Jacek Pająk

Medical University of Silesia in Katowice, Catowice, Silesian Voivodeship, Poland

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Publications (17)17.18 Total impact

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    ABSTRACT: Background: The aim of this study was to investigate the distribution of different types of primary orbital tumors, histopathological diagnosis, and postoperative complications. Material/Methods: We analyzed 122 patients (68 women and 54 men) with orbital tumors, hospitalized in the ENT Department of the Medical University of Silesia in Katowice during 1990–2013. The patients were characterized in terms of anatomic, topographical, histopathological, and clinical parameters. The role of diagnostic imagining such as CT, NMR, and fine-needle aspiration (FNB) in preoperative diagnostics is discussed. Results of FNB, cytological, and histopathological examination of the postoperative specimens were compared. Results: There were 56 (46%) patients with malignant tumors, 42 (34%) with benign tumors, 19 (16%) with inflammatorytumors, and 5 patients (4%) had other tumors. In cases of malignant tumors, local recurrence up to 5 years was found in 36 (64.3%) cases. In the other 20 (35.7%) cases of malignant tumors, the patients remained underclose follow-up in the outpatient clinic, without signs of local recurrence (follow-up 1–17 years). Acording to histopathological examination, malignant tumors were detected in 45.9% of patients and non-malignant tumor in 34.4% of patients. In 19.7% of patients, inflammatory and other types of tumors were diagnosed. Conclusions: We characterized the occurrence and pathological profiles of orbital tumors. The tumor location, histopathological diagnosis, and postoperative complications give us important information for the diagnosis of tumor prior to biopsy or tumor resection and for the determination of the treatment strategy and possible complications after surgery.
    Medical science monitor: international medical journal of experimental and clinical research 04/2014; 2014(20):988-994. · 1.36 Impact Factor
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    ABSTRACT: Hodgkin's lymphoma (HL) is a systemic disease that constitutes 30% of all systemic lymphomas. HL of the orbit is extremely rare. It involves the orbital soft tissues and the lacrimal gland. Similarly, HL within parotid gland is an unusual finding. Hodgkin's disease has good prognosis when radiation therapy and chemotherapy is performed. The authors present the case report of a patient with Hodgkin's orbital lymphoma and simultaneous parotid gland tumor who was hospitalized in the Department of Laryngology and Department of Internal Medicine and Oncologic Chemotherapy, Medical University of Silesia in 2011 and 2012. Also, they report on similar reviews found in the worldwide literature. The case reported in this paper is the first case known to bear HL simultaneously within parotid gland and orbit. It seems that despite short diagnostic period and intensive chemotherapy, the prognosis of the disease is poor.
    Polski Przegląd Otorynolaryngologiczny. 01/2014;
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    ABSTRACT: Long-term treatment with gonadoliberin analogs is used to block the hypothalamic-pituitary-gonadal axis. The use of these agents is generally considered to be safe; however, some observations suggest the possibility of adverse effects. We investigated whether a 3-months administration of a low dose (6 µg/kg b.w.) of dalarelin - a new agonist, and cetrorelix - a known antagonist of GnRH to female rats causes morphological changes in pituitary gland, ovaries, uterus and liver (HE and VG staining); effects on pituitary, hepatic and blood enzyme activities (histochemical and kinetic methods, respectively), and on the blood lipid profile (colorimetric methods); and to what extent these changes are reversible. Applying analogs effectively inhibited ovulation, affected the uterine endometrium and changed histological appearance of the liver (e.g., steatosis). They altered activities of marker enzymes of cellular respiration, gluconeogenesis and intracellular digestion in the liver and, partially in the pituitary gland, caused undesirable changes in the activities of aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and creatine kinase, and a concentration of cholesterol HDL fraction and triglycerides in the blood. Both morphological and enzymatic effects were more evident after antagonist administration; changes in the blood lipid profile were more evident after agonist administration. In both analogs histological and enzymatic changes persisted a relatively long time after the discontinuation of the treatment. The low dose of dalarelin and cetrorelix is sufficient to cause limited damage of hepatic cells and may modify the function of pituitary, ovaries, uterus and liver as well as other organs, even after discontinuation of the treatment.
    Medical science monitor: international medical journal of experimental and clinical research 08/2012; 18(8):BR315-330. · 1.36 Impact Factor
  • Advances in anatomic pathology 03/2012; 19(2):125-7. · 3.22 Impact Factor
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    ABSTRACT: Although durable polymer coated drug-eluting stents (DES) are standard care in percutaneous coronary interventions, new stent platforms employing biodegradable polymer based drug delivery are increasingly being used in clinical practice. To evaluate the short- (28 days) and medium-term (90 days) vascular effects of the new biodegradable polymer coated sirolimus-eluting stent - the PROLIM stent. The objectives of the study were evaluated using standard angiographic and histological methods. In addition, the mechanical integrity of tested stents was assessed using Faxitron imaging. A total of 12 PROLIM stents, 11 biodegradable polymer only coated stents (BPCS), and 12 bare metal stents (BMS) were implanted in the coronary arteries of 16 female non-atheroslerotic domestic swine using an overstretch of 1.1:1.0. At 28 days, neointimal proliferation was significantly lower in the PROLIM and BMS stents compared to the BPCS stents (p ≤ 0.05). Interestingly, despite thin neointima found at this time in the PROLIM group, there was a further significant decrease in neointimal formation between 28 and 90 days (p = 0.04). Although a statistically bigger neointima was found in BPCS stents at 28 days compared to the PROLIM and BMS stents, there was a 50% decrease in the neointimal area at 90 days follow-up (p = 0.02) which reached the level seen in other groups. The endothelialisation was completed in all tested stents after 28 days. There was a significant increase of fibrin depositions in the PROLIM treated arteries at 28 days which were resorbed nearly completely at 90 days follow-up. At 28 days, the inflammatory response was found to be numerically higher in the BPCS stents (p = NS) compared to other tested groups. On the contrary, at 90 days follow-up when the degradation process of the polymer had been completed, the inflammatory reaction decreased substantially to the level seen in the PROLIM and BMS stents. Faxitron analysis of the stented arteries revealed no major abnormalities except for isolated strut fractures observed in the mid portions of two BMS stents and one BPCS stent. The PROLIM - a biodegradable polymer coated sirolimus-eluting stent - demonstrates very good short-term and medium-term angiographic and histological results. The lack of 'catch-up phenomenon', fast endothelialisation process, and minimal inflammatory reaction may contribute to favourable clinical outcomes using PROLIM stents.
    Kardiologia polska 01/2012; 70(7):703-11. · 0.54 Impact Factor
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    ABSTRACT: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms located in the alimentary tract. Our aim was to assess the influence of prognostic factors on survival in patients surgically treated for GISTs. One hundred and five patients treated between January 1989 and December 2008 were available for study. A retrospective analysis of prognostic factors (age, gender, mitotic index, tumor location, tumor size, risk of malignant behavior, and coexisting other neoplasm) was performed. Univariate and multivariate survival analyses were undertaken. Univariate analyses revealed the importance of patient gender (p = 0.007), disease location (p = 0.055), mitotic index (p = 0.054) and coexistence with other neoplasms (p = 0.004). However, multivariate analysis showed 3 independently statistically significant factors: coexistence with other neoplasm (RR = 3.53, p = 0.004), male gender (RR = 2.60, p = 0.011) and mitotic index ≥10/50 HPF, (RR = 2.60, p = 0.042). Our study has shown that male gender, a high mitotic index ≥10/50 HPF, and coexistence with other malignant neoplasms were independent poor prognostic factors in patients with GIST. The presence of middle or lower gut disease location leads to an increased risk of mortality when compared with the upper gut.
    European Surgical Research 12/2011; 48(1):3-9. · 0.75 Impact Factor
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    ABSTRACT: The reperfusion injury (RI) remains a significant limitation of primary PCI, therefore we evaluated the role of intracoronary abciximab and bivalirudin for anticoagulation on myocardial salvage and RI in the porcine model of ischemia/reperfusion. Myocardial infarction was induced in 23 pigs by 60-minute over-the-wire (OTW) balloon occlusion of the LAD. Animals received intravenous bivalirudin and then five minutes prior to reperfusion, either a coronary downstream infusion of abciximab (n=11) or saline (n=12) through the central lumen of an OTW catheter. All animals were followed for 48 hours. Histological analysis showed that infarct area (IA) and area at risk (AAR) were comparable between groups (IA/AAR%: 57.6 ± 8% vs. 57.1 ± 7%, p=0.8). Confirming this trend, biochemical markers (troponin I, TNF-alpha, IL-6, hsCRP, adiponectin, and VCAM) and left ventricular ejection fraction were also similar at 48 hours. Adhesion markers like ICAM and P-selectin were significantly decreased in the study group, nevertheless histological evidence of leukocyte extravasation was similar. The enhancement of apoptosis by TUNEL was comparable in both groups. The number of hemorrhagic infarctions confirmed by micro and macroscopic evaluation tended to be higher in the study group (70% vs. 20%, p=0.07). Despite lowered concentrations of adhesion molecules, intracoronary abciximab with peripheral bivalirudin is not superior to bivalirudin unaided in terms of myocardial salvage caused by RI in the porcine ischemia/reperfusion model. This might be due to local hemorrhage caused by abciximab.
    Thrombosis Research 11/2011; 130(2):265-72. · 3.13 Impact Factor
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    ABSTRACT: Early onset pancreatic cancer (EOPC) constitutes less than 5% of all newly diagnosed cases of pancreatic cancer (PC). Although histopathological characteristics of EOPC have been described, no detailed reports on precursor lesions of EOPC are available. In the present study, we aimed to describe histopathological picture of extratumoral parenchyma in 23 cases of EOPCs (definition based on the threshold value of 45 years of age) with particular emphasis on two types of precursor lesions of PC: pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasms (IPMNs). The types, grades, and densities of precursor lesions of PC were compared in patients with EOPCs, in young patients with neuroendocrine neoplasms (NENs), and in older (at the age of 46 or more) patients with PC. PanINs were found in 95.6% of cases of EOPCs. PanINs-3 were found in 39.1% of EOPC cases. Densities of all PanIN grades in EOPC cases were larger than in young patients with NENs. Density of PanINs-1A in EOPC cases was larger than in older patients with PC, but densities of PanINs of other grades were comparable. IPMN was found only in a single patient with EOPC but in 20% of older patients with PC. PanINs are the most prevalent precursor lesions of EOPC. IPMNs are rarely precursor lesions of EOPC. Relatively high density of low-grade PanINs-1 in extratumoral parenchyma of patients with EOPC may result from unknown multifocal genetic alterations in pancreatic tissue in patients with EOPCs.
    Archiv für Pathologische Anatomie und Physiologie und für Klinische Medicin 03/2011; 458(4):439-51. · 2.68 Impact Factor
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    ABSTRACT: Reperfusion injury (RI) remains an important limitation of myocardial revascularization. The aim of the present study was to evaluate the influence of the intracoronary injection of adiponectin on RI and cardiomyocyte death in a porcine myocardial infarction model. Acute infarction in 14 Polish domestic pigs was induced by inflation of an over the wire balloon (OTW) catheter in the medial left anterior descending artery for 60 min. The study group consisted of 7 pigs in which intracoronary adiponectin (50 µg) was infused through the OTW catheter immediately before reperfusion. The control group (n=7) was administered placebo. Animals were sacrificed after two days of follow-up. The infarct area (IA) was stained with tetrazoline and the area at risk (AAR) with intracoronary administration of Evans Blue dye before euthanasia. Hearts in each group had similar AARs (46.2±9.9% vs. 48.4±6.2% of the whole myocardium, p=ns). The IA/AAR% and IA were smaller in the study group when compared to the control (24.7±4.0% vs. 45.3±22.5%, p=0.005; and 11.7±4.9% vs. 20.5±5.6%, p=0.01, respectively). These outcomes corresponded well with the peak troponin levels after 12 h (109.9±60.9 ng/ml vs. 185.5±39.4 ng/ml, p=0.017). After two days there was a significantly higher LVEF in the study group (51.4±8.5% vs. 33.9±8.6%, p=0.002). There was also a trend toward lower apoptosis enhancement in the viable myocardium in the study group (3.11±2.3 vs. 8.92±6.3; p=0.07). The administration of adiponectin into the infarct- related artery is safe and feasible. The treatment significantly reduced the infarct size.
    International Journal of Molecular Medicine 03/2011; 27(6):775-81. · 1.96 Impact Factor
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    ABSTRACT: The aim of our study was to identify and describe potential inconsistencies between two alternative staging systems of pancreatic neuroendocrine neoplasms (pNENs)--the European Neuroendocrine Tumor Society (ENETS) system (2006) and the American Joint Committee on Cancer/Union for International Cancer Control (AJCC-UICC) system (2010). To address this issue, we performed a retrospective clinico-pathological study of 50 cases of pNENs. We found 9 (18%) cases of ENETS/AJCC-UICC discrepancies regarding the primary tumor stage. They included 7 cases of T2/T3 disagreement and 2 cases of T3/T4 disagreement. In addition, we discussed the issue of potential T1/T2 discrepancy (however, we did not observe any such a case). Another inconsistency was related to the application of different stage prognostic groupings between both systems. In conclusion, the discrepancies between ENETS and AJCC-UICC staging systems for pNENs are relatively frequent and heterogeneous. We believe that they should be rigorously recognized. This is necessary for the evaluation of prognostic factors and the effectiveness of therapeutic options used in patients with pNENs.
    Pathology - Research and Practice 02/2011; 207(4):220-4. · 1.21 Impact Factor
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    ABSTRACT: Introduction The aim of this work was to reveal the problems of diagnostics and treatments of fungal rhinosinisitis. Material and methods Material includes 6 patients (4 women and 2 man, average age 55) treated between years 2005-2010 in the ENT Department of Silesian Medical University in Katowice. All patients were treated by surgery in general anesthesia. All patients had performed CT scan of paranasal sinus before surgical procedures. Removed materials were send to a histological and microbiological examination. Results In the studied material were 5 cases of noninvasive fungal rhinosinusitis (3 case of a fungal rhonosinusitis of the right and 2 of the left maxillary sinus) and 1 case of an invasive fungal rhinosinusitis that coused destroyment of apper and lower wall of the maxillary sinus and penetration to the right orbital. All patients underwent external approach surgery under general anesthesia. All of examinations the histological and microbiological confirmed fungal etiology (Aspergillus). A possible factor in the development of fungal sinusitis in one patient was previously treated pulmonary aspergillosis, but in a patient with invasive fungal sinusitis probably played a role in type 2 diabetes and old age. Pharmacotherapy included in a patient with invasive fungal sinusitis (Amphotericin B®) and in a patient with a history of lung Aspergillozie (Orungal®). The results of the control CT scan obtained full recovery. Conclusion Fungal infection of paranasal sinuses is a problem located at the intersection of many medical specialties. Force look at the patient in a multidisciplinary. Do not forget that it may be the final diagnosis as well as a symptom of immune deficiency, or metabolic disorders.
    Journal of Electrocardiology - J ELECTROCARDIOL. 01/2011; 65(3):15-18.
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    ABSTRACT: Introduction Papillomas of nasal cavity and paranasal sinuses according to WHO classification (1991) are divided into inverted papilloma, exophytic papilloma and cylindrical papilloma. Inverted papillomas expand most aggressively and turn malignant more often than others. Papillomas in sinonasal mucous membranes are considered pre-neoplastic condition, where the HPV virus is responsible for its aetiology. A sub-group of oncogenetic viruses is made up of: HPV 16, 18, 21. The results of epidemiological studies indicate some 20% risk of occurrence of neoplasm in case of stated local HPV viremia. Aim The aim of this study was to present diagnostic procedures (especially computed tomography examination and histopatological examination), classification and treatments methods (comparison of FESS technique and traditional via external approach) of inverted papillomas. Material and methods Material consists of 8 cases of inverted papillomas: 7 cases of nasal cavity and paranasal sinuses and 1 case of sinonasal and middle ear inverted papillomas treated surgically in ENT Department of Silesian Medical University. Patients admitted to our Department usually suffering from unilateral nasal obstruction, purulent and bloody rhinorrhoea from the nose and headache. On otolaryngological examination has been detected a lively red granulation, which filled all nasal meatus and tympanic cavity. Results All patients were treated surgically (FESS technique or traditional). The recurrence rate of our group was 25% (2 case for 8 treated) with a mean 2 years follow-up. Conclusions Classification and clinic – histopathological analysis of Schneiderian papillomas in this article were introduced.
    Journal of Electrocardiology - J ELECTROCARDIOL. 01/2011; 65(3):10-14.
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    ABSTRACT: Serous neoplasms (SN) of the pancreas account for 1-2% of all pancreatic tumours. Six morphological variants of SN were previously recognized: serous microcystic (cyst)adenoma, serous macrocystic (cyst)adenoma, von Hippel-Lindau-associated serous cystic neoplasm, solid serous adenoma/neoplasm, mixed serous-neuroendocrine neoplasm and serous cystadenocarcinoma. It was recently postulated that SN shows a continuous spectrum of morphological patterns rather than distinct clinico-pathological subtypes. To address this issue, we performed a detailed review of 40 SN cases diagnosed at our institution between 1989 and 2011. We found 11 cases of serous microcystic (cyst)adenoma, 5 cases of serous macrocystic (cyst)adenoma, and a single case of von Hippel-Lindau-associated serous cystic neoplasm. Apart from that, we found 20 cases of SN which showed features of both microcystic and macrocystic (cyst)adenomas, 2 cases of small 'incipient' SN and a single case of a mixed microcystic and solid adenoma. In conclusion, we showed that 'borderline' lesions among SNs truly exist and are not rare. The reason for such a wide diversity of morphological patterns of SN remains unknown.
    Polish journal of pathology: official journal of the Polish Society of Pathologists 01/2011; 62(4):206-17. · 0.49 Impact Factor
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    ABSTRACT: Küttner's tumor is a benign tumour-like lesion of the salivary glands. Predominantly affects the submandibular gland. It is also known as chronic sclerosing sialoadenitis or cirrhosis of submandibular gland. This is an underrecognized entity in the surgical pathology and cytology literature. Most patients experience recurrent pain, discharge and swelling that is often associated with eating, but others only have asymptomatic hard swelling of the submandibular gland. Histologic examination of the excised submandibular glands revealed preserved lobular architecture, thickening of interlobular septa by sclerotic tissue, dense lymphoplasmacytic infiltrate, preservation of ducts with periductal fibrosis, and variable loss of acini. The morphologic appearance, in conjunction with the elevated IgG4 expression, distinguishes chronic sclerosing sialadenitis from other inflammatory diseases of the salivary glands. Chronic sclerosing sialadenitis belongs to the spectrum of IgG4-related diseases. We present a case of Küttner's tumor in a 62-year-old female treated by surgery. Although this disease was first described by Küttner in 1896, this clinical entity which masquerades as carcinoma is underdiagnosed by many surgeons. There is not enough evidence to support any diagnostic means that could help in the differential diagnosis of this benign condition. Given the high rate of malignancy in firm, painless lesions of the submandibular gland, surgical excision is often advocated and Küttner's tumor is usually diagnosed by the histopathologist.
    Journal of Electrocardiology - J ELECTROCARDIOL. 01/2011; 65(4):289-292.
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    ABSTRACT: There are a few studies concerning epidemiology of pancreatic ductal adenocarcinoma (PDAC) in the Polish population. Analysis of age distribution patterns of patients with different types of cancer may be useful for studying their specific biology. In the present study we aimed to describe age distribution patterns of 580 patients with PDAC diagnosed in one centre during a 25-year period. All the histopathological diagnoses were re-reviewed using current histopathological diagnostic criteria. Age distributions of selected subpopulations of patients (defined based on gender, potential tumour resectability and type of the surgery) were compared using mean values, medians, age frequency density plots and logarithmic plots of age-specific frequencies. The mean and median values of patients' age were 60.8 y and 61.0 y, respectively. Females were approximately 2 y older than males at the time of PDAC diagnosis. Females with non-resectable PDAC were approximately 2 y older than females with resectable tumours. Mean age values of males with non-resectable and resectable PDAC were similar. Patients treated with pancreaticoduodenectomy were approximately 2 y older than patients undergoing other types of resections. Age distribution density plots showed that some subgroups of patients studied were somewhat heterogeneous and might include several yet poorly recognized clinico-pathological entities. Logarithmic plots of age-specific frequencies showed that PDAC epidemiology is in concordance with a multistage theory of carcinogenesis. PDAC is an age-dependent cancer. Single-institutional pathology-oriented cancer epidemiological databases may add some information to population-based cancer registries.
    Polish journal of pathology: official journal of the Polish Society of Pathologists 01/2010; 61(2):65-77. · 0.49 Impact Factor
  • Polish Journal of Surgery. 01/2008; 80(6):321-330.
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    ABSTRACT: Küttner's tumor is a benign tumour-like lesion of the salivary glands. Predominantly affects the submandibular gland. It is also known as chronic sclerosing sialoadenitis or cirrhosis of submandibular gland. This is an underrecognized entity in the surgical pathology and cytology literature. Most patients experience recurrent pain, discharge and swelling that is often associated with eating, but others only have asymptomatic hard swelling of the submandibular gland. Histologic examination of the excised submandibular glands revealed preserved lobular architecture, thickening of interlobular septa by sclerotic tissue, dense lymphoplasmacytic infiltrate, preservation of ducts with periductal fibrosis, and variable loss of acini. The morphologic appearance, in conjunction with the elevated IgG4 expression, distinguishes chronic sclerosing sialadenitis from other inflammatory diseases of the salivary glands. Chronic sclerosing sialadenitis belongs to the spectrum of IgG4-related diseases. We present a case of Küttner's tumor in a 62-year-old female treated by surgery. Although this disease was first described by Küttner in 1896, this clinical entity which masquerades as carcinoma is underdiagnosed by many surgeons. There is not enough evidence to support any diagnostic means that could help in the differential diagnosis of this benign condition. Given the high rate of malignancy in firm, painless lesions of the submandibular gland, surgical excision is often advocated and Küttner's tumor is usually diagnosed by the histopathologist.
    Otolaryngologia polska. The Polish otolaryngology 65(4):289-92.

Publication Stats

15 Citations
17.18 Total Impact Points

Institutions

  • 2011–2014
    • Medical University of Silesia in Katowice
      • • Department of Pathomorphology
      • • Department of Histopathology
      Catowice, Silesian Voivodeship, Poland