Spirov, Goran

Preferred name

Spirov, Goran

Official Name

Spirov, Goran

Main Affiliation

goranspirov@gmail.com

Now showing 1 - 10 of 22

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Extranodal Diffuse Large B-Cell Lymphoma of the Small Bowel in Female Patient Causing Intestinal Obstruction: A Case Report
(Vilnius University Press, 2022-12-30)
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Dukovski, Dushko
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Diffuse large B cell lymphoma is the most common extranodal non-Hodgkin lymphoma of the small intestine accounting for more than 50% of cases. Forty percent of these cases initially present with small bowel obstruction. Therefore, the diagnosis is usually established after surgery for bowel obstruction. The treatment is then continued with a certain chemotherapy regimens. We present a case of a 46-years-old female patient with signs of small bowel obstruction due to previously undiagnosed diffuse large B-cell lymphoma. Postoperatively, the patient was treated with 7 cycles of R-CHOP protocol and complete response was achieved in the short follow-up period.</jats:p>
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MONOMORPHIC EPITHELIOTROPIC INTESTINAL T-LYMPHOMA – CASE REPORT
(Scientific Foundation SPIROSKI, 2022-06-28)
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Saliu, Valon
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Karanfilska, Aleksandra
Background: Monomorphic epitheliotropic intestinal T cell lymphoma (MEITL) (formerly termed enteropathy-associated T cell lymphoma, type II) is an extremely rare peripheral T-cell lymphoma that involves the malignant proliferation of a T- lymphocyte in the gastrointestinal tract. Over time, these T cells commonly spread throughout the mucosal lining of a portion of the GI tract (particularly the jejunum and ileum of the small intestine), lead to GI tract nodules and ulcerations, and cause symptoms such as abdominal pain, weight loss, diarrhea, obstruction, bleeding, and/or perforation. Its clinical, morphologic, and immunophenotypic features distinguishing it from the more common Enteropathy Associated T-Lymphoma (previously EATL type I) made it a separate entity. Case report: We present a case of a rare extremely aggressive T cell lymphoma that originates from the gastrointestinal tract, spreads to surrounding organs and is refractory to surgery and chemotherapy. We describe а case report of 79 years old patient with clinical features of acute abdomen, ileus, treated with surgery two times. During the first surgery partial resection of jejunum was performed. Pathohistology and immunоhistochemistry findings of MEITL. PET/CT scan revealed infiltration of intestinum, uterus, ovarium. During the second operation partial resection of ileum and hysterectomy with adnexectomy was performed. The patient is treated with antracycline-based regimen CHOP21 (4 cycles). Re-evaluation with second PET/CT scan revealed residual tumor on the intestinum and bladder. The patient deteriorate with acute renal failure and multi-organ failure. Despite aggressive treatment with extensive surgery and aggressive anthracycline-based chemotherapy, in a short time the tumor spread to surrounding organs (sigma, bladder). The patient survived 11 months from the initial definitive diagnosis. Conclusion: MEITL is a challenging primary intestinal T cell lymphoma to treat as the outcome is frequently poor despite surgery and chemotherapy. Most patients are elderly with co-morbidities and they usually present late rendering any therapy ineffective. Young age, early Ann-Arbor/Lugano disease stage, good performance scale status, patients receiving autologous stem cell transplantation and less bulky disease are associated with an improved survival outcome. Further research is needed to incorporate new therapeutic modalities based on molecular research for successful treatment of this aggressive lymphoma.</jats:p>
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3D Printing for Preoperative Planning in Pancreatic Resection for Rare Metastasis from Ovarian Cancer: a case report
(Research Square Platform LLC, 2024-04-02)
Arsenkov, Stefan
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Plavevski, Ognen
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Arsenkov, Emilija
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Secondary pancreatic malignancies are a rarely reported entity, limited to sporadic case reports in the medical literature. Most often, these secondary malignancies are of renal origin, followed by gastrointestinal tumors and lung cancer as the primary tumor sites. Metastatic tumors from ovarian origin are few and far between. In our understanding this is the first time 3D printing has been used in the preoperative planning of one such case. Case presentation We present the case of a 63 year old patient with a history for bilateral ovariectomy for ovarian tumor 5 years prior, with a 3D printed model of the patient’s anatomy used for preoperative planning as a novel approach. During regular check-ups, an elevated CA19-9 level prompted a CT scan showing a distal pancreatic mass entering the splenic hilum, and a PET scan showed FDG avid lesion considered malignant and no other lesions were detected. The location of the metastasis warranted a distal pancreatectomy with splenectomy. To aid in the preoperative planning a 1:1 replica of the patient’s anatomy was constructed based on the CT scan, and it was manufactured using 3D printing. After extirpation of the tumor, the histological analysis showed a pancreatic pseudocyst with an intraluminal neoplastic proliferation, and further immunohistochemistry analysis determined the immunophenotype suitable of an ovarian cystadenocarcinoma metastasizing to the pancreas. Conclusions The surgical team was unanimous in the impression that the 3D printed model facilitated a swift surgery without any complications. Not only the model helped the planning phase, it is useful as a tool for patient education and further education of students and residents.</jats:p>
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Extranodal Diffuse Large B-Cell Lymphoma of the Small Bowel in Female Patient Causing Intestinal Obstruction: A Case Report
(Vilnius University Press, 2022-12-30)
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Dukovski, Dushko
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Diffuse large B cell lymphoma is the most common extranodal non-Hodgkin lymphoma of the small intestine accounting for more than 50% of cases. Forty percent of these cases initially present with small bowel obstruction. Therefore, the diagnosis is usually established after surgery for bowel obstruction. The treatment is then continued with a certain chemotherapy regimens. We present a case of a 46-years-old female patient with signs of small bowel obstruction due to previously undiagnosed diffuse large B-cell lymphoma. Postoperatively, the patient was treated with 7 cycles of R-CHOP protocol and complete response was achieved in the short follow-up period.</jats:p>
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18F-FDG PET/CT IN DIFFERENTIATING EQUIVOCAL CT LESIONS IN PATIENTS WITH COLORECTAL CANCER
(Macedonian Association of Anatomists, 2022-05-22)
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Beshliev, Simon
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Imaging is vital in the follow-up strategy of patients with colorectal cancer. Computed tomography is widely accepted as a method of choice, but further work up is required when equivocal findings are present. The objective of this study was to investigate the potential of positron emission tomography (PET)/computed tomography (CT) as a problem-solving tool of dubious CT findings in patients with colorectal cancer (CRC) in the follow-up period. This was a retrospective review of thirty-two patients referred for 18F-fluorodeoxyglucose (FDG) PET/CT imaging due to suspicion of recurrent disease solely based on CT exam. The diagnosis of a malignancy lesion was based on intensity of the lesion, location, shape, size, as well as CT findings. There was a follow-up period of at least six months after the PET/CT examination. The most common site of detected lesions that could not be characterized by CT were the lungs (13/32; 40.5%), followed by liver (8/32, 25%) and lymph nodes (5/32, 15.6%). Additionally, lesions were reported at adrenal gland, spleen, peritoneum, ovary and at surgical site. In almost half of the patients (15/32; 46.8%) lesions were detected by PET/CT and characterized as disease recurrence. Metastases at additional site were detected in five patients (6/15, 40%). In the follow-up period recurrent disease was detected in two patients (2/32, 6.2%) with negative PET/CT findings. Only one person had a false positive finding. The overall positive and negative predictive value of FDG-PET/CT was 93.3% and 84.6% respectively. PET/CT offers a high overall positive and negative predictive value in distinguishing CRC metastasis. Furthermore, it exceeds CT performance in detecting extrahepatic recurrent disease.
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Imaging features of aneurismal bone cysts
(2012)
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Jordanovska, Elena
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Nevcev, Ivan
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Purpose: To analyze different imaging presentations of primary aneurismal bone cyst. Methods and Materials: Retrospectively, images from 52 histologically provenprimary aneurismal bone cysts were analyzed. Male were30 and 22 female, age range 5-35 years (median age 18years). All of them have plain film, computed tomography was done in 40 cases and magnetic resonance in 22cases. Classification after Capanna in five morphological types was done. Results: Type 1: central with little expansion 10 (19.2%) cases; Type2: central with expansion and cortical thinning 13 (25%)cases; Type 3: eccentric with involvement of only one cortex19 (36.5%) cases; Type 4: subperiosteal extending “outwards” with intact or only superficially eroded cortex 3(5.8%) cases; (Fig.1-8) Type 5: subperiosteal with growth both outwards and centrally towards the medulla, with cortical destruction 7 (13.5%) cases. Size range of the lesions was 4 mm to 12 cm. Conclusion The primary aneurismal bone cysts has specific radiological features that should enable the radiologist to make the diagnosis with high degree of certainty.
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Ингвино-скротална хернија на мочен меур
(ID Design, 2016-03-27)
Gligorievski, Antonio
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Nevcev, Ivan
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Хернијацијата на мочниот меур преку ингвиналниот канал е ретка болест која бара хируршка интервенција. Како резултат на комбинација на слабост на абдоминалниот ѕиди зголемување на интраабдоминалниот притисок се јавува пролапс на мочниот меур во ингвиналниот канал и појава на ингвино-скротална хернија. Оваа појава е многу ретка и често погрешно се дијагностицира. Се јавува почесто кај постари мажи со зголемена телесна тежина и со симптоми на опструкција на дисталните уринарни патишата и уринарни инфекции. Симптомите вообичаено се од благи до умерени, поврзани се со отежнатото мокрење и уринарни инфекции, а доколку оваа состојба навремено не се лекува може да доведе до посериозни здравствени проблеми, па се до бубрежна инсуфициенција. CT со реконструкција во три рамнини е метода на избор во дијагностиката на ингвино-скроталните хернии на мочниот меур. Оваа метода овозможува јасен приказ на хернираниот дел од мочниот меур, а овозможува и детекција на содржината на килната кеса.
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PET/CT in the management of primary angiosarcoma of the heart
(2022)
Todorova-Stefanovski D
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Tasevski S
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Beshliev S
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Angjeleska M.
INTRODUCTION Primary cardiac tumors are rare and mostly benign, with only 30% of them being malignant. The most common pathological type is angiosarcoma, which mainly affects the right atrium and has a fatal prognosis with survival of 3-11months. It is very important to make a difference patohistologically with epitheloid hemangioendothelioma, which has low to medium potential to metastasize and better prognosis from the angiosarcoma. CASE REPORT 35 years old, 9 months pregnant woman was diagnosed with a tumor in the right atrium. The tumor was surgically removed and the baby delivered in one instance. The first histopathology reported epithelioid hemangioendothelioma. The patient was referred for a PET/CT scan. The results showed increased FDG uptake in the right atrium (SUVmax=7.3), consistent with residual tumor or postoperative inflammation, and multiple bone metastases (SUVmax=5.4). After the PET scan histopathology was reviewed once again and the second report was in concordance with angisarcoma of the heart . After 4 cycles of chemotherapy, PET/CT was performed for restaging and treatmenmt response assesment and it showed progression of the disease with local recidiv (SUVmax=5.8), lymph nodes, bilateral adrenal (SUVmax=6.1) and hepatic metastases (SUV max=4.6). Despite haemotherapy the disease rapidly progressed and patient died 11 months after the diagnosis. CONCLUSION The imaging diagnostic workup in cardiac tumors is not well established yet. The case report that we’ve presented illustrates the role of FDG /PET in the assessment of malignant potential of the primary tumor, and in staging and restaging of the disease.
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Metabolic Characteristics of Recurrent and Metastatic Colorectal Carcinoma in F-18 FDG-PET/CT imaging
(2019)
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Besliev, Simon
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Angeleska, Meri
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OBJECTIVE: The purpose of this study was to evaluate the metabolic characteristics of recurrent colorectal carcinoma at the surgery site and distant metastases after treatment. MATERIAL AND METHODS: Records of of 78 patients with colorectal carcinoma 50 men, 28 women, mean age: 60 years, (range: 28-82 years) who were treated with surgery and chemotherapy underwent FDG PET/CT scanning for restaging of colorectal carcinoma. Increased FDG uptake in the postsurgical area, liver parenchyma and lung nodules >9mm were retrospectively analysed and SUVmax as well tumor to liver ratio (TLR) were calculated. RESULTS: In 20 patients (25%) there was increased FDG uptake in the liver parenchyma with SUVmax=8.07 (range: 4.1-17) and TLR=3.0 (range: 1.7-6.5). Increased FDG uptake in the postsurgical area suspicious for local recurrence was detected in 14 patients (18%) with SUVmax=9.85 (range: 3,6-24.7) and TLR=3.9 (range: 1.1-9.5). Lung nodules with average diameter of 15.4mm (range: 10-27mm) were detected in 18 patients (23%) with SUVmax=5.0 (range:1.5-10) and mean TLR=1.8 (range: 0.5-3.4). CONCLUSIONS: The widely used semiquantitive measurements SUVmax and TLR significantly vary in local recurrence and distant metastasis in colorectal cancer. FDG uptake was highest in local recurrence, and lower in distant metastases. The lung metastases showed lower metabolic activity compared to liver metastases. These features should be taken into account during the interpretation of the scans in these patients.
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MASTOID OSTEOMA OF THE TEMPORAL BONE.
(Macedonian Association of Anatomists, 2021-07)
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Gordana Antulevska Belcevska
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Osteomas are osteoblastic neoplasms affecting the parietal and frontal bone. Mastoid osteomas of temporal bone are rare benign tumors with incidence of 0.1%-1% of all benign tumors of the skull.We present a case of a young 19-year-old female who complained of right posterior auricular hard swelling which had gradually increased in size over the past 2 years and felt pain for less than a year.There was no history of trauma, symptoms of inflammation or occlusion of the ear canal. She felt a pain during the eruption of her second molar teeth. Non-contrast CT was done and it showed a well-defined densely calcified lesion of bone attenuation in the right mastoid posteriorly measuring 1.7 × 1 × 2.3 cm. The middle ear cavity, ossicular chain, inner table of skull and diploe were normal with no extension intracranially and no bony destruction. These findings spoke in favor of a mastoid osteoma.

Spirov, Goran

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