with the appearance of undifferentiated cells are regularly found in the nephrosclerotic areas. The disturbance of the epithelium differentiation is followed by the development of dysplasia the phenotypical variants of which are similar to those of renal cell carcinoma. Adenomas are found in 11.3% of cases of renal cell carcinoma which may originate from the adenomas developing against the background of nephrosclerosis.

[Renal adenomatosis against a background of hydronephrotic transformation]. / Adenomatoz pochki na fone gidronefroticheskoi transformatsii.

A rare case of multiple (over 60) renal adenomas in a 24-year-old patient is described; the adenomas developed against the background of the hydronephrotic transformation resulting from the stenosis of the ureteropelvic segment.

[Oncocytoma of the kidneys]. / Onkotsitomy pochek.

Fourteen cases (4%) of renal oncocytoma have been detected in a retrospective and current analysis of 350 operative observations of renal carcinoma. Clinical and morphologic (macro-, microscopic, electron microscopic, and angiographic) characteristics of this tumor are described, the differential diagnostic criteria of oncocytoma and renal-cell carcinoma are discussed, as is the prognosis of this condition. The authors point to the possibility of oncocytoma growth into the renal capsule, of invasion into the intra- and extratumor veins, of metastases to the lymph nodes. They recommend distinguishing between well- and intermediately differentiated oncocytomas, for this factor determines the course and prognosis of the disease.

[Multilocular cystic nephroma]. / Mul'tilokuliarnaia kistoznaia nefroma.

The nephroma occurred in a 38-year-old woman, and its sole clinical manifestation was an aching pain in the lumbar region. Angiographic, macroscopic, and light- and electron-microscopic findings are presented. A special feature of the tumor was the presence of secretory granules in its epithelial cells. The possibility of prostaglandin synthesis by the tumor is discussed.

[Prognostic criteria in renal cell cancer]. / Kriterii prognoza pri pochechnokletochnom rake.

Survival of 94 patients with hypernephroma is evaluated kinetically. The following factors were analysed: sex, age, tumour size, tumour invasion in the fibrous renal capsule, venous invasion, morphologic variant of the tumour, differentiation degree, angiographic tumour type. The main factors affecting the prognosis appeared to be tumour invasion in the fibrous renal capsule and the degree of tumour differentiation. Adenocarcinoma has a better prognosis.

[Clinico-morphological characteristics of renal-cell carcinoma]. / Kliniko-morfologicheskaia kharaktsristika pochechnokletochnogo raka.

One hundred and fifty patients aged 19 to 79 years operated on for renal-cell carcinoma in 1978-1982 were examined. In 46% of the patients tumour was confined to the kidney, in 30%, it grew into the perirenal fat, and in 18.7%, into the renal veins, in 11.3%, there were metastasis to the regional lymph nodes and in 8%, remote metastasis. Morphologically, tumours were verified according to the classification by N. A. Kraevsky et al.: clear-cell carcinoma was diagnosed in 50.7%, granular-cell carcinoma in 12.7%, sarcoma-like carcinoma in 4.7%, adenocarcinoma in 13.3%, mixed-cell carcinoma with signs of different variants in 18.7% of patients. The morphological picture was compared to the angiographic and main clinical data; the frequency of tumour growth into the fibrous capsule of the kidney and vein and the incidence of metastasis were established for various morphological types of tumour. The incidence of these parameters is not similar at different morphological types, thus it is possible to distinguish different clinicomorphological variants of renal-cell carcinoma.

[Bronchiolar-alveolar cancer in idiopathic fibrosing alveolitis]. / Bronkhiolo-al'veoliarnyi rak na fone idiopaticheskogo fibroziruiushchego al'veolita.

An observation of bronchiolo-alveolar carcinoma that developed in the presence of the idiopathic fibrosing alveolitis (IFA) in a woman of 57, is described. The duration of IFA was 12 years. Diffuse pneumosclerosis with the development of the so-called "honey-comb" lungs was observed. Numerous confluent foci of the bronchiolo-alveolar carcinoma in both the lungs are found in the presence of alterations typical for IFA (diffuse sclerosis of alveolar septa, microcystosis). The cause of death was progressing respiratory deficiency.

[Pathogenesis and morphology of pregnancy toxemias]. / Patogenez i morfologiia nefropatii beremennykh.

Data from the literature on the pathogenesis and morphological manifestations of nephropathy in pregnant women are presented. Three most common concepts of the pathogenesis of this disease are described: coagulopathy, primary alteration of the endothelium, and immunological disorders. The latter is currently considered to be the most convincing. Information on morphological changes in the kidneys and placenta in nephropathy are presented. The data from the literature on immunohistochemical and electron microscopic manifestations found in kidney biopsies and their reversibility are discussed in detail.