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A clinical case of atypical cellular protein dissociation in the study of cerebrospinal fluid in a patient with a penetrating gunshot wound to the skull and brain is described. The composition of the cells responsible for increased pleocytosis is described. The interest of this case for attending physicians and staff of clinical diagnostic laboratories (CDL) is due to the unusually high content of cerebrospinal fluid not of leukocytes, but of cells of the membranes of the brain, which was proved by the data of light microscopy of the stained preparation. In the stained smear prepared from the cerebrospinal fluid sediment, mainly cells of the arachnoendothelium, the soft meninges and vascular plexuses of the brain were found, a significant content of which caused increased cytosis during cell counting.
The problems of the clinical and diagnostic significance of the study of cerebrospinal fluid pleocytosis and the role of differential cell counting in stained cell preparations for determining the type of pleocytosis are discussed.
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Sepsis in oncology patients is 10 times more common than in patients with non-tumor pathologies. This is due not only to the immunosuppressive effects of tumors, but also to the use of modern anti-tumor therapies. In this particular case, the patient, who was receiving chemotherapy for squamous cell lung cancer, did not show any classical morphological signs of sepsis. However, microcirculatory disorders with severe endothelial dysfunction and the presence of septic bacterial emboli in the vessels of various organs were found. Additionally, clusters of microorganisms were often detected in the stromal tissue of these organs. Alterative changes, such as dystrophy and necrosis, were observed in parenchymal tissues, although there was no perifocal inflammatory infiltration. No hyperplastic changes were seen in the lymphoid tissues.
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The case of death of a 74-year-old man with bilateral multisegmental pneumonia with progressive pulmonary-cardiac insufficiency is presented. The pathological anatomical examination verified rectal cancer, as well as extensive lesions of visceral and parietal lymph nodes of the small pelvis, lymph nodes along the main trunks of the inferior, superior mesenteric arteries, in peri-aortic and para-aortic areas behind the peritoneum along the spine along the course of the abdominal aorta, further in the lower and upper tracheobronchial localisations (a total of 25 lymph nodes) and lower lobes of the lungs. When comparing the structural characteristics of rectal carcinoma and tumour growths in lymph nodes and lungs, phenotypic morphological discordance was found, which required additional immunohistochemical study of the material (PAN-CK, CDX-2, CD20). When comparing the results of all the morphological studies performed, the evidence base was obtained to interpret the changes in groups of lymph nodes and lung tissue as a metastatic process of intestinal cell carcinoma.
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The increased frequency of multiple neoplasms was recorded in the last few years. Insufficient awareness of doctors about the possibility of multiple tumor lesions is the common reason why after the detection of one malignant tumor, a second lesion is most often interpreted as a metastatic process following the diagnosis of one malignant tumor. In this case cytological examination of peritoneal washing fluids, combined with subsequent immunocytochemical analysis, enabled the identification of a second malignant neoplasm – ovarian adenocarcinoma – in a patient with a previously diagnosed adenocarcinoma of the transverse colon.
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In clinical practice, cases of metastatic thyroid disease are infrequent, and the symptoms of this disease are nonspecific, which can lead to errors in diagnosis. One of the most common secondary malignant neoplasms of the thyroid gland is renal cell carcinoma. Over the past few decades, fine needle aspiration biopsy has been considered as the main method of differential diagnosis of thyroid lesions, which determines the further tactics of patient management. Verification of a metastatic thyroid lesion can be a difficult task for a cytologist, especially if the time interval from the moment of detection of the primary lesion is quite long. This article presents cases of cytological diagnosis of metastatic thyroid lesions from patients with renal cell carcinoma.
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Vulvar malignant melanoma is a rare disease and poses a serious problem for women's health. This pathology is characterized by a high degree of malignancy and an unfavorable prognosis. The article presents a clinical observation demonstrating the possibilities of cytological examination to detect vulvar melanoma in a 67-year-old patient.
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Melanoma is one of the most difficult skin tumours to diagnose cytologically and histologically. The accuracy of the examination results in the diagnostic process with cutaneous melanoma depends on strict compliance with the technological procedures of the pre-analytical extra-laboratory stage – adequacy of the obtained material; pre-analytical laboratory stage – correct sample preparation and quality staining of biopsy and surgical material; analytical laboratory stage – expertise of the pathologist in dermatopathology; post-analytical stage – selection of the necessary further diagnostic tactics, namely, the implementation of ancillary procedures; and the use of auxiliary procedures. The key role is given to interdisciplinary interaction between cytologists and pathologists in verification of melanoma diagnosis.
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Abstract. Currently, the diagnosis ‘normozoospermia’ independently and in combination with ‘viscosipathy’ does not exclude male infertility and stopping further examination of patient. Moreover, these semiological diagnoses seem to be the most important diagnostic criteria for determining the cause of a significant number of idiopathic infertility in couples who had unsuccessful attempt to conceive from 12 months or more. These clinical cases demonstrate the importance of combine approach to basic semen examination made it much more extended by ancillary technique e.g. sperm sediment cytology (SSC), fragmentation of sperm DNA (DFS) and of level of reactive oxygen species (ROS) estimation.
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A case of ovalocytosis of peripheral blood erythrocytes in a patient with normal peripheral blood parameters according to data from a 5-diff hematology analyzer is presented. The interest of the clinical case for attending physicians and specialists of clinical diagnostic laboratories is due to significant discrepancies between the results of clinical blood analysis according to automated and non-automated assessment. Changes in morphology of erythrocytes were detected in the stained blood smear, which were not accompanied by changes in erythrocyte indices (MСV, МСН, RDW) or the appearance of signal flags on hematological analyzers.
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This clinical report presents inconsistency of diagnosis “idiopathic male infertility”. For the extended examination, basic semen examination, MAR-test, ultrasound of scrotum, hormonal examination, MRI (magnetic resonance imaging) of pituitary gland, TRUSE (transrectal ultrasound examination) of prostate gland, as well as a MANA/PCR-RT (method of amplification of nucleic acids with polymerase chain reaction in real time) with Androflor test have been implemented to exclude bacteriospermia. According to current diagnosis, treatment with combination of non-antibacterial drugs was prescribed. This approach was applicated to decrease the total bacterial mass. According to recommendations of professional association [1] a three-stage examination was applied which was resulted with etiological factor of male infertility.
