Medical Research

Immunohistochemical and histochemical marker expression in the differential diagnosis of renal cell tumors

Tue, 07 Oct 2025 00:00:00 +0200

Introduction

The most common renal cell tumors (RCTs) include clear cell renal cell carcinoma (ccRCC), ccRCC with eosinophilic component (ccRCCe), papillary RCC (pRCC), chromophobe RCC (chRCC), and renal oncocytoma (RO). Due to overlapping morphological features, immunohistochemical (IHC) and histochemical (HC) markers are crucial for accurate differential diagnosis.

Materials and Methods

This retrospective study included 237 patients. Tissue microarrays were manually prepared and stained with H&E, CAIX, AMACR, CD10, CD117, CK7, PRMT1, ZEB1, and Hale's colloidal iron. Semiquantitative analysis was performed using a BX53 microscope and scanned with a Leica-Aperio AT2 scanner.

Results

Significant gender differences were observed (p = 0.0003), with a higher proportion of males in ccRCC, ccRCCe, and pRCC, while RO was more common in females. Tumor size varied significantly (p = 0.0041); ccRCCe tumors were the largest (73.1 mm), and RO the smallest (48.3 mm). Compared to ccRCC, ccRCCe showed lower PRMT1, ZEB1, and CAIX expression and higher CD10 expression. pRCC showed high AMACR expression. RO was strongly positive for PRMT1, ZEB1, and CD117, and negative for CK7, CD10, and Hale’s stain. Conversely, chRCC was negative for PRMT1 and ZEB1, but positive for CK7, CD117, and Hale’s stain.

Conclusion

The following IHC panel may improve diagnostic accuracy: PRMT1+/ZEB1+/CK7−/Hale− for RO; CK7+/PRMT1−/ZEB1−/Hale+ for chRCC; CAIX+/CD10+/AMACR−/CK7− for ccRCC; and AMACR+ for pRCC. Demographic and clinicopathological differences highlight the importance of integrating clinical parameters into diagnosis and treatment planning.

MATERNAL AND NEONATAL OUTCOMES OF ADOLESCENT PREGNANCY AT A TERTIARY UNIVERSITY CLINIC

Tue, 07 Oct 2025 00:00:00 +0200

Introduction/Aim: Pregnancy in adolescents increases the risk for numerous complications. The study aimed to investigate maternal and neonatal outcomes of adolescent pregnancies as well as the factors that can impact these outcomes.

Materials and Methods: The Study included all viable singleton pregnancies of adolescent patients (14 to 19 years) and an equal number of adult patients (20 to 25 years) delivered during 2022 at the Clinic for Obstetrics and Gynecology, University Clinical Center of Serbia. We analyzed the patients' age, comorbidities, parity, pregnancy controls, gestational complications, mode of delivery, complications during delivery, and in the early postpartum period, as well as the week of gestation at delivery, gender, birth weight, and Apgar score of newborns, and neonatal intensive care use.

Results: The Study included 234 patients (117 adolescents and 117 adults). The majority of patients from both groups did not have any comorbidities or gestational complications. Adolescent patients control their pregnancy less often. Spontaneous vaginal deliveries were more frequent among adolescents. Apart from obstetric ruptures (30%), delivery complications were rare in both groups. Adolescents had preterm deliveries more often than adults.
Nevertheless, almost all the children were born alive and healthy, regardless of the maternal age. Children of adolescents spent more time in intensive care. Regression analysis revealed that different parameters influenced the outcomes of adolescent and adult patients, while neonatal outcomes had the same predictors.

Conclusion: Most of our adolescents do not regularly control their pregnancies. However, pregnancy complications in adolescents are not frequent.

Dialysis-dependant patients’ outcomes during coronavirus-19 hospitalization early vs. Late survival

Tue, 23 Dec 2025 00:00:00 +0100

INTRODUCTION: During the COVID-19 pandemic, receiving hemodialysis was recognized as a predictor of poor survival. This study evaluated in-hospital and late survival in patients treated with hemodialysis during COVID-19 hospitalization.

METHODS: This single-center retrospective study included 176 patients requiring hemodialysis during COVID-19 hospitalization. Patients were divided into three groups: acute kidney injury (AKI), acute-on-chronic kidney disease (aCKD), and chronic hemodialysis (HD). Data was collected from patients' electronic records.

RESULTS: The majority (73.3%) of the study population were chronic hemodialysis patients. The overall in-hospital mortality was high (35.8%), and differed significantly among groups: 82.1%, 57.9% and 22.5% in the AKI, aCKD, and HD patients, respectively (p<0.001). After 12 months, death occurred in almost 30% of the reached patients, of whom the majority were from the chronic hemodialysis group.

CONCLUSION: Dialysis-dependent patients experience high mortality during COVID-19, especially those who develop AKI and aCKD. Chronic hemodialysis patients are exposed to better in-hospital survival; however, their one-year mortality remains significant.

Keywords: COVID-19, acute kidney injury, chronic kidney disease, exacerbation of chronic kidney disease, hemodialysis

Examining the social support network in people with depressive disorder regarding age: differences between adolescent and adult patients

Thu, 25 Sep 2025 00:00:00 +0200

Introduction: Loneliness, isolation, and social support networks have routinely been shown to have a positive correlation with depressive disorder, but have not been sufficiently researched in different age groups. This study aimed to examine social network support in depressed patients and explore the association between social networks in adolescents and adults with depressive disorders.

Material and Methods: The cross-sectional study was conducted, including 101 hospitalized patients: 47 adolescents and 54 adult patients. The examinees completed two questionnaires: the Beck Depression Inventory (BDI) and the Lubben Social Network Scale (LSNS-6).

Results: There were no statistically significant differences between adults and adolescents in socio-demographic characteristics, except partnership status and household members, where adults lived with significantly fewer family members. Most patients (63.4%) were at risk of social isolation. A statistically significant moderate negative correlation was established between depression scores measured by the BDI and the Lubben Social Network Scale results and the family subscale scores in an adult patient sample. The severity of depression, as expressed through BDI scores, was not correlated with social support network results in adolescents.

Conclusion: There is an association between depression in adulthood and the lack of family support, as well as the lack of a broader social support network, compared to depression in the younger, adolescent population. By understanding the intricacies of social support, we can more effectively predict and enhance the well-being of individuals.

Turner disease: a contemporary clinical approach

Thu, 20 Nov 2025 00:00:00 +0100

Turner syndrome (TS) is a rare genetic disorder in females caused by partial or complete loss of one X chromosome. It presents with multisystem clinical manifestations that require lifelong multidisciplinary care and monitoring. Phenotypically, TS is characterized by short stature, short neck with lateral skin folds (pterygium colli), low-set ears, and a low posterior hairline. Clinically, it is associated with cardiovascular diseases (CVD) and primary hypogonadism. The diagnosis of TS is based on clinical presentation and genetic analysis, with early prenatal detection possible. In newborns, TS should be suspected in the presence of oedema of the hands and feet. Short stature becomes evident in early childhood, while delayed puberty and primary amenorrhea are common later findings. CVDs may be congenital or acquired; coarctation of the aorta is a key diagnostic sign, whereas aortic dissection and rupture of an aortic aneurysm are life-threatening complications. Most women with TS have primary hypogonadism and high infertility rates. Spontaneous pregnancies are rare, and fertility preservation options, such as oocyte or embryo cryopreservation, should be considered early. Associated autoimmune diseases, kidney anomalies, liver disorders, and hearing loss are also common. Hormone replacement therapy is essential for pubertal induction, maintenance of general health, and prevention of long-term complications of untreated hypogonadism. Due to numerous comorbidities and variable phenotypes, an individualized multidisciplinary approach is required. With early diagnosis, appropriate management, and psychosocial support, individuals with TS can lead a good quality of life despite ongoing health risks.

CAPILLAROSCOPY IN HEALTHY SUBJECTS OF DIFFERENT AGE

Thu, 17 Jul 2025 00:00:00 +0200

Introduction: Capillaroscopy is a non-invasive diagnostic tool used to detect morphological abnormalities in the microcirculation. The assessment of capillaroscopic findings in healthy subjects is likely the area where controversies are most difficult to resolve. This review focuses on capillary architecture in healthy individuals across different age groups.
Methods: A search was conducted in PubMed, MEDLINE, and Scopus using the following terms: capillaroscopy, healthy subjects, Raynaud’s phenomenon, microcirculation, and microvascular abnormalities. A total of 10 relevant articles were identified.
Results: The shape of capillaries and the architecture of the nailfold microvascular network can vary significantly among healthy individuals. The most commonly observed abnormalities in this population include tortuosity, crossovers, homogeneously enlarged loops, neoangiogenic capillaries, and microbleeding. Less frequently, more unusual
patterns, such as ramified, bushy, or glomerular loops, may be observed. These atypical features require careful evaluation to avoid missing a potential underlying disease.
Conclusion: This review critically examines capillaroscopy findings in healthy individuals, taking into account typical nail care practices and age-related changes. These insights may assist clinicians in distinguishing physiological variations from early signs of microvascular damage.

GENETIC FOUNDATION OF BROWN ADIPOSE TISSUE AND ITS ROLE IN CHILDHOOD OBESITY

Thu, 20 Nov 2025 00:00:00 +0100

Obesity is a chronic complex disease, defined by excessive fat deposits, that may have adverse health consequences. Long-term childhood obesity has been linked to the development of different chronic illnesses and is often accompanied by various psychological and social issues. It typically develops due to complex, subtle biological predispositions, exacerbated by social and environmental factors that promote obesogenic behaviors. Brown adipose tissue (BAT) was initially identified as a thermogenic organ in small rodents and human infants. Although its amount decreases with age, adults retain some metabolically active functional BAT tissue, which can help regulate metabolism and energy expenditure, making it a potential target for obesity treatments. Metabolic stress can lead to the "whitening" of BAT, associated with its dysfunction and the development of inflammation and systemic metabolic disorders. Conversely, the transformation of white adipose tissue (WAT) into thermogenic BAT, a process known as "browning", represents another form of adipose tissue “transdifferentiation". In this complex network, specific genes, such as UCP1, PRDM16, PPARG, PPARGC1A, and EBF2, were identified. Identification of polymorphic variants within BAT-related genes, as well as the hormonal regulation, neurotransmission, and inflammation associated with BAT, could enhance our understanding of the causes of obesity and facilitate the development of novel treatments. This review summarizes recent studies on the genetic regulation of brown adipose tissue (BAT) differentiation and transdifferentiation, as well as gene variants that may predispose individuals to obesity at an early age. Based on this genetic foundation, we also explore and summarize mechanisms to prevent the "whitening" of BAT and its functional decline.

very rare localization for metastasis of breast carcinoma in the urinary bladder wall

Wed, 05 Nov 2025 00:00:00 +0100

Introduction: As a widespread malignancy in women throughout the world, breast cancer has an extremely high incidence and mortality rate and therefore poses a serious public health concern. Metastasis of breast carcinoma in the urinary bladder wall poses a challenge in diagnosis because it is a rare and sometimes asymptomatic disease.

This paper aims to present a rare case of urinary bladder metastasis originating from invasive lobular breast carcinoma and to emphasize the importance of recognizing atypical metastatic sites.

Case Report: A 58-year-old woman with a three-year history of lobular carcinoma of the right breast presented with urinary symptoms and bilateral hydronephrosis. The initial tumor was triple-negative, staged T4bN3M0. Following neoadjuvant chemotherapy (anthracyclines and taxanes), radiotherapy, and modified radical mastectomy. The histopathological assessment of tumor response to therapy: almost complete response (pNCR), and two of ten lymph nodes were positive for metastases. The treatment was continued with Capecitabine in an adjuvant approach (8 cycles), and the patient remained asymptomatic for two years. Subsequently, she developed urosepsis and was hospitalized for bilateral hydronephrosis and renal calculi. Imaging (CT) revealed retroperitoneal lymphadenopathy, and cystoscopy showed bullous edema of the bladder wall. The histopathological examination after TUR showed infiltratory carcinoma of the urinary bladder wall, and immunohistochemical staining was positive for GATA3, GCDFP-15, CDX2, and Mamaglobin. It was concluded that it was a metastasis of breast carcinoma in the urinary bladder wall.

Conclusion: Despite therapeutic advances, prognosis remains poor. Awareness of this unusual metastatic pattern is crucial for timely recognition, accurate diagnosis, and multidisciplinary management.