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KLINIČKO-PATOLOŠKE KARAKTERISTIKE MALIGNOG PLEURALNOG MEZOTELIOMA – NAŠE PETOGODIŠNJE ISKUSTVO /

CLINICAL AND PATHOLOGICAL CHARACTERISTICS OF MALIGNANT PLEURAL MESOTHELIOMA – OUR FIVE YEAR EXPERIENCE

Authors

 

Uroš Pupavac1, Dragana Tegeltija2,3, Aleksandra Lovrenski2,3, Vanesa Sekeruš2,3, Siniša Maksimović3 , Milorad Bijelović2,3 , Dragana Oluški4

1Opšta bolnica dr Radivoj Simonović Sombor, Sombor, Srbija
2Univerzitet u Novom Sadu, Medicinski fakultet, Novi Sad, Srbija
3Institut za plućne bolesti Vojvodine, Sremska Kamenica, Srbija
4Klinički centar Vojvodine, Novi Sad, Srbija

 

UDK: 616.25-006.32


The paper was received / Rad primljen: 22.02.2019.

Accepted / Rad prihvaćen: 04.03.2019.

 


Correspondence to:


Uroš Pupavac
Opšta bolnica dr Radivoj Simonović Sombor, Vase Pelagića 49,
25000 Sombor
e-mail: uros.pupavac@gmail.com

 

 

Sažetak

 

Uvod: Maligni pleuralni mezoteliom (MPM) je redak maligni tumor porekla mezotelnih ćelija, u preko 80% slučajeva je povezan sa ekspozicijom azbestu. Najčešće se javlja kod muškaraca u sedmoj deceniji. Dijagnoza se postavlja morfološkom i imunohistohemijskom analizom citoloških, biopsijskih ili hirurških uzoraka. Cilj: Cilj ovog istraživanja je bio da prikažemo kliničko-patološke karakteristike bolesnika sa MPM. Materijal i metode: Istraživanje je bilo retrospektivnog karaktera, uključeno je 44 bolesnika. Dijagnoza MPM postavljena je na Institutu za plućne bolesti Vojvodine u Sremskoj Kamenici od 2013. do 2018. godine. Analizirani podaci su preuzeti iz Zdravstvenog informacionog sistema naše ustanove. Rezultati: U istraživanje je bilo uključeno 84% muškaraca i 16% žena prosečne starosti od 67,4 +/- 6,2. Više od polovine obolelih (55%) se bavilo “rizičnim” zanimanjem. Najfrekventniji kliničko-patološki nalazi bili su: dispneja (75%), pleuralni izliv (82%), difuzne promene po pleuri (86%) i epiteloidni subtip (87%). Imunohistohemijska pozitivnost mezotelnih markera je bila evidentirana kod: D2-40 (21/21), kalretinin (40/41), WT1(36/37) i CK 5/6 (15/23). Svi od nemezotelni markeri (CEA, TTF-1, MOC31 i napsin A) su bili negativni. Zaključak: MPM svojim nespecifičnim kliničkim simptomima bolesti, radiološkim i makroskopskim nalazom imitira različita primarna i sekundarna oboljenja pleure. Dijagnoza MPM je veoma teška, uloga IHH markera je od krucijalnog značaja.

 

 

Ključne reči:

maligni pleuralni mezoteliom, Imunohistohemija

 

 

Abstract

 

Introduction: Malignant pleural mesothelioma (MPM) is a rare malignant tumor of mesothelioma origin, in over 80% of cases it is associated with exposure to asbestos. It is most common in men in the seventh decade. Diagnosis is made by morphological and immunohistochemical analysis of cytological, biopsy or surgical samples. Objective: The aim of this study was to present the clinical and pathological characteristics of patients with MPM. Material and methods: The research was retrospective, 44 patients were included. Diagnosis of MPM set at the Institute for Lung Diseases of Vojvodina in Sremska Kamenica from 2013 to 2018. Analyzed data were taken from the Health Information System of our institution. Results: The survey included 84% of men and 16% of women with an average age of 67.4 +/- 6.2. More than half of the diseased (55%) were engadged in “risky” occupations. The most frequent clinical and pathological findings were: dyspnoea (75%), pleural effusion (82%), diffuse changes in pleura (86%) and epitheloid subtype (87%). The immunohistochemical positivity of mesothelium markers was recorded in: D2-40 (21/21), calretinin (40/41), WT1 (36/37) and CK 5/6 (15/23). All of the non-mesothelium markers (CEA, TTF-1, MOC31, and napsin A) were negative. Conclusion: MPM imitates different primary and secondary diseases of pleura with its non-specific clinical symptoms of the disease, radiological and macroscopic findings. The diagnosis of MPM is very difficult, the role of IHC markers is of crucial importance.

 

 

Key words:

malignant pleural mesothelioma, immunohistochemistry.

 

 

 

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PDF Pupavac U. et al • MD-Medical Data 2019;11(1): 019-022

 

 

 

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