4. Hrvatski kongres kliniËke citologije 4th Croatian Congress ... - Penta

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4. Hrvatski kongres kliniËke citologije / 1. Hrvatski simpozij analitiËke citologije / 2. Hrvatski simpozij citotehnologije PELVIC GANGLIONEUROMA - CASE REPORT Roganović J1 , Šegulja S1 , Jonjić N2 , Seili-Bekafigo I3 60 Klinička citologija - Plenarna i pozvana predavanja 1 Division of Hematology and Oncology, University Children’s Hospital Rijeka 2 Department of Pathology, School of Medicine Rijeka 3Department of Cytology, Department of Internal Medicine, Clinical Hospital Center Rijeka, Croatia Ganglioneuroma is a rare benign tumor originating from sympathetic tissue. The most common locations are the posterior mediastinum and retroperitoneum. Pelvic ganglioneuroma is extremely rare. We report a case of pelvic ganglioneuroma in a 12-year-old who presented with one week history of lower abdominal pain. Abdominal ultrasound demonstrated a large homogeneous well-circumscribed presacral tumor with few calcifications. This finding was confirmed by pelvic computed tomography (CT) and magnetic resonance imaging. CT-guided fine needle aspiration biopsy was performed. Cytologic and pathologic features were suggestive of ganglioneuroma. The patient underwent a complete surgical resection and the diagnosis of ganglioneuroma was subsequently confirmed on histopathologic examination. At 3-years follow-up the patient is asymptomatic and without evidence of disease. Ganglioneuroma should be considered in the differential diagnosis of soft tissue pelvic tumors in children. Fine needle aspiration biopsy plays an important role in facilitating an appropriate diagnosis and an adequate therapeutic approach. jelena.roganovic1@ri.t-com.hr
Clinical Cytology - Plenary and Invited Lectures MORPHOLOGICAL AND MOLECULAR ANALYSIS OF GISTS ON CYTOLOGY Schmitt FC Medical Faculty of Porto University, Unit of Molecular Pathology - IPATIMUP, Porto, Portugal The term “targeted therapies” refers to treatment strategies directed against molecular targets considered to be involved in the process of neoplastic transformation. One of the most attractive molecular targets for therapeutic intervention in cancer is the protein tyrosine kinase (TK) family. More than 100 dominant oncogenes are recognized to data and many encode receptor and cytoplasmic TKs known to be mutated and/or overexpressed in human cancers. Targeting receptor protein kinases family as cancer therapy has continued to become a compelling approach with time. However, some general conditions should be considered prior to selecting a TK as a therapeutic target in cancer. It should be involved in experimental tumour progression and be demonstrable in diagnostic tumour tissue. (Cyto)pathology is crucial for the accurate assessment of the target to ensure that the patients who may benefit from the therapy are correctly identified. Since the last decade, there have been an increasing number of new drugs which indications depends upon a pathological report. Fine needle aspiration (FNA) cytology has proven its value as a minimally invasive, easy, accurate and reliable technique for the diagnosis of tumours and has also been used for the assessment of prognostic and predictive factors. The evaluation of predictive factors in FNA specimens should be largely confined to patients who will undergo neoadjuvant chemotherapy before surgery or in the setting of metastatic disease. FNA is a less traumatic method that provides a good source of cancer cells to study therapeutic targets. Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract, with an annual incidence of 10 to 20 cases per million, being most commonly found in the stomach (40 to 70%), in the small intestine (20 to 50%), in the colon and rectum (5 to 15%), and in the esophagus (< 2%). Activating mutations of c-kit oncogene are the major genetic alterations in GISTs. c-kit is a proto-oncogene that codes for a transmembrane TK receptor: CD117. Once activated, KIT propagates signalling events throughout the cell via multiple signal transduction pathways. Until recently, the prognosis of patients with GISTs was poor due to its frequent recurrence and resistance to chemo and radiotherapy regimens. The development and current treatment with specific RTK inhibitors is changing this scenario. Imatinib mesylate is a selective inhibitor of RTKs, by competing with the ATP for its binding site, preventing further phosphorylations of signaling molecules downstream of the receptor, responsible for abnormal viability and proliferation signals in these cells. Several studies have linked different responses to the drug with c-kit alterations. In particular, tumors harboring exon 11 c-kit mutations are more likely to respond to an Imatinib therapy than those with either exon 9 c-kit mutations or no detectable mutation. Currently, Imatinib is used for the treatment of Kit positive GIST patients with unresectable and/or metastatic malignant tumor. Besides Imatinib, another RTK inhibitor, Sunitinib has been approved 61 4 th Croatian Congress of Clinical Cytology / 1 st Croatian Symposium of Analytical Cytology / 2 nd Croatian Symposium of Cytotechnology
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