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.

1 JZU Univerzitetska klinika za digestivna hirurgija, 2 JZU Univerzitetska klinika za nefrologija, "Sv. Kiril i Metodij", Medicinski fakultet Skopje, Republika Makedonija Apstrakt Voved. Normalnata anatomija na дuktus цistikus (DC) e opi{ana odamna а osnovnite postulati se validni i deneska: prose~na dol`ina 2-4 cm, kalibar 1-1,5 mm, a volumenot e reduciran so spiralni mukozni nabori na Haister. Anatomskite varijanti na DC i negovata aberantna insercija vodat do konfuzija pri predoperativnite imixing isleduvawa, i neprijatna situacija pri hirur{kite intervencii, koga hirurgot mora da ja potvrdi sigurnata identifikacija na anatomskite strukturi, so cel da odbegne jatrogena bilijarna lezija. Celta na ovaa na{a prospektivna, oпservaciona studija be{e utvrduvawe na eventualnata vrska pome|u niskata insercija na duktus cistikus vo duktus hepatikus komunis, od edna strana, i prisustvoto-pojavata na karcinom na glavata na pankreasot, od druga strana. Metodi. Vo tekот na studijata isledivme 21 pacient so pankreati~en cefali~en karcinom (PCK). Inkluzioniot kriterium be{e dijagnosticiran PCK vo operabilen stadium. Metodata za odreduvawe na vlivot na DC vo дuktus хepati-kus кomunis (DHK) se sostoe{e od ultrazvuk, endoskopska retrogradna holangiopankreatografija, kompjuterski i magnetni isleduvawa za natamo{na hirur{ka intervencija. Rezultati. Kaj 6 pacienti (>28%), pronajdovme нiska иnsercija na дuktus цistikus (NIDC) kaj koi hirur{ki se napravi еkstenzivna рadikalna дuodenopankreatektomija (ERDP). Kaj 4 pacienti (3 ma`i i 1 `ena), postoe{e NIDC so kompletna dilatacija na bilijarnoto steblo, vklu~uvaj-}i go i DC, DHK i `ol~noto }ese, dodeka kaj 2 ____________ Korespondencija i reprint do: Aleksandar [umkovski, JZU Univerzitetska klinika za digestivna hirurgija, "Vodwanska" 17, 1000 Skopje, R. Makedonija; Tel.: 00 389 2 31 47 025; E-mail: aleksum@yahoo.com pacienti, DC i negovata niska insercija bea otsutni na slikite-ERCP kako posledica na tumorskata nagorna invazija na NIDC. Zaklu~ok. Vo sporedba so drugi referentni radiolo{ki i anatomski studii na{ite rezultati zna~ajno se razlikuvaat vo odnos na ~esto-tata na NIDC {to delumno mo`e da se dol`i na brojnite i razli~ni kriteriumi i definicii {to e NIDC. No, ovaa razlika mo`e da bide uslovena i od eventualno postoјната vrska pome|u NIDC i pojavata na PCK od druga strana. Zatoa, potrebni se studii so pogolem broj pacienti (anatomski, patolo{ki, a i genetski), koi bi ja potvrdile ili pak otfrlile pretpostavenata vrska me|u ovie два entitetа-NIDC i PCK.Klu~ni zborovi: нiska insercija, дuktus цistikus, дuktus хepatikus, пankreati~en cefali~en karcinom, ERCP, ekstenzivna duodenopankreatektomija ___________________________________________ Abstract Introduction. The normal anatomy of the cystic duct (CD) has been described a long time ago, but the basic description is valid up today: average length 2-4 mm, caliber 1-1.5 mm, and reduced volume by the spiral mucous folds of Heister. Anatomic variants of the CD and its aberrant insertion lead to confusion during preoperative imaging e...

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.

BACKGROUND:HER2 protein expression in gastric carcinoma, in correlation with existing, acknowledged prognostic factors which include the parameters that determine the TNM stage of the disease, could become the basis for ongoing research in the field of molecular targeted and personalised therapy.AIM:To determine the expression of the HER2 protein in gastric carcinoma and to correlate the expression of a HER2 protein with clinicopathological characteristics of the disease.MATERIAL AND METHODS:The data of HER2 protein expression and the parameters of the TNM classification were obtained from the histopathological reports of the Institute of Pathology in Skopje, and for the clinical stage we used patient’s files from the University Clinic for Abdominal Surgery in Skopje.RESULTS:The analysis of the correlation of HER2 protein expression and TNM classification parameters pointed out a significant correlation between HER2 protein expression and intragastric localisation of gastric carcinoma (P = 0.005), and the tumour grade of differentiation (P = 0.034). There was also a positive correlation between HER2 protein expression pattern and positive lymph nodes in patients with gastric carcinoma (P = 0.03). The expression pattern of HER2 +++ was significantly more common registered in patients with positive lymph nodes (P = 0.03)CONCLUSION:The expression of HER2 protein could represent a biological marker with prognostic and predictive value in patients with gastric carcinoma. Considering the high mortality rate in patients with gastric carcinoma and lack of international standardised therapeutic approach, research of the role and significance of HER2 overexpression and Trastuzumab therapy may prove useful in the development of new therapeutic strategies.