The morphometry in histopathology is used to characterize cell populations belonging to different tissues and to identify differences in their parameters with prognostic implications. To achieve morphometric examination were selected 6 of 24 cases identified as small cell lymphocytic lymphoma. For each case analysis was done on five fields, for each field measuring the parameters of 20 cells. The studied parameters were for cytoplasm: cytoplasmic area, maximum and minimum cytoplasmic diameter, cytoplasmic perimeter; for nucleus were measured: nuclear area, minimum and maximum nuclear diameter, nuclear perimeter, nuclear contour index, nuclear ellipticity index, nuclear irregularity index. Also the nucleocytoplasmic ratio was calculated in all studied cases. Small cell lymphocytic lymphoma is characterized in morphometric terms having a small cytoplasmic area (average 29.206) and also a small nuclear area (mean 28.939) having a nucleo-cytoplasmic ratio appearance suggestive for adult lymphocyte. A nuclear contour index small value (3.946), ellipticity index value also small (3.521) and small nuclear irregularity index (3.965). Standard deviations, in any of the studied morphometric categories, is around or below 1 suggesting monomorphic cell appearance. These morphometric and microscopic features characterized mainly by a small population of adult lymphocytes, monomorphic, with rounded hipercromic nuclei, dense chromatin, support the framing into indolent lymphoma group in terms of clinical outcome.
The morphometry in histopathology is used to characterize cell populations belonging to different tissues and to identify differences in their parameters with prognostic implications. To achieve morphometric examination were selected 6 of 8 cases identified as marginal zone lymphoma. For each case analysis was done on five fields, for each field measuring the parameters of 20 cells. The studied parameters were for cytoplasm: cytoplasmic area, maximum and minimum cytoplasmic diameter, cytoplasmic perimeter; for nucleus were measured: nuclear area, minimum and maximum nuclear diameter, nuclear perimeter, nuclear contour index, nuclear ellipticity index, nuclear irregularity index. Also the nucleo-cytoplasmic ratio was calculated in all studied cases. Marginal zone lymphoma is characterized in terms of morphometric parameters by small cytoplasmic and nuclear area, and small nucleo-cytoplasmatic ratio of about 1:1. Nuclear contour index is small, accompanied by a large ellipticity index and an small index of nuclear irregularity. Standard deviations for measured morphometric parameters are variable, having high values for cytoplasmic and nuclear area, highlighting the polymorphic nature of the cells. Morphometric aspects, with corresponding microscopic aspects of large and small lymphocyte proliferation with cleaved and uncleaved nuclei, fit this form of lymphoma in terms of clinical outcome in indolent lymphomas category.
The study was retrospective and the purpose was to assess how screening and monitoring of chronic kidney disease are performed in patients with diabetes mellitus, in terms of routine medical practice. The study was performed on a sample of 127 patients with diabetes mellitus who died during hospitalization, between 2006-2010. Data were collected from autopsy reports and from clinical medical records of patients with diabetes mellitus, aiming for 5 years prior to death. The main cause of death was represented by cardiovascular events (61.4% of patients). Most of the patients associate high blood pressure and dyslipidemia. To diagnosis and monitoring the development of chronic kidney disease were performed albuminuria measurements (0.6 determinations / patient / year) and serum creatinine measurements (0.41 determinations / patient / year). 91.8% of patients with diabetes duration greater than 1 year had at least one determination of albuminuria within five years. Most patients in the study group associated multiple cardiovascular risk factors. Investigations for diagnosis and monitoring the development of diabetic kidney disease are performed less frequently than recommendations and the causes are multiple.
A large number of publications recognize that there are melanocytic lesions with microscopic features similar to melanoma, related to their location, with no prognostic importance. Those locations are represented by the ear, the milk lines (axillary, breast, periumbilical and inguinal regions), palms, soles and flexural regions. The periumbilical nevi are included by some authors in the category of the flexural nevi. In 2004, Rongioletti et al., performed a study on a number of 101 breast nevi, considering 10 histologic parameters. Starting from Rongioletti’s study we measured 10 histologic parameters on 121 nevi (26 from the periunmbilical area) and notes with 0 if absent or impossible to evaluate and with 1 if present. The score for each lesion ranged from 0 to 6 and we compared the features of the periumbilical nevi with the nevi from the control sites and found that the ones in the periumbilical area have more frequently atypical features than the nevi from the other sites (lemtiginous proliferation of nevus cells, architectural disorder of the nevus cell nests and stromal reactions as dermal fibroplasias and dermal lymphocytic infiltrate). We also performed immunohistochemical examination on lesions that presented three or more of the examined histologic parameters, but the results were not very suggestive. The conclusion of this study is that the atypical features of the breast nevi are only site related atypias and have no hormonal influences
V. Cristurean, Mariana Deacu, Corina Nour, Roxana-Celopatra Penciu and Mariana Aschie
Preeclampsia is a multisystemic disease with yet unknown etiology, specific only for human gestation and with symptoms like arterial hypertension, proteinuria and edema. The study group was composed by 65 pregnant women with gestational age between 38-40 weeks, which gave birth in Obstetrics and Gynecology Clinic of Constanta Emergency Clinical County Hospital, during January 2001 - July 2011 and was divided in two groups, A and B, depending on the blood pressure values measured during hospitalization. Group A was composed of 33 hypertensive pregnant women and group B was composed of 32 pregnant women with physiological pregnancy evolution. The retroplacental arterioles diameter was measured by specific methods of morphometry, the probes being obtained from myometrial tissue after caesarian section for both groups. Morphometric differences between spiral retroplacental arterioles of preeclampsia pregnant women and of those with physiological evolution during gestation certify the presence of incomplete structural parietal vessel wall changes in preeclampsia.
Mădălina Boşoteanu, C. Boşoteanu, Mariana Deacu and Mariana Aşchie
Liposarcoma is the most common malignant mesenchymal neoplasm affecting soft tissues and, less frequently, viscera. Gastric localisation of liposarcoma is extremely rare. We present the case of a 69-year-old female patient, who underwent subtotal gastrectomy with processing of the specimen in the Clinical Service of Pathology, Emergency County Hospital of Constantza. Histopathologically, the tumor exhibits a neoplastic population composed predominantly of lipoblasts in different stages of differentiation, with a massive disposition involving submucosa, muscularis and serosa. These cells contain intracytoplasmic small optically empty lipid vacuoles that produce indentations of centrally located nuclei; isolated lipoblasts have the appearance of signet ring cells. Predominant cellular population is admixed with scattered mature adipocytes and with stellate/spindled mesenchymal cells. Tumoral stroma has a myxoid character. A distinctive feature of this neoplasm is the existence of a vascular network composed of curved thin-walled capillaries with a branching pattern (“chicken-wire”). The histopathological traits and immunohistochemical profile of this tumor, characterized by positive reaction to Vimentin and S100 and negative staining to pancytokeratin, support the diagnosis of myxoid liposarcoma. The rare incidence of this tumor in the stomach requires a careful microscopical examination, in order to differentiate it from other clinico-pathological entities and to apply an appropriate therapy with a proper monitoring protocol.
Deacu Mariana, Așchie Mariana, Bălțătescu Gabriela Izabela and Boșoteanu Mădălina
The role of histopathology department in establishing a correct and final diagnosis is essential, this leading to an effective treatment for the patient so its healing to be complete. In order to achieve this goal, it is necessary that all complex steps belonging to this department to be properly carried out because any mistakes in a pathology report may adversely affect the patient outcome. Therefore, it is mandatory the quality assessment of all procedures from the laboratory to be constantly done so that the report to be reliable and accuracy. All three main categories of activities specific to a pathological laboratory (pre-analytic, analytic and post-analytic phases) must undergo quality control. During the progress of these phases, it also must be identified the risks and safety problems regarding the personal staff. These may be different for each activity or procedure which is performed by the laboratory workers. All the physical, chemical or biological hazards must be identified to assess, appreciate the possible risks and to implement preventive measures. The aim of this study is to highlight the importance of quality management for all phases included in a surgical pathological laboratory based on the pathological errors observed, identify emerging risks exposure and necessary measures to prevent them.
Mirela-Simona Nicodim, Mariana Aşchie, Doina Catrinoiu and Laurenţiu-Tony Hangan
Background and Aims. Patients with diabetes mellitus, especially type 2 diabetes, have often a multifactorial renal impairment. The aim of this study was to correlate renal vascular lesions occurring in patients with diabetes mellitus with clinical and laboratory parameters. Material and method. We performed a retrospective study on a sample of 127 patients with diabetes mellitus, who died in hospital. Data from necropsies were correlated with the clinical and laboratory data collected from the medical records of these patients. Results. Renal vascular lesions were frequently found in patients from the study group. The most common were nephroangiosclerosis lesions, which correlated with age, diabetes duration, systolic blood pressure and mean fasting glucose. Conclusions. Most patients in the study group had multiple cardiovascular risk factors (advanced age, dyslipidemia, hypertension) that explain the high prevalence of renal vascular lesions.
Sinziana-Andra Ghitoi, Mariana Aşchie, Manuela Enciu, Georgeta Camelia Cozaru and Anca Chisoi
Non-Hodgkin malignant lymphomas represent a heterogeneous group of monoclonal tumors developing from cells belonging to the immune system. Primary gastric lymphomas are defined as those malignant limphoproliferative diseases whose initial symptoms are located in the stomach or tumor mass located in the stomach. This paper aims to present a new case of primary gastric non Hodgkin lymphoma diagnosed by histologic and immunohistochemical examination of a partial gastrectomy specimen. The patient is a 51-years old man with a history of smoking, hospitalized for asthenia, hematemesis and melena. Microscopically the tumor consisted of mature small lymphocytes admixed with plasmocitoid lymphocytes and mature plasmocytes. Some of the tumoral cells showed citoplasmatic pas positive inclusions. Immunohistochemical stains were strongly positive for CD20 and 30-40% positive for Ki67.Based on the clinical and histological findings, a diagnosis of gastric primary non-Hodgkin lymphoma was established.
Gabriela Izabela Bălţătescu, Mariana Aşchie, I. Poinăreanu and Manuela Enciu
Primary neuroendocrine tumor of breast is a rare tumor, with few cases reported each year and with an incidence less than 1% from all neuroendocrine tumors. In our report we present a case of a postmenopausal woman with a lump in her left breast whose histopathological aspect was strongly suggestive for primary solid neuroendocrine breast carcinoma. Immunohistochemical examination has been done using a panel of seven biomarkers in order to confirm our initial diagnose and both prognostic and predictive factors. We used cromogranin A, synaptophysin and neuron-specific enolase as neuroendocrine biomarkers. Diagnose was proved by a positive reaction in more than 50% of tumor cells for the first two antibodies. Immunophenotype of the tumor (estrogen and progesterone receptor positive, low Ki6 index and no supraexpression of HER2) is consisted with luminal A molecular subtype. The prognosis was good based on clinic-pathological features and immunohistochemical expression. The patient has a good clinical evolution after surgical treatment and adjuvant therapy, with no local recurrence or distant metastasis after 3 years of surveillance.