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Introduction: primary membranous nephropathy (pMN) is glomerulopathy caused in the majority of cases by autoantibodies to Phospholipase-A2 receptors (PLA2R-AB). This study aimed to evaluate the clinical course and outcomes of the patients with pMN regarding PLA2R-AB status. Patients and methods: 32 patients (21 males, 11 females) with renal biopsy-proven pMN were included in the study. PLA2R-AB (ELI SA method) and outcomes (defined according to KDIGO) were evaluated after 21 and 64 months of follow-up in 28 patients. Results: 19 patients had positive PLA2R-AB (>20 RU /ml) (59.3%), with median titer of 97 (21-1418 RU /ml). The rate of remission in low PLA2R-AB titer group (< 200 RU /ml) after 21 months was significantly higher than in high PLA2R-AB group (> 200 RU /ml) (90% vs. 50%, p=0.045), and after 64 months the difference was not significant (80% vs. 50%, p=0.210). The relapse rate after 64 months was higher in the high PLA2R-AB group (87% vs. 63%). Multivariant linear regression found serum creatinine (ß=0.682, p, Uvod: primarna membranska nefropatija (pMN) je glomerulopatija, koja je u većini slučajeva uzrokovana autoprotutijelima na receptor za fosfolipazu A2 (PLA2R-PT). Cilj ovog istraživanja bio je analizirati povezanost PLA2R-PT s kliničkim tijekom i ishodima bolesti. Ispitanici i metode: 32 bolesnika (21 muškaraca, 11 žena), s biopsijom bubrega dijagnosticiranim pMN, bilo je uključeno u istraživanje. PLA2R-PT (ELI SA metoda) i ishodi (definirani u skladu s KDIGO) određeni su nakon 21 i 64 mjeseca praćenja u 28 bolesnika. Rezultati: 19 bolesnika imalo je pozitivna PLA2R-PT (>20 RU /ml) (59.3%), s medijanom titra 97 (21-1418 RU /ml). Stopa remisije u skupini s niskim titrom PLA2R-PT (< 200 RU /ml) nakon 21 mjeseca bila je značajno viša u odnosu na skupinu s visokim titrom PLA2R-PT (> 200 RU /ml) (90% vs. 50%, p=0.045), a nakon 64 mjeseca razlika nije bila značajna (80% vs 50%, p=0.210). Stopa relapsa nakon 64 mjeseca bila je viša u skupini s visokim titrom PLA2R-PT (87% vs. 63%). Multivarijatnom linearnom regresijom su kao značajni neovisni prediktori za bubrežnu funkciju na kraju praćenja nađeni serumski kreatinin (ß=0.682, p

Lupus nephritis (LN) is one of the most severe features of systemic lupus erythematosus (SLE). Data on LN is scarce in the Croatian population. We analysed the characteristics of LN patients diagnosed at our tertiary referral centre. In this retrospective study, we analysed the following features of patients with biopsy-proven LN diagnosed between 2011 and 2020: demographics, renal laboratory parameters, renal histopathology, and treatment. A total of 38 patients were included (30 females; mean age 39±15 years). The most common indication for kidney biopsy was proteinuria (89%). The proportion of LN classes was: class I (2.6%), II (5.3%), III (18.4%), IV (42.1%), V (13.2%), III+V (10.5%), IV+V (5.3%). The median time from SLE diagnosis to histologic confirmation of LN was 1.0 year. All patients were treated with methylprednisolone (MP), 68% received MP pulses. Induction treatment included intravenous (IV) cyclophosphamide (CYC) (71%) (15 patients treated per Euro-Lupus and 9 per the National Institutes of Health regimen), oral CYC (3%), or mycophenolate mofetil (11%). 79% of patients received antimalarials. While there is heterogeneity between different populations, our patient profile was similar to that from other European studies. Further follow-up of this group is necessary to assess outcomes in our population., Lupusni nefritis (LN) je česta i vrlo ozbiljna manifestacija sustavnog eritemskog lupusa (SLE). Još uvijek nema dovoljno podataka o karakteristikama bolesnika s LN u Hrvatskoj. Analizirali smo karakteristike bolesnika s LN koji su liječeni u referentnom centru naše tercijarne ustanove. U ovu retrospektivnu studiju uključili smo bolesnike s biopsijom potvrđenim LN u periodu od 2011. do 2020. godine, analizirali smo demografske podatke, parametre bubrežne funkcije, patohistološki nalaz bioptata bubrega i liječenje. U studiju je uključeno 38 bolesnika (30 žena, prosječna dob 39±15godina). Najčešća indikacija za biopsiju bubrega bila je proteinurija (89%). Raspodjela klasa LN bila je sljedeća: klasa I(2,6 %), II(5,3 %), III(18,4 %), IV(42,1 %), V(13,2 %), III+V(10,5 %), IV+V(5,3 %). Prosječno vrijeme od dijagnoze SLE do histološke potvrde LN bilo je 1,0 godina. Svi bolesnici su liječeni kortikosteroidima, 68 % liječeno je bolusima metilprednizolona. Indukcijska terapija uključivala je parenteralnu primjenu ciklofosfamida (CYC) (71 %) (15 bolesnika liječeno je prema Euro-lupus protokolu, 9 bolesnika prema protokolu Nacionalnog instituta za zdravlje (NIH)), peroralni CYC (3 %) ili mikofenolat mofetil (11 %). Antimalarike je primilo 79 % bolesnika. Unatoč heterogenosti između različitih populacija s LN, profil bolesnika uključen u ovu studiju sličan je ostalim europskim studijama. Daljnje praćenje potrebno je da bi se istražili ishodi u ovoj populaciji.

The cancer-testis family of antigens is expressed in a variety of malignant tumors. They are not expressed in normal human tissues, except for the testis. Expression of two genes from this family, MAGE-A3/4 and NY-ESO1, has been described in different malignant tumors such as melanomas, germ cell tumors, and uterine neoplasm. To our knowledge, there are no studies on the expression of these genes and their proteins in renal tumors. The aim of this study was to investigate the expression of MAGE-A3/4 and NY-ESO1 in renal oncocytomas (RO) and chromophobe renal cell carcinomas (CRCC) detected by immunohistochemistry and to compare the expression of MAGE-A3/4 and NY- ESO1 with other prognostic markers (size, grade) in CRCC. A total of 35 patients (17 RO and 18 CRCC) treated at Sestre milosrdnice University Hospital and Dubrava University Hospital were included. Monoclonal antibodies for MAGE-A3/4 and NY-ESO1 were used for immunohistochemical staining. Results were classified as follows: no positive tumor cells (-), slightly expressed (+) if 50% of tumor cells were stained. Results were analyzed using Mann-Whitney test and Spearman's rank correlation coefficient ; P

The abstract describes differences in the presence of capsule around chromophobe renal cell carcinoma and oncocytoma. It also describes differences in capsule diameter.

INTRODUCTION: Frozen section analysis had a great value in the operative management of thyroid lesions in the past. However, with the widespread use of fine needle aspiration biopsy (FNA), the value of frozen sections has been questioned. Although FNA is cost-effective and easy to perform, frozen sections are still preferred by some institutions. METHODS: All patients with thyroid disease operated on between January 2000 and December 2004 at University Hospital for Tumors were identified. Data obtained from pathology files included patient age and sex, number of frozen sections performed, frozen section results, and final histologic diagnosis. RESULTS: A total of 887 patients, 781 (88%) women and 106 (12%) men, were identified. Median age for women was 50 (range 8-80) and for men 52 (range 15-85) years. Frozen section was performed in 675 (76%) patients. The number of examined frozen sections varied from one in cases of macroscopically benign conditions such as nodular goiter to four when malignant follicular lesion was suspected. The intraoperative diagnosis was benign in 135 (20%) and malignant in 172 (25.5%) patients. In 368 (54.5%) patients frozen section showed follicular neoplasm and definitive diagnosis was postponed until final sections. Intraoperative analysis properly recognized 157 (95%) of 165 papillary carcinomas, 3 (14%) of 21 follicular carcinomas, all 7 cases of medullary carcinoma, and two anaplastic carcinomas. In 3 patients with the diagnosis of malignant tumor, final histologic sections revealed a collision tumor (medullary and follicular carcinoma), insular carcinoma and one squamous carcinoma. In 3 cases papillary carcinoma was misinterpreted as follicular lesion, and another five carcinomas, smaller than 5 mm, were found close to serial sliced follicular encapsulated lesions. DISCUSSION: During the last two decades the benefit of intraoperative frozen section analysis in thyroid surgery has been questioned by many authors. Commonly mentioned disadvantages include a limited number of performed sections, lower quality of intraoperative slides, artifact nuclear clearing, difficult interpretation of post-FNA changes, and identification of vascular/capsular invasion. Our study showed a high sensitivity of frozen sections in the diagnosis of papillary lesions. False-positive results of pseudopapillary hyperplasia in hyperplastic nodules misinterpreted as carcinoma were minimized with the experience of the performing pathologist. Intraoperative diagnosis can be difficult in cases of follicular variant of papillary carcinoma or microcarcinoma which can be incidentally found during evaluation of another thyroid lesion (as was the case in 3 and 5 of our patients). The value of frozen sections in the diagnosis of follicular lesions remains uncertain. Our series showed that only 3 of follicular carcinomas with macroscopically suspect invasion were properly recognized with the use of multiple frozen sections. Therefore, an agreement was reached between the surgeon and the pathologist that all follicular and oncocytic lesions except for those clearly malignant on intraoperative sections should be defined as “follicular” or “oncocytic” tumor, and definitive diagnosis postponed until examination of serial sections. Frozen sections can be used for accurate identification of intrathyroid parathyroid neoplasms, normal parathyroid glands, and lymph nodes that may contain metastatic thyroid carcinoma. Although easy to diagnose, the use of frozen sections in the evaluation of non-neoplastic conditions such as nodular goiter and thyroiditis is not justified, except in cases when neoplasm is suspected on preoperative FNA. CONCLUSION: Intraoperative frozen section analysis has a great value in the diagnosis of papillary lesions and nodal involvement of thyroid primaries, especially in cases when preoperative FNA was inconclusive or suspicious for malignancy. Frozen sections are of limited value in the diagnosis of follicular and oncocytic tumors and papillary microcarcinoma. With the wider use of FNA and growing experience of cytopathologists, non-neoplastic thyroid diseases as well as clearly malignant neoplasms can be accurately diagnosed preoperatively and definitive surgical treatment can be planned according to FNA results. However, in most institutions final decision which method to use depends on the surgeon’s experience and quality of cooperation with the performing pathologist and cytopathologist.