5 articles
Psoriasis is a chronic immune-mediated inflammatory condition and is considered a potential risk factor for the development of hematologic malignancies, particularly in the context of immunosuppressive therapy and T-cell dysfunction. B-cell non-Hodgkin lymphomas are neoplasms of the lymphatic system with variable clinical manifestations, most commonly presenting with peripheral lymphadenopathy. Primary localization in the soft tissues of the head, with bone invasion, is rare.
We report a rare case of cephalic aggressive NHL Not Otherwise Specified (NOS) in a 63-year-old patient with a history of psoriasis vulgaris and Clear cell carcinoma (T1N0M0, treated in 2021 at the Oncology Institute in Chișinău), who presented with a painless right temporo-parietal mass. MRI revealed a 48×19×50 mm lesion in the temporal soft tissues with extension into the frontal bone. Surgical biopsy and immunohistochemistry (CD20+, CD79a+, CD45+, BCL6-) confirmed the diagnosis of B-cell NHL NOS. In 2022, the patient received 8 induction cycles of immunochemotherapy followed by maintenance therapy with Rituximab. PET/CT evaluation showed a Deauville score of 3, indicating a partial favorable response. Associated comorbidities (psoriasis, type 2 diabetes mellitus, hypertension) required multidisciplinary monitoring.
This case illustrates an unusual cranial localization of aggressive B-cell lymphoma NOS and highlights the potential link between psoriasis and lymphoproliferative risk, as previously suggested in the medical literature.
Cutaneous malignant melanoma is the most aggressive skin cancer, with a high mortality rate despite advances in therapy. This study aimed to evaluate the relationship between lymphovascular and perineural invasion and key clinicopathological parameters in superficial spreading melanoma, in order to assess their potential prognostic significance.
A retrospective analysis was conducted on 47 cases of superficial spreading melanoma obtained from the Oncology Institute in Chisinau. All cases were histologically confirmed and reviewed for tumor thickness, Clark level, ulceration, mitotic activity, microsatellitosis, pigmentation, and lymph node involvement. Lymphovascular and perineural invasion were assessed using hematoxylin–eosin staining and, where available, immunohistochemistry. Correlations between invasion patterns and clinicopathologic features were analyzed using Pearson correlation coefficients, with statistical significance set at p < 0.05.
Lymphovascular invasion was positive and significantly correlated with tumor thickness (r = 0.54, p< 0.001), Clark level (r = 0.46, p < 0.001), microsatellitosis (r = 0.50, p < 0.001), tumor stage (r = 0.33, p = 0.01), and lymph node involvement (r = 0.29, p = 0.02). A negative correlation was observed with pigmentation (r = –0.26, p = 0.04). Perineural invasion was less frequent, but correlated positively with lymphovascular invasion (r = 0.28, p = 0.03) and showed a trend toward association with amelanotic tumors (r = –0.24, p = 0.05). No significant relationships were found with ulceration or mitotic activity.
Lymphovascular invasion represents a significant indicator of aggressive biological behavior in superficial spreading melanoma, closely associated with established prognostic factors. Perineural invasion occurs less frequently, but may further reflect invasive potential, particularly in amelanotic variants. Routine histopathologic assessment of both invasion patterns is recommended to improve prognostic evaluation.
Ovarian cancer continues to be the most lethal gynecologic malignancy, with high-grade serous ovarian carcinoma representing the most common and aggressive histological subtype. Although estrogen receptor and progesterone receptor have established prognostic and therapeutic relevance in other hormone-dependent cancers, such as breast carcinoma, their role in high-grade serous ovarian carcinoma remains insufficiently characterized and requires further elucidation.
A retrospective study was conducted on 40 cases of high-grade serous ovarian carcinoma diagnosed between 2022 and 2024 at two medical institutions in Chișinău, Republic of Moldova. Estrogen receptor and progesterone receptor expression was evaluated by immunohistochemistry, employing the Allred scoring system (range: 0–8). Clinical and pathological data were collected, including patient age, menopausal status, tumor grade, FIGO stage, CA-125 serum levels, and tumor laterality. Statistical analysis comprised descriptive statistics, Student’s t-test, Kruskal-Wallis test, Spearman’s rank correlation, Mann-Whitney U test, and Chi-square test. A p-value < 0.05 was considered statistically significant.
Estrogen receptor positivity was detected in 60% of cases (Allred scores 4-8), exhibiting a diffuse nuclear staining pattern, whereas progesterone receptor positivity was observed in 50% of cases (scores 2–6) with focal or mosaic staining. Four immunoprofiles were identified: ER+/PR+ (35%), ER+/PR− (25%), ER−/PR+ (15%), and ER−/PR− (25%). A significant positive correlation was found between ER and PR expression (ρ = 0.472, p = 0.001). Elevated CA-125 levels were significantly associated with advanced FIGO stage (H = 15.52, p = 0.0014), higher tumor grade (H = 4.15, p = 0.041), and PR negativity. Bilateral ovarian involvement showed a strong correlation with advanced disease (ρ = 0.658, p < 0.00001). The ER−/PR+ immunoprofile was predominantly associated with the most advanced FIGO stages. No significant differences in estrogen receptor or progesterone receptor expression were observed between premenopausal and postmenopausal patients.
Hormone receptor expression in high-grade serous ovarian carcinoma exhibits significant associations with key clinicopathological parameters, including CA-125 levels, tumor grade, FIGO stage, and tumor laterality. Notably, loss of progesterone receptor expression correlates with more aggressive tumor behavior. Hormonal receptor profiling using the Allred scoring system may provide valuable insights for prognostic stratification and aid in therapeutic decision-making in serous ovarian carcinoma. Further investigations involving larger patient cohorts and comprehensive molecular characterization are warranted to validate and expand upon these findings.
Placentation and autochthonous vascularization during the early period of intrauterine development in primary placental insufficiency are important stages in the establishment of embryo-haemochorial circulation. Vascular and angiogenesis dysfunctions in the early period of gestation are essential in the development of changes in placental vascular status with severe repercussions on pregnancy outcome in the first trimester of gestation.
Evaluation of vascular density by the application of the anti-CD31 antibody in the chorio-villar germinal site in short-term dysregulated pregnancies.
184 cases were divided into 2 groups: stagnant pregnancies (SP (L1 = 144 cases) and early spontaneous abortion (ESA) (L2 = 40 cases). Control material: pregnancies resolved at social indications/desire (A) (n = 18) distributed according to gestational term (3-5 weeks), (6-9 weeks), and (10-12weeks). The estimation of the histomorphological features was performed by applying the classical conventional method with hematoxylin-eosin (H.E.), and the immunohistochemical evaluation of the vascular density in the chorio-villar profile with the help of the endothelial marker anti-CD31. The statistical relationships between fetal conceptus assessment forms, gestational term, and age were analyzed.
Distribution of pregnancies by profile: (SP) – 78.2% vs (ESA) – 21.8%, with vascular disturbances attested in 100% of cases by increasing the density of avascular chorionic villi in the case of stagnant pregnancies in 75% of cases. The application of immunoexpression with anti-CD31 at the level of the stroma of the chorionic villi determined PVI with a maximum mean in the control group (91.51±0.71) vs the ESA and SP groups (82.29±12.96 and 57.47±6.53, respectively). The index of vascularization with lumen (IV/L+) and vascularization index without lumen (IV/L-) were statistically significantly different (p = 0.011) for (SP). Applying the student t-test revealed statistically significant differences for PVI in most groups, except PSD vs SP at the age of 10-12 gestation of weeks (w.g.) At the same time, there are statistically significant differences between the means of vessels with lumen within PSD and SP (t31 = 5.500, p = 0.000005), and the means of vessels without lumen registered statistically significant differences in the PSD and SP groups (t12 = 3.862, p = 0.002).
Pregnancy evolution depends on the degree of vascularization, as well as on the quality of the vascular network. Disruption of placental vasculature is one of the basic links in the development of primary placental insufficiency during placentation.
Breast cancer is one of the most common cancers in females worldwide. There are evidences that women with diabetes mellitus have a 40% higher risk of mortality. CD34 is a cell surface glycoprotein, which functions as a cell-cell adhesion factor. Although its expression is traditionally related to hematopoietic cells, it is actually found on many other types of cells, endothelial too. Nowadays there are evidences that CD34 is a prognostic indicator by emphasizing its low expression in malignant tumors compared to benign ones. The aim of study was to determine the presence and numerical distribution of CD34+ vessels in the normal mammary gland, as well as in NST breast carcinomas, with and without diabetes mellitus type 2.
We processed immunohistochemically 58 invasive breast carcinomas of NST type. In 29 of cases, tumors were associated with diabetes.
The present study did not reveal any statistical and morphological differences in CD34 expression between compared groups.
The expression of CD34 in breast cancer stroma is not homogenous, irrespective of association with diabetes mellitus type 2. The question if breast carcinoma and diabetes mellitus are concurrent or associated disorders remains open. Probably, the effect of carcinoma prevails in influencing the structure of the tumor microenvironment. We expect a further confirmation in larger study groups.