The Journal of Bucharest College of Physicians and the Romanian Academy of Medical Sciences

Marius Cornitescu

Marius Cornitescu

Clinical, Histological, Immunohistochemical Aspects in a Rare Malignant Peripheral Nerve Sheath (Triton) Tumor

Introduction: Immunohistochemistry is a widely used diagnostic technique in pathology, the antibodies used for unvailing a tissue’s origin being made up of proteins, more specifically aminoacids. Malignant peripheral nerve sheath tumors have a distinct immunohistochemistry profile, with great emphasis concerning those with rhabdomyoblastic differentiation being positive for S-100 protein, myogenin, vimentin, CD99, p63, GFAP, caldesmon, desmin, and p53 and Myo-D1 (the later two revealing the striated muscle differentiation). Materials and methods: A case study concerning a patient suffering from a moderately differentiated (G2) non-keratinizing squamous cell carcinoma of the lung highlighted the development of an ndifferentiated sarcomatous proliferation on the left hemithorax, 7 years after the initial external radiotherapy treatment for the malignant lung tumor. Results: The immunohistochemistry analysis of the thoracic wall invasive tumor revealed it to be a malignant peripheal nerve sheath tumor with rhabdomyoblastic differentiation (Triton tumor) with the positivity for the specific aforementioned markers and a proliferation index – Ki67 of 90%. Chemotherapy was the elective treatment which was followed for 1 month, the patient having a rapid downward evolution towards exitus, with a 33 month post-diagnosis survival.

Conclusions: This case was presented due to the rarity and difficulty of the diagnosis, consisting of a rare subtype of malignant peripheral nerve sheath tumor for which there is no therapeutic consensus and with an un-favorable prognosis.

Read More »

Vitamin D Levels Correlate with Wheezing and Asthma Recurrence in Children

Vitamin D is a secosteroid with a pivotal role in the calcium and phosphate metabolism, two ions that are essential for bone mineralization, neuromuscular activity and general cell functions. Sources of vitamin D are either endogenous (production in the skin from 7-dehydrocholesterol under the influence of sunlight UV-B radiation) [1] or exogenous (dietary). The dietary forms of vitamin D are either of vegetal origin (ergocalciferol, vitamin D2) [2] or of animal origin (colecalciferol, vitamin D3) [3]. The two calciferol forms are similarly metabolized in humans, have equal bioavailability and effectiveness [4]. [...]

Read More »

Age-Dependent Prevalence of Persistent Wheezing Phenotypes in Romanian Children

Asthma is a heterogeneous group of disease entities with common characteristics such as intermittent respiratory symptoms (wheezing, tightness, cough, dyspnea), reversible airway obstruction and bronchial hyperresponsiveness [1]. Wheezing, caused by airflow restriction through narrowed airways, is the main clinical sign associated with asthma.
Two concepts related to asthma are currently in a process of disentanglement: the concept of asthma phenotypes (particular clinical characteristics, without reference to the underlying pathologic process) and endotypes (pathological mechanisms of disease) [2]. The disentangling of asthma phenotypes and endotypes is important for the prediction of disease evolution and for accurate therapeutic action.

Read More »