The University of Zagreb was founded in 1669 by Jesuits during the reign of king
Leopold of Austria. It was only in 1917 the Medical School was founded with the
Institute and University Department of Pathology becoming functional as of 1922. The
first Head of the Institute was Professor Sergei Saltykow. Russian by birth, he was
educated and working in many famous institutions of that time, including the
laboratories of Mechnikow, Pasteur, Ribbert and Kaufmann. In 1965, the clinical
disciplines were organizationally separated in the Clinical Hospital Center Rebro
(KBC Rebro) later KBC Zagreb. The Pathology Department was split in two with one
remaining the Institute of Pathology of the Medical School giving pathology service
mainly to outside hospitals and the other becoming the Clinical Department of
Pathology giving pathology service to the clinical units of KBC Rebro. Staff members
are serving both departments.
The accessed period includes years 1999 till 2018. During this period several
pathologist were members of the team, which was established years before by
Professor Bogdan Krstulovic, followed by Dr Mira Devcic. Staff members were in
historical order Spomenka Manojlovic, Sven Seiwerth, Simun Krizanac, Zdenka Hutinec,
Luka Brcic and Lovorka Batelja. In its diagnostic work the team in a closest way
cooperates with the Department of Diagnostic and Interventional Radiology KBC
Zagreb, mostly with Professor Kristina Potocki. During the accessed period the team
was diagnostically covering several in-house and extramural surgically active
departments in Zagreb (Department of Orthopaedic Surgery, KBC Zagreb, Departments of
Oncology and Surgery Childrens Clinic Klaiceva, Departments of Surgery, Traumatology
and Neurosurgery KBC Zagreb, Trauma clinic Zagreb) as well as external hospitals
consultations (representing arr. 2.55 % of material).
The review includes 6449 patients with orthopedic diagnoses established in the
center. Of these, 54 % were diagnosed with tumors and 46 % with non-tumorous
disease. Synovial changes were the most common diagnosed pathology, and among tumors
and tumor-like lesions osteochondromas followed by osteosarcoma and ganglion cyst
followed by chondrosarcoma. The list including rare lesions (appearing with less
than 2 % in our material) is expectedly long.
In 2003 molecular diagnostics of bone tumors started with RT-PCR for EWS and SSX
translocations and since that time the spectrum of molecular investigations of bone
and soft tissue tumors is constantly increasing ([
Fig. 1
]). In 2013 FISH diagnostics for bone lesions was
introduced. The molecular diagnostics is performed on all type of material (liquid,
fresh, fresh frozen and FFPE as well as cytological preparations – smears and
cytoblocks).
Fig. 1 Molecular Pathology in sarcomas
RT-PCR. SS = Synovial
Sarcoma, EWS = Ewing Sarcoma, ARMS = Alveolar Rhabdomyosarcoma, MyLPS =
Myxoid Liposarcoma, DSRCT = Desmoplastic Small Round Cell Tumor, LGFMS = Low
Grade Fibromyxoid Sarcoma, CCS = Clear Cell Sarcoma
Fig 2 Fluorescence in situ Hybridization (FISH). List of investigated
genes: EWSR1, FUS, MDM2, USP6, MAML2, ETV6, CIC, SS18, FOXO1.
Over years the team has produced or significantly taken part in scientific work
concerning the field of orthopaedics, producing a substantial number of
publications, both clinical and experimental [1],
[2], [3],
[4], [5],
[6], [7],
[8], [9],
[10], [11],
[12], [13],
[14], [15],
[16], [17],
[18], [19],
[20], [21],
[22], [23],
[24], [25],
[26], [27],
[28], [29], as
well as several PhD theses (four) mainly with clinical colleagues.
