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Basal cell carcinoma (BCC) is the most frequent human malignancy and at the same time the most frequent periocular malignancy, representing almost 80% of all non-melanoma skin cancers and 90% of eyelid cancers. The study included 50 cases of eyelid BCC, out of which 41 were nodular BCC (NBCC) and nine were infiltrative BCC (IBCC), with various Breslow scores (BS) and primary tumor (pT) category. We analyzed the immunoexpression of matrix metalloproteinases (MMPs) 1 and 13 in the tumoral epithelial component (TEC) and inflammatory stromal component (ISC) of BCC in relation to the two histopathological parameters. The immunoreaction for MMP-1 was identified in 41 (82%) cases and for MMP-13 in 46 (92%) cases both in the TEC and ISC of both types of BCC. The statistical analysis revealed that both collagenases had positive/high scores significantly associated with advanced BS. For MMP-1, there were statistical associations in TEC related to IBCC and high pT category, while MMP-13 only revealed statistical association in ISC with high pT. The presence of collagenase MMP-1 and MMP-13 expression in a high number of cases, both in TEC and ISC, confirms their intervention in the tumor progression and proposes these MMPs as potential targets in antineoplastic therapy.

Inflammation plays an important role in the pathogenesis of nasal polyps. Understanding the biomolecular action mechanisms of inflammatory elements can contribute to improving the prognosis of these lesions. The study analyzed the distribution and immunohistochemically quantified eosinophils [eosinophil major basic protein (BMK-13)], lymphocytes [cluster of differentiation (CD) 4, CD8, CD20] and plasmocytes (CD138) in both the epithelial and stromal compartment in relation to composite scores, which included specific histopathological parameters for 50 sinonasal polyps. Inflammatory elements predominated at stromal level, the high histological composite scores being frequently associated with increased expression of inflammatory elements. Also, the numerical distribution of inflammatory elements indicated positive linear relations within the groups BMK-13∕CD8 and CD4∕CD20∕CD138, and a negative linear relation between the two groups. This aspect can support the existence of alternative or sequential pathogenic mechanisms involved in the pathogenesis of sinonasal polyps, and the results obtained can be used for a better stratification of patients in order to optimize the therapy.

Chronic palatal and nasopharyngeal inflammations are common lesions in pediatric pathology, with major effects on children’s development. The study included 34 cases of chronic tonsillitis and adenoiditis for which we quantified immunohistochemically and analyzed the distribution of inflammatory elements in the follicular, extrafollicular and epithelial compartments, in relation to the composite histological scores and the clinico-epidemiological profile of the lesions. The cases were more frequent under the age of 10, in female patients, coming from urban areas, with the diagnosis of tonsillitis. B-lymphocytes have been associated with follicular areas in tonsillitis and epithelial areas in adenoiditis. In all compartments, T-lymphocytes were more frequently associated with tonsillitis and plasma cells associated with adenoiditis. Macrophages and dendritic cells had a relatively uniform distribution for the three compartments in all cases. The results obtained indicate different inflammatory phenotypes for chronic tonsillitis and adenoiditis, an aspect that may be useful for stratifying patients for optimal therapy.

Basal cell carcinomas (BCC) make up about 90% of malignant tumors of the eyelids. Although they are generally slow-growing tumors, in the periocular region can cause significant morbidity due to orbital invasion. In the present study we followed the associations between the various types of BCC with the depth of invasion, respectively the Breslow stage (BS) and with the pT category. The study included a number of 92 cases of eyelid BCC from the Plastic Surgery and Ophthalmology Departments of the Craiova County Emergency Clinical Hospital which were processed and diagnosed in the Pathological Laboratory of the same hospital. Histopathological analysis of the 92 BCCs indicated that in 72 cases the tumors were composed of a single growth pattern, and in 20 cases they were composite, associating two or more growth patterns. The cases with a single growth pattern corresponded in 53 cases of nodular BCC, in 9 cases of infiltrative BCC, in 2 cases of superficial BCC and in 8 cases of micronodular BCC. The composite types corresponded in 10 cases to the association of the nodular type with the micronodular one, in 8 cases to the association of the nodular type with the infiltrative one and in 2 cases to the association of the infiltrative type with the micronodular one. Statistical analysis indicated significant associations between BS, pTa and the histopathological type of tumors, the mixed types being frequently present in cases with high SB and advanced pT.

Chronic rhinosinusitis with nasal polyps of allergic etiology is one of the most common pathology in the ENT sphere that affect a significant percentage of population. The paper aims to establish the involvement of the allergic component in the genesis of nasal polyposis. The study included 150 nasal polyps from patients hospitalized and operated in the ENT Department of Craiova’s Clinical Emergency County Hospital. The biological material was fixed in 10% buffered formalin, processed by classical paraffin embedding technique followed by hematoxylin-eosin staining and it was interpreted in the Pathology Department of the same hospital. We evaluated a number of histopathological parameters that were given severity scores. The most common changes at epithelial level were: basal layer hyperplasia observed in 87 cases (58%), goblet cell hyperplasia in 121 cases (80.66%), basal membrane thickening with values between 10-42μm corresponding to a number of 118 cases (78.66%). The most important stromal changes were edema in 88% and infiltration with eosinophils 100%, indicating the allergic nature of this disease.

Pathological diagnosis of prostate adenocarcinoma often requires complementary methods. On prostate biopsy tissue from 39 patients including benign nodular hyperplasia (BNH), atypical adenomatous hyperplasia (AAH), and adenocarcinomas, we have performed combined histochemical-immunohistochemical stainings for argyrophilic nucleolar organizer regions (AgNORs) and glandular basal cells. After ascertaining the pathology, we have analyzed the number, roundness, area, and fractal dimension of individual AgNORs or of their skeleton-filtered maps. We have optimized here for the first time a combination of AgNOR morphological denominators that would reflect best the differences between these pathologies. The analysis of AgNORs’ roundness, averaged from large composite images, revealed clear-cut lower values in adenocarcinomas compared to benign and atypical lesions but with no differences between different Gleason scores. Fractal dimension (FD) of AgNOR silhouettes not only revealed significant lower values for global cancer images compared to AAH and BNH images, but was also able to differentiate between Gleason pattern 2 and Gleason patterns 3–5 adenocarcinomas. Plotting the frequency distribution of the FDs for different pathologies showed clear differences between all Gleason patterns and BNH. Together with existing morphological classifiers, AgNOR analysis might contribute to a faster and more reliable machine-assisted screening of prostatic adenocarcinoma, as an essential aid for pathologists.

Aquaporin-4 (AQP4) and glutamate transporter-1 (GLT-1) represent the major water and glutamate astrocyte buffering gateways in the brain. Utilizing perilesional ischemic human cortices, we have performed here for the first time an integrative assessment on both AQP4 and GLT-1, and on their proximity to blood vessels and neurons. Counting the relative number of AQP4±/GLT-1±/glial fibrillary acidic protein± cells showed that double-positive variants were overall most frequent, and their number tended to decrease from organized and recent perilesional cortices to controls. AQP4/GLT-1 colocalization showed higher coefficients for the perilesional cortices compared with controls, suggesting an increased water/glutamate-buffering capability. Distance frequency analysis of AQP4/GLT-1 in relationship to neurons showed that both markers were concentrated at 20-40 μm around the perikarya; with AQP4 being more abundant in close proximity, these differences were not being driven by changes in neuropil density alone. Our study suggests a dual, simultaneous astrocytic function depending on the relative distance to neurons and vessels, with increased water and glutamate-buffering capability in the mid perineuronal space, and an increased water-buffering capability in the immediate perineuronal space, even higher than around vessels. Thus, adding specific AQP4/GLT-1 modulator agents selectively depending on the acute/chronic phase of stroke might increase the efficacy of existing treatments.

The present study aimed to observe and compare the values of microvessel density (MVD), mast cell microdensity (McMD) and macrophage microdensity (MphMD) in intratu- moral areas compared with the advancing edges, and to assess any correlations between these values and the degree and stage of the neoplasia. The cases of 52 patients who were diagnosed with endometrial carcinoma between 2003 and 2011 were analyzed, the majority of which were in the first stage of the disease (44 cases). Double sequential immunohistochemistry and the hot-spot counting method were used to assess the MVD (CD105 + MVD), McMD (tryptase + (Try + ) McMD) and MphMD (CD68 + MphMD) densities. The χ 2 test, paired Student's t-test and the Pearson correlation index were used to assess the significance of the results . A weak correlation was observed at the advancing edge only, between CD105 + MVD and Try + McMD (P=0.039). No significant differences were identified in the analysis of CD105 + MVD, Try + McMD and CD68 + MphMD, but wide variations in their distribution were observed. Depending on the tumor stage, CD105 + MVD exhib- ited an intratumoral, indirect correlation with Try + McMD for stage IA (P=0.026) and II (P=0.013) tumors. CD105 + MVD presented an indirect correlation with CD68 + MphMD in stage IB tumors (P=0.016) and at the advancing edge for well-differentiated tumors (P=0.027). An analysis of the corre- lation between CD68 + MphMD and Try + McMD indicated that the intratumoral levels of CD68 + MphMD were directly proportional with the Try + McMD values in well-differentiated (P=0.005) and stage II (P=0.012) tumors, while at the front of the invasion, this correlation was indirect (P=0.010) in stage II tumors. In endometrioid endometrial carcinoma (EEC), angio- genesis is at its most active at the advancing edge of the tumor, where mast cells play a pro-angiogenic role.

Matrix metalloproteinases (MMPs) are well-recognized denominators for extracellular matrix remodeling in the pathology of both ischemic and hemorrhagic strokes. Recent data on non-nervous system tissue showed intracellular and even intranuclear localizations for different MMPs, and together with this, a plethora of new functions have been proposed for these intracellular active enzymes, but are mostly related to apoptosis induction and malign transformation. In neurons and glial cells, on human tissue, animal models and cell cultures, different active MMPs have been also proven to be located in the intra-cytoplasmic or intra-nuclear compartments, with no clear-cut function. In the present study we show for the first time on human tissue the nuclear expression of MMP-9, mainly in neurons and to a lesser extent in astrocytes. We have studied ischemic and hemorrhagic stroke patients, as well as aged control patients. Age and ischemic suffering seemed to be the best predictors for an elevated MMP-9 nuclear expression, and there was no evidence of a clear-cut extracellular proteolytic activity for this compartment, as revealed by intact vascular basement membranes and assessment of vascular densities. More, the majority of the cells expressing MMP-9 in the nuclear compartment also co-expressed activated-caspase 3, indicating a possible link between nuclear MMP-9 localization and apoptosis in neuronal and glial cells following an ischemic or hemorrhagic event. These results, besides showing for the first time the nuclear localization of MMP-9 on a large series of human stroke and aged brain tissues, raise new questions regarding the unknown spectrum of the functions MMPs in human CNS pathology.

Angiogenesis is involved in tumor progression of oral squamous cell carcinoma (OSCC). In this study, we have investigated by immunohistochemistry vascular endothelial growth factor (VEGF) expression in tumor cells and we have correlated VEGF expression to microvessel area, evaluated by using CD105 as a marker of endothelial cells, in bioptic specimens of 54 human OSCC. Results demonstrated that VEGF is highly expressed in OSCC tumor specimens when compared to pre-neoplastic and normal tissues, without differences between the edge and inside the tumor. Moreover, VEGF expression is reduced in poor differentiated OSCC tumors when compared to moderate and good differentiated forms, and tumor microvessel area is higher in tumors when compared to pre-neoplastic lesions and normal tissues. Finally, VEGF and CD105 may be considered as reliable markers of tumor angiogenesis and progression in OSCC, even if we did not demonstrate any correlation between VEGF expression, tumor microvascular area, clinical stage, and lymph node status.

Papillary thyroid carcinoma represents common injuries that can have different histological variants that may influence the patient’s prognostic. The study included a total of 44 papillary thyroid carcinomas, for which were followed a series of histological factors of aggressiveness for grading tumors. Most studied papillary carcinomas corresponded to the conventional type, followed by the follicular, micropapillary and tall cell variants. Depending on the presence of nuclear atypia, tumor necrosis, the frequency of mitosis, also the vascular invasion and the extrathyroidian extension there were distributions differences of the cases according to the tumor type, most of the cases belonged to the conventional and tall cell types. The assessment of histopathological parameters of aggressiveness with certain types known to have an unfavorable behavior, justify the use of the histological grading of papillary thyroid carcinomas.

Aquaporin‐4 (AQP4) and glutamate transporter‐1 (GLT‐1) represent the major water and glutamate astrocyte buffering gateways in the brain. Utilizing perilesional ischemic human cortices, we have performed here for the first time an integrative assessment on both AQP4 and GLT‐1, and on their proximity to blood vessels and neurons. Counting the relative number of AQP4±/GLT‐1±/glial fibrillary acidic protein± cells showed that double‐positive variants were overall most frequent, and their number tended to decrease from organized and recent perilesional cortices to controls. AQP4/GLT‐1 colocalization showed higher coefficients for the perilesional cortices compared with controls, suggesting an increased water/glutamate‐buffering capability. Distance frequency analysis of AQP4/GLT‐1 in relationship to neurons showed that both markers were concentrated at 20–40 μm around the perikarya; with AQP4 being more abundant in close proximity, these differences were not being driven by changes in neuropil density alone. Our study suggests a dual, simultaneous astrocytic function depending on the relative distance to neurons and vessels, with increased water and glutamate‐buffering capability in the mid perineuronal space, and an increased water‐buffering capability in the immediate perineuronal space, even higher than around vessels. Thus, adding specific AQP4/GLT‐1 modulator agents selectively depending on the acute/chronic phase of stroke might increase the efficacy of existing treatments.

Bladder cancer ranks among eight human malignant lesions, 90% being urothelial carcinomas. We evaluated the Ki67 and Bcl-2 immunoexpression and their correlations with clinicopathological parameters. The study included 45 primitive bladder urothelial carcinoma diagnosed in patients aged in VI and VII decades of life, predominantly in males. Histopathologically, the most numerous were moderately differentiated carcinomas (68.8%), most patients being classified in stage I of disease (48.8%). The analysis for Ki67 immunostain revealed positivity in 71.1% of cases, with higher values in moderate and poorly differentiated tumors in stage III or IV of disease. In contrast, immunoreactivity for Bcl-2 was present in 33.3% of well and moderately differentiated analyzed tumors and classified in stage I and II of disease. Tumor stage and grade is not correlated with Bcl-2 but there was a strong correlation with Ki67 proliferation index. Ki67 immunoexpression may be helpful to identify patients at high risk who may benefit by adjuvant therapies.

In this study, we analyzed the VEGF and CD105 immunoexpression in 24 cervical squamous cell carcinomas and CIN associated lesions with different degrees. For both lesions, MVD values were higher in patients who had associated risk factors. VEGF and MVD expression increased in both categories for high-grade lesions, respectively CIN III lesions compared with CIN I/II and poorly differentiated carcinomas compared with well-differentiated ones. Also, there was a statistically significant association between VEGF and MVD in poorly differentiated carcinoma and CIN III. The study indicated that analyzed markers were specific for both early and advanced stages of cervical angiogenesis. Maximum values of VEGF and MVD in CIN III designate this lesion as critical to the progression of neoplasia.

The research focused on a systematic review of 959 cases operated for uterine fibromyoma (24.8%) from 3859 gynecological surgeries performed over a period of 10 years (2000-2010).The important parameters were those related to the general clinical and laboratory data, and especially those focused on the macro- and microscopic histopathological diagnostic methods. Thus, we inserted some details on the methods used for the histopathological examination of surgically removed samples.The age of patients operated for uterine fibromyoma was between 20 and 60 years, with the highest incidence in the 40-50 years group (594 cases--62.4%). The most frequent anatomo-clinical forms observed were uterine fibromyoma with menometrorrhagia (78.9%), large uterine fibromyoma associated with compression and metrorrhagia (81.1%), uterine fibromyoma with aseptic necrobiosis (33.6%). The other forms showed a reduced frequency. Uterine fibromyoma associated with infertility was found in patients under 40-year-old, their evolution being initially asymptomatic. The incidence of uterine fibromyoma, which degenerated into a leiomyosarcoma, was "0".1/5 of patients operated after the age of 35 years presented with various anatomo-clinical forms of uterine fibromyoma. Several hypotheses are formulated regarding the etiopathogenesis, morphology and embryogenesis of this benign tumor of the myometrium. The estrogen-progestogen hormonal imbalance after this age in correlation with the genetic predisposition lead to the synthesis of various proteins, enzymes, and growth factors, decrease of apoptosis and stimulation of leiomyomatous cells with the development of a large, even gigantic form of fibromyoma, representing the most common form encountered in our study. The medical treatment with progesterone derivatives did not lead to the expected results, radical surgery usually being the final therapeutical approach.Between 31 and 60-year-old, the incidence of operated uterine fibromyoma was 941 cases out of 959 (98.1%). The correlation between the preoperative clinical and laboratory diagnosis, the intra-operative morphological appearance and especially the post-operative histopathological examination was 100%. In all cases of uterine fibromyoma, histopathological examination was and will remain the sovereign exploration for surgical practice in general and for gynecological surgery in particular.

In this study, we have analyzed clinically, histopathologically and immunohistochemically a total of 34 cases of oral squamous carcinoma in 11 of the cases being identified adjacent epithelial dysplastic lesions. Carcinomas were diagnosed in patients aged 40-60 years, males, with chronic exposure to tobacco and/or alcohol, being located especially on the lips. Well-differentiated carcinomas have been predominant (52.9%) in stage I/II tumoral (88.3%). Immunoexpression analysis of p53, p16 and Ki67 did not reveal statistically significant differences between the expression of markers and clinical or histopathological parameters, except Ki67 whose increased expression was associated to the decrease of the degree of tumoral differentiation and with high degree dysplasia. The positivity index and the intensity of reaction were increased at the level of dysplasic epithelium for p16 and at the level of tumoral invasion front for the p53 and Ki67. The study highlights the value of the immunostain for p16 in identifying dysplasic lesions and predictive importance of p53 and Ki67 markers in identifying the aggressive forms of oral carcinomas.

The study included a total of 17 ameloblastomas diagnosed in a range of 15 years. Clinical data processing was followed by histopathological and immunohistochemical analysis, following the expression of p53, Bcl-2 and Ki67 in the tumor epithelial compartments. Lesions predominated in the age range 20-40 years, to male gender, being located mainly in the mandible (88.2%). Typical follicular ameloblastoma was present in 70.6% of analyzed tumors. P53 and Bcl-2 immunoexpression was identified especially in the peripheral cells, the number of marked cells being over 50%, while the percentage of positive cells from the stellate reticulum was below 10%. The Ki67 positivity index was below 10% in both compartments. Squamous and granular cells reveal no stain for the investigated markers. Peripheral columnar cells are active compartment of ameloblastomas being involved in the processes of proliferation-apoptosis.

Warthin tumor is the second most common benign tumors of the parotid gland, after pleomorphic adenoma. Our study was performed on 21 cases with Warthin tumor diagnosed between 2005-2010, which were analyzed clinically, histologically and immunohistochemically, using anti-CD20 and anti-CD45RO antibodies. The analysis of age distribution within the investigated cases indicated that Warthin tumor incidence is increasing in the seventh decade of life, most patients being male (M/F 5/2). Histopathological, the analysis report of stroma÷parenchyma in 14 cases revealed a balanced distribution of the two components, in four cases, the epithelial component was predominant and in three cases, the stromal component was predominant. Immunohistochemical study for the two specific lymphocyte proliferation markers indicated positivity for both epithelial component and stroma. Cell layout of CD45RO and CD20cy at the level of lymphoid stroma had a similar pattern with normal or reactive lymph nodes.

More than 90% of malignant neoplasms of the oral cavity are squamous carcinomas of oral mucosa and most are conventional type. This study included 60 cases of oral squamous carcinoma processed by usual histological technique and stained with Hematoxylin-Eosin and Alcian Blue-Safranin (Alcian Blue powder from Sigma Aldrich, code A5268-25G) and diagnosed in the Department of Pathology, University of Medicine and Pharmacy of Craiova. Double immunohistochemical (CD105-tryptase, VEGF-, VEGFR1-, VEGFR2-tryptase) or combined histochemical and immunohistochemical reactions (VEGF÷ VEGFR1÷ VEGFR2÷Alcian Blue-Safranin) followed the particular morphological aspects of the mast cells, their relation with the blood vessels and the overlap signal of tryptase and Alcian Blue-Safranin÷VEGF and its R1 and R2 receptors in mast cells. Immunostaining for VEGF and its R1 and R2 receptors was present both in tumor cells and mast cells. Double immunohistochemical-histochemical reactions allowed us angiogenic profiling the mast cells. The signal overlap was present for VEGF-, VEGFR1-, VEGFR2-tryptase intratumoral and tumor invasion front mast cells. Student's t-test for comparison of intratumoral and the invasion front MDM showed highly significant value (p=3.23 E-08). VEGF÷ VEGFR1÷ VEGFR2÷Alcian Blue-Safranin revealed particular morphological aspects of mast cells, in with different morphology, shapes, sizes and degrees of degranulation. Statistical analysis showed a linear correlation between MDM and MVD inside the tumor (Pearson coefficient =0.47) and a weak linear correlation at the front of invasion (Pearson coefficient =0.19). This study has highlighted the importance of mast cells in the tumor growth of the oral squamous carcinomas, especially in terms of their proangiogenic profile (expression of VEGF and its R1 and R2 receptors). In addition, their quantification as MDM makes this parameter a useful prognostic marker.

Matrix metalloproteinases (MMPs) are well-recognized denominators for extracellular matrix remodeling in the pathology of both ischemic and hemorrhagic strokes. Recent data on non-nervous system tissue showed intracellular and even intranuclear localizations for different MMPs, and together with this, a plethora of new functions have been proposed for these intracellular active enzymes, but are mostly related to apoptosis induction and malign transformation. In neurons and glial cells, on human tissue, animal models and cell cultures, different active MMPs have been also proven to be located in the intra-cytoplasmic or intra-nuclear compartments, with no clear-cut function. In the present study we show for the first time on human tissue the nuclear expression of MMP-9, mainly in neurons and to a lesser extent in astrocytes. We have studied ischemic and hemorrhagic stroke patients, as well as aged control patients. Age and ischemic suffering seemed to be the best predictors for an elevated MMP-9 nuclear expression, and there was no evidence of a clear-cut extracellular proteolytic activity for this compartment, as revealed by intact vascular basement membranes and assessment of vascular densities. More, the majority of the cells expressing MMP-9 in the nuclear compartment also co-expressed activated-caspase 3, indicating a possible link between nuclear MMP-9 localization and apoptosis in neuronal and glial cells following an ischemic or hemorrhagic event. These results, besides showing for the first time the nuclear localization of MMP-9 on a large series of human stroke and aged brain tissues, raise new questions regarding the unknown spectrum of the functions MMPs in human CNS pathology.

One of the theories regarding oral carcinogenesis is that the tumor growth is dependent on cancer stem cells (CSCs) that have the capacity of self-renewal and of giving rise to more differentiated tumor cells, like the stem cells do in normal tissues. The most used methods of CSCs isolation are based on their identification based on the expression of different cell surface markers. The markers qualified for this purpose have been described originally in studies involving hematopoietic or embryonic stem cells. Thus, we were interested to study the expression of the most used CSCs surface markers for formalin fixed paraffin embedded tissue samples from oral squamous cell carcinoma (OSCC). We investigated by immunohistochemistry thirty tissue samples of OSCCs with different degrees of differentiation and different oral locations. We were interested to establish the tissular localization pattern for cells expressing CD44, CD133 and CD117 in tumoral samples. The results indicated that with the exception of CD44, the other two surface markers were expressed only in tumoral stromal cells. When we looked at their origin (by double immunohistochemistry for cytokeratins AE1-AE3, vimentin and CD34) we concluded that they are of mesenchymal nature. Also, we proved that some of these cells also co-expressed CD44 but were negative for CK5÷6. Moreover, some of the stromal cells that were positive to CD133 and especially for CD117 also had reactivity to tryptase showing their mast cell nature. In conclusion, our study proved that CD44 has limited utility in identifying oral CSCs, while CD117 and CD133 expression appears to be limited more in identifying mesenchymal stem cells.

We analyzed 75 cases of invasive ductal mammary carcinoma type NOS and focused on comparative investigation of hormonal receptors (estrogen receptor ER and progesterone receptor PR) and Her2/neu oncoprotein expression, according to which we ranked the cases in molecular classification subtypes, determining certain correlations between them and morphoclinical prognostic factors. 73.4% of cases were ER+ and 26.6% were ER-. PR was present in 62.6% of cases and absent in 37.4%. Phenotype ER+PR+ (58.6%) had the highest incidence, followed by ER-PR- (22.8%) and ER+PR- (14.6%). Phenotype ER-PR+ (4%) registered the lowest incidence. 14.8% of tumors were Her2/neu + score 3+, 4% had equivocal score 2+ and 81.3% were negative Her2/neu scored 0 and 1+. 9.5% of cases Her2/neu positive scored 3+ were ER+PR+ and 88.5% of cases Her2/neu negative scored 0-1 were ER+PR+. In terms of the correlation among the status of ER, PR and Her2/neu, we determined a molecular classification of the cases, obtaining the following incidences: luminal A 70% of cases, basal 14.7% of cases, luminal B 8.3%, the lowest incidence being registered at Her2, 7% of cases. Luminal A and basal subtypes were associated with patients aged over 50 years (82% for luminal A and 90% for basal), whereas luminal B and Her2 subtypes were registered mostly at patients aged under 60-year-old (83% for luminal B and 100% for Her2). Luminal A subtype was characterized by small tumors (92% of cases were T1-T2), well and moderately differentiated tumors (58% of cases were G1-G2). 83.3% of cases in luminal B subtype had tumors with dimensions ranked T2-T3, all cases being moderately and low differentiated. Her2 subtype had T2-T3 tumors in 60% of cases, which were G3 low differentiated in a percent of 80%. The basal subtype mostly had tumors larger than 5 cm (91% of cases were T2-T3), out of which only a case (9%) presented well-differentiated G1.

With the decline of ovarian hormonal function, from the fifth decade of life, women enter the menopause transition, during which bleeding becomes irregular in duration and time of occurrence. Secondary to ovarian dysfunction, developmental and maturation endometrial anomalies occur, which are clinically translated by abnormal uterine bleeding, which in many cases at this age can be caused by organic lesions (fibroma, polyps, endometritis, endometrial hyperplasia, adenomyosis, etc.). The retrospective study included a total of 256 patients with abnormal uterine bleeding in menopause transition. Statistics showed that the incidence of these types of bleeding increases with age (64.5%) and parity (30.5%), with symptoms consisting mostly in different clinical forms of abnormal uterine bleeding (62.1%), and leiomyomas prevailing at histopathological examination (49.6%). Progesterone replacement therapy was the first therapeutic choice for correcting these types of bleeding. Progesterone therapy is useful not only for therapeutic purposes to amend the bleeding, but also as a precaution against the development of endometrial carcinoma. Progestogens cancel the proliferative and mitogenic effect of estrogens, even when administered in sequential regimen 10-12 days per month.

The study included a total of 28 cases of urothelial carcinomas, which were analyzed histopathologically and immunohistochemically using anti-human p16, c-erbB2 and Ki67 antibodies and the LSAB/HRP work system. Histopathological analysis revealed the presence of urothelial carcinomas with different degrees of differentiation and invasion in the lamina propria or muscularis propria. The immunostain for p16, c-erbB2 and Ki67 was present at the nuclear and cytoplasmic level, respectively at membrane and nuclear level. Immunoreactions had quantified values, which were statistically correlated with the degree of differentiation in case of c-erbB2 or depth of invasion for p16. Tumor activity status and the risk of progression of bladder urothelial carcinomas can be assessed objectively using the antibody panel consisting of p16, c-erbB2 and Ki67.

We present a retrospective histopathological study that included a total of 22 endometrial carcinomas, from patients that were operated in the Obstetrics and Gynecology Clinics of the Emergency County Hospital of Craiova. This current study investigates these cases in order to assess the prognostic value of the correlations between the expression of estrogen and progesterone receptors, Ki67 expression and the histological stage, tumor stage, the degree of myometrial and vascular invasion. The study showed that estrogen and progesterone positive receptors correlate significantly with early stage and well differentiated tumors. The invasion of more than half the thickness of the myometrium and the vascular invasion were associated with decreased expression of the analyzed receptors and an increased proliferation index.

The earliest joint changes in rheumatoid arthritis occur in the synovial membrane, leading to development of an unsuppurated proliferative synovitis. This study is based on 33 cases of early rheumatoid arthritis for which we have investigated a series of clinical and morphological parameters. For the examined cases we found that the disease incidence reached its maximum in fifth and sixth decades of life, predominantly in females, over half of cases being diagnosed in the first six months from the onset of the disease. Histopathological study of synovial membrane samples showed characteristic morphological changes but unspecific for the disease, represented by the synoviocytes proliferation, inflammatory infiltrates, fibrinoid necrosis, fibroblasts proliferation and vascular changes. Reaching composite histological score may be useful by providing some information on the severity of the disease.

In this study, we included 26 cases diagnosed as squamous intraepithelial lesions, which were examined histopathologically, and in terms of p16, E-cadherin and Ki67 immunoexpression. In low-grade lesions, p16 expression was limited to one third below the epithelium, E-cadherin has a membranous pattern and Ki67 proliferation index had low values. In high-grade lesions, the p16 diffuse stain was present in two thirds or all epithelium layers, E-cadherin expression became aberrant, with membranous and cytoplasmic pattern and Ki67 proliferation index was high. These biomarkers have proven useful to accurately assess the extent of lesions and to identify lesions with high risk of progression.

The systemic lupus erythematosus (SLE), a systemic autoimmune disorder with a multifactorial etiology, is characterized by the presence of autoantigens in some organs and tissues that induce the development of some antibodies with extended binding and with various specificities. The presence of antibodies is accompanied by disbalances in the immune cellular response, including alterations in the production of some cytokines. Cytokines, quite a heterogeneous group of protein molecules produced in small quantities by certain specifically stimulated cells, have the capacity to maintain the communication between different cell populations that participate in the immune response (messengers of the immune system), thus modeling a defense function.The purpose of the study is to estimate the seric levels of some proinflammatory, anti-inflammatory and immunomodulating cytokines in patients diagnosed with SLE, as well as some correlations between the seric levels of these cytokines and the histopathological aspects.There were included in the study 35 patients diagnosed with SLE (active÷remission stage of the disorder), in whom there were determined, before administering the treatment with the immunoenzymatic technique ELISA, the seric level of the following cytokines: interleukins (IL) IL-2, IL-6, IL-8, IL-10, and the tumor necrosis factor-alpha (TNF-alpha). The obtained results in the patients were compared to those observed in a control group, made up of 35 healthy subjects.The IL-2 production of T-lymphocytes was a deficient one (low seric levels in the majority of the patients), while cytokines IL-6, IL-8 and TNF-alpha showed high seric levels. IL-10 plays a very important role in the SLE pathogeny, through the high seric levels, and it may be involved, as a predictive biological marker, in the quantification of the activity degree of the disorder.SLE represents an autoimmune disorder, characterized, among others, by a disbalance in the cytokine network. Signaling and regulating abnormalities of B-lymphocytes by cytokines are responsible of the excessive production of antibodies. IL-6 and IL-10 were proved to be key factors in the intensification of the inflammation and regulation of B-lymphocytes activity, by their polyclonal activation. Alongside TNF-alpha, they play an important part in the development of severe dermo-epidermal alterations.

Although a series of premalignant or potentially malignant lesions are described in the tongue, there are many other lesions whose potential of degeneration can be determined by a prolonged action of irritant or carcinogenic factors. Even if they are practically considered to be harmless, benign formations of mesenchymal origin with lingual location represent in the same time a neoplastic lesion under the influence of local and general factors, for a variable period of time. When these structures are located in major risk areas from the oral cavity and in particular, those directly related to the tongue, special attention should be paid to their development. In this study (conducted on a total of 16 cases of benign mesenchymal malignancies), we planned a histopathological evaluation of surgical excision samples obtained from interventions on lingual neoplasias, and harvested from areas with the highest risk for lingual cancer development (pelvilingual groove, the base of the tongue and the insertion of the anterior pillar) in order to assess the histopathological aspects in different types of lesions and the possible presence of degenerative changes.

In this paper, we studied 15 cases of early rheumatoid arthritis presenting with inflammatory lesions in different degrees of evolution. We want to highlight B- and T-lymphocytes in synovial tissue collected from patients diagnosed with early rheumatoid arthritis, to establish the pattern of their distribution, possibly in relation to local neovascularisation to determine the role played by these types of cells. The pathological samples were represented by synovial membrane biopsy fragments, which were examined by histopathological and immunohistochemical methods. We noticed a perivascular distribution of lymphocyte infiltrate, up to formation of lymphoid follicles with germinal centers. There is a close interdependence between B- and T-lymphocytes in these lesions, and their presence in the synovial membrane in relation to newly formed blood vessels facilitates their action and their chemical mediators. Studying the interdependence of different types of lymphocytes and their connection with blood vessels may generate new therapeutic targets.

Our study was carried out on a total number of 158 patients, with a mean age of 32, all tested and identified cytologically (Pap-test) as presenting minor cellular abnormalities, respectively ASCUS (10) and LSIL (119), and major cellular abnormalities, respectively SIL-borderline (8) and HSIL (21), and who, either voluntarily or upon cytopathologists’ recommendation, were colposcopically examined. Subsequently, they were subjected to cervical biopsy or excision therapy. In patients with ASCUS cytology, 6 cases were morphologically diagnosed with benign cervical lesions, 3 were diagnosed with LSIL, and one patient was diagnosed as HSIL (CIN 2). Out of 119 LSIL smears 108 were confirmed by histopathology, while 11 were diagnosed as HSIL (CIN 2). In SIL-borderline patients, 5 cases were screened as LSIL and 3 as HSIL. In patients with HSIL cytology, 18 were diagnosed histopathologically as HSIL (CIN 2 and CIN 3/CIS), while 3 were diagnosed as invasive squamous carcinoma.

In this study, we investigated 30 cases of dysplastic lesions and bladder carcinomas. The lesions presented different degree of differentiation and depth of invasion. The aim of this study was to appreciate the immunoexpression of some proteins, like E-cadherin and p63, which are implicated in the cellular adhesiveness and the normal development of the urothelium, depending on the degree of tumoral differentiation and the depth of invasion. The immunoreactivity of the markers was qualitative and quantitative evaluated. Both markers presented an immunoexpression diminishing with depth of invasion, the carcinomas with muscularis propria invasiveness having a minimum intensity reaction (0 or 1), and a medium percentage of marked cells by 10-50% for E-cadherin, and 30% for p63. The immunostaining intensity for E-cadherin decreased with the tumoral degree of differentiation, the poorly differentiated carcinomas having a reaction with minimum intensity (0 or 1). The p63-immunoexpression was correlated with the degree of differentiation in superficially cases of chorion invasiveness carcinoma. The immunostaining intensity in cases with muscularis propria invasiveness was diminished as the number of epithelial layers becomes bigger, but there was no variation depending on tumoral differentiation. In conclusion, E-cadherin and p63 are implicated in tumoral progression and may be used as a prognostic markers.

Cathepsin-D (CathD) is an aspartyl lysosomal protease expressed in all tissues that might play a role in antigen processing, cell proliferation and tissue renewal, and activation of different pro hormones. The aim of our study was to compare the expression of CathD in most common breast tumors and tumor-like breast lesions. The study includes 21 patients with histologically verified breast lesions (adenosis, ductal hyperplasia, fibroadenomas, and different types of invasive carcinoma). We investigated the cathepsin-D expression in these breast lesions using immunohistochemistry (IH; paraffin-embedded tissues). Cathepsin-D staining within each lesion was assessed by estimating the area of the objects and the medium pixel intensity per object, as the integrated optical density (IOD). The immunostaining was more obvious in breast invasive carcinomas and macrophages. The reaction in tumor tissue was heterogeneous with little variation of staining intensity in positive tumor cells. Adenosis had the maximum area/signal intensity from all studied breast benign lesions (p0.001, Student t-test). The general tendency (all benign lesions, lobular carcinomas and G3 ductal invasive carcinoma) was a more prominent representation of the cellular compartment. In the G3 ductal invasive carcinoma-type, the group of patients with metastases had a stronger expression in the cellular compartment. These results suggest that CathD expression was strongest in malignant than in benign breast disease, the positivity being present in both epithelial neoplastic and stromal cells. We also conclude that our procedure in IOD measurement is prone to less subjective-related biases, and thus more accurate and constant than other methods employed by other authors.

Tumors require a blood supply for growth and hematogenous dissemination. Angiogenesis is one of the mechanism by which tumors acquire their microcirculation. Structurally and functionally, these newborn vessels are abnormal, showing increased permeability, delayed maturation, and potential for rapid proliferation. Such vascular defects could be an explanation for the aggressivity of oral squamous cell carcinoma (OSCC). For these reason we studied the morphology of tumoral vessels in such tumors by using immunohistochemistry and immunofluorescence. Forty formalin-fixed, paraffin-embedded tissue blocks of OSCC were processed for double enzymatic and fluorescence immunohistochemistry. We were interested in analyzing the tumor vessel architecture, and their maturity and activity in such tumors. The tumor vessel architecture had a chaotic pattern, mostly of different sizes, aberrant morphology, tortuous, without clear lumen, and irregularly branches. Regarding pericytes recruitment, the immature and intermediate vessel types (both negative to smooth muscle actin-SMA) were the most numerous type of tumoral vessels. The mature ones (positive to SMA) were readily more numerous at the invasive front of OSCC (85.4 vessels/4 mm(2) +/- 38.3), especially in poor differentiated tumoral type. Investigation of the tumor vessel basal membrane, as reactivity for collagen IV, revealed variability in thickness (2.59 microm +/- 0.48), small surface projections, discontinuities and loose associations with endothelial cells; these abnormalities being more obviously at the tumor-host interface and in poor differentiated OSCC. The most active angiogenesis was noticed in poor differentiated OSCC (0.23 +/- 0.04), at the tumor-host interface with the immature and intermediated vessel as the most active tumor vessel types. In conclusion, our study revealed some peculiar structurally and functionally defects of tumor vessels in OSCC, changes that could be selective targets for the new developing antiangiogenic drugs.

Chronic hepatitis C virus infection (CHCV) has high prevalence of immunological abnormalities. Extrahepatic manifestations (EHM) have been reported in association with CHCV infection, whose heterogeneity makes difficult any correlation between the two disorders. Among extrahepatic symptoms of C virus hepatitis, sicca syndrome is also registered. Sjögren's or sicca syndrome (SS) is a chronic, slowly progressive disease, with inflammatory-immune mediation characterized by lymphocytic infiltration of the lachrymal and salivary glands. A distinct primary form and a secondary one, occurring when presented in the context of an autoimmune or hepatic disease have been described. We present a case of SS in a patient with CHCV, commenting a possible link between primary SS and the CHCV, as well as the similarities and the distinctions among these conditions. Our conclusion is that CHCV can induce SS with some clinical particularities like presence of pericapillary and not pericanalicular lymphocytic infiltrate without destroying the salivary glands, in the absence of SS-A/SS-B antibodies. The favorable evolution of SS under IFN therapy is an argument for an authentic relation. Further studies are necessary to determine if CHCV is an etiological agent of SS or of it can induce a pseudo-sicca syndrome, characterized by a simple glandular inflammation consisting mainly in a simple lymphocytic adenitis.

Recent studies revealed that CD105 is intensively expressed in tumor vasculature, and may be an important prognostic indicator for the outcome in a number of malignancies. The aim of our study was to evaluate the CD105 expression and microvessel density in oral squamous cell carcinoma (OSCC). Nineteen surgical specimens with OSCC were immunohistochemical analyzed with CD105 (Endoglin). We determined the microvessel density (MVD) by "hot spot method". Endoglin was intensively expressed in vessels from the inner and invading front of all investigated OSCC. The highest value of MVD, about 30.89 +/- 22.4, were record in peritumoral area of OSCC, since intratumoral MVD average was about 10.18 +/- 4.7. We did not observe any significant association of MVD with age, sex, primary tumor's location, clinical stage or differentiation grade. In conclusion, CD105 expression is up-regulated in OSCC, and has a significant role in the development of such malignancies.

The mechanisms by which COX-2 contributes to the carcinogenesis are not known until present. It seems that the COX-2 enzyme stimulates the cell proliferation, inhibits the apoptosis, increases the malignant cells' invasiveness and induces the angiogenesis by elaborating some angiogenic factors.In the present study, we intend to evaluate the immunohistochemical expression of COX-2 in gastric carcinomas, keeping track of the correlations between the clinicopathologic factors, the tumor angiogenesis (evaluated by microvascular density--MVD--determination and by VEGF expression) and the patients' survival. In addition, we have tracked the immunoreactions' positivation in the peritumoral mucosa with various lesions, with the purpose to establish the contribution of COX-2 to the gastric carcinogenesis during the pre-invasive stages. A prospective study was realized, regarding the evolution and aggressiveness of the gastric cancer, with a duration of five years, 61 patients operated of gastric cancer being included.The COX-2 immunoreactions have been significantly more frequent noticed in the gastric carcinomas included in the study (57.4%) and in the epithelial dysplasia areas adjacent to the carcinomas of intestinal type (35.5% of the cases), than in the normal peritumoral mucosa (4.9%) (p0.001 ES). The COX-2 immunoreactions have turned positive more frequently in gastric carcinomas of intestinal type (68.4%), in comparison to the carcinomas of diffuse type (29.4%) (p0.001 ES). The COX-2 expression is significantly correlated with the invasion level, the presence of the metastases in the regional lymph nodes and the pTNM stage, but without influencing the prognosis of the gastric cancer patients. The negative VEGF carcinomas have turned positive for COX-2 only for 19% of the cases. Different from those, the positive VEGF carcinomas have associated COX-2 immunoreactivity in 77.5% of the cases.The results obtained are suggestive for the predominant expression of COX-2 in the carcinomas of intestinal type and its precursory lesions. Our results show a tight correlation between the immunohistochemical expressions of COX-2 and VEGF in gastric carcinomas (r = 0.562, p0.001 ES) and also a MVD average value significantly higher in the positive COX-2 carcinomas, suggesting an intense angiogenesis activity in that group of tumors (p0.001 ES).

In spite of the progresses achieved in surgical treatment, radiotherapy and chemotherapy, the survival rate in oral squamous cell carcinoma (OSCC) remain unchanged among past three decades, which made this neoplasia a major problem of health in the entire world. There were investigated 42 cases of OSCC with different sites and various grades of differentiation, by histological and immunohistochemical techniques (by LSAB/HRP method), using E-cadherine and CD44. Considering the differentiation grade, the cases were histopathologically classified as 9 cases of well-differentiated squamous carcinoma, 14 cases of moderately differentiated squamous carcinoma, and 19 cases of poorly differentiated squamous carcinoma. The E-cadherine immunoexpression study indicated an immunostaining degree 3 in well-differentiated squamous carcinoma, 2 in moderately differentiated squamous carcinoma, and 1 in poorly differentiated squamous carcinoma. The results of CD44 immunostaining indicated in most of the cases an immunostaining degree 2, especially in moderately differentiated OSCC. The immunostaining degree 3 corresponded to nine cases of well-differentiated OSCC, and other two cases of moderately differentiated OSCC. Immunostaining degree 1 corresponded to poorly differentiated OSCC. The results indicate the possibility of using the two-immunohistochemical markers as prognostic factors in OSCC.

Periorificial lentiginosis, also knew as Peutz-Jeghers Syndrome (PJS), is an autosomally dominant inherited condition determined by a mutation localized at 19p13.3 responsible for mucocutaneous pigmentation and gastrointestinal polyps. Skin- and mucosal pigmentation may be present at birth but usually occur in early childhood, and occasionally may develop later. Round, oval or irregular patches of brown or almost black pigmentation 1 to 5 mm diameter, irregularly distributed over the oral mucosa, gums, hard palate and lips (especially the lower) are observed. The pigmented maculae on the face, encountered especially around the nose and mouth are smaller. Polyps may appear in the stomach, small bowel or colon, with hamartomatous aspects on histology. Acute upper gastrointestinal bleeding and chronic fecal blood loss may appear during the course of disease. There is a higher risk of intestinal and extraintestinal cancers in those patients. We present the case of an 18-year-old young girl accusing since the age of 3 slight intermittent episodes of bloating and abdominal pain without a particular localization, as well as mild iron-deficiency anemia. Physical examination revealed pigmented lesions suggesting PSJ on the palatine and jugal mucosa while endoscopy found a lot of polyps in stomach and a few, isolated in the colon, all having the same hamartomatous pattern. The presence in early infancy of small, well-demarcated and dark-brown to blue-black lentigines on the lips, buccal mucosa and perioral skin, should alert the clinician to PJS.

The Obstetrical Antiphospholipid Antibody Syndrome (OAAS) is representing a separate entity of the global Antiphospholipid Antibody Syndrome (APS), focusing the pregnancy morbidity. OAAS is generating morphopathological changes in almost all components of the gestational biologic transitory system (GBTS): placenta, umbilical cord or uterine wall. The most important, serious and lengthened anomalies are occuring in placenta. Our research has been developed on a group of 68 patients diagnosed with OAAS, initially using the Sapporo criteria and later using the "Sydney" ones. There have been morphopathologically examined: placenta, umbilical cord and myometrium. Histological examination revealed on one hand macroscopic modifications: fibrinoid deposits, white or red placental infarctions, intervillous thrombosis, marginal or basal decidual hematoma, calcareous deposits, umbilical cord thrombosis, and on the other hand microscopic findings: placental infarction, fibrinoid necrosis, myometrial thrombosis, degenerative myometrial disorders, focal myometrial necrosis, villous stasis and necrosis, umbilical cord thrombosis. Because of the increased prothrombotic background, in APS, any vessel or organ could be involved, with no exception for GBTS elements. The basis of the pregnancy morbidity from the obstetrical APS is represented by the morphopathological changes occurring in fetal adnexa and uterine structures.

Branchial cleft anomalies are developmental disorders of the neck. The aim of this study was to evaluate the data of our patients, who have been diagnosed and treated for second branchial abnormalities in the last six years. We report our clinical experience in second branchial anomalies with a review of the literature. Our study is a retrospective one on a number of 23 patients hospitalized within 2001-2007 in ENT Clinic of Craiova for second branchial abnormalities in relation with age, gender, origin environment, clinical and paraclinical context in which the therapeutic decision was made, surgical procedures, post-surgical evolution. Among the anomalies of the second branchial arch, we encountered 10 (43.47%) patients with branchial cyst and 13 (56.52%) patients with branchial sinus. Twelve (52.17%) of the 23 patients were women and 11 (47.83%) were men; 9 (39.13%) patients were diagnosed and treated within the first age decade, seven (30.43%) within the second age decade, five (39.13%) within the third age decade and two (8.71%) in the fourth age decade. Histological examination of the lesions after excision established the diagnosis in all the cases. Second branchial arches anomalies are the most common branchial anomalies. Sinuses are more frequently than cysts and branchial fistulae are extremely rare. There is no gender predilection. The majority of patients (approximately 70%) were diagnosed and treated during their childhood. Treatment for these lesions is complete surgical excision for prevent recurrences.

The carcinosarcoma is a malignant mixed müllerian tumor with a highly malignant, biphasic tumor consisting of both epithelial and mesenchymal components. The presented case refers to a patient in climax with a vaginal bleeding. The Doppler echography highlights a polypoid mass, which prolapses in the cervical channel. The histopathological and immunohistochemical analysis of the surgically resected piece allowed the carcinosarcoma diagnosis. The uterine carcinosarcoma's incidence is rare, that is why this case is interesting taking in consideration the biphasic pattern of the tumor.

The early gastric cancer is an endoscopic notion in which gastric cancer is strictly placed to mucosis and submucosis without extensive manifestations. It is the form with favorable prognosis and better survival at 5 and 10 years. Our study tries to systematize the debut forms of early gastric cancer and their association with the lesions with malignisation risk. We also try to evaluate the incidence of endoscopic and histopathologic forms of early gastric cancer found in an internal medicine division. Our study included 435 patients with gastric cancer endoscopic and histologic diagnosed. Statistically, 64.36% were men and 35.64% were women, the mean age 48 +/- 7 years. The endoscopic forms of early gastric cancer were type I: protruded in 19 cases, type II: superficially in eight cases, type III: excavated in six cases. Early gastric cancer is diagnosed with difficulty, it represents in 7.58% of the gastric cancer, being most frequently asymptomatic. The endoscopic forms frequently found in early gastric cancer in the population were type I: protruded and type IIa: superficially elevated. The histopathological examination is compulsory at this form of gastric cancer, while in advanced gastric cancer endoscopy is often sufficient for diagnosis. Analysing the histopathological results of cases diagnosed with early gastric cancer we found: 22 cases with intestinal type and 11 cases diffuse type. Microscopically, 15 were intramucosal and 18 had submucosal invasion. I and IIa lesions were predominantly located at the antrum and are histologically differentiated adenocarcinoma. Differentiated carcinoma frequently produces an elevated lesion and the border is well demarcated. There are frequent opportunities to detect gastric cancer in the early phase and the patient can expect a complete cure by the surgical operation or endoscopical mucosal resection.

Although gastric adenocarcinoma continue to be the second continues to be the second cause of death worldwide, its incidence and mortality appear to have decreased in recent decades. Despite this decline, adenocarcinomas from proximal stomach tend to be more frequent during the last three decade. Adenocarcinomas with this location it seems that are a different, specific subtype of gastric carcinoma. The purpose of this study was to clarify the differences between gastric adenocarcinomas from upper and distal gastric pole using the immunohistochemistry. For this reason, we investigate histopathological and immunohistochemically 77 cases of upper gastric pole adenocarcinoma selected from a number of 472 gastric tumors. The immunohistochemistry was performing only in 32 cases by ABC technique with the following primary antibodies: Cytokeratin 7, Cytokeratin 19, Epithelial Membrane Antigen (EMA), Carcinoembryonic Antigen (CEA), Lysozyme, Vimentin, p53 protein, CD34 and Ki67 antigen. The acquired results do not distinguish a peculiar immunohistochemically profile unlike distal gastric adenocarcinomas. Nevertheless, we pointed out the predominance of diffuse adenocarcinomas type according to Laurens classification, which immunohistochemically were strong positive to cytokeratins, EMA, CEA and lysozyme. Moreover, investigation of some antigens likes lysozyme, p53, Ki67 and CD34 seems to be useful for prognostic estimation of carcinoma with this topography.

Adenosarcoma is considered as being a variety of mixed Müllerian tumor having a small grade of malignity. Present case refers to a perimenopause patient examined for a structure of bleeding endocervical polypoid. Diagnostic evaluation performed after biopsy revealed a cervical leiomyosarcoma followed by operation. The range of occurrence is interesting, having in mind positive and differential diagnosis problems that occurred.

Lymphangiomas are uncommon congenital hamartomas of the lymphatic system, usually diagnosed in infancy and early childhood. Commonly located at head and neck, they are rarely situated in the oral cavity. Preferred site of oral involvement is the tongue. In the absence of proper therapy, lymphangiomas of the tongue are extremely recurrent, leading to serious complications such as hemorrhage or obstruction of the upper respiratory airways. The authors present the case of eleven years old boy with pseudo-vesicles, and smooth, glossy lesions on the tongue, and a red prominent pulsative sublingual mass located at the base of the tongue. Both the macroscopic structure and the histological aspect sustain the diagnosis of lymphangioma. CT established that is a profound lymphangioma with a narrow communication with the superficial planes.Though rarely met in the oral cavity, lymphangiomas are an eventuality to take into consideration by the clinician. Early recognition is of utmost importance to initiation of proper treatment, and avoiding serious complication.

We present the diagnostic problems in a case of minimal deviation adenocarcinoma of the cervix. Histopathologic exam of the tumor, made on serial sections, revealed a dense and profound proliferation of the glandular structures that were lined by endocervical type epithelia with minimal cellular and nuclear atypia. The aspect suggested the diagnosis of minimal deviation adenocarcinoma endocervical type; in order to confirm the diagnosis we immunohistochemical investigate the tumor for CEA, CA125, Ki67, ER and PR. The results indicated focal positivity for CEA, CA125 lack of immunostaining for ER and PR and Ki67 positivity with a low index of proliferation. We can conclude that all these markers are useful in the diagnosis, excluding the benign endocervical lesions.