Publications by authors named "Levente Kuthi"

Introduction: Gastric adenocarcinoma with enteroblastic differentiation (GAED) is a rare entity with worse prognosis compared to conventional gastric adenocarcinomas. Its histological characteristics are fetal gut-like architecture and tumor cells with cytoplasmic clearing, as well as positive immunohistochemical reaction to at least one of the enteroblastic markers. Hereby, we present a case of GAED with neuroendocrine marker positivity, with whole exome sequencing (WES), and an updated literature review.

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  • Succinate dehydrogenase-deficient renal cell carcinoma (SDH-deficient RCC) is a rare and aggressive subtype of kidney cancer mostly seen in younger patients, marked by mutations in SDHx genes, especially type B.
  • The tumors have unique histological characteristics, including eosinophilic cells in solid nests or microcysts that can trap normal kidney tubules.
  • In a study of three cases, all tumors showed a lack of SDHB expression and had pathogenic mutations, with two cases confirming the hereditary nature; diagnostic and treatment challenges arise due to overlapping features with other renal tumors.
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In recent years a significant demand to develop computer-assisted diagnostic tools to assess prostate cancer using whole slide images has been observed. In this study we develop and validate a machine learning system for cancer assessment, inclusive of detection of perineural invasion and measurement of cancer portion to meet clinical reporting needs. The system analyses the whole slide image in three consecutive stages: tissue detection, classification, and slide level analysis.

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  • TERT promoter mutations are important tumor markers but are hard to detect due to their high GC content and existing methods lack efficacy for noninvasive detection in bladder cancer.
  • A new PCR-based method called SHARD-PCR was developed to detect common TERT promoter mutations more easily in urine and tissue samples from bladder cancer patients.
  • Testing showed that SHARD-PCR accurately matched results obtained from next-generation sequencing, highlighting its potential as a simple, cost-effective alternative for detecting TERT mutations in cancer.
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  • * The survey received an 85% response rate from 98 uropathologists, revealing strong agreement on distinguishing between luminal and basal UC types, but varied opinions on the importance of certain genetic tests like FGFR3 and TERT promoter mutations.
  • * Most uropathologists acknowledged the aggressive nature of tumors with micropapillary features and favored further evaluation and specific molecular testing for aggressive subtypes, indicating a need for improved consensus in UC classification and treatment strategies.
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Prostate cancer stands as the most prevalent malignant tumor among men; with its incidence increasing with advancing age. The spectrum of patient care options for this disease is broad, encompassing approaches such as "active surveillance," definitive radiation therapy, robot-assisted surgery, among others. These diverse modalities afford opportunities for cure or successful management in the majority of cases.

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Thyroid-like follicular renal cell carcinoma (TLFRCC), an emerging subtype of renal cell carcinoma, presents diagnostic challenges due to its resemblance to normal thyroid tissue. Here, we report a rare case of TLFRCC in a pediatric patient, a demographic rarely affected by this subtype. Histologically resembling a typical TLFRCC, our case exhibited unique features including post-neuroblastoma development, occurrence in a male teenager, and diffuse MelanA expression, which has not been previously reported in TLFRCC.

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  • Human pulmonary dirofilariasis (HPD) is a rare disease caused by the Dirofilaria immitis parasite, typically spread through mosquito bites, with dogs being the main hosts and most cases reported in Mediterranean countries.
  • A study in Hungary documented 5 cases of HPD over 12 years, all involving middle-aged patients with tumor-like lung lesions requiring surgical intervention; histological tests confirmed the presence of remnants of the parasite.
  • The study emphasizes the need for clinicians to be aware of HPD in diagnoses of lung lesions, as early detection is crucial for effective treatment and to avoid unnecessary surgeries.
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Angiosarcoma (AS) of the breast, a rare mesenchymal neoplasm, exhibits distinct forms based on etiological and genetic features. While cases with typical clinical presentation and morphology allow for a straightforward diagnosis, challenges arise when clinical data are scarce, diagnostic material is limited, or morphological characteristics overlap with other tumors, including undifferentiated carcinomas. The trichorhinophalangeal syndrome protein 1 (TRPS1), once regarded as highly specific for breast carcinomas, now faces doubts regarding its reliability.

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Introduction: Colorectal tubular adenomas displaying clear cell change are rare entities, with unknown clinical relevance, prognosis, immunohistochemical, and molecular features.

Case Presentation: Hereby we report a case of a 43-year-old female patient with a rectosigmoid polyp. Histologically, conventional dysplasia was visible with scattered areas displaying clear cell change.

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Background: Follicular dendritic cell sarcoma (FDCS) is a rare low-grade tumor of the lymph nodes, but roughly one-third of the cases emerge from extranodal sites, posing diagnostic challenges.

Case Presentation: In this report, we present the case of a 59-year-old lady who complained of renal colic. During investigation, a kidney tumor was discovered.

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  • * The depth of invasion in invasive urothelial cell carcinoma affects clinical outcomes, and different morphological variants respond differently to treatments, but many are underdiagnosed due to unclear criteria.
  • * The 2022 WHO classification has improved understanding of these subtypes, and this paper aims to educate pathologists, oncologists, and urologists in Hungary to enhance personalized care in urological oncology.
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Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare, low-grade, painless tumor of mesenchymal origin. In the current, 5th edition of the World Health Organisation (WHO) 'Classification of tumors: Soft tissue and bone tumors', there is no exact diagnostic genetic alteration defined in MIFS. Hereby we present the case of a 71-year-old female patient, with a medical history of benign essential hypertension, who visited the hospital because of a lesion above her right shin.

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  • - Penile melanoma (PM) is a rare type of cancer that makes up less than 2% of penile cancers, mainly affecting older individuals and typically found on areas like the glans and foreskin, with a generally poor prognosis and no specific staging system.
  • - The report discusses two case studies involving PM: one 62-year-old male with hematuria and a painful tumor, and another 68-year-old male with a rapidly evolving spot, both confirmed through histological analysis as melanoma.
  • - Findings highlight the significance of PRAME as a diagnostic marker for PM, while enhanced PD-L1 expression in tumors suggests potential for immunotherapy; also emphasized is the need for a specific staging system tailored for penile melanomas
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Wilms' tumor (WT) is the most common renal malignancy in children. In diffuse hyperplastic perilobar nephroblastomatosis (DHPLN), nephrogenic rests result in a bulky enlargement of the kidney, a condition considered as a premalignant state before WT. Despite relevant clinical differences between WT and DHPLN, they are often challenging to distinguish based on histology.

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It is acknowledged that nephron develops after bilateral induction of the metanephric mesenchyma and branching ureteric bud (UB), and that nephrogenic rest and Wilms' tumor (nephroblastoma) arises from impaired differentiation of metanephric blastema. The aim of this study was to obtain more information on the involvement of UB derivatives in nephrogenic rest and Wilms' tumor. We applied immunohistochemistry to analyze nephrogenic rests and Wilms' tumors with mixed histology, including regressive and blastemal types.

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Renal cell carcinoma (RCC) is the most common malignant kidney tumor. It is not a single entity but an umbrella term for several distinct tumor types. The most prevalent and clinically significant subtype of RCC is clear cell carcinoma, which consists of cells with empty cytoplasm.

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The lack of oestrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 expression in breast cancer (BC) is the basis for the categorization of the tumour as triple negative breast carcinoma (TNBC). The majority of TNBCs are aggressive tumours with common metastases and decreased expression of markers that could help in identifying the metastatic lesion as of mammary origin. Breast markers, such as gross cystic disease fluid protein-15 (GCDPF-15), GATA binding protein 3 (GATA3), mammaglobin (MGB) and SOX10, are not uniquely specific to BC.

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Kidney tumors may develop in association with hereditary tumor syndromes. The clinical presentation of these disorders is various, and in some cases, the renal tumor is the first manifestation of the syndrome. Thus, pathologists need to be aware of the gross and histological signs that may suggest the possibility of a tumor syndrome.

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The renal angiomyolipoma (AML) is a benign tumor characteristically composed of fat, smooth muscle tissue, and vessels. We collected AMLs from our nephrectomy database, reclassified them according to their histological appearance, recorded the demographic, clinical, and pathological parameters, and compared them with oncocytoma (RO) and renal cell carcinoma (RCC). Immunohistochemistry was ordered in 41 cases.

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  • End-stage renal disease (ESRD) increases the risk of developing renal cell carcinoma (RCC), and this study analyzed the characteristics of RCC found in ESRD patients.
  • A total of 34 tumors from 31 ESRD patients were examined, revealing a median age of 56 years, with clear cell RCC being the most common subtype.
  • The findings suggest a favorable prognosis for RCC in ESRD patients, with no tumor-specific deaths reported during the study period.
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Introduction: The COVID-19 (coronavirus disease 2019) caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is associated with high mortality rates worldwide. Polymerase chain reaction (PCR) is extensively used for virus detection in both infected patients and deceased persons. PCR, however, gives no information about the localization of the virus in cells and tissues.

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