Retrospective analysis of the appendiceal neoplasms: sampling technique may influence neoplasm detection

Background and aimsAppendiceal neoplasms are uncommon entities that are usually determined incidentally during the histopathological examination. Different techniques used for the macroscopic sampling of appendectomy material may affect the determinating neoplasms.Materials and methodsH&E-stained slides of 1280 cases who underwent appendectomy between 2013 and 2018 were reviewed retrospectively for histopathological features.ResultsNeoplasms were determined in 28 cases (3.09%); 1 lesion was observed in the proximal part of the appendix, 1 covering the entire length from proximal to distal and 26 in the distal part. In the 26 cases that observed in the distal part, the lesion was seen on both sides of the longitudinal section of the distal appendix in 20 cases, while it was seen on only one distal longitudinal section in the remaining 6 cases.ConclusionThe vast majority of appendiceal neoplasms are seen in the distal part of the appendix, and, in some cases, neoplasms might be seen on only one side of the distal section. Sampling only one-half of the distal part of the appendix, where tumours are most often observed, could result in some neoplasms being missed. Therefore, sampling the whole distal part would be more beneficial to determine small diameter tumours that do not create macroscopic findings.

LED Photobiomodulation Therapy Associated with Heterologous Fibrin Biopolymer Optimizes Wound Repair in Rats

This study aimed to evaluate the effect of LED photobiomodulation therapy associated or not with heterologous fibrin biopolymer to repair skin wounds in rats. Full-thickness skin wounds were induced on the back of 84 Wistar rats and they were randomly divided into 4 groups: control group (CG), LED group (LED), heterologous fibrin biopolymer group (HFB), and LED + heterologous fibrin biopolymer group (LED + HFB). The animals were euthanized at 7, 14, and 21 days after surgery. In the macroscopic findings, it was observed in the control group, mild local inflammation, evidenced between the 5th and 6th day after the injury, not manifested in the other groups. The analysis of the wound reduction index shown that the treated groups presented greater wound reduction in the three periods evaluated. The results of the degree of inflammation showed that the LED and LED + HFB groups showed a predominance of chronic inflammation, while the control group showed a predominance of diffuse acute inflammation. The quantity of type I collagen it was bigger after 7 days in the LED and LED + HFB groups, and at 14 and 21 days this type of collagen appears more intensely in the group that used only HFB. The traction force at 7 days of the experiment, the treated groups showed better performance, while at 14 and 21 days the group that used only the biopolymer obtained greater strength in the suture region. Results have indicated that treatments using HFB and LED, either isolated or associated, stimulated the wound repair process in rats. HFB promote collagen maturation.

Idiopathic Aneurysms of the Ascending Aorta in the Mouse and Rat

Aneurysms of the ascending aorta, unrelated to xenobiotic administration, are described in 5 rats and 2 mice in nonclinical safety studies conducted at Charles River Laboratories (CRL) sites over the past 10 years. The most prominent microscopic finding was focal dilation with disruption of the wall of the ascending aorta with chronic adventitial inflammation or fibroplasia. The pathogenesis of this finding is unknown. There were no associated macroscopic findings, clinical abnormalities, or vascular lesions elsewhere. The results of a search of historical control data from toxicology studies of 1 day to 72 weeks’ duration performed at CRL for aortic findings from 5900 mice and 23,662 rats are also reported. Aortic lesions are uncommon in mice and rats used in nonclinical safety studies, but toxicologic pathologists should be aware that aneurysms of the ascending aorta with fibroplasia and inflammation in the aortic wall and adventitia may occur spontaneously or iatrogenically, as they have the potential to impact interpretation in toxicology studies.

Neuropathology of SCA34 showing widespread oligodendroglial pathology with vacuolar white matter degeneration: a case study

Spinocerebellar ataxia type 34 (SCA34) is an autosomal dominant inherited ataxia due to mutations in ELOVL4, which encodes one of the very long-chain fatty acid elongases. SCA38, another spinocerebellar ataxia, is caused by mutations in ELOVL5, a gene encoding another elongase. However, there have been no previous studies describing the neuropathology of either SCA34 or 38. This report describes the neuropathological findings of an 83-year-old man with SCA34 carrying a pathological ELOVL4 mutation (NM_022726, c.736T>G, p.W246G). Macroscopic findings include atrophies in the pontine base, cerebellum, and cerebral cortices. Microscopically, marked neuronal and pontocerebellar fiber loss was observed in the pontine base. In addition, in the pontine base, accumulation of CD68-positive macrophages laden with periodic acid-Schiff (PAS)-positive material was observed. Many vacuolar lesions were found in the white matter of the cerebral hemispheres and, to a lesser extent, in the brainstem and spinal cord white matter. Immunohistological examination and ultrastructural observations with an electron microscope suggest that these vacuolar lesions are remnants of degenerated oligodendrocytes. Electron microscopy also revealed myelin sheath destruction. Unexpectedly, aggregation of the four-repeat tau was observed in a spatial pattern reminiscent of progressive supranuclear palsy. The tau lesions included glial fibrillary tangles resembling tuft-shaped astrocytes and neurofibrillary tangles and pretangles. This is the first report to illustrate that a heterozygous missense mutation in ELOVL4 leads to neuronal loss accompanied by macrophages laden with PAS-positive material in the pontine base and oligodendroglial degeneration leading to widespread vacuoles in the white matter in SCA34.

Infectious laryngotracheitis of chickens: Pathologic and immunohistochemistry findings

Infectious laryngotracheitis (ILT) is an important upper respiratory disease of chickens. Gross and histologic lesions of ILT in chickens are compared to immunohistochemistry to evaluate the diagnostic test sensitivity. A total of 31 separate ILT-confirmed necropsy submissions (12 commercial meat-type flocks, 13 egg-type producers, and 6 backyard flocks) were arbitrarily selected. Each submission ranged from 1 to 18 birds, for a total of 246 chickens. Cases with available formalin-fixed tissues were selected to include a range of bird production types, ages, clinical histories, and severity of macroscopic and histologic lesions. Macroscopic findings in the respiratory tract varied from increased mucus (55.6%) to fibrinonecrotic exudate (20.3%) and hemorrhages in the larynx and trachea (13.0%). Syncytia with intranuclear inclusion bodies were present in the respiratory tract epithelium with or without hemorrhages. Sections of conjunctiva, sinus, larynx, trachea, lung, and air sac were analyzed by immunohistochemistry (IHC) to detect gallid alphaherpesvirus 1 (GaHV-1) antigen. Positive immunolabeling was detected in the cytoplasm and nuclei of syncytia and epithelial cells in 18/22 conjunctivae (82%), 12/13 sinuses (92%), 18/22 larynxes (82%), 23/25 tracheas (92%), 10/21 lungs (57%), and 3/8 air sacs (37%). Of the 34 tissues with no visible syncytia or inclusion bodies, 8 were positive by IHC. In conclusion, IHC was useful to study the viral antigen tissue distribution and support the diagnosis of ILT when the histopathologic interpretation was doubtful.

Upper gastrointestinal endoscopy findings in Mbale Regional Referral Hospital, Eastern Uganda: a 10-year retrospective analysis

Background: Endoscopy is required for formal diagnosis of many upper gastrointestinal (UGI) conditions including oe- sophageal cancer (OC). There is a paucity of data on endoscopy findings in East Africa as access to testing is challeng- ing for patients. We describe the findings of 10 years of UGI endoscopy in Mbale Regional Referral Hospital (MRRH). Method: Records of patients that underwent UGI endoscopy in MRRH, November 2009 – March 2019 were retrospective- ly analysed. Indication, macroscopic findings, histology and patient demographics were retrieved. Sub-group analyses were performed on those with a histological diagnosis of oesophageal cancer. Results: 833 eligible patients received single UGI procedures during the study period. Mean age was 54.8 years, range 16-93 years and 56.9% of patients were male. The main indication was dysphagia (42%) and the most common findings OC (34%) and gastritis (28%). 151 patients had histologically proven OC with a median age of 60 years and a 2:1 male to female ratio. 145/151 (96%) of samples tested revealed squamous cell carcinoma (SCC). Conclusion: Those undergoing endoscopy in MRRH are most commonly male patients presenting in their 5th decade with dysphagia. There is a high proportion of significant findings including gastritis, peptic ulcer disease, and oesophageal cancer. Keywords: Gastrointestinal; OGD; LMIC; oesophageal cancer.

Twin-to-twin transfusion syndrome: new macroscopic and microscopic findings

Background Twin-to-twin Transfusion Syndrome (TTTS) is a serious complication of monochorionic twin pregnancies. Affects about 10% to 15% of pregnancies and it is associated with high fetal and neonatal mortality, as well as cardiac and neurological morbidity in surviving fetuses. The main objective was to characterize a series of fetuses with TTTS since the pathophysiology of the syndrome is not fully understood and the clinical spectrum is broad. Methods Post-mortem macroscopic and microscopic examination of 26 fetuses (from 2010 to 2020) with TTTS syndrome. Results The most frequent macroscopic findings in placenta were discrepancy in size and pallor/placental congestion. Other macroscopic findings not described in the literature were calcifications, areas of infarction and hematomas. Infarction areas and villi heterogeneity growth were the most common microscopic findings, described in the literature. Regarding the fetus, the restriction of intrauterine growth, the alteration of anthropometric parameters and the presence of a plethoric/anemic fetus were the main characteristics associated with this syndrome. The most common microscopic findings were signs of anoxia and congestive organs, already described in the literature. We also found frequently pulmonary abnormalities as new findings in our study. Conclusions The results allowed the identification of TTTS aspects that can contribute to the characterization of this syndrome. Given that the progression of TTTS remains unpredictable and the mortality rate for both fetuses is 90%, it becomes increasingly important to identify strategies for diagnosing and characterizing the syndrome.

Pathological Results (Benign/Malignant) Can be Inferred from Macroscopic Findings for Breast Vacuum Associated Biopsy Specimens

Background: If the histopathological results could be inferred from the macroscopic findings for breast biopsy specimens, false-negative needle biopsies due to poor specimens could be prevented. However, no research on this has been reported to date.Methods: Biopsy specimens from 101 patients who underwent mammary gland Vacuum Associated Biopsy (VAB) were photographed with a smartphone, and the relationships between the macroscopic findings (presence/absence of turbidity, surface properties, presence/absence of white spots, and characteristic findings) and the pathological results (benign/malignant) were examined.Results: A significant difference was observed with regard to the presence/absence of turbidity: malignancy was detected in 33/37 (89%) specimens with turbidity and in 2/47 (4%) cases without turbidity (p<0.001). A significant difference was also observed regarding the surface properties: malignancy was detected in 14/70 (19%) smooth specimens and in 24/29 (83%) rough specimens (p<0.001). Also, malignancy was detected in 11/13 (85%) specimens with white spots, and the difference was significant (p<0.001).Conclusions: The pathological results (benign/malignant) were able to be predicted from the macroscopic findings for the breast VAB specimens. These findings warrant performance of reproducibility and prospective studies at multiple facilities.