Faculty of Medicine
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Item type:Publication, THE ROLE OF МR SPECTROSCOPY AND CONTRAST ENHANCED MRI IN PROSTATE CANCER DIAGNOSIS(Macedonian Association of Anatomists and Morphologists, 2025-11-25); ; ; Bozhinovska, BiljanaIn patients with increased prostate-specific antigen, the next diagnostics tool is transrectal ultrasound-guided biopsy. The biopsy can cause pain, bleeding and infection. Multiparametric magnetic resonance imaging (mp MRI) as non-invasive diagnostics tool is used as a triage test to avoid biopsy, as well as to improve the diagnostics. The aim of this study was to examine the value of MR spectroscopy and dynamic post-contrast series in the diagnosis of prostate cancer. This cohort prospective study included 100 patients from CGH “September 8th” with increased levels of PSA. The MRI equipment used was Siemens Essenza 1,5T with body coil. The results obtained by MR spectroscopy analysis were correlated with the post-contrast series, whereby by mapping suspicious areas, patients underwent biopsy according to the PIRADS (prostate imaging and reporting data system) classification. Of the 100 patients, 96 were biopsied according to the PIRADS (prostate imaging and reporting data system) classification. The MRI results and pathohistological findings were then compared. On MR postcontrast series, a malignant lesion was detected in 52% of patients, in 33% of patients the lesion was suspicious for malignancy. On MR spectroscopy, a choline+creatinine/citrate ratio of 0.8 to 2 indicating a possible malignant lesion was confirmed in 33% of patients, this ratio was greater than 2 in 33% of patients, indicating a lesion highly suspicious for malignancy. MR spectroscopy combined with contrast enhanced MRI is a powerful tool for non-invasive differentiation of benign prostatic hyperplastic nodule and prostatitis from a malignant nodule. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, FT3/FT4 ratio predict survival in surgically treated patients with renal cell carcinoma(Македонско лекарско друштво = Macedonian medical association/De Gruyter, 2023-12); ; ; ; Aim. The primary objective of this study was to exa-mine the connection between hormone levels, speci-fically the fT3/fT4 ratio, and surgical outcomes in renal cell carcinoma patients. The study aimed to assess the prognostic value of hormone status in predicting progression-free survival and overall survival follo-wing surgery. Methods. This prospective study included patients scheduled for surgical treatment of renal cell carcino-ma. Patients aged over 18 years with ASA status I-III were enrolled in the study. Thyroid status was eva-luated by pre- and post-surgery hormone values and ultrasonography findings preoperatively. The fT3/fT4 ratio was calculated for every patient. Results. Analysis was conducted on 40 patients with complete data. The median age of the cohort was 64.3 years, with 1/4 of patients aged over 70. Clear cell carcinoma predominated (92.5%), with 55.1% falling into the intermediate international metastatic renal cell carcinoma database consortium, risk group. Surgery. In 82.5% of patients laparoscopic intervention was performed. The fT3/fT4 ratio significantly correlated with the median progression free survival (5, 14, and 20 months for low, intermediate, and high ratio groups, respectively) and median overall survival (7, 26, and 40 months for low, intermediate, and high ratio groups, respectively) (p<0.005). Conclusion. Our findings underscore the importance of the fT3/fT4 ratio as a valuable prognostic indicator for renal cell carcinoma patients undergoing surgery. The fT3/fT4 ratio was related to worse progression free survival and overall survival, emphasizing the po- potential role of hormone status in predicting out-comes. potential role of hormone status in predicting outcomes. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Plasmacytoid urothelial carcinoma(Macedonian Association of Pathology, 2016-09); ; ; Objective: Plasmacytoid urothelial carcinoma (PUC) is a rare histological and aggressive variant of urothelial carcinoma that is often diagnosed at an advanced stage. We report a case of a 58-year-old male with hematuria and lower abdominal pain. After thorough clinical examination, he underwent a radical cystoprostatectomy. Material and Methods: The cystoprostatectomy specimen showed gray-brown exophytic tumor measuring 10x8x5 cm on the front bladder wall. The tumor infiltrated the bladder wall, extended into the perivesical fat, and grossly infiltrated the prostate. Standard tissue samples were embedded in paraffin blocks and hematoxylin-eosin and immunohistochemical stainings were made. Results: Histological analysis showed infiltrative high-grade invasive urothelial carcinoma, mainly composed of dyscohesive polygonal to round tumor cells, with hyperchromatic, eccentrically located nuclei with eosinophylic cytoplasm, with plasmacytoid appearance. The microscopic analyses confirmed the extension of the tumor into perivesical fat and the prostate, as well as into the mucous and submucous layer of the left ureter. Bilateral iliac and obturatory lymph nodes were free of tumor. Immunohistochemical staining showed positive signal for CK-7, CK-20, CK AE1/AE3, EMA, CD-138 and negative signal for LCA, S-100, kappa, lambda, CD79-a. Conclusions: The diagnosis of this rare histological variant can be difficult because of its morphological resemblance with plasmacytoma, although the PUC cells are lacking prominent perinuclear clearing and there is no multinucleation. Our case did not have such a diagnostic dilemma, since alongside the PUC, there was a typical invasive urothelial carcinoma.