Arkhiv patologii最新文献

{"title":"[Post-Covid aortitis with cardiac involvement: progressive aortic aneurysm combined with active myocarditis].","authors":"O V Blagova, P O Savina, E A Kogan","doi":"10.17116/patol20258702153","DOIUrl":"https://doi.org/10.17116/patol20258702153","url":null,"abstract":"<p><p>The new coronavirus infection is characterized not only by pronounced cytokine and autoimmune reactions in the acute period, but is also an inducer of a whole spectrum of chronic immunoinflammatory conditions, which differ in varying degrees of specificity from general manifestations of the so-called post-COVID syndrome to single-organ diseases (including myocarditis) and nosologically defined systemic autoimmune diseases and vasculitis. Isolated post-COVID aortitis is one of the rarest complications of SARS-CoV-2 infection. We present a clinical observation of a patient with myocarditis and aortitis simultaneously developing 1 month after COVID-19 with damage to the infrarenal section and formation of an aortic aneurysm. Myocarditis was verified by MRI, manifested by severe dysfunction of the left ventricle with a drop in the ejection fraction to 30% and was of an autoimmune nature (a 4-fold increase in the titers of anticardiac antibodies was revealed). At the same time, MSCT revealed an aortic aneurysm with thickening of its walls. Therapy with medium doses of corticosteroids resulted in clinical remission of myocarditis, but progression of the aortic aneurysm required surgical treatment. The diagnosis of chronic immune inflammation associated with SARS-CoV-2 was morphologically confirmed (nucleocapsid and spike proteins of the virus were detected in macrophages, lymphocytes of infiltrates and endothelium of microvessels). The combination of post-COVID myocarditis and chronic aortitis has not been described previously. The issues of pathogenesis, diagnostics, and nosological nature of combined immune-inflammatory damage to the heart and blood vessels after a new coronavirus infection are discussed.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"87 2","pages":"53-58"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952742","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}

{"title":"[Quality control of immunohistochemical studies: compulsory duty or urgent need?]","authors":"L E Zavalishina, Yu Yu Andreeva, A A Barinov, I Yu Vinogradov, S V Vtorushin, I A Demidova, O A Kuznetsova, E M Olyushina, S V Petrov, G A Raskin, N A Savelov, K A Skripnikova, G A Frank","doi":"10.17116/patol20258702143","DOIUrl":"https://doi.org/10.17116/patol20258702143","url":null,"abstract":"<p><p>Immunohistochemical study is an integral component of modern morphologic diagnostics, providing accurate marker detection and identification of molecular subtypes of malignant neoplasms. A quality control system is fundamental in the aspect of standardizing laboratory protocols, ensuring reproducibility of results and increasing the reliability of diagnostic conclusions.</p><p><strong>Objective: </strong>To conduct a comprehensive assessment of the quality of immunohistochemical studies at the successive stages of the laboratory process (pre-analytical, analytical, post-analytical) in medical organizations that are participants of the external quality control program of the IHC Quality Control Center of Russian Medical Academy of Continuous Professional Education for 2024.</p><p><strong>Material and methods: </strong>The present study analyzed the results of external quality control rounds initiated by the Quality Control Center. The nature and frequency of errors at all stages of immunohistochemical study, including procedures for fixation of biological material, methodology of immunohistochemical staining, and interpretation of the results obtained were evaluated. Analytical evaluation was carried out by experts in accordance with the criteria of international standards (CAP, NordiQC).</p><p><strong>Results: </strong>The analysis of the pre-analytical stage revealed methodological inconsistencies related to the processes of fixation of biological material, to the degree of DNA degradation and to the qualitative characteristics of histologic processing. At the analytical stage, the main errors were inadequate selection of antibodies and detection systems, and insufficient validation of diagnostic protocols.</p><p><p>The postanalytic phase was characterized by a predominance of factors of incorrect conclusions, including errors in interpretation of HER2 status and molecular genetic subtypes of breast carcinoma. Repeated rounds of follow-up demonstrate that implementation of expert recommendations contributes to statistically significant improvements in diagnostic quality.</p><p><strong>Conclusion: </strong>The system of external quality control of immunohistochemical studies represents a key tool to optimize the accuracy and reproducibility of morphological diagnostics. Systematic participation of laboratories in control programs, standardization of methodological approaches and improvement of professional qualification of specialists ensure minimization of diagnostic errors and increase of clinical significance of research results.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"87 2","pages":"43-52"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967183","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}

{"title":"[Infectious diseases of the respiratory system in Irkutsk in 2023 according to autopsy data].","authors":"V V Svistunov, A E Makarova","doi":"10.17116/patol20258702137","DOIUrl":"https://doi.org/10.17116/patol20258702137","url":null,"abstract":"<p><strong>Objective: </strong>To characterize infectious diseases of the respiratory system in Irkutsk based on autopsy data for 2023.</p><p><strong>Material and methods: </strong>The results of 1166 autopsies of those who died in multidisciplinary hospitals in Irkutsk in 2023 were analyzed. The data of macro- and microscopic, immunohistochemical, bacterioscopic, microbiological studies, and PCR were evaluated.</p><p><strong>Results: </strong>The total number of deaths from infectious diseases of the respiratory system was 683 - 59% of the total number of autopsies. Of these, acute pneumonia, including secondary, was 557 (48%). The etiology of secondary pneumonia is in most cases associated with <i>Klebsiella pneumoniae</i>, including in various combinations with other pathogens. The largest number of registered secondary pneumonias occurred during the period of increased incidence of acute respiratory viral infections and influenza. Among those who died from tuberculosis, HIV-infected individuals predominated; in 67% of cases, the etiology of the disease was associated with the Beijing genotype.</p><p><strong>Conclusions: </strong>Infectious diseases of the respiratory system remain one of the most pressing problems in medicine, and acute secondary pneumonia is the most common complication and the most common cause of death of patients in somatic hospitals in Irkutsk.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"87 2","pages":"37-42"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061957","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}

{"title":"[Eosinophilic cells associated with BRAF mutation in borderline serous ovarian tumors].","authors":"A S Badlaeva, A V Tregubova, A A Udina, A V Asaturova","doi":"10.17116/patol20258702118","DOIUrl":"https://doi.org/10.17116/patol20258702118","url":null,"abstract":"<p><strong>Objective: </strong>To define the diagnostic value of eosinophilic cells for the detection of <i>BRAF</i>-mutated serous borderline ovarian tumors.</p><p><strong>Material and methods: </strong>The study included 42 cases of serous borderline ovarian tumor, each of which was analyzed by 3 pathologists for the presence of eosinophilic cells. Genetic profiling using Sanger sequencing was performed to identify the <i>BRAF</i>^V600E mutation. Comparisons between two groups were performed using the Mann-Whitney test, Fisher's exact test. Fleiss's kappa was used to assess the interobserver agreement. To assess the diagnostic value of eosinophilic cells, sensitivity and specificity were assessed.</p><p><strong>Results: </strong>According to the results of a genetic study, the <i>BRAF</i>^V600Emutation was found in 19 of 42 tumors. When analyzing interobserver agreement, the Fleiss's kappa values allowed us to determine the reliability of the test as sufficient (ϰ=0.7). The sensitivity and specificity for predicting <i>BRAF</i>^V600Emutation for eosinophilic cells were 78.9% and 91.3%, respectively. Patients with the <i>BRAF</i>^V600E mutation were significantly younger than patients without it. Thus, the average age of patients in the group with the <i>BRAF</i>^V600E mutation was 33.6±15.6 years, while in the group of tumors without the mutation the average age of patients was 43.9±12.7 years (<i>p</i>=0.002). Non-invasive implants were less frequently found in tumors with the <i>BRAF</i>^V600E mutation compared to tumors without the mutation: 11.76% (2/17) versus 33.3% (6/18), respectively, but these differences were not statistically significant (<i>p</i>=0.228).</p><p><strong>Conclusion: </strong>Eosinophilic cells in ovarian serous borderline tumors may sufficiently reflect the <i>BRAF</i>^V600E mutation, thereby correlating with disease prognosis (low risk of progression to low-grade serous carcinoma).</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"87 2","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963634","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}

{"title":"[Predictive immunotherapeutic markers of adenocarcinomas and adenosquamous carcinoma of the cervix].","authors":"A D Kolina, N V Danilova, Yu Yu Andreeva","doi":"10.17116/patol20258705174","DOIUrl":"https://doi.org/10.17116/patol20258705174","url":null,"abstract":"<p><p>Adenocarcinoma and adenosquamous carcinoma of the cervix together account for up to 20% of all cervical cancers. These histologic subtypes are characterized by a worse prognosis compared with squamous cell cancer of the same grade and have specific epidemiologic, morphologic and molecular features. Despite fundamental differences, therapeutic approaches for cervical cancer are similar regardless of tumor histology. This article discusses promising companion diagnostic markers for cervical cancer treatment, including MSI, PD-L1 and TIL's, that may find application in the therapy of prognostically unfavorable subtypes of cervical cancer. The literature review revealed that despite the low frequency of immunotherapy markers among adenocarcinomas and adenosquamous carcinomas of the cervix, analyzing them will allow us to identify a group of patients who will benefit most from immunotherapy, a key step towards improving treatment outcomes.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"87 5","pages":"74-79"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145372063","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}

{"title":"[Clinical and morphological analysis of a case of retroperitoneal malakoplakia].","authors":"A N Belkin, D A Lobanov","doi":"10.17116/patol20258704158","DOIUrl":"10.17116/patol20258704158","url":null,"abstract":"<p><p>Malakoplakia is a rare chronic inflammatory disease that mainly affects the genitourinary system. A case of malakoplakia in the retroperitoneal space in a 53-year-old female patient with abdominal pain syndrome is presented. According to the results of computed tomography and magnetic resonance imaging of the abdominal organs and retroperitoneal space, the changes were assessed as nonspecific. Diagnostic biopsy revealed specific microscopic signs - the presence of inflammatory cell infiltration in the soft tissues of the retroperitoneal space with an abundance of CD68-positive macrophages containing PAS-positive cytoplasmic inclusions - Michaelis-Gutman bodies. Morphological examination allows differential diagnosis of malakoplakia with other pathological processes.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"87 4","pages":"58-61"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940462","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}

{"title":"[Philosophy in pathological anatomy].","authors":"E F Lushnikov","doi":"10.17116/patol20258704162","DOIUrl":"10.17116/patol20258704162","url":null,"abstract":"<p><p>This lecture provides data on the role of philosophy in modern pathologic anatomy. Subjects and activities, objects, methods of lifetime and postmortem studies are consecutively considered.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"87 4","pages":"62-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940566","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}

{"title":"[Immunophenotypic characteristics of mast cells in non-metastatic seminoma].","authors":"V I Shchekin, A A Krasheninnikov, D V Belokopytov, N N Volchenko, P V Shegay, A D Kaprin, G A Demyashkin","doi":"10.17116/patol20258705146","DOIUrl":"https://doi.org/10.17116/patol20258705146","url":null,"abstract":"<p><p>Germ cell tumors are rare testicular neoplasms that occur in young men, and their proportion is 2%. Pathological changes in the immune landscape of seminoma - the interaction of mast cells, T-, B-lymphocytes and macrophages with atypical spermatogenic cells, possibly impart a certain uniqueness to seminoma, and their number determines the stage of tumor growth. At the same time, the question of the participation of mast cells in the progression of seminoma remains debatable.</p><p><strong>Objective: </strong>Immunophenotypic analysis of mast cells in non-metastatic seminoma.</p><p><strong>Material and methods: </strong>According to anamnestic and clinical-morphological data, the following groups were formed: Group I (<i>n</i>=73; age 20-53 years) - seminomas, according to the pTNM classification: subgroup Ia - T1N0M0 (<i>n</i>=31); Ib subgroup - T2N0M0 (<i>n</i>=42). II group - comparison (<i>n</i>=21, age 20-53 years) - intact testicles. Histochemical (Toluidine blue) and immunohistochemical (antibodies to Tryptase, Chymase and CPA3) research methods were used.</p><p><strong>Results: </strong>Based on the conducted histochemical reactions, it was found that mature mast cells predominate in seminoma, and their number is directly proportional to the pTNM stage. In immunohistochemical analysis of mast cells, we also observed a quantitative change in specific proteases, especially Tryptase, depending on the pTNM stage of seminoma, towards their decrease.</p><p><strong>Conclusion: </strong>Immunophenotypic distribution of secretome granules indicates a decrease in the number of Tryptase-, Chymase- and CPA3-mast cells, which is inversely proportional to the pTNM stage of non-metastatic seminoma.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"87 5","pages":"46-53"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145375914","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}

{"title":"[Rare case of round cell sarcoma of bone with EWSR1-NFATC2 fusion].","authors":"M M Rawia, A Ashraf, J V Anu, Ch Oussama, D Mohanad, M A Hazem","doi":"10.17116/patol20258706149","DOIUrl":"https://doi.org/10.17116/patol20258706149","url":null,"abstract":"<p><p>Undifferentiated small round cell sarcoma of bone and soft tissue are rare, malignant neoplasms, often presenting diagnostic challenges due to its overlapping features with other conditions such as osteomyelitis and Brodie abscess. Accurate diagnosis requires a combination of imaging studies, histopathology, and genetic testing. Delayed or misdiagnosis can impact the prognosis and treatment outcomes. We present the case of a 34-year-old female who initially presented with persistent left upper thigh pain. Initial imaging raised suspicion of chronic osteomyelitis, with subsequent MRIs showing abnormal bone marrow edema and a lytic lesion in the left femoral diaphysis. Despite undergoing multiple biopsies, results remained inconclusive, with differential diagnoses including Brodie's abscess. The patient experienced temporary improvement, but her symptoms recurred, prompting further investigations. A repeat MRI showed the progression of intramedullary lesions and the appearance of new focal lesions. A biopsy eventually confirmed the presence of a malignant round cell tumor, identified as Ewing sarcoma through immunohistochemical evaluation and detection of <i>EWSR1</i> gene rearrangement on FISH analysis and further NGS confirming <i>EWSR1-NFATC2</i> fusion, diagnostic of the rare entity - round cell sarcoma with <i>EWSR1-NFATC2</i> fusion. This case highlights the diagnostic complexities of round cell sarcoma of bone, which can mimic other benign bone lesions. It underscores the importance of multidisciplinary evaluation, genetic testing, and timely oncological intervention to improve patient outcomes.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"87 6","pages":"49-55"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653174","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}

{"title":"[Neuroendocrine tumor of the extrahepatic bile ducts. Case report and literature review].","authors":"D E Suraev, S O Zagagov, N A Savelov, A A Ajazova, D Yu Kanner, O V Paklina","doi":"10.17116/patol20258701141","DOIUrl":"10.17116/patol20258701141","url":null,"abstract":"<p><p>Neuroendocrine neoplasms (NENs) are heterogeneous tumors with a common phenotype. There are two fundamentally different groups of NENs: well differentiated with a low proliferative index, called neuroendocrine tumors (NETs) and poorly differentiated with a high proliferative index, called neuroendocrine carcinoma (NEC). Extrahepatic bile duct NETs (EBNETs) account for 0.2% to 2% of all gastrointestinal NETs and up to 2% of all malignant neoplasms of the extrahepatic bile ducts. To date, 114 cases of EBNETs have been described, with disease-free survival ranging from 2 to 240 months. In most cases, the tumors expressed Chromogranin A, Synaptophysin, CD56, and NSE. This report presents a rare case of an EBNET in a 61-year-old patient following resection of the extrahepatic bile ducts. The description includes data from radiological and ultrasound diagnostic methods, macro- and microscopic characteristics of the tumor, and immunohistochemical profile.</p>","PeriodicalId":8548,"journal":{"name":"Arkhiv patologii","volume":"87 1","pages":"41-47"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405494","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}