[The first experience in Hungary with split-course multimodal treatment in high risk bladder cancer].

Összefoglaló. Az izominvazív vagy nagyon nagy kockázatú, felületes hólyagdaganatok kezelésének arany standardja a radikális húgyhólyag-eltávolítás (cystectomia). Válogatott betegek esetében hasonló hatékonyságú kezelés lehet az osztott dózisú (split-course) trimodális terápia, az endoszkópos tumorreszekció és a kemoirradiáció megszakított ciklusokkal történő alkalmazása.

Gastrointestinal stromal tumor presenting as a hormonally inactive adrenal mass.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Rarely, tumors with the same histological and immunohistochemical features arise in organs having no connection to the tubular gastrointestinal tract designated as extra-gastrointestinal stromal tumors (EGISTs). In this article, we report the first case of an EGIST presenting as a hormonally inactive adrenal mass.

Assessing remission in clinical practice.

Objective: Remission constitutes the best achievable state in patients with rheumatoid arthritis. We aimed at evaluating sustained remission in a large cohort of patients followed prospectively in clinical practice and to evaluate available instruments to define remission for their stringency in defining this state.

Patients And Methods: We analysed remission and sustained remission in 621 patients who had two consecutive and complete clinical observations; the average period between the two visits was 92 days (median; quartiles: 82; 105).

[Squamous papilloma of the esophagus. Clinical and pathological observations based on 172 papillomas in 155 patients].

Introduction: The papilloma of the oesophagus is a rare disease. The pathogenesis and biological features of the disorder are not clearly known.

Aims: The purpose of the present paper is to outline the clinical and pathological significance of the papilloma of the oesophagus as detected in the authors' endoscopic laboratory.

Low level of cyclin D1 protein expression in thyroid microcarcinomas from an autopsy series.

In a recent epidemiological screening study in an autopsy series, we found a high prevalence of microcarcinomas (MCs) (21/443 = 4.74%). We found no iodine intake-, gender-, or age-dependent differences in the prevalence of MCs.

Epidemiology of thyroid microcarcinoma found in autopsy series conducted in areas of different iodine intake.

The prevalence of thyroid microcarcinomas found at autopsies is 100-1000 times higher than in clinical cancer. The epidemiological and histological characteristics of thyroid microcarcinomas in consecutive series of autopsies performed in two areas of different iodine intake were investigated. Iodine deficient (ID) area: n = 222 (M = 109, F = 113), median age: 74-76 years, median iodine excretion (MIE) of nursing home residents from this area: 70 microg/g creatinine.

Quantitative analysis of p53 expression and cell proliferation in gastric carcinomas. An immunohistochemical study.

Background/aims: Adenocarcinoma of the stomach is still among the leading malignancies in human morbidity and mortality statistics in spite of endoscopic screening of the high-risk patients. Investigation of prognostic factors of gastric cancer disease seems to be still very important. The authors present a clinicopathological study based on the analysis of 49 gastric carcinomas.

Synchronous multiple glomus tumors of the esophagus and lung.

A case of synchronous esophageal and multiple pulmonary tumors presenting complex diagnostic problems is described. In the course of routine pulmonary screening a pulmonary coin lesion of the right lung and three very small foci on the left side, under the pleura falling just within the range of diagnostic parameters was identified in a symptom-free patient. In addition to the multiple lung lesions a single sub-mucosal esophageal tumor was detected.

[Intramural esophageal metastasis of diffuse, infiltrative gastric adenocarcinoma].

Authors report a patient with a gastric carcinoma that developed an intramural metastasis to the oesophagus. The diagnosis of the metastasis was suggested on endoscopy and was verified by pathohistology. Preoperative investigations suggested advanced cancer.

Esophageal intramural metastasis from adenocarcinoma of the gastroesophageal junction.

Among a total of 143 patients examined for diagnosis of adenocarcinoma of the cardia, intramural esophageal metastases were verified in six patients (4.19 %). In each case the diagnosis was confirmed by histological examination.

[Esophageal implantation metastasis from adenocarcinoma of the cardia].

A 74 years old male patient was admitted to our department suffering from dysphagia for five months. Gastric Barium studies showed a cardia tumour with polypoid lesions in the wall of the esophagus, and gastro-esophageal reflux disease was also diagnosed. Endoscopy verified a cardia tumour with esophageal metastasis, and biopsy was obtained from the two lesions.

[Rare late complication after subtotal esophagectomy].

We report a case of a peptic ulcer developed in the stomach tube used for the replacement of the esophagus. The patient was a 60 years old female who had undergone subtotal esophagectomy for mid esophageal malignancy, with intrapleural stomach replacement. Urgent endoscopy revealed an excavated, bleeding ulcer in the thoracic part of the stomach.

[Siewert-Stein classification of adenocarcinoma of the esophagogastric junction].

Nowadays the terminology used for the definition of adenocarcinomas at the oesophagogastric junction is "cardiac carcinoma", which can be easily misunderstood. This definition of adenocarcinomas of the oesophagogastric junction does not allow correct comparison of diagnosis (endoscopic, radiological and pathologic), epidemiology and surgical therapy in national and international aspects, because different tumours can develope in the same area, and all called cardia tumors. Siewert and Stein recommended a classification to solve this problem.

[Regression of gastric MALT lymphoma after eradication of Helicobacter pylori infection followed by endoscopic ultrasound].

The authors report a case of a 42 year-old female patient, who was admitted with epigastric pain and weight loss to our department. Upper gastrointestinal endoscopy two ulcerated lesions revealed in the stomach at the corpus-antrum border. Histologically the lesion proved to be a low grade, malignant B cell MALT lymphoma.

Pituitary adenylate cyclase activating polypeptide (PACAP) is present in human and cat gastric glands.

In the present work we have studied the occurrence of pituitary adenylate cyclase activating polypeptide (PACAP) in human and cat stomach mucosa using immunohistochemistry. As seen under a light microscope, there were many large rounded and ovoid cells that were PACAP immunopositive, mainly in the neck of the gastric glands of both species. The immunopositive material was predominant in the perinuclear area.

[Ganglioneuroma of the adrenal gland].

149 patients with adrenal incidentalomas were examined. Sixty-eight cases were histologically confirmed, five of them had ganglioneuromas. On the basis of these patients history current knowledge of this benign tumour was summarized.

Metastasis of an esophageal carcinoma to a giant gastric ulcer.

In patients with esophageal carcinoma it is considered that stomach metastasis is induced mainly via the lymphatic route rather than via the bloodstream route that is common in other types of distant organ metastasis. A 56 year-old patient is reported who underwent synchronous subtotal esophagectomy and total gastrectomy for a middle third esophageal carcinoma and a giant peptic ulcer within the gastric fundus. The final histopathologic examination revealed a squamous cell carcinoma of the esophagus with concomitant squamous tumor implantation within the gastric ulcer.

[Pulmonary echinococcosis].

Two patients with pulmonal Echinococcosis are presented by the authors. Contact with cestoda carrier animals cannot be revealed. At the first patient, who was without any complaints, the two round shadows in her chest X-ray were detected accidentally by screening examination and before the operation only eosinophilia, many eosinophil granulocytes in the pleural effusion and the positive complement binding reaction were related to the Echinococcosis, which was proved by the histological examination of the intraoperative biopsy.

The value of ultrasound in preoperative assessment of the myometrial and cervical invasion in endometrial carcinoma.

This study was undertaken to determine the accuracy of ultrasonography in depicting the depth of myometrial invasion and cervical involvement in women with adenocarcinoma of the endometrium. During the past 2 years, pelvic ultrasound using abdominal and vaginal probes was carried out as part of routine preoperative work-up in 69 consecutive patients with carcinoma of the endometrium. Fifty-eight patients were primarily operated on; the remaining 11 had preoperative intracavitary irradiation followed by surgery at the referral hospital.

[Solitary plasmacytoma of the lung].

A case of solitary plasmacytoma of the lung in a 64 year old woman is reported. The anatomical and clinical features of this exceedingly rare form are discussed. Stress is laid on the 'fact that diagnostic certainty can only be obtained by immunohistochemistry.