Pub Date : 2025-01-01DOI: 10.1016/j.mpdhp.2024.10.002
Simon Elliott
Post-mortem toxicology is an important diagnostic part of the investigative process, not least when drugs of abuse are suspected, some of which require special attention. This updated article summarizes key information regarding current common drugs of abuse, including amphetamines, benzodiazepines, cannabis, cocaine, ketamine, pregabalin as well as new psychoactive substances (NPS). There have also been recent trends in substances used in suicide (e.g. gases and chemicals). The importance of sufficient and appropriate information (such as case circumstances and drug history) in addition to scene evidence and other considerations (including analytical and sampling factors) are presented that are relevant to the interpretation of results and the pathological process.
{"title":"Investigating drugs of abuse at autopsy","authors":"Simon Elliott","doi":"10.1016/j.mpdhp.2024.10.002","DOIUrl":"10.1016/j.mpdhp.2024.10.002","url":null,"abstract":"<div><div>Post-mortem toxicology is an important diagnostic part of the investigative process, not least when drugs of abuse are suspected, some of which require special attention. This updated article summarizes key information regarding current common drugs of abuse, including amphetamines, benzodiazepines, cannabis, cocaine, ketamine, pregabalin as well as new psychoactive substances (NPS). There have also been recent trends in substances used in suicide (e.g. gases and chemicals). The importance of sufficient and appropriate information (such as case circumstances and drug history) in addition to scene evidence and other considerations (including analytical and sampling factors) are presented that are relevant to the interpretation of results and the pathological process.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 1","pages":"Pages 1-6"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152705","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 : 2025-01-01DOI: 10.1016/j.mpdhp.2024.10.006
Brian Hanley, Dominic Chambers
Most post-mortem examinations in the United Kingdom (UK) are currently performed at the request of the Coroner to differentiate between natural and unnatural causes of death on balance of probabilities. This has curtailed the remit of the practicing pathologist to only include additional investigations where the results of which would directly influence the cause of death given. The current review discusses sudden unexpected causes of death where additional investigations are required to make the correct diagnosis in certain circumstances. It is focused at pathologists working within Coronial systems and on causes of death outside the cardiovascular and central nervous systems. Specifically, we discuss the utility of cultures in sepsis, histology in unexpected tumours and special investigations in pneumothorax, asthma, anaphylaxis, diabetes mellitus, insulin-overdose, acute pancreatitis, acute liver failure and acute kidney injury.
{"title":"Significant and potentially overlooked causes of unexpected death outside the cardiovascular and central nervous system","authors":"Brian Hanley, Dominic Chambers","doi":"10.1016/j.mpdhp.2024.10.006","DOIUrl":"10.1016/j.mpdhp.2024.10.006","url":null,"abstract":"<div><div>Most post-mortem examinations in the United Kingdom (UK) are currently performed at the request of the Coroner to differentiate between natural and unnatural causes of death on balance of probabilities. This has curtailed the remit of the practicing pathologist to only include additional investigations where the results of which would directly influence the cause of death given. The current review discusses sudden unexpected causes of death where additional investigations are required to make the correct diagnosis in certain circumstances. It is focused at pathologists working within Coronial systems and on causes of death outside the cardiovascular and central nervous systems. Specifically, we discuss the utility of cultures in sepsis, histology in unexpected tumours and special investigations in pneumothorax, asthma, anaphylaxis, diabetes mellitus, insulin-overdose, acute pancreatitis, acute liver failure and acute kidney injury.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 1","pages":"Pages 32-38"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152709","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 : 2025-01-01DOI: 10.1016/j.mpdhp.2024.10.005
Kieren Simon James Allinson
Cerebrovascular disease is a common cause of death and the general histopathologist will often be responsible for the post mortem examination of stroke-related death. The pathological findings vary depending on the type of stroke, its location and aetiology. The underlying pathology is variable and includes atherosclerosis, cardiogenic embolism and small vessel disease alongside many rarer causes. The adequate post mortem examination of stroke is essential to usefully inform clinical teams, coronial services and relatives and requires proper preparation, familiarity with the range of underlying pathological processes, careful gross examination and judicious use of histology.
{"title":"Deaths related to stroke and cerebrovascular disease","authors":"Kieren Simon James Allinson","doi":"10.1016/j.mpdhp.2024.10.005","DOIUrl":"10.1016/j.mpdhp.2024.10.005","url":null,"abstract":"<div><div>Cerebrovascular disease is a common cause of death and the general histopathologist will often be responsible for the post mortem examination of stroke-related death. The pathological findings vary depending on the type of stroke, its location and aetiology. The underlying pathology is variable and includes atherosclerosis, cardiogenic embolism and small vessel disease alongside many rarer causes. The adequate post mortem examination of stroke is essential to usefully inform clinical teams, coronial services and relatives and requires proper preparation, familiarity with the range of underlying pathological processes, careful gross examination and judicious use of histology.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 1","pages":"Pages 22-31"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152710","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 : 2025-01-01DOI: 10.1016/j.mpdhp.2024.10.004
Brett Lockyer
Hanging is a form of death caused by constriction of the neck by a ligature, where the force is derived from the gravitational drag of the victim's body weight. Hanging deaths are becoming increasingly important to pathologists. Injuries play a decisive role in determining the manner of death, particularly if doubt exists as to whether the cause is suicidal, accidental or by homicide. There are no standards specifically directed at post-mortem examination in cases of fatal hanging, but general autopsy guidelines are published by the Royal College of Pathologists and are applicable to deaths by this means. While the incidence of external injuries in hanging is consistent across the literature, significant variation exists regarding the presence of internal injuries. Since publication of the original version of this article, several papers have been published. This paper aims to remind the reader of the original article and to discuss relevant literature published since 2019. There are differences to the autopsy approach of victims of hanging across the United Kingdom, but full external and internal examination with focused neck dissection remains best practice despite the widespread use of post-mortem computed tomography (PMCT). Auditing of pathologists' practices may help improve the standards of post-mortem examination and subsequent reporting and clarify uncertainty regarding internal injuries.
{"title":"Death by hanging: examination of autopsy findings and best approach to the post-mortem examination – an update","authors":"Brett Lockyer","doi":"10.1016/j.mpdhp.2024.10.004","DOIUrl":"10.1016/j.mpdhp.2024.10.004","url":null,"abstract":"<div><div>Hanging is a form of death caused by constriction of the neck by a ligature, where the force is derived from the gravitational drag of the victim's body weight. Hanging deaths are becoming increasingly important to pathologists. Injuries play a decisive role in determining the manner of death, particularly if doubt exists as to whether the cause is suicidal, accidental or by homicide. There are no standards specifically directed at post-mortem examination in cases of fatal hanging, but general autopsy guidelines are published by the Royal College of Pathologists and are applicable to deaths by this means. While the incidence of external injuries in hanging is consistent across the literature, significant variation exists regarding the presence of internal injuries. Since publication of the original version of this article, several papers have been published. This paper aims to remind the reader of the original article and to discuss relevant literature published since 2019. There are differences to the autopsy approach of victims of hanging across the United Kingdom, but full external and internal examination with focused neck dissection remains best practice despite the widespread use of post-mortem computed tomography (PMCT). Auditing of pathologists' practices may help improve the standards of post-mortem examination and subsequent reporting and clarify uncertainty regarding internal injuries.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 1","pages":"Pages 14-21"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152708","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 : 2025-01-01DOI: 10.1016/j.mpdhp.2024.10.003
Guy N Rutty
This updated review considers how cross-sectional imaging, principally but not exclusively, post-mortem computed tomography (PMCT) can be and is used globally in forensic pathology practice today. It touches upon the origin of forensic radiology, the introduction to practice of PMCT and questions the invasive autopsy as the gold standard for death investigation. It considers, in broad terms, the role of cross-sectional imaging in the four investigative areas of who, where, when and how a person came by their death. It summarises with a view as to where we go next, specifically in terms of practitioner training and accreditation.
{"title":"What has post-mortem computed tomography ever done for forensic pathology? Part deux","authors":"Guy N Rutty","doi":"10.1016/j.mpdhp.2024.10.003","DOIUrl":"10.1016/j.mpdhp.2024.10.003","url":null,"abstract":"<div><div>This updated review considers how cross-sectional imaging, principally but not exclusively, post-mortem computed tomography (PMCT) can be and is used globally in forensic pathology practice today. It touches upon the origin of forensic radiology, the introduction to practice of PMCT and questions the invasive autopsy as the gold standard for death investigation. It considers, in broad terms, the role of cross-sectional imaging in the four investigative areas of who, where, when and how a person came by their death. It summarises with a view as to where we go next, specifically in terms of practitioner training and accreditation.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 1","pages":"Pages 7-13"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152707","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 : 2025-01-01DOI: 10.1016/j.mpdhp.2024.10.007
Richard John Digby, Hannah Olivia Hawrot
The term “vasculitis” refers to a family of conditions characterized by inflammation of blood vessels. These processes can affect small, medium or large vessels, and have a wide range of clinical presentations, histological appearances, and prognoses. As histopathologists, we usually see these vasculitides in a partially or well-treated state; patients have often commenced local or systemic therapy by the time of their biopsy, and this can significantly affect the histological appearances. This case report describes the clinical history and associations of a fatal case of granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis. GPA is an uncommon multisystem vasculitis, classically involving the respiratory tract and kidneys, though other systems are also known to be affected including the GI tract, skin, and joints among many others. The post-mortem examination identified the immediate cause of death, and demonstrated very well the typical histological features that may be observed in this condition.
{"title":"Post-mortem findings in a case of fatal vasculitis","authors":"Richard John Digby, Hannah Olivia Hawrot","doi":"10.1016/j.mpdhp.2024.10.007","DOIUrl":"10.1016/j.mpdhp.2024.10.007","url":null,"abstract":"<div><div>The term “vasculitis” refers to a family of conditions characterized by inflammation of blood vessels. These processes can affect small, medium or large vessels, and have a wide range of clinical presentations, histological appearances, and prognoses. As histopathologists, we usually see these vasculitides in a partially or well-treated state; patients have often commenced local or systemic therapy by the time of their biopsy, and this can significantly affect the histological appearances. This case report describes the clinical history and associations of a fatal case of granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis. GPA is an uncommon multisystem vasculitis, classically involving the respiratory tract and kidneys, though other systems are also known to be affected including the GI tract, skin, and joints among many others. The post-mortem examination identified the immediate cause of death, and demonstrated very well the typical histological features that may be observed in this condition.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"31 1","pages":"Pages 39-41"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152704","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 : 2024-10-24DOI: 10.1016/j.mpdhp.2024.09.004
Christopher Mark Milroy
Forensic neuropathology is a subspecialty of neuropathology involving those cases that may enter the criminal and civil justice courts and medico-legal death investigation systems. The cases involve trauma, poisons and diseases related to the central and peripheral nervous system. Though nervous system disorders and trauma to the brain are recorded in literature from Ancient Egypt, a better understanding of diseases, trauma and mechanisms of injury began to emerge with the writings of Renaissance surgeons with military experience. Further development came with the knowledge of cell theory and neurohistology in the nineteenth century, with the ability to examine the whole brain after fixation. Textbooks on forensic neuropathology were not produced until after World War Two. A better understanding of the pathology of neurotrauma and poisons affecting the central nervous system was developed in the twentieth century. Concepts of sudden death in epilepsy, paediatric head injury, vertebral artery trauma and hypoxic brain damage were all recognized in the last century. More recently immunohistochemistry has added to our knowledge of axonal injury. Neuroimaging, particularly CT scans have become regular tools for postmortem examinations. Recently genetic testing has become available for autopsy investigation, with applicability to vascular and thrombotic disorders as well as epilepsy. Forensic neuropathology has both an ancient and more recent history and continues to develop.
{"title":"A history of forensic neuropathology","authors":"Christopher Mark Milroy","doi":"10.1016/j.mpdhp.2024.09.004","DOIUrl":"10.1016/j.mpdhp.2024.09.004","url":null,"abstract":"<div><div>Forensic neuropathology is a subspecialty of neuropathology involving those cases that may enter the criminal and civil justice courts and medico-legal death investigation systems. The cases involve trauma, poisons and diseases related to the central and peripheral nervous system. Though nervous system disorders and trauma to the brain are recorded in literature from Ancient Egypt, a better understanding of diseases, trauma and mechanisms of injury began to emerge with the writings of Renaissance surgeons with military experience. Further development came with the knowledge of cell theory and neurohistology in the nineteenth century, with the ability to examine the whole brain after fixation. Textbooks on forensic neuropathology were not produced until after World War Two. A better understanding of the pathology of neurotrauma and poisons affecting the central nervous system was developed in the twentieth century. Concepts of sudden death in epilepsy, paediatric head injury, vertebral artery trauma and hypoxic brain damage were all recognized in the last century. More recently immunohistochemistry has added to our knowledge of axonal injury. Neuroimaging, particularly CT scans have become regular tools for postmortem examinations. Recently genetic testing has become available for autopsy investigation, with applicability to vascular and thrombotic disorders as well as epilepsy. Forensic neuropathology has both an ancient and more recent history and continues to develop.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"30 12","pages":"Pages 699-711"},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702733","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 : 2024-10-15DOI: 10.1016/j.mpdhp.2024.10.001
Federico Roncaroli, Carmine Antonio Donofrio, Liam Walker, Roger Laitt, Chiara Villa, Waseem Majeed
Tumours of the anterior pituitary account for around 20% of intracranial neoplasms and are the most common tumours of the entire neuroendocrine system, representing a sizeable proportion of the diagnostic workload for specialist pituitary centres. The 5th edition WHO Classification of Endocrine and Neuroendocrine Tumours (ENDO5) introduced changes to the classification of adenohypophyseal cell tumours including the nomenclature of pituitary neuroendocrine tumours (PitNET), the introduction of an ICD-O code for malignancy, and the term ‘metastatic PitNET’ to replace pituitary carcinoma, and further emphasis in the diagnostic use of lineage restricted transcription factors. ENDO5 did not mention any progress in the molecular profiling of PitNETs or any proposal to identify PitNETs with aggressive potential. This review aims to appraise the changes introduced in ENDO5 and provide practical suggestions to interpret the classification of PitNETs and to their diagnostic approach.
{"title":"Update on the classification and diagnostic approach of pituitary neuroendocrine tumours","authors":"Federico Roncaroli, Carmine Antonio Donofrio, Liam Walker, Roger Laitt, Chiara Villa, Waseem Majeed","doi":"10.1016/j.mpdhp.2024.10.001","DOIUrl":"10.1016/j.mpdhp.2024.10.001","url":null,"abstract":"<div><div>Tumours of the anterior pituitary account for around 20% of intracranial neoplasms and are the most common tumours of the entire neuroendocrine system, representing a sizeable proportion of the diagnostic workload for specialist pituitary centres. The 5th edition WHO Classification of Endocrine and Neuroendocrine Tumours (ENDO5) introduced changes to the classification of adenohypophyseal cell tumours including the nomenclature of pituitary neuroendocrine tumours (PitNET), the introduction of an ICD-O code for malignancy, and the term ‘metastatic PitNET’ to replace pituitary carcinoma, and further emphasis in the diagnostic use of lineage restricted transcription factors. ENDO5 did not mention any progress in the molecular profiling of PitNETs or any proposal to identify PitNETs with aggressive potential. This review aims to appraise the changes introduced in ENDO5 and provide practical suggestions to interpret the classification of PitNETs and to their diagnostic approach.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"30 12","pages":"Pages 668-679"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702730","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 : 2024-10-08DOI: 10.1016/j.mpdhp.2024.09.001
Simon Deacon, Matt Loose, Stuart Smith, Simon Paine
Advances in both our understanding of tumour biology and our technological capacity to interrogate these molecular characteristics have led to the ever-increasing use of genomic sequencing in routine diagnostic decision making, long offering the hope of more efficacious personalized cancer therapies. Yet, despite this fidelity, in order that genomic testing is truly able to deliver its promise of better outcomes for patients, it is vital that such testing can be performed within a clinically relevant timeframe. Presently, molecular diagnosis of brain tumours is largely delivered via an effectively centralized model as few institutes possess the necessary facilities. Yet, this approach has inherent delays that mean a wait, often of several weeks, before the diagnosis is available to the treating clinical team. This review introduces Nanopore sequencing, a long-read technology that can be used to enable rapid and comprehensive molecular diagnosis. The epigenetic signatures of brain tumours have been shown to reliably segregate tumour subtypes, and methylation-based tumour classification now forms a cornerstone of neuropathological diagnosis. Crucially, Nanopore is a direct-strand sequencing technology which can detect methyl DNA modifications, alongside base-calling, delivering methylation classification in parallel with copy number, fusion and mutation detection as well as single gene methylation analysis. This review summarises the present state of nanopore sequencing for brain tumour diagnostics and highlights areas for further development.
我们对肿瘤生物学的了解和分析这些分子特征的技术能力都在不断进步，这使得基因组测序在常规诊断决策中的应用日益广泛，长期以来为更有效的个性化癌症疗法带来了希望。然而，尽管如此，为了使基因组检测能够真正兑现为患者提供更好治疗结果的承诺，在临床相关的时间范围内进行此类检测至关重要。目前，脑肿瘤的分子诊断主要通过有效的集中模式进行，因为只有少数机构拥有必要的设施。然而，这种方法存在固有的延迟，这意味着临床治疗团队需要等待数周才能获得诊断结果。本综述介绍了纳米孔测序技术，这是一种可用于快速、全面分子诊断的长读数技术。脑肿瘤的表观遗传学特征已被证明能可靠地区分肿瘤亚型，基于甲基化的肿瘤分类现已成为神经病理学诊断的基石。最重要的是，Nanopore 是一种直接链测序技术，它可以检测 DNA 甲基修饰，同时还能进行碱基调用，在进行拷贝数、融合和突变检测以及单基因甲基化分析的同时进行甲基化分类。本综述总结了纳米孔测序在脑肿瘤诊断中的应用现状，并重点介绍了有待进一步发展的领域。
{"title":"Nanopore-based brain tumour classification: the harbinger of near-patient, ultra-rapid tumour sequencing","authors":"Simon Deacon, Matt Loose, Stuart Smith, Simon Paine","doi":"10.1016/j.mpdhp.2024.09.001","DOIUrl":"10.1016/j.mpdhp.2024.09.001","url":null,"abstract":"<div><div>Advances in both our understanding of tumour biology and our technological capacity to interrogate these molecular characteristics have led to the ever-increasing use of genomic sequencing in routine diagnostic decision making, long offering the hope of more efficacious personalized cancer therapies. Yet, despite this fidelity, in order that genomic testing is truly able to deliver its promise of better outcomes for patients, it is vital that such testing can be performed within a clinically relevant timeframe. Presently, molecular diagnosis of brain tumours is largely delivered via an effectively centralized model as few institutes possess the necessary facilities. Yet, this approach has inherent delays that mean a wait, often of several weeks, before the diagnosis is available to the treating clinical team. This review introduces Nanopore sequencing, a long-read technology that can be used to enable rapid and comprehensive molecular diagnosis. The epigenetic signatures of brain tumours have been shown to reliably segregate tumour subtypes, and methylation-based tumour classification now forms a cornerstone of neuropathological diagnosis. Crucially, Nanopore is a direct-strand sequencing technology which can detect methyl DNA modifications, alongside base-calling, delivering methylation classification in parallel with copy number, fusion and mutation detection as well as single gene methylation analysis. This review summarises the present state of nanopore sequencing for brain tumour diagnostics and highlights areas for further development.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"30 12","pages":"Pages 691-698"},"PeriodicalIF":0.0,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702732","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 : 2024-10-07DOI: 10.1016/j.mpdhp.2024.09.006
Dilek Taze, Kathryn J Griffin, Aruna Chakrabarty
We discuss the case of a 70-year-old female who presented acutely with temporal headache and vision disturbance. She was commenced on high dose glucocorticosteroids and a subsequent temporal artery biopsy revealed granulomatous inflammation affecting all layers of the temporal artery, confirming the suspected diagnosis of giant cell arteritis (GCA). At present, there are four validated histological patterns for the diagnosis of GCA. Nonetheless, the diagnosis of GCA remains challenging in subtle cases which do not show the “classic” histological features. There is currently a lack of agreement among experienced pathologists regarding the diagnostic features and classification of inflammation observed in TAB sections in the diagnosis of GCA. Recent research has attempted to standardize the minimum reporting criteria for the diagnosis of GCA however international controversy remains, justifying further work in this field.
{"title":"Giant cell arteritis: a not-so-straightforward diagnosis in routine practice","authors":"Dilek Taze, Kathryn J Griffin, Aruna Chakrabarty","doi":"10.1016/j.mpdhp.2024.09.006","DOIUrl":"10.1016/j.mpdhp.2024.09.006","url":null,"abstract":"<div><div>We discuss the case of a 70-year-old female who presented acutely with temporal headache and vision disturbance. She was commenced on high dose glucocorticosteroids and a subsequent temporal artery biopsy revealed granulomatous inflammation affecting all layers of the temporal artery, confirming the suspected diagnosis of giant cell arteritis (GCA). At present, there are four validated histological patterns for the diagnosis of GCA. Nonetheless, the diagnosis of GCA remains challenging in subtle cases which do not show the “classic” histological features. There is currently a lack of agreement among experienced pathologists regarding the diagnostic features and classification of inflammation observed in TAB sections in the diagnosis of GCA. Recent research has attempted to standardize the minimum reporting criteria for the diagnosis of GCA however international controversy remains, justifying further work in this field.</div></div>","PeriodicalId":39961,"journal":{"name":"Diagnostic Histopathology","volume":"30 12","pages":"Pages 712-714"},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142702734","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号