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Ceskoslovenská Patologie

Lucie Bartoňová, Vít Campr, Renata Chmelová, Miloš Taudy, Roman Kodet
We report on the case of a 39-year old man who underwent a thyroidectomy and a parathyroidectomy with misdiagnosed medullary carcinoma of the thyroid in 2013. During the operation the thyroid gland and parathyroid glands were artificially damaged due to the complicated surgical access to the glands because of the obesity of the patient as well as the deep placement of the enlarged parathyroid glands. Three years later, the neck ultrasound showed bilateral nodules on the neck, suspected to be metastases of the medullary carcinoma...
2018: Ceskoslovenská Patologie
Kristýna Němejcová, Jana Rosmusová, Michaela Bártů, Radoslav Matěj, Pavel Dundr
We report the case of a 54-year-old female with dedifferentiated carcinoma of the ovary. Grossly, both ovaries were affected by a tumor of up to 25 mm (right ovary) and 220 mm (left ovary) in diameter. Microscopically, the tumors of both ovaries showed features of well differentiated endometrioid carcinoma with mucinous differentiation. Moreover, in the left ovary there was an undifferentiated solid component consisting of larger cells. Immunohistochemically, the undifferentiated component showed diffuse vimentin positivity and focal expression of cytokeratin 18...
2018: Ceskoslovenská Patologie
Pavel Dundr, Kristýna Němejcová, Michaela Bártů, Ivana Tichá, Radek Jakša
The evaluation of inflammatory infiltrate (tumor infiltrating lymphocytes - TIL) should be a standard part of biopsy examination for malignant melanoma. Currently, the most commonly used assessment method according to Clark is not optimal and there have been attempts to find an alternative system. Here we present an overview of possible approaches involving five different evaluation methods based on hematoxylin-eosin staining, including the recent suggestion of unified TIL evaluation method for all solid tumors...
2018: Ceskoslovenská Patologie
Ondřej Daum, Magdaléna Dubová, Alena Skálová, Tomáš Rozkoš, Jan Laco
Anti-HER2 monoclonal antibody trastuzumab remains the only targeted therapy of gastric carcinoma based on histopathological predictive diagnostics used in current routine clinical practice. In the Czech Republic only the adenocarcinomas with HER2 immunohistochemical score of 3+, together with HER2 amplification detected with in situ hybridization are indicated for treatment with trastuzumab. There has been recent progress in our understanding of the molecular biology of gastric cancer, the role of its tumor microenvironment and vascular supply points to PD-1/PD-L1 and VEGFR2 as possible future targets of targeted therapy...
2018: Ceskoslovenská Patologie
Pavel Fabian, Radim Němeček
The combination of modern systemic chemotherapy and anti-EGFR monoclonal antibodies improves overall survival and the quality of life for patients with metastatic colorectal cancer. By contrast, the addition of anti-EGFR therapy to the treatment regime of resistant patients may lead to worse progression-free and overall survival. Therofore, identifying sensitive and resistant patients is key during initial decision-making. A number of clinical trials show that primary resistance to EGFR blockade is in most cases caused by constitutive activation of signalling pathways downstream of EGFR...
2018: Ceskoslovenská Patologie
Aleš Ryška
Detection of predictive markers in breast carcinoma has undergone significant changes, the most important ones - at least in the context of Czech Republic - are related to the detection of HER2 - detection of both over-expression of oncoprotein HER-2/neu and amplification of the c-erbB-2 gene, respectively. In the Czech Republic, immunohistochemical testing is performed as a method of first choice, followed, if needed, by in situ hybridization. The update of the guidelines published in 2013 decreased the threshold for positive tumor cells from 30% to 10%, shifted the threshold for gene amplification (HER2/CEP17 ratio) from 2...
2018: Ceskoslovenská Patologie
Šárka Hadravská, Magdaléna Dubová, Markéta Miesbauerová, Petr Mukenšnabl, Ondřej Daum, Alois Mádle, Karel Smetana
Hamartoma of mature cardiac myocytes (HMCM) is a rare benign pseudoneoplastic myocardial lesion. We describe a case of 39-year-old Bulgarian woman living in the Czech Republic, who died because of rupture of anterior communicating artery aneurysm, and severe bronchopneumonia. An incidental finding at the autopsy was a whitish unencapsulated and not sharply demarcated tumor of the left ventricle and adjacent area of interventricular septum, which protruded above the plane of section. Microscopically the tumor consisted of various different forms of disorganized hypertrophic mature cardiac myocytes without vacuolization of cytoplasm, focally in a "herringbone" pattern...
2017: Ceskoslovenská Patologie
Zdeněk Kinkor, Petr Grossmann, Magdaléna Dubová, David Bludovský, Andrea Černá, Lenka Krsková, Petr Lhoták
The literature is reviewed regarding of a rare molecularly defined group of sarcomas with rearrangement of both CIC and BCOR genes, which were originally placed into the EWSR1wt Ewing-like category. Personal experience with three cases demonstrating difficulties of this issue is added. Both groups of lesions differ not only by age and topography, but also vary in both the prognostic and the predictive parameters. CIC-rearranged tumors are very aggressive and almost never occur in the skeleton; in contrary, the BCOR-rearranged ones are predominantly bone tumors in young males behaving even better than classical Ewing sarcoma...
2017: Ceskoslovenská Patologie
Alena Kalfusová, Roman Kodet
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Most of them arise due to activating mutations in KIT (75 - 85 %) or PDGFRA (less than 10 %) genes. Identification of the activating mutations in KIT and PDGFRA genes, which code for receptor tyrosine kinases (RTKs), has improved the outcome of targeted therapy of metastatic, unresectable or recurrent GISTs. Primary and/or secondary resistance represents a significant problem in the targeted therapy by Imatinib mesylate (IM) in patients with GIST...
2017: Ceskoslovenská Patologie
Radoslav Matěj, Zdeněk Rohan, Kristýna Němejcová, Pavel Dundr
The group of non-small cell lung carcinomas includes tumors that are variable at the clinical, histopathological and molecular levels. Advances in the understanding of molecular pathology of lung adenocarcinomas in particular led to changes in their histopathological classification and treatment. Patients diagnosed with lung adenocarcinoma harboring specific mutations benefit from the administration of specific targeted therapy. Analysis of EGFR gene mutations and ALK rearrangement in lung adenocarcinomas are already routinely performed and are closely related to the indication for the administration of tyrosinkinase inhibitors...
2017: Ceskoslovenská Patologie
Arpád Szabó, Igor Richter, Dana Frydrychová, Martina Saláková, Tomáš Jirásek
Merkel cell carcinoma is a rare cutaneous tumor with an aggressive clinical course. In most cases it is associated with Merkel cell polyomavirus infection. Exceptionally, the tumor can present as a lymph node metastasis without a discernible cutaneous primary. In this report we present the case of a 42 year-old man with inguinal lymphadenopathy, histologically consistent with Merkel cell carcinoma. Tumor cells expressed immunohistochemically chromogranin-A, synaptophysin and displayed dot-like positivity for cytokeratin 20...
2017: Ceskoslovenská Patologie
Jan Hrudka, Monika Grussmannová, Václav Mandys
Isolated infectious endocarditis of the pulmonary valve is a rare condition and represents 1,5-2% of all cases of infectious endocarditis. We present a case of a 37year-old woman without any relevant medical history. The woman was hospitalized with hallmarks of severe sepsis and bilateral pneumonia; she died several hours after admission with progressive multiorgan failure and disseminated intravascular coagulopathy. Microbiologic examination approved Staphylococcus aureus as the etiological agent. The autopsy showed isolated endocarditis of the pulmonary valve, without any known predisposing factor...
2017: Ceskoslovenská Patologie
Tomáš Balhárek, Juraj Marcinek, Lukáš Plank
As a result of increasing knowledge, the validity of any tumour classification could not be unlimited. The aim of this article is to review the most important changes in the WHO classification of lymphoid neoplasms of a non-Hodgkin type that have been announced and published in relation to its revision in 2016. These changes are based on better understanding of pathogenesis and genetics of diseases, refine diagnostic criteria, reflect existence of rare forms and introduce new provisional categories of lymphoid neoplasms...
2017: Ceskoslovenská Patologie
Juraj Marcinek, Tomáš Balhárek, Lukáš Plank
Continual progress of knowleges in hematopathology and genetics of hematologic tumors requires actualisation of widely accepted and presently used WHO classification of myeloid neoplasms published 8 years ago. However, the basic principles of this classification remain unchanged, therefore the authors of new WHO classification mention the "revision" of previous and not the introduction o new classification. The aim of this paper is to outline the most important changes of myeloid neoplasm diagnostics to pathologists, hematologists and other clinicians in Czech Republic and Slovakia...
2017: Ceskoslovenská Patologie
Jan Galko, Pavel Dundr
We report a case of a 37-year old female with a mature teratoma of the uterine corpus presented by metrorrhagia. Grossly, the tumor was polypoid without apparent invasion into the myometrium. Microscopically, the tumor consisted of disorganized mature neural tissue intermingled with nodular foci of cartilaginous tissue, groups of seromucionous glands and ciliated columnar respiratory epithelium. Fifteen months after the diagnosis, the patient showed no signs of tumor relapse. Then she was lost for a follow-up...
2017: Ceskoslovenská Patologie
Tomáš Rozkoš, Aleš Ryška, Markéta Nová, Helena Hornychová, Lukáš Krbal, Radoslav Matěj, Jan Laco
The aim of the retrospective part of the study was a) to select an optimal clone of immunohistochemical (IHC) antibody against the ALK protein with specificity and sensitivity high enough to use this antibody as a screening method for selecting non-small cell lung cancer (NSCLC) cases for fluorescence in situ hybridization (FISH) testing of ALK gene rearrangement and b) to determine the diagnostic yield of "small" biopsies i.e. endobronchial, transbronchial and transthoracic biopsies and cytoblocks for ALK gene rearrangement testing...
2017: Ceskoslovenská Patologie
Karel Veselý
Myxoid tumours of soft tissue represent a heterogeneous spectrum of lesions with variable biological behaviour, from completely benign to highly aggressive malignancies. Myxoid tumours share abundant myxoid extracellular matrix, overlapping histopathologic features and immunohistochemical findings, with resulting diagnostic problems. This review article attempts to give the most complete list possible, with the characterization of gross and microscopic features, relevant immunohistochemical and molecular biology findings and to outline differential diagnosis...
2017: Ceskoslovenská Patologie
Michael Michal, Dmitry V Kazakov, Michal Michal
Hybrid peripheral nerve sheath tumors (HPNST) are relatively recently described tumors. With ongoing research, a considerable amount of important findings have been made, much of which has substantial clinical implications. However, a comprehensive review of the whole topic has not been published in the literature so far. In the presented manuscript, the various hybrid tumors are discussed separately with a special emphasis on the morphological and immunohistochemical findings as well as on their association with tumor syndromes...
2017: Ceskoslovenská Patologie
Iva Zambo, Lukáš Pazourek
Giant cell-rich lesions form a heterogeneous group of reactive and truly neoplastic processes with diverse clinical presentation and biological behavior. Common to all of them are variably numerous multinucleated osteoclast-like giant cells and the presence of mononuclear stroma. Based on the histological picture alone it is sometimes impossible to reliably distinguish certain tumors from each other. The pathologist has to know the patient´s age, the exact localization, tumor growth dynamics and its radiographic characteristics...
2017: Ceskoslovenská Patologie
Daniel Farkaš, Radoslav Matěj, Marián Ml Švajdler, Marcela Sluková, Jana Seligová, Lucia Fröhlichová, Silvia Farkašová Iannaccone, Vlasta Vyhnálková, Alžbeta Ginelliová
In this case report the authors describe histomorphological findings of acute lung injury with laboratory-confirmed influenza type A(H1N1) pneumonia leading to the death of a 30 year-old unvaccinated man after 27 days of hospitalisation. Histologically all three types of acute lung injuries were unusually present (diffuse alveolar damage, acute interstitial pneumonia, organizing pneumonia) in different phases of resorption and reparation with transition to extensive fibrosis.
2017: Ceskoslovenská Patologie
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