ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Vol. 47 No. 3, 2006

1. The article has been retracted

The article has been retracted

The article has been retracted

Corresponding author: The article has been retracted

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2. Comparative detection of high-risk HPV (16, 18, 33) in cervical bioptic material of County Hospital of Tg. Mures

Z. Pávai, T. Füle, E. Horváth, M. Máthé, Zs. Pap, L. Denes, J. Jung

The purpose of this study was to collect data about the incidence of high-risk HPV (16, 18, 33) types in paraffin embedded cervical bioptic material, including LSIL, HSIL and cervical cancers using immunohistochemistry and nested PCR methods. In our study were included randomly selected 10 LSIL, 18 HSIL and 30 cervical cancer cases. We analyzed the expression of HPV in this specimens with immunohistochemistry used DAKO K1H8 antibody and CHEMICON Mab HPV 16, 16 antibody using LSAB method and Tiramin amplification method, and nested PCR for HPV 16, 18 and 33. In LSIL cases three, in HSIL cases eight and in carcinoma 20 cases were positive for HPV 16 or 18 for immunohistochemistry or PCR. Although this proportion in lower than those reported in the literature, our work signals the existence of the infection in our country and presents a relatively cheap diagnostic method.

Corresponding author: Zoltan Pávai, MD, PhD, e-mail: zpavai@umftgm.ro

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3. Early gastric carcinoma diagnosed on endobiopsic and surgical specimens

Maria-Sultana Mihailovici, M. Danciu, Luminita Ivan, D. Ferariu

Early gastric carcinoma (EGC) is difficult to diagnose without a screening program. Aims. In this study, we reveal the importance of endobiopsy in EGC diagnosis. Material and methods. We examined multiple gastric endobiopsies from 1201 patients with or without symptoms and endoscopical aspect for gastric carcinoma. All specimens were fixed in 15% buffered neutral pH formaldehyde and paraffin embedded. Histological sections were stained using current techniques: Hematoxylin-Eosin, trichromic van Gieson, Giemsa (for Helicobacter pylori) and Alcian blue, pH 1 and 2.5 (for acid and sulfated mucins). We used Laurén histological classification with two main types of gastric carcinoma: intestinal and diffuse. Results. From 1201 gastric endobiopsies, we diagnosed gastric carcinoma in 257 patients (21.3%) and only four of them were EGCs, although their endoscopical examination was negative for gastric tumor. Among these malignant proliferations, three cases showed intestinal type EGC and one case was diffuse type EGC. The additional endobiopsies fragments presented chronic atrophic gastritis with H. pylori infection, intestinal metaplasia and dysplasia. Conclusions. EGC had an incidence of 0.34%, which is very low because the lack of an endoscopical screening program favors the diagnosis of gastric cancer in advanced stages. Both histological types - intestinal and diffuse, were present in EGC, associated with H. pylori chronic gastritis, intestinal metaplasia and dysplasia. The presence of dysplasia recommends the endoscopical surveillance of these patients.

Corresponding author: Maria-Sultana Mihailovici, MD, PhD, e-mail: msmihailovici@yahoo.com

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4. Predictive parameters for advanced neoplastic adenomas and colorectal cancer in patients with colonic polyps - a study in a tertiary medical centre in the South-West region of Romania

Sevastița Iordache, A. Săftoiu, T. Ciurea, Claudia Valentina Georgescu, Mirela Ghiluşi

Although many papers had described the role of colorectal adenomas and the risk for colon cancer, there is a lack of data about epidemiological factors, the histological type, the pit-pattern and type of polyps in Romania. In polypoid adenomas the risk of malignant transformation is well known, and is increasing over time with size and villous architecture. In this paper, we evaluate the predictive parameters that allowed us to establish a correlation between the macroscopical aspect and histological architecture of adenomas in our geographical area (South-West region of Romania). Two predictive parameters of cancer characterize early neoplastic lesions: their size and their surface elevation (elevated, flat or depressed). The morphology of adenomas and multiplicity of polyps also have a prognostic value. In our study, the main localization of polyps was in the left colon, while the main histological type was tubulo-villous adenomas. We consider that the significant parameters for dysplasia and malignant lesions are the size of lesions, multiplicity of polyps and villous architecture.

Corresponding author: Sevastița Iordache, MD, PhD candidate, e-mail: sevastita@gmail.com

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5. Diagnosis problems in a case of minimal deviation adenocarcinoma of the cervix

Cristiana Simionescu, Claudia Valentina Georgescu, Cl. Mărgăritescu, Mihaela Niculescu

We present the diagnostic problems in a case of minimal deviation adenocarcinoma of the cervix. Histopathologic exam of the tumor, made on serial sections, revealed a dense and profound proliferation of the glandular structures that were lined by endocervical type epithelia with minimal cellular and nuclear atypia. The aspect suggested the diagnosis of minimal deviation adenocarcinoma endocervical type; in order to confirm the diagnosis we immunohistochemical investigate the tumor for CEA, CA125, Ki67, ER and PR. The results indicated focal positivity for CEA, CA125 lack of immunostaining for ER and PR and Ki67 positivity with a low index of proliferation. We can conclude that all these markers are useful in the diagnosis, excluding the benign endocervical lesions.

Corresponding author: Cristiana Simionescu, MD, PhD, e-mail: csimionescu2004@yahoo.com

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6. Angiogenesis and tumor grading in primary breast cancer patients: an analysis of 158 needle core biopsies

S. Vameşu

Angiogenesis, the formation of new blood vessels from a preexisting vascular bed, is a complex multistep process. To investigate how tumor angiogenesis correlates with tumor grading in breast carcinoma diagnosed on core biopsy, microvessels were counted (and graded the density of microvessels) within the initial invasive carcinomas of 158 patients. Using light microscopy, the number of microvessels was counted manually in a subjectively selected hot spot (in the most active areas of neovascularization per 400x field), and their values were separated as above or below median (low and high), without knowledge of the outcome in the patient or any other pertinent variable. When the mean values of MVD of the various groups defined by tumor grading were compared, significant difference was noted (P = 2.61E-17). When the mean values of MVD of the groups defined by tumor grading risk were compared, significant difference was noted (P = 7.68E-05). When tumors were classified as high or low MVD, based on a cut-off value (30.70175 microvessels/square-mm), cases with high MVD were significantly more numerous in MSBR four patients. MVD did show a relationship with groups defined by MSBR grade (P = 3.25209E-07) or with tumor grading risk (P = 2.54181E-06). Assessment of tumor angiogenesis may therefore prove valuable in selecting patients with early breast carcinoma for aggressive therapy.

Corresponding author: Sorin Vameşu, MD, PhD, e-mail: sorinvamesu@yahoo.com

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7. Histochemical and histopathological study of the gastric mucosa in the portal hypertensive gastropathy

Alina-Cătălina Drăghia

It has been studied 'in situ' the action of NADH2-cytochrome C reductase, an aerobe oxidative enzyme, in comparison to lactate dehydrogenase, a glycolitic enzyme in the gastric mucosa and with portal hypertensive gastropathy (PHG) accompanied by morpho-pathological observations. In the normal gastric mucosa, the aerobe oxidative metabolism is predominant over the anaerobe one in all types of cells, but in different intensities (medium in the surface epithelium and low in the vascular endothelium, weak, medium, intense and very intense in fibroblasts and in secretory cells of fundic glands and macrophages). In the portal hypertensive gastropathy, this type of metabolism decreases and the anaerobe metabolism increases, tending to equal the first, especially in the glandular cells. The oxidative activity decreases in the surface epithelium and in the vascular endothelium, increases in cells of the inflammatory infiltrate and in fibroblasts and mast cells.

Corresponding author: Alina-Cătălina Drăghia, MD, PhD candidate, e-mail: draghia_alina@yahoo.com

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8. Radiological and microscopic aspects of the denticles

V. Deva, L. Mogoantă, H. Manolea, Oana-Adina Pancă, Mihaela Vătu, Maria Vătăman

In this paper we have realized a study on 43 patients on which the retro-alveolar radiological exam has shown the existence of a calcareous structure within the pulp chamber having in view a better knowledge of this structure and its etiology, way of forming and pathological implications. For 16 of the patients the radiological exam was supplemented by a microscopic examination. Radiologically, the denticles were noticed more often in the pulp chamber of the molars. The examination of the histological samples has evidenced aspects such as the size, shape and structure of the denticles. The concentric disposition of the tissue elements shows that in the formation of a denticle there is a "center" around which a conjunctive substance avid of calcium salts is deposited. The microscopic aspects noticed on large denticles allowed us to sustain the hypothesis that in a large pulp chamber many denticles form simultaneously and grow up and merge generating a large-sized unique calcareous structure.

Corresponding author: Virgil Deva, MD, PhD, e-mail: virgil_dv@yahoo.com

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9. Choroidal melanocytes and associated pathology

Mihaela Coroi, Gabriela Muțiu, Elena Roşca, Ligia Burtă, Roxana Ilin, Felicia Manole

The embryologic origins of choroidal and cutaneous melanocytes, also of the genes involved in cutaneous and choroidal melanoma, are identical, even the two kinds of tumors are different entities. This is a general scientific report, which stretches the molecular mechanisms, as basement of choroidal melanocytes proliferation.

Corresponding author: Mihaela Coroi, MD, PhD, e-mail: opticlar@gmail.com, opticlar@rdslink.ro

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10. Morpho-physiological aspects of rapports between bone and marrow bone

Ligia Rusu, M. Dănoiu, Suzana Dănoiu, Elvira Păun

Border between bone and marrow bone has many problems regards differentiation, cells topography, dynamic process of osteoclasto-genesis. Therefore, this study tries to present morphophysiological aspects of this border, using many bone fragments that include compact and spongious bone. We observed genesis process of trabecular bone near the chondroclast zone and the osteoblast between sinusoid capillaries. Also, the development of lamellar bone and the rapports between this structures, new marrow cells and angiogenesis process that exist near the lamellar trabecular bone surface. We observed the relation between immune system and bone, because it exist some factors that involve the development of cells precursors of lymphocyte B. Using a special staining method we observed the process of angiogenesis, hematopoetic system and reticuline fibers.

Corresponding author: Ligia Rusu, MD, PhD, e-mail: ligiarusu@hotmail.com

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11. Former and present aspects in neuro-skull architecture

M. C. Niculescu, V. Niculescu, Adelina Jianu, M. Zăvolan, A. Motoc

The classical authors considered the functional resistance of the neuro-skull to consist of arcs at the arch level, rafters at the base and pillars at the joint of the arcs and rafters, those last also connecting the neuro-skull framework and that of the viscero-skull. The new outlooks replace the term pillar with that of resistance node and assemble the arcs and rafters within common structures, named resistance belts. The belts are: one in transversal, three sagittal, two in frontal plane and two oblique positions. At the intersection of the belts, the resistance nodes are placed.

Corresponding author: Marius Corneliu Niculescu, MD, PhD, e-mail: niculescu.virgil@gmail.com

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12. Correlations between anomalies of jugular veins and areas of vascular drainage of head and neck

Monica-Adriana Vaida, V. Niculescu, A. Motoc, S. Bolintineanu, Izabella Sargan, M. C. Niculescu

The study conducted on 60 human cadavers preserved in formalin, in the Anatomy Laboratory of the "Victor Babeş" University of Medicine and Pharmacy Timisoara, during 2000-2006, observed the internal and external jugular veins from the point of view of their origin, course and affluents. The morphological variability of the jugular veins (external jugular that receives as affluents the facial and lingual veins and drains into the internal jugular, draining the latter's territory - 3.33%; internal jugular that receives the lingual, upper thyroid and facial veins, independent - 13.33%, via the linguofacial trunk - 50%, and via thyrolinguofacial trunk - 33.33%) made possible the correlation of these anomalies with disorders in the ontogenetic development of the veins of the neck. Knowing the variants of origin, course and drainage area of jugular veins is important not only for the anatomist but also for the surgeon operating at this level.

Corresponding author: Monica-Adriana Vaida, MD, PhD, e-mail: monicaadrianavaida@yahoo.com

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13. Primary chondroblastic osteosarcoma of the breast. Case report and review of the literature

C. D. Olinici, Doinița Crişan, Liliana Resiga

Primary osteosarcomas of the breast are rare tumors. We report a 58-year-old woman who presented with a left breast lump suggestive of phyllodes tumor. A sectorectomy was performed and histological examination revealed a chondroblastic osteosarcoma, an unusual finding. Two months later, she underwent a mastectomy. A review of the literature revealed the divergence of therapeutic options.

Corresponding author: Corneliu Dorin Olinici, MD, PhD, e-mail: anapatol@yahoo.com

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14. 46,XY Hypergonadotropic hypogonadism and myasthenia gravis

Corina Lichiardopol, V. Herlea, Virginia Ioan, V. Tomulescu, F. Mixich

Both hypergonadotropic hypogonadism and myasthenia gravis can be parts of type II autoimmune polyendocrine syndrome and association between the two disorders has been reported in few cases. A 14-year-old male patient with a personal history of bilateral cryptorchidism and ptosis was referred for delayed puberty. Clinical examination revealed eunuchoid habitus, small, soft testes, gynecomastia, ptosis, a myasthenic deficit score of 22.5 points and an IQ of 84 points. Decreased testosterone (0.064 ng/mL) and elevated LH (64.5 mUI/mL) were consistent with hypergonadotropic hypogonadism and karyotype was normal: 46,XY. Thyroid function, haematologic evaluation, BUN, elecrolytes, and glycemia were in the normal range. Therapy consisted of anticholinesterase inhibitors, immunosuppressants, corticotherapy, testosterone; thoracoscopic thymectomy was performed showing thymic lymphoid hyperplasia on histopathologic examination. Myasthenic score improved (12.5 points), progressive virilization occurred, and a year later the patient presented with cushingoid features and obesity.

Corresponding author: Corina Lichiardopol, MD, e-mail: corinalich@gmail.com

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15. Asymptomatic abdominal wall endometrioma 15 years after cesarean section

V. I. Tica, C. L. Tomescu, Aneta Tomescu, Luminița Micu, M. Zaher, S. Bafani, M. Beghim, L. Serbănescu, Irina Tica

Abdominal wall endometriosis is rare and its diagnosis is difficult. However, the consequences may be serious, like recurrences or even malignant transformation. We report a rarer case of asymptomatic abdominal wall endometrioma, accidentally found during a surgical procedure for a second cesarean section, in a 39-year-old patient, without any relevant history of endometriosis. The tumor was subcutaneous, 3/3 cm in size, located in the left angle of the incision from the 15 years previously performed cesarean section and freely mobile in relation with the skin and the fascia. It was excised, with clear margins (to prevent recurrences), during the procedure. The patient was discharged after five days. The postoperative period and the follow-up at one and three months were uneventful. The pathological examination clarified the diagnosis by revealing an endometrioma with decidual reaction. Such a condition may be, therefore, evoked before an abdominal wall tumor, even without specific symptoms, even in a 39-year-old woman and longtime after the possible causal surgery. Pathological examination remains the ultimate diagnostic tool. Relevant prophylactic attitude at the end of the cesarean section may be considered.

Corresponding author: Vlad I. Tica, MD, PhD, e-mail: vladtica@datanet.ro

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