Faculty of Medicine
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Item type:Publication, PRIMARY SINONASAL MENINGIOMA MIMICKING BENIGN NASAL LESIONS - A CASE REPORT AND LITERATURE REVIEW(Macedonian Association of Pathology and North Macedonia Division of IAP, 2025); ; ; Jovcheva, AIntroduction: Primary extracranial meningiomas are rare neoplasms, accounting for less than 2% of all meningiomas. The sinonasal tract represents an uncommon site of origin and frequently presents diagnostic challenges due to nonspecific clinical and radiological features. Case Presentation: A 79-year-old male presented with a unilateral nasal cavity mass. Computed tomography revealed diffuse polypoid mucosal thickening with near-complete opacification of paranasal sinuses and obliteration of aeration. Histopathology showed a circumscribed neoplastic proliferation arranged in lobular and whorled patterns beneath intact respiratory epithelium. Tumor cells displayed uniform morphology with oval nuclei, eosinophilic cytoplasm, and inconspicuous nucleoli. Psammoma bodies and delicate vascular channels were present. Necrosis, nuclear atypia, and mitotic activity were absent. Immunohistochemistry showed strong positivity for epithelial membrane antigen (EMA), vimentin, p63, and progesterone receptor, while cytokeratin AE1/AE3, CD34, smooth muscle actin (SMA), S100, SOX10, desmin, and synaptophysin were negative. The proliferative index (Ki-67) was <5%. Discussion: Extracranial meningiomas are rare neoplasms with poorly understood histogenesis, presumably arising from displaced meningothelial cells during embryonic development. Sinonasal meningiomas may mimic other nasal masses including nasal polyps, inverted papilloma, olfactory neuroblastoma, or carcinoma. In this case, the morphological features combined with the supportive immunohistochemical profile confirmed the diagnosis of WHO Grade I meningothelial meningioma with angiomatous features. Conclusion: Primary sinonasal meningioma should be included in the differential diagnosis of sinonasal masses. Accurate recognition through comprehensive histopathological and immunohistochemical analysis is essential for proper diagnosis and management. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Gallbladder and gastric metastasis as initial presentation of an undiagnosed primary lobular breast carcinoma(Oxford University Press (OUP), 2026-02-24); - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Gastric schwannoma: a case report(Oxford University Press, 2024-03-27); ; ; ; Kostovska, IrenaGastric schwannomas are rare mesenchymal tumors that arise from the intestinal nerve plexuses. They present with nonspecific symptoms and are often discovered incidentally. We present the case of a 68-year-old patient who had been suffering from abdominal discomfort for 6 months. After a complete examination, including abdominal computed tomography and upper gastrointestinal endoscopy, we discovered a submucosal gastric lesion with benign gross features without evidence of lymph node or metastatic involvement. He underwent an open laparotomy. Final pathohistological and immunohistochemically identification of the surgical specimen established the diagnosis of benign schwannoma. Considering the excellent prognosis of the tumor, no adjuvant treatment was suggested other than simple clinical monitoring every 6 months. Despite the accessibility of advanced endoscopy and imaging techniques, the diagnosis of gastric schwannoma is rarely made preoperatively. In the latter case, the best treatment is still complete excision with wide margins. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Immunohistochemical expression of CD44 in patients with hepatocellular carcinoma(Macedonian Association of Anatomists and Morphologists, 2020); ; ; ; Nikolovska Trpchevska, EmilijaIntroduction: CD44, a transmembrane glycoprotein with a role in cell-cell and cell-matrix interactions and one of the stem cell markers, is considered to participate in progression and prognosis of hepatocellular carcinoma (HCC), which makes it a potential prognostic marker and therapeutic target. We aimed to evaluate immunoexpression of CD44 in tumor and surrounding non-tumor liver tissue and to correlate it to multiple clinicopathological data in order to determine its prognostic value in patients from the Republic of North Macedonia. Material and Methods: Presence of the immunosignal and the percentage of CD44+ tumor cells at the whole tumor tissue sample and adjacent cirrhotic liver tissue were semi-quantitatively determined. The immunohistochemistry results were correlated to B and C hepatitis, tumor dimensions, enlarged lymph nodes, T status, differentiation (G), microvascular invasion, and survival. Results: We found a significant difference in CD44 expression between tumor and non-tumor liver tissue (p < 0.000) and significantly higher CD44 expression was also found in T4 tumors in comparison with T1 tumors (p < 0.01). Conclusion: Expression of CD44 was significantly higher in tumor in comparison to non-tumor tissue and was significantly associated to T4 local tumor growth, making it a potential prognostic marker and therapeutic target. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Correlation between PD-L1 expression and clinicopathological characteristics in triple-negative breast cancer patients(Springer, 2020-12); Ognenoska-Jankovska, BiljanaBackground & objectives: While immunotherapy is emerging as an effective treatment option for advanced triple-negative breast carcinoma (TNBC) patients, the clinicopathological significance of PD-L1 expression in TNBC remains unclear. Our objective was to investigate the association between PD-L1 expression and clinicopathological characteristics in TNBC. Methods: The study group comprised 47 TNBC patients in which PD-L1 status was evaluated by immunohistochemistry with SP142 assay on the Ventana BenchMark. All PDL1(+) tumour-associated immune cells (IC) were quantified as % of the tumour area. Tumours were classified as PDL1(+)(>=1%) or PD-L1(-)(<1%). The statistical significance of the correlation between PD-L1 status and clinicopathological characteristics was determined by chi-square test. Results: PD-L1(+) were 24(51.1%) of the 47 TNBC patients whose median age at diagnosis was 59 (range, 39-79). 53.5% (23/43) of the primary and 25%(1/4) of the metastatic TNBC cases were PD-L1(+). 21(87.5%) of the PD-L1(+) TNBC had IC1( 1 and <5%), 2(8.3%) had IC2( 5 and <10%), and 1(4.2%) had IC3( 10) score. The PD-L1(+) status significantly associated with high histological grade (G3, P=0.022), and higher proliferative index (Ki-67>35%, P=0.004), while the correlation with larger tumour size (>2 cm, P=0.055) did not reach statistical significance. No significant relationship was found between PD-L1 status and other variables such as patients` age, postoperative stage, tumour status, lymph nodal status, tumour type, vascular invasion, and p53 expression. Conclusion: Our preliminary results suggest that PD-L1 expression is associated with several high-risk clinicopathological parameters in TNBC patients. Further larger studies are warranted to clarify the clinical relevance of PD-L1 expression in TNBC patients. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Correlation of programmed death ligand-1 (PD-L1) expression with clinicopathological features in lung carcinoma in a Macedonian population(Springer, 2022-09) - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Epidermal Growth Factor Receptor immunohistochemical expression in hepatocellular carcinoma without Epidermal Growth Factor Receptor exons 18-21 mutations(Walter de Gruyter GmbH, 2022-09-01); ; ; ; Introduction: EGFR targeted therapies, have been proved beneficial for patients with HCC, nevertheless additional research on EGFR immunoexpresion and EGFR mutations is still needed, especially in population in which it has not been done yet. The aim of this study is to evaluate EGFR immunoexpression in HCC without EGFR exons 18-21 mutations and to evaluate its influence on survival in HCC patients in North Macedonia. Methods: We studied 31 cases of HCC for EGFR immunohistochemical expression and EGFR exons 18-21 mutations. The following clinical parameters were analyzed: Hepatitis B and C virus infection, presence of cirrhosis, tumor size, enlarged lymph nodes, metastases, alpha fetoprotein level and overall survival. Presence of the EGFR immunosignal (membranous and cytoplasmic) and the percentage of positive tumor cells in the entire tumor tissue specimen were semi-quantitatively determined. Results: Hepatitis B and C virus infection, tumor size, metastatic disease and EGFR immunoexpression have influence on patient's survival. No EGFR exons 18-21 mutations were detected in this group of HCCs. EGFR expression of 61%-80% in tumor tissue significantly influenced survival of the patients (p < 0.01). Multiple Cox regression confirmed tumor size of 5-10 cm (p < 0.05), tumor size > 10 cm (p < 0.01) and EGFR expression in range of 61% to 80% (p < 0.05) as independent survival predictors in patients with HCC. Conclusion: EGFR overexpression in range of 61% to 80% was an independent survival predictor in patients with HCC, implying that these patients could benefit from EGFR inhibition. However, the absence of EGFR mutations in exons 18-21 in any of the cases of this study suggest that single drug EGFR targeted therapy in patients with HCC may be insufficient. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, CORRELATION BETWEEN HER2 AND EBV EXPRESSION IN GASTRIC CARCINOMA(Macedonian Association of Anatomists, 2020); ; ; Hadzi-Mancev DIntroduction: The understanding of the etiopathogenesis and the molecular basis of gastric carcinoma will facilitate the development of novel molecular target therapies, which interfere with different signal cascades involved in cellular proliferation, differentiation and survival. The aim of this paper was to determine the correlation between HER2 and EBV expression in patients with gastric carcinomas. Material and methods: Eighty patients with gastric carcinoma surgically treated were included in the study. Data of HER2 protein expression were obtained from the archived histopathological reports of the Institute of Pathology in Skopje. For detection of EBV, immunostainings were performed on tumor tissue and the peripheral nontumor gastric mucosa. Results: The results of this study confirmed a significant association between HER2 and EBV expression (p=0.041). The value of the Spearman correlation coefficient (R = - 0.258) indicated a negative, indirect connection of HER2 and EBV expression, which was confirmed as statistically significant (p = 0.02). The HER2 expression in gastric carcinomas was significantly associated with EBV expression, and the expression of HER2 was significantly more common in EBV negative cancers.