Clinical Center for Serbia

Belgrade, Serbia

Clinical Center for Serbia

Belgrade, Serbia
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Colovic M.,University of Belgrade | Vidovic A.,University of Belgrade | Vidovic A.,Clinical Center for Serbia | Jankovic M.,University of Belgrade | And 3 more authors.
Laboratory Medicine | Year: 2013

Myeloid sarcoma is a localized tumor composed of myeloblasts and other immature myeloid cells outside the bone marrow. It is usually associated with acute myeloid leukemia and rarely with chronic myeloproliferative disorders. We present a 43-year-old male who developed a solitary tumor in his left testis 6 years after an initial diagnosis of primary myelofibrosis. Four months later, another infiltrative tumor in the skin overlying his left wrist was discovered. After orchiectomy, the immunohistochemistry revealed tumor cells expressing LCA, CD34, CD117, MPO, CD15, lysozym, and CD43+, which confirmed diagnosis of myeloid sarcoma. The histologic and immunohistochemical findings were similar. The patient was treated with local radiotherapy to the skin tumor site, resulting in regression of the tumor and with chemotherapy when acute myeloblastic leukemia developed. The patient survived 21 months after initial presentation.


Colovic N.,University of Belgrade | Colovic N.,Clinical Center for Serbia | Suvajdzic N.,University of Belgrade | Suvajdzic N.,Clinical Center for Serbia | And 8 more authors.
Biomedicine and Aging Pathology | Year: 2013

We present two cases of acute myeloid leukemia (AML) who developed Varicella-Zoster Virus (VZV) encephalitis after completion of standard "3 + 7" induction remission chemotherapy. A 50-year-old patient developed disseminated cutaneous Herpes Zoster (HZ) 2 days after completion of induction chemotherapy for AML. The patient was treated with intravenous acyclovir 7 days and then orally. On the second day following intravenous acyclovir discontinuation confusion, cerebelar ataxia somnolescence and VZV encephalitis was diagnosed. The other 38-year-old patient developed neuroleukemia and VZV encephalitis without skin rash after completion of induction chemotherapy. In both patients the diagnosis was confirmed by polymerase chain reaction (PCR) for VZV DNA in serum and liquor. The first patient completely recovered after reinstitution of intravenous acyclovir while the other patient a month later. This is unusual presentation of VZV encephalitis occurring in a patient with AML after standard induction remission chemotherapy which implies the significance of early diagnosis and screening for viral infections in AML patients with unusual neurologic presentation even in absence of rash. The screening for viral infections should be performed because antiviral prophylaxis is not routinely recommended for AML during standard induction chemotherapy by most clinical guidelines. © 2013 Elsevier Masson SAS.


Stijak L.,University of Belgrade | Bumbasirevic M.,Clinical Center for Serbia | Kadija M.,Clinical Center for Serbia | Stankovic G.,University of Belgrade | And 2 more authors.
Vojnosanitetski Pregled | Year: 2014

Background/Aim. The anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee, representing 50% of all knee injuries. The aim of this study was to determine the differences in the morphometry of knee injury patients with an intact and a ruptured anterior cruciate ligament. Methods. The study included 33 matched pairs of patients divided into two groups: the study group with the diagnosis of anterior cruciate ligament rupture, and the control group with the diagnosis of patellofemoral pain but no anterior cruciate ligament lesion. The patients were matched on the basis of 4 attributes: age, sex, type of lesion (whether it was profession-related), and whether the lesion was left- or right-sided. Measurements were carried out using magnetic resonance imaging (MRI). Results. The anterior and posterior edges of the anterior cruciate ligament in the control group were highly significantly smaller (p < 0.01; in both cases). The control group showed a statistically significantly larger width of the anterior cruciate ligament (p < 0.05). A significant correlation between the width of the anterior cruciate ligament and the width (p < 0.01) and height (p < 0.05) of the intercondylar notch was found to exist in the control group, but not in the study group (p > 0.05). The patients in the control group showed a shorter but wider anterior cruciate ligament in comparison to their matched pairs. The control group of patients was also characterized by the correlation between the width of the intercondylar notch and the width of the anterior cruciate ligament, which was not the case in the study group. Conclusions. According to the results of our study we can say that a narrow intercondylar notch contains a proportionally thin anterior cruciate ligament, but we cannot say that this factor necessarily leads to rupture of the anterior cruciate ligament.


Colovic M.,University of Belgrade | Todorovic M.,University of Belgrade | Todorovic M.,Clinical Center for Serbia | Colovic N.,University of Belgrade | And 4 more authors.
Polish Journal of Pathology | Year: 2014

Immunosuppressive therapy is one of the standard therapy protocols for aplastic anemia (AA). However, immunosuppressive therapy and androgenic steroids can promote development of solid tumors such as squamous carcinoma, head and neck tumors, adenocarcinoma of the stomach, hepatocarcinoma and breast carcinoma in long surviving patients with aplastic anemia. We present here arare case of a56-year-old woman in whom bilateral adenocarcinoma of the breast developed 11 years after the start of immunosuppressive and androgenic steroid therapy for aplastic anemia. Histological examination showed invasive ductal carcinoma with intense nuclear staining for estrogen receptors. Her2 immunohistochemistry was positive for 80% of stained cells, and chromogenic in situ hybridization showed ahigh level of HER2 gene amplification. This case indicated that anew therapy option is needed for estimation and evaluation to avoid the consequence of cancer occurrence.


Rakic V.S.,Clinical Center for Serbia | Colic M.M.,Clinical Center for Serbia | Lazovic G.D.,Clinical Center for Serbia
International Wound Journal | Year: 2011

Only a few papers have been published about unusual localisations of pressure ulcer. To date, no papers were published presenting pressure ulcer on external genitals in women. The paper presents the mechanism of origin of vulval pressure ulcer, surgical treatment (excision of lesion tissue of the pressure ulcer) and reconstruction of the vulva. The patient, aged 50, has been paraplegic for 20 years. During the last 3 years she has had a wound which was spreading in the region of the vulva. The pressure ulcer was surgically removed, external female genitals were reconstructed using advancement skin flap and the function and natural appearance of organs were re-established. The presence of all three aetiological factors for the formation of pressure ulcer - presence of prolonged pressure, swelling and infection - were proven in the described patient. For this reason, we are able to claim that this was in fact a pressure ulcer of the vulva. Reconstruction was simple without any complications and donor-site morbidity. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.


PubMed | Clinical Center for Serbia
Type: Case Reports | Journal: International wound journal | Year: 2011

Only a few papers have been published about unusual localisations of pressure ulcer. To date, no papers were published presenting pressure ulcer on external genitals in women. The paper presents the mechanism of origin of vulval pressure ulcer, surgical treatment (excision of lesion tissue of the pressure ulcer) and reconstruction of the vulva. The patient, aged 50, has been paraplegic for 20 years. During the last 3 years she has had a wound which was spreading in the region of the vulva. The pressure ulcer was surgically removed, external female genitals were reconstructed using advancement skin flap and the function and natural appearance of organs were re-established. The presence of all three aetiological factors for the formation of pressure ulcer - presence of prolonged pressure, swelling and infection - were proven in the described patient. For this reason, we are able to claim that this was in fact a pressure ulcer of the vulva. Reconstruction was simple without any complications and donor-site morbidity.

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