Non Public Health Care Unit

Kielce, Poland

Non Public Health Care Unit

Kielce, Poland
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Wincewicz A.,Non Public Health Care Unit | Kowalik A.,Jan Kochanowski University | Kowalik A.,Holy Cross Cancer Center | Zieba S.,Holy Cross Cancer Center | And 4 more authors.
Polish Journal of Pathology | Year: 2016

Here we review prognostic and predictive aspects of mutated TP53 in Wilms’ tumor biology on the basis of the morphological report and molecular analysis of adult nephroblastoma (diffuse blastemal pattern) of a 37-year-old man. Among quite different proteins, TP53 affects expression of several genes such as hypoxia inducible proteins GLUT1 and EPO as well as multidrug resistance (MDR) mediated by P-glycoprotein (Pgp/MDR1) and multidrug-resistant related protein (MRP1), with certain clinical implications. TP53 mutation was found both in our primary tumor (c.746G>T p.R249M frequency 92%) and in nodal metastasis (c.746G>T p.R249M frequency 90%), and the common polymorphism p.P72R in the same gene was revealed with frequency of about 97% in both primary tumor and metastatic disease with appliance of NGS technology (IonTorrent – LifeTechnology) using Ion AmpliSeq Cancer Hotspot Panel v2. © 2016, Versalius University Medical Publisher. All rights reserved.


Wincewicz A.,Non Public Health Care Unit | Kowalik A.,Jan Kochanowski University | Kowalik A.,Holy Cross Cancer Center | Zieba S.,Holy Cross Cancer Center | And 3 more authors.
Romanian Journal of Morphology and Embryology | Year: 2016

Here we present a report of 61-year-old female patient. Uterus with left appendages was removed together with clinically tagged “tumor of right ovary” and then extensively sampled and routinely processed with Hematoxylin-Eosin (HE) and some additional staining. There was discernible oviduct adherent to grayish, solid, polycyclic 22 cm in diameter focally necrotic tumor to be diagnosed high-grade conventional leiomyosarcoma FNCLCC (Fédération Nationale des Centres de Lutte Contre le Cancer) G3 pT2b, according to 7th edition pTNM, according to World Health Organization (WHO) 2013 International Classification of Diseases for Oncology (ICD-O): 8890/3, in nearby of right oviduct. Grade of differentiation was given according to FNCLCC classification: grade 3 {point score: 6 = 1 [microscopically necrosis comprised 10% of the tumor] + 3 [high mitotic index eight mitoses/one high-power field (HPF) in hot spots in HE slides; Ki67 labeled approximately 60% of tumor cells] + 2 [histopathological type: conventional leiomyosarcoma]}. The staging was more appropriate for pT2b (7th edition pTNM) for deeply seated sarcoma of soft tissues, in examined samples, there was no trace of microscopically evident ovarian texture) rather than pT1a for ovarian tumors. The tumor was alpha-smooth muscle actin (α-SMA)-positive. Detected epithelial membrane antigen (EMA) immunoreactivity indicates a possible change in mesenchymal origin. Next generation sequencing revealed tumor protein p53 (TP53) mutation C275Y (7577114 C>T). Each soft tissue malignancy should be carefully reported with appropriate choice of staging and precisely graded with internationally acknowledged classification. © 2016, Editura Academiei Romane. All rights reserved.


Wincewicz A.,Non Public Health Care Unit | Sulkowski S.,Medical University of Bialystok
Advances in Clinical and Experimental Medicine | Year: 2017

The roles of STAT (signal transducers and activators of transcription) proteins are widely discussed in relation to other agents like IFN-ã that are involved in cardiovascular diseases. STAT3 protects cardiomyocytes during endotoxic shock and ischemia and prolongs survival of these cells by activation of antiapoptotic genes like Bcl-2 and c-Fos. Moreover, IL-6 dependent expression of STAT3 is probably responsible for hypertrophy of cardiomyocytes. On the contrary, STAT1 mediates cell death by induction of caspase-1. STAT6 probably enhances cellular damage in myocardial infraction, which is significantly reduced in mice with the knockout STAT6 gene. Considering these facts, we attempted to review in this paper the role of STAT proteins in myocardial remodeling, highlighting STAT3 as a potent mediator of cardioprotection. Our review also aims to acquaint a broad audience of internal medicine practitioners with the STAT3-related molecular mechanisms that underlie the therapeutic properties of such widely administered drugs as angiotensin II type 1 (AT1) receptor antagonists and HMG-CoA reductase inhibitors, such as losartan and lovastatin. © 2017 by Wroclaw Medical University.


Wincewicz A.,Jan Kochanowski University | Wincewicz A.,Non Public Health Care Unit | Kowalik A.,Holy Cross Cancer Center | ZiEba S.,Holy Cross Cancer Center | And 5 more authors.
International Journal of Surgical Pathology | Year: 2015

Here we present the case of a 73-year-old woman with an ulcerated, advanced, hepatoid, and α-fetoprotein-producing poorly differentiated (G3) primary gastric adenocarcinoma pT3 N3a M1 with multinucleated cells and evident neuroendocrine component. This tumor was consistent with giant cell tumor type gastric carcinoma with osteoclast-like giant cells (OGCs). The cancer was HER2 and E-cadherin negative, chromogranin A dispersedly and moderately positive, and strongly α-fetoprotein-positive with evident CK AE1/AE3 immunoreactivity, while OGCs expressed CD68. To provide an insight into the molecular background of this peculiar neoplasm, next-generation sequencing (NGS) was performed to analyze the 50 most frequently mutated oncogenes and tumor suppressors. We detected mutations in the primary tumor in the following genes: KIT, EGFR, PTEN, ATM, and RB1. In the liver metastasis, we revealed mutations in 3 genes: PIK3CA, KIT, and CDKN2A. © The Author(s) 2015.


Lewitowicz P.,Jan Kochanowski University | Lewitowicz P.,Non Public Health Care Unit | Wincewicz A.,Non Public Health Care Unit | Wincewicz A.,Jan Kochanowski University | And 5 more authors.
Romanian Journal of Morphology and Embryology | Year: 2014

This report presents a case of 69-year-old woman, who was operated due to renal tumor. Apart from renal neoplasm, the adjacent adrenal gland contained another one tumor in medulla of the organ. The renal lesion was diagnosed renal cell carcinoma, clear cell type with undifferentiated cell sarcomatoid component. The adrenal neoplasm was composed of wavy S100-positive, Schwann-like cells and dispersed chromogranin A-reactive ganglion cells to be consistent with mature ganglioneuroma. It was accompanied by coexistent myelolipoma that contained hematopoietic cells including clearly visible megakaryocytes and foci of fat. To our knowledge, our paper is the first to report sporadic clear cell renal cell carcinoma with sarcomatoid cell type component and mature adrenal ganglioneuroma with myelolipoma in the same patient.


Wincewicz A.,Jan Kochanowski University | Wincewicz A.,Non Public Health Care Unit | Lewitowicz P.,Non Public Health Care Unit | Lewitowicz P.,Jan Kochanowski University | And 5 more authors.
Romanian Journal of Morphology and Embryology | Year: 2014

Background: Adenoid basal carcinoma (ABC) of uterine cervix is an extraordinary example of carcinoma with both basal and glandular cell types. Here we present such a case of ABC combined with invasive squamous cell carcinoma (SCC) of 55-year-old woman. Methods: The tumor was stained with Hematoxylin-Eosin (HE), Mucicarmine, PAS/Alcian Blue, CK AE1/AE3, CK7, CD117 and Ki67. Results: The whitishgrey 1 cm in-depth infiltration of endocervix was composed of infiltrative coalescing areas of CK AE1/AE3 positive carcinoma with peripheral palisading of basal cell type with spaces lined by Mucicarmine-and Alcian Blue-positive benign looking, glandular epithelium. There were also foci of apparently malignant squamous epithelium with evident dyskeratosis. Thus, a lesion was diagnosed of adenoid basal carcinoma combined with invasive squamous cell carcinoma foci of uterine cervix. The tumor was further CD117 negative what favored diagnosis of ABC over adenoid cystic carcinoma (ACC). There were rare mitoses on HE slides but 60% of all tumor cells were positive for Ki67 that would partially contradict reported benign nature of ABC lesion. Moreover, tumor was CK7-positive and this finding was controversial and according to one report favored diagnosis of ABC-like adenosquamous carcinoma (ACC). Due to CK7 positivity and high index of Ki67, the neoplasm was re-classified as adenoid basal carcinoma-like tumor. Conclusions: It seems reasonable to treat the patient in the same manner as in case of pure simple invasive squamous cell carcinoma because much more aggressive, minor component of invasive SCC was found within ABC in our case. © 2014, Editura Academiei Romane. All rights reserved.


Wincewicz A.,Jan Kochanowski University | Wincewicz A.,Non Public Health Care Unit | Lewitowicz P.,Jan Kochanowski University | Lewitowicz P.,Non Public Health Care Unit | And 3 more authors.
Romanian Journal of Morphology and Embryology | Year: 2015

Here we present a systematic approach to histopathological reporting of high-grade myxofibrosarcoma of 66-year-old male patient. The tumor was biopsied with fine-needle aspiration (FNA) and core-needle biopsy (CNB) and then the whole myxoid tumor was excised with left musculus gluteus maximus. The lesion was stained with Hematoxylin–Eosin (HE), Periodic acid–Schiff (PAS), Alcian blue, Masson’s trichrome, Ki67, alpha-smooth muscle actin (α-SMA), S100, CD34 and vimentin. FNA material grounded the diagnosis of non-epithelial neoplasia, while CNB was enough to produce diagnosis of myxoid sarcoma. The tumor lied under superficial fascia with no extension beyond deep fascia or any invasion of skin, vessels or nerves, either. The tumor was intramuscular, mainly myxoid with hypercellular areas of highly atypical cells with bizarre giant multinucleated cells that clearly belonged to category of high-grade sarcoma. According to Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC), the case was assessed for 5 points. Ki67 index reached more than 80% malignant cells. Alcian blue was strongly positive in myxoid background. Masson’s trichrome emphasized fibrillary structure of tumor. Negativity for S100, α-SMA with strong co-expression of CD34 and vimentin supported the diagnosis of myxofibrosarcoma. The lesion was diagnosed as high-grade myxofibrosarcoma (formerly myxoid malignant fibrous histiocytoma) G2 pT2b [7th edition pTNM (pathological tumor-node-metastasis), code ICD-O 8811/3 in World Health Organization (WHO) Classification 2013]. In approach to diagnosis of soft tissue malignancies, a strict sequence of procedures should be applied as only meticulous and ordered diagnostic pathway would succeed in and correct identification of a peculiar type of sarcoma. © 2015 ROMANIAN ACADEMY PUBLISHING HOUSE. All rights reserved.

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