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Current nomenclature and histopathological criteria for assessment of the noninflammatory degenerative diseases of the aorta. 评估主动脉非炎性退行性疾病的现行命名法和组织病理学标准。
Q4 Medicine Pub Date : 2020-01-01
Ondřej Fabián

A histopathological examination of the surgical specimen of the aorta usually follows a surgical reconstruction of the aortic aneurysm or dissection. Among the adults, the frequent cause of the aneurysm development is a severe atherosclerosis, while in children the aneurysm or dissection usually come as a complication of genetic syndromes. The common microscopical denominator of those diseases is a medial degeneration of variable degree. For a long time, a terminology of microscopical structural alterations used to be subjective and unsettled. In 2016, the first international guidelines for the histopathological assessment of the non-inflammatory degenerative diseases of the aorta were established. They introduced unified nomenclature, defined individual microscopic alterations and implemented a three-tier grading system. This work aims at practical aspects of the microscopical assessment and interpretation of the degenerative processes in the aorta with regards to the aforementioned consensus.

主动脉手术标本的组织病理学检查通常在动脉瘤手术重建或夹层手术后进行。在成人中,动脉瘤发展的常见原因是严重的动脉粥样硬化,而在儿童中,动脉瘤或夹层通常是遗传综合征的并发症。这些疾病在显微镜下的共同特征是不同程度的内侧变性。长期以来,微观结构变化的术语都是主观的、不确定的。2016年,建立了首个国际主动脉非炎性退行性疾病组织病理学评估指南。他们引入了统一的命名法,定义了个体的微观变化,并实施了三层分级制度。这项工作的目的是在微观方面的评估和解释在主动脉退行性过程与上述共识的实际方面。
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引用次数: 0
Changes in histopathological classification of neuroendocrine tumors in 5th edition of WHO classification of gastrointestinal tract tumors (2019). 2019年第5版WHO胃肠道肿瘤分类中神经内分泌肿瘤组织病理分类的变化
Q4 Medicine Pub Date : 2020-01-01
Tomáš Jirásek, Václav Mandys

In a brief review is presented a summary of news in the classification of neuroendocrine neoplasms of the digestive system, as they were introduced in the 5th edition of the WHO Classification of Digestive System Tumors published in summer 2019.

本文简要回顾了消化系统神经内分泌肿瘤分类方面的新闻摘要,这些肿瘤已在2019年夏季出版的《世卫组织消化系统肿瘤分类》第五版中介绍。
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引用次数: 0
A case of amoebic colitis with Crohn-like endoscopic and histopathological features. 具有克罗恩样内窥镜和组织病理学特征的阿米巴结肠炎1例。
Q4 Medicine Pub Date : 2020-01-01
Ondřej Fabián, Milan Trojánek, Lenka Richterová, František Stejskal, Kamila Dundrová, Markéta Roznetinská, Josef Zámečník

Amoebic colitis represents a common parasitic infection in developing countries. In western world, it is encountered only sporadically. The clinical presentation is usually non-specific, non-invasive laboratory tests are often false negative and endoscopic and histopathological appearance may mimic other illnesses, especially Crohns disease. The disease therefore harbours a huge risk of misdiagnosing and a proper diagnosis is usually challenging. We present a case of an amoebic colitis with Crohn-like features and negative parasitological testing in a 53-years-old woman, in which the final diagnosis was established on the basis of its histopathological examination.

阿米巴结肠炎是发展中国家常见的寄生虫感染。在西方世界,这种情况只是偶尔发生。临床表现通常是非特异性的,非侵入性实验室检查常为假阴性,内窥镜和组织病理学表现可能与其他疾病相似,尤其是克罗恩病。因此,这种疾病存在误诊的巨大风险,而正确的诊断通常具有挑战性。我们提出一个病例阿米巴结肠炎与克罗恩样特征和阴性寄生虫学测试在一个53岁的妇女,其中最终诊断是建立在其组织病理学检查的基础上。
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引用次数: 0
Pathophysiology of ANCA-associated vasculitis. anca相关性血管炎的病理生理学。
Q4 Medicine Pub Date : 2020-01-01
Bartoňová Lenka, Hrušková Zdenka, Honsová Eva

ANCA positive vasculitis (AAV) is a serious autoimmune disease mainly affecting small vessels in various organ systems, accompanied by the presence of ANCA antibodies in serum. AAV represents a group of the most common systemic vasculitis in adulthood, and based on clinical manifestations this disease entity includes 3 phenotypes, namely: granulomatosis with polyangiitis (formerly Wegeners granulomatosis), microscopic polyangiitis and eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome). Similar to other autoimmune diseases, AAV develops in patients with a predisposing genetic background who have been exposed to causative environmental factors, such as infections. The mechanisms by which ANCA antibodies cause vasculitis involves excessive neutrophil activation, that subsequently leads to release pro-inflammatory cytokines, reactive oxygen species and lytic enzymes. In addition, activated neutrophils induce the formation of neutrophil extracellular traps in a process called NETosis. The released neutrophil antigens are exposed to the immune system via antigen presenting cells, which further stimulates antibody production and creates a vicious circle with tissue destruction. Understanding the pathogenesis of AAV represents the key which provides not only optimal diagnosis and treatment, but also gives the pathologist a tool for deeper insight into the morphological features of disease progression, including the various stages of development and healing.

ANCA阳性血管炎(AAV)是一种严重的自身免疫性疾病,主要影响各器官系统的小血管,伴有血清中ANCA抗体的存在。AAV是一组成人中最常见的系统性血管炎,根据临床表现,该疾病实体包括3种表型,即:肉芽肿合并多血管炎(原Wegeners肉芽肿病)、显微镜下的多血管炎和嗜酸性肉芽肿合并多血管炎(原Churg-Strauss综合征)。与其他自身免疫性疾病类似,AAV发生在暴露于致病环境因素(如感染)的易感遗传背景的患者中。ANCA抗体引起血管炎的机制涉及过度的中性粒细胞活化,随后导致释放促炎细胞因子、活性氧和裂解酶。此外,活化的中性粒细胞在称为NETosis的过程中诱导中性粒细胞胞外陷阱的形成。释放的中性粒细胞抗原通过抗原呈递细胞暴露于免疫系统,进一步刺激抗体的产生,造成组织破坏的恶性循环。了解AAV的发病机制不仅是提供最佳诊断和治疗的关键,而且还为病理学家更深入地了解疾病进展的形态学特征,包括发展和愈合的各个阶段提供了工具。
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引用次数: 0
Echinococcus multilocularis: Diagnostic problem in a liver core biopsy. 多房棘球蚴:肝核心活检的诊断问题。
Q4 Medicine Pub Date : 2020-01-01
Alena Chlumská, Petr Mukenšnabl, Jana Němcová, Lenka Nedbalová, Petr Hrabal, Miroslav Ryska, Květa Michalová

Echinococcus multilocularis causes an aggressive form of hydatidosis whose histomorphological picture is generally not well recognized. We report a case of 39-year-old women presenting with poorly circumscribed nodules in the right hepatic lobe. Owing to the clinical suspicion of focal nodular hyperplasia and hepatocellular adenoma, a core biopsy was performed. The histological findings of necrotic fibrous tissue infiltrated by narrow epithelial cords and small cysts containing cytokeratin positive material were in concordance with the diagnosis of cholangiocarcinoma. Subsequent examination of the surgically resected necrotic nodules with a vital tissue at the periphery corresponded to a reparative fibrosis accompanied by a striking ductular proliferation. Serological and molecular genetic work-up led to the diagnosis of Echinococcus multilocularis. The aim of this report is to point out the unusual histological features of the solid foci of alveolar hydatidosis, which consisted of necrotic fibrous tissue with ductular reaction. Such findings in a core biopsy may simulate regressively altered carcinoma.

多房棘球蚴引起一种侵袭性的包虫病,其组织形态一般不太清楚。我们报告一个39岁的女性在右肝叶表现为界限不清的结节。由于临床怀疑局灶性结节增生和肝细胞腺瘤,我们进行了核心活检。组织学表现为坏死纤维组织浸润狭窄的上皮索和含有细胞角蛋白阳性物质的小囊肿,与胆管癌的诊断一致。手术切除的坏死结节周围有重要组织,随后的检查显示修复性纤维化伴显著的小管增生。血清学和分子遗传学检查导致诊断为多房棘球蚴。本报告的目的是指出肺泡包虫病实灶的不同寻常的组织学特征,它由坏死的纤维组织和导管反应组成。核心活检的这些发现可能模拟退行性改变的癌。
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引用次数: 0
Immunohistochemistry in hollow urinary tract. 空心尿路免疫组化。
Q4 Medicine Pub Date : 2020-01-01
Kristýna Pivovarčíková, Marián Švajdler, Ondřej Hes

There is no ideal marker or established immunohistochemistry panel to confirm urothelial differentiation. Immunohistochemistry must be always indicated in concrete differential diagnostic consideration. In this review article, immunohistochemistry will be discussed in the three different settings - distinction of benign and malignant changes of urothelium, the most frequent pitfalls and non-urothelial neoplasms of urinary tract.

目前还没有理想的标志物或已建立的免疫组织化学小组来证实尿路上皮分化。在具体的鉴别诊断考虑中,免疫组织化学必须始终予以指示。在这篇综述文章中,免疫组织化学将在三种不同的情况下进行讨论-尿路上皮良恶性变化的区分,最常见的陷阱和非尿路上皮肿瘤。
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引用次数: 0
Immunohistochemistry in prostate pathology. 前列腺病理中的免疫组织化学。
Q4 Medicine Pub Date : 2020-01-01
Kristýna Pivovarčíková, Ondřej Hes

The diagnosis of prostatic adenocarcinoma is based on a combination of histological features, none of which is absolutely sensitive and specific. Immunohistochemical examination is therefore sometimes necessary in difficult cases for confirmation of the diagnosis and distinction of mimickers. The second major indication of immunohistochemical staining in prostatic pathology is metastatic prostatic adenocarcinoma.

前列腺腺癌的诊断是基于多种组织学特征的结合,没有一种是绝对敏感和特异性的。因此,免疫组织化学检查有时在不同的病例中是必要的,以帮助诊断和区分模拟者。前列腺病理中免疫组化染色的第二个主要指征是转移性前列腺腺癌。
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引用次数: 0
Lymph node metastasis of parotid gland high-grade adenoid-cystic carcinoma. 腮腺高级别腺样囊性癌的淋巴结转移。
Q4 Medicine Pub Date : 2020-01-01
Jan Hrudka, Jana Drozenová, Anasuya Guha, Martin Chovanec

Adenoid cystic carcinoma (ACC) is one of the most common salivary gland malignancies. In rare cases, ACC undergoes high-grade transformation, which is associated with poor prognosis, in contrast to relatively long survival in the conventional ACC. Conventional ACC is characterized by typical histopathology showing glandular arrangement with sharply demarcated lumina, the tumor cells have sparse cytoplasm and angulated hyperchromatic nuclei. ACCs undergoing high-grade transformation lack these morphological features. In this paper we present a case of 46 years old female patient presenting with locally advanced tumor of the parotid gland and neck lymphadenopathy, coming for surgery. A suspect lymph node was sent to freeze section histology. Large non-cohesive cells with vesicular nuclei and prominent nucleoli along with well persevered lymph node architecture were seen in the frozen slide. This finding lead to suspicion of a lymphoma, the surgery finished in the extent of superficial parotidectomy and selective neck dissection of regions II-IV. Subsequent histopathological examination of formalin-fixed lymph node proofed epithelial nature of the atypical cells by p63 positivity. In the parotid gland resection specimen, an ACC with high-grade component was indentified. The high-grade ACC shared cell morphology with the lymph node metastasis. 17 from 20 lymph neck nodes contained metastases of high-grade ACC. Interestingly, there was strong CD117 expression in the high-grade ACC, whereas the conventional part was fully negative. To the best of our knowledge, the high-grade ACC of the parotid gland was reported only in 10 cases in the medical literature.

腺样囊性癌是唾液腺最常见的恶性肿瘤之一。在极少数情况下,ACC发生高级别转化,与预后差相关,而传统ACC的生存期相对较长。常规ACC的病理组织学表现为腺状排列,腔内界限分明,肿瘤细胞胞质稀疏,核呈角状深染。经历高级别转化的acc缺乏这些形态特征。本文报告一位46岁女性病患,因局部进展性腮腺肿瘤及颈部淋巴结病变而求医。一个可疑的淋巴结被送去冷冻切片组织学。冻玻片上可见大的非内聚细胞,具有泡状核和突出的核仁,并有良好的淋巴结结构。这一发现导致怀疑淋巴瘤,手术结束于腮腺浅表性切除术和选择性颈部II-IV区清扫。随后对福尔马林固定淋巴结的组织病理学检查证实非典型细胞的上皮性质为p63阳性。在腮腺切除标本中,鉴定出具有高级别成分的ACC。高级别ACC的细胞形态与淋巴结转移相同。20个淋巴结中有17个有高级别ACC转移。有趣的是,CD117在高级别ACC中表达强烈,而常规部位则完全阴性。据我们所知,在医学文献中,只有10例腮腺高级ACC被报道。
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引用次数: 0
Comments on the 5th edition of WHO classification of digestive system tumors - Part 1. Gastrointestinal tract. 对世界卫生组织第五版消化系统肿瘤分类第1部分的评论。胃肠道。
Q4 Medicine Pub Date : 2020-01-01
Ondřej Daum, Magdaléna Daumová, Marián Švajdler

The new 2019 WHO classification of digestive system tumors reflects some important advancements in our understanding of etiopathogenesis and molecular background of selected neoplastic diseases of the gastrointestinal tract, offers more integrated review of non-epithelial neoplasms and updates the spectrum of genetic tumor syndromes of the digestive system. Recently recognized conditions, such as gastroblastoma and “gastric adenocarcinoma and proximal poly-posis of the stomach” are described, including molecular alterations associated with these entities. On the other hand, the new interpretation of some topics, mainly grading of serrated lesions or ICD-O coding of adenomas and dysplasia, is rather controversial. Last but not least, the definition of pTis in the large intestine according to WHO conflicts its definition according to AJCC/UICC TNM classification, 8th edition, issued in 2017.

2019年世卫组织消化系统肿瘤新分类反映了我们在了解某些胃肠道肿瘤疾病的发病机制和分子背景方面取得的一些重要进展,对非上皮性肿瘤提供了更全面的综述,并更新了消化系统遗传肿瘤综合征的谱。最近发现的疾病,如胃母细胞瘤和“胃腺癌和胃近端息肉;描述,包括与这些实体相关的分子改变。另一方面,对一些主题的新解释,主要是锯齿状病变的分级或腺瘤和不典型增生的ICD-O编码,是相当有争议的。最后但并非最不重要的是,世卫组织对大肠内pti的定义与2017年发布的AJCC/UICC TNM分类第8版的定义相冲突。
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引用次数: 0
Primary vasculitides - current diagnostics and therapy. 原发性血管炎-目前的诊断和治疗。
Q4 Medicine Pub Date : 2020-01-01
Radim Bečvář

By term „vasculitis“ inflammatory disease of blood vessels is designated that leads to vessel wall destruction followed by proliferation and occlusion of their lumina. Basic condition for this diagnosis is that vessel wall is a primary site of the pathological process. Clinical syndromes are a consequence of this process resulting into ischaemia of tissues supplied by the affected vessels and with constitutional symptoms associated to the inflammatory disease. Vasculitis can occur de novo as a primary involvement of vessel wall of unknown aetiology or it develops secondary to other diseases. The diagnosis of vasculitis is usually based on pathological findings from biopsy or abnormalities detected by imaging methods. This review describes the common primary vasculitides, their diagnostics and management.

按术语„血管炎“血管的炎症性疾病是指导致血管壁破坏,接着是血管腔的增殖和闭塞。这种诊断的基本条件是血管壁是病理过程的主要部位。临床综合征是这一过程的结果,导致受影响血管供应的组织缺血,并伴有与炎症性疾病相关的体质症状。血管炎可因不明原因的血管壁原发受累而从头发生,也可继发于其他疾病。血管炎的诊断通常基于活检的病理结果或通过影像学方法检测到的异常。本文综述了常见的原发性血管病变及其诊断和治疗。
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引用次数: 0
期刊
Ceskoslovenska patologie
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