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Biomedical subjects

B Kruslin

Publications and source records attributed to B Kruslin.

At least 19 recordsLinked to original sources

Myofibroblastic stromal reaction and expression of tenascin-C and laminin in prostate adenocarcinoma.

The aim of this study was to analyse relationship between changes of the stroma and expression of tenascin-C (TN-C) and laminin in prostate carcinoma. Tenascin-C immunostaining was increased, and laminin decreased in carcinomas compared with peritumoral tissue and benign prostate hyperplasia (P<0.05). Statistical analysis confirmed connection between stromal changes and TN-C expression in prostate carcinoma (P<0.05). Gleason pattern 3 carcinomas showed more pronounced stromal reaction and TN-C expression compared with Gleason pattern 4 carcinomas (P<0.05). The main cells in prostate cancer stroma are myofibroblasts that are also responsible for tenascin production. Degradation of laminin was not connected with myofibroblastic stromal changes.

Actins↗

Primary glomangioma of the esophagus mimicking esophageal papilloma.

We report a case of glomangioma of the esophagus in a 28-year-old woman who presented with a 3-year history of vague discomfort, pain and heat in the neck. At initial gross examination, the tumor mimicked an esophageal papilloma. The resected esophageal specimen contained a polypoid, whitish-gray mass, which measured 3 cm in maximum diameter. Microscopically the tumor consisted of loose fibrovascular stroma heavily infiltrated with mononuclear inflammatory cells and covered with focally hyperkeratotic, parakeratotic and acanthotic squamous epithelium without atypia. In the deeper area immediately above the true muscular layer of the esophageal wall, microscopical examination revealed the neoplasm consisting of numerous, small-to-medium branched vessels covered by regular endothelium and filled with erythrocytes. The loose stroma around the vessels contained poorly circumscribed nests of small, round to oval cells with a uniform appearance. Immunohistochemically, the tumor cells were immunoreactive for smooth muscle actin and vimentin and non-immunoreactive for CD34, CD117, desmin, pan-cytokeratin, synaptophisin, neuron-specific enolase and S-100 protein. Despite its bland histology, the infiltrative growth pattern was suggestive of aggressive behavior; thus, an appropriate clinical follow-up was recommended. An accurate diagnosis and an understanding of the behavior of these rare tumors, especially in an unusual location, are crucial to their management and clinical outcome.

Adult↗

Correlation between Bcl-2 and Bax in atrophic and hypertrophic type of actinic keratosis.

BACKGROUND: Recent investigations consider actinic keratosis (AK) as an earliest visible pattern of squamous cell carcinoma (SCC). We have analysed the expression of apoptosis-related proteins TP53, Bcl-2 and Bax in 30 atrophic and 30 hypertrophic AK cases. MATERIAL AND METHODS: Immunohistochemical analysis was performed following microwave streptavidin immunoperoxidase protocol on DAKO TechMate Horizon automated immunostainer (DAKO, Copenhagen, Denmark). Monoclonal antibody for TP53 and Bcl-2 and polyclonal antibody for Bax (DAKO, Copenhagen, Denmark) were used. RESULTS: Expression of TP53 showed no significant differences between two analysed groups (chi2-test, P = 0.35636) whereas expression of Bcl-2 and Bax protein was significantly higher in atrophic compared to hypertrophic AK (chi2-test, P = 0.01458 and P = 0.00358, respectively). Comparison of Bcl-2 : Bax ratio in two analysed AK showed significantly higher value in hypertrophic compared to atrophic AK (Mann-Whitney U test, P = 0.02272). Statistical analysis did not show any correlation between patient's sex and age, localization and size of the lesion with expression of investigated oncoproteins (anova, P > 0.05). CONCLUSIONS: Our results may indicate higher resistance of keratinocytes on apoptotic stimuli in hypertrophic compared to atrophic AK. Thus, we suppose that keratinocytes in hypertrophic AK live longer and probably have higher propensity for additional mutations and conversion to overt SCC.

Aged↗

Renal artery changes in patients with primary renal cell carcinoma.

Arterial fibromuscular dysplasia (FMD) is a noninflammatory, nonatherosclerotic, occlusive condition of the systemic arteries, most frequently affecting renal arteries. Renal cell carcinoma (RCC) might be associated with arterial hypertension; however, there are no data in the literature regarding the relationship between RCC and associated renal artery changes. We analyzed a consecutive series of 57 (35 male and 22 female) patients aging from 35 to 79 years (mean 58.9 years) who underwent nephrectomy due to RCC in the year 2003. The patients had RCC measuring from 2 to 16 cm (mean 7.1 cm). Specimens were routinely fixed, embedded in paraffin, cut, and stained with hematoxylin and eosin, Mallory trichrome method, and orcein. Renal arteries of 26 patients (20 male, 6 female) showed no changes. In these patients, RCC measured 2.5-11 cm in largest diameter (mean 6.6 cm). In 24 patients (10 male, 14 female), renal arteries showed FMD. RCCs in these patients measured between 2 and 16 cm (mean 8.0 cm). Seven patients had atherosclerotic changes in renal arteries. In this series, FMD was found in a significant proportion of patients with RCC, mainly in women. The cause of such changes and their relationship with RCC and systemic hypertension should be further analyzed.

Adult↗

Langerhans' cell granulomatosis in an adult: a 22-year follow up.

A 57-year-old patient with Langerhans' cell granulomatosis (LCG) is presented. During 22 years of treatment, there were five relapsing infiltrations at different sites of the skull bones, which were treated by surgery, local radiotherapy, and chemotherapy. During the last relapse, the right temporal bone was infiltrated by granuloma and the petrous bone was destroyed with an intimate spread to the internal carotid artery. After two palliative surgical resections and ineffective radiotherapy, 12 cycles of chemotherapy (vinblastine plus prednisolone) were applied and a clinical remission of the disease was achieved. Special attention is paid to the complexity of diagnosis and choice of therapy. It is concluded that the behavior of LCG may change with time, and assume an aggressive form of the disease. Chemotherapy is the treatment of choice for this type of multifocal malignant form of LCG. Prognosis of the disease is unpredictable.

Combined Modality Therapy↗

Syringoid eccrine carcinoma.

A rare case of a syringoid eccrine carcinoma in a 52-year-old male patient is described. During the first hospitalization, syringoma was diagnosed, both clinically and histologically, keeping in mind the possibility of its malignant alteration. Difficulties in making a diagnosis with histological and immunohistochemical examinations are reported. The possibility of differential diagnosis of primary breast carcinoma and methods of its exclusion are also described. Treatment of the patient was surgical with good results.

Acrospiroma↗

DNA ploidy analysis and cell proliferation in congenital sacrococcygeal teratomas.

BACKGROUND: Congenital sacrococcygeal teratoma is the most common germ cell tumor in infants and children. It usually is diagnosed at birth, is benign, and consists of fully differentiated mature tissues. Congenital sacrococcygeal teratomas (SCTs) also may contain immature tissues, most commonly of neural origin. The proportion of malignant teratomas increases with advancing age, but the relation between mature and immature SCTs is not well understood. Thus, it is very important to determine proliferative activity, DNA ploidy, and DNA index to predict biologic behavior of these tumors. METHODS: DNA ploidy and cell proliferation were analyzed by flow cytometry, and the expression of proliferating cell nuclear antigen (PCNA) and Ki-67 were analyzed immunohistochemically on paraffin embedded tissue. RESULTS: All the tumors that were surgically treated within 3 months after birth, including immature teratoma, were diploid. Strongly positive PCNA immunostaining was found in both immature teratomas, and weakly positive PCNA was found in nine cases. Weak positivity for Ki-67 was observed in 2 cases, and moderate positivity was observed in 6 cases including immature teratomas. CONCLUSION: The value of flow cytometry in the prediction of biologic behavior of congenital SCT should be analyzed further. Our results suggest that Ki-67 and especially PCNA may reflect the proliferative activity of these tumors.

Cell Division↗

nNOS expression in reactive astrocytes correlates with increased cell death related DNA damage in the hippocampus and entorhinal cortex in Alzheimer's disease.

The immunocytochemical distribution of the neuronal form of nitric oxide synthase (nNOS) was compared with neuropathological changes and with cell death related DNA damage (as revealed by in situ end labeling, ISEL) in the hippocampal formation and entorhinal cortex of 12 age-matched control subjects and 12 Alzheimer's disease (AD) patients. Unlike controls, numerous nNOS-positive reactive astrocytes were found in AD patients around beta-amyloid plaques in CA1 and subiculum and at the places of clear and overt neuron loss, particularly in the entorhinal cortex layer II and CA4. This is the first evidence of nNOS-like immunoreactivity in reactive astrocytes in AD. In contrast to controls, in all but one AD subject, large numbers of ISEL-positive neuronal nuclei and microglial cells were found in the CA1 and CA4 regions and subiculum. Semiquantitative analysis showed that neuronal DNA fragmentation in AD match with the distribution of nNOS-expressing reactive astroglial cells in CA1 (r = 0.74, P < 0.01) and CA4 (r = 0.58, P < 0.05). A portion of the nNOS-positive CA2/CA3 pyramidal neurons was found to be spared even in the most affected hippocampi. A significant inverse correlation between nNOS expression and immunoreactivity to abnormally phosphorylated tau proteins (as revealed by AT8 monoclonal antibody) in perikarya of these CA2/3 neurons (r = -0.85, P < 0.01) suggests that nNOS expression may provide selective resistance to neuronal degeneration in AD. In conclusion, our results imply that an upregulated production of NO by reactive astrocytes may play a key role in the pathogenesis of AD.

Aged↗

Calcified leiomyoma of the lateral pterygoid muscle in an 8-year-old boy.

Deep soft tissue leiomyomas are extremely rare benign tumors in childhood. An unusual case of benign calcified leiomyoma of the pterygoid muscle in an 8-year old boy is presented. Clinical manifestations and radiographic and histologicpathologic findings, as well as the differential diagnosis and possible histogenesis of this rare tumor, are discussed.

Calcinosis↗

Ultrastructural analysis and TUNEL demonstrate motor neuron apoptosis in Werdnig-Hoffmann disease.

Werdnig-Hoffmann disease (WHD) is the most severe clinical type of spinal muscular atrophy characterized by loss of lower motor neurons and paralysis. We examined the hypothesis that disease pathogenesis is based on an inappropriate persistence of normally occurring motor neuron programmed cell death. The diagnosis of WHD was made on the basis of clinical findings, electromyoneurography, and biopsy, and further confirmed by mutation analysis of the survival motor neuron (SMN) and neuronal apoptosis inhibitory protein (NAIP) genes using PCR. We used ultrastructural analysis as well as TUNEL and ISEL methods to assess DNA fragmentation, and immunocytochemistry to identify expression of the apoptosis-related proteins bcl-2 and p53. A significant number of motor neurons in the spinal cord of children with WHD were shown to die by apoptosis. As revealed by TUNEL, dying neurons in WHD patients comprised 0.2%-6.4% of the neuron numbers counted. This finding contradicts earlier studies that failed to find such evidence and suggests that early blockade of prolonged motor neuron apoptosis may be a potential therapeutic strategy for WHD.

Apoptosis↗

Correlation between vimentin expression and morphological features of renal cell carcinoma.

The aim of this study was to analyze the correlation between the expression of vimentin and morphological features of renal cell carcinoma (RCC). We analyzed tumor tissue of 20 patients with RCC. There were 13 female and 7 male patients with RCC confined to the kidney (pT1, pT2). They were ranging in age from 36 to 80 years (mean age 60.6 years). Thirteen tumors measured > 5 cm and 7 tumors < 5 cm in diameter. Two tumors were papillary and 18 tumors showed a non-papillary pattern. Six tumors were composed of granular cells and 14 tumors of clear cells. Formalin fixed, paraffin-embedded tumor tissue was cut at 5 microns, deparaffinized, and stained with a monoclonal antibody to vimentin (Dako, Denmark). There were 4 tumors with nuclear grade I, 3 with grade II, 11 with grade III, and 2 with grade IV. Histopathologic examination showed vimentin expression in eight cases (40%), while 12 tumors (60%) were negative. Positive reaction for vimentin was observed in all four grade I tumors, none of three grade II tumors, four of 11 grade III tumors and in none of 2 nuclear grade IV tumors. In our study, there was no statistically significant difference between the expression of vimentin and morphologic features of RCC. Our study showed the lack of correlation between the expression of vimentin and nuclear grade, cell type and histologic pattern of RCC. Further studies on a larger series of tumors as well as follow-up of patients are obviously needed.

Adult↗

[Primary malignant melanoma of the female urethra].

Primary malignant melanoma of the genitourinary tract is rare and accounts for less than 1 per cent of all melanomas. The most frequent locations in male are penis and urethra. The most frequent site in female is urethra and it most commonly affects meatus and the distal urethra. The prognosis is poor. We report a patient with primary malignant melanoma of the female urethra. Clinicopathologic features and treatment of this tumor are discussed.

Aged↗

Inflammatory myofibroblastic tumor with extensive involvement of the bowel in a 7-year-Old child.

We present a case of unusual localization of inflammatory fibroblastic tumor in the terminal ileum, cecum, and ascending colon in a 7-year-old child. Segmental resection of the terminal ileum, cecum, and ascending colon with a tumor mass up to 6 cm in diameter was performed. Pathohistological examination of biopsy specimen was performed on routine hematoxylin-eosin sections, as well as immunohistochemically with primary antibodies to CD3, CD20, CD68, factor VIII, vimentin, smooth muscle actin, desmin, cytokeratin and S-100 protein, and k and l light chains. The tumor was composed of highly vascularized tissue with interlacing fascicles of elongated spindle cells admixed with plasma cells, histiocytes, lymphocytes, and eosinophils. The diagnosis of inflammatory myofibroblastic tumor was confirmed by immunohistochemistry. Inflammatory myofibroblastic tumor cannot be distinguished clinically from highly malignant neoplasm or some other conditions. Surgical resection and careful pathohistological analysis are needed, and a long-term follow-up is recommended.

Anastomosis, Surgical↗

Unusual features of metastatic atypical carcinoid of the larynx.

This report describes a case of atypical carcinoid of the larynx with metastatic tumor to cervical lymph nodes showing features similar to paraganglioma. Immunohistochemically, both the primary and metastatic tumor were positive for epithelial membrane antigen, cytokeratin, neuron-specific enolase, chromogranin, synaptophysin, calcitonin and carcinoembryonic antigen. The sustentacular cells in pseudo-cell ball ("Zellballen") formations were shown by a positive S-100 marker. Electron microscopic analysis revealed numerous neuroendocrine granules measuring 150-250 nm in diameter. Clinical features, histological appearance, histochemical, immunohistochemical and ultrastructural findings, as well as differential diagnosis are discussed.

Aged↗

Congenital anomalies of the central nervous system at autopsy in Croatia in the period before and after the Chernobyl accident.

In this study, we analyzed the frequency, type and sex distribution of congenital anomalies of the central nervous system (CNS) at autopsy in the period prior to and after the Chernobyl accident in northwest Croatia, one of the areas with the highest exposure to nuclear contamination from Chernobyl. All autopsies in both periods were performed by the same technique, i.e. dissection of the trunk and head, and inspection of the extremities. There were 53 infants with congenital anomalies of the CNS in the period prior to, and 99 in the period after the Chernobyl accident. Our results showed a statistically significant increase in the incidence of CNS anomalies in general (chi 2 = 4,719, p < 0.05, D. F. = 1) and of neural tube defects (chi 2 = 5.380, p < 0.05, D. F. = 1) in the period after the Chernobyl accident. Differences in the incidence of various CNS anomalies, in all types of anomalies, and in sex distribution were not statistically significant. Studies of the association between the Chernobyl accident and congenital anomalies showed no clear changes in the prevalence of anomalies at birth which might have been associated with the accident. This study provided some additional data on the frequency of CNS anomalies in the period after the Chernobyl accident in one of the areas with the highest exposure to the nuclear contamination from Chernobyl. We suggest that the frequency of all anomalies, including CNS, in the period after the Chernobyl accident should be carefully monitored.

Abnormalities, Radiation-Induced↗

Basaloid squamous cell carcinoma of the larynx: report of two cases.

AIM: To present two patients with basaloid squamous cell carcinoma of the larynx, a rare, highly aggressive variant of the squamous cell carcinoma. METHODS: Surgical excision of the polypoid tumor of the anterior comissure of the larynx was performed in a 62 year-old male, and in the second case, total laryngectomy with radical dissection of the neck was performed in a 66 year-old male with supraglottic tumor of the larynx and enlarged lymph nodes of the neck. Histopathological analysis of biopsy specimens was performed on routine hematoxylin-eosin stained sections and on sections stained with antibodies to cytokeratin, epithelial membrane antigen, S-100 protein, neuron-specific enolase, and chromogranin. RESULTS: In both cases, the tumors were composed of moderately pleomorphic basaloid cells forming nests, cords, and cribriform patterns with foci of necrosis, squamous differentiation, and small cystic spaces containing mucin-like material. Surface mucosa showed squamous dysplasia. Cytokeratin and epithelial membrane antigen were positive. After surgery, both patients recieved radiotherapy and had no signs of tumor recurrence or metastases 12 and 15 months later, respectively. CONCLUSION: Basaloid squamous cell carcinoma has a potential for diagnostic confusion because of its basaloid and squamous component. It should be distinguished from adenoid cystic carcinoma that is much less aggressive.

Aged↗

Glandular odontogenic cyst: a case report and clinicopathologic analysis of the relationship to central mucoepidermoid carcinoma.

Glandular odontogenic cyst (GOC), an unusual multilocular cystic lesion of jaws exhibiting the features of both botryoid odontogenic cyst and mucoepidermoid tumor has been reported recently as a new entity with uncertain histogenesis. The World Health Organization named GOC as an independent pathologic entity and classified it as a developmental odontogenic epithelial cyst. We report an additional case, describe its clinicopathologic features, and discuss the similarity to the central mucoepidermoid carcinoma.

Adult↗