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 90 Klinička citologija - Usmena predavanja T LYMPHOBLASTIC LEUKEMIA WITH AN UNUSUAL BURKITT LYMPHOMA MORPHOLOGY - A CASE REPORT Milas M1 , Jelić Puškarić B1 , Planinc-Peraica A2 , Šiftar Z3 , Kardum-Skelin I1 , Jakšić B2 1Merkur University Hospital, Department of Medicine, Laboratory for Cytology and Hematology, Zagreb, Croatia 2 Merkur University Hospital, Department of Medicine, Zagreb, Croatia 3 Merkur University Hospital, Institute of Clinical Chemistry, Zagreb, Croatia Precursor T- cell acute lymphoblastic leukaemia (T-ALL)/lymphoma (T-LBL) is a neoplasm committed to the T-cell lineage. It comprises about 20 – 25% of adult cases of ALL and about 85 - 90% of LBL. In adults it is still a disease with poor prognosis with median survival to 12 months in spite of progress made in understanding its pathogenesis and treatment. Complications such as infections, sepsis, meningeal involvement can occur at any time during treatment and be the cause of fatal outcome. We report a case of a 56-year-old male who was hospitalized due to high fever and kidney infection. Further examination showed anemia, thrombocytopenia, normal level of white blood cells and high level of lactat-dehidrogenase (LDH). Bone marrow aspiration revealed 87% and peripheral blood 41% of lymphoblasts with cytoplasmic vacuoles which suggested Burkitt lymphoma morphology. Patient’s karyotype showed no chromosomal aberations. Identification of immunophenotype discovered cells which were CD2 positive and CD20 negative with focal acid phosphatase activity in 67% of blasts. This excluded Burkitt lymphoma and led to diagnosis of T-ALL. Patient was submitted to a numerous chemotherapy treatments and autologous stem cell transplantation. Despite these efforts, complicatons of disease (infection and pleural effusion) led to fatal outcome after 10 months from diagnosis. Our case report showed how morphology alone can be misleading and is not enough in diagnosing ALL. Beside morphologic criteria, setting correct diagnosis depends on identification of immunophenotype by flow cytometry and cytogenetic-molecular abnormalities. Further improvements in the molecular definition of ALL subtypes, development of new and targeted drugs will improve patient’s outcome and prognosis. marina.milas@gmail.com
Clinical Cytology - Oral Presentations CURRENT ORGANISATION OF CLINICAL CYTOLOGY IN CROATIA Miličić-Juhas V1 , Lončar B1 , Mahovlić V2 , Kardum-Skelin I3 , Pajtler M1 1 Clinical Hospital Osijek, Department of Clinical Cytology, Osijek, Croatia 2 Zagreb University Hospital Center, Department of Gynecologic Cytology, University Department of Gynecology and Obstetrics, Zagreb, Croatia 3 University Hospital Merkur, Laboratory for Cytology and Hematology, Zagreb, Croatia Current cytological service in Croatia is organised in 46 cytological organisational units in 23 towns with total of 350 employees: 101 specialists of clinical cytology, 20 residents in clinical cytology, 141 cytotechnologists (cytoscreeners), 45 health technicians, and 25 administrators and 18 auxiliary personnel. In spite of employment of significant number of cytotechnologists in the last ten years, there is still an unacceptable ratio of number of cytologists and cytotechnologists (1:1.4) which is the result of unresolved education of cytotechnologists which should be permanent, complete and acknowledged. Education and scientific promotion of cytologists is continuous and today our profession has 31 masters of science and 9 doctors of science, one of which is assistant professor, and four of them are associate or full professors at medical schools in Zagreb and Osijek. Croatian cytology, in average, is in its “best years”, i.e. average cytologist is 46 years old, and cytotechnologist is in average 43 years old, but „suffers” from personnel deficit. With regard to type of activity, the most numerous are units dealing the entire diagnostic cytology (72%), 13% general cytology without gynaecological cytology, while 15% are engaged in one diagnostic field (gynaecological, pulmological or thyroid cytology). According to accessible data, total of 770996 cytological examinations were done in Croatia in 2008. The increasing application of additional methods (cytochemical, immunocytochemical, molecular, cytogenetics and computer-assisted image analysis) has become a trend in numerous cytological units. Exclusively morphological analysis of standard stained samples is performed in 37% of units, morphological and cytochemical staining methods are used in 17% of units, and additional immunocytochemical methods in 30% of units. According to the long tradition of cytology in Croatia, that has progressed thanks to the enthusiasm and great effort of our teachers, we believe that the following generations of cytologists will continue working on its improvement and will be able to concord basic cytomorphology and sophisticated diagnostic procedures with other diagnostics, to stay the field of optimal results in the shortest time with the reasonable price. valerija.mj@gmail.com 91 4 th Croatian Congress of Clinical Cytology / 1 st Croatian Symposium of Analytical Cytology / 2 nd Croatian Symposium of Cytotechnology
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Final programme and abstract book
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UTORAK, 13.10.2009. SRIJEDA, 14.10.
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4. Hrvatski kongres kliniËke citologije 4th Croatian Congress ... - Penta

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