Background and objective: Sclerosing pneumocytoma is a rare, benign tumor of the lung that represents a diagnostic challenge due to the diversity of pathohistological findings. The aim of this study was to present a 10-year experience with sclerosing pneumocytoma of a large center for the diagnosis and treatment of pulmonary diseases, and to emphasize differential diagnostic dilemmas as a potential source of errors. Material and Methods: This represents a retrospective study of six patients diagnosed and treated with sclerosing pneumocytoma in the 10-year period. The study analyzed various parameters, which are: Sex, age, symptoms, size and localization of the tumor, and its gross and histological features. Results: Sclerosing pneumocytoma was more frequently diagnosed in females (83.34%). The patients ranged in age from 38 to 61. Most of the patients (66.66%) were asymptomatic. Two patients underwent a video-assisted thoracoscopic surgery, two patients had a video-assisted minithoracotomy, and two patients underwent a thoracotomy in order to remove the tumor. The tumor was localized in the left lower lobe, in the right upper lobe, and in the right lower lobe in 50%, 33.34%, and 16.66% of patients, respectively. The tumor size ranged from 1 to 2.5 cm. A pathohistological examination of all six cases reported that all four major histological patterns were found in tissue sections: solid, papillary, sclerosing, and hemorrhagic. In all six cases, an immunohistochemical analysis showed positive expression of TTF-1 and panCK in surface epithelial cells, and TTF-1 positivity and panCK negativity in round stromal cells. Conclusions: Sclerosing pneumocytoma is a strictly histological diagnosis supported by clinical and radiological findings and corresponding immunohistochemical methods. Lung pathologists should always keep this tumor in mind, since its spectrum of differential diagnosis is wide, and therefore it can be an important diagnostic pitfall.

Alveolar adenoma is a rare benign lung tumor. We report 5 patients within a 20-year period diagnosed with this rare tumor and its clinical and histopathological features, in order to emphasize its significance in differential diagnosis of other lung tumors. Alveolar adenoma was more frequently diagnosed in female patients (80%). The patients ranged in age from 52 to 68. Eighty percent of the patients had symptoms like dyspnea, and shoulder or back pain. Three patients underwent a video-assisted thoracoscopic surgery, while 2 patients underwent a thoracotomy in order to remove the tumor. The tumor was localized within the right upper lobe, right lower lobe, and left lower lobe in 40%, 40%, and 20% of patients, respectively. The tumor size ranged from 14 to 30 mm. A frozen section finding of all 5 tumors reported that the lesion was benign. In all analyzed tumors, immunohistochemical analysis showed positive expression of TTF-1 and pankeratin in surface epithelial cells, and Vimentin positivity and TTF-1 and pankeratin negativity in round stromal cells. Alveolar adenoma should be carefully considered in the differential diagnosis of solitary pulmonary nodules. Complete surgical removal of the lesion is widely used in its primary management.

Background/Aim. The histological phenomenon of tumor budding is being recognized as an important determinant of disease progression and poor prognosis in various types of carcinoma. We aimed to evaluate the clinicopathological significance of tumor budding in adenocarcinoma of the lung. Methods. The study included 114 patients operatively treated for lung adenocarcinoma in a one-year period. Microscopic analysis of routine histological slides was performed to establish the presence and density of tumor buds. These results were compared in relation to gender, age, tumor size, nodal status, and pathological stage. Results. The budding-positive group included 34 (53.1%) men and 27 (54%) women. There were 30 (46.9%) men and 23 (46%) women in the budding-negative group. No statistical significant difference in age was found between males (64.3 ? 6.59 years) and females (63.1 ? 6.53 years) in the budding-positive group, nor in the budding-negative group (males 63.3 ? 6.02 years; females 63.2 ? 6.72 years). Statistically significant result in tumor size was found in females with the presence of tumor budding (p < 0.05). The budding-positive group of patients in nodal stage N1 and stage III of the disease pointed to the statistical significance (p < 0.05). Conclusion. With the statistical significance confirmed between the higher nodal status, higher pathological stage, and tumor budding found in this study, this histological phenomenon is still relatively new for the diagnostics domain of pathology. However, it increasingly receives attention as an adverse prognostic factor. These results may help tumor budding incorporate into the existing staging systems in addition to other factors known to be predictors of worse outcome.

Introduction/Objective. Urothelial carcinoma is the most commonly diagnosed malignancy of urinary bladder in clinical and pathohistological practice where various prognostic factors play significant role. One of the most important pathohistological prognostic factors is the intensity of immunohistochemical staining. Among various immunohistochemical markers that have been proven to influence disease progression and patient’s survival, role of Ki-67 and GATA3 in prediction of disease prognosis has not been completely clarified yet. The aim of this study was to determine the predictive value of GATA3 and Ki-67 mutual expression in urothelial carcinoma. Methods. 80 patients were included in this study, where 4 groups were formed based on the pathological stage of urothelial carcinoma. After using preferred antibodies, their staining intensity was analyzed semiquantitatively. Results. Results showed that there was statistically important significance between type of urothelial carcinoma, pathological stage and invasiveness and different grades of GATA3 expression, as well as statistically important significance between type of urothelial carcinoma and pathological stage and different grades of Ki-67 expression. The regression model showed low value of GATA3 and Ki-67 mutual expression. There was also a statistical significance considering pathological stage and invasiveness of the tumor in survival analysis. Conclusion. Predictive value of GATA3 and Ki-67 mutual expression resulted as low from this study, but to our knowledge it was the first one to examine their predictive capability on biopsy and transurethral resection specimens.

Background/Aim. To date, most of the scientific attention has been aimed at the morphometric analysis of the nephrogenic zone (NZ) of the fetal renal cortex, while the quantification and analysis of the maturation zone (MZ) and other indicators of renal maturity were missing. The aim of the study was to examine the characteristics of fetal kidney cortex maturation, as well as to propose the development of a new cortical maturity index (CMI). Methods. The study included 42 paraffin molds of the fetal kidney, divided into three groups according to gestational age (GA). After hematoxylin and eosin staining, tissue sections were analyzed through the following parameters: the thickness of the NZ and MZ, the renal corpuscles area (RCa) and the glomerular capillary tuft area (GCTa), and the maturation stages of the glomeruli. In addition, a new parameter, CMI, was formed as a ratio of NZ and MZ thickness. The collected data were statistically processed. Results. Changes in NZ and MZ thickness were statistically significant, and they correlated with GA. A value of CMI higher than 0.2 was recorded in the kidney samples of fetuses younger than the 20th gestational week (GW), while a value lower than 0.1 was recorded in the samples older than the 30th GW. With an increase in GA in all zones of the renal cortex, RCa and GCTa decreased. A statistically significant reduction of GCTa was observed in the oldest group in the juxtamedullary and intermediate zones of the cortex (p < 0.01). Glomeruli located in the deeper parts of the cortex were more mature than the superficial ones. Conclusion. The measured parameters can serve as a starting point for future studies that would analyze the histomorphological characteristics of the fetal kidney cortex. In the absence of clinical data, a newly formed parameter CMI can represent assistance with the determination of GA, as it significantly correlates with GA (p < 0.01).