Arkhiv patologii最新文献

Donat Semenovich Sarkisov was born in Moscow on September 5, 1924. In the summer of 1942 D.S. Sarkisov was drafted into the army and sent to the Naval Medical Academy (VMMA), from which he graduated in 1947. Thus began his path in medicine, which lasted about 60 years.

New coronavirus infection is registered less frequently in children than in adults. Among all patients with COVID-19, the share of children is 8.6%. Clinical practice shows that in children, COVID-19 can be severe and even fatal. Articles have been published reflecting the clinical manifestations of Long Covid in children, while data on pathomorphological examination of the lungs during long-term COVID-19 in children are not available in the literature. On the basis of the Department of Pathological Anatomy with a course of Forensic Medicine and the Pathological-Anatomical Department of the Clinic of St. Petersburg State Pediatric Medical University, an analysis of medical documentation was carried out, autopsy materials were selected from 3 observations of the death of children from COVID-19. The selection criterion was the duration of the disease. A histological examination using standard methods and IHC analysis using antibodies to the nucleocapsid of SARS-Cov-2, CD95, CD31 were carried out on the lung tissue of 3 children aged 2 months to 2 years who died from a new coronavirus infection. Microscopically, all three patients showed microvessels damage, their thrombosis, angiogenesis, as well as signs of diffuse alveolar damage The combination of expression of the SARS-CoV-2 nucleocapsid and the apoptosis marker on the vascular endothelium of the MCR is of interest.

Conclusion: The data obtained indicate infection with coronavirus and death of endothelial cells due to apoptosis. Endothelial damage in the microvessels of the lungs is the initiating factor in the development of capillary-alveolar block, tissue hypoxia, and disseminated intravascular coagulation syndrome, leading in some cases to respiratory/multiple organ failure and death.

Vasoproliferative retinal tumor (VPT) is a term proposed by ophthalmologists in relation to the totality of manifestations of an intraocular volumetric process with involvement of the inner lining of the eye, an integral part of which is the active growth of blood vessels. The available literature data on the morphology of this process are very contradictory and ambiguous. The article presents two clinical cases of vasoproliferative retinal tumor with own illustration of morphological studies.

Ippolit Vasilyevich Davydovsky was born in 1887 in Danilov, Yaroslavl province, into the family of a clergyman. He received his primary education in a parochial church school. After I.V. Davydovsky's family moved to Yaroslavl, he continued his education in a men's gymnasium. Having successfully graduated from the gymnasium, I.V. Davydovsky in 1905 entered the medical faculty of Moscow State University, where he studied and was influenced by Acad. A.I. Abrikosov formed his first scientific interests. After graduating from the university in 1910, I.V. Davydovsky worked as a sanitary doctor and then as a zemstvo doctor. In 1912. I.V. Davydovsky received the title of Doctor of Medicine and a year later became a prozektor of the Yauza Hospital, which today bears his name. At this time, under the influence of Prof. M.N. Nikiforov, I.V. Davydovsky began to be interested in infectious pathology, which was later reflected in a number of his scientific works on typhus, paratyphus, dysentery and other infectious diseases.

Cardiac myxoma in its morphology is a typical benign tumor, meanwhile, the fact of its localization in the heart chamber, directly in the constant blood flow, largely determines the clinical behavior of this neoplasm, which is often manifested by the development of characteristics that formally determine the aggressive and even malignant nature of the course. Accordingly, the malignancy of cardiac myxoma is determined more by its clinical behavior (recurrence, multifocality of the lesion, the presence of mechanisms of spread similar to metastasis) rather than by its histological picture. In the structure of primary benign tumors of the heart, myxoma occupies a dominant position and its incidence is up to 85%. According to some authors, the tumor develops from multipotent mesenchymal stem cells of the endocardium, mainly in the area of the fossa ovale, while according to others the histogenesis of the tumor remains unclear. The obligate morphology element is the myxoma cell. The presence of so-called "ring" structures is special, regular and highly specific, and Gamna - Gandy bodies, foci of calcification and superficial thrombosis are considered characteristic secondary destructive morphological signs. The review describes the morphology features, specific clinical manifestations, immunohistochemical parameters of cardiac myxoma, and presents information available in the literature on the mechanisms of tumor spread (metastasis).

Rhabdomyosarcomas (RMS) are one of the most common types of sarcomas in children and adolescents. The alveolar RMS subgroup is of particular interest because in some cases, the translocation of the PAX3 and FOXO1 genes is combined with an amplification of the corresponding hybrid gene. According to literature data, the frequency of the PAX3::FOXO1 translocation is 70-90% and the PAX7::FOXO1 translocation 10-30%.

Objective: To determine the frequency of variable FOXO1 translocations in the alveolar RMS patient group.

Material and methods: Thirty-two tumor samples were collected and analyzed using a combination of histological, immunohistochemistry (Myogenin, MyoD1), and molecular genetic techniques (fluorescence in situ hybridization (FISH) and real-time polymerase chain reaction (RT-PCR)).

Results: Cytogenetic analysis using the FISH technique with a FOXO1-specific probe identified 26 (81%) samples with rearrangements at the FOXO1 locus and seven (19%) without rearrangements. Real-time PCR identified the translocation partners PAX3 in 58% (15/26) and PAX7 in 42% (11/26) of samples.

Conclusion: Four cytogenetic patterns were observed: classical translocation, translocation with amplification, translocation with deletion, and normal signal distribution. Alveolar rhabdomyosarcomas exhibit genetic heterogeneity and a diversity of cytogenetic profiles. The frequency ratio of PAX3/PAX7::FOXO1 variable transcripts is 1:1. Approximately 20% of cases of alveolar RMS do not have cytogenetic signs of rearrangements of the FOXO1 gene.

The molecular classification of endometrial cancer developed by The Cancer Genome Atlas project (TCGA, 2013) is currently actively used in gynecological oncology. According to it, endometrial carcinoma is divided into four molecular subtypes: POLE-mutated, MMR deficient (dMMR), TP53-aberrant and unspecified. Endometrial cancer samples belonging to the dMMR and POLE-mutant types are characterized by specific genetic profiles reflecting the hyper- and ultramutant phenotypes of the tumor. At the same time POLE-mutated endometrial carcinomas recur rarely and exhibit the excellent prognosis. Here we report the rare case of 65 y.o. female patient with endometrioid carcinoma sharing immunohistochemical and molecular features of TP53-aberrant, MMR deficient and POLE-mutated subtypes.

Objective: An evaluation of podocyte's molecular phenotype alterations in primary focal segmental glomerulosclerosis (pFSGS) and IgA nephropathy (IgAN).

Material and methods: The exploratory study included 14 cases of morphologically confirmed pFSGS, 14 cases of IgAN, and 12 negative controls. The negative controls comprised samples of the unaltered renal cortex obtained during laparoscopic nephrectomy in patients with malignant neoplasms of the kidney and bladder and without proteinuria. A quantitative immunomorphological study of Wilms tumour protein (WT1) expression and mesenchymal markers of podocytes (desmin and vimentin) was conducted on all kidney samples. The co-expression of the aforementioned molecules was analysed using confocal microscopy.

Results: Cases of pFSGS exhibited nephrotic syndrome with proteinuria of 9.3 (3.1-14) g/24 and typical glomerular alterations in light microscopy and ultrastructural analysis. In the IgAN group, proteinuria was less severe (1.2 (0.7-1.6) g/24). The estimated glomerular filtration rate in pFSGS and IgAN was similar (pFSGS: 85 (53-103) ml/min/1.72 m², IgAN: 76 (52-87) ml/min/1.72 m²; p=0.40). In both pFSGS and IgAN, there was a reduction in WT1 expression in podocytes and an increase in vimentin expression when compared to negative controls. Compared to IgAN and controls, pFSGS exhibited a lower prevalence of glomerular WT1 expression and higher expression of desmin, which was predominantly localised in WT1-negative glomerular areas in confocal microscopy. In pFSGS, decreased nuclear expression of WT1 and increased expression of desmin were observed in the parietal epithelium of the glomerular capsule.

Conclusion: Bidirectional alterations in the glomerular expression of WT1 and intermediate filament proteins are apparent in pFSGS and IgAN. These findings are suggestive for the genomic reprogramming of podocytes and the parietal epithelium of the glomerulus as part of the epithelial-mesenchymal transition, determining the structural and functional disorders of these cells, more prominent in pFSGS.

The functional state of the placenta and extraplacental membranes, determined by their morphological characteristics, is of key importance in the implementation of both physiological and complicated pregnancy. Of great practical value for the diagnosis of congenital infections is the morphological study of the placenta, extraplacental membranes and umbilical cord, which allows optimizing the supervision of newborns and preventing the development of severe perinatal complications. This article presents methodological approaches to the morphological study of the placenta, extraplacental membranes and umbilical cord in infectious pathologies of both bacterial (ascending intraamniotic infection) etiology and viral placentitis caused by parvovirus, human immunodeficiency virus, respiratory syncytial virus, viruses of the Herpesviridae family - herpes simplex viruses types 1 and 2, cytomegalovirus and Epstein - Barr virus) and SARS-CoV-2 with a description of the morphological features of typical changes and immunohistochemical verification of their etiology.

ALK-positive anaplastic large cell lymphoma is a rare T-cell lymphoma with ALK gene rearrangement that develops in children and young adults. The disease almost always affects the lymph nodes, and extranodal areas are also frequently involved. This article describes two cases of atypical localization of ALK-positive anaplastic large cell lymphoma with involvement of the paranasal sinuses.