BACKGROUND:Tumor-infiltrating lymphocytes (TIL) in tumour stroma are considered to be involved in the elimination of malignant cells and prevention of metastasis formation. TIL consist of T lymphocytes including cytotoxic lymphocytes that are a constituent part of the effector mechanism of anti-tumour immunity and B lymphocytes that can form tertiary lymphoid structures (TLS). TLS has been described in several solid tumours and colorectal carcinoma (CRC), and the influence on the local and systemic anti-cancer response.AIM:This study aimed to quantify the presence of TLS in CRC patients and to determine their role in tumour progression.PATIENTS AND METHODS:The study included 103 patients with CRC who underwent surgery at the University Clinic of Digestive Surgery in Skopje, whose operative material was analysed at the Institute of Pathology, Medical Faculty in Skopje. The density of TLS was determined and correlated with the neoplasm status of local growth (T), positive lymph nodes, lymphatic invasion, and stage of the disease and tumour grade.RESULTS:The density of TLS was significantly higher in patients with higher stage, lower T status, and negative lymph nodes, in patients with no lymphatic invasion and with better-differentiated tumours.CONCLUSION:The density of TLS plays an important role in controlling the tumour growth, and it can be a parameter for neoplasm progression in CRC patients. The density of TLS influences the control of tumour progression.

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BACKGROUND:The understanding of the etiopathogenesis of gastric carcinoma (GC) can be a base for development of new therapeutic methods to reduce mortality and to increase survival in patients with GC. The percentage of Epstein - Barr virus (EBV) positive gastric carcinomas is uncertain, and the etiologic importance of EBV in the pathogenesis of GC has still not been elucidated.AIM:This study aimed to determine the percentage of EBV associated GC as well as to determine their clinicopathological characteristics.MATERIAL AND METHODS:The study included 80 patients with GC who were analysed for ethnicity, local growth of a tumour (T status), the presence of nodal metastases (N), the presence of distant metastases (M), stage of the disease and degree of carcinoma differentiation. For detection of EBV, immunostainings were performed on tumour tissue and the peripheral non-tumour gastric mucosa.RESULTS:Positive immunostaining with an antibody against EBV was found in 19 (23.75%) of the 80 patients with gastric carcinomas. EBV immunostainings were significantly different in patients with or without metastasis and between patients of Macedonian and Albanian ethnicity (p < 0.0001, p < 0.009, respectively). EBV immunoexpression was significantly associated with the presence of distant metastases and with patients of Albanian ethnicity.CONCLUSION:Association of EBV immunostainings with distant metastasis in patients with GC suggests the influence of EBV infection on the progression of gastric carcinoma. Due to scarce and doubtful literature data on EBV associated GC, further studies are necessary to determine the role of EBV regarding aetiology, treatment and prognosis in patients with EBV associated gastric carcinoma.

Background: Retroperitoneal sarcomas are neoplasms that occupy only 0.3 -3% of all solid tumors. Liposarcomas are the most frequent soft tissue sarcomas in adults. Symptoms would only be detected if the liposarcoma infiltrates on the surrounding organs. Case presentation: 58-year-old woman presented with complaints of progressive abdominal distension, loss of appetite, malaise, constipation and weight loss of about 7 kg. Abdominal CT scanning showed the presence of a retroperitoneal tumor that occupied almost the entire right part of abdominal cavity. 16 months earlier, the patient was operated in another surgical facility due to liposarcoma, derived from retroperitoneum (Histopathological finding: Poorly differentiated (G3) liposarcoma pleomorphic cell type). The patient was operated under the diagnosis of retroperitoneal liposarcoma. Conclusions: Treatment of choice is radical surgical procedure including elimination of all the structures and organs involved by the tumour process -RO resection as a basic principle of surgical treatment.

Primary retroperitoneal tumors are an exceedingly rare clinical problem. Masses in the retroperitoneum can be categorized as one of three entities: lymphomas, extragonadal germ cell tumors, and sarcomas. Malignant peripheral nerve sheath tumors are uncommon, biologically aggressive soft tissue sarcomas of neural origin that pose tremendous challenges to effective therapyWe present a young adult with retroperitoneal tumor. The patient presented a lumbar pain on the left side. Echotomography of the abdomen was madeand cystic tumor under the pancreas was detected. CT showed retroperitoneal tumor with hypodense features,with defined borders with size of 5,6x9,6 cm. Blood results and tumor markers showed no abnormalities. The patient had a surgery and whole extirpation was made without damaging the surrounding organs.This case illustrate early diagnosis of MPNST is key to reduce mortality, with complete surgical extirpation with clear margins as treatment of choice.