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Introduction. In modern pathological anatomy, the dominant pre-mortem histopathological diagnosis requires health management professionals and specialists in the Pathological Anatomy Service to ensure proper laboratory organization, with particular attention paid to laboratory safety and research quality. Objective. To analyze laboratory safety and research quality issues at Pathology department (hereafter - PD) at JSC “National Centre for Neurosurgery” (hereafter – JSC “NCN”). Material and Methods. The structure of PD of JSC “NCN”, SOPs of PD, and safety reports for the buildings of JSC “NCN” were examined. The main research methods include informational-analytical, functional, and expert analyses. Results. Issues of laboratory safety and research quality at PD of JSC “NCN” are addressed on an ongoing basis at all stages of the research process (pre-analytical, analytical, and post-analytical phases), in accordance with the developed laboratory safety program, standard operating procedures, and quality indicators. Safety and quality control in laboratory diagnostics in pathology are integral parts of healthcare control. Conclusions. The laboratory operates in compliance with the legislation of the Republic of Kazakhstan, the developed laboratory safety program, standard operating procedures, and quality indicators. To ensure the quality of laboratory work, the entire process of preparing histological specimens has been automated and standardized. Quality indicators for histopathological diagnosis should be viewed as a tangible contribution of clinical pathology to the protection of public health. Both internal and external audits of histological specimens and reports should be carried out. Non-compliance with laboratory safety rules and research quality standards directly affects the quality of histopathological diagnosis, with serious consequences for patient health. [ABSTRACT FROM AUTHOR]

The pedicled groin flap is an effective and adaptable method for covering wounds on the hand and distal forearm. This approach offers reliable results and is less complex and time-consuming than free-tissue transfer. Despite the common belief that the groin flap should be avoided in elderly patients due to the risk of shoulder stiffness, we found success-ful outcomes in a 93-year-old woman with type 2 diabetes mellitus, arterial hypertension, rheumatoid arthritis, and a history of bilateral hip TEP surgeries in 2009 and 2007. Immediate shoulder mobilization and ongoing physical therapy during the flap maturation and pedicle division phases were crucial in achieving these favorable results. This case report was performed in Department of plastic, reconstruction and Hand surgery, University hospital Magdeburg, Germany.

Pulmonary hypertension is a condition characterized by a progressive increase in pressure in the pulmonary circulation. The simplest and most common experimental model of pulmonary hypertension is the monocrotaline model. It is based on the process of transformation of monocrotaline in the liver by cytochrome P450 into endothelial toxic monocrotaline pyrrole, which in turn, damaging the endothelium of the pulmonary vessels, leads to circulatory disorders in the pulmonary circulation and the formation of pulmonary hypertension. Thus, additional prestimulation of cytochrome P450 may increase the stability and representativeness of the monocrotaline model. The purpose of this work was to determine differences in morphological changes in the myocardium and pulmonary vessels of rats in which pulmonary hypertension was modeled using monocrotaline with and without additional stimulation of liver enzymes. Material and methods. The study was conducted on 24 mature male Wistar rats. The animals were divided into 4 groups of 6 rats. Group 1 was represented by intact animals. In groups 2, 3 and 4, modeling of pulmonary hypertension in rats was carried out with a single subcutaneous injection of an aqueous-alcohol solution of monocrotaline at a dose of 60 mg/kg. In order to induce cytochrome P450 in groups 3 and 4, animals were intragastrically administered phenobarbital for one and three days, respectively. Results and discussion. The area of cardiomyocyte nuclei in the groups with one- and three-day preliminary stimulation of liver enzymes was 22.78 ± 3.4 and 23.63 ± 3.72 µm2 , respectively, significantly different from the corresponding values of the control group and group 2. Similar results were revealed when determining the index of the thickness of the medial membrane of small-caliber pulmonary arteries – 58.32 ± 10.02 and 76.44 ± 18.55 % in the groups with one- and three-day preliminary stimulation, respectively. In addition to quantitative changes, qualitative changes were also noted: with additional activation of cytochrome P450, interstitial fibrosis and myocarditis more intensively formed in the myocardium, and signs of “monocrotaline syndrome” more rapidly arose and progressed in the lungs. Conclusions. Based on the data obtained, it can be assumed that preliminary cytochrome P450 causes an increase in the stability, reproducibility and severity of morphological changes in the monocrotaline model of pulmonary hypertension.

Purpose of the study: differential diagnosis of tumors arising from the mediastinum, as well as the analysis of the biological potential of the tumor, taking into account the relatively low incidence of these tumors among the population.Material and Methods. Macroscopic and microscopic examinations of the surgical specimen were performed using routine H&E staining. Immunohistochemical staining of paraffin-embedded tissue sections was performed using a Roche Ventana BenchMark Ultra system. The results obtained were evaluated taking into account the available literature data published on this nosology.Description. We present a rare case of a benign neoplasm of the thymus, lipofibroadenoma (LFA), which was localized in the left pleural cavity and originated from the anterior mediastinum with partial compression of the lower lobe of the left lung in a 59-year-old man. The tumor was revealed during a routine medical examination. The patient underwent left-sided thoracotomy with complete excision of the tumor and anterior mediastinal lymph node dissection. Macroscopic examination reveled that the tumor was predominantly composed of adipose tissue with fibrous layers. Histological examination showed a tumor composed of mature adipocytes of various sizes, among which remnants of the thymus with Hassal’s bodies and small number of lymphocytes and calcifications were found. Areas of fibrous stroma predominated over narrow strands of anastomosing epithelial cells with clear nuclei. Epitheliocytes formed slit-like structures infiltrated with lymphocytes, resembling the structure of breast fibroadenoma. Immunohistochemical examination revealed that epithelial cells were positive for PanKeratin and CK19, lymphocytes were positive for CD3 and CD20, and thymic cells expressed TdT. In this case, the neoplasm was almost asymptomatic, in contrast to previously published observations, which described an association with erythrocyte aplasia.Conclusion. Considering the clinical, histological and immunohistochemical data, it was feasible to make a differential diagnosis of the neoplasm and determine the histological type of the tumor as lipofibroadenoma.

This review contains up-to-date data on the role of heavy metal ions in the functioning of the thyroid gland. Collected data on the effect of heavy metals on the metabolism of iodine in the body. The influence of a combination of iodine deficiency and changes in the concentration of certain metal ions in the body on the morphology and function of the thyroid gland is described. Ambiguous data are presented on the results of clinical and experimental studies aimed at identifying the role of deficiency and / or excess of copper, iron, zinc and selenium compounds entering the body in the formation of pathological changes in the thyroid gland. Also described are the results of experiments aimed at identifying morphological and functional changes in the thyroid gland when excessive doses of lead, mercury, nickel, manganese, nickel and cobalt compounds enter the body.

Relevance. Epithelial-mesenchymal transformation (EMT) largely determines the biological behavior and prognosis of cancers of various localizations. It is known that the determining role in the control and implementation of the transition of the epithelial phenotype to the mesenchymal belongs to the microenvironment. At the same time, the histochemical and microscopic characteristics of stromal elements remain unclear; therefore, the aim of our study was to establish the morphological features of the stroma that affect the development of EMT in lung cancer. Materials and Methods. We studied 32 cases of lung cancer with hematoxylin and eosin staining of sections, Alcian blue at pH 1.0 and 2.5, PAS reaction, as well as immunohistochemical studies with monoclonal antibodies to HMW, AE 1 / AE 3, cytokeratin 18, c-erb B 2, vimentin E-cadherin, alpha-smooth muscle actin, GFAP and chromogranin A, Ki-67. In 16 cases, there was widespread epithelial-mesenchymal transformation (EMT), in 14 cases - focal and in 2 cases EMT was absent. In half of the cases of widespread EMT, it was complete; among the cases of focal EMT, it was not complete. The transition from the epithelial to the mesenchymal phenotype was facilitated by the activation of the stroma, namely, the presence of myofibroblasts and alcianophilia of the extracellular matrix, inflammatory cell infiltration, expression of the epidermal growth factor receptor (c-erb B 2) in stromal cells, proliferation and neurogenic differentiation of stromal cells of stromal cells. Results and Discussion. The activated stroma correlates with the frequency of EMT. Thus, large areas of activated stroma with the presence of myofibroblasts and alcianophilia of the extracellular matrix are more common in cases of widespread EMT (14 out of 16-87.5 %) than in cases of focal EMT (4 out of 14-28.6 %). The differences are statistically significant, p 0.01. Inflammatory cell infiltration, which is the source of a signal for transformation, expression of the epidermal growth factor receptor (c-erb B 2) in stromal cells, proliferation, and neurogenic differentiation of stromal cells also correlated with the frequency of EMT. In all cases, the differences are statistically significant, p0.01. Conclusions. The data obtained indicate the undoubted influence of signals from the activated stroma on the development of epithelial-mesenchymal transformation of tumor cells.

Background: Research into the pathogenesis and morphogenesis of new coronavirus infection (COVID-19) is currently a hot topic that requires the accumulation, management and analysis of the data. Understanding the mechanisms of the disease and their characteristics would help to improve diagnostic quality, treatment efficacy and reduce mortality. Aim: To identify morphological and immunohistochemical characteristics of the bronchopulmonary lymph node tissues in autopsied patients with COVID-19. Materials and methods: The study was carried out on 44 autopsy samples from patients who were hospitalized and died from the new coronavirus infection COVID-19 in the Moscow Regional Research and Clinical Institute. Macroscopic, histological, and immunohistochemical assessment methods were used.Results: We found stereotypical abnormalities in the morphology and cellular composition of the lymphoid tissue depending on the duration of the disease. These included signs of B-cell-mediated immunity suppression manifested by a decrease in the number and size of lymphoid follicles and occurs at latest after 7 days from the onset of the disease. In the patients with the disease duration of up to 14 days, the T-cell pool of the lymph nodes is represented mainly by CD4+ T-lymphocytes. With longer duration of the disease, there is a gradual increase in the number of lymphoid follicles and their sizes, with changes of the CD4+ to CD8+ T-cell ratio towards higher CD8+ counts. After 21 days of the disease, the CD4+ to CD8+ ratio levels off.Conclusion: The results obtained indicate a direct damaging effect of SARS-CoV-2 on the lymph node tissues of the bronchopulmonary group. The possibility of secondary transient immune deficiency and infectious complications in patients with a new coronavirus infection is discussed.

Aim: to demonstrate the necessity of modern methods of morphological verification in the differential diagnostics of primary and secondary neoplastic lesion of spinal cord. It is shown that histogenesis of tumor cells should be regarded from the viewpoint of comparative assessment of traditional and complementary methods of morphological verification that outlines the necessity of complex differential morphological diagnostics with apparent priority of immunohisto-chemical methods for the verification of final diagnosis of metastatic lesion in a rarely seen localization.

Objective: To study the clinical and morphological manifestations of lung sequestration., Material and Methods: Surgical material (lung tissue) of 18 patients (2017-2021) and 8 archival observations (1972-1994) of confirmed lung sequestration were examined. Histological staining (hematoxylin and eosin, Schiff reagent, Ziehl-Neelsen, picrofuchsin according to Van Gieson) and immunohistochemical reactions with antibodies to SMA, TTF1, CK5/6 (DAKO) were performed., Results: The ratio of men to women was 5:4; the average age of the patients was 35 years. Lung sequestration is localized mainly in the lower lobe segments, the left lung is involved in the pathological process more often. The cystic variant of lung sequestration with a chronic inflammatory process prevailed. Histological examination revealed the similarity of lung sequestration with congenital adenomatous lung malformation type 2 and rhabdomyomatous dysplasia. The respiratory and bronchial epithelium lost differentiation in the sequestered area., Conclusion: The morphological picture of lung sequestration is nonspecific and can manifest itself in various types of inflammatory reactions and remodeling of lung tissue.

The review presents key concepts and global developments in the field of artificial intelligence used in pathological anatomy. The work examines two types of artificial intelligence (AI): weak and strong ones. A review of experimental algorithms using both deep machine learning and computer vision technologies to work with WSI images of preparations, diagnose and make a prognosis for various malignant neoplasms is carried out. It has been established that weak artificial intelligence at this stage of development of computer (digital) pathological anatomy shows significantly better results in speeding up and refining diagnostic procedures than strong artificial intelligence having signs of general intelligence. The article also discusses three options for the further development of AI assistants for pathologists based on the technologies of large language models (strong AI) ChatGPT (PathAsst), Flan-PaLM2 and LIMA. As a result of the analysis of the literature, key problems in the field were identified: the equipment of pathology institutions, the lack of experts in training neural networks, the lack of strict criteria for the clinical viability of AI diagnostic technologies.

The article gives a brief review of some rare diseases of the lungs. According to international registers, rare diseases are those which occur in one individual per 2000 population. Brief characteristics, description of pathological anatomy of tumor and other lesions of the lungs are outlined.

This review was compiled for the 170th anniversary of the birth of Fedor Orestovich Evetsky - a prominent Russian ophthalmologist, and contains a summary of the published facts of his biography, clinical work and scientific research, as well as a number of archived materials made publicly available for the first time. The main attention is paid to the activity of F.O. Evetsky as an employee and teacher at the Medical Faculty of the Moscow University, the article also notes his efforts to defend the right of female doctors to work as residents in Moscow University clinics, and highlights his part as the main initiator of the creation of the Moscow Ophthalmological Club. To the regret of the scientific community, the activities of F.O. Evetsky as a residency professor of the academic department and the director of the eye clinic at the Yuriev University remain little known and unexplored.

The paper presents the life and creative career of Professor Alexander Alexandrovich Vasiliev, MD, a prominent Russian pathologist, one of the organizers of Red Army postmortem service, team physician.

The biographical article is dedicated to the memory of Boris Petrovich Ugryumov, a graduate of the Imperial Military Medical Academy (1914), a prominent military pathologist, the First Head of the Department of Pathological Anatomy, Ryazan Medical Institute. The paper presents the major milestones in the life of B.P. Ugryumov; his service on the fronts of the First and Second World Wars and his teaching activity at the Military Medical Academy and the Naval Medical Academy occupy an important place. For about 10 years, he was in charge of the Pathology Department, S.P. Botkin Clinical Infectious Diseases Hospital in Leningrad, which largely determined the area of his professional interests, such as the pathomorphology of infectious diseases, tuberculosis in particular. The archiving and personal photographic documents that have been previously unknown to the public are published for the first time.

The paper describes a case of a perinatal lethal Gaucher disease in a 29-week-old fetus with non-immune hydrops, facial dysmorphia, hepatosplenomegaly, and hypoplasia of cerebellum and pons. Gaucher cells were found in the lymph nodes, spleen, lungs, thymus, cerebellum, and bone marrow. No storage cells have been detected in the placenta. There was a significant placental weight increase due to swelling. The diagnosis of Gaucher disease was confirmed by biochemical analysis (deficiency of glucocerebrosidase activity and sharply increased hexanoylsphingosine concentration) and molecular genetic techniques (the presence of two mutations of the GBA gene). Our observation shows that characteristic histologic signs of disease can be detected at early stages of development.

The article dedicated to the 120 th anniversary of the birth of Academician A.I. Strukov shows his role in the development of Russian and European pathological anatomy and describes his life and merits in the modernization of teaching pathological anatomy at medical universities. In addition, A.I. Strukov is shown as the standard of a teacher and a public figure.

Preeclampsia is the most menacing complication of pregnancy and childbirth worldwide and remains one of the leading causes of maternal and perinatal morbidity and mortality. It is characterized by a complex etiopathogenesis with specific clinical and laboratory changes (hypertension, proteinuria and edema), as well as by the morphological pattern of target organ damage and uteroplacental blood vascular lesions. However, the triad of clinical signs of preeclampsia is not encountered in all cases now., Objective: to study the clinical and anatomical aspects of preeclampsia at the present stage., Material and Methods: 17 maternal deaths due to preeclampsia were studied at the medical institutions of the Moscow Healthcare Department from 2012 to the first half of 2017 through postmortem examination at City Clinical Hospital Thirty-One, Moscow Healthcare Department., Results: This analysis showed the atypical course of preeclampsia (without substantial blood pressure elevations, with mild/moderate proteinuria, but almost always with edema). The characteristic feature is a laboratory sign, such as thrombocytopenia and liver enzyme dysfunction. Morphological examination of deceased patients showed that almost half of the cases had brain hemorrhages of different localization and size; in most cases, renal changes corresponded to the pattern of a shock kidney with endotheliosis and frequently with cortical necroses. The liver was characterized by a considerable increase in size with the development of fatty dystrophy, centrolobular necroses and hemorrhages; there were metabolic damage foci in the heart in almost half of the cases, as well as signs of disseminated intravascular coagulation with numerous hemorrhages in the organs and tissues., Conclusion: Characteristic uteroplacental artery morphological changes in both the surgical and autopsy material render a leading assistance in the diagnosis of preeclampsia/eclampsia.