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The review of modern achievements in morphology and genetic characteristics of pancreatic tumors with ductal phenotype is presented. Problems of intraductal pancreatic neoplasia (PanIN) as precancerous process for ductal adenocarcinoma are considered in detail.

A case of sygmoid endometriosis is described in a 40-year-old female. After clinical and endoscopic examination, the patient was operated for sigmoid tumor, acute obturation colon obstruction. Histologically diagnosis of intestinal wall endometriosis was established. This is an example of therapeutic policy in extragenital intestinal endometriosis with difficulties in the clinical diagnosis.

The data on monoclonal antibody monotherapy (mabtera, rituximab) in 44 patients with B-cell low grade non-Hodgkin's lymphoma were assessed. Thirty-four of them had received several courses of second- or third line chemotherapy: mabtera was used as first-line therapy in 10. Mabtera was administered in a dose of 375 mg/m2 body surface, once a week, by slow intravenous infusion, 4-14 times depending on effect. Each relapsing patient received, on the average, 4 infusions, while each refractory one--8 weekly infusions. Overall response in the first group was 44%. Median overall relapse-free survival was 9 months. Apparenti effect of treatment was reported in 50% of primary patients (median overall relapse-free survival--15 months). Therapy was well tolerated. Fever and shivering stage I and II were among the most frequent post-infusion effects. High level of CD-20+B-lymphocytes should be used as prognostic indicator for effectiveness of therapy.

The authors present histological and immunohistochemical characteristics of a rare skin tumor--merkelioma.

The study was undertaken to enhance the efficiency of diagnosis of breast cancer shown up as calcium micromasses since breast diseases appear as clusters of 50-600-um calciferous inclusions that are not inclined to the formation of conglomerates without a visible node on a X-ray film, may be a manifestation of both sclerosing adenosis and nonpalpable cancer. Of the examined 4500 females aged 15 to 83 years, breast calcium masses were detected in 207. Of them, 39 females were found to have clustered calcium micromasses without a node on a X-ray film; in them cancer and sclerosing adenosis were diagnosed in 28 (71.8%) and 11 (28.2%) females, respectively. Examination was made by using clinical, mammographic, and sonographic studies. Intervention radiology and pathomorphological studies were studied. This has yielded a number of signs that are characteristic of malignant and benign diseases attended by clusters of calcium micromasses in a restricted area without a visible node on X-ray films that assist in making a correct preoperative conclusion with a greater probability in 80%.

The data on 25 cases of histologically verified bronchioloalveolar carcinoma and papillary adenocarcinoma are discussed. Reliable differential diagnostic cytological features of both diseases were established using a statistical, program and fine-needle biopsy findings. Statistical analysis data pointed to the sets of cytological features: "serial pattern--clear cell boundaries" and "serial pattern--presence of macrovacuoles" as a major factor of accuracy of bronchiolo-alveolar carcinoma and papillary adenocarcinoma diagnosis. These cytological features may be used for reliable diagnosis of the diseases.

Pagetoid reticulosis is a rare form of T-cell skin lymphoma. A case of this disease is reported.

The data on the surgical and combined treatment of 35 cases of lung cancer associated with pleural effusion detected during surgery have been evaluated. Mean 5-year survival was 68.5%, pleural effusion--70%.

The paper analyzes the results of examination of 260 patients with bronchioloalveolar cancer (BAC) who were followed up at the Russian Research Center of Radiology and Roentgenology for 30 years. It provides its clinical, X-ray, and morphological manifestations and classification and the methodological aspects of differential diagnosis. An optimum radiation diagnosis programme has been drawn up, which involves currently available procedures, including computed tomography. The morphological forms of BAC are given in detail.

A case of a rare malignant tumour of the sweat glands is reported. Such tumors are often taken for visceral adenocarcinoma metastasis. The tumor was diagnosed by means of immunohistochemistry.

One case of a rare vascular tumor which occurs mainly in the childhood is presented. The tumor has a tendency to recurrence and metastases into the regional lymph nodes in spite of a relatively mature structure.

Cytological differential diagnostic features of bronchiolo-alveolar carcinoma and papillary adenocarcinoma are established basing on the material of needle biopsies by means of Statistica program. It is found that the strongest influence on the cytological diagnosis of these two tumors is associated with the following pairs of cytological features: lane--clear-cut cell borders and lane--the presence of macrovacuoles.

This review concerns the development and progression of one of the forms of peripheral lung cancer--bronchiolo-alveolar carcinoma (BAC). The study is based on the comparison of roentgenological, histological, immunohistochemical examinations and results of surgical treatment of 482 patients with this tumor. Morphological and clinical variants of BAC are defined. It is confirmed that their biological behavior may vary within the forms and differ from common adenocarcinoma. A close correlation exists between clinicoroentgenological picture and histological form of BAC.

Clinicomorphological analysis was performed in 12 cases of atypical adenomatous hyperplasia of the lung (AAH). This is the proliferative lesion consisting of atypical epithelial cells along the alveolar septa which are found incidentally during pathologic examination of the lung resected because of cancer. We studied morphological and biological characteristics of AAH cells including cytodifferentiation, proliferative activity, tumor-suppressor genes. Our review of the studies of AAH revealed that AAH is alveolar intraepithelial dysplasia and a precursor of lung adenocarcinoma. AAH is an important lesion corresponding to a step in carcinogenesis for peripheral lung adenocarcinomas.

336 patients with locally-advanced breast cancer underwent neoadjuvant chemotherapy or chemoradiotherapy. Increase in T- and N-indices (change of stage after neoadjuvant chemotherapy) proved an important prognostic factor. Survival rates correlated with clinical effect and dropped as it diminished. This tendency was clear in both groups. There was no relationship between stage and overall and disease-free survival rates at early stages but later they declined as T- and N-indices decreased.

A correlation was established between the end-results of neoadjuvant chemotherapy for locally-advanced breast cancer and pathological response of tumor cells. Also, the end-results correlated with CR or PR and pathological response. Only a small proportion of patients with tumor progression were registered as stage III or IV of pathological response (0.6 and 0.8%, respectively).

Radiation as a method of treatment was carried out in 16 (25.0%) out of 64 patients with tracheal adenocystoma (radical dosage of 50-70 Gy (12) and palliative--40-48 Gy (4). The dosimetric profile consisted of the cervical, cervico-thoracic, thoracic and bifurcation sections of the trachea. Complete resorption of tumor was registered in 12, partial--3, no effect in 1 cases. Three-, five- and ten-year survival was 65.2 +/- 12.6; 55.9 +/- 13.5 and 10.4 +/- 13.1%, respectively.

6,212 lung cancer patients have been examined and treated. The data on surgical and combined treatment of 2,702 patients have been analyzed. Postoperative complication incidence has dropped to 5.4% in recent years. End results have improved due to use of organ-saving, reconstructive and plastic procedures for the bronchi and trachea in conjunction with radiotherapy.

Surgery for primary multiple malignant tumors of the respiratory system was carried out in 141 patients. Reconstruction, plastic operations and sparing resections were performed in 79 cases (68.5%). Five-year survival after radical surgery was 43.8%.

The results of 3-year combined and surgical treatment of 173 patients with rectal tumors are discussed. Single dose of 7.5 Gy was administered to 83 patients on the eve of radical surgery. Ninety patients in control received radical surgery alone. One-, two- and three-year radical cure rates in the study group were higher by 22.9, 21.2 and 29.3%, respectively, while 3-year recurrence-free survival in the same group was 2.7 times that in the surgical patients.

Experience has pointed to a rather low potential of traditional procedures of roentgenography and tomography in detecting small foci (ca. 4-5 cm in dia.). Metastases are often not seen in the shadow of the ribs, diaphragm and cardio-vascular complex. X-ray computed tomography (CT) is a method of choice for early diagnosis and further tracking tumor process in the lung. Superior spatial resolution offers complete summation-free visualization of the lung parenchyma. Provision of more data, including information on "occult" pathology in the lung, is instrumental in confirming or rejecting diagnosis of solitary tumor.

Treatment of squamous-cell tracheal tumors was given to 85 patients. Surgery was carried out in 48 (56.5%), radical resection--22 (25.9%). Distant metastases detected preoperatively in 19 (22.4%) patients were an absolute contraindication for radical surgery. Combined therapy was received by 14 cases without any grave postoperative complications. Three- and five-year survival after combined and surgical treatment was 59.9 +/- 10.5 and 40.9 +/- 10.5%, respectively. Radiation was given to 48 (56.5%) patients. This group included 26 cases of palliative operations and exploratory laparatomy. Three- and five-year survival after radiation was 30.1 +/- 6.7 and 27.6 +/- 6.7%, respectively.

The effectiveness of therapy of pancreato-biliary cancer in jaundice patients has been raised due to introduction of sparing slightly-invasive (percutaneous, transhepatic) procedures for suppression of choleostasis and restoring biliary return to intestine. Also, such measures as pancreato-digestive anastomosis, radical surgery to compensate jaundice-related functional and morphological disorders and changes in the liver as well as perfection of procedures of combined and radiation therapy were used.

Detailed review of literature and analysis of 4 authors's cases of the trachea non-Hodgkin lymphoma and lymphogranulomatosis are presented.

4 cases of melanoma of the respiratory tract (trachea and bronchi) are analysed clinico-morphologically. A case of melanoma with a primary multiple location (trachea and the main bronchus), rapid recurrence after surgery and radiation therapy is described in detail. Melanocytic nature of the tumor is proved immunohistochemically.

Analyzing about 1000 cases of metastatic lesion of the lung indicated that the incidence of metastases was 12.9% (117 patients). Computed tomography (CT) enhances the informative value of X-ray studies in solitary metastases. CT detects tumor nodes invisible on routine X-ray films due to their small sizes (up to 1.0 cm) or location in the areas undetectable by other studies (behind the first rib, clavicle, in the posterior phrenicocostal sinus, behind the heart shadow). The sensitivity and accuracy of CT as to small solitary metastatic lymphs in the lung were 97.4 and 89.4%, respectively, which were higher than those of X-ray study (60.0 and 55.3%) and longitudinal tomography (80.0 and 68.0%) at a virtually equal specificity in the three types of studies. The high diagnostic value of a complex radiation study, including CT, and its simplicity make it possible to identify solitary metastatic formations, which is of great importance in choosing adequate but less aggressive treatment.

84 tracheal tumors the correct diagnosis of which was established during roentgenoendoscopical investigation combined with urgent cytological diagnosis are reported. Cytological fast diagnosis can be considered a reliable method of morphological diagnostics.

Detailed cytological, histological and electron microscopic characteristics of pulmonary carcinoid tumors are listed on the basis of surgical clinic material. Various variants of the carcinoid tumors structure, their differential diagnosis are presented.

Morphology of the thymus in autoimmune and some other conditions with an accidental thymus involution is studied. Metaplasia and dysplasia of epithelial cells which should be regarded as precancer condition were found in 7-10% of cases in the parenchyma in the presence of atrophic changes.

Late outcomes of radiation and chemoradiation treatments and chemotherapy were analysed in 255 patients with low-grade generalized non-Hodgkin's lymphomas (NHL). In terms of total and relapse-free survival, chemoradiation treatment regimen yields the best results, as compared to chemotherapy. There is a general trend to improve the late outcomes when each of two components of the chemoradiation regimen is intensified. Chemoradiation treatment improves late outcomes not only in primary patients, but in patients with relapses after radiation or chemical therapy. Complete remissions are one of the most important predictors of total and relapse-free survival. There is a small group of patients with a diffuse lymphocytic type of NHL (about 10-15%). which is characterized by extremely slow disease progression and enlargement of individual lymph organs (tonsils, lymph nodes, spleen) in whom long-term total and relapse-free survival can be achieved by local radiation therapy.

The remission rates were analysed during radiation and chemoradiation treatments and chemotherapy of 255 patients with low-grade generalized non-Hodgkin's lymphomas. Complete remission was achieved in 15.3% of patients, partial remission was in 82.4%. No effect was seen in 2.3% of patients. The rate of complete remissions was 4.2% for radiation treatment, 29.5% for chemoradiation, and 10.6% for chemotherapy. Chemoradiation treatment regimen was the most effective for this group of patients, in all morphological types and chiefly in Stage III. The intensified chemoradiation regimen improves the immediate outcome of treatment; a combination of series polychemotherapy with radiation applied to all diseased lymphatic collectors in a cumulative radiation dose of 30-40 Gy. The effect of the chemoradiation regimen is virtually completely revealed in the combination of three series of polychemotherapy and radiation therapy; the continued chemotherapy does not increase the rate of complete remissions.

The incidence of axillary lymph nodal metastases in breast cancer is proportional to the size of a focus: To is 25 +/- 25%, T1-33 +/- 17%, T2-55 +/- 7%, T3-65 +/- 11%, the choice of the optimum treatment regimen requires more accurate preoperative detection of metastatic lymph nodes. Ultrasound technique (its accuracy is 80%, sensitivity-88%) is of the most diagnostic value in the detection of metastatic lymph nodes. The absence of echographic signs supports the nonspecific nature of changes. Palpation is preferable in nonspecific axillary lymph nodal lesions. The status of axillary lymph nodes in breast cancer may be correctly assessed by comprehensive clinical and ultrasonic studies of the axillary area wherein, supplementing each other, each technique yield the maximum information.

Two hundred-thirty patients were operated on for peripheral lung cancer TIN0M0 in 1960-1990. Pheumonectory was performed in 3 cases, lobectomy-123, segmentectomy-40, wedge-like resection-57 and removal of tumor-in 7 cases. Limited resection in 20 patients was not followed by radiation therapy, Radiation treatment was given to 15 patients preoperatively, 53-postoperatively and 16 patients-pre-and postoperatively, Five-year survival after combined treatment was recorded in 70.5%, while without this treatment-68.7%. Local recurrences following limited intervention were usually detected 3-5 years later, regional and distant metastases developing within the first 24 months. A reverse correlation was established between extent of surgery and local recurrence incidence. Reoperation such as lobectomy or pneumonectomy is feasible in cases of timely diagnosis. The highest 5-year survival rates were registered for segmentectomies carried out in combination with postoperative radiotherapy (77.2%). Prognosis proved best in cases of adenocarcinoma and tumor arising in the cicatrix. Paliative surgery appeared preferable for primary tumor 1.5 cm in diameter and less. Even in small-size malignancy, removal of tumor is not radical enough, Wedge-like resection is admissible in small-size subpleural lesions only. Preoperative radiotherapy results proved inferior to those of other procedures of combined treatment. Pronounced radiation-induced pneumonitis involving re-hospitalization for symptomatic treatment occurred in 7 (5.5%) cases of lobectomy combined with radiotherapy and in 2 (1.9%) cases of limited resection.

Regular investigations on application of hyperthermia in oncology have been carried out since the second half of the 1950s. The usage of distant tissues heating faces considerable difficulties in maintenance of therapeutic temperature in the whole volume of the tumor. Thus, the use of interstitial hyperthermia is promising, especially, ferromagnetic hyperthermia which causes damage not only to central but also to peripheral zones of tumors. Light and electron microscopies have not revealed specific features of cell damage by which ferromagnetic hyperthermia might differ from other methods of antitumor treatment.

The authors stated that WHO classification allows identification of two groups of morphological variants of non-Hodgkin's lymphomas: low- and high-grade malignancy. These differ by principal clinical characteristics, incidence of complete and partial remissions, survival duration. The analysis of clinical course, long-term and short-term treatment outcomes is provided for 674 patients with the above lymphomas.

283 cases of bronchiolo-alveolar lung carcinoma (BALC) are studied and clinico-roentgenologic forms are compared with morphological variants. Structural features of BALC with and without mucus production as well as those of the undifferentiated variants are described.

The following pulmonary lesions were studied: carcinoma, carcinoid, tuberculoma, chondromatous hamartoma, chronic non-specific inflammatory process. Material was obtained through fiber bronchoscopy and roentgeno-endoscopical examination. Pappenheim staining in the modification of Astrakhantsev-Nechaeva and Ziehl-Neelsen staining were used. 80 cases within 1993 were studied, among them 71 peripheral lung carcinomas. 3 carcinoids, 3 tuberculoses, 1 non-specific inflammation. Basic cytological criteria are summarized which will improve the quality of the presurgical diagnosis.