Search

Straipsnyje aprašomas VACTERL asociacijos klinikinis atvejis ir išsami literatūros apžvalga. VACTERL asociacija – tai daugybinių vaisiaus raidos ydų kompleksas, pasitaikantis atsitiktinai, kai nėra vienos aiškios minėtą patologiją lemiančios priežasties. VACTERL akronimas apima tam tikrų organų sistemų vystymosi defektus: stuburo, širdies ir kraujagyslių sistemos, virškinamojo trakto (analinės angos atrezija, stemplės atrezija), trachėjos ir stemplės fistulę, inkstų ir galūnių vystymosi ydas (ypač stipinkaulio). Diagnostikai svarbus išsamus ultragarsinis tyrimas nėštumo metu. Diagnozė yra klinikinė, apimanti bent tris minėtų organų sistemų vystymosi ydas. Prognozė priklauso nuo apsigimimų išraiškos sunkumo ir specializuotos pagalbos gimus naujagimiui.

Introduction.: There is no effective and reliable biomarker to distinguish benign thyroid nodules (BTN) from papillary thyroid carcinomas (PTC). In this study we analyzed a set of four miRNA molecules in plasma of patients with papillary thyroid cancer, benign nodules and healthy controls to identify miRNA molecules that may be markers of PTC.Aim.: We aimed to investigate the dysregulation of plasma miRNAs in PTC and evaluate the diagnostic value for differentiation of PTC from BTN. Methods.: The expression levels of 4 miRNAs (miR-221, miR-222, miR-146b, miR-21) were measured in 48 PTC patients before thyroidectomy and again after thyroidectomy in a subgroup of 36 patients. Preoperative and postoperative plasma miRNA expression levels were compared with baseline levels established in plasma from the heathy controls group (N=57) and patients with BTN (N=22). MicroRNA-222 and miR-146b, miR-221, miR-21 were included in a panel because they all reportedly were overexpressed in PTC compared to benign nodules or normal thyroid tissue.Results.: Compared with baseline levels in the healthy controls group, miR-221, miR-222, miR-146b, miR-21 levels were significantly higher in the preoperative PTC group (P

Many miRNAs and cancer-related mutations have been proposed as promising molecular markers of papillary thyroid carcinoma (PTC). However, there are limited data on the correlation between miRNA expression, BRAFV600E mutation, and PTC recurrence. Therefore, to evaluate the potential of BRAFV600E mutation and five selected miRNAs (-146b, -222, -21, -221, -181b) in predicting PTC recurrence, these molecular markers were analyzed in 400 formalin-fixed, paraffin-embedded PTC tissue specimens. The expression levels of miRNAs were measured using qRT-PCR. It was demonstrated that expression levels of all analyzed miRNAs are significantly higher in recurrent PTC than in non-recurrent PTC (p &lt, 0.05). Moreover, higher expression levels of miR-146b, miR-222, miR-21, and miR-221 were associated with other clinicopathologic features of PTC, such as tumor size and lymph node metastases at initial surgery (p &lt, 0.05). No significant differences in the frequency of BRAFV600E mutation in recurrent PTC and non-recurrent PTC were determined. Our results suggest that miRNA expression profile differs in PTC that is prone to recurrence when compared to PTC that does not reoccur after the initial surgery while BRAFV600E mutation frequency does not reflect the PTC recurrence status. However, the prognostic value of the analyzed miRNAs is rather limited in individual cases as the pattern of miRNA expression is highly overlapping between recurrent and non-recurrent PTC.

We analyzed five miRNA molecules (miR-221, miR-222, miR-146b, miR-21, miR-181b) in the plasma of patients with papillary thyroid cancer (PTC), nodular goiter (NG) and healthy controls (HC) and evaluated their diagnostic value for differentiation of PTC from NG and HC. Preoperative PTC plasma miRNA expression (n = 49) was compared with plasma miRNA in the HC group (n = 57) and patients with NG (n = 23). It was demonstrated that miR-221, miR-21 and miR-181b were overexpressed in preoperative PTC plasma samples compared to HC (p &lt, 0.0001, p &lt, 0.002, respectively). The upregulation in tumor tissue of these miRNAs was consistent with The Cancer Genome Atlas Thyroid Carcinoma dataset. A significant decrease in miR-21, miR-221, miR-146b and miR-181b expression was observed in the plasma of PTC patients after total thyroidectomy (p = 0.004, p = 0.001, p = 0.03, p = 0.036, respectively). The levels of miR-222 were significantly higher in the preoperative PTC compared to the NG group (p = 0.004). ROC curve (receiver operating characteristic curve) analysis revealed miR-222 as a potential marker in distinguishing PTC from NG (AUC 0.711, p = 0.004). In conclusion, circulating miR-222 profiles might be useful in discriminating PTC from NG.

Background Primary pericardial mesothelioma is a rare primary cardiac malignancy, with three main histopathological types, sarcomatoid histotype being the rarest. The imaging features were atypical due to concomitant extensive calcification, which resulted in aggravated differential diagnosis. Case summary A 45-year-old man presented to our hospital with non-specific clinical symptoms. According to clinical history, a mediastinal tumour had been suspected with a previous unsuccessful attempt of transthoracic computed tomography-guided biopsy at an overseas hospital with limited data of performed imaging procedures. Multimodality imaging at our centre revealed extensively calcified solid masses in the pericardium, invading the left atrium. As the imaging features suggested an atypical primary pericardial malignancy, a diagnostic thoracoscopy was performed. Histopathological analysis of specimen revealed sarcomatoid type of pericardial mesothelioma with areas of necrosis and foci of osteogenic differentiation. Despite planned treatment, 2 weeks after histological diagnosis, the patient passed away due to perforated peptic ulcer-related sepsis. Discussion The presence of extensive calcification in the lesion resulted in a challenging imaging workup and diagnosis. Initial differential diagnosis included primary or metastatic calcification-prone tumour, secondary calcification due to haemorrhage after previous interventional procedure and other pathologies, such as tuberculous pericarditis, calcified amorphous tumour, among others. Calcification may be part of the histological tumour characteristics; however, proper history taking is crucial as concomitant diseases, previous treatment, and interventional procedures may alter the imaging pattern.

Laryngeal carcinoma is a rare pathology in children, with only 92 cases reported. Spontaneous regression of laryngeal carcinoma is even more unique clinical event, so far only observed in adults. In this report we present an extraordinary case of a 10 year old patient with laryngeal squamous cell carcinoma that underwent spontaneous regression.

Introduction: Papillary thyroid carcinoma (PTC) is the most common type of endocrine cancer. Although PTC is a malignancy that has a good prognosis, disease progression occurs in up to 20 % of patients. Currently, recurrence risk stratification is accomplished by using clinicopathologic factors, despite their limited prognostic value. Number of biomarkers for PTC recurrence prediction is still very limited. Identification of possible associations of traditional clinicopathological parameters of disease recurrence with molecular biomarkers of PTC may help better understanding the carcinogenesis and improving the clinical management of patients with PTC. Objectives: The aim of this study was to identify specific miRNAs as biomarkers for predicting the recurrence of PTC and to analyze the association between miRNAs expression levels and clinicopathologic characteristics of PTC. Methods: We selected 5 miRNAs (miRNA- 146b, -222, -21, -221 and -181b) and measured the expression levels of these miRNAs in 400 FFPE PTC tissue specimens and compared the levels of selected miRNAs expression to healthy thyroid tissue. We also analyzed the correlation between miRNAs (- 146b, -222, -21, -221 and -181b) expression and clinicopathologic characteristics of PTC. Results: Levels of miR-146b, miR-222, miR-21, miR-221 and miR-181b expression in PTC tissue samples (n = 400) were compared with those in healthy thyroid tissue (n = 4). All miRNAs were over-expressed in PTC tissue compared to healthy thyroid tissue (p ˂ 0.01, p ˂ 0.01, p ˂ 0.01, p ˂ 0.01 and p = 0.19 respectively). Higher expression levels of miRNAs (miRNA-146b p

We analyzed miR-146b, miR-21, miR-221, miR-21, and miR-181b in formalin fixed paraffin-embedded papillary thyroid carcinoma (PTC) tissue samples of 312 individuals and evaluated their expression relationship with clinicopathological parameters. A higher expression of miR-21 was related to unifocal lesions (p &lt, 0.011) and autoimmune thyroiditis (0.007). miR-221, miR-222 expression was higher in the PTC tissue samples with extrathyroidal extension (p = 0.049, 0.003, respectively). In a group of PTC patients with pT1a and pT1b sized tumors, the expression of miR-146b, miR-21, miR-221, and miR-222 in PTC tissue samples was lower than in patients with pT2, pT3, and pT4 (p = 0.032, 0.0044, 0.003, 0.001, 0.001, respectively). Patients with lymph node metastases had higher expression of miR-21, -221, -222, and -181b (p &lt, 0.05). A high expression of miR-146b, miR-21, miR-221 panel was associated with decreased overall survival (OS) (Log rank p = 0.019). Univariate analysis revealed that presence of metastatic lymph nodes and high expression of miR-146b, miR-21, and miR-221 panels were associated with increased hazard of shorter OS. After multivariate analysis, only sex (male) and age (≥55 years) emerged as independent prognostic factors associated with shorter OS (HR 0.28 (95% CI 0.09–0.86) and HR 0.05 (95% CI 0.01–0.22), respectively). In conclusion, 5 analyzed miRs expression have significant relations to clinicopathologic parameters so further investigations of these molecules are expedient while searching for prognostic PTC biomarkers.

Introduction Fine-needle aspiration (FNA) is the most accurate diagnostic approach for determining thyroid nodule malignancy. Most nodules are benign, therefore, only suspicious ones require FNA. In 2017 American College of Radiology proposed a scoring system – Thyroid Imaging, Reporting and Data System (TI-RADS) for identifying clinically significant malignancies. Whether a nodule requires FNA depends on various criteria, one of which is the size. The aim of this study was to determine whether size is an important factor in deciding the necessity for FNA. Methods A total of 288 ultrasound images of patients with thyroid nodules were analysed. The nodules were scored, measured and assigned to one of five TI-RADS levels (TR): TR1 – benign, TR2 – not suspicious, TR3 – mildly suspicious, TR4 – moderately suspicious, TR5 – highly suspicious. The results were compared with histology findings. Results 219/288 (76%) benign and 69/288 (24%) malignant thyroid nodules were verified histologically. Nodules were distributed as follows: TR1 – 17 (5.9%), TR2 – 27 (9.4%), TR3 – 72 (25.0%), TR4 – 126 (43.8%), TR5 – 46 (16.0%). The mean size of measured nodules was 2.05G1.02 cm. In categories TR1 and TR2 100% of nodules were benign according to FNA. In TR3 68/72 (94.4%) of nodules were benign and 4/72 (5.6%) malignant, 38/72 (52.7%) !2.5 cm in size and 34/72 (47.22%) – R2.5 cm. None of the malignant nodules in TR3 were R2.5 cm. Negative correlation (rs ZK0.298, PZ0.011) was found between size and malignancy. In TR4 93/126 (73.8%) of nodules were benign and 33/126 (26.2%) malignant, 59/126 (46.8%)!1.5 cm in size and 67/126 (53.2%) –R1.5 cm. Size of R1.5 cm had sensitivity of 39.39%, specificity of 41.94%, positive predictive value (PPV) of 19.40%, negative predictive value (NPV) of 66.10% and accuracy of 41.27%. No significant correlations between size and malignancy in TR4 were found. In TR5 14/46 (30.4%) of the nodules were benign and 32/46 (69.6%)

Idiopathic pulmonary fibrosis (IPF) IPF is a specific form of chronic, progressive fibrosing interstitial pneumonia of unknown cause occurring in adults. The incidence has been rising in recent years probably due to improved diagnostic methods and increased life expectancy du to disease-modifying therapy. Novel antifibrotic drugs as nintedanib and pirfenidone that slow disease progression are now available. In current recommendations diagnostic aspects, pharmacological and non-pharmacological management of IPF are presented.

Nazolabialinės cistos - tai ne odontogeninės kilmės, minkštųjų audinių cistos, neturinčios sąsajos su kaulu. Tai reta, dažniausiai vienpusė patologija. Straipsnyje aprašoma nazolabialinių cistų patogenezė, nusiskundimai, klinikinė ir radiologinė diagnostika. Apžvelgiama diferencinė diagnostika ir pagrindiniai chirurginiai gydymo būdai. Pristatomas 59 m. pacientės, kuriai diagnozuota retai pasitaikanti abipusė nazolabialinė cista, klinikinis atvejis.

Objective: The aim of the study was to evaluate correlations between throat-related symptoms and histological findings in adults with chronic tonsillitis. Materials and methods: A prospective cohort study was carried out. Throat-related symptoms (complaints, tonsillitis rate, and pharyngeal findings) of 81 adults with histologically proven chronic tonsillitis followed by tonsillectomy were analyzed. Four types of histological changes in removed tonsils were determined: (1) pure hyperplasia, (2) chronic inflammation, (3) chronic inflammation with hyperplasia, (4) chronic inflammation with scarring/fibrosis. The power of correlation was tested using the Pearson contingency coefficient (CC). Results: Recurrent throat infections were the most common complaint (74.1%). The mean tonsillitis rate was 3.6 (SD 1.9) episodes per year. Tonsillar cryptic debris (61.7%) and hyperemia of the anterior pillars (59.3%) were the most common pharyngeal findings. Chronic inflammation with hyperplasia was predominant (38.3%) histological type of chronic tonsillitis. The statistically significant correlations between histological type and combination of tonsillitis rate ≥3 times per year with cryptic debris (CC = 0.346, P = 0.010) and cryptic debris alone (CC = 0.294, P = 0.051) were detected. Conclusions: Assessment of throat-related symptoms is complementary to histological examination in adults with chronic tonsillitis.

Background and Objective. The literature lacks data about the evaluation of throatrelated symptoms proving chronic tonsillitis as the most common indication for adult tonsillectomy. Therefore, the aim of this study was to assess the most important throat-related symptoms suggestive of chronic tonsillitis in adults. Material and Methods. A prospective cohort study was carried out. The analysis of throatrelated symptoms (complaints, tonsillitis rate, pharyngeal signs, and antistreptolysin-O titer) in 81 adults with histologically confirmed chronic tonsillitis was conducted. Results. Recurrent tonsillitis was the most common complaint (74.1%). The mean number of tonsillitis episodes was 3.6 (SD, 1.9) times per year. There were no significant differences comparing the frequencies of all the analyzed pharyngeal signs (P>0.05). The antistreptolysin-O titer (mean, 279.8; SD, 211.6 UL) was pathological in 33.3% of patients. The study identified the most important throat-related symptoms revealing chronic tonsillitis: tonsillar cryptic debris (OR, 8.84; 95% CI, 1.93–40.53; P=0.005) and enlarged anterior cervical lymph nodes along with the frequency of tonsillitis episodes exceeding 3 times per year (OR, 8.27; 95% CI, 1.33–51.57; P=0.024). The classification accuracy of 85.2% was obtained. Conclusions. Tonsillar cryptic debris and enlarged regional lymph nodes along with recurrent tonsillitis could support the diagnosis of chronic tonsillitis in adults when considering tonsillectomy.

Plaučių vėžys – viena labiausiai paplitusių ir didžiausią mirtingumą sąlygojančių onkologinių ligų visame pasaulyje. Nepaisant visuomenės švietimo ir šiuolaikinių diagnostikos metodų, nesmulkiųjų ląstelių plaučių vėžys nustatomas toli pažengusių stadijų, kai reikalingas sisteminis plaučių vėžio gydymas. Molekulinės biologijos atradimai sudaro prielaidas onkologinių ligų ankstyvai diagnostikai, prognozinių ir predikcinių veiksnių atradimui, gydymo optimizavimui.

Objective. The aim of this study was to examine the prevalence of epidermal growth factor receptor (EGFR) gene mutations among patients with advanced nonsquamous non–small cell lung cancer (NSCLC) treated in our institution and to evaluate the associations between EGFR mutations and clinicopathological characteristics. Materials and Methods. A total of 103 patients with NSCLC were examined from April 2010 to September 2011. The patients were screened for EGFR mutations in exons 19 and 21 using sequence analysis. Results. EGFR mutations were detected in 10 patients (9.71%): 23.1% of women and 5.2% of men (P0.05). Eight mutations (80.0%) were found in exon 21: 7 patients had the L858R mutation and 1 patient had the L861G mutation. Two mutations (20.0%) were found in exon 19: 1 patient had the L747-A748 deletion and 1 patient had the L747-A750insE deletion. The overall response rate was significantly greater in the EGFR mutation-positive group than in the EGFR mutation-negative or control groups (P

Intersticinės plaučių ligos – tai klinikinėje praktikoje santykinai reta heterologinė grupė ligų. Etiologija dažniausiai tiksliai nežinoma ir gali būti lemiama daugybės veiksnių. Intersticinės plaučių ligos taip vadinamos dėl joms būdingo uždegimo ląstelių pagausėjimo ir susikaupimo, taip pat dėl jungiamojo audinio išvešėjimo plaučių intersticiniame audinyje. Atskiros intersticinės plaučių ligos dažnai esti tarpusavyje panašios tiek pagal klinikinius, tiek pagal radiologinių tyrimų duomenis. Tiksliai diagnostikai dažniausiai prireikia operacinės medžiagos – biopsinės medžiagos nepakanka. Siekiant tikslios diagnostikos, adekvataus gydymo ir ligoniui palankios prognozės, turi būti užtikrintas įvairių sričių specialistų bendradarbiavimas.

Data from the Registry of the International Society for Heart andLung Transplantation (ISHLT) indicated that in 2000-2006 54 proc. patients after lung transplantation received induction therapy. with antilymphocyte antibodies, monoclonal antibody or anti-interleukin-2-receptor monoclonal antibodies. The vast majority of lung transplant recipients receive a triple-drug maintenance regimen including a calcineurin inhibitor, a cell-cycle inhibitor and steroids. Shift from cyclosporin A to tacrolimus has emerged as the first treatment step of refractory acute rejection followed by high-dose steroids or antilymphocyte agents, total lymphoid irradiation or photopheresis. The treatment of chronic rejection remains deceptive and includes varied strategies such as modification of the maintenance regimen, augmentation of the immunosuppression and/or total lymphoid irradiation and photopheresis.