Introduction. Despite the treatment methods’ improvement, the brain glioblastoma (GB) patient survival remains at the level of 12–14 months. In this regard, it is very relevant to optimize the choice of the treat-ment of recurrent GB, including using stereotactic radiosurgery (SRS). Materials and methods. Comparative analysis of the endothelial cells in the capillaries of blood vessels of the brain peritumoral zone (PZ) before (1 group – 32 capillaries) and 12 – 14 months after (2 group – 75 capillaries) adjuvant external radiation therapy (AERT) was performed using transmission electron micros-copy (TEM). Results. Apoptosis of endotheliocytes was observed in the capillaries of the brain PZ from 2 group much more often than from 1 group (60% and 12.6% of capillaries, respectively, p<0.001). Capillary death and thrombosis occurred in 4% and 1.4% of 2 group capillaries. An important finding was that only 69.3 of capillaries from 2 group revealed thickening of the basement membrane (BM), and 26.9% of them also revealed its peak deformation. Conclusion. 12–14 months after AERT, the brain PZ remains ischemic due to apoptosis of the capillary endothelium, thickening and peak deformation of the BM. The detected signs of revascularization of the brain PZ after previously performed AERT suggest that it is possible to consider SRS as a method of treat-ment for recurrent brain GB. Keywords: brain glioblastoma, peritumoral zone, endotheliocyte apoptosis, thickening of the basement membrane, stereotactic radiosurgery, glioblastoma relapse

Background: Cancer of the parotid salivary gland (PSG) accounts for more than a half of all cases of salivary gland malignancies. Its treatment strategy remains a matter of debate. Aim : To identify factors significantly associated with the 3-year survival of patients with PSG cancer after combination treatment. Materials and methods : Thirty nine patients with morphologically confirmed PSG cancer (T1-4N0) were recruited into the study. Surgery (partial or total parotidectomy without the cervical lymphatic node dissection) was performed in 32 patients. The most frequent diagnosis (n = 10; 25.6% of all cases) was adenocarcinoma. Radiation to PSG and the regional lymphatic nodes was used in 15 patients as neoadjuvant and in 24 as adjuvant regimen. Three-year survival rates were analyzed in 36 patients by the Kaplan-Meier method, with consideration of their sex, age and the sequence of surgical and radiation treatment. Results : The 3-year survival after combination treatment of PSG cancer patients was 82.7%. Women, patients above 60 years of age and those who received adjuvant radiation therapy demonstrated a trend towards better 3-year survival, although it was non-significant (p > 0.05). Conclusion : Combination strategy remains an effective approach to PSG cancer irrespective of age and sex of patients. The use of radiation therapy as a single modality is possible only in exceptional cases.

Background: Cancer of the parotid salivary gland (PSG) accounts for more than a half of all cases of salivary gland malignancies. Its treatment strategy remains a matter of debate.Aim: To identify factors significantly associated with the 3-year survival of patients with PSG cancer after combination treatment.Materials and methods: Thirty nine patients with morphologically confirmed PSG cancer (T1-4N0) were recruited into the study. Surgery (partial or total parotidectomy without the cervical lymphatic node dissection) was performed in 32 patients. The most frequent diagnosis (n = 10; 25.6% of all cases) was adenocarcinoma. Radiation to PSG and the regional lymphatic nodes was used in 15 patients as neoadjuvant and in 24 as adjuvant regimen. Three-year survival rates were analyzed in 36 patients by the Kaplan-Meier method, with consideration of their sex, age and the sequence of surgical and radiation treatment.Results: The 3-year survival after combination treatment of PSG cancer patients was 82.7%. Women, patients above 60 years of age and those who received adjuvant radiation therapy demonstrated a trend towards better 3-year survival, although it was non-significant (p > 0.05).Conclusion: Combination strategy remains an effective approach to PSG cancer irrespective of age and sex of patients. The use of radiation therapy as a single modality is possible only in exceptional cases.

A high blood D-dimer level is often diagnosed in patients with malignant brain glioma (MBG), with 24% of these patients being detected with deep vein thrombosis of the leg and/or pulmonary embolism (PE). The cause of an elevated blood D-dimer level in most other cases remains unclear. The purpose of this study is to identify the features associated with an increased blood D-dimer level in patients after MBG resection, which may be used to improve the efficacy of adjuvant radiation therapy (ART).RESULTS:The study included 50 patients. Three to four weeks after resection of malignant brain glioma (MBG), the blood D-dimer level was determined in patients immediately before the onset of ART. An increase in the blood D-dimer level more than by 0.25 μg/mL was detected in 78% of patients. More often, a high D-dimer level was detected in patients aged 60 years or more. In the same age group, an increase in the D-dimer level was significantly larger (p<0.05) than in younger patients (1.2 and 0.6 μg/mL, respectively). The degree of brain tumor malignancy did not affect the rate and value of an increase in the blood D-dimer level.CONCLUSION:Our findings indicate that an increased blood D-dimer level in patients without symptoms of venous thrombosis after craniotomy for MBG is more pronounced in patients aged 60 years and over. The degree of glioma malignancy has no significant effect on this indicator.

Pulmonary embolism in breast cancer is one of the causes of major deterioration of health status of the patients. Pulmonary artery occlusion is most often a consequence of venous thromboembolism; this condition is referred to as "pulmonary thromboembolism". Significantly less common cause of occlusion of the pulmonary artery branches can be embolism by a cluster of tumor cells, accompanied by development of pulmonary tumor thrombotic microangiopathy. This paper reviews data on the etiology and pathogenesis of pulmonary embolism in breast cancer, and approaches to its prevention and treatment.

Pulmonary embolism in breast cancer is one of the causes of major deterioration of health status of the patients. Pulmonary artery occlusion is most often a  consequence of venous thromboembolism; this condition is referred to as "pulmonary thromboembolism". Significantly less common cause of occlusion of the pulmonary artery branches can be embolism by a  cluster of tumor cells, accompanied by development of pulmonary tumor thrombotic microangiopathy. This paper reviews data on the etiology and pathogenesis of pulmonary embolism in breast cancer, and approaches to its prevention and treatment.

A number of inflammatory systemic and non-systemic pharyngel and laryngeal diseases may clinically imitate a tumor. In these cases, computed tomography provides rapid assessment and significant additional information to that obtained from endoscopy. We present 4 clinical observations with certain common features. These are a suspicion of a neoplasm and absence of typical computed tomography symptoms characteristic of tumor lesions. IgG4-related systemic disease, rheumatoid arthritis, amyloidosis, and actinomycosis are rare disorders, however, they should be considered in the differential diagnosis. In this context, the knowledge of the radiation diagnostic characteristics of these rare nosologies will be useful for a practitioner.

Abstract. Our results suggest that the combined use of optical coherent tomography (OCT) and fluorescence diagnosis helps to refine the nature and boundaries of the pathological process in the tissue of the colon in ulcerative colitis. Studies have shown that an integrated optical diagnostics allows us to differentiate lesions respectively to histology and to decide on the need for biopsy and venue. This method is most appropriate in cases difficult for diagnosis.

The paper presents a clinical case of jejunal duplication, a rare anomaly of the gastrointestinal tract. It describes an algorithm for hospital diagnostic and therapeutic measures. The capacities of radiodiagnostic studies, such as ultrasonography and magnetic resonance imaging, applied to this clinical case, are analyzed. The paper is supplemented by a concise review of the literature. An update suggests that there are diagnostic difficulties in this anomaly, even when a complete set of radiation techniques is applied and trained specialists participate.

We present a case of a very rare heart tumor, a primary epithelioid hemangioendothelioma with secondary pulmonary metastases. Despite of the expanded diagnostic possibilities of current radiological diagnosis procedures, the final diagnosis in such patients is made only after histological examination and immunohistochemistry.

Our results suggest that the combined use of optical coherent tomography (OCT) and fluorescence diagnosis helps to refine the nature and boundaries of the pathological process in the tissue of the colon in ulcerative colitis. Studies have shown that an integrated optical diagnostics allows us to differentiate lesions respectively to histology and to decide on the need for biopsy and venue. This method is most appropriate in cases difficult for diagnosis.

Gastrointestinal tract duplications constitute a group of rare congenital malformations. We describe a case of removal of the cystic form of extensive jejunal duplication during videoassisted surgical intervention in a 6 year old girl. Preoperative verification of the diagnosis encountered difficulties despite the use of up-to-date methods. The definitive diagnosis was established intraoperatively. The mini-invasive intervention with the application of the laparoscopic technique made it possible to significantly reduce the surgical injury and the duration of hospital stay.

OBJECTIVE:To make an integrated assessment of the proliferative activity of gastric cancer (GC) (Ki-67 and mitotic index - MI) and the degree of tumor cell apoptosis (apoptotic index - AI), by calculating the cell regeneration coefficient (CRC) in relation to the histological variant and functional immunophenotype (IPT) of a tumor and to determine if there is a possible association of the above indicators with adjusted 4-year relapse-free survival rates.SUBJECTS AND METHODS:Surgical specimens obtained from 55 patients with CC were examined. The tumors were divided into histological variants in accordance with the International histological classification criteria (WHO, 2010) and into IPT by a set of the produced mucins MUC1, MUC2, MUC5AC, MUC6, and the glycoprotein CD10. MI and AI were estimated from the number of mitoses and apoptotic bodies in the 5-microm-thick hematoxylin- and eosin-stained tumor histological sections; Ki-67 was determined by scoring the number of its immunopositive nuclei per 1000 counted tumor cells at x1000 magnification.RESULTS:The values of Ki-67, MI, AI, and CRC in GC were found to be significantly related to the tumor histological variant and IPT; and MI, AI and CRC were also associated with adjusted 4-year relapse-free survival rates. The Ki-67 index in the gastric carcinomas is of no prognostic value, which is most likely to be attributable to the inadequacy of this indicator for the estimation of the biological potential of tumors growing in the tissues with constantly regenerative cell populations, which is peculiar to the epithelium of the gastric mucosa, particularly to that of the necks of the glands, which most GCs are histogenetically related to.CONCLUSION:Thus, the values of MI, AI, and CRC are best used as additional prognostic factors in patients with GC. At the same time, the prognostic value of Ki-67 in GC has been overestimated, as shown by the authors' data.

Immunohistochemistry research on detecting of special protein called galektin-3 in stomach cancer was made. Depending on produced mucines carcinomas have been divided into three variants: gastric, intestinal and mixed. It is established that in cancer cells of mixed variant of a cancer, galektin-3 was detected significantly less; this may indicate their higher malignant potential.

Mucins and glycoprotein CD10 expression in 55 carcinomas of the stomach has been studied by immunohistochemistry. According to a profile of mucins and CD10 expression, 3 immunophenotypic variants of carcinoma were founded: gastric, intestinal and gastro-intestinal. Gastric and gastro-intestinal variants were more frequently than intestinal one. The correlation between the expression of investigated markers and histological type of carcinoma wasn't revealed The estimation of Ki-67 index has shown that the highest proliferative activity (>20%) in carcinomas with gastric phenotype has been found more often than in gastro-intestinal ones.

A comparative immunohistochemical investigation was carried out on the E-cadherin expression in gastric, intestinal, and mixed immunophenotypical variants of 55 gastric carcinomas and extratumoral mucosa. Statistically significant prevalence of abnormal E-cadherin expression was established in the group of gastric phenotype carcinomas as compared with mixed phenotype tumors which allowed supposing in the first the presence of a higher invasive potential. Normal E-cadherin expression was observed in all cells of neotumorous gastric mucosa and in the foci of both intraepithelial neoplasia of a low degree and intestinal metaplasia. In the foci of a high degree intraepithelial neoplasia, the normal E-cadherin expression was noted in 69% of cases and abnormal one in 31% manifesting itself by geterogeneous staining of separate cells which could be an early sign of carcinoma.