Arkhiv patologii最新文献

The results of autopsies performed in the pathological department of the Infectious Diseases Hospital named after. S.P. Botkin during the siege of Leningrad (from September 8, 1941 to January 27, 1944). The structure of diseases of the deceased varied during different periods of the siege of Leningrad. In the first period (September-December 1941), diphtheria, dysentery, measles, typhoid fever, and scarlet fever prevailed among the diseases. The most common causes of death in the second period (April-December 1942) were typhus, dysentery, tuberculosis, lobar pneumonia, and typhoid fever. Nosological structure in the third period of the blockade (January 1943 - January 1944): tuberculosis, dysentery, cachexia, lobar pneumonia, infectious jaundice. The discrepancy between clinical and morphological diagnoses is most often noted for the following nosology: pulmonary tuberculosis, typhoid fever, pneumonia, stomach and hepatopancreatobiliary cancer, measles, influenza. The first period of the blockade was distinguished by a high specific proportion of examination of children's bodies - 51.2% of all autopsies; in subsequent periods, the specific share of autopsies of deceased adults (20-59 years) increased to 76.2%. The difference in the nosological structure and age groups of those who died during different periods of the siege of Leningrad was determined by the epidemiological situation in the city, social and living conditions and medical and organizational factors. Conducted in the pathological-anatomical department of the hospital named after. S.P. Botkin during the siege of Leningrad, pathological studies made it possible to timely establish the causes of deaths and identify the peculiarities of the course of infectious diseases against the background of cachexia. Regularly held clinical and anatomical conferences contributed to the reduction of defects in the diagnosis and treatment of infectious diseases.

Hypersensitivity pneumonitis (HP) is one of the most common interstitial lung diseases, the manifestations of which are diverse, and the diagnosis is complex and requires a multidisciplinary approach. HP is an immunologically determined disease in response to inhaled antigens. The main feature of the disease is terminal bronchiole's involvement accompanied by interstitial inflammation and/or fibrosis together with the presence of non-necrotizing granulomas in the interalveolar septa and bronchioles. The article presents the histological features of non-fibrous and fibrotic variants of the disease. Well-defined diagnostic criteria were formulated on the basis of published international recommendations and the authors' own experience.

Today a global problem for humanity is represented by cancer, in particular gastric cancer, which is characterized by high mortality and aggressive course. In this regard, there is a search for new approaches to the diagnosis and therapy of gastric cancer, one of these areas is the study of the expression level of the intercellular adhesion molecule claudin-18.2 in tumor tissue and its use as a target molecule. In the case of various pathological processes, including tumors, the expression profile of claudin-18.2 changes, which indicates its possible role in the initiation and progression of cancer. The aim of this review is to systematize the data on claudin-18.2, its role in normal cell physiology and embryology, as well as in the development of pathological processes in the stomach, its relation to the clinical and morphological characteristics of gastric cancer and importance in biological therapy.

Currently, chronic salpingo-oophoritis (CS) is still an urgent problem in the statistics of diseases of the female genital organs. In 35% of women, its course leads to disorder of the fallopian tubes patency and infertility. An additional indirect mechanism of infertility can be the morpho-functional failure of the endometrium.

Objective: To establish the morphofunctional characteristics and level of endometrial receptivity in patients of reproductive age with CS before and after surgery.

Material and methods: The study included 55 patients with unilateral or bilateral tubectomy - 1st group, 42 with preserved fallopian tubes - 2nd group. The comparison group included 30 somatically healthy fertile women. Before and 6-12 months after laparoscopic cystectomy aspiration biopsy of endometrium was performed in the middle stage of secretory phase. Firstly, the phase and stage of menstrual cycle, the percentage and degree of maturity of pinopodes were determined. Secondly, the immunohistochemical study was conducted with the assessment of the expression level of estrogen (ER) and progesterone (PR) receptors in glands and stroma of endometrium.

Results: In the 1st group before surgery, we determined a decrease in the number of mature pinopodia. A decrease in ER in the endometrial stroma was detected; PR levels correlated with the comparison group. In 2nd group all parameters were associated with healthy women. In the postoperative period, pinopodia were not visualized in the majority of patients in 1st group. ER levels remained reduced in stroma, similar results were found for PR. In 2nd group an insignificant decrease in the number of mature pinopodia on the apical surface of the endometrium, a reduction of ER in the glands and stroma of the uterine mucosa were recorded; PR corresponded to the values founded before surgical treatment.

Conclusion: The presence of CS and subsequent removal of the fallopian tubes is accompanied by indirect damage of the morpho-functional state and receptivity of the endometrium.

In a patient after implantation of a metal screw implant into the bone with suturing of the soft tissues above it after 6 months there was a spontaneous delimitation of the product by a thin strip of compact bone tissue, most likely formed from the bone structures damaged during the operation. Small bone fragments formed during the preparation of the implantation bed were found in the tissues as homogeneous eosinophilic deposits without inflammation and macrophage reactions.

Lung cancer occupies a leading position in the structure of global cancer morbidity and mortality, due to the biological properties of the key pool of tumor cells - cancer stem cells (CSCs). The effects of SARS-CoV2 on tumor CSCs and its niche have not been studied.

Objective: To study CSCs in lung adenocarcinomas after COVID19.

Material and methods: Surgical material from lung adenocarcinoma from 12 patients who had a new coronavirus infection and from 12 patients who did not have COVID19 was examined. Analysis of clinical and anamnestic data, macroscopic and microscopic examination of tumor samples and adjacent intact tissue, immunohistochemical reactions using antibodies to virus proteins and CSC markers ALDH1, CD133 and CD34 were performed.

Results: Adenocarcinoma samples from patients in the main group showed a significant increase in the number of cells expressing the CSCs markers ALDH1, CD133 and CD34 compared to adenocarcinoma samples from control group patients without SARS-CoV2 infection. We found an increase in the number of CSCs in patients with adenocarcinoma metastasis in lymph nodes in both the main and control groups. CSCs of lung adenocarcinomas from SARS-CoV2 survivors contain virus proteins Nucleocapside and Spike protein.

Conclusions: We found an increase in the number of CSCs with expression of ALDH1, CD133 and CD34 in lung adenocarcinoma in patients with new coronavirus infection. Increased number of ALDH1+, CD133+ CD34+ CSCs in tumor tissue enhance the metastatic potential of lung adenocarcinoma. The Nucleocapsid and Spike proteins of SARS-CoV2 virus are detectable in lung tissue from patients with new coronavirus infection, both in adenocarcinoma cells, CSCs, and in type II pneumocytes, macrophages, and endothelial cells, suggesting prolonged persistence of the virus proteins and probably the virus.

Objective: To assess morphological changes in the diaphragm and phrenic nerve in patients who died from COVID-19.

Material and methods: In a case-control study, an analysis was made of autopsy material of the diaphragm and phrenic nerve of those who died from COVID-19 infection complicated by SARS-CoV-2-associated pneumonia, confirmed in vivo by the presence of SARS-CoV-2 RNA (Group 1, n=12), and those who died with a diagnosis of acute cerebrovascular accident of the ischemic type without parenchymal respiratory failure (Group 2, n=3).

Results: The main histopathological features in the diaphragm of the 1st group were the edema of the pericellular spaces of muscle fibers, edema of perivascular spaces, diapedese hemorrhages, plethora in arteriolas, in most veins and capillaries, red blood clots were revealed; in the diaphragmatic nerve - swelling of the perineral space, severe edema around the nerve fibers inside the nerve trunk. In the diaphragm of group 2, edema of pericellular spaces of muscle fibers and edema of perivascular spaces were less pronounced (p<0.001), hemorrhages were not determined; in the diaphragmatic nerve, moderate edema of the perineral space, mild swelling inside the nerve trunk around the nerve fibers was revealed (p<0.001). The glycogen content in the muscle cells of group 1 is significantly lower compared to group 2 (p<0.001).

Conclusion: The study confirms the characteristic pathological picture of organ damage in COVID-19. However, the leading pathological mechanism of organ damage requires further investigation.

The presented case describes the difficulties of diagnosis of the breast microglandular adenosis (MGA), taken by clinicians for a malignant process due to the nature of growth and large size. Criteria for histological and immunohistochemical diagnosis and differentiation of MGA with malignant neoplasms, in particular, with tubular breast carcinoma, are presented. Taking into account the rarity of the pathology and the absence of described cases in the Russian-language literature, the observation is of interest to pathologists and clinicians.

In 2022, the 5th edition of the of the WHO Classification of Tumours of Endocrine Organs was published, which outlines the current understanding of adrenocortical cancer (ACC), resulting from interdisciplinary research over the past decade. This article highlights the new provisions of the WHO classification for the morphological diagnosis of ACC.

The article presents a rare clinical observation of a vaginal tumor detected during pregnancy, which prevented delivery through the natural birth canal and caused a cesarean section at full term. According to the primary biopsy at 34 weeks, neurofibroma was diagnosed. In the postpartum period, due to profuse bloody discharge, the patient was admitted to the Moscow Regional Research Institute of Obstetrics and Gynecology for surgical treatment, where, according to the results of a morphological study of the removed tumor, vaginal leiomyosarcoma was diagnosed.