VOL 5, No. 1 (2025)

The availability of medicines is associated with the number and uniformity of distribution of pharmacies throughout the territory of the Russian Federation. In this regard, this paper presents the results of assessing the level of market concentration of entities in the pharmacy segment of the Russian pharmaceutical market. The data obtained show that with an increase in the number of pharmacy chains and their share in the retail segment, the level of market concentration also increases and leads to an increase in the market power of the leaders of the pharmacy segment of the Russian pharmaceutical market. At the same time, the dynamics of the number of pharmacies in the Russian pharmaceutical market (simultaneously with the increase in market concentration indices) also demonstrates an upward trend, which indicates the rapid development of the pharmacy segment. The level of market concentration of the TOP-5 pharmacy chains based on the results of 2024 is established, and the dynamics of changes in the number of pharmacies in the Russian pharmaceutical market in the period 2017 – 2024 are determined.

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.

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.

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.

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.

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.

In this review, authors conduct a short fragment of an in-depth analysis of the 6th Edition (2021) of the WHO procedural manual for human semen analyses comparing with 5th Edition (2010) one. Highlighting the pitfalls we clarify the key points of problems. Also, authors note the well way for basic semen examination for laboratory in Russia at the present time.