The development of Zemun Hospital in the 19th century was followed by better work conditions and an increasing number of patients. The arrival of doctor Vojislav Subotić to the hospital and his work were key moments in the general improvement of the hospital. Since 1887, the hospital was administered by a society known as „Sisters of Charity of Saint Vincent De Paul“. By the end of 1891, they had constructed a new hospital building.

The 20th century was the most eventful period in the history of Zemun Hospital and it brought many changes. Working through out both world wars, the hospital staff aided those who were wounded or ill, both soldiers and civilians. Throughout this period, the hospital worked in three different countries, under various administrations and owners.

Aim: To investigate co-expression of ATRX and HIF-1α in kidney neoplasm in relation to its origin. Introduction: A heterogenous group of kidney tumors is believed to arise from a variety of specialized cells along the nephron – proximal tubules [Clear cell Renal Cell carcinoma (ccRCC) and papillary RCC (pRCC)] and collecting tubules [chromophobe RCC (chRCC) and oncocytoma]. ATP-dependent helicase (ATRX) is a chromatin remodeling protein involved in gene regulation and aberrant DNA methylation during cancerogenesis. Activation of hypoxia inducible factor (HIF-1α) is an early event in most RCC following inactivation of the VHL tumor suppressor gene. Material and Methods: A total of 46 kidney tumors (n=33 ccRCC, n=1 mRCC, n=4 pRCC, n=5 chRCC and n=3 oncocytomas) was immunohistochemically analyzed for ATRX and HIF-1α expression. Results: Diffuse and focal positivity of ATRX expression was found in 51.5% of ccRCC, while 54.5% had HIF-1α positivity. Co-expression of ATRX/HIF-1α was not related to nuclear grade and stage of ccRCC. Metastatic ccRCC had strong expression of both markers. pRCC type II showed weak ATRX/HIF-1α expression, while pRCC type I was negative for both markers. Interestingly, all analyzed oncocytomas and chromophobe RCC were negative for ATRX/HIF-1α. Conclusion: Our results suggest that signaling pathways have different patterns of activation/suppression of ATRX/HIF-1α in oncocytomas and chRCC compared to other RCC types. Downregulation or loss of ATRX/HIF-1α coexpression in benign tumors should be further investigated in order to determinate mechanisms of ATRX/ HIF-1α signaling transport renal neoplasm with different origin.

Aim: Reporting a patient with unusual metastatic site of invasive lobular breast cancer (ILC) as initial presentation of the disease. Introduction: Due to specific growth pattern, ILC rarely forms an apparent tumor, which makes diagnosis very challenging at early stage. ILC is also known for unconventional metastatic spread, with deposits being discovered prior to the primary tumor in 3-10% of cases. Case report: While evaluating renal function in 51-year old female patient hospitalised at the Urology Clinic (Clinical centre of Montenegro), static scintigraphy revealed left kidney functional capacity of 7-8%. Nephrectomy was indicated. Kidney, 11x6x4cm in size, with slightly reduced, paler parenchyma, firmly attached fatty capsule and pyelocaliceal system and ureter of regular gross appearence, was delivered to the Centre for Pathology. Analysis of H E sections revealed chronic pyelonephritis. In a few sections taken from urether, pyelon and subcapsular parts of parenchyma, infiltrates of small, cuboid, atipical cells, mostly arranged in one-cell-thick files, were noted. Immunohistochemistry reveiled strong pozitivity for EMA, CK(ae1/ae3), CK7, estrogen and mammaglobin, with Ki67<10%. A few cells were progesteron positive, while vimentin, CK20 and neuroendocrine markers were negative. ILC metastasis was suspected. ILC, with axillary lymph POSTER SESIJA 66 MATERIA MEDICA • Vol. 34 • Issue 1, suplement 1 • april 2018. node involvement, was confirmed later, although there was no macroscopically apparent tumor in the breast. Tumor cells were estrogen and progesterone positive, HER2 negative, with Ki67 of 3%. Conclusion: While assessing metastatic deposits in unconventional sites in women, primary ILC should be considered. Special diagnostic algorhytm is required for efficient initial detection of the primary tumor.

Introduction: A pleural effusion describes an excess of fluid in the pleural cavity, usually resulting from an imbalance in the normal rate of pleural fluid production or absorption, or both. Pleural effusions are associated with a number of pathological medical conditions. In the vast majority of these cases the cellular response is quite nonspecific and will show varying proportions of mesothelial cells, macrophages, erythrocytes, lymphocytes, neutrophils and other leukocytes. Certain diseases may occasionally show cellular changes in the effusion that will reflect their presence. Examples of these include infections such as tuberculosis, blastomycosis, aspergillosis, viral infections, echinococcosis and cryptococcosis. Noninfectious, nonneoplastic diseases diagnosable by cytopathologic methods include rheumatoid arthritis, luAPSTRAKTI 89 MATERIA MEDICA • Vol. 34 • Issue 1, suplement 1 • april 2018. pus erythematosus, eosinophilic pleural effusion, pleural endometriois and sickle cell disease. In spite of these occasional specific cytopathologic diagnoses which can be rendered for the nonneoplastic diseases named above, the most significant role of cytopathology by far is in the examination of effusion fluid for the presence of cancer cells. Cytologic examination of pleural effusions is an important initial step in management of malignant effusions. Although most patients with a malignant effusion have a known history of cancer, a positive effusion may be the first sign of an unsuspected malignancy. Cytologic examination of a serous effusion may offer the possibility of an early and accurate diagnosis by using a minimal intervention. The presence of pleural effusions typically signals an advanced stage of disease so it is associated with poor prognosis. The accuracy of cytologic examinations of malignant pleural effusion is in high range (from 40% to 87%). Lung, breast, ovarian, and gastrointestinal cancers are most likely to cause malignant effusions. The histologic type of cancer most commonly seen in serous effusions is adenocarcinoma but a variety of other cancers can cause effusions. Less common malignancies are squamous cell carcinoma, small cell carcinoma (SCC), hematopoietic malignancies, melanoma, germ cell tumours and sarcomas. Mesotheliomas often present with recurrent serous effusions. One of the most important diagnostic doubts in pleural effusion analysis is distinguishing adenocarcinoma from mesothelioma and mesothelioma from benign mesothelial cells. In most cases the diagnose is based on regular cytomorphology analysis and immunocytochemistry is necessary in low percent of cases to establish the diagnose. The specimens are collecting by thoracentesis, processing in a routine fashion and staining by hematoxylin-eosin (H&E) and Papanicolaou stain after wet fixation with 95% ethanol and May-Grunwald-Giemsa stain after air drying. It is important to evaluate the same cells when constructing coordinate immunoreactivity pattern for various immunomarkers. Since the same cells cannot be followed on different cytology smears, they are not ideally suited for routine immunocytochemical evaluation of effusion fluids. Serial sections of cell-blocks show the same cells in adjacent levels which allow proper evaluation of the coordinate immunoreactivity pattern. Conclusion: Pleural fluid cytological analysis has important diagnostic role in most cases so primary aim should be to establish the correct diagnosis with minimal investigation. Cytology is the only method by which one may retrieve cells from fluid, often in the absence of solid lessions or when obtaining a biopsy from the latter is more difficult and costly and entails much greater discomfort or risk for the patient. Effusion cytology is important for: primary diagnosis of cancer, staging, diagnosis of recurrence or disease progression. Evaluation of effusion cytology is one of the most challenging areas in diagnostic cytopathology. A remarkably wide cytomorphological spectrum of reactive mesothelial cells overlaps with various benign and malignant processes. Due to these limitations, a significant proportion of effusion fluids are difficult to interpret with objective certainty by cytomorphology alone. The use of immunocytochemical panel of antibodies with combination of high sensitivity and specificy is the only way for precise distinguishing of adenocarcinomas from mesothelioma, especially in cases with scant tumor cells particularly in metastatic disease from well differentiated carcinoma, and reactive mesothelial cells from mesothelioma. Other stains are used to confirm pulmonary origin and should be selected as a complement to the panel once adenocarcinoma is confirmed. Molecular diagnostics are feasable on routine cytopreparations, primary diagnostics as well as molecular monitoring during targeted therapy.

As a consequence of significant development of neurosciences several different scientific fields as neuroeducation, neuroesthetics, nerotheology, neuromarketing etc. had been established. Neuroeconomics is interdisciplinary scientific field that has aim to explain neurological mechanisms of decision making process, mental ability of consideration of several possible alternatives, and ability to follow certain direction of action. Neuroeconomics is based on research methods, techniques and models that are overtaken from neurosciences, but also from cognitive and social psychology, as well as from experimental and behavioral economics. In practical sense, neuroeconomics is mainly involved in situations in which humans are not behaving according to rational model, but rather according to innate and adapted schemes of behavior and due to their strong emotional reaction. In this way, knowledge from the scientific fields of neurology and neurosciences that are obtained mainly by usage of neuroimaging, are used in example to investigate market or to determine functioning of employees in critical situations. This kind of practical approach opens several ethical and legal dilemmas..