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Aims: To determine the efficacy of XPro1595 to improve pathophysiological and functional outcomes in a mouse model of traumatic brain injury (TBI). Background: Symptoms associated with TBI can be debilitating, and treatment without off-target side effects remains a challenge. This study aimed to investigate the efficacy of selectively inhibiting the soluble form of TNF (solTNF) using the biologic XPro1595 in a mouse model of TBI. Objectives: Use XPro1595 to determine whether injury-induced solTNF promotes hippocampal inflammation and dendritic plasticity and associated functional impairments. Methods: Mild-to-moderate traumatic brain injury (CCI model) was induced in adult male C57Bl/6J WT and Thy1-YFPH mice, with XPro1595 (10 mg/kg, S.C.) or vehicle being administered in a clinically relevant window (60 minutes post-injury). The animals were assessed for differences in neurological function, and hippocampal tissue was analyzed for inflammation and glial reactivity, as well as neuronal degeneration and plasticity. Results: We report that unilateral CCI over the right parietal cortex in mice promoted deficits in learning and memory, depressive-like behavior, and neuropathic pain. Using immunohistochemical and Western blotting techniques, we observed the cortical injury promoted a set of expected pathophysiology’s within the hippocampus consistent with the observed neurological outcomes, including glial reactivity, enhanced neuronal dendritic degeneration (dendritic beading), and reduced synaptic plasticity (spine density and PSD-95 expression) within the DG and CA1 region of the hippocampus, that were prevented in mice treated with XPro1595. Conclusion: Overall, we observed that selectively inhibiting solTNF using XPro1595 improved the pathophysiological and neurological sequelae of brain-injured mice, which provides support for its use in patients with TBI.

The airways are frequently involved in nonneoplastic lung diseases, and sometimes their involvement dominates the clinical picture. In these situations, the combination of clinical and radiologic findings is sometimes sufficient to reach a firm diagnosis; however, in a significant proportion of cases a biopsy is obtained, frequently representing a challenge for the practicing pathologists. In the present chapter, beside the description of some well defined entities, we present the most relevant morphologic features that can be encountered on small endoscopic biopsies and on surgical samples, trying to identify the elementary lesions and to correlate them with the complexity of the different clinical settings where they can be found. It is a rare case in which the morphological features are diagnostic per se of a specific disease. Conversely, the identification of a few key elementary lesions can be of help to narrow the differential diagnoses that can be offered to clinicians to complete the difficult puzzle of interstitial lung diseases.

Chronic diffuse lung diseases involve a spectrum of nonneoplastic inflammatory conditions that affect the lung parenchyma. This chapter reviews the spectrum of disease including idiopathic interstitial pneumonias, pulmonary manifestations of systemic collagen vascular disease, diffuse eosinophilc lung disease, drug-associated lung disease, diffuse granulomatous lung disease, and a variety of miscellaneous diseases that defy classification. Individual entities are reviewed, followed by a section highlighting a practical approach to the four most common patterns of injury encountered in practice.

Pseća je herpesviroza globalno prisutna virusna zarazna bolest prouzročena psećim herpesvirusom 1 (Canid alphaherpesvirus-1; CHV). Infekcija ovim virusom ima dvije faze: litičku i latentnu. Sam ishod infekcije uvelike ovisi o dobi i razvijenosti imunološkog sustava psa. Najznačajnija patološka posljedica pseće herpesviroze je liza endotelnih stanica i epitelnih stanica više organskih sustava koja se pojavljuje u imunodeficijentnih štenaca. Zbog pantropizma CHV-a, posljedica infekcije je nekrohemoragična upala mnogobrojnih organa zbog koje štenci nerijetko i ugibaju. U imunokompetentnih starijih pasa, iako često asimptomatska, litička infekcija može biti i smrtonosna. Klinički simptomi uključuju infekcije dišnog i spolnog sustava i očiju. Najčešće prisutna lezija očiju je konjunktivitis, ali mogu se pojaviti i ulceracije, petehijalna krvarenja i eksudativni blefaritis s krustama i alopecijom. Utjecaj CHV-a na respiratorni sustav rezultira blagim rinitisom, faringitisom i traheobronhitisom, iznimno pneumonijom. CHV se često povezuje i sa zaraznim traheobronhitisom u pasa, tzv. ‘’kašaljem štenare’’. Infekcija spolnog sustava ograničena je na hiperemiju vagine ili prepucija s hiperplastičnim limfoidnim folikulima te papulovezikularnim lezijama, ali se smatra najvažnijim izvorom infekcije za štenad pri porođaju. Prestankom kliničkih simptoma CHV prelazi u fazu latencije u živčanim ganglijima te se na taj način trajno zadržava u domaćinu. Prilikom stresa i imunosupresije latentni se CHV virus može reaktivirati i uspostaviti litičku fazu. Time se virus ponovno počinje replicirati i izlučivati, a oboljeli pas se mora isključiti iz uzgoja jer predstavlja izvor daljnjeg širenja virusa. Ipak, primjenom cjepiva u gravidnih kuja moguće je zaštititi novorođenu štenad te spriječiti teške posljedice herpesviroze u pasa., Canine alphaherpesvirus-1 (CHV) is a globally present virus causing infectious disease in dogs. The outcome of CHV infection depends significantly on the age and immune system development of the dog and occurs in two phases: lytic and latent. Due to the pantropism of CHV, lysis occurs in the endothelium and epithelium of various organ systems, causing necrohaemorrhagic inflammation and frequently death in immunodeficient puppies. Lytic infection produces reduced or silent symptoms in older, immunocompetent dogs, although it can occasionally be fatal. Clinical signs of infection appear in the ocular, reproductive, and respiratory systems. The most typical eye lesion is conjunctivitis, though other conditions such as ulcers, petechial haemorrhages, exudative blepharitis with crusts, and alopecia can also occur. When CHV affects the respiratory system, it can cause mild rhinitis, pharyngitis, and tracheobronchitis, as well as severe pneumonia. The virus is also frequently linked to infectious tracheobronchitis in dogs, or “kennel cough.” Although infection of the reproductive system is restricted to hyperaemia of the vagina or prepuce with hyperplastic lymphoid follicles and papulovesicular lesions, it is thought to be the most significant source of infection for puppies after birth. After the onset of clinical symptoms, CHV enters the latency phase in the nerve ganglia, where it remains in the host indefinitely. During times of stress and immunosuppression in dogs, the latent CHV virus can occasionally reactivate and establisha lytic phase, at which point it resumes replication and shedding. These CHV latency effects are a significant problem since the affected dog is permanently infected, cannot be bred, and is always a source of possible virus outbreak. Although death ensuing from CHV infection is the worst conceivable consequence, immunisation of pregnant females can protect newborn puppies and breeders from this outcome.

Aim: This study was conducted for the purposes of investigating pathological changes in intestines of dogs, detecting prevalence of them and determining their role in being the cause of death. Materials and Methods: The intestines of 100 dead stray dogs were examined in macroscopic, histopathologic, microbiologic, and parasitic aspects. Immunohistochemical stainings were also performed for parvovirus and distemper diseases. Results:Hemorrhages in 61, ulcers in 8, parasites in 36, invagination in 14 and foreignobjects in2ofdogsweredetermined.Microscopically,histopathological findings such as degeneration, necrosis and desquamation in epithelium, bacteria colonies, hyperaemia, hemorrhages, fibrosis and inflammatory cell infiltrations in propria, degeneration, dilatation and hyperplasia in crypts, and depletion in lymphoid tissues were observed and their severity were scored. Canine parvovirus positive IHC reaction was found in 90 out of 100 dogs and canine distemper virus positive reaction was found in 27 dogs, also. Microbiologically, Campylobacter spp., Escherichia coli, Enterococcus spp., Streptococcus spp. are found in 58 dogs. Histopathologically, 29 acute, 51 chronic, 15 lymphocytic and plasmacytic enteritis; 5 acute, 10 chronic, 6 diffuse and 20 idiopathic mucosal colitis were diagnosed,respectively. Conclusion: It has been emphasized that alimentary tract diseases and lesions, mainly Parvoviral enteritis, are the first-degree cause of death in street dogs gathered in shelters. Generally, mixed infections were found, and it has been noticed that the lesions are increased, or primary lesions are masked according to participation period of secondary factors to infection., Amaç: Bu çalışma, köpeklerin bağırsaklarında meydana gelen patolojik değişiklikleri araştırmak, yaygınlıklarını tespit etmek ve ölüm nedeni olarak rollerini belirlemek amacıyla yapılmıştır. Gereç ve Yöntem: 100 ölü sokak köpeğin bağırsakları makroskopik, histopatolojik, mikrobiyolojik ve parazitik olarak incelendi. Parvovirüs ve distemper hastalıkları için immünohistokimyasal boyamalar da yapıldı. Bulgular: Köpeklerin 61'inde kanama, 8'inde ülser, 36'sında parazit, 14'ünde invaginasyon ve 2'sinde yabancı cisim tespit edildi. Mikroskobik olarak epitellerde dejenerasyon, nekroz ve deskuamasyon, bakteri kolonileri, propriyada hiperemi, kanama, fibrozis ve yangısal hücre infiltrasyonları, kriptlerde dejenerasyon, dilatasyon, hiperplazi, lenfoid dokuda boşalma gibi histopatolojik bulgular gözlendi ve her birinin şiddeti skorlandı. 100 köpekten 90'ında köpek parvovirüs pozitif IHC reaksiyonu ve 27 köpekte de distemper virüsü pozitif reaksiyonu bulundu. Mikrobiyolojik olarak 58 köpekte Campylobacter spp., E. coli, Enterococcus spp., Streptococcus spp. belirlendi. Histopatolojik olarak; sırasıyla 29 akut, 51 kronik, 15 lenfositik ve plazmasitik enteritis; kalın bağırsaklarda 5 akut, 10 kronik, 6 diffuz ve 20 idiopatik mukozal kolitis tanımlandı. Öneri: Köpeklerde, başta Parvoviral enteritis olmak üzere sindirim kanalı hastalıkları ve lezyonlarının birinci derecede ölüm sebebi olduğu ortaya konuldu. Genelde miks enfeksiyonların görüldüğü, sekonder etkenlerin enfeksiyona katılma dönemlerine göre lezyonların arttığı veya primer lezyonların maskelenmiş olduğu dikkati çekti.

Cystic hydatid disease or cystic echinococcosis (CE) is a globally endemic zoonosis caused by the larval cyst stage of the tapeworm Echinococcus granulosus. Concomitant presence of CE and hepatocellular carcinoma (HCC) is a rare clinical scenario. A 70-year-old male patient presented with acute abdominal pain to the surgical outpatient department. On evaluation, a cystic lesion with solid components and free fluid in the abdomen was observed, which led to multiple differentials in the working diagnosis. A CT showed the mass to have a delayed enhancement. Surgical exploration revealed a partially ruptured hydatid cyst with daughter cysts in the abdominal cavity and a solid-component mass lesion. We proceeded with a right partial hepatectomy. Pathological evaluation revealed a pale mass lesion with a large collapsed cyst. HCC with unusual dense fibrillar fibrosis and cystic interface with normal parenchyma was observed. This case connects the multimodal assessment of radiology, surgery and pathology.

Bruck syndrome is an autosomal recessive disease characterised by the clinical combination of both osteogenesis imperfecta and arthrogryposis multiplex congenita (AMC). It is caused due to collagen miss-folding and cross-linking defect resulting from a deletion in FKBP10 (OMIM #259450) and/or PLOD2

Beaches are major sites of microbiological pollution. Assessment of the abundance of resistant forms of enteric protozoa on these recreational waters is important for the prevention and management of health risks. Based on sedimentation and flotation methods, this study found that Kribi beach waters concentrate considerable amounts of enteric protozoa, which are potentially pathogenic. They include Coccidia (Cryptosporidium sp. and Cyclospora cayetanensis), Amoebae (Endolimax nana, Entamoeba histolytica and Entamoeba coli) and Flagellates (Giardia intestinalis). In general, seasonal changes and tidal cycles have significantly impacted the spread of these parasites along Kribi beaches. Thus, at all sites surveyed (Mpalla, Ngoyè and Mboamanga), maximum protozoan abundances were recorded at low tide and during the rainy seasons. It should also be noted that at each sampling site, significant correlations were recorded between certain protozoa and certain physico-chemical variables (p < 0.05). At Mboamanga, for example, Cryptosporidium sp. and Endolimax nana were positively correlated during the Short Rainy Season with temperature (r = 0.601, p = 0.044 and r = 0.632, p = 0.042). At Mpalla, a positive and significant correlation was observed during the Short Rainy Season between Entamoeba coli and pH (r = 0.605, p = 0.033). The high concentration of resistant forms of these enteric protozoa at Kribi beaches is a real public health threat for bathers. Therefore, in this tourist town, it is urgent to put in place an effective plan for the collection and sustainable treatment of solid and liquid waste, which are the main sources of contamination.

Neurofibromatosis (NF) is an inherited neuroectodermal abnormality that primarily affects the growth of neural tissues, and Riccardi classified it into eight types. Segmental neurofibromatosis, which is a rare form of neurofibromatosis, is classified as type 5. We report a case for very unusual presentation of segmental NF with unilateral lisch nodules and uncommon sites involving the scalp. Moreover, we could find only one case report of segmental NF with lisch nodules in the literature and could not find any case report involving the scalp.

Multicentric reticulohistiocytosis, also called as lipoid dermato-arthritis is a rare form of non-Langerhans cell histiocytosis characterised by nodular and papular skin lesions containing characteristic bizarre multinucleate giant cells with ground glass cytoplasm. The disease commonly involves the skin, mucosa, synovium, and internal organs with cutaneous nodules and progressive erosive arthritis being the most common presenting features. We report a case of a 61-year-old male presenting with multiple swellings over distal part of fingers for 6 years without involvement of joints. A diagnosis of multicentric histiocytosis was made based on typical histopathological features of sheets of histiocytes and multinucleate giant cells with ground glass eosinophilic cytoplasm. The disease has a low incidence and about 300 cases have been reported so far in literature. The present case is being reported as it is uncommon for the disease to present in absence of arthritis.

That pathology and normality exist on a complex spectrum of bodily manifestation is an enduring problem at the heart of the philosophy, anthropology and history of medicine. As the primary locus for the reproduction of medicine, medical schools are important sites for cultivating knowledge of what is normal and what is not. Here students come to engage with the slippery concepts of normality and pathology in collaboration with a wide range of educational technologies - the cadavers, plastic models, illustrations and diagnostic tools which corral student knowledge of the body in both health and disease. These technologies are not universally employed across medical faculties, and variations in their use contributes to various constructions of pathology and normality. Ethnographic observation and historical research in medical faculties in Hungary, the Netherlands and Ghana, shows that educational practices are shaped by the epistemic traditions which manifest in the material environment of the medical school, and that these different sociomaterial settings contribute to inconsistent notions of normalcy. Although educational technologies often tend towards fixity in their representations of the body in health and disease, medical school practice in the north of Ghana resists the imposition of the often alien standards typically found in teaching materials imported from Europe or North America. By teaching around and beyond these materials, Ghanaian educators also challenge their assuredness and the intellectual history of contemporary medicine.

Mixed pancreatic epithelial and mesenchymal tumors are rare, usually invasive, entities. Intraductal papillary mucinous neoplasm (IPMN) is a precursor of invasive ductal carcinoma and shares mutations with its invasive counterparts. We report the case of a 72-year-old female with a previously undescribed sarcomatous transformation of a residual IPMN with no evidence of an invasive component. The mesenchymal component showed no heterologous differentiation. Both the epithelial and the mesenchymal populations showed aberrant expression of p53 protein and the same point mutation in KRAS gene. After a 6 month follow up, there were no signs of local or distant relapse. The present case suggests that sarcomatous transformation is possible in non-invasive, intraductal pancreatic lesions.

ImportanceDiagnostic incidence data for syndromes associated with frontotemporal lobar degeneration (FTLD) in multinational studies are urgent in light of upcoming therapeutic approaches.ObjectiveTo assess the incidence of FTLD across Europe.Design, Setting, and ParticipantsThe Frontotemporal Dementia Incidence European Research Study (FRONTIERS) was a retrospective cohort study conducted from June 1, 2018, to May 31, 2019, using a population-based registry from 13 tertiary FTLD research clinics from the UK, the Netherlands, Finland, Sweden, Spain, Bulgaria, Serbia, Germany, and Italy and including all new FTLD-associated cases during the study period, with a combined catchment population of 11 023 643 person-years. Included patients fulfilled criteria for the behavioral variant of frontotemporal dementia (BVFTD), the nonfluent variant or semantic variant of primary progressive aphasia (PPA), unspecified PPA, progressive supranuclear palsy, corticobasal syndrome, or frontotemporal dementia with amyotrophic lateral sclerosis (FTD-ALS). Data were analyzed from July 19 to December 7, 2021.Main Outcomes and MeasuresRandom-intercept Poisson models were used to obtain estimates of the European FTLD incidence rate accounting for geographic heterogeneity.ResultsBased on 267 identified cases (mean [SD] patient age, 66.70 [9.02] years; 156 males [58.43%]), the estimated annual incidence rate for FTLD in Europe was 2.36 cases per 100 000 person-years (95% CI, 1.59-3.51 cases per 100 000 person-years). There was a progressive increase in FTLD incidence across age, reaching its peak at the age of 71 years, with 13.09 cases per 100 000 person-years (95% CI, 8.46-18.93 cases per 100 000 person-years) among men and 7.88 cases per 100 000 person-years (95% CI, 5.39-11.60 cases per 100 000 person-years) among women. Overall, the incidence was higher among men (2.84 cases per 100 000 person-years; 95% CI, 1.88-4.27 cases per 100 000 person-years) than among women (1.91 cases per 100 000 person-years; 95% CI, 1.26-2.91 cases per 100 000 person-years). BVFTD was the most common phenotype (107 cases [40.07%]), followed by PPA (76 [28.46%]) and extrapyramidal phenotypes (69 [25.84%]). FTD-ALS was the rarest phenotype (15 cases [5.62%]). A total of 95 patients with FTLD (35.58%) had a family history of dementia. The estimated number of new FTLD cases per year in Europe was 12 057.Conclusions and RelevanceThe findings suggest that FTLD-associated syndromes are more common than previously recognized, and diagnosis should be considered at any age. Improved knowledge of FTLD incidence may contribute to appropriate health and social care planning and in the design of future clinical trials.

PURPOSE Overexpression of the HER2 protein occurs in 25% to 30% of human breast cancers and leads to a particularly aggressive form of the disease. Efficacy and safety of recombinant humanized anti-HER2 monoclonal antibody as a single agent was evaluated in women with HER2-overexpressing metastatic breast cancer that had progressed after chemotherapy for metastatic disease. PATIENTS AND METHODS Two hundred twenty-two women, with HER2-overexpressing metastatic breast cancer that had progressed after one or two chemotherapy regimens, were enrolled. Patients received a loading dose of 4 mg/kg intravenously, followed by a 2-mg/kg maintenance dose at weekly intervals. RESULTS Study patients had advanced metastatic disease and had received extensive prior therapy. A blinded, independent response evaluation committee identified eight complete and 26 partial responses, for an objective response rate of 15% in the intent-to-treat population (95% confidence interval, 11% to 21%). The median duration of response was 9.1 months; the median duration of survival was 13 months. The most common adverse events, which occurred in approximately 40% of patients, were infusion-associated fever and/or chills that usually occurred only during the first infusion, and were of mild to moderate severity. These symptoms were treated successfully with acetaminophen and/or diphenhydramine. The most clinically significant adverse event was cardiac dysfunction, which occurred in 4.7% of patients. Only 1% of patients discontinued the study because of treatment-related adverse events. CONCLUSION Recombinant humanized anti-HER2 monoclonal antibody, administered as a single agent, produces durable objective responses and is well tolerated by women with HER2-overexpressing metastatic breast cancer that has progressed after chemotherapy for metastatic disease. Side effects that are commonly observed with chemotherapy, such as alopecia, mucositis, and neutropenia, are rarely seen.

Lymphoepithelial-like carcinoma (LELC) usually presents as a head and neck tumor with a close resemblance to nasopharyngeal carcinoma. We present an extremely rare case of Primary Pulmonary lymphoepithelioma in a 14-year-old female patient. The patient presented with a right-sided lung mass, which on biopsy revealed to be a lymphoepithelioma. There was no evidence of any mass elsewhere in the body, including the nasopharynx, as evidenced by PET CT. The IHC was positive for both cytokeratin and lymphoid cell markers. Hence, we conclude that lymphoepitheliomas can present as a primary lung mass in a young nonsmoking female, of which only two case reports are available from the Indian subcontinent till date.

PURPOSE Immunohistochemistry (IHC) is a newer technique for assessing the estrogen receptor (ER) status of breast cancers, with the potential to overcome many of the shortcomings associated with the traditional ligand-binding assay (LBA). The purpose of this study was to evaluate the ability of ER status determination by IHC, compared with LBA, to predict clinical outcome—especially response to adjuvant endocrine therapy—in a large number of patients with long-term clinical follow-up. PATIENTS AND METHODS ER status was evaluated in 1,982 primary breast cancers by IHC on formalin-fixed paraffin-embedded tissue sections, using antibody 6F11 and standard methodology. Slides were scored on a scale representing the estimated proportion and intensity of positive-staining tumor cells (range, 0 to 8). Results were compared with ER values obtained by the LBA in the same tumors and to clinical outcome. RESULTS An IHC score of greater than 2 (corresponding to as few as 1% to 10% weakly positive cells) was used to define ER positivity on the basis of a univariate cut-point analysis of all possible scores and disease-free survival (DFS) in patients receiving any adjuvant endocrine therapy. Using this definition, 71% of all tumors were determined to be ER-positive by IHC, and the level of agreement with the LBA was 86%. In multivariate analyses of patients receiving adjuvant endocrine therapy alone, ER status determined by IHC was better than that determined by the LBA at predicting improved DFS (hazard ratios/ P = 0.474/.0008 and 0.707/.3214, respectively) and equivalent at predicting overall survival (0.379/.0001 and 0.381/.0003, respectively). CONCLUSION IHC is superior to the LBA for assessing ER status in primary breast cancer because it is easier, safer, and less expensive, and has an equivalent or better ability to predict response to adjuvant endocrine therapy.

INTRODUCTION: Serous ovarian carcinomas constitute the largest group of epithelial ovarian cancer (60%-75%) and are further classified into high- and low-grade serous carcinoma. Low-grade serous carcinoma (LGSC) is a relatively rare subtype (approximately 5% of serous carcinomas) and epidemiologic studies of large cohorts are scarce. With the present study we aimed to report trends in stage, primary treatment and relative survival of LGSC of the ovary in a large cohort of patients in an effort to identify opportunities to improve clinical practice and outcome of this relatively rare disease.MATERIAL AND METHODS: Patients diagnosed with LGSC between 2000 and 2019 were identified from the Netherlands Cancer Registry (n = 855). Trends in FIGO stages and primary treatment were analyzed with the Cochran-Armitage trend test, and differences in and trends of 5-year relative survival were analyzed using multivariable Poisson regression.RESULTS: Over time, LGSC was increasingly diagnosed as stage III (39.9%-59.0%) and IV disease (5.7%-14.4%) and less often as stage I (34.6%-13.5%; p 1 cm residual disease in only 15/252 patients (6%), compared with 17/95 patients (17.9%) after interval surgery. Full cohort 5-year survival was 61% and survival after primary debulking surgery was superior to the outcome following interval debulking surgery (60% vs 34%). Survival following primary debulking surgery without macroscopic residual disease (73%) was better compared with ≤1 cm (47%) and >1 cm residual disease (22%). Survival following interval debulking surgery without macroscopic residual disease (51%) was significantly higher than after >1 cm residual disease (24%). Except FIGO stage II (85%-92%), survival did not change significantly over time.CONCLUSIONS: Over the years, LGSC has been diagnosed as FIGO stage III and stage IV disease more often and interval debulking surgery has been increasingly preferred over primary debulking in these patients. Relative survival did not change over time (except for stage II) and worse survival outcomes after interval debulking surgery were observed. The results support the common recommendation to perform primary debulking surgery in patients eligible for primary surgery.

A 23-year-old man with a history of migraine and focal seizures, developed painless visual loss in the left eye associated with optic disk edema. There was no recent history of cat exposure except for a cat that lives outside. Initial laboratory studies were negative. magnetic resonance imaging brain and orbits without and with fat suppression and intravenous contrast was normal. The patient admitted to routinely skinning, processing and consuming deer while not wearing gloves, and he also frequently had cuts on his hands while doing so. The serum Toxoplasma gondii IgG antibody returned at400 (0-7.1 IU/mL) with the IgM at 10.4 (0-7.9 AU/mL).

Signet ring cell carcinoma, in general, is a peculiar tumour. There is always a query regarding its exact site of origin. Even, immunohistochemistry shows overlapping staining patterns between various sites. On one hand, signet ring cell carcinoma of the bladder is a rare occurrence, but on the other hand metastatic signet ring cell carcinoma to the bladder is not uncommon. However, without prior knowledge of the primary site of tumour clinically and radiologically, definitive diagnosis is challenging based on morphology and immunohistochemistry.

We discuss an extremely rare case of low-grade Schwann cell leptomeningeal neoplasm with no evident intradural primary, presenting with rapid neurological decline leading to death reflecting the aggressive biological behaviour of this entity despite its low-grade morphology. Notwithstanding extensive investigations, the diagnosis was only established on autopsy as clinical presentation is non-specific making diagnosis challenging. This condition could be considered in patients presenting with leptomeningeal disease if initial workup of more common causes is non-revealing.

An 8-year-old girl presented with precocious puberty and an otherwise normal examination. MRI of the pituitary was normal; however, an incidental oval, non-enhancing T2 hyperintense lesion in the right temporal subcortical white matter was identified ([figure 1][1]). The neuro-radiographic

A 67-year-old man was referred to the renal team following an episode of acute kidney injury on a background of chronic kidney disease. He had a 9-year history of steroid-sensitive arthritis, epigastric pain and isolated submandibular gland enlargement. He was noted to have a raised eosinophil count, total serum protein and total immunoglobulin G4 (IgG4) level as well as a serum hypocomplementaemia. A renal biopsy showed a tubulointerstitial nephritis with lymphoplasmacytic infiltrates, fibrosis and IgG4-positive plasma cells on immunohistochemistry. A diagnosis of IgG4-related disease was made based on clinical presentation and pathology. Renal function improved with glucocorticoids and the patient was successfully transitioned to azathioprine as a steroid-sparing agent.

A 74-year-old woman presented with fever, jaw claudication and bilateral temporal pain lasting for 1 week. On examination, the bilateral temporal arteries (TAs) were nodularly swollen, tender and hypopulsatile ([figure 1A][1]). A blood test showed elevated white cell count (9.33×109/L), high

Necrotising myopathy with pipestem capillaries is a distinct form of inflammatory myopathy exhibiting only sparse inflammation on biopsy, with clinical presentation and histopathological profile entirely different from dermatomyositis, polymyositis or inclusion body myositis. A 51-year-old non-diabetic man presents with progressively worsening shortness of breath and myalgias with only mild proximal muscle weakness and elevated serum creatine kinase. Autoimmune workup, ordered after ruling out infectious and cardiac aetiologies, returned positive for Sjögren’s syndrome antibody (SSA/Ro-52). Lung imaging and biopsy were suggestive of cryptogenic organising pneumonia and muscle biopsy showed myositis with pipestem capillaries and abnormal deposition of membrane attack complex with only sparse inflammation. The patient received high-dose steroids, mycophenolate mofetil, intravenous immunoglobulin and rituximab with improvement in muscle symptoms. However, his pulmonary findings progressed, requiring evaluation for a lung transplant. This case emphasises the need for further research to better understand this disease entity and improve mortality and morbidity in these patients.

Objective: Radiation therapy is commonplace for cancer treatment but often results in fibrosis and atrophy of surrounding soft tissue. Decellularized adipose matrices (DAMs) have been reported to i...

Approximately 12% of routinely examined fallopian tubes of endometrial carcinoma (EC) cases have intraluminal tumor cells (ILTCs). ILTC associations with EC characteristics and outcomes are understudied, and unknown in serially examined and embedded tubal fimbriae. Glass slides of serially examined and embedded tubal fimbriae for 371 EC cases were independently reviewed by 2 pathologists who recorded ILTC presence and characterized them as mucosal if involved and floating if not. Disagreements were reviewed by a third pathologist, and agreement between any 2 determined final ILTC status. Clinico-pathologic associations and ILTC presence were tested for significance (P

Background:We compared the location of the false lumen within the medial layer between acute intramural hematoma (AIH) and acute aortic dissection (AAD) using microscopic images of aortic specimens and examined the associations with patient characteristics, CT findings, and late outcomes.Methods and Results: Among 293 patients undergoing surgery for Stanford type A acute aortic syndrome between 2008 and 2018, 45 patients had neither an identifiable intimal tear, flow to the false lumen on preoperative CT or intimal tear by intraoperative observation (AIH group), and 98 patients with patent false lumen were enrolled (AAD group). The AIH group had a significantly thinner outer media thickness (OMT) than the AAD group. The AIH group showed more pericardial effusion, but distal progression of dissection and branch vessel involvement were limited. The change in aortic diameter after surgery was insignificant in the AIH group, whereas in the AAD group it continued to increase. Cumulative incidence of aortic adverse events was significantly higher among AAD patients, but no significant difference was observed in survival between groups., Conclusions:The AIH group had a significantly thinner OMT than the AAD group, which was significantly associated with a large amount of pericardial effusion, greater false lumen diameter, and limited progression of aortic dissection.

In recent years, the focus of numerous studies has been the predictive value of inflammatory and nutritional parameters in oncology patients. The aim of our study was to examine the relationship between the inflammatory and nutritional parameters and the histopathological characteristics of patients with bladder cancer. A retrospective study included 491 patients who underwent radical cystectomy for bladder cancer between 2017 and 2021. We calculated the preoperative values of the neutrophil-to-lymphocyte ratio (NLR), the derived neutrophil-to-lymphocyte ratio (dNLR), the systemic immune-inflammation index (SII), the systemic inflammatory response index (SIRI), the platelet-to-lymphocyte ratio (PLR), the lymphocyte-to-monocyte ratio (LMR), the prognostic nutritional index (PNI), and the geriatric nutritional risk index (GNRI). Statistically significant positive correlations were observed between NLR, dNLR, SII, SIRI, and PLR and the pathological stage of the tumor. We observed statistically significant inverse correlations for LMR, PNI, and GNRI with the tumor stage. SIRI was identified as an independent predictor of the presence of LVI. dNLR was identified as an independent predictor of positive surgical margins. GNRI was identified as an independent predictor of the presence of metastases in the lymph nodes. We noticed the predictive value of SIRI, dNLR, and GNRI in the pathology of bladder cancer patients.

Warburg micro syndrome (WARBM) is a rare, autosomal recessive, neurodevelopmental disorder characterized by microcephaly, cortical dysplasia, corpus callosum hypoplasia, congenital hypotonia leading to subsequent spastic quadriplegia, severe developmental delay and hypogenitalism. Ophthalmologic findings that may affect any ocular segment including characteristic, small, atonic pupils. WARBM is known to be caused by biallelic, pathogenic variants in at least five genes although additional genetic loci may exist. The RAB3GAP1 c.748 + 1G>A, p.Asp250CysfsTer24 founder variant has been described in families of Turkish ancestry. We report the clinical and molecular findings in three, unrelated, Turkish families with WARBM. A novel c.974-2A>G variant causing WARBM in three siblings of Turkish descent was found. Functional studies of the novel, c.2606 + 1G>A variant in patients\" mRNA revealed skipping of exon 22 which results in a premature stop codon in exon 23. However, the clinical consequences of this variant are blended given that the individual also had a maternally inherited chromosome 3q29 microduplication.

Leptospirosis, caused by pathogenic spirochaetes belonging to the genus Leptospira, is a globally distributed zoonosis that can affect many species of domestic and wild animals, and humans. The red fox (Vulpes vulpes) is a native species in Croatia and, due to constant food availability and lack of interspecies competition, is becoming more abundant in urban and suburban areas. Although antibodies for Leptospira spp have been detected in red foxes, lethal disease has not been reported. We necropsied a young, male red fox that had jaundice, multifocal haemorrhages in the heart, lungs and urinary bladder, hepatomegaly, non-congestive splenomegaly and slight yellow discolouration of the renal cortex and medulla. Histology revealed multifocal haemorrhages in parenchymal organs, thrombi within lung septal capillaries and other blood vessels, interstitial lymphocytic and plasmacytic nephritis and erosions of the gastric mucosa. A microscopic agglutination test on the post-mortem cardiac blood clot revealed a high titre to Leptospira interrogans serovar Icterohaemorrhagiae, which implies contact with rats, which are natural reservoirs of this serovar in Croatia. The gross and histological findings in this fox were similar to those in dogs with leptospirosis, indicating that fatal leptospirosis can occur in foxes and suggesting that this species can act as a source of infection for other animals and humans.

ObjectiveWhile human papillomavirus (HPV) has been shown to play a significant role in cervical cancer carcinogenesis (HPV associated cases), a considerable percentage of cervical cancers occur independently of HPV status (HPV independent).MethodsIn this retrospective study of 254 locally advanced cervical cancer patients treated with chemoradiotherapy and radical surgery, HPV genotypes were determined using the Anyplex II HPV28 kit that uses multiplex, real time polymerase chain reaction technology. The primary endpoints of this study were to evaluate the complete response to chemoradiotherapy (pathologic complete response), the presence of microscopic (<3 mm, pathologic micro partial response, group 1) and macroscopic (>3 mm, pathologic macro partial response, group 2) residual carcinoma in the cervix, and the persistence of metastatic lymph nodes (group 3) in HPV independent cervical cancers. Secondary endpoints were evaluation of disease-free survival and overall survival.ResultsOf 254 patients studied, 21 cases (8.3%) of cervical cancer were determined to be HPV independent. The percentage of pathologic complete response was found to be higher in the HPV associated group compared with the HPV independent group (pConclusionsThis study showed that HPV status at diagnosis could be a relevant factor for clinical outcomes in locally advanced cervical cancer patients.

Inflammatory pseudotumor (IPT) is a rare benign tumor of unknown etiology that can occur in almost any organ system. It has neoplastic features such as local recurrence, invasive growth, and vascular invasion, leading to the possibility of malignant sarcomatous changes. The clinical presentations of colonic IPT may include abdominal pain, anemia, a palpable mass, and intestinal obstruction. A few cases of colonic IPT have been reported, but colonic IPT with pedunculated morphology is very rare. Furthermore, since it can mimic malignant polyps, understanding the endoscopic findings of colonic IPT is important for proper treatment. Herein, we present a case of colonic IPT with pseudosarcomatous changes, presenting as a large polyp, mimicking a malignant polyp in the cecum, along with a literature review.

BackgroundHearing loss in older adults is associated with increased dementia risk. Underlying mechanisms that connect hearing loss with dementia remain largely unclear.MethodsWe studied the association of hearing loss and biomarkers for dementia risk in two age groups with normal cognition: 65 participants from the European Medical Information Framework (EMIF)-Alzheimer’s disease (AD) 90+ study (oldest-old; mean age 92.7 years, 56.9% female) and 60 participants from the EMIF-AD PreclinAD study (younger-old; mean age 74.4, 43.3% female). Hearing function was tested by the ‘digits-in-noise test’ and cognition by repeated neuropsychological evaluation. Regressions and generalised estimating equations were used to test the association of hearing function and PET-derived amyloid burden, and linear mixed models were used to test the association of hearing function and cognitive decline. In the oldest-old group, mediation analyses were performed to study whether cognitive decline is mediated through regional brain atrophy.ResultsIn oldest-old individuals, hearing function was not associated with amyloid pathology (p=0.7), whereas in the younger-old individuals hearing loss was associated with higher amyloid burden (p=0.0034). In oldest-old individuals, poorer hearing was associated with a steeper decline in memory, global cognition and language, and in the younger-old with steeper decline in language only. The hippocampus and nucleus accumbens mediated the effects of hearing loss on memory and global cognition in the oldest-old individuals.ConclusionsHearing loss was associated with amyloid binding in younger-old individuals only, and with cognitive decline in both age groups. These results suggest that mechanisms linking hearing loss with risk for dementia depends on age.

PURPOSE In patients with resectable gastric/gastroesophageal junction (GEJ) adenocarcinoma, surgery plus perioperative platinum-based chemotherapy is the standard of care. Perioperative chemotherapy remains debatable for gastric/GEJ adenocarcinoma with deficient mismatch repair (dMMR)/microsatellite instability–high (MSI-H). PATIENTS AND METHODS NEONIPIGA (ClinicalTrials.gov identifier: NCT04006262 ) phase II study evaluated neoadjuvant nivolumab 240 mg once every two weeks ×6 and ipilimumab 1 mg/kg once every six weeks ×2, followed by surgery and adjuvant nivolumab 480 mg once every four weeks (nine injections) in patients with locally advanced resectable dMMR/MSI-H, clinical (c) tumor (T)2-T4 node (N)x metastasis (M)0 gastric/GEJ adenocarcinoma. The primary end point was a pathological complete response (pCR) rate. RESULTS Between October 2019 and June 2021, 32 patients with dMMR/MSI-H gastric/GEJ adenocarcinoma were enrolled. The median age was 65.5 years (range, 40-80). Clinical stages were cT2-T3N0 (n = 9), cT2-T3N1 (n = 22), and cT3N1M1 (n = 1, wrongly included). With a median follow-up of 14.9 months (95% CI, 10.6 to 17.6), 32 patients received neoadjuvant immunotherapy (27 patients completed all cycles). Neoadjuvant therapy-related grade 3/4 adverse events occurred in six patients (19%). Twenty-nine patients underwent surgery; three did not have surgery and had complete endoscopic response with tumor-free biopsies and a normal computed tomography scan (two refused surgery and one had metastasis at inclusion). The rate of surgical morbidity (Clavien-Dindo classification) was 55% (one postoperative death occurred). All 29 patients had an R0 resection, and 17 (58.6%; 90% CI, 41.8 to 74.1) had pCR (pathological T0N0). Becker tumor regression grades 1a, 1b, 2, and 3 were observed in 17 patients, three (including two pathological T0N1), two, and seven patients, respectively. Of the 29 patients with surgery, 23 received adjuvant nivolumab. At database lock, no patient had relapse and one died without relapse. CONCLUSION Nivolumab and ipilimumab-based neoadjuvant therapy is feasible and associated with no unexpected toxicity and a high pCR rate in patients with dMMR/MSI-H resectable gastric/GEJ adenocarcinoma.

Makale, WOS:000925209300013, C3 glomerulopathy is a newly defined glomerular disease dominated by C3 complement storage and uncertain C1, C4, and immunoglobin accumulations. Hereditary mutations associated with Complement Factor H (CFH) causing hyperactivation of the alternative complement pathway were identified. Most mutations associated with C3 glomerulopathy are associated with the N-terminal end. Whether mutations are pathogenic or not will direct diagnosis and treatment. We present 2 cases, one 61-year-old and one 24-year-old attending our clinic at different times with hematuria, proteinuria, edema, and kidney failure. Both patients had C3 glomerulopathy diagnosed based on the results of kidney biopsy and were treated with eculizumab. Both cases had CFH-associated mutations.

Introduction. Mucous membrane pemphigoid (MMP) is a rare autoimmune, chronic inflammatory disease that affects mucous membranes, most commonly the eyes and mouth, with or without skin involvement. It is a complex disease with several complications, including scarring, especially on conjunctival mucosa, that can lead to visual loss. Case report. We report four patients (two men and two women) with MMP. In all patients, the disease started between seventy and eighty years of age. The diagnosis was confirmed based on clinical appearance, histology, direct and indirect immunofluorescence studies, indirect split skin technique, and enzyme-linked immunosorbent assay (ELISA) test. The majority of lesions were on the gums and buccal mucosa; one patient had laryngeal involvement and a lesion on the umbilicus. No ocular involvement and no malignancy were detected. Direct immunofluorescence tests revealed continuous linear IgG deposition in the basal membrane zone in two patients, and they were treated with oral nicotinamide and tetracycline hydrochloride. In two patients, we detected IgG along with IgA linear deposition; they received treatment with methylprednisolone. Complete remission was achieved in all patients. Conclusion. Early diagnosis and an adequate therapeutic approach are necessary for the MMP treatment in long-term disease control and reduction of disease-related complications.

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Although new ultrasound (US) methods able to quantitatively assess liver fat content have been recently developed, B-mode US is still the major method for detecting liver steatosis during medical checkups. However, some pathological cases yield false-positive or false-negative liver steatosis results using B-mode US. In addition, histologically, the degree of fat deposits and the size of fat droplets in the liver can affect the sensitivity and specificity of the diagnosis of liver steatosis using B-mode US. As B-mode US evaluation of fatty liver relies on operator expertise, the operator should be aware that there are some cases of liver steatosis that are difficult to evaluate with B-mode US. Here, we describe the pathological findings of liver steatosis that is difficult to evaluate with US.

Posterior reversible encephalopathy syndrome (PRES) is an acute neurological disorder characterized by variable symptoms and radiological images characteristic of vasogenic parietal-occipital edema. It is associated with clinical conditions such as high blood pressure, infection / sepsis, or cytotoxic / immunosuppressive drugs, among others. It is characterized pathophysiologically by endothelial damage with breakdown of blood-brain barrier (BBB), cerebral hypoperfusion, and vasogenic edema.The cases are presented on two critical COVID-19 patients who were admitted to pneumonia requiring mechanical ventilation and who, after removing sedation, developed acute and reversible neurological symptoms consisting of epilepsy and encephalopathy, associated with hyperintense subcortical lesions on brain magnetic resonance imaging (MRI) compatible with PRES.SARS-CoV-2 coronavirus would activate an inflammatory response that would damage brain endothelium. It could be triggered by cytokine release, as well as by direct viral injury, given that endothelium expresses ACE2 receptors. It could explain the possible association between PRES and COVID-19.

The objective:to study the structure of gynecological pathology and the hormonal background in women with infertility and various types of thyroid pathology. Materials and methods.The anamnesis of infertile patients was studied. The women, depending on the pathology of the thyroid gland and the method of fertilization were divided into the following groups: the 1st group included 119 women with infertility without thyroid pathology who became pregnant after the use of assisted reproductive technologies (ART); the 2nd group – 47 patients who became pregnant with the help of ART and in whom antibodies to thyroid peroxidase (anti-TPO antibodies) were detected; the 3rd group – 30 women with compensated hypothyroidism, whose pregnancy occurred with ART; the 4th group – 39 women without thyroid pathology and with spontaneous pregnancy; the 5th group – 128 patients with compensated hypothyroidism and spontaneous pregnancy. The concentrations of the following hormones in the blood plasma in the early follicular phase were determined in all the patients: luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, prolactin, testosterone, cortisol, 17-hydroxyprogesterone, dehydroepiandrosterone sulfate. Results.There were no significant differences between the women with infertility and thyroid pathology and the patients with spontaneous pregnancy without thyroid pathology regarding the age of menarche onset, the period of regularity onset of the menstrual cycle after menarche. The most frequent disorder of the menstrual cycle in patients of the 1st (26.9 %), 2nd (25.5 %) and 3rd (26.6 %) groups was dysmenorrhea. Oligomenorrhea was more often detected in women with infertility and thyroid pathology who became pregnant with the help of ART (25.5 % of patients in the 2nd group and 23.3% – in the 3rd group), compared to women with spontaneous pregnancy. The endocrine factor of infertility was most often determined in women with infertility who became pregnant after ART and had thyroid pathology: in the presence of anti-TPO antibodies, this factor was found in 29.8 % of women, hypothyroidism – 23.3 %. External genital endometriosis as a cause of infertility prevailed among patients with infertility without thyroid pathology, who became pregnant after ART (34.4 %), and women with compensated hypothyroidism, whose pregnancy occurred with the help of ART (26.6 %). In patients with infertility and anti-TPO antibodies, who became pregnant after ART, a significant increase of LH concentration was found compared to the patients with spontaneous pregnancy without thyroid diseases. A significant increase of FSH level was also determined in women of the 1st group compared to healthy patients with spontaneous pregnancy. Conclusions.In women with infertility and various types of thyroid pathology the disorders of the ovarian-menstrual cycle such as dysmenorrhea and oligomenorrhea are typical. The main factor of infertility in patients without thyroid diseases is external genital endometriosis, in persons with thyroid pathology – an endocrine factor. In women with infertility and various types of thyroid pathology, a significant increase of luteinizing hormone concentration in the blood plasma in the follicular phase of the menstrual cycle was established.

Semantic dementia (SD) is a clinical subtype of frontotemporal dementia consistent with the neuropathological diagnosis frontotemporal lobar degeneration (FTLD) TDP type C, with characteristic round TDP-43 protein inclusions in the dentate gyrus. Despite this striking clinicopathological concordance, the pathogenic mechanisms are largely unexplained forestalling the development of targeted therapeutics. To address this, we carried out laser capture microdissection of the dentate gyrus of 15 SD patients and 17 non-demented controls, and assessed relative protein abundance changes by label-free quantitative mass spectrometry. To identify SD specific proteins, we compared our results to eight other FTLD and Alzheimer’s disease (AD) proteomic datasets of cortical brain tissue, parallel with functional enrichment analyses and protein–protein interactions (PPI). Of the total 5,354 quantified proteins, 151 showed differential abundance in SD patients (adjusted P-value N-cadherin. In summary, we discovered a specific increase of cell adhesion proteins in SD constituting the cadherin-catenin complex at the synaptic membrane, essential for synaptic signaling. Although further investigation and validation are warranted, we anticipate that these findings will help unravel the disease processes underlying SD.

Introduction Desmoplastic malignant pleural mesothelioma (DMPM) is a sarcoma type mesothelioma, comprising about 5% of malignant pleural mesotheliomas. Although effusion cytology is commonly used as the primary diagnostic approach for mesothelioma, this may not be useful for DMPM due to its desmoplastic nature and bland cellular atypia. We hereby report a case of DMPM diagnosed through autopsy along with its cytological features that have not been described previously. Case presentation A male in his 60s with a history of occupational asbestos exposure was referred to our hospital with right chest pain. Chest computed tomography scan showed right pleural effusion. Thirteen months later, the patient died of respiratory failure. In autopsy, the scrape-imprint smear and the pleural effusions cytology were performed. The scrape-imprint smear samples exhibited spindle cells with mild nuclear atypia and grooves with fibrous stroma. In the pleural effusion cytology, spindle cells having mild nuclear atypia and grooves with loose epithelial connections were observed. Histological examination of the right pleura showed spindle cells proliferating with dense collagen fibers, as seen in cytological samples, thus rendering the diagnosis of DMPM. Diagnosis was confirmed by fluorescence in situ hybridization. Conclusion Cytological procedures, such as pleural effusion cytology and scrape-imprinting method, may be useful as an ancillary tool in the diagnosis of rare tumors such as DMPM.

ObjectiveThere is increasing interest in using artificial intelligence (AI) in pathology to improve accuracy and efficiency. Studies of clinicians’ perceptions of AI have found only moderate acceptability, suggesting further research is needed regarding integration into clinical practice. This study aimed to explore stakeholders’ theories concerning how and in what contexts AI is likely to become integrated into pathology.Materials and MethodsA literature review provided tentative theories that were revised through a realist interview study with 20 pathologists and 5 pathology trainees. Questions sought to elicit whether, and in what ways, the tentative theories fitted with interviewees’ perceptions and experiences. Analysis focused on identifying the contextual factors that may support or constrain uptake of AI in pathology.ResultsInterviews highlighted the importance of trust in AI, with interviewees emphasizing evaluation and the opportunity for pathologists to become familiar with AI as means for establishing trust. Interviewees expressed a desire to be involved in design and implementation of AI tools, to ensure such tools address pressing needs, but needs vary by subspecialty. Workflow integration is desired but whether AI tools should work automatically will vary according to the task and the context.ConclusionsIt must not be assumed that AI tools that provide benefit in one subspecialty will provide benefit in others. Pathologists should be involved in the decision to introduce AI, with opportunity to assess strengths and weaknesses. Further research is needed concerning the evidence required to satisfy pathologists regarding the benefits of AI.

Amaç: Malatya Eğitim ve Araştırma Hastanesi Patoloji Laboratuvarına gelen numunelerin Akılcı Laboratuvar kapsamında yaşa, cinsiyete, organa göre değerlendirilmesi ve patoloji laboratuvarlarının akılcı kullanımının sağlanmasına yönelik çözüm önerilerinin sunulması amacıyla yapılmıştır.Yöntem: Araştırma. 2019 yılında Malatya Eğitim ve Araştırma Hastanesi Patoloji Laboratuvarına gelen numunelerin tamamı (22365) üzerinden retrospektif olarak yapılmıştır.Bulgular: Çalışmada kullanılan patoloji numunelerinin %26.9’u (n=6026) erkek, %73.1’i (n=16339) kadın hastalara aittir. Patoloji tipi biyopsi olanların %32.7’si (n=5550) erkek, %67.3’ü (n=11430) kadın, patoloji numune tipi sitoloji olanların %8.8’i (n=476) erkek ve %91.2’si (n=4909) kadındır. Çalışmada kullanılan patoloji ve sitoloji (n=22365) örneklerinin sonucuna göre, olguların %84.3’ünün (n=18857) patoloji sonucu benign, %3’ünün (n=678) malign, %1.8’inin (n=403) uygunsuz materyal ve %10.9’unun (n=2427) şüpheli veya pre-malign numune olduğu belirlenmiştir.Sonuç: Patoloji laboratuvarlarında daha doğru ve hızlı sonuç verebilmek için patoloji hekimlerinin iş yüklerinin azaltılması gerekmektedir. Bunun için gereksiz istenen tetkiklerin azaltılması için tetkik isteyen hekim ve klinik bazında analizler düzenli olarak yapılmalı ve gerektiği durumlarda kök neden analizi yapılarak gerekli iyileştirmenin yapılması sağlanmalı ve numuneler için bakanlıkça azami sonuç verme süre hedeflerin belirlenmesi önerilmektedir., Objective: This study was conducted in order to evaluate the samples coming to a Training and Research Hospital Pathology Laboratory according to age, gender and organ within the scope of Rational Laboratory and to present solution suggestions for rational use of pathology laboratories.Method: The research was carried out retrospectively on all of the samples (22365) that came to Malatya Training and Research Hospital Pathology Laboratory in 2019.Results: Of the pathology samples used in the study. 26.9% (n=6026) belonged to male patients and 73.1% (n=16339) to female patients. Of those with pathology type biopsy, 32.7% (n=5550) were male, 67.3% (n=11430) were female, 8.8% (n=476) of those with pathology sample type cytology were male and 91.2% of them (n=4909) were women. According to the results of the pathology and cytology (n=22365) samples used in the study, the pathology result of 84.3% (n=18857) of the cases was benign, 3% (n=678) was malignant, and 1.8% (n= 403) were found to be inappropriate material and 10.9% (n=2427) were suspicious or pre-malignant specimens.Conclusion: In order to provide more accurate and faster results in pathology laboratories, the workload of pathology physicians should be reduced. For this reason, analyzes should be carried out regularly on the basis of physicians and clinics requesting the examination in order to reduce unnecessary required examinations, root cause analysis should be carried out when necessary, necessary improvement should be ensured, and it is recommended that the Ministry determine the maximum result time targets for the samples.

The International Collaboration on Cancer Reporting (ICCR) was founded by major pathology organizations from around the world to produce internationally standardized and evidence-based datasets for pathologists' reporting of cancer. Its goal is to improve cancer patient outcomes worldwide and to advance international benchmarking in cancer management. The ICCR cancer dataset development schedule is aligned with revisions of the WHO Classification of Tumours ("Blue Book") series, and in 2015 ICCR developed an initial series of thoracic datasets including a dataset for neoplasms of the heart, pericardium, and great vessels. This edition has now been updated to align with the 2021 WHO Blue Book series. An expert panel was convened to review and revise the dataset. While the majority of ICCR datasets are focused on malignant tumors, the scope of this dataset includes a number of benign tumors and tumor-like entities because of the rarity of cardiac malignancies and the serious implications of even histologically benign lesions. Due to the rarity of cardiac tumors, evidence in support of reporting elements is limited.