Assessment of Biochemical Markers in Two Particular Cases with Maxilary Cysts

Biochemical markers have been previously described as predictors of bone remodelling in dental disorders. Here we present 2 cases, diagnosed with inflammatory maxillary cysts in whom biochemical markers of bone remodeling have been evaluated. Clinical evaluations, radiological and laboratory tests, including histopathological examinations were performed in both patients. Laboratory test results indicated an activation of osteoblasts in both cases. Bone alkaline phosphatase (BAP) serum levels, as a marker for bone deposition, were significantly increased in both patients. In addition, differences in the cyst size and the tartrate-resistant acid phosphatase (TRACP-5b) test results have been noted in these cases. In the first case, with a cyst [ 1.5 cm in diameter, TRACP-5b serum levels were within the normal reference laboratory values, suggesting that the process of bone resorption may be slightly decreased or potentially lacking. In the second case, with a cyst ] 3 cm in diameter, TRACP-5b serum levels were 1.5 times higher than the upper limit of the normal reference laboratory values, suggesting that a process of osteolysis apparently occured. The two cases diagnosed with maxillary cyst presented differences in the size and the TRACP-5b test results. This suggest a possible correlation between TRACP-5b serum levels, bone resorption and the size of maxillary cysts. Further studies should be performed to confirm this hypothesis.

New advances in targeted gastric cancer treatment

Despite a decrease in incidence over past decades, gastric cancer remains a major global health problem. In the more recent period, survival has shown only minor improvement, despite significant advances in diagnostic techniques, surgical and chemotherapeutic approaches, the development of novel therapeutic agents and treatment by multidisciplinary teams. Because multiple genetic mutations, epigenetic alterations, and aberrant molecular signalling pathways are involved in the development of gastric cancers, recent research has attempted to determine the molecular heterogeneity responsible for the processes of carcinogenesis, spread and metastasis. Currently, some novel agents targeting a part of these dysfunctional molecular signalling pathways have already been integrated into the standard treatment of gastric cancer, whereas others remain in phases of investigation within clinical trials. It is essential to identify the unique molecular patterns of tumours and specific biomarkers to develop treatments targeted to the individual tumour behaviour. This review analyses the global impact of gastric cancer, as well as the role of Helicobacter pylori infection and the efficacy of bacterial eradication in preventing gastric cancer development. Furthermore, the paper discusses the currently available targeted treatments and future directions of research using promising novel classes of molecular agents for advanced tumours.

Evaluation of proliferation potential in thyroid normo-/hypofunctioning and hyperfunctioning nodules

INTRODUCTION

Thyroid follicular adenomas (FA) and adenomatous thyroid nodules (AN) - lesions that are frequently found in areas with iodine deficiency, can be normo-/hypofunctioning (scintigraphically cold - SCN) or hyperfunctioning (scintigraphically hot - SHN) nodules.

AIM

Evaluation of proliferation potential in thyroid nodules on tissue samples obtained at surgery from euthyroid patients clinically diagnosed with SCN and from patients with thyroid hyperfunction and SHN.

MATERIALS AND METHODS

We investigated the proliferation activity estimated by assessing PCNA and Ki-67 proliferation markers in 20 SCN (eight FA and 12 AN) and 16 toxic nodules (six hyperfunctioning FA and 10 toxic multinodular goiters), on formalin-fixed and paraffin-embedded tissue samples, 4-5 μm thick; we used the immunohistochemical technique in LSAB system (DAB visualization) with anti-PCNA (PC10) and anti-Ki-67 (MIB-1) monoclonal antibodies. For each case, we calculated the proliferation index PI-PCNA and PI-Ki-67. The dates were statistically evaluated using the t-unpaired test.

RESULTS

We observed a higher PI-PCNA in thyroid nodules than in the normal surrounding thyroid tissue, with statistically significant values for FA (14.3% vs. 3.8%; p<0.029) and also for AN (8.36% vs. 1.24%; p<0.001). The mean PI-Ki-67 in nodules vs. surrounding thyroid tissue was 1.64% vs. 1.10% in FA (p<0.35) and 1.07% vs. 0.51% in AN (p>0.05). We also noted: (1) significantly higher PI-PCNA values (p < 0.01) in FA (14.03%) than in AN (8.36%), as compared to statistically insignificant values for Ki-67 (1.64% vs. 1.07%; p>0.05); (2) increased proliferation rate (p<0.01) in thyroid nodules with aspects of lymphocytic thyroiditis (LT) (PI-Ki-67 was 1.21%) as compared to nodules without LT (PI-Ki-67 was 0.12%); (3) a mean PI-PCNA of 8.5% and PI-Ki-67 of 4.61% in toxic thyroid nodules (TTN) vs. 3.01% and 1.5% in normal surrounding thyroid, respectively.

CONCLUSIONS

The clinical expression of SCN is the consequence of increased thyrocyte proliferation in the nodules; the increased proliferative potential of TTN thyrocytes is a common feature of nodules, independent of their histopathological characteristics.

Prostate lesions with cribriform / pseudocribriform pattern

Prostate lesions with cribriform / pseudocribriform architecture range from normal histological structures to infiltrative carcinoma. In each group of lesions with cribriform architecture (benign, premalignant and malignant intraductal or infiltrating), there are situations in which histological classification of the lesion is difficult or impossible on routine stains. A more wide-scale application of the immunohistochemical investigation for clearing up the problematic prostate lesions led to the definition and reclassification of cribriform lesions in distinct categories and sometimes very different in terms of progression, prognosis and treatment. This paper proposes an overview of the prostate lesions with cribriform / pseudocribriform architecture, emphasizing the morpho-immunohistochemical criteria for positive and differential diagnosis.

Primary malignant non-Hodgkin's lymphomas of salivary glands

We evaluated the medical record of patients with salivary gland neoplasms diagnosed at Timisoara City Hospital from 2002 to 2009. A study has been carried out for seven years on 204 cases of salivary gland tumors and only two cases of salivary gland lymphomas were diagnosed. The two cases were females of 71- and 49-year-old, respectively. The formalin-fixed paraffin-embedded tissue samples were cut in 4 mum thick sections and stained with Hematoxylin and Eosin. The primary monoclonal antibodies for the immunohistochemical analysis were the followings: LCA (2B11, Dako), CD20 (L26, Dako), cytokeratin (MNF116, Dako), p53 (DQ-7, Dako), and PCNA (PC-10, Dako). The histopathology and immunohistochemistry suggested in the first case a low-grade diffuse large B-cell mucosa associated lymphoid tissue lymphoma and in the second case a high-grade extranodal marginal zone B-cell lymphoma.

Warthin tumor: a curious entity--case reports and review of literature

Warthin tumor was first described in the American literature, by Aldred Warthin, in 1929, the pathologist who named this tumor papillary cystadenoma lymphomatosum, but since than it was also knew as adenolymphoma, cystadenolymphoma, and Warthin tumor. Because of its microscopically appearance and unknown origin, this tumor entity is still fascinating head and neck surgeons and pathologist. We evaluate the histopathological aspect of Warthin tumors using Hematoxylin-Eosin stain, and immunohistochemical and histological techniques. We reviewed the medical record of patients with salivary gland tumors diagnosed at County Hospital of Timisoara from 2002-2008. In six years, 22 cases with Warthin tumor were diagnosed and among them 17 men and five women, with average age 58.47. The analysis showed that 77.27% of Warthin tumors occurred in men, and the main histopathological aspect was with 50% epithelial component. The stromal component showed a prominent B-cell population by staining with CD20, and histological techniques for mucin were positive, and reticulin fibers were revealed while using Gordon-Sweets stain. The standard and the histological and immunohistochemical techniques highlighted the complex and variable microscopical appearance of Warthin tumor that the pathologist should consider when a diagnosis for this tumor is to be considered.

Schwannoma of the lip: case report and review of the literature

Schwannomas of the lip are rare, benign neoplasms which vary in size. The diagnosis is typically made at the time of surgery following biopsy and surgical resection is the mainstay of treatment. We present one case of lip schwannoma: the patient was 25-year-old and he has presented to otorhinolaryngologist for a non-dolorous tumor on the mucosal side of his inferior lip, which was increasing in size for the last six months. The tumor had a superficial ulceration and infection. Initially it was suspected to be a papilloma. The tumor was radically removed, and the sections were stained with Hematoxylin-Eosin. The tumor was encapsulated and showed two different pattern of growth. Antoni A areas displayed spindle cells closely packed together with palisading of nuclei. Verocay bodies, which were presented in Antoni A areas, are whorled formations of palisading tumor cells. The cells of neoplasm were monotone. Only few spindle cells were moderately pleomorphic, but mitotic figures were unusual. In addition, immunohistochemical labeling was performed for S-100 protein, vimentin, GFAP and NSE and confirmed the diagnosis. This report describes a case of lip schwannoma, which was correctly diagnosed by routine staining and confirmed by immunohistochemical staining for S-100 protein, vimentin, GFAP and NSE.

Expression of β-Catenin in Hepatocellular Carcinoma

Alteration of β-catenin expression is involved in the development and evolution of hepatocellular carcinoma (HCC); β-catenin is able to influence tumor cell proliferation. We analyzed the immunohistochemical (IHC) expression of β-catenin on a group of 32 patients diagnosed with HCC using the anti-β-catenin monoclonal antibody (clone E247). We correlated the expression of β-catenin with the proliferation index of Ki-67 (PI Ki-67), the mitotic index (MI) and other clinical and pathological features. We observed an altered β-catenin expression in 58.38% of all HCC cases. This expression was insignificantly correlated with tumor size (]5 cm) (p = 0.683), histological grade G1-G2 (p = 0.307), vascular invasion (p = 0.299) and advanced pT stage (p = 0.453); we obtained a significantly higher MI in HCC with altered β-catenin expression (p = 0.018), as compared to HCC without overexpression (1.66 � 1.37) (p = 0.038) and a PI Ki-67 of 22.49 � 20.1 and 28.24 � 18.2, respectively in tumors with altered β-catenin expression with insignificant differences compared to HCC without overexpression (25.95 � 15.2) (p = 0.682 and p = 0.731, respectively). According to the results we obtained, aberrant β-catenin expression in HCC was correlated with a high mitotic index, therefore playing an important role in tumor progression by stimulating tumor cell proliferation; non-nuclear β-catenin overexpression can have a pathological significance in HCC, especially in cases of HCC associated with hepatitis B virus (HBV) infection.

The control of some viral epidemics by antiepidemic programmes elaborated by an expert system

A base of data for viral epidemiological studies is presented containing correlation between outer symptoms (observable characteristics of the mass morbid phenomena), inner symptoms (characteristics of intensity of elementary processes implied in the virosis propagation) and influencing factors (risk or protective ones). A resolutive nucleus of processing these is divided in to three parts: an inductive one (specification of the mentioned correlations, of the mathematical model and its equation solutions); a deductive one (explaining or prognosing the epidemiological evolution); a decisional one (specifying the antiepidemic services, necessary for a possible or desired reduction of the morbidity).