Histopathological and clinical-progressive profile of skin carcinomas: study on 1688 cases

Skin carcinomas represent 90-95% of skin cancers. With the objective of identifying the histopathological and clinical-progressive profile of skin carcinomas, we undertook a retrospective study over a period of seven years, which included a total of 1688 patients with carcinoma of the skin, hospitalized and treated in Craiova Dermatology Clinic between January 1999 and December 2006. Patient data such as identification data, environment, profession, phototype, location of cancer, history of the disease, clinical diagnosis, histopathological diagnosis and response to treatment were included in clinical charts. Basal cell carcinoma (BCC) was diagnosed in a total of 1162 patients, representing 68.84% of cases taken to the study. The most common clinical forms were: pearly BCC (37.95%), nodular BCC (29%), and superficial BCC (22.03%). Regarding the histological type, the most frequent forms were: BCC polymorphic (29.95%), BCC solid (24.96%), and keratinized BCC (19.97%). Epidermoid carcinoma (EC) was encountered in a total of 482 patients, representing 28.55% of all cases. The most frequent forms were: vegetated ulcerated EC (34.03%), nodular EC (31.33%) and keratosic EC (24.27%). Regarding the degree of differentiation, the situation was as follows: well-differentiated EC (64.94%), medium differentiated (29.88%), poorly differentiated (5.18%). Metatypical carcinoma (MC) was found in 44 patients (2.61%). This type of cancer did not presented clinical particular signs, the diagnosis was strictly pathological.

Clinical and histopathological aspects in otomastoiditis

We aimed to establish correlations between the clinical manifestations and histopathological changes occurring in otomastoiditis. To this effect, we have made a retrospective clinical and statistical study on a number of 146 patients diagnosed with otomastoiditis, admitted in the Otorhinolaryngology Clinic of the Emergency County Hospital, Craiova, during 2003-2007. Of the 146 patients, 128 (87.67%) were suggested to follow a radical surgical treatment (total petromastoidian evidation), in 10 cases (6.85%) a partial petromastoidian evidation was performed, and in eight cases (5.48%) there were made reappraisals of the petromastoidian evidation cavities. When the surgical procedures were performed, there were collected fragments of mucous from the middle ear or from the mastoid cavities, which were sent for examination to the Laboratory of Anatomical Pathology, where there were performed classical histological (Hematoxylin-Eosin and trichromic Van Gieson) and immunohistochemistry staining. The clinical and statistical study emphasized the fact that the onset of the disease was chronic in 143 patients (97.95%) and of acute type in three patients (2.05%). Taking into account the medical history of the patients, repeated episodes and incorrectly treated of acute infections of the middle ear (otitis) were found in most cases, amounting to a percentage of 97.95%. The distribution of the patients on the five years was relatively uniform, in 2003 - 24 cases (16%), in 2004 - 36 cases (25%), in 2005 - 28 cases (19%), in 2006 - 25 cases (17%), in 2007 - 33 cases (23%), and the most affected age groups were 21-30-year-old (19.86%) and 51-60-year-old (21.92%). Analyzing the cases included in the studied group emphasized the fact that for a relatively large percentage of patients (87.67%) it was required as an immediate necessity the surgical procedure of total petromastoidian evidation, due to the extensive damages, the negligence of the patients that did not contact in proper time a medical specialist. The most frequent histopathological diagnose was of cholesteatoma in 60 cases (41.10%), fact which also grounded the surgical procedure. Immunohistochemical and microscopic study highlighted in the epithelium areas of necrosis, associated with areas of reactive hypertrophy and hyperplasia, and in the chorion, the existence of a chronic inflammatory infiltrate made up of lymphocytes, plasmocytes and macrophages. The immunohistochemistry studies stressed the preponderant presence of T-lymphocytes and macrophages in the chorion of the mucous of the middle ear, confirming the presence of an immune reaction, predominantly of cellular type.

[Nutritional behaviour at persons between 55-70 years of age from different activity domains]

In the present work we decided to find out more about nutritional behaviour at persons between 55-70 years from the four activity domains, representative for the professional background of the Dolj county (agriculture, education, industry and health), using the following hypothesis of work: the grade of medical culture specific for some groups of population induces decisive changes in the nutritional behaviour and, after that, in the health state and professional performance.

MATERIAL AND METHOD

129 subjects were included in the research, with the age between 55 and 70 years, selected from the recalled activity sectors. With the aim of knowing the nutritional behaviour, we have done a nutritional inquiry, each subject completed thee kinds of questionnairies.

RESULTS

The farmers and the subjects from industry preferred to eat cheese, eggs, vegetable concentrated lipids and cereal products which were consumed in excess; on the oher hand, they ate few meat and meat products, fish, animal concentrated lipids, vegetables and fruits, sugar and sweets. The educators preferred more various food: meat products, cheese, eggs, vegetable concentrated lipids, cereal products, bread, dried vegetables, sugar and sweets, but they consumed few milk, meat, vegetables and fruit. The food preffered by the persons coming from health was: meat and meat products, cheese, eggs, vegetable concentrated lipids, cereal products, dried vegetables but some of them were eaten in excess. Any proteins were consumed in excess by the subjects coming from agriculture, education and health, and almost normally by the persons coming from industry. Sweets were deficiently used by the persons coming from agriculture and industry and in excess by those ones coming from education and health. Lower caloric values were observed in patients belonging to the second age group coming from health and education. Mineral and vitamins consumption was in deficit in all the subjects we studied.

CONCLUSION

We could identify two kinds of nutritional behaviour: one common for the persons from agriculture and industry and the other very resembling for the persons from educational and medical sector.

Chronic tonsillitis: histological and immunohistochemical aspects

OBJECTIVES

Chronic tonsillitis represents the most common inflammatory lesions of the pharynx determining numerous local or distant evolutive complications. We decided to study the histological and especially immunohistochemical expression of this pathology.

MATERIAL AND METHODS

We have studied 112 surgical samples representing tonsils resected from 56 patients with chronic tonsillitis. The tonsillectomies were performed in the ENT Clinic of the Emergency County Hospital of Craiova, between 01.01.2007--31.12.2007. The processed histological samples were stained using Hematoxylin-Eosin, light green trichromic and argental impregnation. For the immunohistochemical study, we used LSAB method with CD20, CD45 RO, CD68 antibodies in order to reveal and differentiate T- and B-lymphocytes and also the macrophages.

RESULTS

In all samples, we found hyperplasia and hypertrophy of the lymphoid follicle with excessive developing of the clear germinal center as a normal reaction to antigens presence. In some cases, we remarked micro hemorrhages and hematic extravasations inside the follicles, probably due to the excessive virulence of the pathogens causing endothelial lesions. The conjunctive stroma was enriched in collagen fibbers, in some cases organized in strong fascicles with an obvious tendency to divide the tonsils in lobules. The young fibroblastic type cells were numerous. The specific reticulin fibbers had a low representation being disorganized. The immunohistochemical study proved that the clear center of the lymphoid follicles was occupied by B-lymphocytes, but the T-lymphocytes were present in the cortical region of the follicles, perifollicles and in the surface epithelium.

CONCLUSIONS

In some pathological cases, the predominant cellular population of the clear center was formed by T-lymphocytes.

Histopatological aspects of endometroid carcinoma in correlation to the state of tumoral progression in women patients during their premenopausal period

The performed study has comprised a number of 60 endometrial carcinomas, prevailed from women aged in the premenstrual period, in whose cases we have followed also the appreciation of the differentiating grading as well as the various aspects in neoplasies progression. The appreciation of the differentiating grading has allowed their placing as it follows: 39 cases of endometroid carcinoma well differentiated, seven cases of endometroid carcinoma mildly differentiated and five cases of endometroid carcinoma poorly differentiated. The correlation of the differentiating grading with the stage of tumoral progression has allowed the observation of the fact that while well invasive differentiated endometroid adenocarcinoma have been limited to the level of the uterine body, mildly and poorly differentiated invasive endometroid carcinoma besides profound myometrial invasion have associated cervical invasion and metastasis in structures situated at a real distance.

P53 and PCNA immunoexpression in endometrial carcinomas

This paper analyzes 18 endometrial carcinomas with different degrees of differentiation, the objective being to estimate involvement of p53 oncoprotein in the mechanism of endometrial carcinogenesis and the possible correlations with the tumoral proliferative activity evaluated by PCNA. The p53 immunoexpression was positive in 44.4% of the studied endometrial carcinomas, divided in three groups, the intensity of the immunostaining for p53 being increased for the low differentiated and undifferentiated endometrial carcinomas, whereas the differentiated endometrial carcinomas were moderate or low p53 positive. All the investigated tumors were PCNA positive, the PCNA index being of 40% in well-differentiated carcinomas, while in low differentiated and undifferentiated endometrial carcinomas the medium values of PCNA were of 60%, respectively 85%. Correlating the p53 and PCNA findings, we noted that PCNA was expressed especially in the cases with increased proliferative activity, without a significant statistic correlation between p53 and PCNA expression.