Polish journal of pathology: official journal of the Polish Society of Pathologists

Print ISSN: 1233-9687
Publications
This report based on 11 cases of pulmonary Langerhans cell granulomatosis describes the histological features of this condition and presents results of discourse about its character.
 
The authors present the true incidence of non-Hodgkin's lymphomas basing on the cases diagnosed in Małopolska district during one-year period. The data point to higher lymphoma morbidity than the incidence of them reported by National Cancer Register. Noteworthy is also the distribution of lymphoma types in Polish population being different from that one reported in majority of other Europe countries. The present report indicate the lymphomas become growing diagnostic and clinical challenge, as they place among the most frequent neoplasms in population.
 
The paper evaluates the usefulness of cytologic examination of urine sediment performed by millipore method, based on 125 cases. The method permits high quality cytologic smears obtained even from cellularly poor urines. The sensitivity of this analysis is directly proportional to the histological grade of the tumour. In the case of transitional cell carcinoma G1, the sensitivity was 65%, in G2-79.3% and in G3-92.9%. High sensitivity of this examination was found in carcinoma in situ. Our study is of retrospective character, the results presented were obtained on the basis of one cytoanalysis of urine sediment.
 
Immunostaining for chromogranin A, serotonin, glucagon and somatostatin revealed the presence of endocrine cells in 20 (35.1%) out of 57 randomly selected colorectal carcinomas. Expression of a general "neuroendocrine" marker, chromogranin A was detected in 18 tumours, whereas in the remaining two carcinomas positive reactivity with glucagon only was seen. Serotonin was expressed in 9 carcinomas, glucagon in 5 and somatostatin in 4 carcinomas. In 3 tumours coexpression of active products was found: in one--serotonin and glucagon, in another--serotonin and somatostatin, and in the last one--serotonin, glucagon and somatostatin. In 6 carcinomas expressing chromogranin A there was no expression of active products. Twelve carcinomas were assigned to a group with a small number of endocrine cells (up to 50/cm2 of tumour cross sectional area), 6 to a group with an intermediate number of endocrine cells (over 50 to 500/cm2) and 2 to a group with a large number of endocrine cells (over 500/cm2). The endocrine cells were significantly more frequent in less advanced and better differentiated carcinomas and in neoplasms with abundant mucin production. The cells were an integral part of glandular structures of the carcinoma, which argues in favour of a unitarian theory, i.e. common, endodermal origin of endocrine cells and other cellular elements of intestinal epithelium.
 
Background: Despite advanced diagnostic and therapeutic procedures, endometrial cancer (EC) is still responsible for high morbidity and mortality of women. The genetic variability in RAD51 may contribute to the appearance and progression of various cancers including EC. Aim: We investigated the association of polymorphisms in the DNA repair genes RAD51 135G>C and 172G>T with endometrial cancer risk. Material and methods: The genotypes of RAD51 135G>C and 172G>T polymorphism were determined by PCR-RFLP methods in endometrial tissue of 240 cancer subjects and 240 healthy subjects who served as controls. Results: In the present work we demonstrated a significant positive association between the RAD51 C/C genotype and endometrial carcinoma, with an adjusted odds ratio (OR) of 13.0 (p < 0.0001). The distribution of genotypes for 135G>C SNP in endometrial cancer patients vs. controls was: 10% vs. 27% for GG, 13% vs. 58% for GC and 77% vs. 15% for CC genotype, respectively. Variant 135C allele of RAD51 increased the cancer risk (OR = 1.81; 95% CI 0.11-2.93, p = 0.022). The higher risk of EC occurrence was associated with the combined C135C-G172T genotype (OR = 7.69; 95% CI 3.45-17.12). Conclusion: The results indicated that the polymorphism 135G>C of the RAD51 gene may be positively associated with endometrial carcinoma in the Polish population. Further studies, conducted on a larger group, are required to clarify this point.
 
This report analysed the phenotype of fourteen cases of Ki-1-positive anaplastic large cell lymphoma, recently described high-grade malignant lymphoma. In 12 cases the neoplasm involved lymph nodes, two patients presented with primary extra-lymphoid involvement (stomach, larynx), whereas secondary involvement of the skin was observed in one patient. Immunohistochemical study revealed B-cell phenotype in seven cases; three cases presented T-cell specific markers; in three cases we found antigens characteristic for both lymphoid lineages and one case presented null phenotype. Ki-1 (CD30) antigen was found in every of 14 cases, and LeuM1 (CD15) antigen was not expressed in any of studied cases. In two cases we revealed the expression of cytokeratins (CAM 5,2). The foregoing results confirm heterogeneity of this neoplasm and suggest careful interpretation of the results of morphologic and immunohistochemical findings in any pleomorphic and anaplastic tumour.
 
Chemokine receptor 4 (CXCR4) and γ-catenin are known to play an important role in development of metastasis in breast cancer. However, there is not enough information about these biological markers' distribution in different breast cancer subtypes, or their relationship to lymph node metastases in each subtype. In this study, staining characteristics of CXCR4 and γ-catenin were analyzed in each breast cancer subtype and their relationship to lymph node involvement explored. There was a statistically significant relationship between CXCR4 and certain tumor subtypes (p < 0.05). Basal-like and HER2 enriched tumors showed strong CXCR4 positivity (45.7%). Furthermore, a significant correlation was discovered between CXCR4 positivity and lymph node involvement (p < 0.05). Among tumor subtypes staining positively with CXCR4, 80% of basal-like, 90% of HER2 enriched, and 78.5% of luminal A showed axillary lymph node involvement. In general, there was a positive relationship between histological grade and CXCR4 expression (p = 0.004). A statistically significant correlation existed between HER2 positivity and γ-catenin expression (p < 0.05). Basal-like and HER2 enriched breast cancer subtypes express CXCR4 staining more often than the other subtypes. Additionally, there is also a positive relationship between lymph node involvement and CXCR4 staining of these subtypes.
 
Glaucoma is an ocular disorder that is characterized by progressive degeneration of the optic nerve and loss of visual field (VF). Recent data have suggested that the level of oxidative DNA damage in human trabecular meshwork is significantly increased in glaucomatous patients as compared to controls. It was also noted that progressive loss of visual field may by connected with elevated levels of oxidative DNA lesions. This hypothesis may suggest the role of an inefficient base excision repair pathway in primary open angle glaucoma (POAG) pathogenesis. The aim of the study was to evaluate the association of the 148 Asp/Glu APE1 gene polymorphism with the risk of POAG development. One hundred fifty patients with POAG and 190 controls were enrolled in our study. Gene polymorphisms were analyzed by PCR-CTPP. We did not observe a statistically significant difference between the frequencies of alleles and genotypes of the 148 Asp/Glu APE1 gene polymorphism in POAG patients and controls. However, the presented study indicated that 148 Asp/Glu of the APE1 gene was associated with decreased risk of progression of POAG with reference to the parameter VF. We suggest that the 148 Asp/Glu APE1 gene polymorphism may decrease the risk of POAG progression.
 
The incidence of primary adrenal gland tumors observed at the Pathology Department, Cracow, in the period of 16 years was examined. The frequency of adrenal lesion in males and females was studied and compared. The mean age of the patients was calculated. The results were shown in tables and diagrams and compared with data given in the WHO Classification of Tumors and the literature on the subject.
 
A 16-year-old girl was admitted to a hospital after having noticed clearly palpable abdominal mass, without accompanying symptoms. At surgery a tumour superficially attached to the pancreatic tail, well-encapsulated, measuring approx. 8x5x3 cm, had been found and resected. Histological examination using routine hematoxylin and eosin staining, additional histochemical and immunohistochemical techniques revealed low-grade tumour with mixed appearances of PSEN and pancreatoblastoma; both of these tumours originate from pancreatic primordia.
 
We present the first part of work concerning the history of autopsy. During the development of the pathology the role of autopsy was changing. The attitude towards the human body was often a result of struggles between human will to learn and religious beliefs. The knowledge was built upon religious procedures (mummification) through medical and surgical care of the victims of fights and wars and first autopsies. Until the 13th century dissections were seldom performed, sometimes in public. The aims varied from strictly scientific and practical (surgery) to artistic (human body in arts). Later on physicians were learning how to draw conclusions from autopsy results including malformations, pathologies, diseases, causes of death in order to try to put right diagnoses.
 
We present the second part of our review concerning the history of autopsy. During the development of medicine the role of autopsy was obviously changing. Concurrently with the progress in the anatomical knowledge, the anatomists observed and noted both single anomalies and repetitive changes which correlated with symptoms in living patients. This is how anatomopathology came into being. We present the most famous people engaged in autopsy comprehension. We discuss main trends and ideas influencing the phenomenon of autopsy in the analyzed period: from sporadic public dissections, through theatra anatomica, introduction of autopsy to the hospital medicine and separation of anatomopathology as a medical speciality. The golden age of autopsy was the 19th century and the first half of the 20th century, with a consecutive decline in frequency. Nevertheless, despite the progress in diagnostics in vivo, it seems that autopsy will keep its important place in medicine according to the old motto "Mortui vivos docent" (the dead teach the living).
 
We described the case of an unusual, complex genetic alteration in 57 year-old male patient with glioblastoma multiforme (GBM) with short survival (6 and half months). Alterations consisted of p53 mutation, LOH 10, LOH 17, LOH 19q and EGFR amplification. LOH1p, LOH 9 and LOH 13 were negative. Immunohistochemical study did not correlate with molecular results. The overexpression of TP53 protein and RB protein was detected only in small percentage of cells and interestingly the overexpression of EGFR was present only focally. Immnunostainings for PTEN, P16, PI3-K were negative. Additionally, we observed an overexpression of IGFB2 protein. This case indicates the accumulation of molecular changes in glioblastoma multiforme in patient with short survival.
 
Hamartomas are the third most common cause of solitary pulmonary nodule and the most common benign tumors of lung. Recent study indicated that hamartoma may be associated with a chronic inflammatory diseases. Histochemical analysis of the expression profile of growth-relevant was shown the upregulation of macrophage migration inhibitory factor (MIF) in hamartomas and surrounding lung parenchyma. We investigated polymorphism G/C at position -173 promoter gene of MIF, pro-inflammatory cytokine in pulmonary hamartoma. This polymorphism of the MIF gene are association with increased production of MIF and have been found to confer increased risk of susceptibility to chronic inflammatory diseases. DNA samples were obtained from hamartoma tissue fixed with formalin, embedded in paraffin, from 52 patients and from blood samples of 123 sex and age matched healthy person served as control. The G/C polymorphism of MIF gene was determined by PCR-based AluI restriction fragment length polimorphism. The frequencies of the C allele did not differ significantly between pulmonary hamartoma patients and healthy controls (18% vs 15%, OR 1.26 CI95% 0.68-2.40). The obtained results suggest no association between G/C polymorphism at promoter gene of MIF and the incidence of pulmonary hamartoma, but our study has a preliminary character and should be extended on larger population.
 
Cytokeratins (CKs) 8 and 18 are normally expressed in simple epithelia. This unique pair of CKs is believed to be involved in hepatic diseases and many human cancers. Little is known about the role of tissue expression of both CKs in patients with cholelithiasis (CH). The aim of the study was to analyse tissue expression of CK8 and 18 in the specimens of gallbladder mucosa in 35 young (up to 25 years of age) and 20 older patients (approximately 50 years of age) with CH. An immunocytochemical ABC method and the spatial visualization technique were conducted. Our study demonstrated significantly lower amounts of both CKs in young patients, as compared to older patients. The higher cellular expression of CK8 in older patients was linked to acute clinical course vs. chronic ones. Tissue expression of neither CK correlated with inflammatory activity (grading) of the gallbladder mucosa. A positive correlation between reciprocal expressions of the two CKs may confirm a cytoprotective role of the two proteins in both groups of patients with symptomatic CH. Significantly higher expression of CK18 than that of CK8 in younger patients suggests a different role of CK8 and 18 in lithogenesis in this group.
 
Spinal canal tumours constitute a minor part of CNS invading neoplasm. However, due to their damaging influence on the spinal cord and the spinal roots, they cause serious clinical problems and can lead to severe disability. The aim of this study is to review material collected on tumours of the spine and the spinal canal at the Department of Neuropathology over the past ten years. One hundred and eighty five histopathological examinations of spinal tumours were evaluated between August 1997 and August 2007. The group of patients included 94 females and 91 males between the age of 18 and 79 years with a mean age of 53. Apart from typical intraspinal tumours (i.e. astrocytomas and ependymomas), and extraspinal tumours, (i.e. meningiomas, schwannomas, neurofibromas), rare neoplastic and non-neoplastic tumour-like changes occur in the same localizations. These rare conditions include: capillary haemangioma, paraganglioma of filum terminale, meningeal gliomatosis, different variants of cysts such as the dermoid cyst, synovial cyst and aneurysmatic bone cyst, neoplastic and non-neoplastic bone tumours like the giant cell tumour, chordomas, and intramedullary metastatic carcinomas. This paper presents and discusses spinal lesions from collected data with special attention paid to the rare conditions, which are reviewed in more detail.
 
In this study, 105 cases of thyroid lesions were evaluated to assess the role of HBME-1, cytokeratin-19 (CK-19), galectin-3 in distinguishing benign from malignant thyroid lesions. Thirty-seven papillary, 10 follicular, 6 medullary, 1 mixed medullary follicular cell carcinoma, 3 poorly differentiated carcinoma, 18 adenomatous nodular hyperplasia, 30 follicular adenoma cases were included in the study. Immunohistochemical staining was performed with HBME-1, CK-19, galectin-3 on cross-sections derived from selected paraffin blocks. Benign and malignant lesions were compared in terms of intensity, percentage and type of staining with CK-19, HBME-1 and galectin-3, and a statistically significant difference (p < 0.05) was found. The percentage and intensity of staining was higher in malignant lesions. Especially, strong and diffuse expressions of CK19, HBME-1 and galectin-3 were observed in papillary carcinomas. Membranous (luminal) staining was seen more frequently in malignant lesions; cytoplasmic staining in benign lesions. It was concluded that these markers could assist in the diagnosis of thyroid lesions with cellular properties suspicious for the diagnosis of papillary carcinoma and without capsule and vessel invasion. They may be used especially in cases where the follicular variant of papillary carcinoma, follicular adenoma and follicular carcinoma are confused with each other and follicular adenoma cannot be differentiated from follicular carcinoma.
 
Influence of three vanadium compounds on H35-19 hepatoma cell line growth inhibition. Reaction with crystal violet (CV) or Bürker chamber counting (BC).
Experimental H35-19 hepatoma cells with 0.5 mM sodium orthovanadate. Numerous organelles fill the cytoplasm of a hepatoma cell. Note the double membrane in the perinuclear zone that corresponds to a Golgi structure. The bar represents 5 mm.  
Experimental H35-19 hepatoma cells with 0.5 mM sodium metavanadate . A well differentiated cell. Apart from organelles described in the previous group, electron-dense lysosome-like structures and more numerous compartments of smooth endoplasmic reticulum. The bar represents 5 mm.  
This study presents the investigation and comparison the influence of VOSO4 [V(IV)I, Na3VO4 and NaVO3 [V(V)] in the range of 0.5-20.0 microM on the rat hepatoma cell line H35-19. The cells were tested with crystal violet (N-hexamethylpararosaniline), and counted in a Bürker chamber to determine their rate of proliferation, while the survival level was established with neutral red and MTT [bromide 3-(4,5-dimetyltioazo-2)-2,5-diphenyl-tetrazole]. Parallel independent pathomorphological studies with electron microscopic examinations were done. We found progressive growth inhibition of rat hepatoma H35-19 cells within the range 0.5-20.0 concentrations of three vanadium salts. The most effective (and/or toxic) was NaVO3, whereas VOSO4 showed a relatively mild action. As compared with metavanadate or vanadyl sulphate and especially organic vanadium derivatives, previously studied by the same authors under similar experimental conditions, sodium orthovanadate showed an intermediate effect. Electron microscopic examinations confirmed these results. Vanadium salts in low concentration in medium (0.5 microM) were observed to normalize cell morphology. Higher doses of vanadium salts (greater than 2.5 or 5.0 microM) resulted in damaging cell organelles and the more cytotoxic the compounds seemed to be.
 
Papillary thyroid cancer (PTC) metastases in the lymph nodes (LNs) were detected by real-time polymerase chain reaction (PCR) for TG and cytokeratin 19 (CK19), and the obtained results were compared with histopathology. 107 LNs from 34 PTC patients were divided into four blocks by a special cutting device - 2 for histopathology, while the other 2 were tested by quantitative real-time PCR. Metastases were detected in 20 nodes from 10 (29.4%) patients. TG and CK19 expression levels differed vastly between nodes with and without metastatic cells. ddCt of TG in the genetic material extracted from N0 nodes was 9.97 ±4.20, while in nodes with metastases ddCt was 0.91±4.20 (p < 0.0001). Cytokeratin 19 showed similar results with expression level (ddCt) in N0 nodes of 10.96 ±2.58 vs. 7.73 ±3.63 in nodes with metastases (p < 0.0001). Evaluation of the utility of both parameters showed efficient differentiation of node involvement in the case of TG, with area under the ROC curve (AUC) equal to 0.91 (95% CI: 0.85-0.96). Cytokeratin 19 also allowed for a degree of differentiation but its diagnostic efficacy was lower (AUC 0.76, 95% CI: 0.64-0.88). The combined TG and CK19 quantitative real-time PCR could be used to select a previously missed group of patients with nodal involvement undetectable by standard histopathology.
 
The authors investigated the effect of streptozotocin (STZ) in low--micromoles (up to 500 microM)--or higher --millimoles (1-10 mM)--concentrations in culture media of the H35-19 cell line. Up to 500 microM, STZ did not show any cytotoxic or cytostatic action in the investigated cells; on the contrary, it triggered an "improved growth" of these cells, as an antibiotic effect of the drug was observed. The concentration of 1-10 mmoles of STZ in the medium inhibited proliferation and viability of the studied cells. This action depended (proportionally) on drug concentration and time (up to 72 h) of experiment. Statistical analysis of the results obtained by four methods: staining with MTT, neutral red (NR) or crystal violet (CV) and Biirker chamber counting (BC), demonstrated no significant difference in STZ impact between 48 h and 72 h of incubation, according to the Benferoni post-hock test. The results obtained by MTT showed an extremely high statistical significance (p<0.001) of the effect of concentration on the results, with a non-significant interaction (p=0.2236) and general time effect (p=0.3600). An extremely significant (p<0.001) interaction of the effect of time and concentration was observed in the results obtained by neutral red method, whereas a significant effect of general time and concentration was also observed, but according to [17] it is difficult to explain. The results obtained by crystal violet staining showed a highly statistical significance (p<0.001) in time and concentration effect on the data, without a significant interaction between the above-mentioned factors (p>0.05). Cell counting in a Biirker chamber demonstrated a highly significant time and concentration effect on the results, but the interaction was mildly significant (0.01<p<0.05); the time and concentration effect are said to be difficult to interpret. The main STZ effect exerted on proliferation and growth inhibition was noted after 48 h and 10 mM of STZ. Morphological studies after 48 h and 5 mM STZ were performed, since these experimental conditions allowed for observing changes induced by the drug, when not all cells were destroyed by streptozotocin. At the studied streptozotocin concentration, the death of these cells occurred mainly by necrosis.
 
Histopathological examinations performed between 1987 and 1992 at the Department of Pathology of the Lublin Medical Academy were analysed statistically. Endometriosis was found in 885 cases, i.e. 13.3% of all gynecological cases. An increased frequency as well as a shift in the peak age of incidence to the third decade, were found.
 
This paper presents the main trends in the activity of veterinary pathologists in the context of their oral presentations, short speeches and posters during annual congresses of the European Society of Veterinary Pathology (ESVP) in the years 1997-2009. During the thirteen analyzed congresses, 2668 presentations were prepared, including 72 plenary lectures, 946 short oral presentations and 1489 posters. Based on the analysis, organ pathology (779 presentations) was the most popular branch of pathology. Infectious and parasitic diseases (714 presentations) and oncology (563) were also quite popular. This paper analyzes also the role of congresses of the Society in disseminating knowledge on veterinary pathology and training pathologists in Europe as well as the trends in their scientific activity.
 
The development of pathological anatomy in the second half of the 19th century was mainly associated with the scientific activity of Rudolf Virchow. Last year we celebrated the 180th birth anniversary and this year the 100th death anniversary of this outstanding man. The paper presents the scientific achievements of Rudolf Virchow as it was presented in Polish medical magazines in the 19th century and the beginning of 20th century. In 1858, his theory of cellular pathology became a basis for the understanding and fight against pathologic processes in living organisms. The theory also contributed to an increased interest in pathologic anatomy, especially histopathology and Virchow himself. In 1859 an extensive summary of the article, issued a year before, entitled "Cellular pathology based on physiological and pathological theory of tissues" appeared in the subsequent issues of "Tygodnik Lekarski" ("Medical Weekly"). Also a translation of the XI chapter of "Cellular pathology..." devoted to nerve tissue appeared in the same magazine. This is the only treatise in Polish on the most important work in the history of pathological anatomy of the 19th century. Three years later, in 1862, Włodzimierz Brodowski delivered to the students of Medical and Surgery Academy in Warsaw a lecture "Introduction to the lecture on pathological anatomy" which was later printed in "Pamietnik Towarzystwa Lekarskiego Warszawskiego" ("Diary of Warsaw Medical Association"). He presented the development of pathological anatomy along with the achievements of Virchow. Brodowski was the first Polish anatomopathologist who lectured to students on Virchow's theory. Moreover, a paper "Scientific activity of Rudolf Virchow and its importance for medicine" by Edward Przewoski was published in the series "Clinical Lectures" issued by the editors of "Gazeta Lekarska" ("Medical Magazine") in 1892. The article included a detailed description of the scientific activity of that outstanding scholar. Apart from the above mentioned examples, Virchow's opinion not only on pathological anatomy and medicine but also on, for example, anthropology was often presented. Rudolf Virchow's death was announced in all the then Polish medical magazines.
 
Józef Frank (1771-1842) and his monument in Vilnius. 
Pathological anatomy lecture schedule at the Medical and Surgery Academy 
Classes schedule -"Operations on death bodies" subject at the Medical and Surgery Academy 
The first post mortem examination was performed in Vilnius by a priest Stefan Bisio in 1770. At the end of the 18th century, Jakub Briotet, a surgeon and anatomist, founded a modest anatomical (surgery) study. In 1804, Jan Piotr Frank and his son Józef arrived to Vilnius and became professors of the University. Jan Piotr Frank took charge of the University Teaching Hospital and Józef of the Chair of Pathology. When, in 1805, Józef Frank took charge, after his father, of the University Hospital, he founded the first anatomopathological examination room there. The samples were obtained mainly from post mortem studies--autopsies. Most of the samples kept in spirit in the Frank's room were eaten by the starving French soldiers during the retreat of Napoleon's army. Getting dead bodies for the Universities was easy thanks to Tsar's decrees from the years 1793-1809 which ordered to open dead bodies and collect monsters. Moreover, a permission to transfer dead bodies from military hospitals to the University was issued in 1810. These decrees did not stop the cases of students digging out dead bodies from the graves, which still happened in 1810 and 1817. Józef Frank acknowledged great role of post mortem in medicine teaching. He wrote: an author describing a disease with lethal outcome, who does not mention pathological changes found through autopsy is backward. Beside Frank's study, there was still a study founded by Briotet at the Vilnius University, at the Chair of Anatomy. In 1808, Tsar Alexander I designed ruins of Spaska Orthodox Church for an anatomic theater. After seven year redecoration works, it was opened. Beside the theater, dissection room and Veterinary Institute, the building included zoological, veterinary and anatomical museum. The growing anatomical museum had, in 1841, 2895 preparations including 1239 anatomopathological preparations. After closing down Vilnius University and opening Medical and Surgery Academy, pathological anatomy classes were introduced for the 5th year students in 1834. The first lecturer of pathological anatomy, as an individual subject, was Ludwik Siewruk. He started the classes in 1840 when he took charge of the Chair of Anatomy at the Moscow University. Jan Leonow continued the classes till the closing down of Medical and Surgery Academy by the tsar in 1842. The classes performed by Siewruk and Leonow were limited to lectures. Practical knowledge, autopsies were a part of pathology classes and specific therapy (3rd and 4th years of studies). After the Academy had been closed down, all the exhibits of the Vilnius anatomical museum, including anatomopathological preparations were moved to the anatomical museum of Kiev University. Few of them remained in the Vilnius Medical Society.
 
In recent years there have been many intensive studies on the molecular mechanisms involving the carcinogenesis of colorectal cancer (CRC). An inflammatory process and genetics play the key role in neoplasia of CRC. Currently, there are two known pathways of CRC carcinogenesis, such as the adenoma and the serrated adenoma, which are referred to as "classic" and "alternative", respectively. Among all the components of the inflammatory process, the proinflammatory and anti-inflammatory cytokines play a major role as a factor influencing the process of malignant transformation. In our study we focused on key inflammatory factors such as cytokines interleukin (IL)-10, IL-1β, IL-4, tumor necrosis factor α (TNF-α) and cyclooxygenase-2 (COX-2) in adenomas, serrated adenomas, hyperplastic polyps, adenocarcinomas and normal mucosa. Our study confirmed the hypothesis that inflammation has a major effect on carcinogenesis of CRC. Our studies also showed the difference in carcinogenesis of CRC. It showed a greater effect of the inflammatory process in carcinogenesis of CRC by a "serrated" (alternative) way as compared to the classic way. In a serrated way all the inflammatory factors had a higher expression. It might suggest that effectiveness of cancer prevention with the use of NSAIDs has a greater impact in patients whose tumors were formed in an alternative way. Additionally, it also showed that the inflammatory process has no influence on the final form of cancer.
 
Identification of a vanadium compound with the highest efficacy and least toxicity is the main scientific problem in diabetes treatment. All vanadium complexes, both inorganic and organic, apart from improving physiological and biochemical diabetic parameters, show more or less toxic effects in living organisms. For this reason we decided to test a new vanadium compound: bis(2,2'-bipyridine)oxovanadium(IV), [VO(bpy)2], not used or described so far. This paper stressed morphological alterations of rat liver Golgi apparatus originated from control or streptozotocin (STZ)-diabetic rats treated with 1.8 mmol VO(bpy)2 solution in 0.5% NaCl as drinking liquid for 7 days and compared them with a parallel biochemical study. There was a correlation between the activity of Golgi marker enzyme i.e. galactosyl transferase and morphology of this organelle. In control rats treatment with VO(bpy)2 caused drastic changes, in many cases leading to a complete destruction of liver Golgi apparatus. In STZ-diabetic liver of rats treated with VO(bpy)2 the Golgi apparatus showed characteristic of untreated diabetes arching or even twisting of stack cisternae but improvement of the secretory activity (dilatation of cisternae edges, some secretory vacuoles and vesicles). In our opinion, the parallel action of two drugs: STZ combined with VO(bpy)2, relieves or even eliminate harmful effects of each compound alone.
 
Brain tumors are the most frequent solid neoplasms of childhood. We present here a series of 200 consecutive cases of neuropathologically verified brain tumors in children under 18, operated on between 1990-1996 at the Polish Mother Memorial Hospital in Lódź. The respective diagnoses were established on the basis of light microscopy, ultrastructure and immunohistochemistry. The criteria of the World Health Organization (WHO) classification of central nervous system (CNS) tumors were used in all but one (superficial desmoplastic cerebral astrocytoma of infancy) case. The location of tumors, age and sex of children and tumors' histology in our material were compared with those of previously published series of pediatric brain tumors.
 
This is a review of the 2000 World Health Organization (WHO) classification of tumors of the nervous system. It contains an overview of the most important changes and short descriptions of the new entities or variants of already existing entities included in the current classification. These are: chordoid glioma of the third ventricle, cerebellar liponeurocytoma, large cell medulloblastoma, medulloblastoma with extensive nodularity and advanced neuronal differentiation, atypical teratoid/rhabdoid tumor, perineuroma, and rhabdoid meningioma. In contrast to the former WHO tumor classification series, the present one is based on the complex criteria, which include not only the clinical course and histologic appearance of the neoplasm but its immunophenotypic features and molecular/cytogenetic profile as well. Thus, it is strongly disease-oriented and uses extensively the recent advances in the basic sciences.
 
Fundic gland polyps (FGPs) are tiny multiple sessile polyps of the acid-secreting gastric mucosa. They have been described both in a sporadic form, mainly in middle-aged females, and in a syndromic form, associated with familial adenomatous polyposis (FAP)-Gardner's syndrome and attenuated variants (AFAP). They share the same histology, characterised by superficial and deep cystic dilatations, shortened gastric pits, with an inconspicuous lamina propria. They have been for a long time described as innocuous lesions, but some recent reports have shown that FGPs may harbour dysplastic foci and ultimately (particularly syndromic polyps) gastric cancer. Factors influencing their genesis are unknown. A circulating factor in FAP patients has been postulated and a role of female hormones has been suggested for sporadic FGPs. Whereas patients with sporadic FGPs have normal basal acid output, normal fast serum levels of gastrin and pepsinogen I, the role of gastrin seems crucial for the development of cystic changes in flat body-fundus mucosa, and for the appearance of FGPs in patients with Zollinger-Ellison syndrome. A role of H. pylori induced gastritis has been excluded. Actually, patients with both sporadic and syndromic FGPs appear consistently free from H. pylori colonisation, again for an unknown factor(s). Some recent reports have claimed a role for omeprazole in the genesis of FGPs, a highly controversial issue. Ultimately, the nature of FGPs is still debated: some have interpreted them as hamartomatous lesions, others as a peculiar form of hyperplastic polyp.
 
In Poland, data on the incidence and mortality associated with malignancies are collected by the National Cancer Register (NCR). The Register is based on the International Classification of Diseases (ICD-10), which does not allow for assessing the incidence of lymphatic neoplasms classified according to the WHO classification system enforced since 2001. Under the National Program of Combating Neoplastic Diseases that focuses on detection and diagnosing malignant lymphomas in Poland in order to record and precisely classify lymphatic neoplasms, in 2006, the Haematopathological Section of the Polish Society of Pathologists, acting in collaboration with the Polish Lymphoma Study Group, initiated a nationwide register of lymphatic malignancies, a continuation of the Register of Lymphomas for the Province of Małopolska. The register not only renders epidemiological data more specific, but also allows for a comprehensive quality control.
 
Rare in occurrence, the following case of intrapulmonary lipoma is only the fifth known case in a female patient reported in the literature. Importantly, the incorporation of this lesion into the differential diagnosis during frozen section of a predominantly adipocytic lesion limited the extent of surgical intervention and provided the patient with an optimal standard of care.
 
The proliferation factors: mitotic activity index (MAI), phosphohistone H3 (PPH3) and Ki67 have strong prognostic value in early breast cancer but their independent value to each other and other prognostic factors has not been evaluated. In 237 T1-2N0M0 breast cancers without systemic adjuvant treatment, formalized MAI assessment and strictly standardized, fully automated quantitative immunohistochemistry (IHC) for Ki67, PPH3, estrogen (ER) and progesterone receptor (PR), HER2, cytokeratins-5/6 and -14, and automated digital image analysis (DIA) for measuring PPH3 and Ki67 were performed. Section thickness was measured to further control IHC measurements. All features were measured in the periphery of tumors. The different proliferation assessments and other well-established clinicopathological and biomarker prognostic factors were compared. DIA-Ki67 added prognostically to PPH3. None of the other biomarkers or clinicopathological variables added prognostically to this PPH3/Ki67 combination. However, when PPH3 is replaced by MAI the prognostic value is nearly the same. In early operable node negative breast cancer without adjuvant systemic treatment, Ki67 with a threshold of 6.5% assessed by digital image analysis in the periphery of the tumor is prognostically strong. The combination of either PPH3/Ki67 or MAI/Ki67 overshadowed the prognostic value of all other features including Ki67 alone.
 
Gallbladder cancer (GBC) is one of the most aggressive tumors; we examined the expression level of DNA fragmentation factor 45 (DFF45) and thyroid transcription factor 1 (TTF-1) in benign and malignant lesions of the gallbladder by immunohistochemistry. The results were correlated with clinicopathological features and prognosis. DNA fragmentation factor 45 and TTF-1 expression was significantly higher in gallbladder adenocarcinomas than in the corresponding peritumoral tissues (χ2DFF45 = 6.92, χ2TTF-1 = 8.68, ps < 0.01), polyps (χ2DFF45 = 4.49, χ2TTF-1 = 5.35, ps < 0.05), and chronic cholecystitis (χ2DFF45 = 12.98, χ2TTF-1 = 17.74, ps < 0.01). Negative expression of DFF45 and TTF-1 was significantly associated with tumor differentiation, tumor mass, lymph node metastasis and invasion of adenocarcinomas (p < 0.05). Univariate Kaplan-Meier analysis showed that elevated expression levels of DFF45 and TTF-1 (p < 0.05) were closely associated with increased overall survival. In addition, the average survival time of patients with DFF45(+) TTF-1(+) tumors was significantly higher than those with DFF45(-) TTF-1(-) tumors (p < 0.05). Finally, multivariate Cox regression analysis showed that negative expression of DFF45 and TTF-1 was an independent prognostic predictor in gallbladder adenocarcinoma (p < 0.05). The expression of DFF45 and/or TTF-1 is closely related to the carcinogenesis, progression, clinical behavior and prognosis of gallbladder adenocarcinomas. DNA fragmentation factor 45 and TTF-1 could be progression-associated genes correlating with good prognosis in GBC.
 
The content of S-100 protein and antigen HMB-45 in various types of melanomas and skin naevi was compared with respect to the frequency of two antigens, their distribution within lesions as well as diagnostic or prognostic relevance. The study material comprised 72 skin melanomas, 25 melanomas of the oral cavity and 63 non-malignant skin naevi. Formalin fixed, paraffin-embedded sections were used for immunohistochemical reactions with polyclonal rabbit anti-S-100 antibody (Dako) and monoclonal anti-HMB-45 antibody (Dianova) followed by PAP and APAAP Kits (Dianova), respectively. Detection of HMB-45 was preceded by a microwave treatment of sections. S-100 protein was found in all cases of melanomas irrespective of their location or histological type, but HMB-45 was missing in 8% of oral melanomas. Distribution of the antigens within tumors was heterogeneous and often mutually exclusive. S-100 protein was also present in all types of naevi, while HMB-45 was absent in intradermal naevi and strictly confined to epidermal component in the remaining ones. The intensity of staining for S-100 correlated inversely with the patients' survival. It was concluded that demonstration of HMB-45 might facilitate a differentiation of naevi from melanomas, whereas staining for S-100 protein might have some prognostic significance.
 
Here we report on histopathological findings from 46 cases of primary Fallopian tube carcinoma (PFTC) which were diagnosed and/or consulted in the Department of Pathology, University Medical School of Wrocław between 1982 and 1997. PFTCs can be classified according to the WHO International Classification of Ovarian Tumors. Reexamination of glass slides revealed at least five histological types of PFTC. Our results indicated better prognosis in patients with primary Fallopian tube endometrioid carcinoma rather than with serous carcinoma. Patients with PFTC expressing urothelial differentiation also show better prognosis. These findings confirm greater usefulness of primary ovarian carcinoma classification in the evaluation of the primary salpingeal carcinomas. The problems encountered in diagnosis, prognosis and therapy of PFTC are discussed.
 
We report a rare case of silicosis, histologically corresponding to silicoproteinosis and tuberculosis, in a man working consecutively as a miner, blacksmith and founder. A microscopic study revealed deposits in alveoli, in which immunohistochemistry did not reveal surfactant (SP-A), that was present in the alveolar fluid in alveolar lipoproteinosis.
 
The study evaluated the incidence of infections and neoplasms in 55 out of 104 patients with AIDS who died in Poland from January 1986 to April 1994 (the estimated autopsy rate-52.8%). Histopathological examination revealed 103 infections and 11 neoplasms. In 40 persons (73%) either multiple infections or a neoplasm and an infection were diagnosed. Cytomegalovirus infection was most common. (65.5% of cases) followed by Pneumocystis carinii (24% of cases). These infections were the leading cause of death in 20% and 16% of cases, respectively. The results of this study showed a significantly lower incidence of Pneumocystis carinii, Kaposi's sarcoma and non-Hodgkin's lymphoma in comparison with the results of similar studies in countries with a large number of AIDS cases.
 
Localization of actin was studied in erythroleukemic cell line K-562 after treatment with etoposide for 72 hours in a range of concentrations 0.02-200 microM/L. Actin was visualised by fluorescence microscopy and streptavidingold method. These findings indicate that changes in actin after treatment with etoposide were dose-dependent. Significant changes in the cellular distribution of F-actin in K-562 cells were obtained after treatment with 20 and 200 microM/L etoposide. In comparison with control cells, the number of the cells decreased and cells were larger especially at 200 microM/L. F-actin was diffusely distributed throughout the cell at 20 microM/L. Treatment of cells with 200 microM/L etoposide showed F-actin diffusely distributed throughout the cell with local actin assemblies and also at the cell periphery. Immunogold labelling of actin was observed in cells treated with all doses of etoposide and control cells. Labelling was found in the nucleus and also in the cytoplasm. At the ultrastructural level, cells treated with 200 microM/L etoposide showed protrusions at the surface, in which increase of actin was often observed. Etoposide causes changes in actin distribution of K-562 cells, and the changes in expression of actin were not only restricted to cell with features of apoptosis.
 
Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disease which pathogenesis is associated with destruction of the basement membrane components and the anchoring fibers. The binding of autoantibodies to antigens localized in the basement membrane of the epidermis activates a series of immunological and enzymatic phenomena that lead to blister formation. There are some data that MMPs are involved in the development of skin lesions in BP, however their exact role in this process is not fully understood. We aimed to investigate whether MMPs and their inhibitors (TIMPs), assessed by their tissue expression, are involved in the pathogenesis of BP. The localization and expression of collagenase (MMP1), gelatinase (MMP2), 92 kD gelatinase (MMP9) and stromelysin 2 (MMP10) and TIMP1, 2, 3 were examined by immunohistochemistry in skin biopsies as well as in normal human skin specimens. The study included 21 patients with BP at an active stage of the disease. The MMPs and TIMPs serum levels were measured by ELISA method. Expression of MMP1, MMP2, MMP9 and MMP10 was observed either in the whole epidermis or in the basal keratinocytes. Most of the enzymes examined, apart from TIMP3, were detected in dermal part of the blister. Expression of the majority of the enzymes examined was observed in blister fluid however, the most intense signal was noted for MMP10. In cellular infiltrate we found expression of all the MMPs and TIMPs, the most distinct for MMP1, MMP2, MMP10 and for TIMP2. In all biopsies obtained from healthy volunteers only single basal keratinocytes gave positive, weak signal for the examined proteins. The MMPs and TIMPs serum levels in the control group were normal while in some cases of BP patients they were increased. Based on the results we conclude that imbalance between these enzymes really occurs in BP and it is likely to take important part in the pathogenesis of the disease.
 
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.
 
Top-cited authors
Krzysztof Okoń
  • Jagiellonian University
Malgorzata Wagrowska-Danilewicz
  • Medical University of Łódź
Hanna Romanowicz
  • Instytut Centrum Zdrowia Matki Polki
Smolarz Beata
  • Instytut Centrum Zdrowia Matki Polki
Jerzy Lasota
  • National Institutes of Health