Spasevska, Liljana

Preferred name

Spasevska, Liljana

Official Name

Spasevska, Liljana

Main Affiliation

liljana.spasevska@medf.ukim.edu.mk

Now showing 1 - 10 of 35

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Synchronous occurrence of ileal stromal tumor (GIST) and colonic adenocarcinoma: a case report.
(2015)
Trajkovska, Elizabeta
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Introduction: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. There is an increasing number of literature reports on synchronous occurrence of gastrointestinal stromal tumors and another malignancy of distinct etiology and evolution. The most reported cases include gastric synchronous occurrence of gastrointestinal stromal tumors and adenocarcinoma and gastric gastrointestinal stromal tumors and colonic adenocarcinoma. Case report: We present a case of a 77-old female, with synchronous cecal moderately differentiated adenocarcinoma in Stage IIA according to the TNM classification and ileal spindle cell type GIST with low malignant potential, positive for c-Kit, CD34, vimentin, Actin, and negative for S100. Conclusion: The synchronous occurrence of small bowel gastrointestinal stromal tumors and other primary gastrointestinal malignancies has been rarely reported. There is a need of further investigations to identify the relationship between gastrointestinal stromal tumors and colorectal cancers.
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Tertiary Lymphoid Structures in Colorectal Cancers and Their Prognostic Value
(ID Design 2012/DOOEL Skopje, 2018-10-25)
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Karadzov, Zoran
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Hadzi-Manchev, Dragan
Tumor-infiltrating lymphocytes (TIL) in tumour stroma are considered to be involved in the elimination of malignant cells and prevention of metastasis formation. TIL consist of T lymphocytes including cytotoxic lymphocytes that are a constituent part of the effector mechanism of anti-tumour immunity and B lymphocytes that can form tertiary lymphoid structures (TLS). TLS has been described in several solid tumours and colorectal carcinoma (CRC), and the influence on the local and systemic anti-cancer response.
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Standardization and optimization of fluorescence in situ hybridization (FISH) for HER-2 assessment in breast cancer: A single center experience
(Association of Basic Medical Sciences of FBIH, 2018-05-20)
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<jats:p>Accurate assessment of human epidermal growth factor receptor 2 (HER-2) is crucial in selecting patients for targeted therapy. Commonly used methods for HER-2 testing are immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). Here we presented the implementation, optimization and standardization of two FISH protocols using breast cancer samples and assessed the impact of pre-analytical and analytical factors on HER-2 testing. Formalin fixed paraffin embedded (FFPE) tissue samples from 70 breast cancer patients were tested for HER-2 using PathVysion™ HER-2 DNA Probe Kit and two different paraffin pretreatment kits, Vysis/Abbott Paraffin Pretreatment Reagent Kit (40 samples) and DAKO Histology FISH Accessory Kit (30 samples). The concordance between FISH and IHC results was determined. Pre-analytical and analytical factors (i.e., fixation, baking, digestion, and post-hybridization washing) affected the efficiency and quality of hybridization. The overall hybridization success in our study was 98.6% (69/70); the failure rate was 1.4%. The DAKO pretreatment kit was more time-efficient and resulted in more uniform signals that were easier to interpret, compared to the Vysis/Abbott kit. The overall concordance between IHC and FISH was 84.06%, kappa coefficient 0.5976 (p < 0.0001). The greatest discordance (82%) between IHC and FISH was observed in IHC 2+ group. A standardized FISH protocol for HER-2 assessment, with high hybridization efficiency, is necessary due to variability in tissue processing and individual tissue characteristics. Differences in the pre-analytical and analytical steps can affect the hybridization quality and efficiency. The use of DAKO pretreatment kit is time-saving and cost-effective.</jats:p>
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Novel Ret Mutations in Macedonian Patients with Medullary Thyroid Carcinoma: Genotype-Phenotype Correlations
(Walter de Gruyter GmbH / MANU, 2015-05-01)
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Bogoeva, Biljana
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Medullary thyroid carcinomas (MTCs) are rare neoplasms comprising 2-10% of all thyroid malignnancies. More than 75% are sporadic tumors and the remainder is familial and MEN2 related. Both sporadic and syndromic MTCs frequently show mutations in the RET proto-oncogene. It has been noted that some MTC cases present an indolent, and some an aggressive clinical course. Ki-67 expression is generally low, with documented exceptions, whereas high expression of Bcl-2 has been reported in majority of the cases. Some studies have shown that Ki-67 and Bcl-2 expressions have prognostic value, as well as RET mutational status. We analyzed 20 unrelated MTC cases for Ki-67, Bcl-2 expression and RET mutations and tested their intercorrelations, correlations to the morphologic features and stage of the tumors, as well as their influence on survival. In 13 of the 20 analyzed cases we found 23 sequence changes distributed in exons 8, 10-13 and 16. There were 11 different missense mutations, single nucleotide deletion with frameshift, and 8 different synonymous mutations. Only 4 of the sequence changes have been previously published. Twelve patients (60%) had tumors expressing one or more missense mutations or single nucleotide deletion and 7 of them (35%) had at least one damaging or possibly damaging RET mutation. Most of the tumors had low Ki-67 expression (mean 6.48% of cells) and high Bcl-2 expression (mean 68.3%). Significantly better survival was observed in cases with low Ki-67 (< 6.5%; p < 0.05), high Bcl-2 expression (> 68.3%; p < 0.01) and younger age at diagnosis (< 51 years; p < 0.05).
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From aneurysmal bone cyst to telangiectatic osteosarcoma with metastasis in inguinal lymph nodes: Case report
(National Library of Serbia, 2015)
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Introduction. Aneurysmal bone cyst is a benign bone lesion composed of blood filled cystic cavities lined by fibrous septa. Its malignant transformation of is a rare event. Case report. We report a case of a lesion in the second metatarsal bone in a 29-year-old male, presented as a slight swelling of the right foot. After the curettage had been done, the diagnosis of aneurysmal bone cyst was made but the recurrence occurred 4 years later. The biopsy of the recurrent tumor showed compact neoplastic tissue consistent with diagnosis of giant cell tumor with malignancy. The malignant component was recognized as a high grade sarcoma with osteoid production. A tumor mass with the whole II metatarsal bone was extirpated and a resected part of fibula was transplanted. A year later, another recurrence occurred, an amputation was performed and a teleangiectatic osteosarcoma with ingvinal lymph nodes metastases was diagnosed. No other tumor mass was confirmed, either clinically or by imaging techniques at the time of his third operation. He died 4 months later with multiple pulmonary metastases. Conclusion. We emphasize the importance of team work in order to achieve the accurate diagnosis, highlighting careful radiological examinations, good sampling and awareness of unusual cases in bone tumor pathology.
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A true epidermotropic apocrine neoplasm in the form of perianal Paget's disease: a case report.
(BioMed Central, 2013-06-20)
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Introduction Extramammary Paget’s disease is an uncommon intraepithelial neoplasm that arises in areas rich in apocrine glands. Treatment includes wide surgical excision and nonsurgical modalities. We present the case of a patient with perianal Paget’s disease with no recurrent disease after wide surgical resection. Case presentation Our patient was a 46-year-old man of Macedonian ethnicity who presented with a pruritic perianal lesion measuring up to 6cm without pain or bleeding. Two biopsies and a perianal wide surgical excision were performed. The tissue specimens were formalin-fixed and the paraffin-embedded samples analyzed according to standard histochemical and immunohistochemical procedures. Surgical perianal skin excision revealed diffuse eczematoid, whitish plaques. Pathohistology showed Paget cells infiltrating his epidermis and adnexal epithelium, with ulceration. Immunohistochemical analysis revealed positive Paget cell expression for cytokeratin 7, epithelial membrane antigen, carcinoembryonic antigen, androgen receptor and human epidermal growth factor receptor 2, and negative expression for cytokeratin 20 and melan-A. Conclusion Paget’s disease is a rare disorder that should be considered in the differential diagnosis of perianal lesions. Reporting cases of extramammary Paget’s disease is crucial for diagnostic guidelines and different therapeutic options.
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Synovial sarcoma of the liver - a case report
(Scientific Foundation SPIROSKI, 2011-06-15)
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Filipovski, Vanja
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Banev, Saso
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Jovcevski, Alen
We report a case of synovial sarcoma of liver in a 44 year old man, presented as a tumor mass in left hepatic lobe. The patient was admitted at the hospital with clinical symptoms of acute abdomen and severe pain in the right upper quadrant. Imaging examinations showed a tumor mass in the left hepatic lobe and free liquid in the abdominal cavity, due to the rupture of the tumor. A resection of 2 segments of the left hepatic lobe, where the tumor was located, was performed. Morphological, immunohistochemical and FISH studies confirmed the diagnosis of monophasic synovial sarcoma. Additional clinical and imaging examinations, made after the surgery, did not confirm tumor mass in any other localization. The patient refused any therapy other than surgery, at that time. A relapsing tumor mass was found 6 months later and another surgical intervention was done. The patient received five monotherapy cycles of Doxorubicin, 75 mg/m2, after the second surgical intervention. He is still alive 11 months after the first operation receiving the same therapy and having second relapsing inoperable tumor mass filling the retroperitoneal space and a great fraction of the abdominal cavity.
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Pterygium excision with limbal autograft transplantation and its histopathological caracteristics of the epithelium
(2015)
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INTRODUCTION: Pterygium is a chronic fibro vascular and degerenative process and originates from the basal limbal stem cells. AIM: The eximination of morphology and cytoceratin expresion of the epithelium of primary stationary and progressive pterygium. Also the method of pterygium excision with limbal autographt transplantation was evaluated. The post operative complications as recidives were evaluated. MATHERIAL AND METHOD: Impression cytology and imunohistohemical staining with antikeratin antibodies were performed in 140 eyes with pterygium. The pterygium was surgically excised using the limbal grapht from imferior or superior bulbar conjunctiva. Avidin – Biotin (ABC and LSAB) technique was performed for the imuno histochemical investigation of the tissue slides of pterygium on Poly-L-lysine-glasses. RESULTS: There were epithelial diversity in the tissues slides of primary stationary and progressive pterygium. Diversity of epithelium was found between the different cuts of the same pterygium depending which part of the pterygium was examined. The areas of squamous epithelial prone to keratinisations was relatively frequent. Also there were areas of erosion and even dysplastic areas. Goblet cells were found isolated or associated and were intensively PAS positive. The post operative incidence of recidivating pterygium was 7%. CONCLUSION: Pterygium shows significant changes in the epithelium even in the different slides of the same pterygium and its not associated with the stadium of the primary pterygium. Pterygium excision with limbal autographt transplantation is a surgical method of choice for primary stationary and progressive pterygium.
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Colorectal adenocarcinoma with heterotopic bone.
(Springer, 2015-09)
Gjorgjievska, A
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Objective: Heterotopic bone is rarely found in colorectal carcinoma with low incidence of 0,4 %. We report a case of a 75-years old male presenting with constipation, vomiting and abdominal, i.e. acute abdomen, due to large bowel obstruction. He underwent urgent surgical operation. Method: The received material was a total colectomy with egsophytic tumour in the sigmoid colon, measuring 4 cm in length, with proximal dilatation of 16 cm in diameter. Standard tissue samples were embedded in paraffin blocks and Hematoxylin-Eosin and imunohistochemical stainings were made. Results: Histological analysis showed poorly differentiated adenocarcinoma Stage IVA. We found abundant desmoplastic stroma, partly hyalinised, with deposition of osteoid and focal formation of well-defined osseous islands of various shapes and sizes, with evident osteoblasts arranged as osteoplasts, with focally formed Haversian canals. Immunohistochemical staining showed CK18(+), Vimentin(-) signal for tumour cells, and Vimentin(+) signal for the osteoid, Osteopontin(+) signal for osteoblasts and osteoid. Conclusion: Pathogenesis is unclear, but there are theories describing fibroblast metaplasia into osteoblasts or production of BMP-2 and FGF-2 by tumour cells, inducing bone formation. The finding of osseous metaplasia in colorectal carcinoma does not change the prognosis, although is very important to differentiate this entity from carcinosarcoma, that have poor prognosis.
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Serous adenocarcinoma of the fallopian tube: a case report
(Macedonian Association of Pathology, 2016-09)
Trajkovska, Elizabeta
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Objective: Primary serous adenocarcinoma of the fallopian tube (PSAFT) is a rare tumor which histologically and clinically resembles epithelial ovarian cancers. Although it has been postulated that both ovarian and tubal high-grade serous carcinomas actually share common histogenesis, PSAFT has a worse prognosis than ovarian cancer. We report a case of PSAFT that presented clinically as hydrosalpinx. Material and Methods: A 62-year-old patient with complaints of a low abdominal pain and vaginal discharge was admitted at the gynecological department. During the diagnostic procedure, the ultrasound examination revealed uterine fibroid and a right-sided hydrosalpinx. The patient underwent hysterectomy with bilateral adnexectomy. Due to the clinical assessment of benign disease, no tumor markers were required preoperatively, nor biopsy from the omentum and parietal peritoneum, as well as peritoneal washing, were obtained intraoperatively. The operative material was routinely dissected and a standard procedure for histology and immunohistochemistry was performed. Results: The right tube was tortuous, 17 cm in length, having 5 cm long dilatation in the proximal third. In the dilated part, few exophytic, neoplastic, white-grayish soft lesions were found. The histopathologic examination revealed areas of in situ as well as high-grade PSAFT with lamina propria involvement. The malignant cells were positive for CK7 and WT1. The tumor did not infiltrate the muscle layer, so it was defined as FIGO stage IA. The leiomyoma previously diagnosed by ultrasound was histologically confirmed, while the left adnexa and right ovary revealed regular morphology and were free of tumor. Two months after the operation the patient is in good health and diseasefree. Conclusions: PSAFT should be distinguished as a different clinical entity from primary ovarian epithelial neoplasms so that the patient could receive adequate therapy and follow-up.

Spasevska, Liljana

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