Biomedical subjects

M Ludvíková

Publications and source records attributed to M Ludvíková.

At least 19 recordsLinked to original sources

PubMed2006

[Prediction of treatment outcome after adjuvant loco-regional chemotherapy following liver resection for colorectal metastases--preliminary results].

INTRODUCTION AND AIM OF STUDY: Czech Republic leads the worldwide league in colorectal cancer's occurrence. Colorectal liver metastases are detected in about a half of patients with colorectal cancer. Liver resection of colorectal metastases is currently the only potentially curative treatment with a chance for a long-term survival rate. Until now there has remained a question of whether adjuvant HAIC can improve the treatment results of radical resection. The aim of our study is to verify predictive efficiency of thymidylátsyntasis (TS), dihydropyrimidindehydrogenasis (DPD) and thymidinfosforylasis (TP) in patients undergoing adjuvant hepatic artery infusion chemotherapy (HAIC) following radical liver resection for colorectal metastases. METHODS: From 1990 to 2005 80 patients underwent 84 liver resections for colorectal metastases. R0 resection was achieved in 60 events. Ten patients who underwent R0 resection both for primary cancer and for colorectal liver metastases and who were given portcatheter for HAIC were included in this study. Adjuvant chemotherapy contained 5-fluorourycil (1200 mg/m2) combined with oxyliplatinum and leukovorin. Whole dose was administered via hepatic artery. The samples were procured both from healthy liver tissue and from metastases for imunohistochemical and molecular biological analysis. RESULTS: The recurrence of disease was verified in 2 of 10 included patients (20%). We detected neither occurrence of death nor serious complication in early postoperative course in none of ten patients. Low expression of TS was found in both events and very high expression of DPD in one event was detected. DISCUSSION: High expression of DPD in one of these patients could contribute to lower outcome of adjuvant chemotherapy. Low expression of TS in both patients responds to the written statement regarding contribution of adjuvant chemotherapy only in patients with high TS level. CONCLUSION: The expression of TS and DPD responds to expected outcome of HAIC. Low number of patient does not permit statistic evaluation.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed2004

Epithelioid haemangiosarcoma of the thyroid gland. Report of six cases from a non-Alpine region.

AIM: To report a series of six cases of thyroid haemangiosarcoma (HAS) from a non-Alpine region. METHODS AND RESULTS: The patients were four females and two males, aged 54-81 years (average 68 years). The tumours presented as large haemorrhagic masses (diameter 40-70 mm, average 56 mm) with extensive necrosis. Histologically, they were composed of polymorphous epithelioid cells with vesicular nuclei and abundant eosinophilic cytoplasm with occasional intracytoplasmic lumina. Mitotic activity was high. Tumor cells expressed vimentin (6/6), CD31 (6/6), FVIII (5/6), CD34 (2/6), and cytokeratins (5/6). One tumour (1/6) over-expressed p53 protein in more than 20% of cells. Ultrastructurally, Weibel-Palade bodies were present (4/6). Clinical follow-up of four patients (range 3-24 months, median 9 months) showed that two of them have died of the disease 0.5 and 3 months after diagnosis, one died of unrelated causes (with 24 months' uneventful follow-up) and one is alive 21 months after operation with no evidence of disease. CONCLUSIONS: Although thyroid HAS is usually regarded as an extremely aggressive neoplasm with a dismal prognosis similar to anaplastic carcinoma, one of our cases suggests that HAS can behave in a less aggressive way. The morphological, immunohistochemical and ultrastructural findings support the hypothesis that thyroid HAS is a distinct entity, unrelated to other thyroid malignancies.

Aged↗

PubMed2004

[Thyroid peroxidase in the differential diagnosis of thyroid gland lesions. A marker of biological behavior or differentiation?].

Human thyroid peroxidase (hTPO) is a membrane protein with a key role in the thyroid hormones synthesis. Loss of hTPO was described in malignant tumours of the thyroid gland. hTPO was tested as a marker of malignancy. Immunohistochemical study of hTPO in 321 thyroid lesions (45 malignant tumours, 72 benign tumours, 199 benign non-tumours lesions, and 5 normal thyroid glands) is presented. The sensitivity of hTPO in predicting malignancy in thyroid is 64%, and the specificity is 87%. Thus, hTPO is of limited value in the diagnosis of thyroid malignancy. The authors discuss the role of hTPO as a marker of differentiation.

Adolescent↗

PubMed2003

Dipeptidyl peptidase IV expression in thyroid cytology: retrospective histologically confirmed study.

Fine needle aspiration cytology (FNAC) of the thyroid gland is a well-established method. However, it has inherent limitations, especially in the diagnosis of follicular and oncocytic tumours and in distinguishing between nuclear atypia in colloid goitre with regressive changes and cystic papillary carcinoma. The aim of our study was to evaluate dipeptidyl peptidase IV (DPP IV) as a marker of malignancy in FNAC. We tested 254 thyroid specimens (intraoperative imprint smears) for DPP IV. The sensitivity was 71%, the specificity was 96%, and the diagnostic accuracy was 93%, respectively, with a threshold of 50% of positive cells. To the best of our knowledge it is the largest histologically confirmed study reported in the literature. We suggest the assessment of DPP IV as an adjunct diagnostic marker of malignancy in thyroid specimens suspicious of papillary carcinoma. However, the value of the marker in follicular lesions is very limited.

Adolescent↗

PubMed2003

Molecular diagnosis of Epstein-Barr virus in paraffin-embedded tissues of tumors with abundant lymphoid infiltration.

To evaluate the significance of Epstein-Barr virus (EBV) infection in tumorogenesis, we examined ten archival samples of acinic cell carcinomas of salivary glands with lymphoid-rich stroma, four archival samples of lymphoepithelioma-like carcinomas (LELC) of the urinary bladder, ten samples of oncocytic papillary carcinoma of the thyroid (Warthin-like tumors) and one sample of lymphoepithelioma-like carcinoma of the cervix, together 25 paraffin-embedded tumor tissues. Polymerase chain reaction (PCR) and in situ hybridization (ISH) assays were used. The EBV genome was detected by PCR using primers targeting the IR region. ISH was performed using EBER oligonucleotide probes. Each examination was repeated two times. Positive PCR result was obtained in 12% of samples only. However, this result was not confirmed by the subsequent second PCR examination. ISH revealed negative signals in all samples. Our results demonstrate the importance of the diagnostic strategy based on combination at least two independent methods. PCR due to its sensitivity may produce false positive results depending on the degree of infiltration the tumor sample by EBV carrying lymphocytes.

DNA, Viral↗

PubMed2003

[Dipeptidyl peptidase IV (DPP IV, CD 26): a tumor marker in cytologic and histopathologic diagnosis of lesions of the thyroid gland].

BACKGROUND: Morphological diagnostics of thyroid gland tumours faces certain differential diagnostic problems. Extensive histological examination of the entire tumour is required for the final diagnosis of follicular and oncocytic tumours. Thus, assessment of reliable definitive cytological and/or intraoperative histological diagnosis is not possible. No marker of malignancy has been so far generally accepted in the thyroid tumour diagnosis. The aim of the study was to evaluate membrane protease dipeptidyl peptidase IV (DPP IV) in the differential diagnosis of thyroid tumours. METHODS AND RESULTS: DPP IV was assessed cytochemically in 254 smears, histochemically in 314 cryostat sections, and immunohistochemically in 309 paraffin-embedded sections obtained from the group of 336 patients. There were 283 females and 53 males with the mean age of 48 years (range 15-80 years) in this series. Sensitivity of cytochemical detection was 71%, specificity was 96%, and diagnostic accuracy was 93% using the 50% threshold. Histochemically, sensitivity was 71%, specificity was 93%, and diagnostic accuracy was 90% using the 5% threshold. Using the immunohistochemical assessment, sensitivity was 68%, specificity was 94%, and diagnostic accuracy was 91% using the 5% threshold. CONCLUSIONS: According to our results, DPP IV can be used as a marker of malignancy in well-differentiated carcinomas of follicular cell origin, namely in papillary carcinoma. However, it is less reliable in follicular and oncocytic carcinomas.

Adolescent↗

PubMed2003

Immunohistochemical detection of dipeptidyl peptidase IV (CD 26) in thyroid neoplasia using biotinylated tyramine amplification.

Differential diagnosis between malignant and benign thyroid tumors derived from follicular cells can pose certain difficulties in routine surgical pathology. The aim of the study was to evaluate dipeptidyl peptidase IV (DPP IV/CD 26) in differential diagnostics of thyroid lesions. DPP IV/CD 26 was evaluated in thyroid glands of 309 patients (261 females and 48 males, age range of patients 15-80 years). DPP IV/CD 26 was assessed in paraffin-embedded thyroid specimens immunohistochemically using commercially available antibody (Serotec) and biotinylated tyramine amplification kit (DAKO). Well-differentiated carcinoma revealed DPP IV/CD 26 positivity in 33 out of 42 cases (79%). Neither medullary nor insular carcinoma was DPPIV/CD 26 positive (only one case of each tested). DPPIV/CD 26 expression in isolated cells was seen in 18/261 (7%) benign disorders. The sensitivity of the method was 68%, the specificity was 94%, and the diagnostic accuracy was 91%, respectively, using 5% threshold of positive follicular cells. DPP IV/CD 26 can be assessed immunohistochemically using biotinylated tyramine amplification kit. DPP IV/CD 26 could be an adjunct in the thyroid gland differential diagnosis. However, DPP IV/CD 26 positivity is limited to the group of well-differentiated carcinomas, particularly papillary carcinoma. Furthermore, it is of limited value for follicular and oncocytic tumors.

Adolescent↗

PubMed2002

[Dipeptidyl(amino)peptidase IV in the differential diagnosis of thyroid gland tumors: methods and results of a pilot study of 200 cases].

The use of dipeptidyl aminopeptidase IV (DPP IV) staining by azo-coupling in preoperative and intraoperative diagnostics of thyroid lesions is presented. In a series of 200 histologically confirmed cases examined, the sensitivity and the specificity were 71% and 99%, respectively in 124 smears, and 70% and 94%, respectively in 189 frozen sections. DPP IV expression showed high negative predictive value as well. DPP IV is suggested as an additional tool in the preoperative and intraoperative diagnostics of thyroid lesions.

Adolescent↗

PubMed2002

[Role of the MIB-1 proliferative markers in the diagnosis and prognosis of tumors of the thyroid gland].

Well-differentiated thyroid tumors may sometimes cause diagnostic uncertainty due to difficulties in the evaluation of certain morphological criteria (capsular and/or vascular invasion, cytomorphological features). Therefore, various diagnostic/prognostic markers are currently studied, namely the markers of tumor proliferation. The aim of our study was to evaluate the proliferative MIB-1 index in 155 thyroid tumors, and to correlate it with morphological diagnosis, size of the tumors, and the patients' age. Oncocytic tumors were represented by 59 follicular adenomas, 27 follicular carcinomas and 12 papillocarcinomas. Nononcocytic tumors comprised 24 follicular adenomas and 33 conventional papillary carcinomas. The Ki-67 antigen (formalin resistant epitope MIB-1) was detected immunohistochemically and the proliferative index (PI) of tumors was evaluated. The results were statistically analyzed using analysis of variance (ANOVA) and Wilcoxon tests (significance level p < 0.05). Carcinomas showed significantly higher PI than adenomas. Moreover, PI in oncocytic adenomas was higher than in nononcocytic ones. However, proliferative activity in all types of the carcinomas was similar. The higher rates of proliferation correlated with the advanced age of the patients with follicular carcinomas (p < 0.0016).

Adenoma↗

PubMed2002

[Secondary changes in the thyroid gland induced by aspiration cytology].

Due to the introduction of fine needle aspiration cytology (FNAC) to the routine clinical preoperative examination surgical pathologists are faced with thyroid gland specimens with FNAC-induced secondary changes. These changes can cause diagnostic difficulties and be a source of incorrect diagnosis. Authors present a review of FNAC-induced changes with differential diagnostic criteria helpful in these pitfalls. FNAC-induced changes can be schematically divided into two major groups--recent ones (intranodal bleeding and/or necrosis) and subacute/late ones (proliferation of granulation tissue with predominance of myofibroblasts or endothelial cells, resorptive pseudoxantomathous granulomas, formation of sarcoid-like granulomas, capsular pseudoinvasion and scarring). Pathologists should be informed about the previously performed FNAC and must be aware of these lesions to prevent their misinterpretation.

Biopsy, Needle↗

PubMed2001

Oncocytic papillary carcinoma with lymphoid stroma (Warthin-like tumour) of the thyroid: a distinct entity with favourable prognosis.

AIMS: We report the clinicopathological and immunohistochemical characteristics of 12 cases of a recently recognized entity, oncocytic papillary thyroid carcinoma (PC) with lymphoid stroma (Warthin-like tumour). METHODS AND RESULTS: The cases were retrieved from the surgical pathology files of our departments. There were 11 female patients and one male patient; they ranged in age from 45 to 85 years (mean 64.2 years). The immunohistochemical profile demonstrated positivity of tumour cells for cytokeratins, thyroglobulin, Leu-M1 and anti-mitochondrial antigen. S100 protein-positive stromal dendritic/Langerhans cells were uniformly present. Polymerase chain reaction, in situ hybridization, and immunohistochemistry for Epstein-Barr virus (EBV) detection revealed no significant positive signal. MIB-1 labelling index was low, compatible with that of 'classical' PC. CONCLUSIONS: Warthin-like tumour is a rare variant of PC, occurring predominantly in elderly women. Its histological features are distinct and well recognizable, differentiating this tumour from a more aggressive tall-cell variant of PC. The apparent indolent behaviour seems to be consistent with the presence of dendritic/Langerhans cells and with low proliferative activity. A possible role of EBV in pathogenesis of this lesion was not proven. Further studies are necessary to determine the prognosis and metastatic potential of this neoplasm.

Adenolymphoma↗

PubMed2001

[Stromal tumor of the small intestine--a cause of massive gastrointestinal hemorrhage].

A 41-year-old man attended our clinic with massive gastrointestinal bleeding due to a tumor of the small intestine. The tumor was not diagnosed until during acute laparotomy. The histological examination revealed a gastrointestinal stromal tumor with uncertain biological behaviour. The authors discuss the rare gastrointestinal stromal tumors, where preoperative diagnosis is difficult and in symptomatic forms urgent laparotomy is usually the only diagnostic method. The differential diagnosis between leiomyoma, schwannoma, mesenterial fibromatosis or intraabdominal solitary fibrous tumor as well as metastatic melanoma is not simple and immunohistochemistry plays a leading role. Prediction of biological behaviour of these tumors is also problematic and depends on the histological picture, site, size and mitotic activity.

Gastrointestinal Hemorrhage↗

PubMed2000

[Angiogenesis in tumors. Part II. Methods and significance of quantification; angiogenesis as a prognostic indicator and the target of therapeutic approaches].

The efforts to quantify tumor angiogenesis (AG) have been limited by the methods available. Only since introduction of immunohistochemistry, detection of early stages of capillary vessel formation is enabled. There were reports showing strong correlation between AG and behavior of the tumor (namely formation of metastases, disease free interval, and overall survival) particularly in carcinomas of the breast, prostate, esophagus, stomach and colon. However, significance of these studies is strongly dependent on the methodological aspects, e.g. the choice of visualized endothelial antigen, microscopic magnification and selection of areas with highest angiogenic activity (so called "hot spots"). We present a review of studies focused on AG and discuss pitfalls, which could bias the results. Current clinical applications as well as perspectives of future antiangiogenic treatment are also discussed.

Breast Neoplasms↗

PubMed1998

Gastric lipoma presenting as upper gastrointestinal obstruction.

A 61-year-old man presented with an upper gastrointestinal obstruction caused by a submucosal gastric lipoma in the prepyloric area. The diagnosis was made coincidentally during his admission for another disease. Gastric resection was performed because of a large lipoma combined with florid gastric ulcers. The frequency of gastric lipoma, its differential diagnosis, means of diagnosis, and treatment are discussed.

Diagnosis, Differential↗

PubMed1998

Hyalinizing spindle cell tumors with giant rosette-like structures.

We report two cases of hyalinizing spindle cell tumors with giant rosettes arising in the pararectal space and soft tissues of the wrist in a 46-year-old man and 22-year-old-woman, respectively. Microscopically, the tumors exhibited a varied morphology, including hyalinizing hypocellular and cellular fibromatosis-like areas. The most striking morphologic feature was the formation of giant rosette like structures with collagen cores scattered throughout the tumors. Most of the tumor spindle cells were diffusely immunoreactive for lysozyme, CD-68, factor XIII and vimentin. Reactivity for smooth muscle actin, desmin and S-100 protein was not found. Ultrastructural examination of the rosettes in one case only showed normal native collagen.

Adult↗

PubMed1998

Pigmented microcystic chromophobe cell carcinoma: a unique variant of renal cell carcinoma.

Five cases of pigmented chromophobe renal cell carcinoma are presented. The patients included four men and one woman between the ages of 60 and 73 years (median age, 66.5 years), who presented with symptoms due to their renal mass. Surgical resection of the renal mass was performed in all patients. Grossly, the tumors were well encapsulated, yellow to dark gray, with a vague nodular pattern on cut surface. The tumors varied between 2.5 and 9 cm in greatest diameter. Histologically, all tumors shared similar features, namely, a malignant cellular proliferation composed of deeply eosinophilic to clear cytoplasm with round nuclei and inconspicuous nucleoli. The cellular proliferation was arranged in a microcystic and/or microalveolar pattern. In one tumor, conventional areas of clear cell carcinoma in association with the chromophobe component were present. In addition, all tumors contained pigmented areas, which were shown by light microscopy to have features of lipochrome pigment. Ultrastructural studies of these areas demonstrated the presence of intracytoplasmic polygonal to round, electron-dense pigment granules, which in some areas seemed to coalesce to form larger granules. In addition, numerous mitochondria and cytoplasmic vesicles were present. The cases described herein highlight an additional morphologic variant of chromophobe renal cell carcinoma.

Aged↗

PubMed1998

Nodular mucinosis of the breast: report of three cases.

Three cases of nodular mucinosis of the breast are presented. They occurred in one male and two female patients. The patients had no signs of Carney's syndrome. All lesions were located under the nipple. They were poorly circumscribed and unencapsulated. They were soft and had a gelatinous consistency and white color. No patient had any evidence of recurrence or metastasis 6 months, 3 years and 6 years, respectively, after the surgical excision. The mucinous tissue consisted of acid mucopolysaccharides, which stained Alcian blue, Hale's colloidal iron positively, and they were periodic acid-Schiff (PAS) negative. Mucicarmine reaction was only faintly positive. The lesion should be distinguished particularly from mucocele-like lesions of the breast by the location, nodular arrangement, absence of accompanying ductal hyperplasia and staining properties of the mucous substances.

Adenocarcinoma, Mucinous↗

PubMed1997

Intrathyroidal lymphoepithelial cyst. A report of two cases not associated with Hashimoto's thyroiditis.

Two cases of intrathyroidal lymphoepithelial cyst are described. Both of them were solitary, one being found incidentally in a patient operated on for a multinodular goiter, the other being clinically obvious as a cold nodule. They exhibited features of cysts of branchial cleft origin, i.e. squamous cell lining epithelium and abundant lymphoid tissue with reactive germinal centers. The thyroid gland parenchyma showed a discrete lymphoid infiltration consistent with the diagnosis of focal lymphocytic thyroiditis. In the first case a single epidermoid solid cell nest was found. The histogenesis of intrathyroidal lymphoepithelial cysts remains unclear, but their origin from cystically degenerated ultimobranchial body remnants (solid cell nests) seems to be most probable. This assumption is supported by a similar immunohistochemical profile of solid cell nests and epithelial cells lining the cysts and also by the presence of one solid cell nest in the proximity to the cyst in one of our cases.

Adult↗