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R Kordek

Publications and source records attributed to R Kordek.

At least 73 records · Page 4Linked to original sources

Clinical, radiological and histological presentations of dysembryoplastic neuroepithelial tumors (DNT). Report of two cases.

Dysembryoplastic neuroepithelial tumor (DNT) is a recently described rare brain neoplasm with characteristic clinical and morphological features and favorable prognosis. We report here two cases of DNT. The first concerned a 12 years old girl who presented complex seizures preceded by acoustic aura (melodies). Computed tomography revealed a hypodense tumor measuring 2 x 2.5 cm in diameter, located paracortically in the left temporal lobe. The second tumor was removed from a 21-year-old man with partial complex seizures. Nine years earlier patient underwent neurosurgery with partial removal of the tumor The tumor's histopathologic diagnosis is unfortunately lacking. Computed and magnetic resonance imaging showed a mass occupying the cortex and paracortical areas of the anterior pole of the temporal lobe. Histologically, both tumors consisted of small, S-100 protein immunopositive oligodendrocyte-like cells (OLCs) arranged between synaptophysin- and, to a lesser degree, NFP-immunopositive axons (glioneuronal element). In the second case, an area of pilocytic astrocytoma-like appearance was also found, these cells were immunopositive for GFAP. The present study provides clinical, radiological and histological data, which may be helpful in differential diagnosis of this newly recognised brain tumor.

Adult↗

Pleomorphic xanthoastrocytoma with a gangliomatous component: an immunohistochemical and ultrastructural study.

We report a case of a 24-year-old woman with left temporal pleomorphic xanthoastrocytoma (PXA) with atypical neuronal cells. Many neoplastic cells, otherwise typical of PXA, expressed glial fibrillary acidic protein, while neuronal cells with marked atypia were immunopositive for synaptophysin and neurofilament protein. This report supports a notion that PXA, like other astrocytic tumors, may have its gangliogliomatous counterpart.

Adult↗

p53 protein and epidermal growth factor receptor expression in human astrocytomas.

p53 mutations are the most frequently detected genetic alterations of gliomas, appearing in a similar proportion of low and high grade astrocytomas, while the amplification of epidermal growth factor receptor (EGFR) gene appears mainly in glioblastomas. Thus, these changes seem to delineate two subgroups of high grade astrocytomas: those originating from preexistent low grade astrocytomas and those originating de novo. Paraffin-embedded surgical specimens from 56 human astrocytomas (8 pilocytic (I.) astrocytomas, 9 low grade (II.) fibrillary astrocytomas, 9 high grade (III.) anaplastic astrocytomas and 30 glioblastomas) were analyzed immunohistochemically for the presence of p53 protein and EGFR. Approximately 41% of all cases were p53-protein-positive while 23% were EGFR-positive. Five cases (8.9%) were double-positive for p53 protein and EGFR. The p53-immunopositive nuclei were revealed in 16 cases (53.3%) of glioblastomas, 3 cases (33.3%) of high grade and 4 cases (44.4%) of low grade astrocytomas. None of pilocytic tumors was p53-positive. EGFR immunopositivity increased with the grade of malignancy (11.1%, 22.2% and 33.3%). Double EGFR-p53-positive cases occuried in similar proportions in all grades (approximately 10%) and did not show different survival rate. There were no differences between average age of patients with only-p53-positive, p53-negative (pilocytic tumors excluded) and only-EGFR-positive tumors.

Astrocytoma↗

Over-expression of p53 protein as an indicator of the malignant transformation in spiradenoma.

Malignant spiradenomas (spiradenocarcinomas) are exceedingly rare tumours of cutaneous adnexal origin, consisting of two components: benign--the pre-existent adenoma, and malignant--developing from the former part. We studied p53 protein expression in both compartments of three cases of malignant spiradenoma and compared these results with results obtained with eight cases of spiradenoma. Nuclear staining was consistently negative in all benign tumours, whilst in the cases of malignant transformation within spiradenoma p53 protein was present in the carcinomatous component, but the immunostaining remained negative in the benign counterpart of the tumour. In the zone of transition between both components of the spiradenocarcinomas p53 expression was positive in the cells with morphological atypia, providing clear discrimination. Thus, we conclude that the accumulation of p53 protein, which results from alterations in its turnover, accompanies the process of malignant transformation within long-standing spiradenomas.

Adenoma, Sweat Gland↗

Cellular blue nevi with myxoid change--diagnostic difficulties and the review of the literature.

We report three cases of a rare morphologic variant of the cellular blue nevus, which usually occurs in young patients on the buttocks and lumbar area. This variant is characterized by the myxoid degeneration of the stroma, which separates alveolar nests of nevus cells. The uncommon occurrence and atypical pathologic features may bring about diagnostic pitfalls and unnecessary excessive treatment modalities, therefore, we tried to re-evaluate the criteria of diagnosis of cellular and malignant blue nevi.

Adolescent↗

Diagnosis of Alzheimer's disease with commercially available anti-beta peptide (beta A4) antibodies following microwave oven pretreatment.

Alzheimer's disease (AD), the most common presenile dementia is underdiagnosed in Poland, thus every attempt to make the frequency of this diagnosis approaching standards of Western countries should be recommended. Deposits of beta A4 amyloid in a form of amyloid (senile) plaques, diffuse amyloid deposits and congophilic angiopathy is central to the pathogenesis of AD. These amyloid deposits are virtually invisible in routine pathological stainings like HE but may be visualized with Bielschowsky silver impregnation, other metallic impregnations, and following Thioflavine S or Congo red stainings. We report here that amyloid deposits are as easily immunolabeled with commercially available antibodies against beta A4 (DAKO) and such a staining was greatly enhanced by microwave oven pretreatment. In all cases of AD, the diagnosis could be easily made using either 4GM or commercial DAKO anti-beta A4 antibodies following pretreatment with formic acid or processing in microwave oven. Pretreatment in microwave oven even for only one second was already sufficient to visualize beta A4-immunopositive plaques while after 5 second the intensity of staining approached that obtained after formic acid pretreatment.

Alzheimer Disease↗

Malignant blue nevus with neurosarcoma-like lymph node metastases.

We report a case of malignant blue nevus (MBN) of the foot with unusual morphologic presentation of nodal metastases. Their structure resembled neurosarcoma, and differed from the appearance of the primary tumor. This case confirms the mutual close histogenic relationship between MBN and neurosarcoma, both tumors originating from the structures of the neural crest. We also discuss the problem of so-called "benign" metastases of malignant melanoma.

Biopsy↗

Expression of bcl-2 protein and Epstein-Barr virus latent membrane protein in Hodgkin's disease.

The presence of Epstein-Barr virus (EBV) correlates with some cases of Hodgkin's disease (HD), and its latent membrane protein (LMP) has oncogenic potential by inducing expression of bcl-2 protein. Bcl-2 confers a longer half-life to the cell, which overexpresses it. As the translocation t(14,18), which is most often found in follicular lymphomas, and leads to overexpression of bcl-2, has also been reported in HD, it is possible that there is a correlation between these events in this entity. We stained immunohistochemically 40 cases of HD for the presence of bcl-2 and EBV-LMP. Bcl-2 positivity within reactive lymphocytes was revealed in 29 cases. In five of these cases a week, positive reaction in cytoplasm of Reed-Sternberg cells was observed (one mixed cellularity and four nodular sclerosis cases). The EBV-LMP immunopositivity was observed in 16 of these 29 cases (ten MC and six NS cases). The simultaneous presence of bcl-2 protein and EBV-LMP was found in two cases, the remaining three bcl-2-positive cases did not have EBV-LMP. These results do not support the hypothesis of the correlation between the expression of bcl-2 protein and the presence of EBV-LMP in the pathogenesis of HD as the LMP-dependent stimulation of bcl-2 oncogene.

Antigens, Viral↗

Papillary eccrine adenoma--a case of cutaneous sweat gland tumor with secretory and ductular differentiation.

We report a case of the papillary tubular adenoma (PTA) with histological features of differentiation toward secretory and ductal portions of the eccrine gland (papillary eccrine adenoma). The papillary eccrine adenoma (PEA) is a rare benign adnexal neoplasm of the skin characterised by confined growth; however, in some cases it may present a locally aggressive behaviour. This tumor has a unique histopathological appearance, but sometimes the differential diagnosis with other malignant adnexal neoplasms may be difficult and become a source of excessive surgical procedures. We emphasized the need of the assessment of the whole arrangement of the tumor (symmetry, perpendicularity of its long axis to the epidermis, its own fibrous stroma well separated from the surrounding dermis), which prevents the diagnostic pitfalls with adnexal cutaneous carcinomas.

Adenoma, Sweat Gland↗

Expression of p53-protein, epidermal growth factor receptor (EGFR) and proliferating cell antigens in human gliomas.

Paraffin-embedded surgical specimens from 56 human astrocytomas (8 pilocytic [I degree] astrocytomas, 9 low grade [II degrees] fibrillary astrocytomas, 9 high grade [III degrees] astrocytomas and 30 glioblastomas) were immunostained with the anti-PCNA, anti-p53, anti-Ki-67 and anti EGFR antibodies. Approximately 41% of all cases were p53 protein-positive while 23% were EGFR positive. Five cases (8.9%) were positive for both p53 protein and EGFR. Low grade gliomas showed low PCNA LI while high PCNA LI was observed in high grade gliomas. The same trend was observed with anti-Ki-67 antibodies but the proportion of Ki-67 immunolabelled cells was always much lower. In conclusion, we found two populations of astrocytic tumors with EGFR and with p53 protein overexpression but no dependence between p53 immunoreactivity and PCNA or Ki-67 LI.

ErbB Receptors↗

Pleomorphic xanthoastrocytoma and desmoplastic infantile ganglioglioma--have these neoplasms a common origin?

We report a case of a 24-year-old woman with left temporal pleomorphic xanthoastrocytoma (PXA) with atypical neuronal cells. Many neoplastic cells, otherwise typical of PXA, expressed glial fibrillary acidic protein, while neuronal cells with marked atypia were immunopositive for synaptophysin and neurofilament protein. This report supports a notion that PXA, like other astrocytic tumors, may has its gangliogliomatous counterpart as superficial cerebral astrocytoma of infancy has it in desmoplastic infantile ganglioglioma.

Adult↗

Percentage of proliferating cell nuclear antigen (PCNA)-positive Reed-Sternberg cells in nodular sclerosis Hodgkin's disease.

Proliferating cell nuclear antigen (PCNA/cyclin) is a useful marker of proliferation and its expression correlates with prognosis in some human neoplasms. The clinical course of nodular sclerosis Hodgkin's disease (NSHD) varies in both grades (NSI, NSII) as defined by the British National Lymphoma Investigation. Expression of PCNA in Reed-Sternberg cells and their variants was evaluated in NSI and NSII. There were no significant differences in the ratio of PCNA-positive cells in both groups. The results suggest that differences in the clinical course do not depend on the proliferative rate of Reed-Sternberg cells and their variants in NSHD.

Antigens, Neoplasm↗

Plasmablastic lymphoma in a patient with chronic lymphocytic leukemia heavily pretreated with cladribine (2-CdA): an unusual variant of Richter's syndrome.

Patients with chronic lymphocytic leukemia (CLL) may develop a large-cell transformation known as Richter's syndrome (RS). RS usually presents as diffuse large-cell lymphoma (DLCL) or its immunoblastic variant, and it can be recognized simultaneously with CLL or even 23 yr after its diagnosis. We describe an unusual case of CLL treated with cladribine (2-CdA) in whom DLCL of the plasmablastic type (PBL) developed 4 yr after CLL (Rai IV) diagnosis and 1.5 yr after the 10th course of 2-CdA treatment. Immmunologic, cytogenetic, and molecular studies performed at the time of CLL and PBL coappearance indicated that both tumors originated from different B-cell progenitors. Both malignancies were refractory to VAD (vincristine, doxorubicin, dexamethasone)-based chemotherapy, and only partial response was achieved with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) salvage treatment. However, the patient died 6 months after the occurrence of RS due to rapid progression of PBL. This is the first description of a CLL patient who developed an unusual plasmablastic variant of RS. Recently, the PBL entity has been identified among DLCL associated with the human immunodeficiency virus (HIV) infection. We suggest that in our CLL patient heavily pretreated with 2-CdA, PBL arose as a second clone due to the prolonged and severe state of the host's immunosuppression. Overall survival with current strategies is poor, and further insight into the natural history, biology, and treatment of PBL are needed.

Antineoplastic Agents↗

Dysembryoplastic neuroectodermal tumor: an ultrastructural study of six cases.

Dysembryoplastic neuroectodermal tumor (DNT) is a rare brain neoplasm. Although the tumor pathology is relatively well charactererized, its full clinicopathological spectrum is still discussed, and ultrastructural data on it are very limited. Here, the authors describe detailed ultrastructural pathology of 7 cases of DNT. Each tumor consisted of 3 major elements: neoplastic cells (oligodendroglial-like cells, OLC), elongated processes forming neuropil-like structure, and expanded "mucoid" extracellular space, the latter giving an impression of cellular elements floating within it. Neoplastic cells had round, oval, or elongated nuclei, no discernible nucleoli, and a relatively narrow rim of cytoplasm. Some nuclei were irregular and invaginated, and pseudoinclusions (invaginations of cytoplasm penetrated into toroid-like nuclear formations) were observed. Part of the cytoplasm sequestrated within pseudoinclusions often appeared degenerated with large blebs and electron-lucent vesicles, and some of these contained, in turn, semicircular profiles of unknown significance. Chromatin was clustered below the nuclear membrane. The cytoplasm contained a few mitochondria, round rather than elongated, a few stacks of rough endoplasmic reticulum, and scanty microtubules and clear vesicles. The second element consisted of innumerable cellular processes. Some of these were elongated and formed stacks connected by symmetric or asymetric adhesive plaque junctions. Others had shorter "neck" containing microtubules extending into bulbous extensions. Dense-cored vesicles were occasionally observed, both in the cytoplasm of neoplastic cells and within processes. In one cell, cross-sectioned annulate lamellae were found. In the cytoplasm of a few cells, unusual inclusions reminiscent of ribosome-lamellae resembled "laboratory tubes" with cone-like endings. At higher power, walls of the "tubes" resolved into layered structures composed of several laminae; between these, ribosome-like structures were visible. The authors conclude that OLC exhibit clear-cut characteristics of neuronal cells and not true oligodendocytes.

Adolescent↗

Breast fibroadenoma with atypical features: a case report.

BACKGROUND: Although the cytologic features of fibroadenoma are well established, some of the smears from these tumors cause serious diagnostic problems. CASE: In the cytologic smears from a deeply located breast nodule in a 53-year-old female we found, besides the typical features of fibroadenoma, atypical cells suggesting carcinoma, with intranuclear indentations, nuclear molding, mitotic activity and intracytoplasmic vacuoles. Histologic examination confirmed the diagnosis of fibroadenoma, but marked ductal cell hyperplasia was also revealed. CONCLUSION: Some disturbing atypical changes may occur in fibroadenoma smears.

Biopsy, Needle↗

Ultrastructural pathology of glial brain tumors revisited: a review.

The ultrastructural pathology of primary brain tumors of glial origin is examined. These are divided into two major groups. The first category comprises astrocytoma with the variants: fibrillary, protoplasmic, gemistocytic, and anaplastic. These are biologically aggressive tumors of a relatively high proliferative potential and include a substantial proportion of cases that transform into the most malignant secondary glioblastoma. The second category, comprised of rather benign tumors of a limited proliferative capacity and a reasonable good prognosis, includes such clinico-pathological entities as pilocytic astrocytoma, pleomorphic xanthoastrocytoma, and subependymal giant cell astrocytoma of tuberous sclerosis. There is no ultrastructural feature, however, which makes it possible to discriminate between major subclasses of astrocytes; but secondary glioblastoma cells, while still retaining the stigmata of neoplastic astrocytes, are characterized by nuclei that seem to be more indented, cisterns of the endoplastic reticulum may be distended, and intranuclear pseudoinclusions are frequently observed. Primary glioblastoma, which probably originates de novo, is characterized by poorly differentiated cells with a paucity of subcellular organelles and no obvious features of astrocytic origin. Granular cell tumor also belongs to neoplasms of astrocytic lineage and the hallmark of this entity is a cell characterized by the presence of numerous membrane-bound, electron-dense autophagic vacuoles. Its malignant analogue is the granular cell glioblastoma. Two subtypes of granular cell glioblastoma have been distinguished. The first is characterized by the presence of numerous granular, electron-dense bodies which correspond to autophagic vacuoles. The second type is characterized by numerous electron-dense, amorphous masses within cellular processes. These electron-dense inclusions are virtually indistinguishable from minute Rosenthal fibers. The pilocytic astrocytoma is virtually indistinguishable at the ultrastructural level from fibrillary astrocytomas but cells tend to be more elongated. Besides Rosenthal fibers, two types of distinctive structures are relatively common in pilocytic astrocytomas: eosinophilic hyaline droplets and round granular bodies, which are composed of large aggregates of electron-dense secondary lysosomes or small electron-dense bodies, respectively. Pleomorphic xanthoastrocytoma is characterized by astrocytes surrounded by basal membranes. It belongs to a peculiar category of astrocytic "desmoplastic" brain tumors occurring in younger patients, the common denominator for which is the presence of basal lamina. The last category in this group is subependymal giant cell astrocytoma, a tumor of bivalent (glial and neuronal) differentiation, the cells of which are characterized by the presence of peculiar crystalloids. The hallmark of oligodendroglioma is the presence of concentric arrays of membranes (so-called membrane laminations, whorls, or scrolls). A fragment of the cytoplasm sequestrated within a particular whorl may contain mitochondria, lysosomes, or abundant glycogen granules. Ependymomas are characterized by a florid picture dominated by the presence of microlumina, cilia with basal bodies (blepharoplasts), microvilli, and long, interdigitating intercellular junctions of the zonulae adherentiae type. Ganglioglioma, the last category covered by this review, is a mixed glio-neuronal tumor. While glial cells are indistinguishable from their counterparts encountered elsewhere (mostly pilocytic astrocytes), the ganglion cells are characterized by abundant intracytoplasmic dense-core vesicles, absence of intermediate filaments, and numerous microtubules. Occasionally a close apposition of ganglion cells and Rosenthal fibers is seen. Dense-core vesicles are pleomorphic and ranged in a diameter from small synaptic vesicles to large lysosome-like neurosecretory granules.

Brain Neoplasms↗

Microsatellite instability and expression of DNA mismatch repair genes in malignant astrocytic tumors from adult and pediatric patients.

Microsatellite instability (MSI) is used as a molecular marker for defective DNA mismatch repair (MMR) genes. We report here alterations of MSI in 15 malignant astrocytomas (WHO grade III) and glioblastomas (GBM; WHO grade IV) of pediatric patients (2 - 21 years) and 12 GBM from adults (44 - 68 years) by comparative analysis of BAT25/BAT26 loci and 10 other microsatellite markers. High-level microsatellite instability (MSI-H) occurred in 4 of the 15 pediatric cases (26.7%) and in 1 of the 12 adult GBM cases (8.3%). Low-level microsatellite instability (MSI-L) was observed in 6 pediatric cases (40%) and 8 adult GBM (66.7%). Unstable BAT-25 locus was found in 1 of the MSI-H pediatric cases. Thus, 2 unstable cases showed no instability of this marker. For BAT-26, such a discordance was even more profound: in 1 of MSI-H cases, we obtained no PCR product and the remaining 3 showed no alterations of this marker. MSH2 (Human MutS, Homologue2) protein was detected in all but 3 pediatric cases (1 highly unstable and 2 low-level unstable) and in all adult cases. MLH1 (Human MutL, Homologue 1) protein was detected in all but 2 pediatric cases (1 highly unstable and 1 low-level unstable). Thus, 2 highly unstable pediatric cases showed no detectable MLH1/MSH2 proteins. Our data support earlier observations that MSI occurs predominantly in malignant astrocytic tumors of young patients, which lends support to the hypothesis of different molecular mechanisms of pediatric brain tumors. Surprisingly, we found no significant correlation between the status of 10 microsatellite markers and that of either BAT25 or BAT26 loci or with the expression of MMR genes.

Adaptor Proteins, Signal Transducing↗

[Evaluation of the efficacy of cytodiagnosis in patients with breast cancer].

In connection with two year material from Oncological Department of the Medical Academy in Lódź concerning 4661 cytologic examinations of breast tumors, the percentage of false positive and false negative diagnoses has been determined in cases with histologic confirmation. False positive diagnoses amounted to 0.086% of all cytologic examinations of the breast and 0.62% of all cytologic diagnoses of the breast cancer. The percentages are comparable with false positive diagnoses obtained in large oncological centers, in which cytologic diagnosis is sufficient for therapeutical decision. The percentage of false negative diagnoses has been 5.4 or 11.6 relatively to accepted criterion. With preservation of necessary caution by clinician such index is not suggesting the discontinuation of this diagnostic procedure.

Adult↗