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The acute abdomen with its many clinical aspects is not a condition that eludes pregnancy; acute appendicitis being the most frequently incriminated, but when it comes to its complication - peritonitis and the pregnant is a teenager, the cases cited in the literature are quite rare. We present the case of a 15-year-old teenager pregnant within 24 weeks admitted from the emergency department with the diagnosis of acute abdomen and operated for generalized peritonitis due to a perforated appendicitis. The microscopic analysis of the specimen indicated the presence of ulceration and extensive and deep and necrosis of the appendicle wall, the residual structures being dissected by a predominantly polymorphonuclear leukocytes inflammatory infiltrate associated with eosinophilic fibrinous deposits. Gangrenous extended necrosis of appendicle tissues, on the background of inflammatory thrombosis of appendicle vessels and mesothelium, sustained the diagnosis of acute gangrenous appendicitis. After a rather difficult evolution, she gave birth to a healthy fetus through a segmental-transverse Caesarean section at 35 gestational weeks. One week after the birth, the patient was operated for bowel obstruction by means of bridles and adherents. Both the appendicitis and the intestinal obstruction syndrome have been resolved by classic surgery. The fetal and maternal, vital and functional prognosis was good.

p53 is a marker described in the premalignant lesions with a high risk of malignant transformation for laryngeal cancer. It is a tumor suppressor gene that during the cancer gains also oncogenic activity. We aimed to study the p53 immunoexpression in 38 cases of laryngeal squamous cell carcinomas and the relation with the clinicopathological aspects. We obtained variable p53 expression regarding the differentiation degree and tumor stage. The higher p53 immunotaining values were observed in high grade and advanced stages lesions. P53 may be useful in identifying aggresive laryngeal squamous carcinomas, a useful aspect for better stratification of patients for therapy.

Epidermal growth factor receptor (EGFR) is a tyrosine kinase molecule associated to the initial stages of neoplastic transformation. High expression of EGFR is connected to aggressive tumor behavior and high risk of metastasis and treatment failure. The aim of our study was to analyze the immunohistochemical expression of EGFR in 38 cases of laryngeal squamous cell carcinomas depending on clinicopathological parameters related to prognosis. The EGFR immunoreactions have statistical significant higher values in high grade carcinomas. Although the EGFR values were superior in advanced stages lesions, the aspect was not significant EGFR may be useful in identifying the aggressive laryngeal squamous carcinomas.

E-cadherin, β-catenin and Snail are important molecules involved in cellular adhesion and epithelial-mesenchymal transition. Loss of E-cadherin expression, nuclear relocation of β-catenin and high expression of Snail are connected to tumor progression, rapid cell growth and metastasis. The aim of our study was to analyze the immunohistochemical expression of β-catenin, E-cadherin and Snail, depending on clinico-morphological aspects of the laryngeal squamous cell carcinomas. Our results revealed variable E-cadherin, β-catenin and Snail expression, depending on differentiation degree and tumor stage. These markers can be helpful in identifying the aggressive laryngeal squamous carcinomas.

Transcription factors play a central role in the epithelial-mesenchymal transition (EMT), which is one of the biomolecular mechanisms involved in the progression of urothelial carcinomas of the bladder (UCB). In this study, we analyzed the immunoexpression of Twist 1, Snail, Slug and β-catenin in relation to histopathological prognostic parameters of UCB. The obtained results indicated the association of Snail and β-catenin expression with low grade and early stage of UCB, as well as the association of Twist 1 and Slug expression with high grade and advanced stage lesions. The specific or sequential action of transcription factors in the bladder tumoral EMT may be useful for identifying the aggressive lesions.

The expression of epidermal growth factor (EGF) receptors is common in human carcinomas and the proteins are used as therapeutics targets. In this study, we analyzed the immunoexpression of EGFR, HER2 (EGFR2) and HER3 (EGFR3) in 41 cases of serous borderline ovarian tumors and carcinomas, in relation to the degree of differentiation and tumor stage. The quantification of the results was done using the final staining score (FSS), which took into account the number of labeled cells and the intensity of immunoreactions. For all the receptors, the FSS values corresponding to the high-grade serous carcinomas were significantly superior compared with low-grade carcinomas and borderline tumors. Also, the FSS values associated with advanced stages ovarian tumors were significantly superior compared to those in the initial stages. In this study, we found positive linear correlations between the values associated with the expression of EGF receptors. The relation of EGFR, HER2 and HER3 immunoexpression with the lesion subtype, tumor grade and stage, designates the EGF receptors system as possible therapeutic target in ovarian serous tumors.

Perinatal autopsy remains the gold-standard procedure used to establish the fetal, neonatal or infant abnormalities. Progressively, perinatal pathology has become a specialized field with important roles of audit for fetal prenatal diagnostic tools, in parents counseling regarding future pregnancies, in scientific research, for epidemiology of congenital abnormalities and teaching. The differences between prenatal ultrasound and autopsy reports represent a strong argument for the autopsy examination following termination of pregnancy. The reasons for such discrepancies are related to the ultrasonographic or pathological examination conditions, the type of the anomalies, the expertise and availability of the operators. Several facts led to an undesirable increase of refusals from parents to consent to a conventional invasive autopsy: the centralization of pathology services, the poor counseling provided by non-experts in fetal medicine and the clinicians' over-appreciation of the importance of the ultrasound diagnostic investigation. Although non-invasive alternatives have been tested with promising results, conventional autopsy remains the gold standard technique for the prenatal diagnosis audit. We report and analyze several cases of prenatally diagnosed malformed fetuses with different particularities that underline the necessity of perinatal autopsy. We discuss the antenatal findings and management and post-mortem autopsies in the respective pregnancies.

Squamous cell carcinoma (SCC) of the lip represents 15-30% of SCC of cephalic extremity, located on the lower lip in about 90% of cases. The present paper aimed to define the profile of SCC of the lip with major risk factors. The study included 20 selected cases diagnosed with lower lip SCC, using a panel of antibodies which addressed cell proliferation (Ki67), perturbation of the cell cycle (p53), angiogenesis (VEGF - vascular endothelial growth factor), factors related to tumor cell interaction with the extracellular matrix (CD44). Ki67 immunoexpression was identified in all the cases. Poorly differentiated (PD) SCC presented a mean value of Ki67 positivity index (PI) significantly higher compared to well-differentiated (WD) and moderately differentiated (MD) SCC. We found significantly higher mean values of Ki67 PI in pT3 lesion, compared with pT2 and pT lesions, and with no statistically significant differences in lip SCC with associated lymph node metastasis (pN1), compared to those with no lymph node metastasis (pN0). PD SCC presented a higher mean value of p53 PI compared to WD and MD SCC, but without significant differences. Analysis indicated significantly higher values in pT3 lesions and in pT2 and pT1 and in pN1 SCC. In WD SCC, CD44 immunoexpression had a higher intensity. For PD and MD SCC the immunolabelings presented low÷moderate heterogeneous intensity. WD lip SCC presented a statistically significant higher mean value for CD44 PI compared to MD and PD SCC, and not statistically significant higher in pT1, pT2 then in pT3 and in pN0 cases then in pN1. WD lip SCC presented statistically significant higher mean value of VEGF PI related to those with MD and PD SCC. VEGF PI values were higher in pT1, pT2 then in pT3 and in the pN0 SCC, but without statistically significant differences. We found a positive linear correlation for Ki67÷p53, although statistically not significant and for CD44÷VEGF statistically significant (p=0.001). Also, the analysis identified negative a linear statistically significant correlation for Ki67÷CD44 and for Ki67÷VEGF statistically significant as well (p=0.001). Immunohistochemical investigations in lip SCC, regarding the expression of p53, Ki67, CD44 and VEGF, revealed results that suggest their ability to assess the prognosis and progression of tumor evolution.

Background: Calcifying epithelial odontogenic tumor (CEOT) is a rare benign neoplasia, locally aggressive, that tends to invade bone and adjacent soft tissues. This case report describes the thirteenth known case of CEOT with maxillary sinus extension and the second one that also involves the buccal vestibule mucosa with peculiar histopathological and immunohistochemical data., Case Presentation: Here we report the case of a 45-year-old female with a CEOT diagnosed and treated at the Oral & Maxillofacial Surgery Department, County Clinical Emergency Hospital of Craiova, Romania. The clinical and imaging investigation revealed an intraosseous tumor developed from the left posterior maxilla with maxillary sinus and buccal vestibule mucosa extension. Histopathology found an epithelium-rich CEOT variant, but with scattered S100 positive clear cells, focal small rounded cementum-like deposits and areas with some degree of nuclear pleomorphism. The immunohistochemical investigations emphasised its local aggressiveness behavior with involvement of multiple molecular mechanisms that underlie tumor invasiveness. A subtotal maxillectomy was performed followed by defect reconstruction., Conclusions: We discuss the relevant clinicopathological features of an aggressive rare case of CEOT with maxillary sinus extension and buccal vestibule mucosa involvement. The immunohistochemical study suggests its utility in attempting to assess the degree of local tumor aggressiveness and thus in adopting the most efficient therapeutic attitude.

The purpose of our study was to determine the incidence and the relationship between prognostic factors (age at diagnosis, pTNM stage, histological grade, lymph vascular and myometrium invasion) in patients with endometrial carcinoma. We evaluated in terms of diagnosis 50 cases of endometrial carcinomas that were hospitalized during 2011-2014 in the Obstetrics, Gynecology and Surgery clinics of the Emergency County Hospital Craiova. The procedure consisted in fixation in 10% buffered formalin, followed by processing with usual technique of paraffin embedding and finally staining in hematoxylin and eosin. The histological analysis of the 50 endometrial carcinomas revealed well-differentiated carcinomas (G1) in 24 cases (48%), moderately differentiated carcinomas (G2) in 17 cases (34%) and poorly differentiated carcinomas (G3) in further 9 cases (18%).The myometrium invasion was present in the internal half of the myometrium in 12 internal cases (24%) and in the external half of myometrium in further 36 cases (72%). In 2 cases (4%) the myometrium invasion was absent. We achieved significant association between histological grade and invasion of myometrium, also between histological grade and lymphovascular invasion, as well as tumor stage and myometrium invasion. We are also able to report significant association between lymphovascular invasion and tumor stage or tumor stage and presence of lymph nodes. The results of this study emphasize the importance of pathological parameters as prognostic factors in endometrial carcinoma.

Endometrioid endometrial adenocarcinomas (EECs) are frequent genital tumors for which the clinical, imaging and histopathological integrated analysis is the basis of differential diagnosis and therapeutic attitude. This research represents a tertiary multicenter study including 58 cases examined histopathologically and immunohistochemically, surgically treated, on a five years period. The main characteristics of the patients in the study group are represented by the average age of 66 years, associated with obesity, hypertension, diabetes, history of infertility, early menopause, nulliparity or long-time oral contraception. The most important clinical sign was the menopausal or postmenopausal vaginal bleeding. The golden standard in the diagnosis of endometrial carcinoma is the dilation and curettage of the uterine cavity, followed by histopathological assessment. The association between transvaginal ultrasonography (TVUS) and endometrial biopsy increases to 100% the diagnostic sensitivity. The use of an antibodies panel that includes CK, ER, PR, vimentin can guide the diagnosis to EEC and the analysis of Ki67, p16, p53 and CEA immunoreactions can be useful both for EEC differential diagnosis and to assess the tumor aggressiveness. The interrelation between the accurate histopathological diagnosis and the adequate surgical staging is the cornerstone of curative therapy in the EEC.

Warthin's tumor is a benign monomorphic adenoma with unclear origin with the highest incidence in the sixth and seventh decades. The analysis of tumor markers involved in the pathogenesis of Warthin's tumor can improve the patients' prognosis. This study included 29 cases of Warthin's tumor, which were histopathologically and immunohistochemically examined for different compartments of tumors. For immunohistochemical study, we used as specific markers for epithelial compartment CD117, CEA and AMA, respectively S100 and D2-40 for the stromal compartment. The evaluation of immunoreactions was performed by semiquantitative analysis. The analysis of the CEA, CD117 and AAM immunoexpression allowed observing various patterns of immunostaining for tumor double-layered epithelia, which has the tendency of being similar to that in the normal ductal epithelia. S100 protein positivity similar to Langerhans cells suggests that delayed hypersensitivity can be involved in tumor development. The presence of D2-40 expression in majority of tumor subcapsular vessels, similar to lymph nodes structure, confirms the hypothesis that Warthin's tumor has its origin in regional lymph nodes.

A tumor represents an abnormal tissue growth that can arise from any ocular structure, such as eyelids, muscles or the optic nerve. At the eyelids, there are two main tumor types: basal cell carcinoma and squamous cell carcinoma. Angiogenesis plays a crucial role in growth, invasion and metastasis processes of any tumor. It is well known the fact that without new vessels formation tumors cannot exceed 1-2 mm diameter. Immunohistochemical analysis has been performed on 43 cases of primary carcinomas of the eyelid, diagnosed between 2010 and 2014 in the Laboratory of Pathological Anatomy of the University Emergency County Hospital of Craiova, Romania. Biological material was represented by surgical resection samples, coming from the Clinic of Ophthalmology the anteriorly named Hospital. Within the immunohistochemical study, we have evaluated epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) expression in a group of 43 cutaneous carcinomas of the eyelid, depending on the type and differentiation grade of the tumor. Of the 43 samples, 23 came from patients with eyelid basal cell carcinoma and 20 came from patients with eyelid squamous cell carcinoma. In our study, EGFR and VEGF immunoexpression was superior for squamous cell carcinomas, compared to basal cell carcinomas, fact that was statistically significant. Regarding squamous cell carcinomas, the immunoexpression of these two markers was superior in moderate÷poor differentiated forms, compared to well differentiated forms, fact that was statistically significant. The markers used in this study were found to be associated with the acquisition of aggression and angiogenic phenotypes by analyzed carcinomas.

E-cadherin and β-catenin are two molecules implicated in cellular adhesion. The reduced expression of β-catenin and E-cadherin is associated with the tumoral epithelial-mesenchymal transition process, a key event in the development of endometrial carcinoma. The aim of our study was to investigate the association between the immunoexpression of β-catenin÷E-cadherin and the tumor differentiation degree, presence of lymph nodes, depth of tumor invasion and pTNM stage of endometrioid endometrial carcinomas in order to enhance the potential aggressiveness of these tumors. Our results revealed significant differences in the expression of β-catenin, when grouping for the tumor stage, invasion in the myometrium and degree of differentiation, as well as significant differences in the expression of E-cadherin for tumor degrees of differentiation. E-cadherin and β-catenin expression was stronger in well-differentiated tumors, superficial myometrium invasion and early tumor stages I or II, thus was associated with better prognostic forms of endometrioid endometrial carcinoma. Our study indicated that decreased of the E-cadherin and β-catenin expression is useful for the assessment of tumor aggressivity.

The incidence of cutaneous squamous cell carcinoma (CSCC) and its precursor lesions argues the research for validating markers that would define the biomolecular mechanisms behind the potential progression and aggressiveness of these lesions. In this study, we analyzed the expression of p53, p16 and Ki67 in 91 cases of CSCC and its precursors in relation with the histological prognostic parameters. The quantification of the immunohistochemical reactions indicated superior significant differences for the studied markers in squamous cell carcinomas compared to keratinocytic intraepithelial neoplasia (KIN). P16 and Ki67 immunostaining for Bowen's disease were similar to those from poorly differentiated carcinomas. In this study, we found significant differences in p53 expression in relation to tumor grading and p16 expression in relation to tumor staging. Ki67 showed higher values in high-grade and advanced stage carcinomas. Positive reactions in preinvasive lesions as well as in CSCC support the sequential development and p53 and p16 involvement from the early stages of skin carcinogenesis.

Introduction: The epithelial-mesenchymal transition (EMT) process is a complex molecular mechanism that is involved in the acquisition of an aggressive, invasive and metastatic phenotype by carcinomas. The cadherin switch consists in the alteration of E-cadherin and N-cadherin expression and is specific for the EMT process., Materials and Methods: This study included 35 cases of primitive urothelial carcinomas investigated in relation with clinicopathological prognostic parameters and expression of E- and N-cadherins in the advancing edge and intratumoral compartments., Results: In both compartments, the immunoexpression of E-cadherin decreased, while that of N-cadherin increased in high grade, deeply invasive, or those cases with lymph node metastases and advanced stages carcinomas, with a negative linear correlation observed between their expression percentage values. In this study, it was observed the presence of cadherin switch in urothelial carcinomas, the variation of the two proteins' immunostaining patterns being higher at the advancing edge. The presence of N-cadherin in intratumoral compartment designated it as actively involved in EMT process., Conclusions: The analysis of cadherins switch can be used to identify superficial urothelial carcinoma with invasion and metastasis potential.

Oral squamous cells carcinoma (OSCC) mortality rate ranges between 29-40/100,000 inhabitants. Regional lymph node metastases occur in 30-40% cases and are associated with unfavorable prognosis and decreased survival. Recentely it was suggested that the tumor-associated lymphatic vessels formation plays an active role in metastasis proces of several human malignancies, including OSCC. In the present study we investigated comparatively podoplanin immunoexpression in OSCC in both the tumor cells and lymphatic vessels reported to clinicopathological prognostic parameters. Material and methods The study included a total of 25 cases of OSCC. We investigated clinico-pathological parameters as age, gender, tumor site, and degree of differentiation, size and depth of invasion (pT), lymph node status (pN). Histologic classification was done according to the WHO criteria. For immunohistochemical (IHC) analysis we used podoplanin (Dako, clone D2-40). As visualization system it was used LSAB2 (Dako, Redox, Romania, code K0675) and chromogen DAB (Dako, Redox, Romania, code K3468). Negative controls were obtained by omitting the primary antibodies. IHC quantification was done intensity score and by lymphatic microdensity (LVD), intratumoral and on the advancing edge. For the statistical analysis we used Student's t-tests, ANOVA, chi square and Pearson, using SPSS 10 software. Results Podoplanin immunoexpression in tumor parenchyma presented with an average of 43%, varying intensity. We found a higher intensity in weak and moderately differentiated SCC then in well differentiated ones and no difference intratumoral aand advancing edge. In relation to the degree of tumor differentiation the mean LVD D2-40 was higher in the advancing edge. SCC who presented lymph node metastasis mean values for LVD D2-4 was higher then at advancing edge and higher than those of non-metastatic carcinomas. Conclusions Podoplanin immunoexpresion suggests the involvement both in tumor growth and the acquisition of an lymphangiogenic phenotype invasive by autocrine mechanisms.

The alteration of epithelial stability, which includes changes in the expression of E-cadherin and CD44, is one of the complex biomolecular mechanisms involved in the tumoral epithelial-mesenchymal transition (EMT) process. We followed the E-cadherin÷CD44 immunophenotype by single and double detections in 25 cases of bladder urothelial carcinomas. Our study investigated simultaneously the differences in expression of the two markers, in different tumoral compartments, according to the prognostic parameters of the lesions. The study indicated significant differences in the expression of E-cadherin in relation to tumor grade, depth of invasion, tumor stage and Ki-67 proliferation index (PI), both intratumoral and at the advancing edge. For CD44, expression differences were found between the tumor grades in intratumoral sites, while for both intratumoral and advancing edge compartments the differences occurred for the depth of tumor invasion, tumor stage and Ki-67 PI. The only differences in the expression of the two markers in relation with the presence of lymph node metastasis were for E-cadherin at the advancing edge. In this study, the intratumoral E-caderin-÷CD44- immunophenotype, respectively E-caderin-÷CD44+ at the advancing edge were associated with the tumor aggressiveness analyzed parameters. The maintenance of CD44 expression at the advancing edge represents a negative prognostic factor for bladder urothelial carcinoma and supports the implication of EMT process, through the existence at this level of a cell population with particular properties.

Introduction: The "silent sinus syndrome" is a rare entity that was first described in 1964 and given this name 30 years later. Although it is well described both from clinically and radiologically point of view we consider that its rarity still makes it a subject for report., Case Presentation: A 46-year-old patient was admitted for facial asymmetry, diplopia, unilateral left enophthalmos, and inferior displacement of the eye globe, and decreased occlusal pressure in left dentate region. CT scan revealed interior bulging of all left maxillary sinus walls with osteolysis and intense opacification, enlargement of the left middle meatus especially in the posterior part and lateralization of the uncinate process. Nasal endoscopy with 00 rigid scope visualized mild deviation to the right of the nasal septum, enlargement of the left middle meatus by the lateral deviation of the left intersinusal septum and uncinate process. Surgery was scheduled and performed a left maxillary sinus antrostomy. Histopathological examination on the biopsies revealed inflammation. A complete study was performed to assess the elements of inflammation. Postoperative course was simple. Follow-up visit at three and six months, showed significant regression of diplopia and improved facial aspect., Conclusions: Silent sinus syndrome is a well-defined clinical entity with characteristic imagistic findings. Surgical intervention that restores sinus drainage will interrupt the pathogenesis of the disease and lead to its progressive regression. Topographic associations and density of inflammatory elements analyzed in relation with neoforming vessels suggest their implication in reparatory angiogenesis characteristic to chronic inflammation. Modulating activity in the frame of inflammatory process, of the T-lymphocytes and especially of T-lymphocytes may represent a target for the therapeutic management. Surgery can and should be performed by an endoscopic approach.

Oral cancers still represent a major health problem; regional lymph node metastases occur in 30-40% of head and neck squamous cell carcinomas and are associated with unfavorable prognosis and decreased survival. The study included 35 cases of oral squamous cell carcinomas (OSCC), which were analyzed by double reactions to determine the proliferative activity (anti-human D2-40/Ki67) and the maturity degree (anti-human D2-40/α-SMA) of lymphatic vessels, both intratumoral (IT) and in the advancing edge (AE), and in relation to clinicopathological prognostic parameters. The mean values of D2-40 lymphatic vessel density (LVD) were higher in AE then in IT level. Poorly differentiated carcinomas, T3/T4, presented the highest LVD values, both IT and in the AE. LVD was higher in advanced stages and metastasizing carcinomas. Ki67 was positive in all cases, Ki67 proliferation index (IP) indicated higher values in poorly differentiated carcinoma, T3/T4, metastasizing ones, both IT and in the AE. LVD and IP Ki67 showed a positive linear correlation. D2-40/Ki67-positive vessels were identified only at the AE or close to it. D2-40/Ki67 LVD had highest values in advanced stages carcinoma, with metastases. D2-40/α-SMA-positive vessels were identified only in the neighborhood of the tumor and LVD highest values were present in early-stage carcinomas and without metastases. A negative linear correlation between proliferation and maturity of the lymphatic vessels was found. The study indicated a strong association between lymphatic proliferative activity and lymph node metastases, suggesting the need for targeted antilymphangiogenic therapies in OSCC.

The incidence of hepatocellular carcinoma (HCC) has been constantly increasing over the last years mainly due to hepatitis C infection and cirrhosis. The new developments in imaging technology, including magnetic resonance imaging (MRI) and computed tomography (CT), allow a better diagnosis of HCC. Cirrhosis is characterized by formation of nodules from regenerative nodules to dysplastic nodules, followed by HCC. Thus, the differential diagnosis of hypervascular hepatic lesions is important, especially in the nodules smaller than 2 cm, although their characterization may be difficult even when histopathology is used. A multistep approach with the comparison of clinical data, pathological findings and imaging features is useful for a more accurate diagnosis. MRI has the ability to assess the same lesions features as CT and to better characterize the enhancement patterns of nodules combined with the lack of irradiation. Moreover, new liver specific contrast agents and imaging techniques as diffusion-weighted (DWI) sequences are available. Regenerative and low-grade dysplastic nodules demonstrate contrast enhancement similar to that of surrounding liver parenchyma, compare to high-grade dysplastic nodules, which may show arterial enhancement similar to that seen in HCC. We present a review of the MR imaging and histopathological features of hypervascular nodules in the cirrhotic liver, with reference to the transition from dysplasia to HCC.

Uterine myometrial smooth muscle tumors sometimes raise concerns related to their histopathological typing, and that especially for benign entities with areas of atypia. In this study, we analyzed a group of myometrial smooth muscle tumors in what it regards their differential diagnosis utilizing a panel of antibodies consisting of α-SMA, Ki-67, p16, p53, PR and bcl-2. The study included a total of 16 cases of cellular leiomyomas, five cases of atypical leiomyomas and six of leiomyosarcomas, which were all analyzed for age, risk factors, mitotic activity, cellular atypia and tumor staging. In cases of cellular leiomyomas, the immunophenotype was characterized by high expression of PR and bcl-2 and low expression of p53 and Ki-67. For atypical leiomyomas, PR, bcl-2 and p53 expression levels were highly compared with low levels of p16 and Ki-67. Leiomyosarcomas immunophenotype was characterized by high expression values of Ki-67, p16 and p53, and decreased levels of PR and bcl-2. The study indicated specific immunophenotypes among the uterine myometrial smooth muscle tumors analyzed. The antibody panel used here might be a useful for the complementary histopathological analysis of myometrial leiomyomas and leiomyosarcomas.

In this study, we investigated the p16 and Ki67 immunoexpression in 19 ameloblastomas in order to highlight some correlations of these markers with the aggressive variants of tumors. The p16 immunoreaction was present in 90.9% of cases; the highest scores are present in the typical follicular and in the intraluminal unicystic variant, at the opposite pole being the granular cells variant. In these cases, the maximum reaction was observed at the level of the stellated reticulum cells while the lowest reaction was present at the level of cubico-cylindrical peripheral cells of the neoplastic islands. The Ki67 immunoreaction was present in all cases, the highest scores being present in the typical follicular variant, opposite being the ameloblastoma with granular cells cases and that with acanthomatous differentiation type. The immunostained cells were located predominantly at the periphery of the tumoral islands but also in the stellated reticulum cells in the central area. The p16 and Ki67 markers may be useful for distinguishing different types of ameloblastomas in terms of aggressiveness.

We are presenting the case of a 19-day-old newborn with HIV-seropositive mother, under antiretroviral treatment since birth, who is admitted in the ICU (Intensive Care Unit) of the 1st Pediatric Clinic at the Emergency County University Hospital in Craiova, Romania, in critical general condition, with severe respiratory insufficiency. The examination of the tracheal and bronchial secretion revealed positive BK (bacillus of Koch). We considered it was an HIV/TB co-infection, the tuberculostatic treatment was instituted, but the evolution was towards exitus in the 11th day after admission.

Gastrointestinal stromal tumors could rise in different areas of the digestive tract, at any age, but very rarely in neonates. We present the case of a 5-day-old male, with intestinal stenosis and atresia (type II) operated for peritonitis. On the resected specimen, the histopathological examination revealed a small gastrointestinal tumor of 8 mm. The immunohistochemical analysis indicated a low malignant potential. He is currently at two years of oncologic follow-up with no evidence of disease.

This study analyzes the microvascular density (MVD) for CD105+ and α-SMA+ vessels and VEGF immunoexpression for 35 oral squamous cell carcinomas and for the associated dysplastic lesions of the lips. CD105+ MVD was superior in the advancing edge compared to the intratumoral area, no matter the analyzed clinico-pathological parameters (gender, age, differentiation degree, tumor stage) (p<0.05), MVD being significantly higher in poorly differentiated carcinomas (p<0.05). α-SMA+ MVD was also superior in the advancing edge compared to the intratumoral area (p<0.05), MVD values being significantly higher in well and moderately differentiated carcinomas (p<0.05). CD105+ MVD and α-SMA+ MVD were significantly lower compared to the analyzed tumor area (p<0.05), in the dysplastic lesions. VEGF score showed significantly higher values in well to moderately differentiated carcinoma and in the tumor area versus dysplastic associated lesions (p<0.05). CD105+ MVD and VEGF are markers able to characterize the angiogenic phenotype of carcinomas and of the dysplastic lesions of the lips, while α-SMA+ MVD quantification is useful in assessing the vascular maturity degree.

Introduction: Colorectal cancer represents a major cause of mortality and morbidity and occupies the third place as cancer incidence and the fourth place as cancer mortality. Colorectal cancer causes 608 000 deaths per year, despite correct applied treatment (surgery and chemotherapy). Interleukin 8 (IL-8) is an important proinflammatory cytokine with an important role in leukocyte chemoattraction. IL-8 also represents an important tumorigenic and proangiogenic factor., Materials and Methods: We have studied 68 patients aged between 55 and 70 years, hospitalized in the IInd Surgery Clinic of the Emergency County Hospital of Craiova, Romania. According to TNM grading, the patients were in stages II, III and IV. From these patients, we have prelevated two types of samples: serum and tumor fragment., Results: IL-8 values were significantly increased, both in serum and tumor supernatant. The highest IL-8 values were found in tumor supernatant and in advanced stages; IL-8 increased values were correlated with tumor growth and TNM stage., Conclusions: IL-8 has an important role in colorectal cancer growth and metastasis and represents an important therapeutic target in this type of cancer. IL-8 represents also a predictor for colorectal cancer prognosis.

Introduction: Metabolic syndrome was defined by IDF (International Federation for Diabetes, 2007) by abdominal obesity plus at least two of the following: high triglycerides, low HDL-cholesterol, hypertension, high levels of glucose or type II diabetes diagnosed. Obesity is associated with a high cardiovascular risk, abdominal obesity being the most aggressive form, because it secretes cytokines and hormones in comparison to subcutaneous adipose tissue. Adipocytokines secreted by adipose tissue are mediators of atherosclerosis and endothelial damage., Materials and Methods: We studied a total of 80 subjects aged between 40 and 60 years with metabolic syndrome, in which the following adipocytokines values were determined: hs-CRP (turbidimetric method), IL-6, TNF-alpha, leptin (ELISA method), in comparison to a control group., Results: The values of these adipocytokines were significantly higher in the studied group compared with the control group and correlated with increased levels of glucose (patients with type II diabetes or increased tolerance test) and with hyper-triglyceridemia., Conclusions: Patients with metabolic syndrome had increased levels of proatherogenic adipocytokines, particularly leptin, leptin-resistance representing the pathogenic link of obesity. The identification as early as possible of the metabolic syndrome patients allows effective monitoring and correction of cardiovascular risk factors, with the opportunity to reduce morbidity and mortality in young ages. In men, proatherogenic cytokines values presented higher values than in women, which prove the role of abdominal obesity in proatherogenic cytokines production. Although women have a higher percentage of adipose tissue, this is not primarily abdominal adipose tissue.

Thyroid carcinomas constitute lesions with an ascending incidence, for which many prognosis assessment systems were developed. This study focused on analyzing the immunoexpression of CK19, vimentin and E-cadherin in a number of 43 differentiated thyroid carcinomas, of which 39 papillary carcinomas and four follicular carcinomas, and assessed the relationship of these markers with clinico-pathological parameters of interest, such as age and gender of patients, the histological type and subtype, tumor size and extension, metastases in regional lymph nodes and tumor stage. CK19 immunostaining indicated higher scores in conventional and follicular papillary carcinomas compared with tall cell variant. In relation to the size and extension of the tumor, we found significantly higher values of vimentin and E-cadherin scores in T1-T2 carcinomas compared with T3-T4 category and a positive linear distribution of these markers, which sustain their involvement in common mechanisms of tumor progression.