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Biomedical subjects

O Hes

Publications and source records attributed to O Hes.

At least 19 recordsLinked to original sources
PubMed2006

Urological complications of congenital nephrogenic diabetes insipidus--long-term follow-up of one patient.

A male with a severe form of congenital nephrogenic diabetes insipidus (diuresis 10 l per day) had megaureters, megavesica, large residuum and a history of three traumatic ruptures of the megavesica and a recurrent urinary tract infection (RUTI). Hemodialysis was introduced at 41 years of age. At age of 42, he underwent a bilateral retroperitoneoscopic nephrectomy to prevent further RUTI and 8 months later transplantation of a cadaver kidney. Intermittent catheterization is necessary due to residual urine in the urinary bladder.

Diabetes Insipidus, Nephrogenic↗
PubMed2006

Frequent expression of neuroendocrine markers in mucinous tubular and spindle cell carcinoma of the kidney.

Mucinous tubular and spindle cell carcinoma (MTSCC) is a new tumorous entity which has been recently established. In this article, we examined the expression of neuroendocrine markers including neuron specific enolase (NSE), chromogranin A and synaptophysin in 16 cases of MTSCC using immunohistochemistry. The sex ratio (male: female) of the patients was 4:12. In normal kidney, distal tubules or collecting ducts were positive for NSE, but no structures were positive for chromogranin A or synaptophysin. All MTSCCs showed a positive reaction for NSE. Additionally, fifteen of sixteen neoplasms (93.8%) with MTSCC showed the expression of either chromogranin A or synaptophysin or both. Finally, it is possible that MTSCC may be one of renal neoplasms which frequently exhibit the neuroendocrine differentiation.

Adenocarcinoma↗
PubMed2006

[Massive breast angiomatosis with dramatic course leading to acute total mastectomy--a case report].

OBJECTIVE: On the background of clinical, radiological and morphologic settings presented is unusual case of the rare angiomatosis of the female breast. Discussed are both clinicopathological aspects and differential diagnosis from the morphological point of view. DESIGN: Case report. SETTING: Biopsy Lab s.r.o. and Sikl's Department of Pathology, Charles University and Faculty Hospital, Pilsen. METHODS: As a case report described is a rare case of the angiomatosis of the female breast. Implemented illustrations consist of local findings, CT scan, specimen gross appearance and histological pictures including immunohistochemistry. Applied antibodies and detection system LSAB+ were provided by Dako, visualization was performed by chromogen DAB (diaminobenzidin tetrahydrochlorid). RESULTS: 30-year-old woman suffering of painful, enormous breast asymmetry underwent core needle biopsy of the right breast. The mastogram showed diffuse process of ambiguous significance. During the next few days her condition dramatically changed and under the circumstances of florid apoplexy and suspicion of tumor of her right breast, total mastectomy was carried out. Histological picture revealed widespread, unlimited vascular lesion dissecting throughout the stroma of the entire gland. Bland morphology and the nature of tissue involvement eventually led to diagnosis of benign angiomatosis. The woman underwent several local plastic operations but is out of final reconstruction of her breast so far. Thirteen months after mastectomy there are no signs of recurrence.

Adult↗
PubMed2006

[Harmatoma of the breast--case report].

OBJECTIVE: To describe rare hamartoma of the breast in a 31-year-old female. DESIGN: Case report. SETTINGS: Department of Special Diagnostics SPAU, Charles University Hospital Pilsen. SUBJECT AND METHOD: A 31-year-old female was examined for breast asymmetry. A huge tumor was revealed in right mammary gland using ultrasonography. Encapsulated tumor 10x10x10 cm was removed. Subsequent histological examination revealed breast hamartoma. The patient is alive and well without signs of disease one year after excision. CONCLUSION: Hamartoma of the breast is a rare benign tumor. Diagnostics is very complicated and it is almost impossible to establish correct diagnosis preoperatively. A simple excision is a sufficient treatment with good curative effect.

Adult↗
PubMed2005

Chromophobe renal cell carcinoma with microcystic and adenomatous arrangement and pigmentation--a diagnostic pitfall. Morphological, immunohistochemical, ultrastructural and molecular genetic report of 20 cases.

We present clinical, morphological, immunohistochemical, ultrastructural and molecular genetic features of 20 cases of a peculiar form of chromophobe renal cell carcinoma (CRCC) with morphology differing from that of conventional CRCC. Microscopically, the typical features of the tumors were microcystic arrangement and formation of adenomatous structures. Microcystic areas were composed of smaller eosinophilic and bigger pale cells having cytological appearance typical of conventional CRCC. Cytological features of the adenomatous structures were mostly different from those of conventional CRCC. They had a typical columnar arrangement with nuclei positioned at the base of the glandular structures and a small amount of a deeply eosinophilic cytoplasm often endowed with brush border facing the lumen of the glands. In addition, all the tumors showed a brown pigmentation. The pigmentation was located mostly extracellularly, where it formed pools of heavy deposits. Microscopic calcifications present in all cases formed psammoma bodies or else the calcifications were more extensive and amorphous in shape. Ultrastructurally, the cells showed features characteristic of CRCC: typical cytoplasmic vesicles were 100-700 nm in size and mitochondria had tubulovesicular, lamellar or circular cristae. Some tumor cells contained dark, variously sized electron-dense pigment granules. Neither melanosomes nor membrane-bound neurosecretory granules were seen. Using fluorescence in-situ hybridization probes for chromosomes 1, 2, 6, 10, 13, 17 and 21, the tumors revealed massive loss of tested chromosomes typical for conventional CRCC. Monosomy of chromosomes 1, 2, 6, 10, 13 and 21 was found in 100, 36, 91, 82, 82, 82 and 64% of cases, respectively. None of the cases showed mutation of exons 9, 11, 13 and 17 of the c-kit gene. The important feature of pigmented microcystic chromophobe renal cell carcinoma is a relatively benign biological behavior and the absence of distant metastases and sarcomatoid transformation.

Adenoma, Oxyphilic↗
PubMed2005

[Pseudolymphoma of the breast nipple. The problem overview].

Clinical, pathological, and molecular-genetic features as well as etiology of cutaneous pseudolymphoma (CPL, cutaneous lymphoid hyperplasia, lymphocytoma cutis) of the breast nipple are summarized. CPL presents as a nipple induration and it is often suspected to be Paget carcinoma pre-operatively. Histologically, atypical microscopic features of a dense lymhoid infiltrate with follicles often mislead to the diagnosis of a malignant lymphoma. However, CPL runs a benign course. Rare cases of CPL contain a clonal lymphoid population. A substantial number of CPL in the breast nipple is caused by antigenic stimulation by Borrelia burgdorferi. In some patients a tick bite is documented. CPL of the breast is commonly treated by excision, but some patients may be cured by antibiotic therapy. The presence of Borrelia burgdorferi should be detected using methods of serology, culture, and molecular biology. Beside CPL, the differential diagnosis of the breast nipple lesions further includes Paget carcinoma, eczema, and florid papillomatosis.

Adult↗
PubMed2005

[Tumorous diseases in patients with the testicular feminization syndrome ("androgen insensitivity" syndrome)--description of two cases].

OBJECTIVE: To describe tumors occurring in two cases of testicular feminization syndrome. SUBJECT: Case report. SETTING: Dpt. of Special Diagnostics SPAU, University Hospital Plzen. SUBJECT AND METHOD: Two cases of testicular feminization syndrome were selected from four cases in our registry. Patients were 45 and 84-year-old Caucasian "females". Resected material was fixed in formaldehyde, routinely processed and stained with hematoxiline-eosin, inhibin, cytokeratines 20, placentar alkaline phosphatase, CD 99, Melan A, hCG. Sertoli cell adenoma was diagnosed in both patients. Older patient had in addition unclassified sex cord tumor of Leydig cell type. The number of sex chromosomes was examined using FISH analysis in both patients. CONCLUSION: Patients with testicular feminization syndrome are frequently affected by benign or malignant tumors in the cryptorchid testes. We documented two benign Sertoli cell adenomas and one sex cord tumor of uncertain biological behavior in our patients. The testes should be removed after puberty with subsequent estrogen therapy in patients with testicular feminization syndrome.

Aged↗
PubMed2005

[Miniinvasive laparoscopic or retroperitoneoscopic radical nephrectomy for the parenchymal tumor].

INTRODUCTION: Laparoscopic (LRNE) or retroperitoneoscopic (RRNE) radical nefrectomy originally published in 1991, respectively in 1993, began to be introduced in common practice at the end of the 20th century. In this work we summarize our findings gathered upon introduction of these methods. SUBJECTS AND METHODOLOGY: We present a group of 50 miniinvasive nephrectomies conducted during 2003-2004 (46 LRNE and 4 RRNE). LRNE was combined with ipsilateral adrenalectomy in five cases and with cholecystectomy in three cases (in all cases the LRNE was on the right side). RESULTS: The mean age of the patient subjects was 65 +/- 11 years (34-81). The blood loss was 134 +/- 201 ml (30-1200). The tumor size according to the CT was 50 +/- 13 mm (30-82). Histologically, 45x renal carcinomas, 4x oncocytomas, 1 x urothelial carcinomas were diagnosed. The drain was removed 2.1 +/- 0.9 days following the surgery. The mean hospitalization time was 6.1 +/- 1.6 days (4-9). Only a single major, however lethal, complication arised: In a 74-year old female, the left-sided LRNE due to the carcinoma pT3bG2 and at the same time vaginal hysterectomy, extraction of the renal preparation through the vagina and anterior and posterior vaginoplasty (for a prolaps) were conducted. The patient was repeatedly revised for haemoperitoneum and she exited on the 18th postoperative day due to pneumonia. The mean duration of the LRNE was 168 +/- 40 minutes (80-265). The combined LRNE and cholecystomic procedure lasted 265 minutes. The mean duration of the LRNE with CHE was 213 minutes, and of the LRNE with adrenalectomy was 170 minutes. In 4 cases of the RRNE (indicated three times due to preceeding major surgical procedures in the abdominal cavity and once for the Crohn's disease) the mean duration was 203 minutes. CONCLUSION: Miniinvasive RNE in TI tumors is a modem reproducible methodology suitable for application in clinical practice. The laparoscopic approach appears more appropriate. The retroperitoneoscopic approach is indicated mainly in cases of postoperative adhesions in the abdominal cavity.

Adult↗
PubMed2005

[Emphysematous cystitis due to Clostridium perfringens--a localised infection in a man with generalized melanoma].

Emphysematous cystitis was found at autopsy of a 47-year-old man suffering from generalised malignant melanoma. Bacteriological cultures from the urinary bladder showed Escherichia coli, Klebsiella sp. and Clostridium perfringens type A, toxic strain. The histological examination revealed cystic dilatation of lymphatic vessels both in bladder mucosa and muscularis propria. There were multinucleated macrophages in the lining of some of these cystic spaces and a few Gram-positive rods inside their lumina. In the mucosal and submucosal connective tissue there were signs of chronic inflammation and, focally, small haemorrhages. We suppose that the gas production was due to the presence of Clostridium perfringens and believe that the infection of the urinary bladder occurred in relation to the repeated insertion of the catheter into the bladder of a patient with secondary immunosuppression. Emphysematous cystitis was, in our case, a localised clostridial infection without clinical and morphological signs of generalised septicaemia.

Clostridium Infections↗
PubMed2005

[The liver splenosis in a patient following a procedure for the malignant seminoma].

Splenosis is characterized by a presence of islets of the splenic tissue in the abdominal and, rarely, also in the thoracic cavity, most frequently as a consequence of the splenic injury. The authors describe a case of splenosis in a patient followed-up after surgery and radiotherapy for the testicular seminoma and who, 42 years ago, had splenectomy for polytrauma. With respect to the location of the splenosis in the hepatic region, the differential diagnosis was difficult, bearing in mind a possibility of the malignancy relaps. Although splenosis was highly suspected, based on the results of the examinations conducted, with respect to the preexisting malignancy, the tumor was excised. The histopathologist confirmed the diagnosis of splenosis. This case is rare in the literature, considering the time gap between the diagnosis of splenosis and the trauma.

Diagnosis, Differential↗
PubMed2005

[Renal angiomyolipoma, histology, diagnostics and therapy].

BACKGROUND: Renal angiomyolipoma is a benign mezenchymal tumour with prevalence of 0.3-3% of all surgically resected renal tumours. Tumour is often associated with tuberous sclerosis complex or with another fakomatosis. Tumour has typical pathological image in computer tomography notation that enables the diagnosis. Symptomatology and possible complications depend on the tumour size. Large or symptomatic tumours are indicated for resection, nephrectomy or local ablation. METHODS AND RESULTS: 612 patients with renal tumour were operated at the Department of Urology faculty hospital in Pilsen. Angiomyolipoma occurred in 7 patients. Average age at the time of operation was 64 years, ratio female and male was 5:2. Clinical symptomatology was expressed in 3 patients. The size of tumour was 2 to 8 cm, in 5 patient the tumors were solitary. Translumbal tumour resection was performed in 3 patients. These tumours were at the same time multifocal. Suspicion from tuberous sclerosis was pronounced in some care. The angiomyolipoma was accidentally found in 2 cases of nephrectomy, which was indicated for other diagnosis. CONCLUSIONS: We define diagnosis by means of CT notation in the most of patients. This notation is not typical by any version of angiomyolipoma and we choose therefore surgical revision.

Aged↗
PubMed2004

[Spindle cell and cuboidal renal cell carcinoma (loopoma). 10 case reports].

BACKGROUND: Current classification systems of neoplasms arising from renal parenchyma distinguish 5 categories of renal cell carcinoma (RCC), i.e. conventional RCC, papillary RCC, chromophobe RCC, collecting duct/medullary RCC and unclassified RCC. We present 13 cases of unusual and unclassified spindle and cuboidal renal cell carcinomas. METHODS AND RESULTS: The studied group consisted of 13 patients (7 men and 6 women). They ranged in age from 22 to 65 years (mean 57.3). Generally, the tumours were well circumscribed and confined to the kidney, whitish to grey on section with a diameter 4.5-13 cm (mean 8.6 cm). One patient was investigated for loin pain and nocturia. Three patients had staghorn nephrolithiasis and vague sonographic findings in renal parenchyma. In one patient the renal tumour was found when examined on follow-up examination for prostatic adenocarcinoma. None of our patients was known to have elevated levels of parathyroid hormone due to hyperplasia, adenoma or carcinoma of the parathyroid gland. Clinical follow-up of the patients ranged from 9 months to 8 years (mean 2.3 years). Microscopically, the tumours were composed of two main populations of cells: flattened, spindle cells with sparse cytoplasm and small cuboidal cells with clear to light eosinophilic cytoplasm. Eight patients are currently well without signs of recurrence or metastasis, one had metastasis in the regional lymph node at the time of nephrectomy, one died of unrelated cause, and three were lost to follow-up. CONCLUSIONS: We present 13 cases of unclassified RCC. Our cases were histologically, immunohistochemically and ultrastructurally similar to the hitherto reported case reports of this variant of RCC. It is obvious, that that variant of RCC should be recognised as a new subtype of RCC.

Adult↗
PubMed2004

[Splenic peliosis associated with adrenal adenoma].

PURPOSE: Peliosis of the spleen is very rare disease diagnosed mainly histologically. The ethiopathogenesis is still unknown and various factors can play the important role (steroids, chemotherapy, chronic infection, hematology disease etc.). Authors present the case of peliosis of the spleen which was combined with suprarenal adenoma. METHOD: The splenectomy for the large spleen with suspicion from lymphoma was done in hypertonic patient with normocytic normochromic anaemia. During operation the left suprarenal adenoma was revealed and epinephrectomy was performed. The diagnosis of peliosis of spleen was done by histological examination. The hypothesis of the connection between hormonal activity of the suprarenal adenoma and development of the peliosis was expressed. Unfortunately the suprarenal adenoma was not diagnosed before operation and so plasma hormone levels were not evaluated. RESULTS: The postoperative course of patient was without complications and patient was discharged 8th postoperative day. One year after operation the patient is in the good health condition. The hypertension is corrigated on the lower dosage of antihypertensive medicaments. CONCLUSIONS: It is probable, that the suprarenal adenoma could play the important role in the ethiopathogenesis of peliosis of the spleen in our case.

Adenoma↗
PubMed2004

[Mesenteric fibromatosis. Case report].

The authors describe a case of a young patient, who underwent a by-pass surgery for ileus of the small intestinal loops due to a wide-spread tumor of the mesentery, conducted in a different hospital. The patient was then re-operated in the Faculty hospital in Plzen, the tumor was successfully removed en-block and the pathologist came to a conclusion and diagnosed mesenterial fibromatosis. The case is being discussed from the point of view of the rarely occurring intraabdominal fibromatosis.

Fibroma↗
PubMed2004

[The peroperative biopsy--an overview of its problematical aspects from the pathologist's viewpoint].

A summary work presenting technically difficult to process lesion samples and those which cannot be diagnosed on peroperative biopsy. The authors specify arguments against examinations of small mammary gland tumors (measuring less than 1 cm in diameter), post-bioptic tumors and sentinel lymph nodes. Furthermore, the authors describe difficulties in processing the adipose tissue resulting in complicated evaluation of the mammary gland tumors in the resection line. Obstacles in the peroperative examination of the thyroid gland lesions are also listed here. In this case, the freezing technique results in smearing specific cytological featuries of the examined tissue. Diagnostic criteria for all non-papillary tumors of the thyroid gland are explained in this article. Application of the above mentioned criteria is, however, worthless in the peroperative biopsy, which is also explained in this work. In the last part of this study, the authors describe macroscopic featuries of the mucinous ovarial tumors and their differentiation from the gastrointestinal tract adenocarcinoma metastases, using macroscopy and histological techniques.

Biopsy↗
PubMed2004

[Papillary renal cell carcinoma surrounded by unusual fibrotic reaction resembling inflammatory pseudotumour--a case report].

Authors report clinicopathological features of an unusual case of composite renal lesion occuring in 32-year-old Caucasian male. The patient was followed for cystic lesion of retroperitoneal-renal region for 5 years. He was indicated for resection of the cystic lesion because of changes of the retroperitoneal mass on CT scan. A cyst was located on upper renal pole. A huge cystic mass filled mainly by necrotic material was resected and submitted for histological examination. The wall of the cyst was composed of fibrous tissue, indistinguishable from inflammatory pseudotumor on histological level. The vital intracystic tissue was formed by well-differentiated papillary renal cell carcinoma. The most important step within differential diagnosis is distinguishing of sarcomatoid differentiation in renal cell carcinoma. This very rare case demonstrates the importance of careful examination of all spindle cell lesions of the kidney.

Adult↗
PubMed2003

[Cystic abdominal lymphangioma in adults].

Cystic abdominal lymphangioma is a rare tumor in adult age. It occurs usually in children and is localised mostly in the head and neck. Only 2-8 % of lymphangiomas are localised intraabdominally. We present a case of a 20-year-old man who complained about acute abdominal pain after physical activity. Diagnosis of intraabdominal multilocular cyst was done by ultrasound, computed tomography and coeliacography. The definitive diagnosis of lymphangioma of the hepatoduodenal ligament was established by laparotomy and histologic examination of the specimen. Cystic abdominal lymphangioma is a rare disease in adults with difficult preoperative diagnosis. The surgical extirpation often completed with resection of involved organ is the method of choice in the treatment of this rare disease.

Abdomen↗