diagnosis reported as 3 years in patients with grade II BLTG (2,10).We present the case of a BLTG manifesting with fast progressive cognitive dysfunction leading to dementia in an elderly patient. █ CASE REpORTA 72-year-old right handed male, treated only for essential arterial hypertension stage I, presented 3 months prior to admittance, with gradual deterioration of the cognitive functions and intermittently aggressive behavior towards close relatives. The symptoms progressed gradually, with the patient not being able to perform basic everyday tasks and presenting periods of extreme agitation. █ INTRODUCTIONPrimary thalamic gliomas are rare and have been presented in recent reports with an incidence of 0.84-5.2% among all intracranial tumors (2,4,15,18).Bilateral thalamic gliomas (BLTG) constitute a unique intracranial tumoral pathology typically manifested by varying degrees of personality disorder. The rate of BLTG is much lower than that of unilateral thalamic glioma and cannot be objectively expressed in any way at present (4-7,13).Imaging in BLTG is typical and reveals large tumors with symmetrical and strictly limited involvement of bilateral thalami, without any apparent connecting tumoral tissue (2).The prognosis of BLTG is poor and a rapid fatal evolution has been observed (14) with the longest period of survival after the Bilateral thalamic glioma is extremely rare and the incidence cannot be adequately expressed. We present the case of a 72 years old male suffering from the rapid deterioration of cognitive function to moderately severe dementia in a short period of time. Magnetic resonance studies demonstrated a bilateral thalamic glioma with a minimal focal gadolinium uptake in the left thalamus. Biopsy was performed and pathology report was of anaplastic astrocytoma, WHO grade III. Radiotherapy was proposed but was rejected by the patient's relatives. The patient deceased 57 days later. We performed an extensive review of the literature and by updating the previous described series we can state that to the best of our knowledge this is the 60th case described in the literature and the second eldest patient presented. Patients suffering from this disease present a poor prognosis, the longest survival described being of 3 years in patients diagnosed with grade II bilateral thalamic glioma. Adjuvant therapy in form of radiotherapy to the thalami is most commonly used but the benefits are unclear. The natural progression of WHO grade III bilateral thalamic glioma left untreated, as can be seen from our case, has an even poorer outcome.

BackgroundFine needle aspiration (FNA) cytology is a well-established diagnostic method based on the microscopic interpretation of often scant cytological material; therefore, experience, good technique and smear quality are equally important in obtaining satisfactory results.Aims of StudyWe studied the use of fresh surgical pathology specimens for making so-called mock-FNA smears with the potential of cytohistological correlation. Additionally, we studied how this process aids the improvement of preparation technique and smear quality.MethodsCytological aspirates from 32 fresh biopsy specimens from various sites: lung (20), lymph nodes (6), and breast (6) were obtained, all with a clinical diagnosis of tumor. Aspiration was performed from grossly palpable tumors. 25G needle and Cameco-type syringe holder was used with minimal or no suction.ResultsUnfixed surgical specimens provided sufficient cytological material that resulted in good quality smears. After standard processing of specimens into microscopic sections from paraffin embedded tissues, cytohistological case-series were created. No significant alteration was reported in tissue architecture on hematoxylin-eosin stained sections after the aspiration procedure. A gradual, but steady improvement was observed in smear quality just after a few preparations.Discussions and ConclusionsOur study proved that surgical specimens may be used as a source of cytological material to create cytohistological correlation studies and also to improve FNA cytology skills. The use of very fine gauge needle (25G, 0,6 mm diameter) during the sampling process does not alter tissue architecture therefore the final histopathological diagnosis is not compromised. We conclude that by using fresh surgical specimens useful cytohistological collections can be created both as a teaching resource and as improving experience.

Although head and neck cancers have a rising incidence, these diseases are less investigated because of their localisations’ heterogenity. The major risk factors susceptible to influence the evolution of the disease are smoking, alcohol consumption and infection with human papilloma virus. Using data from Mures County Emergency Hospital’s histopathology register, we made a retrospective study of 190 cases from the last two years. Factors of interest included age, sex, localization, histopathological subtype and differentiation grade. Median age at diagnosis was 61.31 years, the disease presenting highest incidence in the 51-60 age subgroup and a clear male predominance (5.75:1). The most frequent localization is lower lip (28%) and the dominant histopathological subtype is cheratinised squamous cell carcinoma (83,8%) and G2 differentiation grade (48,1%). This study supports the finding of increased incidence of cheratinised squamous cell carcinoma in this region. However the literature emphasizes rising incidence of head and neck cancer in younger, we observed that increase in Mures area occurred in 51-60 age group. Lower lip most frequent localization makes possible an early diagnosis.