Nedávné zavedení WHO klasifikace cytologie pankreatobiliárních nádorů si kladlo za cíl zlepšit diagnostiku a management těchto tumorů. V předkládané práci jsou stručně popsány metody diagnostiky těchto tumorů. Důraz je pak kladen na detailní srovnání předešlé klasifikace dle Papanicolaou a nové WHO klasifikace a změny, které zavedení WHO klasifikace přivádí. V poslední části článku pak přinášíme konkrétní zajímavé případy z naší praxe ilustrující možná diagnostická úskalí cytologického hodnocení.
The recent introduction of the WHO cytology classification of pancreatobiliary tumours aimed to improve the diagnosis and management of these tumours. The present paper briefly describes the methods of diagnosis. Emphasis is then put on a detailed comparison of the previous Papanicolaou classification and the new WHO classification and description of the changes brought about by the introduction of the WHO classification. In the last part of the paper, we present interesting cases from our practice illustrating possible diagnostic pitfalls of cytological evaluation.
- MeSH
- cholangiopankreatografie endoskopická retrográdní metody MeSH
- cytologické techniky metody MeSH
- diagnostické zobrazování metody MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory slinivky břišní * diagnóza patologie MeSH
- nádory žlučového ústrojí * diagnóza patologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
Sarcoidosis is a disease characterised primarily by lung tissue involvement. Extrapulmonary involvement, particularly in the genitourinary tract, is extremely rare, particularly when it comes to primary disease detection in this location. The gold standard in establishing a definitive diagnosis of sarcoidosis is a combination of the clinical picture, the results of imaging methods, and histopathological examination from the biopsy taken (thus ruling out other causes of granulomatous inflammation). However, it is common for the biopsy to be infeasible or for the patient to refuse such an examination, resulting in the neglect of this critical verification. We introduce the case of a young 29-year-old man of Czech nationality who had been complaining for some time about non-specific pain above the pubic bone and in the lower abdomen, which was combined with a painless enlargement of the right half of the scrotum. Due to suspected malignancy, it was, after considering clinical, imaging, and laboratory findings, decided to perform a radical orchiectomy as a treatment option. The histological examination revealed that it was not cancer, but rather a rare genitourinary form of extrapulmonary sarcoidosis. In this case, radical resection had been, therefore, unnecessary. We also present a review of the literature on published extrapulmonary, genitourinary, and testicular sarcoidosis cases. All the above demonstrates the importance of considering a possible atypical sarcoidosis manifestation and histological confirmation before pursuing radical solutions.
- MeSH
- adheze tkání * diagnóza etiologie komplikace MeSH
- cervix uteri patologie MeSH
- diagnostické zobrazování metody MeSH
- gynekologické chirurgické výkony klasifikace metody škodlivé účinky MeSH
- hysteroskopie metody MeSH
- lidé MeSH
- uterus * patologie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
- Klíčová slova
- isthmocele,
- MeSH
- císařský řez * škodlivé účinky MeSH
- jizva komplikace MeSH
- lidé MeSH
- uterus patologie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- MeSH
- hysteroskopie * MeSH
- lidé MeSH
- senioři MeSH
- vzácné nemoci * diagnóza patologie MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Fractured bones can regenerate and restore their biological and mechanical properties to the state prior to the damage. In some cases, however, the treatment of fractures requires the use of supportive implants. For bone healing, three processes are essential: the inflammatory phase, the repair phase and the remodelling phase. A proper course of the first - inflammatory - stage is important to ensure a successful fracture healing process. In our study, we evaluated tissue samples immunohistochemically from the area surrounding the fractures of upper and lower limbs (bone tissue, soft tissue, and the implant-adhering tissue) for markers: CD11b, CD15, CD34, CD44, CD68, Cathepsin K, and TRAcP that are linked to the aforementioned phases. In soft tissue, higher expressions of CD68, CD34, CD15 and CD11b markers were observed than in other locations. TRAcP and Cathepsin K markers were more expressed in the bone tissue, while pigmentation, necrosis and calcification were more observed in the implant-adhering tissue. Since even the implant materials commonly perceived as inert elicit the observed inflammatory responses, new surface treatments and materials need to be developed.
- Klíčová slova
- submukózní myom,
- MeSH
- diagnostické zobrazování metody MeSH
- hysteroskopie metody MeSH
- leiomyom diagnóza etiologie patologie terapie MeSH
- lidé MeSH
- myom * chirurgie diagnóza etiologie klasifikace terapie MeSH
- myometrium diagnostické zobrazování patologie MeSH
- nádory dělohy diagnóza etiologie klasifikace patologie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
BACKGROUND Histiocytic sarcoma is a rare malignant hematopoietic neoplasm with morphologic and immunohistochemical features of histiocytic differentiation, usually with unfavorable prognosis. Despite aggressive biological behavior, in subgroup of patients with localized disease, the prognosis can be very good. Few publications are available on localized cases of histiocytic sarcoma. These occur infrequently and continue to be a poorly-recognized morphological entity. CASE REPORT A 73-year old man treated for Parkinson syndrome presented with a tumor resistance on the dorsal surface of the left forearm. This lesion was clinically seen as an organized hematoma and was surgically resected. Histologically, the tumor was situated in the dermis and subcutis and it consisted of multiple neoplastic nodules. Vasoformative growth patterns with the vascular-like spaces containing erythrocytes and hemosiderin pigment presence simulated the morphology of angiosarcoma. Based on the immunohistochemical characteristics, we diagnosed the tumor as cutaneous histiocytic sarcoma. Genetic analysis revealed immunoglobulin heavy-chain gene rearrangement without any concomitant hematological malignancy. The patient demonstrated no systemic disease or impairment associated with diagnosed histiocytic sarcoma, and no recurrence has been found to date. CONCLUSIONS We report a case of primary cutaneous histiocytic sarcoma with an excellent outcome after surgical treatment only. Clinical data and histopathological and immunohistochemical evaluation were essential to rule out other malignant tumors in the differential diagnosis. Genetic analysis together with up-to-date knowledge and understanding of principles of tumorous transformations helped to diagnose this poorly-recognized entity with various clinical behaviors.
- MeSH
- endometrium * diagnostické zobrazování patologie účinky léků MeSH
- estrogenní substituční terapie MeSH
- hysteroskopie MeSH
- inhibitory aromatasy farmakologie škodlivé účinky terapeutické užití MeSH
- klomifen farmakologie škodlivé účinky terapeutické užití MeSH
- kontraceptiva hormonální farmakologie klasifikace škodlivé účinky MeSH
- levonorgestrel škodlivé účinky terapeutické užití MeSH
- lidé MeSH
- metformin farmakologie škodlivé účinky terapeutické užití MeSH
- nemoci dělohy chemicky indukované diagnostické zobrazování patologie MeSH
- nežádoucí účinky léčiv * diagnostické zobrazování epidemiologie patologie MeSH
- receptory progesteronu terapeutické užití MeSH
- tamoxifen škodlivé účinky terapeutické užití MeSH
- testosteron dějiny škodlivé účinky terapeutické užití MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- přehledy MeSH
