Prevalence of pulmonary sequestration accounts for up to 6.4% of all congenital pulmonary malformations. We report on a 40-year-old woman who underwent excision of an aberrant solid retroperitoneal mass in the left subdiaphragmatic area. The mass was identified to be an extralobar pulmonary sequestration. The diagnosis could be made without surgery by percutaneous tissue biopsy and imaging. We encourage keeping in mind pulmonary sequestration anomaly presenting as an aberrant retroperitoneal mass. The aim of this case report is to increase awareness about the condition and review the criteria for its definitive diagnosis and treatment.

Background. Currently a particular interest is given to specific active cancer immunotherapy (therapeutic cancer vaccination) strategies such as treatment with specially “educated” autologous dendritic cells (DCs). The purpose of these vaccines is to enhance antitumor immune responses against the existing tumor. DC vaccines are composed of tumor antigen-loaded mature DCs, which are produced for each cancer patient individually. However, recent data indicate that there are at least two types of mature DCs  –  immunogenic, which activate antitumor immune responses, and tolerogenic, which suppress immune responses, thereby interfering with effector mechanisms of protective antitumor immunity. Hence, the aim of our study was to assess the expression of immunogenic and tolerogenic potential-representing markers on the surface of therapeutic DC vaccines generated using two different maturation approaches. Materials and methods. Two different DC maturation approaches were investigated: Cocktail 1, composed of lipopolysaccharide (200 ng/ mL) and interferon-γ (50  ng/mL), and Cocktail  2, composed of IL1β (10  ng/mL), IL-6 (10  ng/mL), TNF-α (10  ng/mL), PGE2 (1  μg/mL). Secretion of two basic cytokines – the immunostimulatory IL-12p70 and the immunosuppressive IL-10 – has also been investigated. Results. We show that a subset of immature DCs expressed tolerogenic markers. Importantly their expression profile considerably differed on mature DCs, depending on the maturation approach used. Conclusions. In particular, our results indicate that Cocktail  1 is superior to Cocktail  2 for the production of clinical-grade therapeutic cancer DC vaccines, both in terms of immunophenotypical attributes of DC tolerogenicity and their cytokine secretory profile.

Algimantas Sruogis1, Ugnius Mickys2, Tadas Petraitis1, Edita Kaubrienė3, Feliksas Jankevičius11 Vilniaus universiteto Onkologijos institutoUrologijos skyrius,Santariškių g. 1, LT-08661 VilniusEl paštas: sruogis@loc.lt2 Lietuvos nacionalinis patologijos centras3 Vilniaus universiteto Onkologijos institutoIntervencinės echoskopijos irultragarsinės diagnostikos skyrius Tikslas Nustatyti diagnostinius prostatos urotelio karcinomos kriterijus, diferencijuojant urotelio karcinomą, peraugančią šlapimo pūslės kaklelį ir prostatą, nuo prostatos adenokarcinomos, peraugančios šlapimo pūslę. Atvejis Pacientas, 37 metų, trejus metus gydytas nuo lėtinio prostatito. Prostatos sekrete nustačius atipinių ląstelių, įtarus prostatos vėžį, ligonis nusiųstas į VU Onkologijos institutą. Tyrimo pro tiesiąją žarną, cistoskopijos, rentgenologinio, ultragarso ir serumo žymenų tyrimo duomenimis, diddesnių pokyčių nerasta. Atlikus transuretrinę šlapimo pūslės gleivinės biopsiją (TUR) iš šlapimo pūslės sienelių, kaklelio ir šlaplės prostatinės gleivinės, histologiškai nustatyti normalūs urotelio audiniai. Šlapimo citologinis tyrimas buvo neigiamas. Atlikus transrektalinę prostatos biopsiją, diagnozuotas prostatos urotelio navikas, imunohistochemiškai neigiamas PSA (prostatos specifiniam antigenui) ir teigiamas citokeratinams CK8 ir CK HMW. Pacientui buvo atlikta radikali cistoprostatektomija, pašalinti dubens limfmazgiai ir suformuotas šlapimo nuotėkis į ileum segmentą, išvestą į priekinę pilvo sieną (Brycker būdu). Morfologinė diagnozė – prostatos urotelio karcinoma. Taip pat diagnozuota prostatos adenokarcinoma ir prostatos intraepitelinė neoplazija. Po 15 mėnesių PSA lygis buvo 0,2 ng/ml, jokių ligos progresavimo požymių nepasireiškė. Remiantis šiuo klinikiniu atveju straipsnyje apžvelgiama literatūra, aiškinantis prostatos urotelio karcinomos ir adenokarcinomos skirtumus. Išvados Diagnozuojant prostatos urotelio karcinomą reikia vadovautis tam tikrais kriterijais: 1) prostatos urotelio karcinoma turi būti verifikuota makro-, mikroskopiškai ir imunohistocheminiais metodais, 2) neturėtų būti kitų urotelio karcinomos židinių organizme. Būtent prostatos biopsija leidžia patologui nustatyti tikslią diagnozę prieš operaciją. Imunohistocheminis tyrimas padeda atlikti diferencinę diagnostiką. Po operacijos tiriant pašalintus audinius, diagnozė patikslinama histomorfologiškai, naudojant imunohistocheminius tyrimus, net jei ir labai retai nustatoma prostatos urotelio karcinoma. Reikšminiai žodžiai: prostatos vėžys, urotelio karcinoma, prostatos urotelio karcinoma, prostatos biopsija Prostate urothelial carcinoma diagnosed on prostatic needle biopsy. Case report with literature overview Algimantas Sruogis1, Ugnius Mickys2, Tadas Petraitis1, Edita Kaubrienė3, Feliksas Jankevičius11 Vilnius University Institute of Oncology,Urology Department,Santariškių str. 1,LT-08661 Vilnius, LithuaniaE-mail: sruogis@loc.lt2 Lithuanian National Centre of Pathology3 Vilnius University Institute of Oncology,Radiology Department Objective To establish criteria for the diagnosis of primary urothelial prostate carcinoma after the differential diagnosis including high-grade urothelial carcinoma extending into the bladder neck and prostate versus poorly differentiated prostate adenocarcinoma extending into the bladder. Case report The patient was a 37-year-old man with severe prostatism symptoms, who presented with an atypical seminal vesicles fluid cytological test result. The prostate was also normal by the digital examination, endoscopy, roentgenography, ultrasonography and serum markers. A diagnostic transurethral resection of bladder mucosa, bladder neck specimen revealed normal urothelial tissues. The urine cytological test result was negative. The transrectal biopsy of the prostate revealed an urothelial carcinoma with a negative staining of PSA (prostate-specific antigen) and positive of cytokeratins CK 8 and CK HMW. The patient subsequently underwent radical cystoprostatectomy and pelvic lymphadenectomy with ileal conduit m. Brycker creation. The histological diagnosis was the urothelial carcinoma of the prostate. Also, the prostate showed foci of High Grade PIN and prostate adenocarcinoma. After 15 months the patient has a PSA level of 0.2 ng/mL, no symptoms, no evidence of progression. Based on this case of the urothelial carcinoma of prostate, the literature was reviewed and the morphological differentiation between urothelial carcinoma and adenocarcinoma of the prostate was discussed. Conclusions The diagnostic criteria are the following: (1) the tumor should be a macro-, microscopically and imunohistochemically verified as urothelial carcinoma localized exclusively in the prostate gland; (2) there must be no other primary urothelial carcinoma in the body. These criteria can be readily applied when evaluating surgical resection specimens. With the use of radiologically guided or endoscopically derived biopsies, however, the pathologist is increasingly called upon to make a diagnosis before definitive surgical resection. In these circumstances, the pathologist will often resort to immunostains to help refine the differential diagnosis. Moreover, even when surgical resection specimens are evaluated, immunostains are still used in conjunction with histomorphology to confirm the diagnosis, particularly when a rare entity such as primary urothelial prostate carcinoma is encountered. Keywords: prostate cancer, urothelial carcinoma, prostate urothelial carcinoma, prostatic needle biopsy

Introduction. CD8 h CD57 + T-cell subpopulation and its functionally different subsets play an important role in antitumour immunity. The relation of competitive subsets may influence the overall effect of CD8 h CD57 + T-cell mediated antitumour immunity and determine an individual response to antitumour immunotherapy. The aim of this study was to evaluate the proportion of cytotoxic, immunomodulating and immunosuppressive subsets of the CD8 h CD57 + T-cell subpopulation in the peripheral blood of cancer patients and agematched healthy controls.Materials and methods. We studied the expression of biomarkers representing the cytotoxic (perforin), immunosuppressive (FOXP3, NKG2A) and immunomodulating (IFNγ) properties of CD8 + CD57 + T cells in the peripheral blood of 49 cancer patients: 30 with clear cell renal cell carcinoma (age median 58, range 43-81), 19 with high risk cutaneous melanoma (age median 68, range 45-86) and 26 controls (age median 55, range 41-81) by multicolour flow cytometry.Results. The percentage of immunosuppressive CD8 h CD57 + FOXP3 + T-cell subset in CD8 h CD57 + T-cell population varied. It was absent in 65% of controls, while only 23% and 26% of such patients were observed in renal cell carcinoma (RCC) and melanoma groups, respectively. Even 40% of RCC and 37% of melanoma patients had a high percentage of CD8 h CD57 + FOXP3 + T-cell subset, while in the control group we found no such subjects.The cytotoxic CD8 h CD57 + Perforin + T-cell subset was significantly increased in RCC patients, but showed no relevant rise in melanoma patients, whereas the immunomodulating CD8 h CD57 + IFNγ + subset was significantly increased in melanoma patients but showed no relevant rise in RCC patients when compared to controls.Conclusions. The amount of various functionally different subsets in CD8 h CD57 + T-cell subpopulation varies greatly among cancer patients. These differences may influence the overall CD8 h CD57 + T-cell mediated antitumour immune response and determine an individual response to antitumour immunotherapy.

Tadas PetraitisVilniaus universiteto Onkologijos institutas,Santariškių g. 1, LT-08660 Vilnius Vladas Lazutka (1948–2000) – šviesi asmenybė. Gimė Vilniuje. 1965 m. pasirinko medicinos studijas Kauno medicinos institute, 1970 m. jas tęsė Vilniaus universitete ir jį baigė 1972 m. Jis dėstė chirurgiją Vilniaus medicinos mokykloje ir dirbo Raudonojo Kryžiaus ligoninės Urologijos skyriuje, nuo 1979 m. – urologu Vilniaus universiteto Onkologijos institute. 1987 m. apgynė medicinos daktaro disertaciją. "Prostatos vėžio epidemiologija Lietuvoje". Nuo 1988 m. dirbo vyr. moksliniu bendradarbiu, o nuo 1997 m. – docentu. Savo didelę klinikinę praktiką docentas perteikė spausdintuose leidiniuose kurių yra daugiau kaip 100. Vladas Lazutka buvo ne tik puikus gydytojas, kolega, dėstytojas, bet ir šeimos žmogus. Reikšminiai žodžiai: urologija, prostatos vėžys, Vladas Lazutka, Onkologijos institutas In the memory of docent Vladas Lazutka Tadas PetraitisInstitute of Oncology of Vilnius University,Santariškių str. 1, LT-08660 Vilnius, Lithuania Vladas Lazutka (1948–2000) a bright personality. V. L. was born in Vilnius. In 1965 he began his studies of medicine at the Institute of Medicine in Kaunas, from 1970 he continued them at the Vilnius University, from which he graduated in 1972. He lectured surgery at the School of Medicine of Vilnius and worked in Red Cross Hospital, department of urology. Since 1979 V. L. worked as an urologist at the Institute of Oncology of Vilnius. In 1988 he defended his dissertation "Epidemiology of prostate cancer in Lithuania". Since 1988 V. L. worked as scientific researcher, and since 1997 as a docent. His large clinical practice was reflected in more than 100 publications. Vladas Lazutka was not only a perfect physician, colleague, teacher, but also a loving family man. Keywords: urology, prostate cancer, Vladas Lazutka, Institute of Oncology