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J Słodkowska

Publications and source records attributed to J Słodkowska.

At least 19 recordsLinked to original sources

[Benign clear cell tumor of the lung (sugar tumor). Morphologic, immunohistochemical and ultrastructural evaluation].

Clear cell tumour or "sugar tumour" of the lung is a rare primary neoplasm with unique histologic and electron microscopic features that may resemble those of metastatic renal cell carcinoma. An immunohistochemical studies are useful in a differential diagnosis these tumours: HMB45 in combination with a panel of various antibodies. The authors present a benign clear cell tumour of the lung, diagnosed on the base of its morphological, immunohistochemical and ultrastructural features.

Adenocarcinoma, Clear Cell↗

[Expression of transforming growth factor beta 1 (TGF beta 1) and angiogenesis in broncho-pulmonary carcinoids].

TGF beta 1 commonly produced by normal and neoplastic human cells, has capacity to regulate new blood vessel formation, to establish and maintain the vessel wall integrity; was found to have some significance in the lung cancer prognosis. Tumour angiogenesis is an important factor for tumour growth and metastasis. The purpose of this study was to find, if the immunoexpression of TGF beta 1 has any significance in determination of the histologic subtypes of carcinoids?; to find, if TGF beta 1 has any role and relation to carcinoids angiogenesis?; and to explore TGF beta 1 expression and angiogenesis with respect to metastatic potential of carcinoids. The study was performed on 48 resected broncho-pulmonary carcinoids: 35 typical (TC) and 13 atypical (AC), classified according to the WHO. Semiquantitative analysis for TGF beta 1 was performed. Sections stained using monoclonal antibody against TGF beta 1 were scored in scale from 0 to 4, according to the percentage of positively stained cells (pc) plus percentage of positively stained stroma (ps). The microvessels stained with CD34 monoclonal antibody, were counted in 0.75 mm2 field (microvessel density--MD), using the computerised image analysis system SAMBA 2005 (the morphometric software). The histologic subtype of carcinoids was related to age of the pts (AC occurred in older pts than TC, p = 0.027), to the tumour size (AC were larger than TC: respectively--3.25 cm and 2.4 cm, p = 0.009). Lymph node metastases were significantly more frequent in AC than in TC (38% vs 13%, p = 0.025). 85% carcinoids showed TGF beta 1 expression with various intensity, mainly in the stroma. There was no significant correlation between TGF beta 1 expression and tumour size, the histologic subtype nor the lymph node metastases. The angiogenesis expressed as MD, was not related to histology, nor to the presence of lymph node metastases. There was no correlation between TGF beta 1 expression and angiogenesis. Shown in our study, lack of relation between TGF beta 1 expression and angiogenesis, could support some of the published data indicating indirect action of TGF beta 1 on the angiogenesis. The rich vascularity found in carcinoids morphology could result from TGF beta 1, commonly expressed by the tumoural stroma. The angiogenesis nor TGF beta 1 expression do not determinate the carcinoids histology.

Adult↗

[Usefulness of CD1 expression on surfaces of cells in bronchoalveolar fluid for diagnosis of histiocytosis X--our experience].

Histiocytosis X (HX), also referred as Langerhans cell granulomatosis is a disorder characterized by the presence of destructive granulomas containing Langerhans cells, lymphocytes, eosinophils and fibroblastes in the involved organs. Three presentations are commonly observed: 1) nonproductive cough or effort dyspnea, 2) spontaneous pneumothorax 3) incidental pulmonary infiltrates on chest X-ray in asymptomatic patients. HRCT may be helpful in the initial diagnosis of pulmonary HX. HRCT scans show nodules, cysts and estimate the extent of disease. But the final diagnosis of histiocytosis X requires the histologic demonstration of specific histiocytosis X cell in biopsy specimens of the lung. The aim of this study was to define the importance of the detection of Langerhans cells in bronchoalveolar lavage fluid (BALF) for the diagnosis of HX. The searched cells express a specific CD1 antigen, recognized by the monoclonal antibody OKT-6. In our study the demonstration of more than 5% of CD1 positive cells was defined to confirm HX. We have studied the BALF in 21 patients with suspected histiocytosis X. In BALF of 4 patients more than 5% of CD1 positive cells were found. In 1 of them HX was confirmed with open lung biopsy. Two patients displayed 5% of CD1 positive cells. The final diagnosis of the first patient was hypersensitivity pneumonitis and of the second one was bronchitis chronica. In 5 patients out of 15 patients in whom less than 5% of CD1 positive cells were found histiocytosis X was histologically proven. In other 10 patients the following disorders were histologically recognised: pulmonary emphysema 3 cases, pneumoconiosis-3, LMA-BOOP-1, sarcoidosis-1 and pleuritis eosinophilica-1. The estimation of Langerhans cells in BALF can be a useful method among the diagnostic procedures for histiocytosis X. It is necessary to remember that demonstration of less than 5% of CD1 positive cells do not exclude histiocytosis X.

Adult↗

[Infection as a main or additional cause of death in patients treated for small cell lung cancer].

The aim of this study was to analyse the frequency of infection as a cause of death in small cell lung cancer (SCLC) patients. Our material consisted of 845 unselected SCLC patients, 246 women and 599 men, aged 29-78 years, treated between 1980-1994 in the Institute of Tuberculosis in Warsaw. 479 patients had limited and 366 extensive disease. 530 were in good (0-2) and 315 in bad (3-4) performance status. 784 patients died. Autopsy was done in 211 patients. Infection was regarded as a main cause of death in 39 patients (4.6%) and as a coexistent cause in 77 (9.1%). At the time of death from and/or with infection in 16 patients complete remission and in 27 partial remission of cancer was confirmed. The risk of death from and/or with infection was not related to the age and sex or to the performance status of patients and to extension of cancer. The risk of death from and/or with infection in the first 3 months of treatment was however greater for patients in bad performance status and with extensive disease and later (after 3rd months) for patients in good performance status and with limited disease.

Adult↗

[The cause of infection as the main or additional cause of death in patients treated for small cell lung cancer].

In 116 out of 845 patients treated for small cell lung cancer (SCLC) in the Institute of Tuberculosis and Chest Disease in Warsaw in the years 1980-1994 infection was the main or coexistent cause of death. In 4.1% infection was proved of bacterial origin and in further 6.5% of probable bacterial origin (in the later group cultures were negative or not done but fungal infection, pneumocystosis pneumonia and tuberculosis were excluded on autopsy). In 1.54% infection was of fungal origin, 1.2% patients died of Pneumocystis carinii pneumonia and 0.35% of tuberculosis. The majority of patients who died with and/or from infection had treatment-related leukopenia and 99 of them were treated with corticosteroids. Fungal infection, pneumocytosis and tuberculosis were found more frequently than bacterial infection in patients treated with cumulative dose of prednisone above 2000 mg. 33.62% patients had no symptoms or signs of infection. No connection was found between the absence of symptoms and treatment with steroids or the grade of leukopenia. In all cases infection was recognised very late, in 58 only at autopsy.

Adult↗

[Myocardial infarction as a cause of death in patients treated for small cell lung cancer].

The aim of our study was to assess frequency of death from myocardial infarction in patients (pts) treated for small cell lung cancer (SCLC). 33 out of 845 patients treated for SCLC died from myocardial infarction. All patients were smokers. In 6 patients coexisted hypertension, in 2--diabetes and in 5--obesity. Eight patients have had cardiac disease in anamnesis. All patients were treated with one or more number of cardiotoxic drugs as DDP, VCR or VBL, E, MTX and ADR which are able to cause ischemic heart disease or myocardial infarction. Sixteen out of 33 patients have had radiotherapy of lung tumour. Death from myocardial infarction occurred from 0.5 up till 98.5 months from the beginning of start treatment. Eighteen men died from myocardial infarction in the first year of treatment. Risk of death from myocardial infarction was 15 times greater in men with SCLC than in men of the polish population at the same age and at the same time.

Adult↗

[Pulmonary thromboembolism as the main or secondary cause of death in patients treated for small cell lung cancer].

The aim of this study was to assess the frequency of pulmonary thromboembolism in small cell lung cancer (SCLC) patients (pts) treated in the Institute of Tuberculosis and Chest Diseases in the years 1980-1994. The second aim was to assess whether the occurrence of thromboembolism is connected with the progression of cancer. Pulmonary thromboembolism was recognised in 17 out of 845 pts (2.01%) treated for small cell lung cancer, that is in 2.01% of pts. The frequency of thromboembolism was 8% among patients in which autopsy was done. Pulmonary thromboembolism occurred in 7 pts during progressive disease but also in 9 with partial or complete regression of SCLC. The potential role of chemo- and radiotherapy in the development of thromboembolism in the last group was discussed.

Adult↗

[Our experience in bronchiolitis obliterans organising pneumonia (BOOP): personal experience].

BOOP is a disease with characteristic histology features which can occur as a secondary lung reaction to the various toxic agents or as a primary idiopathic disease. Idiopathic form of BOOP is a rare disease and may be found in 6-7 patients of 100,000 hospital admissions. We described 3 patients with idiopathic BOOP confirmed by the histologic lung examination. The time from the beginning of symptoms till the microscopical diagnosis ranged from 6 to 12 months. At the beginning of the disease the patients had symptoms compatible with the respiratory infection. In one of the patients the clinical course of the disease had a progressive character. In two patients spontaneous regression of radiological lung lesions was observed. This regression was however only temporary in one of them. In two cases treated by steroids regression of lung lesions was noticed.

Adult↗

[Early and late results of surgical treatment for bronchial carcinoids].

UNLABELLED: The aim of the study was to evaluate the efficacy and safety of surgical treatment of the bronchial carcinoids. Between 1983 and 1996 52 patients (pts) with typical carcinoid were operated. The group consisted of 23 males and 29 females aged from 20 to 68 years (mean 41.3 years). In the chest X-ray and CT scan round shadow were found in 21 (40.4%) cases, lung tissue atelectasis in 23 (44.1%) cases. The bronchial tree was normal in fiberoptic bronchoscopy in 8 cases. We performed 4 pneumonectomies, 3 wedge resection and 45 lobectomies (including 5 "sleeve" lobectomies). We haven't recorded any early post-op deaths. Only two pts (3.8%) developed post-op complications--cardiac arrhythmias. In two cases the surgical treatment was followed by radiotherapy for metastases in regional lymph nodes. The period of follow-up ranged from 3 to 166 months (mean 62.2 months). During that time we noticed the recurrence of tumor in 2 pts (3.8%). One patient died from cardiac reason. The 5-year survival among patients operated in the period 1983-1992 was 91.2%. The 10-year survival in the group of pts operated on between 1983 and 1987 was 90%. CONCLUSION: The surgical treatment of bronchial carcinoid is method of choice, very efficient and safe.

Adult↗

[The pattern of small cell lung carcinoma in autopsy (based on material of the Pathology Department, National Institute of Tuberculosis and Lung Diseases in Warsaw].

The aim of this study was to review autopsy findings in small cell lung carcinoma (SCLC) patients (pts)--in order to assess the distribution of the disease at the time of death and to analyse the pattern of SCLC in relation with different therapeutic modalities. The pattern of autopsy findings was assessed in 100 pts SCLC: 85 pts after treatment with chemotherapy, with or without chest and cranial irradiation; and 15 pts without any therapy. The primary tumours were present in 59% pts (50 of 85), the residual tumour deposits were diagnosed in 32% (27 of 85) pts. The significant difference in the rate of locoregional disease was found between pts given chemotherapy and pts after combined therapy. The tumours occurred significantly more frequently in pts after chemotherapy, than in pts after chemotherapy with irradiation on the chest (75% and 41% respectively, p = 0.03). The chest irradiation with chemotherapy caused less frequent occurrence of the residual tumours than chemotherapy alone (48% and 20%, respectively, p = 0.026). The rate of brain metastases was significantly higher in pts given chemotherapy than in pts treated with chemotherapy and chest irradiation or chemotherapy and curative brain irradiation (90%, 67% and 36% of 50 cases, respectively). Distant metastases were distributed in the same pattern in both studied groups. The distribution of metastases was not dependent on the disease extent at the time of diagnosis.

Adult↗

[Cytostatic treatment of patients with advanced non-small cell lung cancer].

92 patients with advanced non-small cell lung cancer were treated with cisplatin 80 mg/m2 day 1 and etoposide 120 mg/m2 on days 1-3. In 58 of them vinblastine 5 mg/m2 was also applied on days 1 and 3. In 25% of all cases partial response and in another 26% minimal regression was found after 2 courses of chemotherapy, independently to treatment modality. Partial regression was observed significantly more often in patients with adenocarcinoma, but survival time was significantly shorter in this group. Median survival time was 8 months for all patients, 10 months for stage IIIB and 6 months for stage IV. This difference was significant.

Adenocarcinoma↗

[Typical and atypical pulmonary carcinoids--pathologic and clinical analysis of 77 cases].

Neuroendocrine tumors of the lung represent a group of controversial pulmonary neoplasms regarding their classification, criteria for diagnosis, predictors of future behavior, and therapy. The histologic criteria for their classification rest heavily on the proposed by Arrigoni et al. in 1972, for atypical carcinoid (AC). According to these authors AC has mitoses between 5 and 10 per 10 high power fields (HPF), necrosis, hypercellularity and disorganized architecture. The survival analysis performed by Flieder et al. (1997) for a variety of clinical and histologic features revised the histologic criteria for separating AC from typical carcinoid (TC) and proposed a range of mitotic counts between 2 and 20 per HPF for AC. From 1978 until 1997, 77 resected pulmonary carcinoids were reclassified for TCs and ACs according to Flieder's et al. histologic criteria. The clinical and pathological various features were studied for the group of 62 TCs and 15 ACs. 77 patients (pts) entered the study: 29(38%) males and 48(62%)females; mean age 43 years, range 18-75 years, 46 pts underwent lobectomies, 16 bilobectomies, 12 pneumonectomies and 3 wedge resections. The patients with TC were younger than those with AC (males: 40 vs 50 years and females 42 vs 49 years). TCs were significantly smaller than ACs (mean diameter respectively: 24 mm vs 33 mm). Fifty four (87%) of TCs and all ACs had central localization. The time of patients observation ranged from 2 months to 18 and half years; 2 patients with TC died due to tumours progression; 3 due to other diseases. Regional lymph node metastases occurred in 10% TCs and 33% ACs (p = 0.032). The heterotopic bone formation appeared in 11(18%) TCs and 2(13%) ACs. The mitotic counts for AC range between 2 and 6 per 10 HPF, accompanied by small foci of necrosis in 2 cases. Peripheral carcinoids showed a spindle-cell morphology. The performed study has highlighted the new concept of the carcinoids classification and the importance of the mitotic counts as histologic criteria for AC diagnosis. The data based on the largest in Polish literature lung carcinoids collection.

Adolescent↗

[Primary biliary cirrhosis with sarcoid-like infiltrations in the lung].

A women, 50 years old, has been observed for 4 years because of recurrent infiltrations in both lungs. Biopsy of those lesions revealed sarcoid-like granulomas. Tubercle baccilli were not present in those lesions nor in the sputum or bronchial washings. Anti-tuberculosis therapy was without effect. On admission to our hospital she was in good performance state. There was an infiltration in the base of the left lung. Hepatosplenomegaly was observed on USG examination. Aspartate aminotransferase was 49 UI/l, alanine aminotransferase 70 UI/l. Alkaline phosphatase was 167 UI/l and the titer of antimitochondrial antibodies was 1:2000. Primary biliary cirrhosis was suspected, but the patient refused liver biopsy. Prednisone in the dose of 60 mg per day was given to suppress the granuloma formation in the lungs. During this treatment there was a decrease in size of liver and spleen, lung lesion disappeared and the titer of antimitochondrial antibodies decreased to 1:40. After 3 months of treatment the dose of prednisone was reduced gradually. When she was receiving 15 mg of prednisone every other day the titer of antimitochondrial antibodies rose to 1:8000 and the activity of alkaline phosphatase to 448 UI/l. At this time she accepted liver biopsy. Primary biliary cirrhosis was diagnosed. The possible connection between sarcoid-like granulomas in the lungs and the primary biliary cirrhosis is discussed.

Biopsy↗

[Pneumocystis carinii infections in patients with neoplasms and AIDS--clinical-pathologic changes in the lungs].

Pneumocystis carinii (PC) has been documented as a cause of pneumonia in a broad range of immunocompromised patients. The presentation of disease will very based on the underlying predisposing condition but a confirmation depends upon the identification of organisms in a bronchial aspiration or lung biopsy specimen. This retrospective study based on autopsies of 15 patients (pts) with AIDS and 12 non AIDS pts with neoplastic diseases. Pneumocystis carinii pneumonia (PCP) was confirmed by histologic examination. The clinico-pathological analysis emphasizes a spectrum of morphologic variation of the disease in relation to the clinical course of a principal disease. A distinction was made between the microscopical diagnosis of PC infection in AIDS and non AIDS pts; the burden of organisms in infected AIDS pts appeared greater than that of neoplastic diseases (mostly with small cell lung carcinoma). Nonspecific features of diffuse alveolar damage associated with PC organisms were identified in 67% of non AIDS pts and 13% of AIDS pts. Various degree of interstitial fibrosis was more prominent in AIDS pts (67%) than in non AIDS pts. The high frequency of atypical changes in lung might be the result of various chemotherapeutic agents used in managing these pts or repeated pulmonary infections.

AIDS-Related Opportunistic Infections↗

The value of immunohistochemical identification of neuroendocrine differentiation in non small cell lung carcinoma.

Neuroendocrine differentiation (NE) has been found to be a feature of neuroendocrine tumours and also a proportion of non-small cell lung carcinomas. Detection of NE by immunohistochemical assays depends on spectrum of used antibodies and criteria. Immunohistochemical identification of NE in non-small cell lung cancer has been discussed in an article together with criteria, diagnostic helpfulness and prognostic value of this feature.

Biomarkers, Tumor↗

Trophoblastic markers and CEA in non-small cell lung cancer: the comparison studies of tumour cells expression and serum concentration.

The study was designed to explore the tumour cell expression of three markers: hCG, SP1 and CEA in lung cancer in relationship with histological type and histological differentiation of tumours as well as serum concentration of antigens. 58 primary resected lung cancers: 28 adenocarcinomas, 27 squamous cell and 3 large cell carcinomas were included. Tumours immunoreactivity of three markers was evaluated by semiquantitative analysis. Simultaneously serum tumour markers were measured in 42 patients by enzyme radioimmunoassays. CEA and SP1 expressions in lung tumours were found in a majority of carcinomas-86% and 79% respectively. Expression of tumour markers was not associated with any certain histological type of carcinoma but was more characteristic for moderately and well differentiated adenocarcinomas. hCG positive tumour staining was less frequent than CEA and SP1 (only 22% tumours) and was much less intensive (5-50% population of carcinomatous cells) in the tumours. The study showed correlation between increased serum CEA concentration and tumour expression of antigen.

Adenocarcinoma↗

Prolidase and prolinase activities in moderately and poorly differentiated lung adenocarcinoma.

Prolidase (E.C.3.4.13.9) and prolinase (E.C.3.4.13.8) activities were determined in normal human lung and human lung adenocarcinomas of various degree of histologic differentiation. Since these dipeptidases were found to be enzymes catabolizing mainly collagen and simultaneously involved in the recycling of proline for collagen biosynthesis, the measurement of this protein and its degradation products in studied tissues (by hydroxyproline determination) was performed. It has been found that the activity of prolinase in G2-moderately and G3-poorly differentiated lung adenocarcinoma groups, was elevated compared to lung parenchyma and that the increase was proportional to the degree of adenocarcinoma differentiation. Prolidase activity was elevated only in G3 lung adenocarcinoma. The increase of prolidase and prolinase activities were accompanied by an increase of tissue collagen content. Collagen degradation products (CDP) represented one third of total collagen in control lung tissues while in lung adenocarcinomas the CDP represented significantly lower percentage of total tissue collagen. The results suggest that prolidase and prolinase activities may reflect: (i) degree of differentiation of lung adenocarcinoma and (ii) disturbances in tissue collagen metabolism.

Adenocarcinoma↗