Biomedical subjects

Natasa Colović

Publications and source records attributed to Natasa Colović.

At least 19 recordsLinked to original sources

PubMed2006

[Inflammatory pseudotumor of the spleen].

BACKGROUND: Inflammatory pseudotumors are benign tumor lesions of an unknown etiology that can appear almost at any organ, sometimes along with infectious agens, like Epstein-Barr virus. They are extremely rare in the spleen, with less than 80 cases described in the world literature. It is a single, very rarely multinodal lesion. Middle aged patients are mostly affected. Symptoms are either absent or uncharacteristic, so that the tumors are discovered by chance or during investigations of other diseases. CASE REPORT: We presented a 56-year-old woman in whom a nodal lesion of 2 cm in diameter had been discovered in the spleen during a routine check-up after a mild traffic accident. The lesion had grown up to 6 cm in diameter during a 5-year follow-up causing a mild pain over the upper left abdomen and left shoulder. Fine needle biopsy failed to show the exact nature of the lesion. Splenectomy was performed due to a suspected lymphoproliferative disorder. Histology and immunohistochemistry of the lesion of the upper pole of the spleen showed inflammatory pseudotumor. Epstein-Barr virus was not present. The patient developed postsplenectomy thrombocytosis (up to 850 x 10(9)/1) which settled down within 10 weeks. CONCLUSION: . Inflammatory pseudotumors of the spleen are extremely rare. The exact diagnosis can be established only by histology and/or immunohistochemistry of the spleen removed for a suspected lymphoproliferative disorder, most frequently lymphoma. The patient was cured with splenectomy.

Diagnosis, Differential↗

PubMed2006

[Aggressive intraabdominal fibromatosis].

BACKGROUND: Intraabdominal or mesenteric fibromatosis is a rare benign nonmetastatic neoplasm that appears as a sporadic lesion or in patients with familiar polyposis. Its evolution is unpredictable. About 10% of the cases shaw a very aggressive growth. CASE REPORT: We presented a 22-year-old woman in whom an aggressive intraabdominal fibromatosis had appeared during the first pregnancy as a well circumscribed ovoid tumor, involving the terminal ileum, the caecum, the ascending colon, the right kidney, the ureter, and the right common iliac artery. The tumor was excised with right colectomy, nephroureterectomy and resection of the involved artery using arterial reconstruction with graft interposition. Two years after the surgery the patient developed an inoperable tumor recurrency with a fatal outcome. CONCLUSION: In spite of a successful surgical excision during the original surgery intraabdominal or mesenteric fibromatosis might have an aggressive evolution leading to an inoperable tumor recurrency and a fatal outcome.

Adult↗

PubMed2005

Multiple M components in two patients with splenic lymphoma with villous lymphocytes.

Splenic lymphoma with villous lymphocytes (SLVL) is a rare lymphoproliferative disorder characterized by the presence of typical lymphoid cells with villous projections and monoclonal immunoglobulin (M-Ig) in about 30% of patients. The simultaneous presence of more than one M-Ig in SLVL has not been reported. We present two patients with SLVL, each with three serum M components associated with the presence of rheumatoid factor (RF) and antiphospholipid antibodies (APLA) together with fatal thromboembolic events. Both patients presented with splenomegaly and typical bone marrow cytology with 30-50% infiltration of lymphoid cells that had the characteristics of villous lymphocytes. Immunohistochemistry of bone marrow histology showed CD20++, CD43-/+, CD5-, IgM+, lambda+ and kappa-. In serum, two M-IgM lambda components were combined with M-IgG lambda in case 1 and with M-IgA lambda in case 2. In both cases, M-IgM displayed RF as well as lupus anticoagulant activity and free monoclonal lambda (lambda) light chains were present. In addition to M-IgM, in case 1 M-IgG also behaved like an APLA. One patient was splenectomized. Both patients suffered thromboembolic complications and died 3 and 8 months after presentation with signs of massive pulmonary thromboembolism.

Aged↗

PubMedDate not supplied

[Microcystic adenoma of the pancreas].

Microcystic adenoma of the pancreas is a rare benign tumour of the pancreas without malignant potential which usually appears in older women. Pain, weight loss, palpable mass and jaundice (if the tumour is localized in the head of the pancreas) are the main symptoms. Thanks to the modern imaging techniques (US, CT, FNB) the tumour is discovered and with rising frequency exactly preoperatively diagnosed. Surgical excision is the treatment of choice. In risk patients without symptoms surgery is not necessary but patients have to be regularly followed-up. The authors present a 70-year old woman in whom, because of constant epigastric pain, a multicystic mass of the pancreatic body, 58 x 40 mm in diameter, was discovered and removed by distal pancreatectomy. The spleen could not be saved. Histologic examination showed a microcystic adenoma. Three years after surgery the patient is symptom-free with normal ultrasonographic findings.

Aged↗

PubMedDate not supplied

[Pancreatic carcinoid].

Carcinoid tumours arise from argentaffine cells or from a primitive stem cells which may differentiate into anyone of a variety of adult endocrine-secreting cells. Carcinoid tumour of the pancreas is a very rare tumour with less than 50 cases reported in world literature. In literature it is denoted "pancreatic serotoninoma" or "serotonin-producing pancreatic tumour". Due to its rarity the tumour is an unusual cause of carcinoid syndrome. As the carcinoid tumour of the pancreas does not always causes carcinoid syndrome its absence does not necessarily exclude the existence of the tumour. The tumour is frequently malignant. Over 50% of patients have metastases at the time of surgery. This is the reason why radical surgery is not possible in a number of patients. Excisional surgery offers the best chance for recovery or long term survival. We report on a 57-year-old woman with carcinoid syndrome caused by malignant carcinoid tumour of the head of the pancreas without liver or other distant metastases; it was successfully excised with pylorus preserving cephalic duodenopancreatectomy (after Longmire-Traverso) and radical lymphadenectomy. The diagnosis was established on the basis of histologic and immunohistochemical findings. The patient is symptom free for more than eight months.

Carcinoid Tumor↗

PubMedDate not supplied

[Abdominal pregnancy with the placenta located on the spleen left in situ causing subphrenic abscess].

Abdominal pregnancy appears once in 3000 pregnancies. It usually terminates with abortion and urgent surgery. Thanks to ultrasonography and computed tomography the diagnosis is possible before surgery. Most frequently the diagnosis has been established during emergency laparotomy. Gynaecologists are not in agreement whether removal of placenta is mandatory or not, as it may include removal of parts or entire organs or may be followed with serious bleeding difficult to control. We present a 21-year old woman in whom during an urgent laparotomy performed for abdominal pregnancy placenta inserted in the spleen was left in situ. Postoperatively the patient developed subphrenic abscess which could not be solved without reoperation during which both the placenta and the spleen were removed. Ten years after surgery she is symptom-free.

Adult↗

PubMedDate not supplied

[Two cases of pancreatic head polypeptide tumors, one with a central cavity which fistulized into the duodenum].

PP omas are rare, usually malignant tumours of the PP cells of the Langerhan's islets which secrete pancreatic polypeptide. The authors present two women operated for PP-omas of the pancreas. The first was 55 year-old woman in whom we did a cephalic duodenopancreatectomy (Whipple's procedure) for the tumor of the head of the pancreas with central cavity containing gas due to communication with the duodenum. Immunohistochemistry showed a PP oma with strong generalised immunoreactivity with antibodies against Chromogramin A, neuron specific enolasa and PP with more the 95% of tumor cells and coexpression of somatostatine in 35% and VIP in less then 5% of tumor cells. Following uneventful recovery the patient stayed symptom free so far and put 20 kilograms in weight. The second patient was 19 year-old girl with a multinodal tumor of almost the entire pancreas in whom a local excision of the nodal mass of the head of the pancreas had been carried out in the other hospital, three years ago and relaparotomy and tumor biopsy a month before admission to our institution. In her we did a total duodenopancreatectomy and standard lymphadenectomy for a multinodal mass occupying almost the entire pancreas. Immunohistochemistry showed a strong generalised immunoreactivity with antibodies against Chromographin A, Neuron specific enolasa and PP for more then 95% of tumors, cells. Glucagon was expressed in few focuses (in less then 1% of cells), somatostatin was expressed very rarely in single cells while the rest of tumor markers did not show a visible immunologic reactions in the majority of tumors, cells. Three years after surgery she died due to multiple liver secondaries.

Adult↗

PubMedDate not supplied

[Hodgkin's and Reed-Sternberg cells in the peripheral blood of a patient with advanced stage Hodgkin's disease].

The occurrence of abnormal Hodgkin's and Reed-Sternberg cells in the peripheral blood in a patient suffering from Hodgkin's disease has been noticed exceptionally rare in a previous period, and especially rare in last ten years primarily due to successful treatment of this disease. The presence of atypical mononuclear cells in peripheral blood which cytomorphologically resembled Reed-Sternberg cells was registered in 8 patients till 1966. During the last decade, the presence of atypical mononuclear cells in the peripheral blood was used for their isolation, cultivation, and detailed immunophenotypic and genetic analysis. The analysis of mononuclear cells in rare patients with Hodgkin's disease was established that they belong to the B-lymphoid cells with expression of CD30 and CD15 antigens. The examination of presence of Hodgkin's cells in the peripheral blood of patients with Hodgkin's disease is important for patients with advanced stage of the disease in which autologous stem cell transplantation and high dose chemotherapy is planned. The authors present a 33-year-old patient, who noticed enlarged neck lymph nodes in September 2000, high temperature and loss in weight. On physical examination enlarged neck lymph nodes 5 x 8 cm and hepatosplenomegaly were found. There was anemia and thrombocytopenia, and normal WBC count with 24% of lymphoid elements in differential formula. On histologic examination of lymph nodes, Hodgkin's disease, type nodular sclerosis with mixed cellularity was found. Histology of bone marrow showed nodal lymphomatous infiltration. Immunohistochemistry with monoclonal antibodies of concentrate of peripheral blood cells showed expression of CD30+ and CD15+, immunophenotypically and morphologically matching Reed-Sternberg cells. Cytogenetic analysis of mononuclear cells of the bone marrow showed normal karyotype. The patient was in clinical stage IV/V of the disease and chemotherapy with 9 cycles of ABVD + Mp protocol was applied. He is still in remission.

Adult↗

PubMedDate not supplied

[Floating spleen with chronic torsion of the pedicle causing splenomegaly and secondary hypersplenism].

If the spleen is not fixed within the left subphrenic space, it gradually passes into the lower abdomen, where is much more exposed to trauma. Torsion of the splenic pedicle can also occur, causing the infarct necessitating an immediate surgery. Venous stasis causes splenomegaly and sometimes secondary hypersplenism. The authors present 16.5-year old girl with torsion of the splenic pedicle of floating spleen for 720 degrees: in spite of that, the patient had neither splenic infarct nor splenic vein thrombosis, possibly due to thrombocytopenia, but she had splenomegaly and secondary hypersplenism with pancytopenia causing bleeding, sideropenic anemia and mild jaundice. After treatment with iron, the patient underwent splenectomy which resulted in almost immediate rise of the number of all blood cells, and even thrombocytosis. The authors suggest early surgical treatment of the floating spleen, preferably splenopexy, before development of severe complications when splenectomy had to be performed in the majority of patients. Accessory spleens, if present, should be saved.

Adolescent↗

PubMedDate not supplied

[Hydatid cyst of the pancreas].

Hydatid cyst of the pancreas is rare. During the last 30 years, less than 40 cases have been reported in journals on Medline. This is a case report of a 35-year old woman with 2-year history of epigastric pain in whom an ultrasound and computed tomography showed the cyst of the body and tail of the pancreas 6x7 cm in diameters, which was supposed to be hydatid one. During surgery, an isolated hydatid cyst of the pancreas was found without communication with the pancreatic duct. The content of the cyst was removed, and pericyst was partially excised and drained. The recovery was uneventful and the patient has remained symptom free so far. Although rare, hydatid cyst should be considered in the differential diagnosis of the cystic lesions of the pancreas, particularly in patients coming from endemic areas and without history of pancreatitis.

Adult↗

PubMedDate not supplied

[Abscess of the spleen].

Splenic abscess is a rare disease but with increasing frequency. The authors present 9 patients with splenic abscess treated at the Institute of Digestive System Diseases, Clinical Centre of Serbia, in a period from January 1, 1986 to May 15, 2004. Splenic abscess was the complication of septic endocarditis in 4, trauma in 2, dental infection in 1, while in 2 cases it was the complication of chemotherapy in myeloproliferative disorders. All 9 patients had fever, 7 - abdominal pain, 4 - left shoulder pain, and 1 patient had nausea and vomiting. Higher white blood count was found in 6 patients, pleural effusion in 4, elevated left hemidiaphragm in 1 and basal pneumonia in 1 patient as well. Ultrasonography and CT were the most reliable diagnostic procedures. CT was superior in diagnosis of multiple small abscesses. Culture of the pus recovered the Enterococcus in 3 cases, Streptococcus a hemolyticus in 1, Staphylococcus epidermidis and Candida albicans in 1, Staphylococcus aureus, E. Coil and Candida albicans in 1, Staphylococcus aureus i Salmonella enteritidis in 1 case. Eight patients underwent splenectomy and 1 was cured by combined antibiotics in high doses. One patient died postoperatively due to septic endocarditis that had been present before surgery. The authors believe that splenectomy and antibiotics administered according to drug susceptibility test as well as management of underlying disease are the method of choice for splenic abscess treatment. Conservative antibiotic treatment is indicated in selected cases only.

Abscess↗

PubMedDate not supplied

[Biliary mucinous cystadenoma of the liver with focal malignant alteration].

Biliary mucinous cystadenoma of the liver is a rare tumor that develops almost exclusively in women. Its typical localization is near the hepatic hilus. It may become malignant, and therefore careful histological examination of the entire resected specimen is mandatory. Incomplete excision results in recurrence and occasionally in malignant alteration. The authors present a 66-year old woman who presented with the right upper abdominal pain and occasional vomiting, and who was diagnosed with cystic lesion of the right lobe of the liver. The lesion was totally excised by an open operation. It was filled with mucinous viscous fluid and there was proliferation in one part of the internal surface. The cystic lesion communicated with the common hepatic duct through a tiny duct (above the cystic duct), but in spite of that, it did not contain bile. Histological examination showed mucinous cystadenoma with focal malignant alteration. After the uneventful recovery, the pain and vomiting were eliminated and she has remained symptom free so far.

Aged↗

PubMedDate not supplied

[Primary pancreatic non-Hodgkin's lymphoma].

Diffuse large-cell B lymphoma of the pancreas is a rare disease, representing less than 1% of all non-Hodgkin's lymphomas and less than 0.9% of all malignant tumours of the pancreas. About 150 cases of the disease have been observed so far. The tumours are more frequent in the head of the pancreas then in other parts of the organ. They are usually larger (average size of 8 cm) and are non-resectionable. As a rule, exact diagnosis is based on the histology and the immunohistology of the specimen taken during open surgery performed for general diagnosis of the pancreatic tumour. Very rarely can a very reliable and experienced cytopathologist establish a proper diagnosis based on material obtained from a fine needle biopsy. The disease usually responds positively to immunochemotherapy according to protocol R-CHOP. Occasionally, additional radiotherapy may be required. We present two women, 66 and 49 years old, in whom a diagnosis of large-cell B lymphoma of the pancreas was established, based on the histology and the immunohistochemistry of a specimen taken during open surgery performed in order to remove pancreatic tumours, which turned out to be non-resectionable. After immunochemotherapy, the symptoms disappeared and the tumours shrank, in one patient after additional radiotherapy. The authors would like to point out the importance of a proper histological diagnosis, which permitted the application of immunochemotherapy alone or together with additional radiotherapy with at least temporarily favourable results.

Aged↗

PubMedDate not supplied

[Bronchogenic cyst of the abdomen].

A bronchogenic cyst is a rare congenital anomaly that appears in the thorax, usually the lungs or the mediastinum, being much rarer in the retrosternal space, within the pericardium or the diaphragm, as well as in the neck, while localisation within the abdomen is extremely rare, with only about 30 reported cases. We present the case of a 68-year-old woman. During an investigation for an epigastric pain, a cystic lesion in the area of the body and tail of the pancreas was found. During open surgery, a cystic lesion, spanning 95 x 75 x 70 mm, above the body and tail of the pancreas was excised. The wall of the cyst was 8-12mm thick; it contained viscous fluid, the culture of which stayed sterile. Histology determined that it was a bronchogenic cyst. After an early uneventful recovery, the patient developed a left colonic fistula, which healed spontaneously within 3 weeks, probably because of the unnoticed operative damage to the splenic flexure of the colon during splenectomy, which was adherent to the cystic mass and impossible to save during excision. Six months after surgery, the patient continued to remain symptom free.

Aged↗

PubMedDate not supplied

[Focal nodular hyperplasia].

Thanks to ultrasonography, computed tomography, and nuclear magnetic resonance, not only symptomatic but also asymptomatic liver tumours are discovered more frequently than before. Focal nodular hyperplasia (FNH) is one such tumour, most frequently an asymptomatic tumour of the liver, which predominantly appears in women during the generative period, who have taken oral contraceptives for several years. We present a 27-year-old woman, who has never taken either oral contraceptives or other hormones, in whom a left lobe liver tumour was unexpectedly discovered during a routine investigation performed for psychiatric complaints. The tumour, removed by left lateral bisegmentectomy (segments II and Ill), was composed of two tumoural nodes: 70x58x47 mm and 20x20x20 mm, the bigger one of which had a light grey central stellate scar. Histology revealed a focal nodular hyperplasia. The postoperative recovery was uneventful and the patient stayed symptom free for more than three years after surgery.

Adult↗

PubMedDate not supplied

[Bilateral angiomyolipoma of the kidney in patient with tuberous sclerosis].

Angiomyolipomas are relatively frequent tumours of the kidney. It is believed that about 10 million people worldwide have such a tumour. About 1/10 of these 10 million are patients who suffer from tuberous sclerosis. The tumours are frequently bilateral, slow growing, and usually asymptomatic, as well as being rare in children. Due to the benign nature of angiomyolipomas, surgical treatment and embolisation of the tumours are generally not recommended, unless renal function is endangered, the symptoms are severe, or the kidney in question becomes completely dysfunctional. This is particularly the case in patients with tuberous sclerosis in whom these tumours are either already bilateral or may become so. We present a 24-year-old woman with tuberous sclerosis in whom bilateral kidney tumours were diagnosed 7 years earlier and in whom we carried out a left nephrectomy of a 5300 gram angiomyolipoma, which caused pain and complete loss of function. Although tumourous, the right kidney was functional, so it was left untouched. After an uneventful recovery, a close follow-up was recommended, as well as HLA typing, as it is highly probable that the right kidney will gradually become inadequate or completely dysfunctional, so that haemodialysis and/or kidney transplantation along with nephrectomy will become necessary.

Adult↗

PubMedDate not supplied

[Lymphoepithelial cyst of the pancreas].

Lymphoepithelial cysts of the pancreas are very rare with less than 35 cases described in the literature. A 49-year old male with a cystic tumor in the tail of the pancreas of 8 cm in diameter discovered during the investigation for mild pain in the upper abdomen was presented. The tumor was easily removed during the open surgery. It contained yellowish dense pus-like fluid whose culture remained sterile. Histology showed the lymphoepithelial cyst of the pancreas. Postoperative recovery was uneventful and preoperative pain disappeared. Eight and a half years later, he died due to complications after orthopedic surgery of the spine.

Humans↗

PubMedDate not supplied

[Tubular adenoma of the gallbladder with squamous metaplasia].

Adenomas of the gallbladder are rare tumors. They may be papillar or tubular. Tubular adenoma appears in middle aged and older patients, although it may develop even in children. This is a case report of forty-year old woman in whom a polypoid lesion was discovered in the gallbladder during regular ultrasonographic control after the liver surgery for hemangioma. The gallbladder was removed during an open surgery. A polypoid tumour of 20x7x5mm in size on wide pedicle was found in the gallbladder. Histology showed tubular adenoma with mild epithelial dysplasia in some places and with antral and squamous metaplasia. The recovery was uneventful.

Adenoma↗