Bartłomiej Grala - Academia.edu (original) (raw)
Papers by Bartłomiej Grala
Polish journal of radiology / Polish Medical Society of Radiology, 2010
Sialolithiasis is the most common disorder of major salivary glands. The main site of salivary st... more Sialolithiasis is the most common disorder of major salivary glands. The main site of salivary stones' formation is submandibular gland, followed by parotid and sublingual gland. The aim of this article was to present current diagnostic imaging modalities carried out in patients suspected with salivary stones on the basis of own material and review of literature.Current diagnostic imaging tools used in the imaging of salivary stones were described and illustrated in this paper. These are: conventional radiography, sialography, ultrasonography, computed tomography, magnetic resonance sialography and sialoendoscopy.Digital subtraction sialography and ultrasonography are the methods of choice in the imaging of salivary gland calculi. Although sialography is a very old diagnostic method, still it is the best diagnostic tool in the imaging of subtle anatomy of salivary gland duct system. Digital subtraction sialography can show the exact location of salivary stone and enables imaging...
Neurologia i neurochirurgia polska, 2014
Papillary tumor of the pineal region (PTPR) was introduced to the WHO classification in 2007. Thi... more Papillary tumor of the pineal region (PTPR) was introduced to the WHO classification in 2007. This rare tumor of little known natural history and unpredictable behavior was described in fewer than 100 cases. Its optimal treatment is not established yet. We report another two cases of PTPR in whom tumors were totally removed via supracerebellar infratentorial approach and both were treated with radiotherapy. In a 37-year-old man the operation was delayed 6 years after the first tumor diagnosis and subsequent shunt placement. He has no complaints 10 years after the onset of the disease. A 45-year-old woman has no complaints 24 months after surgery. Our experience and the data from literature indicate that a total tumor removal is the major prognostic factor.
Analytical and quantitative cytology and histology / the International Academy of Cytology [and] American Society of Cytology, 2010
To present a computerized system for cell counting in histopathologic slides of meningioma and ol... more To present a computerized system for cell counting in histopathologic slides of meningioma and oligodendroglioma stained immunohistochemically against Ki-67 antigen and discuss the variability of tumor cell numbers in the field of view of analyzed neoplasms to standardize tumor cellularity. A computer program using an algorithm based on mathematical morphology was developed to perform quantitative evaluation of slides. That solution was combined with the Support Vector Machine used for classification of cell immunoreactivity. The mean number of cells in the analyzed field of view from patients with meningioma was 623. Of these, 95% were in the 386-781 cells range. In oligodendrogliomas the mean was 474 cells and all results were in the 204-736 range. The mean relative discrepancy between results of our system and human expert score was 8%. The proposed system appeared to be an efficient tool for supporting histopathologic diagnosis. The applied sequential thresholding simulated well...
Neuro Endocrinology Letters, Apr 5, 2013
Meningiomas are very common neurosurgical problem. Their histological appearance, different size ... more Meningiomas are very common neurosurgical problem. Their histological appearance, different size and localization, adherence to vital neural and vascular structures or extensive peritumoral brain edema (PTBE), especially in deep seated tumors, may lead to severe, life-threatening complications. We report a case of tuberculum sellae meningioma (TSM). A 48-year old female presented with 7-month history of blurred vision and progressive visual impairment. Intracranial tumor was confirmed by magnetic resonance imaging (MRI). After ophtalmological and endocrinological evaluation, the patient underwent surgical removal of the tumor. She immediately recovered from her visual disturbances and no tumor recurrences were seen during follow-up. Pathological diagnosis showed a meningioma of the secretory subtype (MS). We discuss the role of immunohistochemical staining in the diagnosis and the role of different factors in the PTBE formation. Selection of surgical route to the TSM is discussed, as well. Review of the literature is presented.
Forum Medycyny Rodzinnej, Jun 10, 2009
Chinese Medical Journal, 2013
BACKGROUND: The development of angiosarcoma in oedematous tissue is referred to as Stewart-Treves... more BACKGROUND: The development of angiosarcoma in oedematous tissue is referred to as Stewart-Treves syndrome (STS). This rare and fatal complication is associated with chronic post mastectomy lymphoedema and radiotherapy for breast cancer. Angiosarcoma spread is facilitated by the formation of blood vessels (angiogenesis) and lymph vessels (lymphangiogenesis). In the future antiangiogenic therapy may improve the poor outcome of current treatments. There was evidence that blocking the angiogenenesis would inhibit progression of angiosarcoma. It seems reasonable to hypothesize that blocking the lymphangiogenesis may yield similar results. Although angiosarcomas commonly derive from blood vessels, in case of STS angiosarcomas chronic lymphoedema may suggest its lymphatic origin. The goal of this study was to visualize interstitial space and lymphatics in the central and peripheral regions of STS angiosarcoma.METHODS: On tissue samples obtained from STS angiosarcoma we have performed: first colour stereoscopic lymphography to visualise the morphology of lymphatic vessels and extracellular spaces, second immunohistochemical staining specific for lymphatic vessels endothelium (LYVE-1) and blood endothelial cells (CD31, factor VIII) and prolymphangiogenic vascular endothelial growth factor (VEGF-C) for precise identification of lymphatic endothelia. STS angiosarcoma morphology was assessed by comparison of pictures obtained on lymphography, microscopy and confocal microscopy.RESULTS: STS angiosarcomas present heterogenous morphology with areas dominated by hemangiosarcoma and lymphangiosarcoma structures. STS angiosarcoma expressed phenotypes of both blood and lymphatic endothelia. LYVE-1 and VEGF-C is expressed by STS angiosarcoma and may be used to discriminate tumour differentiation. Morphology of lymphatic vessels and spaces in the tumour suggest absence of their normal lymphatic function.CONCLUSIONS: Our results confirmed both hemangio- and lymphangiogenic origin of STS angiosarcoma. Expression of VEGF-C makes STS angiosarcoma a good candidate for targeted antilymphangiogenic therapy. However, morphology of intratumoral lymphatics on colour lymphography suggested their impaired function, which can hamper drug distribution.
![Research paper thumbnail of [Long-term remission after erlotinib therapy in an elderly patient with advanced non-small-cell lung cancer. Case report and conclusions for clinical practice]](https://attachments.academia-assets.com/48223434/thumbnails/1.jpg)
](Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc
Small molecule tyrosine kinase inhibitors (TKIs) of epidermal growth factor receptor (EGFR) -gefi... more Small molecule tyrosine kinase inhibitors (TKIs) of epidermal growth factor receptor (EGFR) -gefitinib and erlotinib -have recently been used as a therapeutic option in advanced non-small cell lung cancer (NSCLC) patients relapsing after first-or second-line chemotherapy. We report here a case of long-term remission in an elderly, non-smoking woman with advanced NSCLC after chemotherapy failure, who was selected for erlotinib therapy using demographic and clinical criteria. Based on this example and on the literature data we discuss the need for careful patient selection for this new therapeutic method.
Analytical Cellular Pathology, 2015
Background. This paper presents the study concerning hot-spot selection in the assessment of whol... more Background. This paper presents the study concerning hot-spot selection in the assessment of whole slide images of tissue sections collected from meningioma patients. The samples were immunohistochemically stained to determine the Ki-67/MIB-1 proliferation index used for prognosis and treatment planning. Objective. The observer performance was examined by comparing results of the proposed method of automatic hot-spot selection in whole slide images, results of traditional scoring under a microscope, and results of a pathologist's manual hot-spot selection. Methods. The results of scoring the Ki-67 index using optical scoring under a microscope, software for Ki-67 index quantification based on hot spots selected by two pathologists (resp., once and three times), and the same software but on hot spots selected by proposed automatic methods were compared using Kendall's tau-b statistics. Results. Results show intra-and interobserver agreement. The agreement between Ki-67 scoring with manual and automatic hotspot selection is high, while agreement between Ki-67 index scoring results in whole slide images and traditional microscopic examination is lower. Conclusions. The agreement observed for the three scoring methods shows that automation of area selection is an effective tool in supporting physicians and in increasing the reliability of Ki-67 scoring in meningioma.
![Research paper thumbnail of [Long-term remission after erlotinib therapy in an elderly patient with advanced non-small-cell lung cancer. Case report and conclusions for clinical practice]](https://attachments.academia-assets.com/48223435/thumbnails/1.jpg)
](Pneumonologia i alergologia polska, 2008
Small molecule tyrosine kinase inhibitors (TKIs) of epidermal growth factor receptor (EGFR) - gef... more Small molecule tyrosine kinase inhibitors (TKIs) of epidermal growth factor receptor (EGFR) - gefitinib and erlotinib - have recently been used as a therapeutic option in advanced non-small cell lung cancer (NSCLC) patients relapsing after first- or second-line chemotherapy. We report here a case of long-term remission in an elderly, non-smoking woman with advanced NSCLC after chemotherapy failure, who was selected for erlotinib therapy using demographic and clinical criteria. Based on this example and on the literature data we discuss the need for careful patient selection for this new therapeutic method.
Gastroenterology Review, 2015
Pancreatic solid tumour diagnoses remain a challenge for modern medicine. However, using endosono... more Pancreatic solid tumour diagnoses remain a challenge for modern medicine. However, using endosonography together with elastography helps to examine the elasticity of tissues and therefore may allow definition of the nature of pancreatic tumours. To evaluate the usefulness of elastography with the strain ratio method and quantitative evaluation of pancreatic solid tumours. A total of 54 patients with pancreatic solid tumours were treated with ultrasound endosonography with fine-needle aspiration biopsy. The control group contained 26 patients with normal pancreas. Pancreatic solid tumours and normal pancreas were analysed with elastography and elasticity evaluation of the interest area (A), reference (B), and the strain ratio factor (B/A). Postoperative histopathological or cytological examinations were the final diagnoses. Both postoperative and cytological diagnoses were compared with average elasticity parameters (A) and strain ratio factors (B/A). Average elasticity parameters (A) and the strain ratio factors (B/A) were: 0.025% (0.01-0.05%) for malignant process, and (B/A) 33.93 (18.23-75.45); (A) - 0.26% (0.14-0.35%), and (B/A) 5.35 (3.47-7.8) for inflammatory process; (A) 0.54% (0.35-0.82%), and (B/A) 1.79 (1.02-2.05) for normal pancreatic tissue. Malignant tumours have higher tightness factor compared to inflammatory tumours and normal pancreatic tissue. Elasticity parameters reach the highest levels in normal pancreatic tissue, lower in inflammatory tumours, and the lowest in malignant tumours.
Journal of Medical Case Reports, 2014
Introduction: Pyoderma gangrenosum is a rare clinical entity of poorly understood pathogenesis, c... more Introduction: Pyoderma gangrenosum is a rare clinical entity of poorly understood pathogenesis, characterized by rapidly progressing skin necrosis. In around half of patients pyoderma gangrenosum is a manifestation of underlying systemic diseases, such as rheumatoid arthritis, inflammatory bowel disease or myeloproliferative disorders. There have been very few reports on the association of pyoderma gangrenosum with solid malignancies. Case presentation: We report a case of a 68-year-old Caucasian woman in whom pyoderma gangrenosum first appeared around 30 years earlier, at the time of exacerbation of rheumatoid arthritis, and recurred as a manifestation of locally advanced breast cancer. The causative role of the neoplastic process was partly confirmed by the healing of the skin ulceration only following effective endocrine cancer therapy, whereas earlier attempts with standard anti-inflammatory therapy were unsuccessful. Conclusions: Pyoderma gangrenosum has a recurrent nature and may be reactivated by various causes within several years. Therefore, a prompt and thorough diagnosis accompanied by treatment of the underlying disease is necessary.
International Journal of Oncology, 2014
In oncology, a rational approach to identify patients who are likely to benefit from therapy, alr... more In oncology, a rational approach to identify patients who are likely to benefit from therapy, already before initiation of treatment, is urgently required. Excision repair cross-complementation group 1 enzyme (ERCC1) has been proposed as a molecular predictor of clinical resistance to platinum-based chemotherapy. Other data suggest Tau protein expression as a predictor of clinical outcome in cancer patients treated with paclitaxel-based chemotherapy as low tau expression may render microtubules more vulnerable to paclitaxel. Therefore, the combination of ERCC1 and Tau may be a valuable predictor of sensitivity to platinum/paclitaxel treatment. The primary aim of the study was to investigate whether ERCC1 and Tau protein expression correlates with patient outcome in newly diagnosed epithelial ovarian cancer (EOC) patients. Formalin-fixed, paraffin-embedded tissue sections from 227 newly diagnosed EOC patients were used for immunohistochemical staining for ERCC1 and Tau proteins. All patients received standard first-line combination platinum and paclitaxel chemotherapy. The patients were divided in a training set of 84 patients and an independent validation cohort of 143 patients. Neither ERCC1 nor Tau expression was associated with clinical response or platinum resistance in both the training and validation sets. Patients with ERCC1-positive tumors had significantly shortened progression-free and overall survival compared to patients with ERCC1-negative tumors, p<0.00001 and p= 0.0006. In multivariate analysis ERCC1 also proved as an independent predictor of PFS and OS with HR of 3.86 and 1.98, respectively but the data could not be confirmed in the validation set. Tau expression was not associated with PFS or OS in this study. ERCC1 and Tau might serve as biomarkers of DNA repair and for paclitaxel sensitivity but the present study could not validate ERCC1 or Tau protein expression in tumors as pre-treatment tools to predict sensitivity to first-line platinum/paclitaxel chemotherapy.
Diagnostic Pathology, 2011
The rationale for choosing a remote quantitative method supporting a diagnostic decision requires... more The rationale for choosing a remote quantitative method supporting a diagnostic decision requires some empirical studies and knowledge on scenarios including valid telepathology standards. The tumours of the central nervous system [CNS] are graded on the base of the morphological features and the Ki-67 labelling Index [Ki-67 LI]. Various methods have been applied for Ki-67 LI estimation. Recently we have introduced the Computerized Analysis of Medical Images [CAMI] software for an automated Ki-67 LI counting in the digital images.
Analytical and Quantitative Cytology and Histology the International Academy of Cytology and American Society of Cytology, Dec 1, 2010
To present a computerized system for cell counting in histopathologic slides of meningioma and ol... more To present a computerized system for cell counting in histopathologic slides of meningioma and oligodendroglioma stained immunohistochemically against Ki-67 antigen and discuss the variability of tumor cell numbers in the field of view of analyzed neoplasms to standardize tumor cellularity. A computer program using an algorithm based on mathematical morphology was developed to perform quantitative evaluation of slides. That solution was combined with the Support Vector Machine used for classification of cell immunoreactivity. The mean number of cells in the analyzed field of view from patients with meningioma was 623. Of these, 95% were in the 386-781 cells range. In oligodendrogliomas the mean was 474 cells and all results were in the 204-736 range. The mean relative discrepancy between results of our system and human expert score was 8%. The proposed system appeared to be an efficient tool for supporting histopathologic diagnosis. The applied sequential thresholding simulated well the human process of cell recognition. Cellularity of the analyzed tumors did not show stability within the specimens from different patients. The results were also highly variable in different fields of view obtained from the same patient.
World Journal of Surgical Oncology, 2007
Background: Seroma formation following modified radical mastectomy with axillary lymph node disse... more Background: Seroma formation following modified radical mastectomy with axillary lymph node dissection for breast cancer is a most common wound complication. In our experience seroma occurs in approximately 50% of patients undergoing mastectomy. Postmastectomy seromas usually vanishes within a few weeks after operation.
Journal of Experimental & Clinical Cancer Research, 2009
Chromophobe renal cell carcinoma (ChRCC) is a subtype of renal cell carcinoma (RCC). ChRCC is dia... more Chromophobe renal cell carcinoma (ChRCC) is a subtype of renal cell carcinoma (RCC). ChRCC is diagnosed mainly in 6th decade of life. An incidence of ChRCC is similar in both men and woman. Eighty six percent of ChRCCs cases are diagnosed in stage 1 or 2. Prognosis of ChRCC is better than in other types of RCC. Five-and 10-year disease free survival (DFS) for ChRCC was 83.9% and 77.9%, respectively. Expression of immunohistological markers: cytokeratins (CK), vimentin, epithelial membrane antigen (EMA), CD10 could be potentially helpful in diagnosis of different subtypes of RCC. From all conventional RCC, CD 117 was detected (overexpression) in membrane of cells ChRCC.
Polish journal of radiology / Polish Medical Society of Radiology, 2010
Sialolithiasis is the most common disorder of major salivary glands. The main site of salivary st... more Sialolithiasis is the most common disorder of major salivary glands. The main site of salivary stones' formation is submandibular gland, followed by parotid and sublingual gland. The aim of this article was to present current diagnostic imaging modalities carried out in patients suspected with salivary stones on the basis of own material and review of literature.Current diagnostic imaging tools used in the imaging of salivary stones were described and illustrated in this paper. These are: conventional radiography, sialography, ultrasonography, computed tomography, magnetic resonance sialography and sialoendoscopy.Digital subtraction sialography and ultrasonography are the methods of choice in the imaging of salivary gland calculi. Although sialography is a very old diagnostic method, still it is the best diagnostic tool in the imaging of subtle anatomy of salivary gland duct system. Digital subtraction sialography can show the exact location of salivary stone and enables imaging...
Neurologia i neurochirurgia polska, 2014
Papillary tumor of the pineal region (PTPR) was introduced to the WHO classification in 2007. Thi... more Papillary tumor of the pineal region (PTPR) was introduced to the WHO classification in 2007. This rare tumor of little known natural history and unpredictable behavior was described in fewer than 100 cases. Its optimal treatment is not established yet. We report another two cases of PTPR in whom tumors were totally removed via supracerebellar infratentorial approach and both were treated with radiotherapy. In a 37-year-old man the operation was delayed 6 years after the first tumor diagnosis and subsequent shunt placement. He has no complaints 10 years after the onset of the disease. A 45-year-old woman has no complaints 24 months after surgery. Our experience and the data from literature indicate that a total tumor removal is the major prognostic factor.
Analytical and quantitative cytology and histology / the International Academy of Cytology [and] American Society of Cytology, 2010
To present a computerized system for cell counting in histopathologic slides of meningioma and ol... more To present a computerized system for cell counting in histopathologic slides of meningioma and oligodendroglioma stained immunohistochemically against Ki-67 antigen and discuss the variability of tumor cell numbers in the field of view of analyzed neoplasms to standardize tumor cellularity. A computer program using an algorithm based on mathematical morphology was developed to perform quantitative evaluation of slides. That solution was combined with the Support Vector Machine used for classification of cell immunoreactivity. The mean number of cells in the analyzed field of view from patients with meningioma was 623. Of these, 95% were in the 386-781 cells range. In oligodendrogliomas the mean was 474 cells and all results were in the 204-736 range. The mean relative discrepancy between results of our system and human expert score was 8%. The proposed system appeared to be an efficient tool for supporting histopathologic diagnosis. The applied sequential thresholding simulated well...
Neuro Endocrinology Letters, Apr 5, 2013
Meningiomas are very common neurosurgical problem. Their histological appearance, different size ... more Meningiomas are very common neurosurgical problem. Their histological appearance, different size and localization, adherence to vital neural and vascular structures or extensive peritumoral brain edema (PTBE), especially in deep seated tumors, may lead to severe, life-threatening complications. We report a case of tuberculum sellae meningioma (TSM). A 48-year old female presented with 7-month history of blurred vision and progressive visual impairment. Intracranial tumor was confirmed by magnetic resonance imaging (MRI). After ophtalmological and endocrinological evaluation, the patient underwent surgical removal of the tumor. She immediately recovered from her visual disturbances and no tumor recurrences were seen during follow-up. Pathological diagnosis showed a meningioma of the secretory subtype (MS). We discuss the role of immunohistochemical staining in the diagnosis and the role of different factors in the PTBE formation. Selection of surgical route to the TSM is discussed, as well. Review of the literature is presented.
Forum Medycyny Rodzinnej, Jun 10, 2009
Chinese Medical Journal, 2013
BACKGROUND: The development of angiosarcoma in oedematous tissue is referred to as Stewart-Treves... more BACKGROUND: The development of angiosarcoma in oedematous tissue is referred to as Stewart-Treves syndrome (STS). This rare and fatal complication is associated with chronic post mastectomy lymphoedema and radiotherapy for breast cancer. Angiosarcoma spread is facilitated by the formation of blood vessels (angiogenesis) and lymph vessels (lymphangiogenesis). In the future antiangiogenic therapy may improve the poor outcome of current treatments. There was evidence that blocking the angiogenenesis would inhibit progression of angiosarcoma. It seems reasonable to hypothesize that blocking the lymphangiogenesis may yield similar results. Although angiosarcomas commonly derive from blood vessels, in case of STS angiosarcomas chronic lymphoedema may suggest its lymphatic origin. The goal of this study was to visualize interstitial space and lymphatics in the central and peripheral regions of STS angiosarcoma.METHODS: On tissue samples obtained from STS angiosarcoma we have performed: first colour stereoscopic lymphography to visualise the morphology of lymphatic vessels and extracellular spaces, second immunohistochemical staining specific for lymphatic vessels endothelium (LYVE-1) and blood endothelial cells (CD31, factor VIII) and prolymphangiogenic vascular endothelial growth factor (VEGF-C) for precise identification of lymphatic endothelia. STS angiosarcoma morphology was assessed by comparison of pictures obtained on lymphography, microscopy and confocal microscopy.RESULTS: STS angiosarcomas present heterogenous morphology with areas dominated by hemangiosarcoma and lymphangiosarcoma structures. STS angiosarcoma expressed phenotypes of both blood and lymphatic endothelia. LYVE-1 and VEGF-C is expressed by STS angiosarcoma and may be used to discriminate tumour differentiation. Morphology of lymphatic vessels and spaces in the tumour suggest absence of their normal lymphatic function.CONCLUSIONS: Our results confirmed both hemangio- and lymphangiogenic origin of STS angiosarcoma. Expression of VEGF-C makes STS angiosarcoma a good candidate for targeted antilymphangiogenic therapy. However, morphology of intratumoral lymphatics on colour lymphography suggested their impaired function, which can hamper drug distribution.
Pneumonologia i alergologia polska: organ Polskiego Towarzystwa Ftyzjopneumonologicznego, Polskiego Towarzystwa Alergologicznego, i Instytutu Gruzlicy i Chorob Pluc
Small molecule tyrosine kinase inhibitors (TKIs) of epidermal growth factor receptor (EGFR) -gefi... more Small molecule tyrosine kinase inhibitors (TKIs) of epidermal growth factor receptor (EGFR) -gefitinib and erlotinib -have recently been used as a therapeutic option in advanced non-small cell lung cancer (NSCLC) patients relapsing after first-or second-line chemotherapy. We report here a case of long-term remission in an elderly, non-smoking woman with advanced NSCLC after chemotherapy failure, who was selected for erlotinib therapy using demographic and clinical criteria. Based on this example and on the literature data we discuss the need for careful patient selection for this new therapeutic method.
Analytical Cellular Pathology, 2015
Background. This paper presents the study concerning hot-spot selection in the assessment of whol... more Background. This paper presents the study concerning hot-spot selection in the assessment of whole slide images of tissue sections collected from meningioma patients. The samples were immunohistochemically stained to determine the Ki-67/MIB-1 proliferation index used for prognosis and treatment planning. Objective. The observer performance was examined by comparing results of the proposed method of automatic hot-spot selection in whole slide images, results of traditional scoring under a microscope, and results of a pathologist's manual hot-spot selection. Methods. The results of scoring the Ki-67 index using optical scoring under a microscope, software for Ki-67 index quantification based on hot spots selected by two pathologists (resp., once and three times), and the same software but on hot spots selected by proposed automatic methods were compared using Kendall's tau-b statistics. Results. Results show intra-and interobserver agreement. The agreement between Ki-67 scoring with manual and automatic hotspot selection is high, while agreement between Ki-67 index scoring results in whole slide images and traditional microscopic examination is lower. Conclusions. The agreement observed for the three scoring methods shows that automation of area selection is an effective tool in supporting physicians and in increasing the reliability of Ki-67 scoring in meningioma.
Pneumonologia i alergologia polska, 2008
Small molecule tyrosine kinase inhibitors (TKIs) of epidermal growth factor receptor (EGFR) - gef... more Small molecule tyrosine kinase inhibitors (TKIs) of epidermal growth factor receptor (EGFR) - gefitinib and erlotinib - have recently been used as a therapeutic option in advanced non-small cell lung cancer (NSCLC) patients relapsing after first- or second-line chemotherapy. We report here a case of long-term remission in an elderly, non-smoking woman with advanced NSCLC after chemotherapy failure, who was selected for erlotinib therapy using demographic and clinical criteria. Based on this example and on the literature data we discuss the need for careful patient selection for this new therapeutic method.
Gastroenterology Review, 2015
Pancreatic solid tumour diagnoses remain a challenge for modern medicine. However, using endosono... more Pancreatic solid tumour diagnoses remain a challenge for modern medicine. However, using endosonography together with elastography helps to examine the elasticity of tissues and therefore may allow definition of the nature of pancreatic tumours. To evaluate the usefulness of elastography with the strain ratio method and quantitative evaluation of pancreatic solid tumours. A total of 54 patients with pancreatic solid tumours were treated with ultrasound endosonography with fine-needle aspiration biopsy. The control group contained 26 patients with normal pancreas. Pancreatic solid tumours and normal pancreas were analysed with elastography and elasticity evaluation of the interest area (A), reference (B), and the strain ratio factor (B/A). Postoperative histopathological or cytological examinations were the final diagnoses. Both postoperative and cytological diagnoses were compared with average elasticity parameters (A) and strain ratio factors (B/A). Average elasticity parameters (A) and the strain ratio factors (B/A) were: 0.025% (0.01-0.05%) for malignant process, and (B/A) 33.93 (18.23-75.45); (A) - 0.26% (0.14-0.35%), and (B/A) 5.35 (3.47-7.8) for inflammatory process; (A) 0.54% (0.35-0.82%), and (B/A) 1.79 (1.02-2.05) for normal pancreatic tissue. Malignant tumours have higher tightness factor compared to inflammatory tumours and normal pancreatic tissue. Elasticity parameters reach the highest levels in normal pancreatic tissue, lower in inflammatory tumours, and the lowest in malignant tumours.
Journal of Medical Case Reports, 2014
Introduction: Pyoderma gangrenosum is a rare clinical entity of poorly understood pathogenesis, c... more Introduction: Pyoderma gangrenosum is a rare clinical entity of poorly understood pathogenesis, characterized by rapidly progressing skin necrosis. In around half of patients pyoderma gangrenosum is a manifestation of underlying systemic diseases, such as rheumatoid arthritis, inflammatory bowel disease or myeloproliferative disorders. There have been very few reports on the association of pyoderma gangrenosum with solid malignancies. Case presentation: We report a case of a 68-year-old Caucasian woman in whom pyoderma gangrenosum first appeared around 30 years earlier, at the time of exacerbation of rheumatoid arthritis, and recurred as a manifestation of locally advanced breast cancer. The causative role of the neoplastic process was partly confirmed by the healing of the skin ulceration only following effective endocrine cancer therapy, whereas earlier attempts with standard anti-inflammatory therapy were unsuccessful. Conclusions: Pyoderma gangrenosum has a recurrent nature and may be reactivated by various causes within several years. Therefore, a prompt and thorough diagnosis accompanied by treatment of the underlying disease is necessary.
International Journal of Oncology, 2014
In oncology, a rational approach to identify patients who are likely to benefit from therapy, alr... more In oncology, a rational approach to identify patients who are likely to benefit from therapy, already before initiation of treatment, is urgently required. Excision repair cross-complementation group 1 enzyme (ERCC1) has been proposed as a molecular predictor of clinical resistance to platinum-based chemotherapy. Other data suggest Tau protein expression as a predictor of clinical outcome in cancer patients treated with paclitaxel-based chemotherapy as low tau expression may render microtubules more vulnerable to paclitaxel. Therefore, the combination of ERCC1 and Tau may be a valuable predictor of sensitivity to platinum/paclitaxel treatment. The primary aim of the study was to investigate whether ERCC1 and Tau protein expression correlates with patient outcome in newly diagnosed epithelial ovarian cancer (EOC) patients. Formalin-fixed, paraffin-embedded tissue sections from 227 newly diagnosed EOC patients were used for immunohistochemical staining for ERCC1 and Tau proteins. All patients received standard first-line combination platinum and paclitaxel chemotherapy. The patients were divided in a training set of 84 patients and an independent validation cohort of 143 patients. Neither ERCC1 nor Tau expression was associated with clinical response or platinum resistance in both the training and validation sets. Patients with ERCC1-positive tumors had significantly shortened progression-free and overall survival compared to patients with ERCC1-negative tumors, p<0.00001 and p= 0.0006. In multivariate analysis ERCC1 also proved as an independent predictor of PFS and OS with HR of 3.86 and 1.98, respectively but the data could not be confirmed in the validation set. Tau expression was not associated with PFS or OS in this study. ERCC1 and Tau might serve as biomarkers of DNA repair and for paclitaxel sensitivity but the present study could not validate ERCC1 or Tau protein expression in tumors as pre-treatment tools to predict sensitivity to first-line platinum/paclitaxel chemotherapy.
Diagnostic Pathology, 2011
The rationale for choosing a remote quantitative method supporting a diagnostic decision requires... more The rationale for choosing a remote quantitative method supporting a diagnostic decision requires some empirical studies and knowledge on scenarios including valid telepathology standards. The tumours of the central nervous system [CNS] are graded on the base of the morphological features and the Ki-67 labelling Index [Ki-67 LI]. Various methods have been applied for Ki-67 LI estimation. Recently we have introduced the Computerized Analysis of Medical Images [CAMI] software for an automated Ki-67 LI counting in the digital images.
Analytical and Quantitative Cytology and Histology the International Academy of Cytology and American Society of Cytology, Dec 1, 2010
To present a computerized system for cell counting in histopathologic slides of meningioma and ol... more To present a computerized system for cell counting in histopathologic slides of meningioma and oligodendroglioma stained immunohistochemically against Ki-67 antigen and discuss the variability of tumor cell numbers in the field of view of analyzed neoplasms to standardize tumor cellularity. A computer program using an algorithm based on mathematical morphology was developed to perform quantitative evaluation of slides. That solution was combined with the Support Vector Machine used for classification of cell immunoreactivity. The mean number of cells in the analyzed field of view from patients with meningioma was 623. Of these, 95% were in the 386-781 cells range. In oligodendrogliomas the mean was 474 cells and all results were in the 204-736 range. The mean relative discrepancy between results of our system and human expert score was 8%. The proposed system appeared to be an efficient tool for supporting histopathologic diagnosis. The applied sequential thresholding simulated well the human process of cell recognition. Cellularity of the analyzed tumors did not show stability within the specimens from different patients. The results were also highly variable in different fields of view obtained from the same patient.
World Journal of Surgical Oncology, 2007
Background: Seroma formation following modified radical mastectomy with axillary lymph node disse... more Background: Seroma formation following modified radical mastectomy with axillary lymph node dissection for breast cancer is a most common wound complication. In our experience seroma occurs in approximately 50% of patients undergoing mastectomy. Postmastectomy seromas usually vanishes within a few weeks after operation.
Journal of Experimental & Clinical Cancer Research, 2009
Chromophobe renal cell carcinoma (ChRCC) is a subtype of renal cell carcinoma (RCC). ChRCC is dia... more Chromophobe renal cell carcinoma (ChRCC) is a subtype of renal cell carcinoma (RCC). ChRCC is diagnosed mainly in 6th decade of life. An incidence of ChRCC is similar in both men and woman. Eighty six percent of ChRCCs cases are diagnosed in stage 1 or 2. Prognosis of ChRCC is better than in other types of RCC. Five-and 10-year disease free survival (DFS) for ChRCC was 83.9% and 77.9%, respectively. Expression of immunohistological markers: cytokeratins (CK), vimentin, epithelial membrane antigen (EMA), CD10 could be potentially helpful in diagnosis of different subtypes of RCC. From all conventional RCC, CD 117 was detected (overexpression) in membrane of cells ChRCC.