Pathologists observed the presence of tumor infiltrating lymphocytes (TILs) in solid tumors many years before the research focus shifted from cancer cells to the tumoral microenvironment. In lung adenocarcinoma TILs vary in number, phenotype and distribution. Our study investigate the type and distribution of TILs regarding the stage of disease and histological subtype in 27 cases of lung adenocarcinoma. By immunohistochemistry we evaluated semi-quantitatively CD3, CD8 and cyclin D1. We have found that CD3+CD8- lymphocytes prevail at the invasive margin and in tumoral stroma. Cyclin D1 was diffusely positive in tumoral cells in all the five cases of lepidic type of lung adenocarcinoma. In other histological types cyclin D1 was focally positive, most at the margin of the tumor irrespective of the presence or absence of TILs.
Breast carcinoma represents the leading cause of oncologic mortality for women. Due to therapeutic and diagnostic advances, the mortality and morbidity in the last decade declined, but breast cancer still has a great impact on quality of life and also on medical service cost. In the light of these facts, an integrated approach, considering histopathology features, molecular profiles and corroboration with clinical and imagistic data is necessary. A descriptive retrospective one-year study analyzed the breast cancer heterogeneity in 121 cases registered in the Pathology Department of the University Emergency Hospital in Bucharest, Romania. Our purpose was to evaluate histopathological, immunohistochemically, clinical and imagistic aspects of breast cancer considering the current molecular classification (Luminal A, Luminal B, HER2 enriched and triple negative/basal like). Our assay revealed that most prevalent histotype was NST (no special type) followed by invasive lobular carcinoma. Considering the molecular pattern, the most common was luminal B. Triple negative basal like and HER 2-enriched were correlated with an aggressive morphologic pattern and lymph-nodes positivity. Considering the imagistic acquisitions, mammography proved to be the most accurate technique for measuring the dimension of NST. In conclusion, breast carcinoma is a heterogeneous disease that needs an integrated approach and personalized treatment based on the histopathologic and molecular features. Considering the great number of advanced stages as diagnosis, a national screening program for breast cancer is imperiously needed.
Single ventricle heart (SVH) is a very rare congenital heart disease. However, since the introduction of Fontan's intervention, the survival rate of patients with SVH has been significantly improved, increasing the number of women who may become pregnant in this condition. It has been already reported, in isolated case presentations or in some series of patients, that the pregnacy in the context of SVH and Fontan circulation carries a very high risk for first trimester miscarriage, maternal cardiovascular or obstetric complications and for an increased rate of pre-term birth. Therefore, it is an open field of debate weather or not to allow pregnancy in this category of patients. We are presenting the case of a 22 years old patient who underwent two surgeries for SVH: a Glenn procedure when she was 2 years old and the implantation of a Fontan circuit at the age of 16 years. Since the last surgery she was under permanent internal cardiac stimulation. During the pregnancy the patient was hemodynamically stable, with a normal resting oxygen saturation and a good ejection fraction of the single ventricle. However, the evolution of this patient has become even more challenging due to an aberrant praevia placental lobe. This condition brought her to hospital for several episodes of metrorrhagia and uterine contractions. She delivered at 33 weeks of gestation by emergency Caesarian section with a good evolution until discharge, for mother and the newborn. This case is supporting the opinion that pregnancy can be tolerated without important cardiovascular events in patients with SVH and Fontan circulation, unless heart failure or cardiac arrythmia are associated. Nevertheless, the obstetrical complications remain an important problem in pregnancy overcome of patients with Fontan circulation for SVH that can be superimposed with other unfavorable conditions, like aberrant praevia placental lobe in this case. During the management of such particular clinical settings difficult decisions must be taken, including those addressing the antithrombotic therapy that will be covered in the presentation of this case. Keywords: Pregnancy outcome; Cardiovascular pregnancy complications; Fontan procedure; Delivery, obstetrics.
Introduction: The gastrointestinal stromal tumors (GIST) are dominated by KIT and PDGFRA mutation. The immunohistochemical detection of CD117, a protein express by KIT gene, is essential for the diagnosis and those that are negative always represented a diagnostic challenge Case reports: In this article we present a series of 4 cases of CD117 negative GIST tumors, diagnosed and surgically resected in Fundeni Clinical Institute and an overview of the histogenesis, diagnostic problems and management of c-kit negative GIST. All patients were males and the tumors were located in the stomach and small bowel. Conclusion: It is important for the pathologists to beware of the fact that a CD117 negative in the context of a typical morphological appearance does not exclude a GIST tumor and also the oncologist must be aware not to exclude the therapy with imatinib based on the negativity of CD117.
Objective: The study subject approaches a topic of cerebral pathology, namely the development of a pathological diagnosis that is as accurate as possible for the cerebral tumors and the metastases, using a new method that complements the optical microscopic examination and immunohistochemistry to correctly diagnose cerebral malignancies. Methods: Two-photon excitation (TPE) microscopy techniques are non-linear optical imaging methods that are gaining momentum in the investigation of fixed tissue sections, fresh tissue, or even for in vivo experiments. This method can be used for offering complementary information on the tissue architecture. We argue that using non-linear optical microscopy (which includes TPE microscopy) images collected on this category of brain tissue samples, can facilitate the interpretation of brain tumors and metastases, thus it is a solution worthy to explore. Scanning large areas of the lesions is important to avoid false-negative diagnoses because lesions are often non-uniform. Finding potential invasion sites is also restricted when using a narrow field-of-view imaging method. Results: Our study demonstrated that TPE microscopy can detect specific cellular features of cerebral tumors and metastases in good correlation with histopathological results. This approach can improve the accuracy of the cerebral tumors diagnosis and possibly other neoplasms. Conclusion: TPE microscopy is very important for future research because it could prevent the false or inadequate diagnosis of specific lesions and differentiate a primary tumor from a metastasis. The significance of the findings is attributable to cross-disciplinary cooperation and the constant use of a working standard across all of the experiments in this study.
