Pub Date : 2021-01-01DOI: 10.31088/cem2021.10.s4.23-33
A. Chernyaev, M. Samsonova, A. Averyanov, M. Makarova, K. Mikhaylichenko
Introduction. Cystic lung diseases are rare (orphan) diseases. Lung cysts are an important X-ray and morphological sign that contributes to the correct diagnosis. The aim of the researchwas to describe histologic features and computed tomography findings in patients with pulmonary Langerhans cell histiocytosis (PLCH), lymphangioleiomyomatosis (LAM), primary malignant lung tumors, and endometriosis of the lung. Materials and methods. We evaluated video-assisted surgical lung biopsies from 139 patients, with 86 patients having LAM, 47 having PLCH, and in threes having primary peripheral lung adenocarcinoma and endometriosis of the lung. The average age of patients with LAM was 41±10 years, LCG – 32±11 years, lung adenocarcinoma – 62±3.5 years, and endometriosis of the lung – 32±4.1 years. All patients had undergone high-resolution computed tomography of the lungs (HRCT) before the biopsy was obtained. We performed histological and immunohistochemical examinations of lung tissue specimens. Antibodies to CD1a, SMA, HMB-45, CD207 (langerin), CD10, receptors to progesterone, and estrogen were used in the study. Results. We described HRCT, histological, and immunohistochemical features of cystic lung diseases, including characteristics of the walls of cystic cavities in patients with PLCH, LAM, primary malignant lung tumors, and endometriosis of the lung. Conclusion. The variety of causes of lung cysts required a differential diagnosis, considering the patients’ ages, HRCT data indicating the localization of the pathological process, histology, and immunohistochemistry if necessary. Keywords: сystic lung diseases, computed tomography, pathological anatomy, Langerhans cell histiocytosis, lymphangioleiomyomatosis, malignant tumors, endometriosis
{"title":"Anatomic pathology and computed tomography of diffuse cystic lung diseases","authors":"A. Chernyaev, M. Samsonova, A. Averyanov, M. Makarova, K. Mikhaylichenko","doi":"10.31088/cem2021.10.s4.23-33","DOIUrl":"https://doi.org/10.31088/cem2021.10.s4.23-33","url":null,"abstract":"Introduction. Cystic lung diseases are rare (orphan) diseases. Lung cysts are an important X-ray and morphological sign that contributes to the correct diagnosis. The aim of the researchwas to describe histologic features and computed tomography findings in patients with pulmonary Langerhans cell histiocytosis (PLCH), lymphangioleiomyomatosis (LAM), primary malignant lung tumors, and endometriosis of the lung. Materials and methods. We evaluated video-assisted surgical lung biopsies from 139 patients, with 86 patients having LAM, 47 having PLCH, and in threes having primary peripheral lung adenocarcinoma and endometriosis of the lung. The average age of patients with LAM was 41±10 years, LCG – 32±11 years, lung adenocarcinoma – 62±3.5 years, and endometriosis of the lung – 32±4.1 years. All patients had undergone high-resolution computed tomography of the lungs (HRCT) before the biopsy was obtained. We performed histological and immunohistochemical examinations of lung tissue specimens. Antibodies to CD1a, SMA, HMB-45, CD207 (langerin), CD10, receptors to progesterone, and estrogen were used in the study. Results. We described HRCT, histological, and immunohistochemical features of cystic lung diseases, including characteristics of the walls of cystic cavities in patients with PLCH, LAM, primary malignant lung tumors, and endometriosis of the lung. Conclusion. The variety of causes of lung cysts required a differential diagnosis, considering the patients’ ages, HRCT data indicating the localization of the pathological process, histology, and immunohistochemistry if necessary. Keywords: сystic lung diseases, computed tomography, pathological anatomy, Langerhans cell histiocytosis, lymphangioleiomyomatosis, malignant tumors, endometriosis","PeriodicalId":36062,"journal":{"name":"Clinical and Experimental Morphology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69279945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.31088/cem2021.10.s4.52-60
Е.L. Каzachkov, А.Yu. Shamanova, I. Panova, D. Rostovcev, Т. Shamaeva
Introduction. Choroidal melanoma is a malignant neoplasm of the eye’s vascular membrane. Prognosing and preventing metastasis are the main objectives of ocular oncology, aimed at maximizing the relapse-free survival of patients. Our goal was to determine the features of the cellular and stromal microenvironment of metastatic choroidal melanoma based on the immunohistochemical characteristics of surgical specimens. Materials and methods. We conducted a retrospective analysis of surgical specimens of cases of choroidal melanoma obtained from 2013 to 2017 and divided them into 2 study groups: group 1 included cases of choroidal melanoma without distant metastases (n=25) and group 2 involved cases of choroidal melanoma with distant liver metastases (n=18). The study was conducted using medical records analysis, histological, immunohistochemical, morphometric, and statistical research methods. Results. In group 2, the level of cells expressing CD4 markers – 138.5 (99.8;153.3), CD68 – 137 (99,5;173,8) and CD56 [5 (3;6)] prevailed significantly. The indicators of CD4 lymphocytes >95 and CD68 macro-phages >104 were found to allow the prediction of the appearance of distant choroidal melanoma metastases with the sensitivity of 83.3% and 72.2% and specificity of 76% and 76%, respectively. The indicators of the volume density of blood vessels in the tumor <3.9 (with a sensitivity of 77.8% and specificity of 64%) were of the same prognostic value. Conclusion. Metastatic choroidal melanoma is characterized by features of the cellular and stromal microen-vironment. Quantitative indicators of CD4 lymphocytes and CD68-macrophages and the volume density of blood vessels in the tumor have prognostic value with high sensitivity and specificity for predicting distant tumor metastasis. Keywords: choroidal melanoma, lymphocytes, macrophages, metastases, tumor blood vessels
{"title":"Cellular and stromal microenvironment of metastatic choroidal melanoma","authors":"Е.L. Каzachkov, А.Yu. Shamanova, I. Panova, D. Rostovcev, Т. Shamaeva","doi":"10.31088/cem2021.10.s4.52-60","DOIUrl":"https://doi.org/10.31088/cem2021.10.s4.52-60","url":null,"abstract":"Introduction. Choroidal melanoma is a malignant neoplasm of the eye’s vascular membrane. Prognosing and preventing metastasis are the main objectives of ocular oncology, aimed at maximizing the relapse-free survival of patients. Our goal was to determine the features of the cellular and stromal microenvironment of metastatic choroidal melanoma based on the immunohistochemical characteristics of surgical specimens. Materials and methods. We conducted a retrospective analysis of surgical specimens of cases of choroidal melanoma obtained from 2013 to 2017 and divided them into 2 study groups: group 1 included cases of choroidal melanoma without distant metastases (n=25) and group 2 involved cases of choroidal melanoma with distant liver metastases (n=18). The study was conducted using medical records analysis, histological, immunohistochemical, morphometric, and statistical research methods. Results. In group 2, the level of cells expressing CD4 markers – 138.5 (99.8;153.3), CD68 – 137 (99,5;173,8) and CD56 [5 (3;6)] prevailed significantly. The indicators of CD4 lymphocytes >95 and CD68 macro-phages >104 were found to allow the prediction of the appearance of distant choroidal melanoma metastases with the sensitivity of 83.3% and 72.2% and specificity of 76% and 76%, respectively. The indicators of the volume density of blood vessels in the tumor <3.9 (with a sensitivity of 77.8% and specificity of 64%) were of the same prognostic value. Conclusion. Metastatic choroidal melanoma is characterized by features of the cellular and stromal microen-vironment. Quantitative indicators of CD4 lymphocytes and CD68-macrophages and the volume density of blood vessels in the tumor have prognostic value with high sensitivity and specificity for predicting distant tumor metastasis. Keywords: choroidal melanoma, lymphocytes, macrophages, metastases, tumor blood vessels","PeriodicalId":36062,"journal":{"name":"Clinical and Experimental Morphology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69280004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.31088/cem2021.10.2.21-31
L. Mikhaleva, A. Konoplyannikov, Y. Kudryavtseva, A. Olenev, N. A. Gracheva, A. E. Biryukov, S. A. Mikhalev, E. Songolova
Introduction. Diseases directly related to pregnancy are still leading the maternеal mortality structure, al-though in many countries there is an increase in the number of deaths from extragenital pathology among pregnant women. A significant number of lethal cases in this group are associated with environmental factors, lifestyle, and the overall increase in somatic diseases. The aim of the study was to determine the main causes of maternal mortality and investigate the role of extragenital pathology based on autopsy data. Materials and methods. The study included 29 autopsy observations. We studied medical records, autopsy protocols of deceased pregnant women, women in labor, and puerperant women. Each cause of death was classified according to ICD-10. A clinical and morphological study was also carried out using additional histochemical and immunohistochemical staining methods. Results. The data from pathological studies show that in Moscow, extragenital pathology accounts for up to 40% of maternal deaths. The leading cause of death is circulatory system diseases, including an arteriovenous malformation; a myocardial infarction; a congenital heart disease (patent foramen ovale); cerebral, aortic, and splenic artery aneurysms. The second most common one is other specified diseases and conditions com-plicating pregnancy. This group of diseases included malignant neoplasms. Less common causes of death are gastrointestinal diseases, other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism that complicate pregnancy, and also respiratory diseases. A single case is associated with a generalized viral infection. Conclusion. Extragenital pathology remains an important obstetric problem, and the management of pregnant women with systemic diseases requires a multidisciplinary treatment approach. Keywords: maternal mortality, extragenital pathology, arteriovenous malformation, cerebral aneurysm, antiphospholipid syndrome
{"title":"Extragenital noninfectious pathology in the maternal mortality structure in Moscow","authors":"L. Mikhaleva, A. Konoplyannikov, Y. Kudryavtseva, A. Olenev, N. A. Gracheva, A. E. Biryukov, S. A. Mikhalev, E. Songolova","doi":"10.31088/cem2021.10.2.21-31","DOIUrl":"https://doi.org/10.31088/cem2021.10.2.21-31","url":null,"abstract":"Introduction. Diseases directly related to pregnancy are still leading the maternеal mortality structure, al-though in many countries there is an increase in the number of deaths from extragenital pathology among pregnant women. A significant number of lethal cases in this group are associated with environmental factors, lifestyle, and the overall increase in somatic diseases. The aim of the study was to determine the main causes of maternal mortality and investigate the role of extragenital pathology based on autopsy data. Materials and methods. The study included 29 autopsy observations. We studied medical records, autopsy protocols of deceased pregnant women, women in labor, and puerperant women. Each cause of death was classified according to ICD-10. A clinical and morphological study was also carried out using additional histochemical and immunohistochemical staining methods. Results. The data from pathological studies show that in Moscow, extragenital pathology accounts for up to 40% of maternal deaths. The leading cause of death is circulatory system diseases, including an arteriovenous malformation; a myocardial infarction; a congenital heart disease (patent foramen ovale); cerebral, aortic, and splenic artery aneurysms. The second most common one is other specified diseases and conditions com-plicating pregnancy. This group of diseases included malignant neoplasms. Less common causes of death are gastrointestinal diseases, other diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism that complicate pregnancy, and also respiratory diseases. A single case is associated with a generalized viral infection. Conclusion. Extragenital pathology remains an important obstetric problem, and the management of pregnant women with systemic diseases requires a multidisciplinary treatment approach. Keywords: maternal mortality, extragenital pathology, arteriovenous malformation, cerebral aneurysm, antiphospholipid syndrome","PeriodicalId":36062,"journal":{"name":"Clinical and Experimental Morphology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69279196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-23DOI: 10.31088/CEM2020.9.3.68-73
A. Kontorshchikov, A. Chernyaev, O. Vasyukova, Zh.R. Omarova
The article presents a clinical case of hypersensitivity pneumonitis complicated by a viral infection in a 72-year-old woman. The introductory part provides a concise literature review on the etiology, classification, frequency, and possible complications of hypersensitivity pneumonitis. The patient’s computed tomography (CT) lung scan showed bilateral interstitial lesions. The patient was diagnosed with idiopathic pulmonary fibrosis based on the clinical manifestations and radiological findings. The autopsy revealed morphological signs of hypersensitivity pneumonitis (obliterative bronchiolitis, moderate interstitial fibrosis with honey-combing, nonspecific interstitial pneumonia, giant multinucleated cells) and viral lung damage (exudative stage of acute respiratory distress syndrome with interalveolar edema, hyaline membranes lining the alveoli, pneumocyte desquamation, and ugly giant cells). Keywords: hypersensitivity pneumonitis, exogenous allergic alveolitis, viral infection, lungs
{"title":"Hypersensitivity pneumonitis complicated by acute respiratory viral infection","authors":"A. Kontorshchikov, A. Chernyaev, O. Vasyukova, Zh.R. Omarova","doi":"10.31088/CEM2020.9.3.68-73","DOIUrl":"https://doi.org/10.31088/CEM2020.9.3.68-73","url":null,"abstract":"The article presents a clinical case of hypersensitivity pneumonitis complicated by a viral infection in a 72-year-old woman. The introductory part provides a concise literature review on the etiology, classification, frequency, and possible complications of hypersensitivity pneumonitis. The patient’s computed tomography (CT) lung scan showed bilateral interstitial lesions. The patient was diagnosed with idiopathic pulmonary fibrosis based on the clinical manifestations and radiological findings. The autopsy revealed morphological signs of hypersensitivity pneumonitis (obliterative bronchiolitis, moderate interstitial fibrosis with honey-combing, nonspecific interstitial pneumonia, giant multinucleated cells) and viral lung damage (exudative stage of acute respiratory distress syndrome with interalveolar edema, hyaline membranes lining the alveoli, pneumocyte desquamation, and ugly giant cells).\u0000Keywords: hypersensitivity pneumonitis, exogenous allergic alveolitis, viral infection, lungs","PeriodicalId":36062,"journal":{"name":"Clinical and Experimental Morphology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41334455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-23DOI: 10.31088/CEM2020.9.3.61-67
D. Otlyga, O. Junemann, E. Tsvetkova, K. Gorokhov, S. Saveliev
Introduction. The carotid body is a chemoreceptor organ and the initial link of the reflex regulation of car-diovascular and respiratory systems. However, molecular genetic and immunohistochemical characteristics of the human carotid body remains underinvestigated. Although there are numerous studies of the second half of the 20th century devoted to the classical light-optical histology of the human organ, the immunohis-tochemical investigations are very few. The aim of our study was to clarify immunohistochemical features of the human carotid body in comparison with those of the most commonly used laboratory animals. Materials and methods. The study was performed on 10 carotid bodies of the adult human of different ages of both sexes using immunoperoxidase labeling with antibodies to bIII-tubulin, tyrosine hydroxylase, syn-aptophysin, PGP9.5, neurofilaments 200kDa, S100, and GFAP. Results. Nerve fibers passing between the lobules, as well as entering them, were positive for bIII-tubulin, tyrosine hydroxylase, PGP9.5 and neurofilaments. Type I cells had cytoplasmic reaction for bIII-tubulin and synaptophysin as well as cytoplasmic and nuclear staining for PGP9.5. At the same time, they had weaker reaction for tyrosine hydroxylase. Type II cells were positive for GFAP and S100. Conclusion. Immunohistochemical characteristics of the human carotid body were similar to those of rats and mice. The human carotid body cells and nerve fibers showed the same distribution of PGP9.5, bIII-tubulin, synaptophysin, neurofilaments, GFAP and S100 as rat and mouse carotid body cells. However, human carotid body reaction for tyrosine hydroxylase was much lower, which may indicate a smaller amount of synthesized catecholamines compared to the carotid body in rats and mice. Keywords: human carotid body, immunohistochemistry, sympathoadrenal system, tyrosine hydroxylase
{"title":"Immunohistochemical features of the human carotid body","authors":"D. Otlyga, O. Junemann, E. Tsvetkova, K. Gorokhov, S. Saveliev","doi":"10.31088/CEM2020.9.3.61-67","DOIUrl":"https://doi.org/10.31088/CEM2020.9.3.61-67","url":null,"abstract":"Introduction. The carotid body is a chemoreceptor organ and the initial link of the reflex regulation of car-diovascular and respiratory systems. However, molecular genetic and immunohistochemical characteristics of the human carotid body remains underinvestigated. Although there are numerous studies of the second half of the 20th century devoted to the classical light-optical histology of the human organ, the immunohis-tochemical investigations are very few. The aim of our study was to clarify immunohistochemical features of the human carotid body in comparison with those of the most commonly used laboratory animals. \u0000Materials and methods. The study was performed on 10 carotid bodies of the adult human of different ages of both sexes using immunoperoxidase labeling with antibodies to bIII-tubulin, tyrosine hydroxylase, syn-aptophysin, PGP9.5, neurofilaments 200kDa, S100, and GFAP.\u0000Results. Nerve fibers passing between the lobules, as well as entering them, were positive for bIII-tubulin, tyrosine hydroxylase, PGP9.5 and neurofilaments. Type I cells had cytoplasmic reaction for bIII-tubulin and synaptophysin as well as cytoplasmic and nuclear staining for PGP9.5. At the same time, they had weaker reaction for tyrosine hydroxylase. Type II cells were positive for GFAP and S100.\u0000Conclusion. Immunohistochemical characteristics of the human carotid body were similar to those of rats and mice. The human carotid body cells and nerve fibers showed the same distribution of PGP9.5, bIII-tubulin, synaptophysin, neurofilaments, GFAP and S100 as rat and mouse carotid body cells. However, human carotid body reaction for tyrosine hydroxylase was much lower, which may indicate a smaller amount of synthesized catecholamines compared to the carotid body in rats and mice.\u0000Keywords: human carotid body, immunohistochemistry, sympathoadrenal system, tyrosine hydroxylase","PeriodicalId":36062,"journal":{"name":"Clinical and Experimental Morphology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45083620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.31088/cem2020.9.2.40-51
Y. Osmanov, E. Kogan, G. Demyashkin, R. Nugumanov
Results. Based on the morphological analysis and immunohistochemical assay, the tumors were divided into 4 groups as follows: renal cystic tumors with low nuclear grading (n=65; 25%); tumors of a kidney of a solid and/or tubulo-papillary structure with low nuclear grading (n=98; 37%); renal tumors with high nuclear grading (n=94; 36%); and polyphase renal cell carcinomas (n=7; 2.7%). Conclusion. The results obtained suggest that there is a direct link between the degree of nuclear grading and the histological pattern of the tumor among the morphological forms of clear cell renal cell carcinoma.
{"title":"Morphological characteristics and immunophenotype of clear cell renal cell carcinomas","authors":"Y. Osmanov, E. Kogan, G. Demyashkin, R. Nugumanov","doi":"10.31088/cem2020.9.2.40-51","DOIUrl":"https://doi.org/10.31088/cem2020.9.2.40-51","url":null,"abstract":"Results. Based on the morphological analysis and immunohistochemical assay, the tumors were divided into 4 groups as follows: renal cystic tumors with low nuclear grading (n=65; 25%); tumors of a kidney of a solid and/or tubulo-papillary structure with low nuclear grading (n=98; 37%); renal tumors with high nuclear grading (n=94; 36%); and polyphase renal cell carcinomas (n=7; 2.7%). Conclusion. The results obtained suggest that there is a direct link between the degree of nuclear grading and the histological pattern of the tumor among the morphological forms of clear cell renal cell carcinoma.","PeriodicalId":36062,"journal":{"name":"Clinical and Experimental Morphology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69279425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.31088/cem2020.9.1.30-39
Y. Kirillov, I. Chernov, E. Malysheva, S. Timofeev, E. Startseva, O. Rozenberg
Results . Atelectasis occurred at the early stages of the experiment is surfactant-dependent, which is confirmed by the decreased amount of PS and PL in lavage fluid. The formation of atelectasis in later periods is caused by the obturation, narrowing of the lumen of the bronchi and bronchioles due to thickening of the epithelial lining and pronounced bronchial bronchoconstriction. Conclusion. Understanding the mechanisms of development of atelectasis is necessary in order to prevent the pathology described above and reduce the risk of complications.
{"title":"Development of pulmonary atelectasis after experimental radiation exposure","authors":"Y. Kirillov, I. Chernov, E. Malysheva, S. Timofeev, E. Startseva, O. Rozenberg","doi":"10.31088/cem2020.9.1.30-39","DOIUrl":"https://doi.org/10.31088/cem2020.9.1.30-39","url":null,"abstract":"Results . Atelectasis occurred at the early stages of the experiment is surfactant-dependent, which is confirmed by the decreased amount of PS and PL in lavage fluid. The formation of atelectasis in later periods is caused by the obturation, narrowing of the lumen of the bronchi and bronchioles due to thickening of the epithelial lining and pronounced bronchial bronchoconstriction. Conclusion. Understanding the mechanisms of development of atelectasis is necessary in order to prevent the pathology described above and reduce the risk of complications.","PeriodicalId":36062,"journal":{"name":"Clinical and Experimental Morphology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69279328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.31088/CEM2020.9.4.71-76
Z. Gioeva, A. Ephiev
Wild type transthyretin amyloidosis (ATTRwt) affects a number of target organs, most commonly the heart. Over the last years, autopsy findings revealed that the lungs are involved in the pathological process more frequently than diagnosed in premortem cases. Due to the nonspecific nature of ATTRwt clinical manifestations and the presence of multiple concomitant conditions in elderly people, the majority of patients are diagnosed at a late stage or the disease is overlooked. As a result, ATTRwt has emerged as a previously underestimated cause of morbidity and mortality in the older age group. This article presents a clinical case report describing an 88-year-old female patient with generalized transthyretin amyloidosis characterized by predominant cardiac and pulmonary involvement. The paper elucidates the difficulties associated with premortem diagnosis of this type of amyloidosis which include the absence of amyloid deposits in biopsy specimens from the rectum and subcutaneous fat. The specific information in this case report is focused on the discrepancy between clinical and autopsy diagnosis. Keywords: wild type transthyretin amyloidosis, cardiac amyloidosis, pulmonary amyloidosis, senile amy-loidosis, chronic heart failure
{"title":"Сardiopylmonary transthyretin amyloidosis","authors":"Z. Gioeva, A. Ephiev","doi":"10.31088/CEM2020.9.4.71-76","DOIUrl":"https://doi.org/10.31088/CEM2020.9.4.71-76","url":null,"abstract":"Wild type transthyretin amyloidosis (ATTRwt) affects a number of target organs, most commonly the heart. Over the last years, autopsy findings revealed that the lungs are involved in the pathological process more frequently than diagnosed in premortem cases. Due to the nonspecific nature of ATTRwt clinical manifestations and the presence of multiple concomitant conditions in elderly people, the majority of patients are diagnosed at a late stage or the disease is overlooked. As a result, ATTRwt has emerged as a previously underestimated cause of morbidity and mortality in the older age group. This article presents a clinical case report describing an 88-year-old female patient with generalized transthyretin amyloidosis characterized by predominant cardiac and pulmonary involvement. The paper elucidates the difficulties associated with premortem diagnosis of this type of amyloidosis which include the absence of amyloid deposits in biopsy specimens from the rectum and subcutaneous fat. The specific information in this case report is focused on the discrepancy between clinical and autopsy diagnosis. Keywords: wild type transthyretin amyloidosis, cardiac amyloidosis, pulmonary amyloidosis, senile amy-loidosis, chronic heart failure","PeriodicalId":36062,"journal":{"name":"Clinical and Experimental Morphology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69279544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.31088/cem2020.9.2.26-32
T. I. Shevchenko, D. S. Shvorob
Колоректальный рак занимает ведущие позиции в структуре заболеваемости и смертности среди онкологических заболеваний. Наличие метастатического поражения сильно ухудшает прогноз течения и исхода колоректального рака, являясь непосредственной причиной смерти у большинства пациентов. В обзоре литературы проанализированы имеющиеся в научных публикациях сведения о влиянии на процесс метастазирования колоректального рака таких клинико-морфологических факторов как пол и возраст пациента, макроскопический и гистологический тип опухоли, степень ее дифференцировки и локализация, степень инвазии, наличие изолированных клеток опухоли и опухолевого почкования, перитуморального фиброза и лимфоцитарной инфильтрации, состояние латерального края резекции, использование неои адъювантной химиотерапии, наличие осложнений. Результаты показали их значимость для прогнозирования метастатического потенциала опухоли, однако оценка, основанная на статистических показателях, позволяет определить лишь тенденцию развития процесса, интерпретируемую не всегда однозначно, не давая возможности комплексно учесть все факторы и их влияние на прогноз для конкретного пациента. Выход из ситуации видится в создании максимально многофакторной математической модели с использованием байесовского метода, позволяющего на основе «обучающего массива» количественно определить влияние каждого как квантитативного, так и квалитативного клинико-морфологического показателя, его информативность и их суммарную прогностическую значимость для оценки метастатического потенциала колоректального рака в конкретном клиническом наблюдении. Ключевые слова: колоректальный рак, метастазирование, прогноз, математическое моделирование. Для корреспонденции: Данил Сергеевич Швороб. E-mail: mcshady@mail.ru Для цитирования: Шевченко Т.И., Швороб Д.С. Клинико-морфологические факторы прогнозирования метастатического потенциала колоректального рака. Клин. эксп. морфология. 2020;9(2):26–32. DOI:10.31088/CEM2020.9.2.26-32
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Pub Date : 2020-01-01DOI: 10.31088/CEM2020.9.4.24-30
A. Asaturova, N. Faizullina, M. Bobkova, A. Arakelyan, A. Tregubova, T.Yu. Smol’nova, L. Adamyan
Introduction. Female patients with Mayer–Rokitansky–Küster–Hauser syndrome (MRKH) have high stigma scores; the condition severely affects the reproductive system. The study aimed at specification of morphological features and assessment of the maturity of connective tissues of the uterine rudiments in MRKH. Patients and methods. The study included 42 patients with vaginal and uterine aplasia having functioning uterine rudiments and 47 patients of the control group without genital malformations. Age of the patients was 20-24 years in 67.2% of the cases, and 31.2% of the patients were aged ≤ 19, inclusive. Immunohistochemi-cal assay was applied to determine expression levels of collagen I, collagen III, ММР2, ММР9, TIMP1, fibronectin and laminin proteins within the functioning uterine rudiments in comparison with levels of the same proteins in normally developed uterine tissues. Results. Decreased expression of collagen type I and elevated levels of MMP2 and MMP9 proteins in uterine tissues were observed for the group of patients with MRKH. Conclusions. 1) Uterine rudiments in patients with MRKH show variable degree of morphological similarity with the normally developed uterus; 2) The functioning uterine rudiments are subject to the same pathological processes as the normally developed uterus (myoma, endometriosis). 3) The functioning uterine rudiments in patients with MRKH show altered patterns of connective tissue remodeling, with decreased expression of collagen type I and increased expression of matrix metalloproteinases MMP2 and MMP9. Keywords: Müllerian aplasia, uterine rudiments, metalloproteinases, connective tissue remodeling, ММР2, ММР9
介绍。女性mayer - rokitansky - k ster - hauser综合征(MRKH)患者耻感评分较高;这种情况严重影响生殖系统。本研究的目的是规范MRKH子宫雏形结缔组织的形态特征和成熟度评估。患者和方法。本研究包括42例阴道和子宫发育不全，子宫功能正常的患者和47例无生殖器畸形的对照组。67.2%的患者年龄在20-24岁之间，31.2%的患者年龄≤19岁(含19岁)。应用免疫组化法测定功能性子宫内膜中胶原I、胶原III、ММР2、ММР9、TIMP1、纤维连接蛋白和层粘连蛋白的表达水平，并与正常发育的子宫组织中相同蛋白的表达水平进行比较。结果。MRKH组子宫组织I型胶原表达降低，MMP2和MMP9蛋白水平升高。结论:1)MRKH患者的子宫雏形与正常发育的子宫形态有不同程度的相似;2)功能子宫雏形与正常发育的子宫(肌瘤、子宫内膜异位症)具有相同的病理过程。3) MRKH患者功能子宫内膜结缔组织重构模式改变，ⅰ型胶原表达降低，基质金属蛋白酶MMP2、MMP9表达升高。关键词:勒氏发育不全，子宫雏形，金属蛋白酶，结缔组织重塑，ММР2， ММР9
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