Aim. To study the ex vivo effect of high temperature exposure (55–56 °C) combined with vancomycin on culture behavior of pathogenic Staphylococcus aureus (S. aureus).

Materials and methods. Liquid cultures of methicillin-resistant S. aureus (MRSA) strain 43300 were heated ex vivo at 55–56 °C for 0–60 min, either with or without vancomycin (20 μg/ml), followed by incubation at 37 °C up to 120 min. A control suspension (100 or 250 microbial cells per 1 ml of isotonic saline) was maintained at 37 °C. Then, cultures were seeded on solid agar medium, and colony-forming units (CFU) were calculated using computer morphometry after 48h growth. Each experimental subgroup (growth control, thermal ablation, antibiotic, and thermal ablation + antibiotic) included at least three replicates.

Results. A semi-lethal heat exposure time (LD50) of 12.25 min was determined for a liquid microbial culture at 100 cells/ml. When the density was increased to 250 cells/ml, 30 min thermal ablation (55–56 °C) was insufficient for MRSA growth suppression. Vancomycin (20 μg/ml) alone did not affect CFU output. However, combined heat and antibiotic treatment resulted in 28% bacteriostatic effect (p < 0.001) on agar medium.

Conclusion. The study revealed a bacteriostatic effect of combined use of high-temperature exposure with vancomycin, which were ineffective when used separately. The obtained results have practical significance for reconstructive surgery of bone tissue, but require additional studies to clarify the mechanisms of the discovered phenomenon.

Aim. To study the effects of local paricalcitol injections into the parathyroid glands on bone turnover in patients with chronic kidney disease (CKD) and secondary hyperparathyroidism (SHPT) with moderately elevated parathyroid hormone (PTH) levels (300–600 pg/mL).

Materials and methods. The study included 48 patients with end-stage CKD and SHPT with PTH levels of 300–600 pg/mL. All patients received standard medical therapy before the study, including correction of hyperphosphatemia, hypocalcemia, and disorders of calcium-phosphorus metabolism. The main group (n = 14) comprised patients for whom ultrasound-guided paricalcitol injections into the parathyroid glands were technically feasible. The dynamics of PTH levels, vascular calcification, bone mineral density (BMD), and levels of PTH, b-CrossLaps, and FGF23 were assessed.

Results. Multivariate logistic regression analysis demonstrated that osteoporosis and vascular calcification were significantly associated with age, PTH levels, dialysis duration, comorbidity index, b-CrossLaps, and FGF23. Threshold values for age and PTH were 33 years and 301 pg/mL for the development of osteoporosis and 29 years and 301 pg/mL for vascular calcification. Correlation analysis revealed a statistically significant relationship between FGF23 and dialysis duration, b-CrossLaps and PTH levels, as well as between FGF23 and b-CrossLaps. The comorbidity index also increased with age and PTH levels. After 3 and 6 months of treatment, PTH levels significantly decreased, while the volume of the parathyroid glands remained unchanged. No serious complications were observed after the injections, and transient local pain was reported in only 8 (57%) patients.

Conclusion. Ultrasound-guided paricalcitol injections into the parathyroid glands contribute to reducing PTH levels, improving bone remodeling parameters, and creating conditions for preventing cardiovascular complications. These findings require further investigation in larger-scale studies.

Aim. To study the cardiometabolic and echocardiographic characteristics of COVID-19 convalescents, including patients with the cardiovascular phenotype of post-COVID syndrome (PСS).

Materials and methods. The sample included 270 COVID-19 convalescents (62 without PСS and 208 with PСS). In the subgroup with PCC, 16 convalescents had a cardiovascular phenotype. The study took into account the data of anamnesis, anthropometry, several clinical and biochemical blood parameters, and instrumental diagnostic data (electrocardiography and echocardiography).

Results.       In the subgroup with PСS (n = 208), fasting plasma glucose levels were 1.10 times higher (p < 0.001), abdominal obesity (AO) was 5.52 times more common (p < 0.001), arterial hypertension (AH) was 4.96 times more common (p < 0.001), diastolic dysfunction grade I was 5.55 times more common (p = 0.002), and left ventricular hypertrophy was 7 times more common (p = 0.005). The indices of maximum blood flow velocity and pressure gradient in the pulmonary artery in convalescents with PCS were 1.08-fold (p = 0.020) and 1.14-fold (p = 0.043) lower, respectively. In COVID-19 convalescents with PCS (n = 16) and a cardiovascular phenotype, total cholesterol (TC) was 1.11 times higher (p = 0.039), low-density lipoprotein cholesterol (LDL-C) was 1.21 times higher (p = 0.004), high-density lipoprotein cholesterol (HDL-C) was 1.22 times lower (p = 0.040), non-highdensity lipoprotein cholesterol (non-HDL-C) was 1.24 times higher (p = 0.005) compared with patients without a cardiovascular phenotype. An increase in TC, LDL-C, and non-HDL-C and a decrease in HDL-C are associated with the cardiovascular phenotype of PCS regardless of gender, age, body mass index, and lipid-lowering therapy. Conclusion. According to the study, echocardiographic changes and cardiometabolic risk factors, such as AO, AH, and carbohydrate metabolism disorders, were more common in patients with PСS. The cardiovascular phenotype of PСS is associated with an increase in TC, LDL-C, non-HDL-C, and a decrease in HDL-C.

Aim. To evaluate the role of biochemical and biophysical parameters in the combined first-trimester prenatal screening for the development of clinical forms of fetal growth insufficiency.

Materials and methods. Group I (main) included 73 patients, whose pregnancies were complicated by the fetal growth insufficiency. The main group was divided into two subgroups: Ia with 30 patients whose pregnancies were complicated by fetal growth restriction (FGR) and Ib with 43 patients whose pregnancies were complicated by small for gestational age fetuses (SGA). Group II (control) included 118 patients whose pregnancies resulted in the birth of a live, full-term infant with normal height and weight. All patients underwent combined first-trimester prenatal screening with calculation of biochemical (pregnancy-associated plasma protein A (PAPP-A), free β-subunit of human chorionic gonadotropin (β-hCG) and biophysical (mean arterial pressure (MAP), uterine artery pulsatility index (PI) parameters, the values of which were subsequently analyzed.

Results. The level of PAPP-A was statistically significantly lower in the FGR group (0.793 MoM) compared to the control group (1.048 MoM), p = 0.005. The level of PAPP-A in the blood below 0.793 MoM increases the risk of fetal growth restriction by 3.244 times (odds ratio (OR) = 3.244; 95% confidence interval (95% CI) 1.394–7.554, p = 0.005). An increase in the pulsation index was found in Doppler ultrasound of the uterine arteries in patients with FGR compared to the SGA group (OR = 2.254; 95% CI 0.990–5.129, p = 0.017). Statistically significant differences were not found in the studied parameters of the combined first-trimester prenatal screening in relation to the development of SGA.

Conclusion. Differences in the biochemical and biophysical parameters of combined prenatal screening for the clinical forms of the fetal growth insufficiency were identified. Further research is needed to identify new prognostic markers of fetal growth insufficiency, which will help reduce perinatal losses. Additional research is required to expand the sample size of the Russian population to clarify the role of the prenatal screening components.

Aim. To study the ultrastructural features of rectal cancer cells and to detect signs of mitochondrial translocation from the tumor to the resection line area with an assessment of the possibility of the formation of new malignant cells. Materials and methods. The present study encompassed the data obtained from 44 patients with an average age of 66 (58–73) years, who underwent surgical intervention for rectal cancer T2–3N0M0 with differentiation grade G2. A portion of the tumor specimen and intestinal tissue along the resection line were preserved in a formaldehyde-glutaraldehyde fixative solution. Standard methods of section preparation were employed. Sections were subsequently examined using a Jeol JEM-1011 electron microscope (JEOL Inc., Japan).

Results. The ultrastructure of rectal adenocarcinoma was characterized by a high density of arrangement and varying sizes and shapes of tumor cells with a large nucleus and deep invaginations of the nuclear membrane, as well as an accumulation of multiple mitochondria at one of the cell poles. The process of pinching off a cytoplasmic fragment, which was found to be densely packed with mitochondria, was observed. This phenomenon was subsequently identified as a mitochondriome. Following this observation, the mitochondria were found to have translocated into healthy intestinal tissues along the resection line. Electron diffraction data revealed the active movement of mitochondria in the form of small spheroids and mitovesicles along the boundaries of the multilayer structure of the rectal submucosa, and subsequent fusion into large organelles capable of implementing nuclear synthesis from transported mitochondrial and nuclear DNA. We observed the presence of individual nuclear structures in conjunction with groups of mitochondria, followed by the self-assembly of abnormal cells.

Conclusion. The ultrastructural analysis of rectal adenocarcinoma indicates the need for mitochondrial translocation to free up intracellular space and prevent the metabolic threat of reactive oxygen species (ROS) accumulation in tumor cells. It also points to the key role of mitochondria in initiating tumor energy and information transfer as leaders of these processes. This observation suggests the possibility of early recurrence and metastasis in rectal cancer cases.

The aim of the study was to conduct a hydrodynamic assessment of the efficiency of heart valve prostheses made of xenopericardium protected by polyvinyl alcohol.

Materials and methods. Experimental prostheses based on the UniLine bioprosthesis model were manufactured for the study. The xenopericardium used for the valve cusps was modified with polyvinyl alcohol to improve its resistance to biological and mechanical effects. Hydrodynamic tests were performed on a Pulse Duplicator system, which simulates the function of the “left heart”. The key parameters of the prosthesis operation were estimated including average transprosthetic gradient, effective orifice area, locking volume, and regurgitant volume. Unmodified prostheses of similar size were used as a control.

Results. Hydrodynamic tests showed that the experimental prostheses demonstrate an increase in the average transprosthetic gradient to 6.59 mm Hg. (compared to 5.29 mm Hg in the control group) and a decrease in the effective orifice area to 1.52 cm² (1.69 cm² in the control group). The regurgitant volume also increased to 23.3 ml per cycle, which is higher than the control value of 12.2 ml per cycle. Despite this, all indicators remain within the permissible values established by the state standard (GOST).

Conclusion. The use of polyvinyl alcohol to protect the xenopericardium demonstrates potential advantages such as increased resistance of the material to biological effects, but is accompanied by some decrease in the hydrodynamics of the prosthesis. Nevertheless, the efficiency indicators remain within the standards, which opens up opportunities for further improvement of the technology. It is necessary to continue research in order to optimize the material and design to improve both the biocompatibility and functional characteristics of the prosthesis.

Aim. To analyze sources of information about antibacterial drugs and antibiotic resistance among the population in the Republic of Belarus.

Materials and мethods. The social study included 1,405 people from all regions of Belarus.

Results. The main sources of information about antibacterial drugs were doctor’s knowledge (59.4%), medication instructions (45.5%), the Internet (22.7%), and personal (past) experience of using antibacterial drugs (21.0%). In the extended analysis, it was found that in most cases, information about antibacterial drugs was received from a doctor by people with lower-middle income, medication instructions were used more often by respondents with upper-middle income, while individuals with higher education were more likely to receive information from the Internet.

Conclusion. To increase awareness of the population of antibacterial drugs, income, age, and socio-occupational characteristics should be considered. Working with health professionals is also essential: holding annual training events in medical organizations and pharmacies, organizing internships for professional development, conversations with patients during doctor’s visits, placing information about the correct use of antibacterial drugs in medical organizations in the form of posters, leaflets, and videos.

Background. Primary open-angle glaucoma (POAG) is optic neuropathy, the etiology of which is associated with genetic and non-genetic factors. IL-10 and MMP2 SNPs are associated with POAG, but the nature of the association depends on the ethnic profile of the population. For the Russian Federation, whose population includes 190 nationalities, this issue is relevant.

Aim. To perform a multicenter comparative analysis of the IL-10 and MMP2 SNPs as potential factors for predicting the development of POAG in patients in four regions of the Russian Federation: the Novosibirsk, Leningrad, and Orenburg Regions, and the Chuvash Republic.

Materials and мethods. We examined 499 POAG patients from 4 branches of S. Fyodorov Eye Microsurgery Federal State Institution (main group), 530 people without visual pathology (control 1), and 100 patients with cataracts (control 2). Genotyping of IL10 (rs1800896 and rs1800872 SNPs) and MMP-2 (rs243865) was performed by real-time polymerase chain reaction (RT-PCR) according to the manufacturer’s instructions (Lytex and Syntol, Russia). The differences were considered statistically significant at the Bonferroni-corrected p < 0.05.

Results. An increase in the incidence of IL-10-1082 A was revealed in POAG patients compared to patients with cataract and healthy individuals. An increase in the incidence of IL-10 AA in both regions and a decrease in the frequency of MMP2-1306 TT were found. Similar patterns were established for interlocus IL-10 and MMP2 genotypes. The group of patients in the Leningrad Region differed the most compared to other regions, which may be due to their long-term residence together with the indigenous Finno – Ugric peoples.

Conclusion. The data obtained should be taken into account when developing additional criteria for predicting predisposition to POAG, which is important in case of POAG in the family history.

Aim. To determine the most significant indicators for predicting a fatal outcome in patients with pneumonia caused by carbapenem-resistant K. pneumoniae.

Materials and мethods. A total of 114 cases of pneumonia caused by K. pneumoniae, including those associated with COVID-19, were retrospectively analyzed. Depending on the outcome of the disease, two groups were formed: group 1 included 54 patients discharged from the hospital upon completion of treatment; group 2 encompassed 60 patients with an unfavorable (fatal) outcome. Patients who did not have a concomitant COVID-19 infection were analyzed separately. The profile of concomitant diseases, hemogram parameters, C-reactive protein (CRP) level, and hematological indices (neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR)) were studied, and the risk of death according to the CURB-65 score was assessed.

Results. Patients with an unfavorable outcome were characterized by higher leukocyte and neutrophil counts, higher NLR, MLR, PLR, and CRP levels, higher risk according to the CURB-65 score, and lower lymphocyte and platelet concentrations. According to the results of the ROC analysis, the most significant prognostic indicators of an unfavorable outcome were lymphocytes, neutrophils, NLR, CURB-65, CRP, and TLR. The diagnostic value of the CURB-65 score (3–5 points) in predicting the risk of an unfavorable outcome was the following: test sensitive ity was 47.5%, specificity was 98.2%, positive predictive value was 96.6%, negative predictive value was 63.1%, accuracy was 71.7%. For NLR (at a threshold value > 6), sensitivity was 85.0%, specificity was 87.0%, positive predictive value was 87.9%, negative predictive value was 83.9%, accuracy was 86.0%. For MLR, the diagnostic accuracy was 79.0%, and for PLR – 73.7%.

Conclusion. The parameter of choice that can be used at the early stage to predict the fatal outcome of pneumonia caused by carbapenem-resistant K. pneumoniae should be NLR (> 6) due to its high sensitivity (85%) and specificity (87%) and ease of use. In addition, the CURB-65 score can be used at NLR > 3. 

Aim. To evaluate the wound-healing effect of substances based on lanolin and Ganoderma applanatum and Fomitopsis pinicola extracts.

Materials and Methods. The experiment used 20 white laboratory rats. The study included 3rd-degree burn modeling with wound exposure to an ointment containing Ganoderma applanatum and Fomitopsis pinicola extracts. A morphological investigation of skin was carried out with an assessment of the following parameters: epidermis thickness, fibroblast count, number of blood vessels, vessel area, and number of vessels with erythrocyte stasis, leukocyte stasis, and leukocyte diapedesis.

Results. Ganoderma applanatum and Fomitopsis pinicola extracts intensified regenerative processes. By day 14 of the experiment, epithelialization of the defect and scar formation took place. Application of the extract-containing ointments reduced exudation, microcirculatory disorders, and inflammatory infiltration.

Conclusion. The results suggested the beneficial effect of the Ganoderma applanatum and Fomitopsis pinicola extracts on the wound-healing process and demonstrated their potential for skin regeneration.

Aim. To investigate changes in laboratory parameters of sympathoadrenal system activity and β-adrenergic receptor reactivity of erythrocyte membranes (β-ARMe) in ischemic heart disease (IHD) patients with clinical forms of arterial hypertension of high cardiovascular risk during coronary artery bypass grafting with anesthetic management including nitric oxide.

Materials and мethods. In this randomized study with parallel distribution, 36 patients (male – 66.7%; average age – 68 [63; 70] years) with IHD and clinical forms of arterial hypertension of high cardiovascular risk were enrolled. According to the indications, all patients underwent elective coronary artery bypass grafting (CABG) using extracorporeal circulation (ECC). Patients were randomly divided into the main and control groups. Patients of the main group intraoperatively received NO at the concentration of 80 ppm first in the breathing circuit and then in the ECC circuit. Patients of the control group underwent CABG with standard mechanical lung ventilation and ECC. Before connecting to the ECC, at the end of ECC, and 1 day after CABG, all patients underwent clinical, laboratory, and instrumental tests in accordance with the clinical standards, β-ARMe was assessed, and the concentration of norepinephrine and epinephrine in the blood plasma was determined by ELISA.

Results. At the presurgical stage and 1 day after CABG, the groups did not differ in clinical and biochemical parameters. At the presurgical stage, the median values of β-ARMe in the main and control groups slightly exceeded the upper limits of normal and did not differ significantly. CABG was not accompanied by changes in β-ARMe in the control group. Intrasurgical NO donation also did not affect the level of β-ARMe. One day after CABG, neither intergroup differences in β-ARMe nor significant changes in the parameter during follow-up in each group were noted. In both control and main groups, a significant increase in the levels of epinephrine and norepinephrine was detected 1 day after CABG compared to the baseline level. At the same time, there were no intergroup differences in the level of catecholamines either before ECC or 1 day after CABG.

Conclusion. In cardiac surgery with extracorporeal circulation, the use of NO for the purpose of organ protection does not affect the level of β-ARMe and changes in the mediator response of the sympathetic system to stress in patients with IHD and clinical forms of hypertension of high cardiovascular risk.

Aim. To identify early clinical and laboratory predictors of death in patients with postoperative abdominal sepsis in the first 48 hours after its verification.

Materials and мethods. A retrospective study was conducted on 40 patients with abdominal sepsis hospitalized in the surgical department of Siberian State Medical University in 2019–2023. All patients were divided into groups according to the outcome of hospitalization (discharge or death). Clinical and anamnestic data, Sequential Organ Failure Assessment (SOFA) and quick SOFA (qSOFA) scores, and dynamic changes in biochemical and hematological markers were evaluated (T1– at verification, T2 – after 48 hours). The Mann – Whitney U test, χ² test, Wilcoxon test, and ROC analysis were applied.

Results. The mortality rate was 45%. Statistically significant predictors of mortality were: SOFA score > 4, serum urea > 12.1 mmol / l, calcium ≤ 1.8 mmol / l, platelet count ≤ 264 × 10⁹ / l, no platelet increase > 15 × 10⁹ / l, neutrophil reactivity intensity (NEUT-RI) > 57.6 fluorescence intensity (FI) at T1 and > 53.8 FI at T2. Prognostic values were also established for reticulocyte parameters and reactive lymphocyte content.

Conclusion. Early assessment of clinical and laboratory parameters, especially indicators of kidney function, calcium metabolism, blood count, and the intensity of the inflammatory response, has high prognostic value in postoperative sepsis and can be used for risk stratification and optimization of therapy.

The new coronavirus infection, COVID-19, led to a global pandemic in 2019–2023. The infection affects not only the lung tissue, but also other organs and systems, including the heart. This causes the frequent development of myocarditis, arrhythmia, and acute coronary syndrome in these patients, as well as worsening of coronary heart disease and chronic heart failure. One of the important mechanisms of heart damage in COVID-19 is the excessive activation of mast cells, which produce cytokines and chemokines with pro-inflammatory activity, thus causing a so-called “cytokine storm” – a special severe form of systemic inflammatory reaction that can be fatal.

The aim of the literature review was to analyze and summarize published data on cardiovascular complications in COVID-19, including the effect of mast cell proteases on myocardial damage.

Alcohol dependence remains a global medical and social issue, despite the advancements in studying its pathogenesis and the diversity of available treatment methods. This determines the relevance of further research aimed at revealing the complex neurobiological effects of ethanol on the human body. A fundamental knowledge of the mechanisms of formation and course of alcohol dependence is the theoretical basis for the development of new pathogenetically substantiated methods of prevention, diagnosis, and treatment of alcohol-related disorders, which will contribute to enhancing the social functioning of patients and reducing the economic burden of socially significant diseases.

The aim of the review was to analyze recent studies conducted by Russian and foreign authors on the role of neurotransmitters, neuroimmune inflammation factors, and endocrine regulation in the pathogenesis of alcohol dependence.

Cardiovascular diseases (CVD) remain the most pressing problem in the healthcare system. Complex interactions between changes in the intima – media thickness of arteries and blood components (accumulation of lipids, complex carbohydrates, fibrous tissue, calcification, etc.) are involved in the pathogenesis of CVD. Various biomolecules play a crucial role in the development and progression of coronary artery calcification, the most common calcification inhibitors being osteopontin, osteoprotegerin, sclerostin, fetuin-A, inorganic pyrophosphate, matrix Gla protein, fibroblast growth factor 23 (FGF-23), Klotho, bone morphogenetic proteins (BMP), in particular BMP7, and the most common activators being leptin, BMP-2, BMP-4, parathyroid hormone, calcitriol, etc. Currently, the most studied biomolecules associated with calcium metabolism are osteoprotegerin, osteopontin, osteonectin, osteocalcin, and Klotho protein.

The paper describes in detail the poorly studied effects of calcification inhibitors (sclerostin, fetuin-A, matrix Gla protein, FGF-23, inorganic pyrophosphate, BMP-7) and some calcification activators (leptin, BMP-2 and BMP-4, parathyroid hormone, and calcitriol).

The aim of this study was to analyze and systematize data on the role of biomolecules in the development and progression of vascular calcification in cardiovascular diseases.

Diagnosis and therapy of malignant neoplasms are increasingly focused on the use of molecular targets involved in the multistage process of tumor pathogenesis. Prostate-specific membrane antigen (PSMA) is currently one of such molecular markers for prostate cancer, and over the past two decades, there have been active developments in PSMA-directed theranostics for prostate cancer therapy. However, numerous studies in recent years have shown that PSMA, despite its name, is not a specific molecular marker only for prostate cancer screening. It was revealed that the expression of this receptor in other neoplasms is associated with neovascular endothelium, which was the prerequisite for the beginning of studies on the clinical application of PSMA-directed visualization of tumors with various localizations.

This lecture analyzes the possibilities of using PSMA-targeted radionuclide diagnosis for various histologic types of tumors, as well as the features of PSMA expression in some tumors. The authors of the lecture demonstrate existing clinical examples of the results of diagnostic studies and the use of targeted radionuclide therapy. The lecture presents possible applications of PSMA-targeted visualization methods for obtaining additional information about the features of the tumor process.

Search queries were conducted in the PubMed and eLIBRARY.ru databases using keywords, including publications from 2018–2024. A review of the literature on vitamin D deficiency in patients with tuberculosis (TB), human immunodeficiency virus (HIV), and TB/HIV combination is presented, which revealed heterogeneous prevalence. The roles of vitamin D in the body immune response to TB are shown depending on the presence of HIV infection. The data on the therapeutic use of single and prolonged administration of vitamin D at various doses in adjuvant TB therapy are presented. The prospects for the use of vitamin D in the combined treatment of TB patients are outlined depending on the HIV status, especially with multidrug-resistant pathogens requiring study in Russian clinical trials.

Dendritic cells (DCs) have been shown to play a pivotal role in orchestrating the immune response against tumors, thereby acting as a link between innate and adaptive immunity. DCs capture, process, and present tumor antigens to T cells, which triggers a specific immune response aimed at destroying cancer cells. DCs are a heterogeneous population that includes several subtypes, such as conventional DCs (cDC1, cDC2) and plasmacytoid DCs (pDC). Each subtype has unique functions: cDC1s specialize in activating CD8+ T cells, while pDCs produce interferons in response to viral infections. In a tumor microenvironment, DCs are often depleted of their functionality due to immunosuppressive factors, such as IL-6 and PGE2, which impedes their ability to activate T cells. Furthermore, an imbalance between oxidative phosphorylation and glycolysis regulated by the AMPK/mTOR axis may lead to the immunosuppressive phenotype of DCs.

A promising direction in cancer immunotherapy is the creation of DC-based vaccines that can restore the immunogenicity of cold tumors lacking T cell infiltration. Such vaccines can be created by generating DCs in vitro or modifying them to enhance the presentation of tumor antigens.

Despite significant advances, the biology of DCs remains poorly understood. This lecture highlights the importance of DCs in developing new cancer treatment strategies and opens up prospects for more effective immunotherapeutic approaches.

Primary diffuse leptomeningeal melanocytosis (PDLM) is a rare neoplastic lesion of the central nervous system, characterized by diffuse infiltration of the leptomeninges by melanocytes without apparent invasion into the brain parenchyma. Diagnosing the disease is challenging due to its nonspecific clinical presentation and the lack of clear neuroimaging criteria, necessitating morphological and immunohistochemical studies for definitive verification.

This article presents a clinical case of a patient with progressive neurological impairments, diagnostic challenges, and postmortem verification of PDLM. The key differential diagnostic aspects, the morphological structure of the tumor, and its immunohistochemical profile are described. Additionally, neuroimaging data are provided, demonstrating characteristic changes associated with PDLM. The presented clinical case highlights the necessity of a multidisciplinary approach to managing patients with chronic meningeal lesions of unknown etiology and underscores the importance of further research in molecular diagnostics and potential treatment strategies.