Ceskoslovenska patologie最新文献

The paper comemmorates a centenary of construction of the current building for the Czech Institute for Pathological Anatomy (First Faculty of Medicine, Charles University in Prague) at Albertov, Prague. Project for the building was being developed since 1911, the construction works began three years later only to be interrupted by the onset of the WWI. The final inspection was carried out in 1921. The building served not just the Institute for Pathological Anatomy, but also Institute for Forensic Medicine as well as Institute for Microbiology and Serology. The Hlavas institute is considered to be an exceptional example of a modern interwar medical facility in the central Europe.

Fabry disease is a rare X-linked hereditary storage disease caused by a mutation of the gene encoding alpha-galactosidase A. The clinical manifestation of the classical disease form is variable depending on the degree of individual organs involvement, including especially kidney, myocardium, central nervous system (CNS) and skin. We report a case of a 51-year-old man whose diagnostic manifestation was cardiac involvement leading to endomyocardial biopsy, which significantly contributed to the diagnosis. Although at that time he was already 9 years dependent on dialysis with terminal renal failure.

A crime scene is the result of the dynamic interrelation of various factors. Where a fatality is involved, thorough analysis of the scene by a forensic pathologist produces the first data for verifying consistency between the necropsy results and witness testimonies toward defining the dynamics of injury and death. This step is extremely important in identifying any liability. We present the case of a construction worker who fell through a trapdoor between two floors while holding an iron beam at a building site. This case demonstrates the effectiveness of an integrated approach, using both classic forensic investigation techniques and digital 3-D reconstruction: it allowed verification of the dynamics of the injury and provided important information in assessing the employers liability.

On 8 June 1972, the Czechoslovak OK DNN aircraft carrier L410 Turbolet was delivered to the regular line Marianske Lazne - Prague to the Federal Republic of Germany. About 8 minutes after the launch from Marianske Lazne Airport, the likely head of the group of kidnappers threw the captain of the plane. During the fight with one of the passenger, the head of the group of kidnappers killed the captain of the aircraft by a shot from 7.65 mm pistol. Other members of the hijackers group attacked other passengers. After the aircraft captains death, the second pilot took command and landed at the sports club at Weiden. After the landing, the kidnappers were detained by the police. Ten kidnappers stayed in the Federal Republic of Germany. An airplane with other passengers and coffin of a shot captain landed in Prague Ruzyne the following day. On June 12, 1972, the re-autopsy of the captain of the aircraft was performed at the Central Military Hospital in Prague. Post-autopsy status was detected. In this re-autopsy, it was possible to reconstruct the fire channel only incompletely, because during the previous autopsy performed in Federal Republic of Germany was excised the shot wound left on the neck. The fire channel began with a hole in the skin 10 cm above the right breast nipple, continued to the left and slightly upward through the subcutaneous tissue, passed through the 2nd rib at the right at a distance of 4.5 cm from the sternum, continued the lower and inner sides of the right collarbone, flowing on the front the ring cartilage and the first ring of the trachea, and on the underside of the left lobes of the thyroid gland, passed on the front of the left common carotid and continued into the area of the left SCM. The exid shot hole was on the left half of the neck. The direction of the shotway canal from right side to left side was detectable only by the fragment of the 2nd rib, which was broken out to the left and inside. The cause of the captains death was a traumatic shock. The injury was caused by a short firearm of small stance. Additional factors of firing were not found on the skin, as well as no signs of gas pressure. At the request of the experts performing the autopsy, a copy of the autopsy protocol from Germany was sent to them by an autopsied doctor. Among other things, it was reported that a 6.5 cm under the lower end of the left ear was a transversely oval, 2.5 cm long and 1.2 cm wide, red-black dried place of the upper skin, from which center run out a little red blood. At the conclusion of the autopsy protocol, it was found that there was a shotgun injury at the left side of the neck and the right side of the chest. The entrance wound according to the sent copy of the autopsy protocol, lay on the left side of the neck, the bullet penetrated the neck muscles, broke the inner branch of the cervical artery, passed through the trachea, penetrated the collarbone, split the 2nd rib to the right about 2 cm next to the sternum and th

In addition to the well-known group of inflammations of infectious etiology, placental inflammations arising on immunological basis are also encountered. The incidence of the latter far exceeds the group of infectious lesions of the placenta caused mainly by microorganisms of the TORCH group. Given the current knowledge of the possible complications of these inflammations, their precise diagnosis becomes more important not only from the clinicopathological point of view, but also because of potential forensic consequences. The aim of this article is to provide readers with a basic overview of the morphology, classification, presumed pathogenesis and clinical aspects of these entities.

The goal of this manuscript is to provide an overview of the significance of immunohistochemical methods in diagnosing endometrial carcinoma. The main points discussed include: the use of immunohistochemistry in the differential diagnosis of the main histological types of endometrial carcinoma, the difference between primary serous endometrial carcinoma and the involvement with high grade serous carcinoma of another primary source, the diagnosis of undifferentiated/dedifferentiated endometrial carcinoma, and diagnosing tumours with neuroendocrine differentiation. The role of p53 expression evaluation is also emphasized as a special area of interest, not only in the context of differential diagnosis, but also from the point of view of the prognosis and prediction of endometrial carcinoma as an ancillary marker for subtypization of these tumours.

Molecular testing of tumor tissue for the detection of somatic aberrations using NGS is increasingly gaining significance in routine practice. The technical aspects of testing are standardized and currently do not pose a problem. However, the situation is evolving very rapidly regarding the indication of testing, which depends on the sometimes rapidly developing medical knowledge and needs in clinical practice. In order to implement NGS testing in practice and arrange its reimbursement by the health care system, first it is necessary to reach an agreement on the level of professional societies concerning the definition of priority and medically clearly justified areas in which molecular testing has a clear impact on therapeutical choices. The next step is to reach an agreement with the health insurance companies regarding NGS testing. The aim of this article is to provide an overview of the issue of routine tumor tissue testing using the NGS method covered by public health insurance, with a summary of the current situation in the Czech Republic. Only the testing of somatic aberrations in solid tumors performed at pathology departments is discussed. The issue of testing in haemato-oncological centres is not the subject of this review.

Examination of changes in the methylation profile of DNA in cancer is currently used to determine the diagnosis or prognostic and predictive biomarkers. It complements histological or molecular biological examinations. At the same time, it helps to identify new diagnostic groups and subgroups. Currently, this diagnosis is most common in brain tumors, where it has become a routine examination. The established methylation profile may help even where the diagnosis or subgroup classification of the disease cannot be determined in any other way, as is the case with medulloblastoma.

Umbilical cord hemangioma is a rare tumor that can be associated with significant fetal and perinatal complications. Although usually described as a single anomaly, sometimes these tumors are reported in association with other vascular lesions. We report an unusual case of simultaneous occurrence of two umbilical cord hemangiomas and vascular malformation of the transverse mesocolon in a stillborn fetus with hydrops. To our knowledge, this is the first report of two simultaneously occurring umbilical cord hemangiomas. Moreover, presence of associated vascular malformation of transverse mesocolon could support the hypothesis of underlying predisposition to the development of vascular tumors.

Symplastic haemangioma is a rare vascular tumor presented with regressive and degenerative atypia in stromal cells. Its morphology represents a challenge in classification of vascular tumors, regarding their biological behaviour in particular. We present a case report of a 47-years-old female with a history of left-sided breast adenocarcinoma treated by resection followed by adjuvant chemotherapy and radiotherapy. Three years after the primary diagnosis a tumorous mass appeared in the region of upper margin of left scapula, in subcutaneous tissues and the trapezius muscle. Histologically, the tumor was formed by multiple blood vessels of varied diameter and wall thickness. Endothelial lining was bland, without atypia; thromboses were observed in vascular spaces. In the interstitium, a population of spindle and pleomorphic cells with distinctive atypia and bizarre nuclei was found. These cells showed positivity in immunohistochemical expression of smooth muscle actin, further extensive immunohistochemistry including cytokeratines was negative. Mitoses were absent, proliferating activity was minimal. Signs of infiltrative growth pattern were not found and the tumor lacked hallmarks of malignant behaviour. A diagnosis of symplastic haemangioma was established. Above mentioned atypical stromal cells show myofibroblastic and sporadically smooth muscle differentiation. Their atypical appearence is associated with degenerative alterations similar to changes in leiomyomas with bizarre nuclei or ancient schwannomas. Etiopathogenesis of these changes is not clear, there are hypotheses considering long-lasting persistence of the lesion, regression of ischaemic or postinflammatory origin, or, like in our case, postirradiative degeneration. Differential diagnosis of symplastic haemangioma is widespred and contains many histological entities of variant histogenesis and biological potential. For proper classification, an extensive investigation including immunohistochemistry, clinical and anamnestic data and imaging methods is necessary.