Gabriela Izabela Baltatescu
@spitalulconstanta.ro
Research and Development Centre for The Morphologic and Genetic Study of Malignant Pathology
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Mariana Deacu, Madalina Bosoteanu, Manuela Enciu, Georgeta Camelia Cozaru, Oana Cojocaru, Gabriela Izabela Baltatescu, Anca Antonela Nicolau, Cristian Ionut Orasanu, Bogdan Marian Caraban, and Raluca Ioana Voda
MDPI AG
Lipomatous tumors are the most frequent soft tissue neoplasms. Sometimes their differential diagnosis is difficult to perform only by microscopic analysis. This study aims to create a histopathological scoring system and highlight the impact of intratumoral microvascular density. This study was conducted over 10 years. We analyzed the main pathogenic pathways (MDM2 and CDK4), as well as the tumor microvascularization (CD31 and CD34) by immunohistochemical tests. We also analyzed the status of the MDM2 gene by CISH. These data, together with the clinical and histopathological information, were statistically analyzed by appropriate tests. We identified 112 eligible cases, with most of the patients being in their sixth decade of life, with a slight predominance of the female sex. We found important associations like tumor location linked to nuclear pleomorphism severity and microvascularization density correlated with atypia severity. Also, we observed that a maximum diameter of a tumor of at least 69 mm is associated with the presence of tumor necrosis. The score designed in this study shows an increased sensitivity and specificity for the diagnosis of lipomas (100%, respectively, 97%), atypical lipomatous tumors (93.8%, respectively, 82.3%), and liposarcomas (100%, respectively, 90.5%). This present study enhances the present data by bringing to attention the histopathological score with a role in differential diagnosis, as well as in the prediction of immunohistochemical and genetic tests. Also, we highlighted the importance of microvascular density, especially in the diagnosis of liposarcomas.
Luana-Andreea Boşoteanu, Emma Gheorghe, Mariana Aşchie, Georgeta Camelia Cozaru, Mariana Deacu, Gabriela Izabela Bălțătescu, Cristian Ionuț Orășanu, and Mǎdǎlina Boşoteanu
MDPI AG
Background and Objectives: In the realm of the rising incidence of cutaneous and mucous melanoma, CDKN2A mutations characterize familial and multiple primary melanoma cases. The involvement of tumor-infiltrating lymphocytes (TILs) is interconnected with survival rates, but may extend even further. The aim of this study is to verify the accuracy of the classical “naked eye” count of CD8-positive T cells comprised within the tumoral population and peritumoral infiltrate versus that obtained via a special software run by the aid of artificial intelligence (AI), used to determine the percentage of CD8-positive TILs. Materials and Methods: The present retrospective cross-sectional study conducted over a period of 5 years (2018–2022) focused on patients diagnosed with mucous and/or cutaneous melanoma, with a positive family history for melanoma, or personal antecedents of primary malignant melanocytic lesions. The 23 selected cases were diagnosed histopathologically, tested for CDKN2A mutations through fluorescent hybridization in situ, and CD8 immunohistochemistry was performed. The included slides were evaluated both manually (naked-eye examination) and automatically (via QuPath platform) for quantifying the CD8-positive TILs. Results: The number of CD8-positive TILs in melanoma samples has been more accurately identified through the use of an AI-mediated software as compared to the human-eye evaluation performed by experimental pathologists. A higher percentage of CD8-positive intratumoral lymphocytes versus stromal lymphocytes was positively associated with more numerous metastatic sites. Conclusions: The CD8 lymphocytic phenotype harbors major significance in the context of familial and multiple primary melanoma and may comprise a cost-effective investigation meant to help in the establishment of melanoma prognosis and response to immunotherapy.
Stela Halichidis, Mariana Aschie, Georgeta Camelia Cozaru, Mihaela Manea, Nicolae Dobrin, Sabina E. Vlad, Elena Matei, Gabriela Izabela Baltatescu, Anca Florentina Mitroi, Mihai Catalin Rosu,et al.
MDPI AG
(1) Background: Human cytomegalovirus (CMV) infection is one of the most frequent opportunistic infections in immunosuppressed patients. Romania has one of the highest incidences of patients living with human immunodeficiency virus (HIV) which determines an immunosuppressive state. The aim of this study was to establish the prevalence of CMV infection among women living with HIV in Southeastern Romania and also to evaluate and correlate antiretroviral therapy (ART) with CD4 level and CMV disease evolution. (2) Methods: Seventy women living with HIV from Southeastern Romania were screened for CMV infection using antigen quantification. Of these, 50 were included in the study. First, the patients filled out a questionnaire regarding social conditions and other associated diseases. Then, we explored the statistical correlations between the data and HIV status, CD4+ cell counts, viral load, and antiretroviral therapy (ART). (3) Results: Median age of the patients was 33 years. Twenty-nine cases were diagnosed with HIV after sexual life beginning and 21 before. Most of the patients had a CD4 level over 200 cells/µL. ART duration in the CD4 under 200 cells/µL group was a bit longer than that in the CD4 over 200 cells/µL group. Forty-one patients had undetectable viremia. CD4 average value in the lot of patients with undetectable viremia was 704.71 cells/µL and in the lot with detectable viremia was 452.44 cells/µL. Viremia values correlated negatively with CD4 level. A positive correlation between IgG CMV values and ART therapy length was identified. A negative significant correlation between values of IgG CMV and values of CD4 was identified. CD4 value correlated negatively with IgG CMV values and with CMV avidity. (4) Conclusions: IgG CMV values had a weak positive correlation with ART therapy length, and a negative statistically significant correlation with values of CD4. CMV avidity has a negative correlation with CD4 value.
Miruna Cristian, Mariana Așchie, Mariana Deacu, Mădălina Boșoteanu, Gabriela Izabela Bălțătescu, Andreea Georgiana Stoica, Anca Antonela Nicolau, Ionuț Poinăreanu, and Cristian Ionuț Orășanu
MDPI AG
The most common NHL subtype in SEEU is DLBCL (39%), and it manifests with a variety of cellular morphologies and a high proliferation index. Also, the GI tract is the most common site of extranodal NHLs, and most NHLs involving the GI tract are of B-cell lineage, of which diffuse large B-cell lymphoma is the most common subtype, irrespective of location. The last few years have seen digital pathology as a vital technology that has a positive impact on diagnostics, but studies on the use of DP for lymphoma identification, however, are still restricted to only determining whether a tumor is present or absent. Using the example of cases of malignant NHL, we aim to investigate the diagnostic utility of DP using QuPath software in evaluating the proliferation index and the prognostic significance and to show that improved visualization and analysis contribute to the convergence of these complementary diagnostic modalities for lymphomas. The average proliferation index (Ki67) was 58.33% with values between 10% and 85%. After the stratification of the cases, an increased proliferation index was observed in the majority of cases (53.33%), and this aspect was associated with the advanced age of the patients (p = 0.045). Visual assessment provides lower Ki67 values than automated digital image analysis. However, the agreement coefficient between the conventional method and the AI method indicates an excellent level of reliability (ICC1–0.970, ICC2–0.990). The multivariate analysis revealed that in the cases where the proliferation index Ki67 is high (˃70%), the IPI score represents an important risk factor predicting mortality (HR = 10.597, p = 0.033).
Roxana-Elena Cîrjaliu, Mariana Deacu, Ioana Gherghișan, Angela-Ștefania Marghescu, Manuela Enciu, Gabriela Izabela Băltățescu, Antonela Anca Nicolau, Doina-Ecaterina Tofolean, Oana Cristina Arghir, and Ariadna-Petronela Fildan
MDPI AG
This review brings together the current knowledge regarding the risk factors and the clinical, radiologic, and histological features of both post-COVID-19 pulmonary fibrosis (PCPF) and idiopathic pulmonary fibrosis (IPF), describing the similarities and the disparities between these two diseases, using numerous databases to identify relevant articles published in English through October 2022. This review would help clinicians, pathologists, and researchers make an accurate diagnosis, which can help identify the group of patients selected for anti-fibrotic therapies and future therapeutic perspectives.
Alexandra Dinu, Mariana Aschie, Georgeta Camelia Cozaru, Anca Florentina Mitroi, Catalin Nicolae Grasa, Ionut Eduard Iordache, Mariana Deacu, Cristian Ionut Orasanu, Antonela-Anca Nicolau, and Gabriela Izabela Baltatescu
Romanian Society of Gastroenterology and Hepatology
Background and Aims: High-grade gastrointestinal neuroendocrine neoplasms (GI-NENs) are divided into well-differentiated G3 neuroendocrine tumors (NETs G3) and neuroendocrine carcinomas (NECs), having identical cut-offs of proliferation, but different biomolecular origins. This translates in distinct treatment choices. Our aim was to establish if p53/Rb1 immunohistochemical status in GI-NENs with Ki67 index >20% can predict the histopathological diagnosis.
 Methods: p53/Rb1 immunolabelling was performed on 42 cases of high-grade GI-NENs, diagnosed as NET G3, NEC and mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN) with NEC component. Immunolabeled slides were digitally scanned, with automatic quantification of p53 and Rb1, blind to the diagnosis.
 Results: The p53 positive percentage was stratified; two cut-offs were selected, naming the intervals as N (null, <1%), T (tumor, 1%-20%) and C (carcinoma, >20%). The Rb1 expression loss in >90% of neoplastic cells was considered mutational. NETs G3 mainly showed the T status (14/16, 87.5%), followed by N (1/16, 6.25%) and C (1/16, 6.25%); NECs and NEC components in MiNENs predominantly expressed the C status (19/26, 73.08%), followed by N (5/26, 19.23%) and T (2/26, 7.69%) (p<0.001, χ 2 =27.017). NET G3s showed positive expression for Rb1; 73.08% of NECs expressed negative Rb1 (p<0.001, χ 2 =21.351). NECs and NEC components in MiNENs showed Rb1 mutational status in 13 C cases (13/19, 68.42%), 4 N cases (4/5, 80%) and in both the T cases (p=0.002, χ 2 =11.187).
 Conclusions: Our results highlight the correlations between the p53/Rb1 immunostainings and the histopathological diagnosis of high-grade GI-NENs. NECs and NEC components in MiNENs showed a p53 mutational status (0% or 21-100%) and predominantly negative Rb1 expression. NETs G3 showed a p53 wild-type status (1-20%) and retained Rb1 expression. These findings suggest that the differential diagnosis of high-grade GI-NENs may benefit from p53/Rb1 immunohistochemical tests in everyday practice.
M. Deacu, M. Enciu, A. Nicolau, G. Bălțătescu, L. Neculai-Cândea, S. Deacu and M. Popa
BACKGROUND
COVID-19 is a systemic disease with multiorgan damage, which requires a better understanding and deepening of histopathogenesis in order to improve treatment. Autopsy remains a gold standard to establish certain diagnoses and to integrate the morphological spectrum of lung lesions, explaining the cause of death, into a clinical context.
METHODS AND RESULTS
The study included 57 autopsies performed during 2020-2021 associated with SARS-CoV-2 infection. Among the autopsies we performed, diffuse alveolar damage (DAD) was the most common pulmonary morphological change, 31.8% of them with acute or exudative phase and 33.3% with proliferative phase of DAD. Acute fibrous organizing pneumonia or organizing pneumonia with fibrous remodeling processes and pulmonary fibrosis were rarely observed. The most unfavorable outcome and death associated with SARS-CoV-2 infection was frequent in older men, with a high rate of comorbidities. Microscopically, SARS-CoV-2 presents many common aspects with MERS-CoV and SARS-CoV-1, such as alveolar hyaline membrane, desquamated alveolar cells, alveolar edema and alveolar and interstitial lymphocyte and monocytes infiltration.
CONCLUSIONS
Our study includes a large number of autopsies on patients with SARS-CoV-2 infection performed in Romania. COVID 19 associated pneumonia combines classical aspects of alveolar and interstitial pneumonia with some peculiarities. Autopsies are of major importance in understanding SARS-CoV-2 infection.
Mariana Deacu, Mariana Aschie, Madalina Bosoteanu, Sorin Vamesu, Gabriela-Izabela Baltatescu, Georgeta Camelia Cozaru, Cristian Ionut Orasanu, and Raluca Ioana Voda
Ovid Technologies (Wolters Kluwer Health)
Rationale: Dedifferentiated liposarcoma is defined as a malignant tumor that changes its shape from a well-differentiated liposarcoma to a non-liposarcomatous form. Most paratesticular liposarcomas manifest as an inguinal, painless, slow-growing mass. The standard treatment is extensive surgical excision, radiotherapy being proposed for cases with positive margins, those with recurrence, or in cases of the existence of unfavorable prognostic factors. Patient concerns: We present the case of a young patient diagnosed initially with left hydrocele, which after 2 years proved to mask a differentiated liposarcoma of the spermatic cord. The initial clinical manifestations were represented by the increase in volume of the left groin-scrotal region and pain at this level. Diagnosis: Microscopic examination in hematoxylin-eosin staining highlighted the presence of lipoblasts and fibroblasts in association with areas of hemorrhage and tumor necrosis. The performed immunohistochemical tests confirmed the diagnosis of dedifferentiated liposarcoma. To support and confirm the presence of the mouse double minute 2 homolog gene mutation, chromogenic in situ hybridization analysis was performed. Interventions: The initial treatment was the surgical one. After 2 weeks, the patient received zolendronic acid for hypercalcemia which was caused by the osseous metastasis. Outcomes: The patient died secondary to acute renal failure caused by hypercalcemia despite the treatment received. Lessons: This case underlines the importance of both the correct management of oncological patients, as well as immunohistochemical and genetic tests in the identification of prognostic factors, with the ultimate goal of administering an appropriate oncological treatment.
Bogdan Marian Caraban, Elena Matei, Georgeta Camelia Cozaru, Mariana Aşchie, Mariana Deacu, Manuela Enciu, Gabriela Izabela Bălţătescu, Anca Chisoi, Nicolae Dobrin, Lucian Petcu,et al.
MDPI AG
(1) Background: Because melanoma is an aggressive tumor with an unfavorable prognosis, we aimed to characterize the PD-L1 expression in melanomas in association with T cell infiltrates because PD-1/PD-L1 blockade represents the target in treating melanoma strategy. (2) Methods: The immunohistochemical manual quantitative methods of PD-L1, CD4, and CD8 TILs were performed in melanoma tumor microenvironment cells. (3) Results: Most of the PD-L1 positive, expressing tumors, have a moderate score of CD4+ TILs and CD8+TILs (5−50% of tumor area) in tumoral melanoma environment cells. The PD-L1 expression in TILs was correlated with different degrees of lymphocytic infiltration described by the Clark system (X2 = 8.383, p = 0.020). PD-L1 expression was observed often in melanoma cases, with more than 2−4 mm of Breslow tumor thickness being the associated parameters (X2 = 9.933, p = 0.014). (4) Conclusions: PD-L1 expression represents a predictive biomarker with very good accuracy for discriminating the presence or absence of malign tumoral melanoma cells. PD-L1 expression was an independent predictor of good prognosis in patients with melanomas.
Manuela Enciu, Gabriela Izabela Baltatescu, Oana Cojocaru, Ionut Burlacu, Viorel Constantin Cristurean, Liliana Mocanu, Sinziana-Andra Ghitoi, Alexandra Dinu, and Antonela-Anca Nicolau
Informa UK Limited
Background: Teratomas can occur in the umbilical cord, and may or may not be associated with other congenital abnormalities. Case report: This 35-year-old primigravida gave birth 37-38 weeks to a 3290-g normal female. The umbilical cord, at 10 cm from the abdominal insertion, had an 8 cm mature teratoma. Work-up revealed no other abnormalities. Discussion: Mature teratomas may occur in the umbilical cord, and may or may not have additional clinical sequalae.
Cristian Ionut Orasanu, Mariana Aschie, Mariana Deacu, Madalina Bosoteanu, Sorin Vamesu, Manuela Enciu, Gabriela Izabela Bălţătescu, Georgeta Camelia Cozaru, Anca Florentina Mitroi, and Raluca Ioana Voda
MDPI AG
Necrosis and increased microvascular density in glioblastoma IDH-wild-type are the consequence of both hypoxia and cellular immaturity. Our study aimed to identify the main clinical-imaging and morphogenetic risk factors associated with tumor necrosis and microvascular in the prognosis of patient survival. We performed a retrospective study (10 years) in which we identified 39 cases. We used IDH1, Ki-67 and Nestin immunomarkers, as well as CDKN2A by FISH. The data were analyzed using SPSS Statistics. The clinical characterization identified only age over 50 years as a risk factor (HR = 3.127). The presence of the tumor residue, as well as the absence of any therapeutic element from the trimodal treatment, were predictive factors of mortality (HR = 1.024, respectively HR = 7.460). Cellular immaturity quantified by Nestin was associated with reduced overall survival (p = 0.007). Increased microvascular density was associated with an increased proliferative index (p = 0.009) as well as alterations of the CDKN2A gene (p < 0.001). CDKN2A deletions and cellular immaturity were associated with an increased percentage of necrosis (p < 0.001, respectively, p = 0.017). The main risk factors involved in the unfavorable prognosis are moderate and increased Nestin immunointensity, as well as the association of increased microvascular density with age over 50 years. Necrosis was not a risk factor.
Cristina-Anita Ionescu, Mariana Aschie, Elena Matei, Georgeta Camelia Cozaru, Mariana Deacu, Anca Florentina Mitroi, Gabriela Isabela Baltatescu, Antonela-Anca Nicolau, Laura Mazilu, Liliana Ana Tuta,et al.
MDPI AG
Prostate intratumoral heterogeneity, driven by epithelial–mesenchymal plasticity, contributes to the limited treatment response, and it is therefore necessary to use the biomarkers to improve patient prognostic survival. We aimed to characterize the tumor microenvironment (T lymphocyte infiltration, intratumoral CD34, and KI-67 expressions) by immunohistochemistry methods and to study the biological mechanisms (cell cycle, cell proliferation by adhesion glycoproteins, cell apoptosis) involved in the evolution of the prostate tumor process by flow-cytometry techniques. Our results showed that proliferative activity (S-phase) revealed statistically significant lower values of prostate adenocarcinoma (PCa) and benign prostatic hyperplasia (BPH) reported at non-malignant adjacent cell samples (PCa 4.32 ± 4.91; BPH 2.35 ± 1.37 vs. C 10.23 ± 0.43, p < 0.01). Furthermore, 68% of BPH cases and 88% of patients with PCa had aneuploidy. Statistically increased values of cell proliferation (CD34+ CD61+) were observed in prostate adenocarcinoma and hyperplasia cases reported to non-malignant adjacent cell samples (PCa 28.79 ± 10.14; BPH 40.65 ± 11.88 vs. C 16.15 ± 2.58, p < 0.05). The CD42b+ cell population with a role in cell adhesion, and metastasis had a significantly increased value in PCa cases (38.39 ± 11.23) reported to controls (C 26.24 ± 0.62, p < 0.01). The intratumoral expression of CD34 showed a significantly increased pattern of PCa tissue samples reported to controls (PCa 26.12 ± 6.84 vs. C 1.50 ± 0.70, p < 0.01). Flow cytometric analysis of the cell cycle, apoptosis, and adhesion glycoproteins with a critical role in tumoral cell proliferation, T cell infiltrations, Ki-67, and CD 34 expressions by IHC methods are recommended as techniques for the efficient means of measurement for adenocarcinoma and hyperplasia prostate tissue samples and should be explored in the future.
Simona Claudia Cambrea, Mariana Aschie, Ghiulendan Resul, Anca Florentina Mitroi, Anca Chisoi, Antonela Anca Nicolau, Gabriela Izabela Baltatescu, Ana Maria Cretu, Gabriela Lupasteanu, Lucian Serbanescu,et al.
MDPI AG
Background and Objectives: Romania faces one of the highest cervical cancer burdens in Europe though it is a preventable cancer through population screening by cytology and human papillomavirus (HPV) detection. Also, it has one of the highest incidences of human immunodeficiency virus (HIV) infection. HPV and HIV coinfection are frequently encountered. The aim of study was to establish the prevalence of HPV infection among HIV-positive women in Southeast Region of Romania, to genotype high risk HPV types -and to correlate the results with clinical data and cytological cervical lesions. Materials and Methods: 40 HIV-positive women were screened for HPV types and for cytological cervical lesions. The findings were evaluated in correlation with CD4 cell counts, HIV viral load, age at first sexual intercourse, number of sexual partners, vaginal candidiasis, and Gardnerella using statistical methods. Results: 19/40 (47.5%) women were positive for HPV types, 63.15% infected with single HPV type and 36.85% with multiple HPV types. The most frequent types were type: 31 (42.1%), 56 (31.57%), 53 (15.78%). On cytology, 34 (85%) women were found with NILM of which 38.23% were HPV-positive. Fifteen percent of women had abnormal cytology (three ASC-US, three LSIL), and all of them were HPV-positive. Through analyzing the value of CD4 count, women with CD4 count ≤ 200 cells/μL were found to be significantly more likely to be infected with HPV; meanwhile there was no correlation between the detection of HPV types and HIV viral load. Candida or Gardnerella were more often associated with HIV-positive women with HPV, than in women without HPV. Conclusions: Infection with HPV types is common among HIV-positive women in the Southeast Region of Romania and it is associated with age at the beginning of sexual life, number of sexual partners, CD4 value, vaginal candidiasis, and Gardnerella infection.
Mădălina Boșoteanu, Raluca Ioana Vodă, Mariana Așchie, Luana-Andreea Bosoteanu, and Gabriela Izabela Bălțătescu
SAGE Publications
We report a rare case of giant uterine leiomyosarcoma in a postmenopausal woman, whose diagnosis was initially suspected at the evaluation of the abdominal efusion, and confirmed after the pathological examination of the uterus in association with the ancillary tests. The evaluation of the abdominal fluid showed single or clusters of malignant, round or spindle-shaped cells. On microscopic examination of the surgical specimen, a dense cell proliferation of spindle cells, with moderate to severe nuclear pleomorphism and significant mitotic activity was observed. Immunohistochemical evaluation demonstrated the loss of myocytic differentiation by focal, weakly positive expression of smooth muscle actin and desmin. The data presented in this case emphasize the relevance of the cytological examination, although the latter has only indicative value, especially since it is an aggressive tumor, frequently associated with mutant expression of p53. In our case, the first indication of the presence of uterine sarcoma was given by the presence of atypical cells in the peritoneal fluid.
Madalina Bosoteanu, Raluca Ioana Vodă, Cristian Ionut Orasanu, Mariana Aschie, Manuela Enciu, and Gabriela Izabela Baltatescu
International Scientific Information, Inc.
Mariana Deacu, , Liliana-Ana Tuţă, Mădălina Boşoteanu, Mariana Aşchie, Anca Florentina Mitroi, Antonela-Anca Nicolau, Manuela Enciu, Oana Cojocaru, Lucian Cristian Petcu,et al.
Societatea Romana de Morfologie
Breast cancer (BC) is the second most frequent type of cancer for both sexes combined, after lung cancer. Triple-negative BC (TNBC) molecular subtype is characterized by lack of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) immunoexpression or amplification and represent 10-20% of all BC cases. The issue of the present study was to analyze the associations between programmed death-ligand 1 (PD-L1) immunoexpression and distribution of stromal tumor-infiltrating lymphocytes (stTILs) combined with clinico-morphological features of patients with TNBC. Secondly, our research evaluated PD-L1 immunoexpression as a prognostic factor and its correlation with p53 immunoexpression. Thirty cases with primary TNBC without prior neoadjuvant therapy were included in this research. stTILs were identified in all cases, most of them with low distribution (66.7%). A positive immunoreaction for PD-L1 was observed in 40% of cases. The PD-L1 immunoexpression was statistically significant associated with age, pathological tumor size, lymphovascular invasion, stTILs level, the presence of cluster of differentiation 8-positive (CD8+) TILs and p53 immunoexpression. In the present study, a positive PD-L1 immunoexpression was associated with a worse distant metastasis free survival (DMFS). We also found not only that high stTILs level were associated with a better DMFS but also that there was a statistically significant association between stTILs level and PD-L1 immunoexpression. Our results bring new insights to the fine connections between tumor microenvironment and molecular changes of TNBC. It helps us to better understand these aggressive tumors to identify the more useful biomarkers for predicting the response to adjuvant therapy and can represent a method for selecting the most suitable patients for immunotherapy.
Liliana Steriu, Roxana-Cleopatra Penciu, Corina Mădălina Nour, Silvia Izvoranu, Iulia-Diana Mocanu, Gabriela-Izabela Bălţătescu, Oana Cojocaru, and Vlad-Iustin Tica
Societatea Romana de Morfologie
We present a case of a pregnant woman in the third trimester who came to the Department of Emergency, Sf. Apostol Andrei Emergency County Hospital, Constanţa, Romania, in September 2016, for abdominal pain and ascites. After admission, the patient was periodically tested (biochemically and by ultrasound). We also payed attention to the fetal well-being. During the hospitalization, the patient was also found positive for syphilis. Biochemical values have progressively altered, the fetus started to present acute fetal distress and the patient gave birth by Caesarean section after two days of hospitalization. The intraoperatory surprise was hemoperitoneum caused by posttraumatic splenic rupture. The relevance of this case consists in its rarity (we were not able to find in the literature a case with the association of pregnancy, syphilis, trauma, and splenic rupture), in the difficult histopathological clear assertion and in the clinical awareness of such a condition.
Roxana-Cleopatra Penciu, , Iulia Postolache, Liliana Steriu, Silvia Izvoranu, Andrei-Adrian Tica, Iulia-Diana Mocanu, Vasile Sârbu, Mariana Deacu, Irina Tica,et al.
Societatea Romana de Morfologie
Endometriosis (EMs) is a benign disease characterized by the presence of endometrial tissue outside the uterine cavity. EMs associated with ovarian cancer (OC) has a relative low incidence (5% to 10%), sometimes with evidence of a transition stage through atypical EMs (1.6% cases). We have assessed 135 consecutive patients with either EMs or OC and, out of them, our study reports on four cases of ovarian EMs and OC: two cases with endometrioid OC and two cases with high-grade serous OC (HGSOC). Cases with EMs and HGSOC are extremely rarely reported in the literature – we could find not more than 30 cases. The main objective of our research was to observe the possible similarities between EMs and OC. Secondly, we analyzed the differences between EMs associated with endometrioid OC and EMs associated with HGSOC. We evaluated them in terms of clinical status (age, stages of EMs and OC) and immunohistochemical (IHC) expression of estrogen receptor (ER), progesterone receptor (PR), Ki67, p53, p16, Wilms’ tumor 1 (WT1), cluster of differentiation (CD) 34 and CD10 immunomarkers – we could not find in the literature all these markers assessed, in the same time, to such samples. Our results indicated that there are no similarities between EMs and OC and no atypical EMs was identified in our cases. We recorded higher values of ER expression in EMs associated with HGSOC than in EMs associated with endometrioid OC. Higher values of ER expression were also recorded in OC than in endometriotic foci. There were no differences in proliferative rate of endometriotic foci associated with endometrioid OC, compared to EMs associated with HGSOC. An aberrant IHC expression for p53 protein and p16 protein was noted only in HGSOC. Also, a positive immunostaining for Wilms’ tumor 1 (WT1) was identified only in HGSOC. Higher values of microvessel density were recorded in OC but not in endometriotic foci. We concluded that there were no similarities between EMs and OC for the cases included in our study, but we noticed differences in terms of Ki67 index and also between hormonal receptors expression in EMs associated with HGSOC, comparing with EMs associated with endometrioid OCs. These results may represent a “brick” for future researches on the less understood EMs associated with type II of OCs, especially with HGSOC. Identifying the best marker, which can predict the risk of developing OC for the patients with EMs, may lead to discover new specific therapeutic agents and, therefore, a better, tailored, therapy.
Roxana-Cleopatra Penciu, Liliana Steriu, Silvia Izvoranu, Iulia Postolache, Andrei-Adrian Tica, Diana Mocanu, Oana-Sorina Tica, Vasile Sarbu, Mariana Deacu, Gabriela Baltatescu,et al.
Revista de Chimie SRL
Endometriosis is a benign disease represented by existence of endometrial tissue outside the uterine cavity. Considered in the past a type of endometriosis, adenomyosis is, presently, described as a possible different entity, comparative to endometriosis. That is the reason why we decided to study two groups of patients - one with endometriosis and one with adenomyosis - in order to determine if they are one and the same disease. We included all successive patients admitted and surgically treated in the Emergency Clinical Hospital Constanta between 2015-2017, and, after applying the selection criteria, we assessed 61 patients (group 1) diagnosed with endometriosis - ovarian, cervical, caesarian section scar - and 39 patients (group 2) with adenomyosis. We studied all patients in terms of age, parity, lesions� size, admissions� symptoms, chronic symptoms and immunohistochemical markers CD10, CD34, Ki67. We chose there three markers because of their possible relation to endometriosis and because we were unable to find data regarding the comparison of CD34 or Ki67 expression in endometriosis and adenomyosis and because we did not find articles that reported the expression of these three immunohistochemical markers, combined, for either endometriosis or adenomyosis. According to our study, it seems that endometriosis and adenomyosis are different clinically with regard of age and dysmenorrhea, but there was no statistical difference between the studied immunohistochemical biomarkers� expression in samples of patients with endometriosis or adenomyosis.
Roxana Cleopatra Penciu, Iulia Postolache, Andrei Tica, Liliana Steriu, Silvia Izvoranu, Diana Mocanu, Vasile Sarbu, Oana Tica, Mariana Deacu, Gabriela Baltatescu,et al.
Revista de Chimie SRL
Endometriosis is a benign disease characterized by the presence of endometrial tissue outside the uterus. It is more associated to chronic pelvic pain, dysmenorrhea and dyspareunia. Adenomyosis is represented by the presence of endometrial tissue inside the uterine muscle. We studied, in 100 successive patients, immunohistochemical markers CD10, CD34 and KI67 in glandular and in stromal cells, in order to assess the correlation between symptoms and them. We did not find any data reporting these aspects. As CD34 is an angiogenesis marker and Ki67 is an aggressivity marker, pelvic pain could predict a more aggressive disease and with a higher spreading capacity in patients with endometriosis. In the same patients, and dysmenorrhea seems to be related with only with angiogenesis.