The aim of the present study is to prospectively investigate the presentation of germ cell testicular tumors (GCCTs) in terms of clinical stage (CS) or histology, as the incidence of this malignancy in increasing. Patients diagnosed with GCTTS between 1976 and 2005 were categorized into 3 period depending on date of diagnosis of GCTTs and presentation characteristics assessed. For purpose of analysis patients were assigned into 1 of 3 similar groups in term of duration (10 years) (1976-1985, 1986-1995, 1996-2005). These 3 periods were compared statistically to identify the possible changes in the presentation of GCTTs. Among 1935 patients, the number diagnosed in each period was 111 (6%), 695 (36%) and 1129 (58%), respectively. There was substantial rise in the percentage of patients with GCTTs during the period of 30 years, particularly in 3rd vs. 2nd and 1st decade (P<0.0001). Overall, 46% of patients were diagnosed with seminoma and 54% with nonseminoma. The greater proportion of the entire cohort of patients presented in CS I (65%). Also, seminoma and nonseminoma occurred more frequently in CS I (78% and 51%, respectively). The median (range) age of the whole cohort of patients was 34 (14-80) years. The median age for developing metastatic seminoma was 4 years more than in CS I disease (38 vs. 42 years, respectively), while the median age for the presentation of CS I and metastatic nonseminoma was identical (31 years). The proportion of seminoma increased significantly in time (40% vs 55%) and this was accompanied by a significant decrease of nonseminoma (60% vs. 45%)(P<0.001). The proportion of patients in CS I disease also increased significantly with time (45% vs. 77%), while the proportion of patients with metastatic disease decreased (55% vs. 23%)(P<0.001). There was a significant rise in proportion of patients with CS I seminoma (27% vs. 47%) (P<0.001) and nonseminoma (18% vs. 30%) (P<0.001), accompanied by a significant decrease in the proportion of patients presenting with metastatic nonseminoma (46% vs. 15%)(P<0.0001). However, the proportion of patients with metastatic seminoma remained largery unchanged (13% vs. 9%). The present study shows a progressive increase of GCTTs during the observation period of 30 years, with increase in the proportion of patients with GCTTs confined to the testis, as opposed to metastatic disease. The other finding is that there has been an increase in the proportion of patients presenting with seminoma rather than nonseminoma. The reason for this remain unclear and require further investigation.

Lymphadenopathy is a common clinical finding, affecting patients of all ages. The majority of lymphadenopathies are reactive processes of lymph nodes in response to a variety of exogenous and endogenous stimulants. They are non-neoplastic conditions that can mimic lymphoma and other malignant tumors. Therefore their recognition and differential diagnosis is of great importance in order to rule-out the neoplastic disease. Signs of malignant etiology include lymph nodes >1,5cm in diameter, supraclavicular localization and generalized lymphadenopathy. A metastatic carcinoma is always in the differential diagnosis of localized lympadenophaty in older individuals. In case of generalized lymphadenopathy lymphomas, metastatic solid tumors and various benign etiologies need to be considered. The reactive lymphadenopathies are grouped into four major categories according to their predominant architectural histologic pattern: follicular-nodular, sinus, interfollicular or mixed, and diffuse. As reactive conditions of the lymph nodes are dynamic processes the predominant pattern may differ depending on when during the course of the disease the biopsy is performed. The most common reactive lymphadenopaties are follicular hyperplasia and toxoplasmic lymphadenitis. Nowdays some lymphadenopathies with foreign-body reaction are side effects of silicone prostheses (silicone lymphadenopathy) and various contrast media (lipid lymphadenopathy). A specific diagnosis and differentiation from neoplastic disease often requires correlation among the morphologic features, the clinical history, serologic studies, immunohistochemistry and molecular genetic analysis.

Plasma cells (PC) are the terminally differentiated effector cells of the B-cell lineage. The aim of this review is to integrate relevant data on the phenotype of plasma cells, including reactive and malignant PC. The current World Health Organisation classification of lymphoid neoplasm is based on correlation of their morphologic, histologic, immunophenotypic, genetic and clinical features. The extensive application of imunohistochemistry is necessary in diagnosis of plasma cell neoplasm, but also in determining prognosis as well as in evaluating residual/ relapsing disease. This review focuses on immunohistochemical analysis non-neoplastic and neoplastic plasma cell proliferation in facilitating the diagnosis and highlights the recent advances that have been made with regard to their stratifying.

The major goals of this presentation are to give the updated knowledge of primary heart muscle disease, cardiomyopathies (CMP), their classification, the diagnostic possibilities using endomyocardial biopsy (EMB) and to estimate the value of EMB in the choice of the right therapeutic approach. Despite many controversies, EMB is today a widely accepted method, with low percentage of complications for analysing CMPs, and is considered to be a routine procedure in many cardiological centers. Inspite the fact that we started with the use of EMB in 80’s, it is not performed often today in Belgrade, like many yeras ago (2). It’s difficult to say why ? The CMPs may be subdivided, according to the functional and structural features, into two groups: idiopathic and specific, or primary and secundary. Idipathic group is consisted of 5 subgroups: hypertrophic, dilated, restrictive, arrithmogenic right ventricular CMP and unclassified. Specific CMPs may be subdivided into 8 groups mainly based on etiopathogenetic characteristics: infective, with viral myocarditis as the most common entity, metabolic, including endocrine disorders and infiltration and storage diseases. Deficiency disorders and heart involvement in connective tissue disorders are also included. Granulomas, neoplasms and neuromuscular disorders are also wery often presented with cardiac disfunction and structural abnormalities. Sensitivity and toxic reactions with long list of substances wich may affect the heart are probably the most present today. Finally, the last group represent miscellaneous systemic syndromes with heart affection. EMB has been increasingly used in the diagnosis of CMPs, with special influnce on diagnosis of heart transplant rejection, myocarditis, treatment modalities of different types of myocarditis, with low complication rate, considered effective, usefull and safe procedure.

The aim of our study was to evaluate the possibility of ultrasonography in differentiating malignant from nonmalignant cysts in postmenopausal women. The study included 100 postmenopausal women with diagnosis of simple ovarian cysts who were treated surgically at our clinic during the study period. In the group of operated patients the histopathological diagnosis confirmed benign cysts in most cases. In 1% of patients histopathological diagnosis was borderline or malignant tumor of the ovary. The risk of malignancy ranged from 0% in the cyst with a diameter below 50 mm, to 3.57% in cysts over 80 mm. Cyst diameter smaller than 50 mm and the volume of cyst less than 50 cm3 in correlation with the values of serum CA125 and clinical findings represent good algorithm for differentiating malignant from nonmalignant simple cyst.

Gastric carcinoma is usually diagnosed using radiologic contrast methods, endoscopic examination with biopsies and histological analyses. In order to determine the stage of the disease, preoperative diagnosis requires determining presence of distant metastasis, malignant lymph node transformation, and involvement of the surrounding structures. Standards for gastric carcinoma staging have international variations, but all of them are based on the routes of metastasis. Different imaging methods are used for diagnosis and staging of gastric carcinoma, each with its advantages and shortcomings, so guidelines for diagnosis and follow-up for this malignoma are established accordingly.

Postoje kontroverze vezane za vreme, vrstu i metod skrininga gestacionog dijabetesa, kao i za populaciju trudnica koju treba podvrgnuti skriningu. Iako najšire primenjen, glucose chalenge test, kao i alternativne metode skrininga različitim glikemijskim vrednostima, ne pokazuju dovoljno visoku specifičnost. Zato se traže alternativne metode skrininga. Osim o kontroverzama skrininga, ovaj pregledni članak razmatra u

Savremeni svetski stavovi podrazumevaju limfadenektomiju kao terapijsku proceduru koja je integralni deo radikalne hirurgije karcinoma želuca. Ona se izvodi u pokušaju da se hirurgija malignoma učini što radikalnijom. Cilj svake hirurške procedure je potpuno uklanjanje tumora i svakog tkiva koje njime može biti zahvaćeno. Težnja radikalne hirurgije je u eradikaciji maligne bolesti, a limfadenektomija bitno doprinosi ovom cilju. Limfadenekotmija kod gastričnog karcinoma podrazumeva disekciju limfnih nodusa prve, druge grupe, što se smatra standardnom limfadenektomijom D2. Pored hirurškog načina lečenja karcinoma želuca, koji je ostao dominanatan, u poslednje vreme se razvijaju novi modaliteti lečenja želuca. I pored isticanja u prvi plan značaj hirurškog lečenja i sistematske limfadenektomije, kriterijumi koje je dalo Japansko udruženje za gastrični kancer od 2010g. razlikuje i druge modalitete lečenja gastričnog karcinoma. Karcinome želuca možemo tretirati: endoskopski, laparoskopski, klasičnom hirurškom resekcionom operacijom, hemioterapijom (koja može biti preoperativna i postoperativna) i palijativnom hirurgijom. Svaki od ovih modaliteta lečenja utiče na bolji ishod bolesti pacijenata. Izbor adekavtnog tretmana pacijenta sa karcinomom želuca zavisi od stepena uznapredovalosti maligne bolesti.

Pregledom literature utvrdili smo da su primarni tumori slezine u dece jako retrka pojava, a angiom slezine u dece ispod pet godina je jako redak. Mi prikazujemo redak slučaj angioma u donjem polu slezine u dečaka uzrasta pet godina.Detetu je tokom rutinskog ultrazvučno pregleda bubrega nađena masa koja je na CT okarakterisana kao tumor donjeg pola slezine zbog koga je dete operisano. Dete je praćeno dve godine po operaciji. Dijagnoza i opcije lečenja su široko razmatrane. Angiom slezine je redak tumor u odnosu na druge uzroke abdominalnih masa u dece. Konačna dijagnoza je postavljena histopatološkom i imunohistohemijskom analizom od strane dva patologa i glasi: angioma slezine. Primarni tumori slezine u dece se jako retki a naročito angiom. Parcijalna splenektomija ili parcijalna embolizacija slezine su metode izbora kad je moguće kod primarnih tumora slezine u dece.

Prezentujemo slučaj obolele od akromegalije, sa prisutnim kožnim visuljcima na vratu i aksilama, kod koje su kolonoskopski detektovani brojni polipi kolona. Akromegalija je hronična endokrinopatija, najčešće uzrokovana adenomom hipofize koji sekretuje hormon rasta (somatotropinom). Povezanost akromegalije sa nastankom neoplazija još uvek je stvar debate i pored brojnih in vitro i in vivo dokaza. Ipak, maligniteti su na trećem mestu uzroka smrti u obolelih od akromegalije. Najučestalije neoplazije se detektuju u kolonu. Prisustvo izvesnih kliničkih znakova (npr. kožnih visuljaka), može ukazati kliničaru na postojanje prevage proliferativnoneoplastične IGF1 aktivnosti (npr. u kolonu). Sa tim u vezi, dužnost kliničara je da preduzme odgovarajuće dijagnostičke procedure u cilju detekcije neoplazija.