Malignant fibrous histiocytoma is a condition involving a tumor of the bone or soft tissues. The tumor often appears in the legs or arms, but it can develop in other parts of the body. The disease is the most common soft tissue cancer that is diagnosed in older adults, and is often diagnosed in people between the ages of 50 and 70. We present a case of giant cell malignant fibrohistiocytoma of the abdominal wall. A 77 year old woman was admitted for further evaluation and treatment of tumor in the right ingvinal region of the abdominal wall. She claimed that tumor have appeared 3 mounths earlier and it was characterized by rapid growth and tenderness. NMR demonstrated expansive heterogeneous mass, 18,6x16,2cm of diameter. We performed total extirpation of the tumor. Postoperative period was uncomplicated and she was discharged from the hospitaly in good condition. Pathohystological examination confirmed malignant fibrous histiocytoma. Depending on the stage of disease and the depth of invasion by the tumor, surgical resection is the treatment of choice. Radiotherapy, chemotherapy, and immunotherapy are other therapeutic modalities. Long term followup with regular chest X-rays and CT scans of the abdomen to detect tumor recurrence, metastasis and any lymph node involvement are mandatory.

The discovery of Helicobacter pylori (Hp) bacteria and causal relationship of Helicobacter pylori infection with the origin of chronic gastritis, stomach and duodenal ulcer and stomach cancer represents an epochal event of the new age. The goal of the study is to examine the incidence of Helicobacter pylori infection of stomach and prove the connection between Helicobacter pylori infection and stomach and duodenum diseases (non-ulcer gastropathy, stomach ulcer, and duodenal bulb ulcer and stomach cancer). The study encompassed 250 randomly selected examinees of both genders and different age categories. All the examinees were subjected to quick urease test (QUT) from antral bioptate and stomach corpus acquired by upper gastrointestinal endoscopy with standard forceps. Hp positive examinees were subjected to one of four therapy protocols for eradication of Hp. The acquired data were treated with application of descriptive statistical methods (SV, SD, Min, MAX) and analytical statistical methods (Student t test, Hi quadrat test, Kruskal-Walish test, Mann-Whitny U-test, Wilcoxon test, ANOVA variant analysis, Spearman and Pearson correlation). 250 examinees tested by quick urease test (QUT), 54% were positive and 46% were negative (p>0.05). The proportion by genders between QUT positives and QUT negatives was approximately the same (p>0.05). Non-ulcer gastropathy was a dominant finding with both QUT negatives (92.2%) and QUT positives (77%) (p<0.01). The highest rate of eradication of Helicobacter pylori infection was shown by protocols B and D (75%), then protocol A (71%) and protocol C (57.2%) (p>0.05). Quick urease test (QUT) which requires upper digestive endoscopy and biopsy of stomach epithelia samples represents a minimum of invasive diagnostics of Helicobacter pylori infection and a minimum of confirmation of eradication in our conditions. Therapeutic protocols B and D have shown the highest rate of success in eradication with our patients.

Nonspeci¿ c interstitial pneumonia is a type of idiopathic interstitial pneumonia. By de¿ nition, the cases of nonspeci¿ c interstitial pneumonia are those which cannot be classi¿ ed as any other type of interstitial pneumonia. The Material of the investigation included 12 transbronchial biopsy lung samples. The quantity, structure and distribution of speci¿ c cellular elements were determined semiquantitatively, recognizing three levels of the lesions’ intensity: mild/ poor, moderate, and intense/abundant. The interalveolar septa were most frequently moderately thickened (50% of the cases) due to the presence of inÀ ammatory cells and multiplied connective. Of the inÀ ammatory cells, lymphocytes were most common and greatest in quantity (abundant, moderate and poor in 4, 5, and 3 cases respectively), followed by plasma cells and macrophages. The septal connective was moderately and mildly multiplied in 2 and 4 cases respectively. The lumen of the alveoli was in¿ ltrated by lymphocytes and macrophages, while poor peribronchial and perivascular lymphocyte in¿ ltrates were most commonly found. The interalveolar septa were most frequently moderately thickened due to the presence of chronic inÀ ammatory cells, predominantly lymphocytes, as well as to mildly-to-moderately multiplied connective. The lymphocytes usually permeated the septa diffusely. Bronchiolar and blood vessel ¿ ndings were nonspeci¿ c.

Sarcoidosis is a multisystemic disease of unknown etiology, which most commonly affects lungs and is characterized by the presence of non necrotizing lymphocyte-epitheloid granulomas. We used the material obtained by transbronchial biopsies of 34 patients having sarcoidosis, 22 (64,7%) women and 12 (35,3%) men, with the mean age of 43,2 years. In this paper, histological characteristics of 102 sarcoid granulomas were established. The quantity, composition and localization of cellular and fibrous elements were determined by quantitative analysis of stereometry, using the numerological density as a stereological variable. The sarcoid granuloma, with the average size of 356x254x microns is most commonly localized in the perivascular region (47% of granulomas). In the central part of the granulomas epitheloid cell, giant cells, macrophages, lymphocytes and plasma cells were found with thw average density of 111751mm 3. The lymphocytes were the most common cell type, followed by three times fewer number of epitheloid cells. The giant cells, most commonly of Langhans cell type, were present in 62% of granulomas. The average numerical density of all types of cells in the peripheral part of granulomas was 241346mm*. In the periphery of the granuloma the most dominant cell population were lymphocytes, which represented 91,5% of all cellular elements. Fibrinoid necrosis was found in 2% of all granulomas. Acidoresistent bacilli were not found. The average density of all cell types in the central part of granulomas was 111751mm*, with lymphocytes and epitheloid cells being the most common cells. The average numerical density of all cell types in the peripheral part of the granulomas was 241346mm 3, with the domination of lymphocytes with 91,5%. Fibrinoid necrosis was present in 2% of granulomas.

LCH is characterized by the presence of Langerhans cells juxtaposed against a backdrop of hematopoietic cells, including T-cells, macrophages, and eosinophils. The investigated material included open lung biopsy samples taken from seven patients (four males and three females) at the mean age of 23.2 years. They were all smokers. The intensity of the histological lesions was semiquantitatively measured, differentiating three intensity grades: mild, moderate and intense. In most cases (3/7), the interalveolar septa were focally and intensively thickened. The inÀ ammatory in¿ ltrates in the septa were focal, intense in 3/7, moderate in 1/7, and mild in 1/7 specimens. Lymphocytes prevailed, followed by macrophages, eosinophil granulocytes, and plasma cells. The lumen of the alveoli was occupied by a few macrophages and lymphocytes, sparse plasma cells and few eosinophil granulocytes. The alveolar cells were focally cuboid in 7 cases. Histiocyte aggregates were detected in all specimens, most frequently localized peribronchiolarly (7/7) and in the intraalveolar septa (4/7). The aggregates had either a clear (15/25), or a relatively clear (10/25) demarcation line against the periphery. The aggregates were predominantly composed of Langerhans’ cells (7/7, abundant), followed by eosinophil granulocytes (abundant in 4/25, moderate in 8/25, sparse in 13/25), lymphocytes (sparse in 10/25 and moderate in 15/25 cases), and plasma cells (sparse in 10/25). The Langerhans’ cells were CD1a and S 100 positive. Histiocyte aggregates were registered in all biopsy samples; the Langerhans’ cells were CD1a and S100 positive.

The conventional cytology has a longstanding role in the diagnostics of primary and metastatic lung carcinoma. Multiple factors have influence on the choice of technique used: for example, the location of the lesion, its size, interpretation of the radiological imaging, the seriousness of the symptoms, as well as the manual skill and commitment of the physician to certain technique. In this paper, the most important sampling techniques and sample processing are shown as the most important factors of a successful pathohistological analysis.

The histologic finding of teratoma occures in aproximately 40% of all postchemotherapy retroperitoneal lymphadenectomy (PC-RPLA) for disseminated nonseminomatous testicular tumors (NSTT). We evaluated patients undergoing PCRPLA for teratoma to determine risk factors for recurrence and clinical outcome. Among a survey of 193 patients submitted to PC-RPLA due to metastatic NSTT from 1980-2005, we identified 82 patients (42%) who were found to have only teratoma in the retroperitoneum. Sixty-seven patients (82%) received only induction cisplatin-based chemotherapy, and 15 (18%) required 2nd line chemotherapy. PC-RPLA histology revealed mature teratoma (MT) in 86%, immature teratoma (IMT) in 12% and teratoma with malignant transformation (TMT) in 2%. Sixteen patients (19%) relapsed within median free interval of 22 months. Among 13 patients submitted to redoRPLA, discordant histology occurred in 6 patients (46%) (2 TMT, 4 viable germ cell tumors [GCT]), all with worst histology in comparison to primary RPLA. One relapsing patient with only elevated serum tumor markers (STMs) achieved complete response with chemotherapy alone. Two patients relapsed at 21 and 74 months with widespread metastasis and died despite salvage chemotherapy. Seven of 13 patients (54%) who were rendered free of disease (FOD) with redo-RPLA, relapsed again. All but one died despite salvage treatment (2 of chemotherapy related toxicity) within mean survival time (MST) of 86.7+/-26.1 (95% confidence interval [CI], 98.79- 149.21). At mean follow-up (MFU) of 135+/-62.6 months (95% CI, 98.79-149.21), alive and free of disease (AFD) are 90% patients. The probability of being reccurence-free at 5- and 10- year was 87% and 81%, respectively. The 5- and 10- year probability of disease speciphic survival (DSS) were 98% and 89%, respectively. On multivariate analysis residual mass size (p<0.005) and worse IGCCCG risk group (p=0.01) predicted disease recurrence. Patients with residual teratoma after PC-RPLA continue to exibit a 19% risk of recurrence even 10 years after RPLA, with 46% recurrence being with worse histology. These data support that these patients should undergo long-term surveillance of their retroperitoneum in the setting of a large residual mass or elevated IGCCCG classification risk.

This sudy is performed to determine disease related outcome in metastatic nonseminomatous germ cell testicular tumors (NSGCTTs) in patients with absence of viable cancer (VC) in the postchemotherapy retroperitoneal lymphadenectomy (PC-RPLA) specimen and determine wheter clinical variables can help predict disease progression Among a survey of 163 patients submitted to PC-RPLA from 1980-2005, 126 patients (77%) had no VC (44 fibrosis, 82 teratoma). At mean follow-up (MFU) of 158+/-77.7months, 20 patients (16%) developed recurrences within median free interval of 19.3 montha, with complete response (CR) following applied therapy in 9 patients (45%). Eleven patients (8%) diead (8 of disease, 3 of' other causes). Predictors for poorer recurrence free survival (RFS) were advanced clinical stage (CS) (P<0.016), intermediate/ poor IGCCCG group (p<0.004), and PC-RPLA nodal size (p<0.0007), while for disease-speciphic survival (DSS) included recurrences (p<0.0001), PC RP residual mass (RM) diameter ((p<0.006), worse IGCCCG risk (p<0.0003) and increased HCG at PC-RPLA (p<0.0001). A subset analysis of potential predictors of poorer RFS in patients with fibrosis identified only worse IGCCCG risk (p=0.05), whereas in teratoma were worse IGCCCG risk classification (p=0.01), PC RP RM size (p<0.0005) and unfavorable histology (teratoma with malignant transformation [TT] vs. mature teratoma [MT]/immature teratoma [IMT]Xp<0.0001). Adverse impact on DSS in fibrosis had elevated HCG on PC-RPLA (p<0.013) and in teratoma the presence of unfavorable IGCCCG risk (p<0.0001), worse RP histology (p<0.05) and postoperative recurrence (p<0.0001). The 5-year DSS and RFS rates for all patients with no VC at PC-RPLA were 87% and 85%, while at 10-year were 79% and 75%, respectively (Log rank=13.155; p<0.003). Patients with no VC at PC-RPLA remain at risk of recurrence. Several clinical variables, including CS, intermediate/poor IGCCCG group, preoperative HCG level, diameter of RP RM and postoperative recurrence help better to define which patients are at risk of disease recurrence and survival; as such these patients should be followed regularly in the postoperative period.

The aim of our study was to determine whether there is a relationship of flow through arteriovenous fistula and adequacy of dialysis in patients treated with repeated hemodialysis. The study included 37 patients who were on the program of repeated hemodialysis for more than three months. Patients were divided into two groups according to the flow through the arteriovenous fistula. For each patient, the observed parameters were recorded at baseline and after six months. In both phases of the study, more patients who had reduced flow through the fistula had inadequate dialysis but none of these differences reached statistical significance. The frequency of abnormal values of laboratory parameters was higher in patients who had reduced flow through the fistula, but these differences were not significant in the first phase of the study. Between the two phases of the study in patients with adequate flow through the fistula, there was a reduction in the frequency of pathological values of laboratory parameters, and in the group of the patients with reduced flow rate the frequences remained the same or increased, so that in the second phase of the study the incidence of hypocalcemia was significantly higher in patients with low flow. Satisfactory flow through the vascular access is important, but not decisive factor for good dialysis adequacy and must be viewed within the context of other clinical and laboratory parameters.

Arterial hypertension is a major risk factor for increased morbidity and mortality from cardiovascular, cerebrovascular and renal disease, and it is shown that it has its roots in childhood. There is an obvious trend in the incidence of hypertension in the pediatric population, which follows the increase in the prevalence of obesity in this population. The de¿ nition of hypertension has undergone signi¿ cant changes over the past few decades. According to the modern de¿ nition, normal systolic and diastolic blood pressure in children above 90 percentile speci¿ c for age and gender. Given the great importance of the disease, both in medical and in the broader social context, it is necessary to establish clear diagnostic criteria and treatment protocols, and effective programs for prevention and early diagnosis of hypertension in children.