Search

In the clinic of tuberculosis of the larynx, one of the factors complicating the course of the process and worsening the prognosis is dysphagia.

Prompted by the autopsy of Ludwig van Beethoven (1770–1827) to seek the origins of disease in a changed anatomy, Carl Freiherr von Rokitansky (1804–1878) initiated a paradigm shift from speculative natural philosophical medicine to systematic scientific medicine. Until then, autopsy reports usually contained clinical observations as well as the diagnosis of the attending physician, which the pathologist merely supplemented with a description of the corpse. Influenced by Rokitansky’s search for scientific explanations for disease, pathology evolved from a descriptive to an explanatory science from the early 1830s onwards. The protocols now contained both a clinical and often divergent pathological diagnosis, which, however, explained the origin of the disease and the cause of death. This research led to Rokitansky’s three-volume Handbook of Pathological Anatomy, the standard textbook for all medical students of the Habsburg monarchy, which has been translated into Russian, English and Italian. In this work he systematically described the diseases of each individual organ and explained the relationships between clinical symptoms and pathological changes to the organs, i.e., the clinicopathological correlation, which enabled a scientifically based diagnosis. Systematic research into each individual organ led to the development of new specialist clinical disciplines. In his role as medical consultant in the State Ministry, Rokitansky supported the establishment of the world’s first clinic for otology. He also influenced the research of such pioneering otorhinolaryngologists as Joseph Toynbee (1815–1866), William Wilde (1815–1876), Prosper Meniere (1799–1862), Friedrich Semeleder (1832–1901), Johann Schnitzler (1835–1893), and Adam Politzer (1835–1920).

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.

The problem of alcohol abuse is high on the agenda for the whole world both medically and socially. However, the fight against this disease is less than effective, mostly due to the fact that its solution has been left to psychiatrists and experts in narcology. They are making attempts to treat alcoholism, a disease which results from long-term, chronic alcohol intoxication and alcohol dependence. What is missed here is a long period of excessive use of hard drinks characterized by alcohol cravings with no alcohol dependence; this period is called “excessive alcohol consumption”. Based on the results of 1113 autopsies of patients aged 18 to 73 years who died at home or in a hospital, the authors propose the concept of the alcohol disease, whose pathogenesis consists of 3 stages: stage 1, episodic alcohol intoxication, stage 2, excessive alcohol drinking, and stage 3, alcoholism and its complications. The article describes the changes over time that can be found in the liver, vessels and other organs. The authors emphasize that the formation of Mallory bodies (auto-antigens), mainly in the stage of alcoholism, triggers an irreversible autoimmune inflammatory reaction explaining an extremely poor effect of alcoholism treatment. In this regard, excessive alcohol drinking is being suggested as a separate stage, which should be treated by internists.

Vilém Dušan Lambl, better known in Russia as Dushan Fedorovich Lambl (1824-1895) — Czech and Russian anatomist, histologist, therapist and parasitologist, doctor of medicine, professor, head of the department of normal anatomy and pathological anatomy of the Imperial Kharkov University (from 1860 to 1871), head of the Faculty therapeutic Department of the Imperial University of Warsaw (from 1871 to 1895), Privy Councilor.Professor Lambl D.F. the main works on parasitology (he was the first to describe in 1859 the simplest microorganism that parasitizes humans and now bears his name), pathological anatomy (his famous lithographs written on stone), normal anatomy, internal medicine, as well as natural science, ethnography, culture and linguistics of Slavs and others. He was a man with the broadest horizons, sharpness of thought, excellent erudition and incredible knowledge in the field of both fundamental and practical medicine.

Introduccion: El objetivo del estudio es describir las caracteristicas clinicas, patologicas, virologicas y geneticas de la respuesta inmune de los pacientes diagnosticados con infeccion por SARS-CoV-2 y su relacion con el curso desfavorable de la enfermedad Metodos: Estudio descriptivo, relacional, longitudinal y retrospectivo basado en la revision de historias clinicas, toma de biopsias tru-cut post-mortem de pulmon e higado, toma de muestras de sangre e hisopado naso-orofaringeo o de aspirado del tubo endotraqueal En la primera fase las biopsias seran procesadas y estudiada scon histologia convencional e inmunohistoquimica en el servicio de Anatomia Patologica del hospital Nacional Carlos Seguin Escobedo de Arequipa, Peru Resultados: La edad media avanzada, el sexo masculino y la presencia de comorbilidades fue predominante en los pacientes fallecidos Las biopsias pulmonares mostraron predominante mente las fases exudativa y parcialmente proliferativa del dano alveolar difuso y focal, asociada principalmente a una hiperplasia de macrofagos intra alveolares con acumulacion dentro del espacio alveolar, semejando una neumonia descamativa, asi como neumocitos intra alveolares bi nucleados y atipicos, con nucleolos eosinofilicos (semejante avirocitos) en algunos casos En la gran mayoria de casos se observaron depositos de fibrina intravascular asociada al acumulo de celulas inflamatorias compuestas por neutrofilos y monocitos, representando micro trombosis Las biopsias de higado mostraron esteatosis predominantemente macro vesicular y en dos casos se observo este atosismicro vesicular Adicionalmente, se observaron diversos grados de necrosis e inflamacion portal y lobular Conclusion: Los hallazgos clinicos y patologicos en este primer reporte son consistentes con publicaciones previas y confirman el patron de dano alveolar difuso asociado a agregados de macrofagos intra alveolares y micro trombosis;ademasesteatosis macro y micro vesicular hepatocitica, junto a grados variables de necrosis Introduction: The objective of the study is to describe the clinical, pathological, virological and genetic characteristics ofthe immune response of patients diagnosed with SARS-CoV-2 infection and its relationship with the unfavorable courseof the disease Methods: Descriptive, relational, longitudinal and retrospective study based on the review of medicalrecords, taking post-mortem tru-cut biopsies of the lung and liver, taking blood samples and naso-oropharyngeal swabor endotracheal tube aspirate In the first phase, the biopsies will be processed and studied with conventional andimmunohistochemical histology in the Pathological Anatomy service of the Carlos Seguin Escobedo National Hospitalin Arequipa, Peru Results: Advanced mean age, male sex, and the presence of comorbidities were predominant indeceased patients Lung biopsies showed predominantly the exudative and partially proliferative phases of diffuseand focal alveolar damage, associated primarily with intraalveolar macrophage hyperplasia with accumulation withinthe alveolar space-resembling desquamative pneumonia, as well as atypical binucleated intraalveolar pneumocytes,with eosinophilic nucleoli (similar to virocytes) in some cases In the vast majority of cases, intravascular fibrin depositsassociated with the accumulation of inflammatory cells composed of neutrophils and monocytes, representingmicrothrombosis, were observed Liver biopsies showed predominantly macrovesicular steatosis and in twocases microvesicular steatosis was observed Additionally, varying degrees of necrosis and mild portal and lobularinflammation were observed Conclusion: The clinical and pathological findings in this first report are consistent withprevious publications and confirm the pattern of diffuse alveolar damage associated with aggregates of intraalveolarmacrophages and microthrombosis;confirms in addition, macro and microvesicular hepatocytic steatosis, togetherwith variable degrees of necrosis

OBJETIVO: Determinar las características epidemiológicas, clínicas y de tratamiento de la Infección del Sitio Operatorio (ISO) post apendicetomía por Apendicitis Aguda Complicada (AAC) en los Servicios de Cirugía General del HNRPP en el periodo 2018. MATERIALES Y MÉTODOS: Investigación aplicada; estudio observacional y descriptivo simple. La población estudiada fue de 246 pacientes operados de apendicitis aguda complicada y confirmados por anatomía patológica en el periodo 2018. Se utilizó un instrumento ad hoc para la presente investigación. RESULTADOS: La ISO post AAC fue más frecuentes en varones (70%), de 35±10 años, provenientes de Huancayo (66%); la ISO con mayor número de casos fue la ISO-IS (61%), los tratamientos más indicados fueron; el arrastre mecánico con solución fisiológica (81%), el uso de trolamina como antimicrobiano tópico (100%) y la indicación de terapia antimicrobiana endovenosa con el esquema de ciprofloxacino y metronidazol (57%). CONCLUSIONES: La ISO es una complicación de frecuencia elevada en la AAC que debe ser reconocida y tratada basada en la mejor información científica disponible.

It is well known that Padua Medical School, Italy, played a fundamental role in shaping modern medicine. Its golden age lasted from the late XV to the late XVIII century, thanks in particular to its extraordinary anatomical school. One of the last fundamental achievements of the Padua Medical School was the founding of the anatomo-clinical method and organ pathology by Giovanni Battista Morgagni, Professor of Theoretical Medicine in Padua from 1711 and 1715 and of Anatomy from 1715 to his death. This method, which dramatically changed the course of medical diagnosis and therapy, was immediately developed by the so-called Anatomo-Clinical School of Paris. Figures such as Jean-Nicolas Corvisart and René Laennec improved this new approach in the clinical setting with the method of auscultation and the introduction of the stethoscope. However, organ pathology probably found its most important modern expression in the so-called Viennese School of Medicine, thanks to figures such as Karl von Rokitansky, Joseph Skoda and Theodor Billroth. In that period, this school was described by the anatomist Rudolf Virchow as "the Mecca of medicine." As is well known, Padua and Venice fell under the rule of the Austro-Hungarian Empire between the end of the XVIII and the beginning of the second half of the XIX century. The most important influences and changes at the University of Padua were introduced by the Viennese School during the so-called Third Austrian Domination (1813-1866), with improvements of medical curriculum, the founding of new specialist medical institutes and a general advancement of medical science, inspired by the technical-practical approach typical of this school. In particular, the new chair and Institute of Pathological Anatomy was founded by Lodovico Brunetti, pupil of Rokitansky, who influenced his appointment at Padua. In this way, we can advance that, at the end, the Morgagni method came back to Padua through the leading role of the Vienna Medical School, which deeply influenced the University of Padua during the different phases of Austrian domination in north Italy.

A unique specimen of argyria is preserved in the Morgagni Museum of Pathological Anatomy at the University of Padua (Italy). It is a stuffed head belonging to a man who decided to cure his syphilis by himself with the so-called infernal stone (silver nitrate) every day for years, thus developing argyria in the second half of the nineteenth century. Paleopathological and historical studies were performed on the specimen to confirm the diagnosis of argyria. Furthermore, a morphological investigation of the specimen was conducted with histological and ultrastructural investigations, including environmental scanning electron microscopy and electron dispersive x‐ray spectroscopy, recording high presence of silver in the dermis and epidermis and also other chemical elements correlated to the “infernal stone.” A comparison with actual cases may also lead to a common feature: a potential dependence on the perceived benefits brought by silver compound that may sustain a further prolonged intake.

Each year about 272,610 new cases of cancer are diagnosed in Brazil, being cervical cancer the third most incident among women. Our country is among those that have made the most progress in consolidating the integrated cancer tracking and surveillance system. This article aims to collect sociodemographic and clinicopathological data from patients who underwent cervical cytopathological examinations at the Laboratory of Pathological Anatomy and Cytopathology at the Hospital Escola Álvaro Alvim (HEAA) from 2014 to 2018, considering a retrospective and longitudinal observation of the data. Sociodemographic and clinicopathological data were collected from 121,044 patients, and it was observed that women from Campos dos Goytacazes (84.7%) over 40 years old (56.8%) were the most prevalent at the service. The following cytological characteristics that predominated in these patients were: absence of atrophy (83.6%) or metaplasia (92.6%) of the uterine epithelium, presence of microorganisms (96.4%) and inflammation (97.2%). The presence of cell atypia (6.5%), squamous intraepithelial lesion (2%) and malignant neoplasm (0.1%) was also observed. Therefore, it becomes possible to highlight the importance of cytological examination in the process of diagnosis of malignant neoplasms of the uterine cervix, being essential for a better control and adequate screening, implementing an effective early diagnosis. It also demonstrates the profile of the patients examined at the Pathological Anatomy and Cytopathology Laboratory of HEAA, as well as the scope of this service for early diagnosis of cervical cancer in the North and Northwest Fluminense. A cada ano cerca de 272.610 novos casos de câncer são diagnosticados no Brasil, sendo o câncer de colo do útero o terceiro mais incidente entre as mulheres. Nosso país se situa entre os que mais têm avançado na consolidação do sistema integrado de rastreamento e vigilância em câncer. Esse trabalho visa coletar dados sociodemográficos e clinicopatológicos dos pacientes, que foram submetidos a exames citológicos dentro do Laboratório de Anatomia Patológica e Citopatologia do Hospital Escola Álvaro Alvim (HEAA), de 2014 a 2018, considerando uma observação retrospectiva e longitudinal dos dados. Foram coletados os dados sociodemográficos e clínico-patológicos de 121.044 pacientes, e observou-se que mulheres, procedentes de Campos dos Goytacazes (84,7%) com idade maior que 40 anos (56,8%) foram as mais atendidas pelo serviço. Predominaram as seguintes características citológicas: ausência de atrofia (83,6%) ou metaplasia (92,6%) do epitélio uterino, presença de microrganismos (96,4%) e de inflamação (97,2%). A presença de atipias celulares (6,5%), de lesão intraepitelial escamosa (2%) e de neoplasia maligna (0,1%) foram observados. Assim, se torna possível evidenciar a importância do exame citológico no processo de diagnóstico de neoplasias malignas do colo uterino, sendo essencial para que haja um melhor controle e um rastreamento adequado, vislumbrando um diagnóstico precoce eficaz. Demonstra também o perfil dos indivíduos atendidos pelo Laboratório de Anatomia Patológica e Citopatologia do HEAA, bem como a abrangência deste serviço para diagnóstico precoce do câncer de colo de útero na região Norte e Noroeste Fluminense.

The recent identification of rearrangements of neurotrophic tyrosine receptor kinase (NTRK) genes and the development of specific fusion protein inhibitors, such as larotrectinib and entrectinib, have revolutionised the diagnostic and clinical management of patients presenting with tumours with these alterations. Tumours that harbour NTRK fusions are found in both adults and children; and they are either rare tumours with common NTRK fusions that may be diagnostic, or more prevalent tumours with rare NTRK fusions. To assess currently available evidence on this matter, three key Spanish medical societies (the Spanish Society of Medical Oncology (SEOM), the Spanish Society of Pathological Anatomy (SEAP), and the Spanish Society of Paediatric Haematology and Oncology (SEHOP) have brought together a group of experts to develop a consensus document that includes guidelines on the diagnostic, clinical, and therapeutic aspects of NTRK-fusion tumours. This document also discusses the challenges related to the routine detection of these genetic alterations in a mostly public Health Care System., SEOM, SEAP and SEHOP have received financial support for this project in the form of unrestricted collaboration in the logistics of expert meeting from Bayer and Roche.

Objetivos. Se desean conocer los cambios en el programa de cirugía menor de un centro de salud urbano tras una década desde su implantación, valorando la cobertura, las características de los pacientes y los profesionales implicados, los procedimientos realizados, la concordancia diagnóstica y la eficiencia del mismo. Material y métodos. Se diseña un estudio descriptivo transversal, mediante auditoría de historias y registros clínicos escritos entre los años 2007 y 2017. Se recoge el tipo de procedimiento realizado, la edad del paciente, el profesional que interviene, el envío de muestras a anatomía patológica, así como los diagnósticos clínicos y anatomopatológicos. Se estimará la diferencia del gasto realizado con el ocasionado en caso de derivación al hospital. Se realizará un análisis descriptivo y bivariante según el año de estudio. Resultados. Se valoran 477 actos quirúrgicos (53% en 2017), con edad media del paciente de 49,9 años (±17,9) (superior en 9 años en 2017, p, Our objective is to assess the changes occurred in the minor surgery program of an urban health centre. We designed a cross-sectional descriptive study to perform audits of patients history and clinical records of 2007 and 2017.477 surgical acts were evaluated. Patient mean age is 49,9 years. Percentage of resident doctors and participating nurses is double on 2017, although the main actor is the general practitioner. The right consignment of tissue samples to pathological anatomy is improved in a 16% with a high diagnostic concordance (kappa 0,703). Skin excisions and infiltrations are increased, cryosurgery is decreased. Costs are estimated to be 320% lower to hospital ones. The results of minor surgery carried out in primary-care are comparable to hospitals; however, costs are lower in primary setting. The diversity of interventions and health staff involved, makes necessary a greater incorporation of staff and training hours.

The article is dedicated to Professor L.L. Fofanof’s scientific activity. He headed the faculty therapeutic clinic of Kazan Imperial University in 1915-1920. Being a student L.L. Fofanov was interested in pathological anatomy and physiology. His dissertation «To physiology of n. depressoris» was dedicated to studying the vasomotor center. During his visit in Germany he worked a lot. In Charite together with Professor His he studied gout and its treatment with Radium emanation. In Halle clinic under Professor Schmidt’s supervision he studied assimilation of starch in normal and pathological digestion. L.L. Fofanov also made a contribution to tuberculosis treatment: with professor V.F. Orlovskiy he studied treatment of tuberculosis with simulated pneumothorax. In his research professor L.L. Fofanov paid great attention to the issues of pathogenesis and pathogenetic substantiation of the clinical manifestation and treatment. During the World War I and Civil War he fought against typhus epidemies: he saw patients, gave lectures, studied the features of myocardial involvement. He died in 1920 from typhus.

Between 1793 and 1914, there were many internationally recognised physicians active in Gdansk. Their scientific activities included, among other things, anatomopathological research, constituting a determinant of progress in medical sciences during this period. One of the most important people was Martin Heinrich Rathke (1793-1860). He is recognised as one of the founders of modern embryology. In Gdansk Rathke's successor was Wilhelm Baum (1799-1883). Baum introduced compulsory post-mortem examinations in the city hospital even after the outbreak, and he was mentor to Theodor Billroth (1829-1894). The successor of Baum as the head of the city hospital was Emil Friedrich Götz (1806-1858). He took up an important topic, which was the consent of the family of the deceased to perform an autopsy. Furthermore, it described the gradual broadening of the scope of anatomopathological activities, consistent with the postulates of the first and second Viennese school, performed in Gdansk in the nineteenth century. However, a detailed analysis of the relationship between the discoveries of nineteenth-century medicine, especially in the field of pathological anatomy, and research carried out in Gdansk, remains in the sphere of research to be done.

Cutaneous melanoma has an aggressive clinical presentation with rapid growth velocity and metastatic dissemination. To evaluate prognostic factors and survival of patients diagnosed with primary cutaneous melanoma. Clinical-epidemiological and histopathological data from 102 patients diagnosed between 2004 to 2008, were retrieved from the archives of the Pathological Anatomy Service of the Araujo Jorge Hospital in Goiânia, Goias, Brazil. For survival analysis, we selected patients who underwent a 60-month follow-up. Cutaneous melanoma affects mostly female individuals with the age of diagnosis ranging from 51 to 70 years. Regarding the clinical evolution of the patients 63.7% were alive during this study, and 25.5% died of melanoma. Metastasis were present in 47% of patients and 70.8% grew in the lymph nodes. The overall survival curve regarding the 5-year follow-up was 73%. The study group with Breslow index ≥2.1mm (p=0.0339), level of Clark IV and V (p=0.0007) and the presence of metastasis presented a lower survival rate. Early diagnosis emphasizing the significant prognostic factors of patients with cutaneous melanoma allows the definition of prognostic with a more reliable estimate and more survival probabilities.

Carl von Rokitansky was one of the most important figures in pathological anatomy, and was largely responsible for the resurgence of Vienna as the great medical center of the world in the mid-19th century. He was born in current Hradec Kralove, studied medicine in Prague and Vienna and was graduated in 1828. He was greatly influenced by the anatomy, embryology and pathology studies of Andral, Lobstein and Meckel. At the Vienna School, he was Johann Wagner pathological anatomy assistant and became a pathology professor, where he remained until four years before his death. Rokitansky emphasized the importance of correlating patient symptoms with postmortem changes. It is possible that he had access to between 1,500 and 1,800 cadavers annually to be able to perform 30,000 necropsies; in addition, he reviewed several thousand more autopsies. In Handbuch der pathologischen Anatomie, published between 1842 and 1846, he made numerous descriptions: lobar and lobular pneumonia, endocarditis, diseases of the arteries, cysts in several viscera, various neoplasms and acute yellow atrophy of the liver. With his brilliant work on gross pathology, Rokitansky established the nosological classification of diseases, for which Virchow named him "the Linee of pathological anatomy". Carl von Rokitansky fue una de las figuras mas importantes en la anatomia patologica y el responsable, en parte, del renacimiento de Viena como centro de la medicina a mediados del siglo XIX. Nacio en la actual Hradec Kralove, estudio medicina en Praga y Viena y se graduo en 1828. Tuvo gran influencia de los estudios de anatomia, embriologia y patologia de Andral, Lobstein y Meckel. En la escuela de Viena fue asistente de anatomia patologica de Johann Wagner y se convirtio en profesor de anatomia patologica, donde permanecio hasta cuatro anos antes de su muerte. Rokitansky hizo enfasis en correlacionar la sintomatologia del enfermo con los cambios post mortem. Es posible que haya tenido acceso a entre 1500 y 1800 cadaveres al ano para que pudiera realizar 30 000 necropsias; ademas, reviso varios miles mas de autopsias. En Handbuch der Pathologischen Anatomie, publicado entre 1842 y 1846, realizo numerosas descripciones: de la neumonia lobular y lobular, endocarditis, enfermedades de las arterias, quistes en varias visceras, diversas neoplasias y de la atrofia aguda amarilla del higado. Con su brillante labor de patologia macroscopica, Rokitansky establecio la clasificacion nosologica de las enfermedades, por lo cual Virchow lo llamo “el Linneo de la anatomia patologica”.

espanolPaciente mujer de 36 anos de edad con amenorrea de 6 semanas, ingresa al servicio de emergencia de ginecologia y obstetricia por dolor pelvico asociado a sangrado vaginal escaso y aumento de tamano del utero para la edad gestacional, con niveles de b-hcg elevados, sospechando un embarazo molar. Se realiza un ameu evidenciandose restos ovulares y vesiculas perladas caracteristicas de la patologia en mencion, sin embargo, los resultados de anatomia patologica informan muerte fetal a decartar mala perfusion materna fetal. De este caso se rescata las diferentes formas de presentacion que puede presentar un aborto English36-year-old female patient with amenorrhea for 6 weeks, enters the emergency service of gynecology and obstetrics for pelvic pain associated with scarce vaginal bleeding and increased uterus size for the gestational age, elevated b-hcg levels and a suspected molar pregnancy. An mva is performed evidencing ovular remains and pearl vesicules characteristics of the pathology in mention, however, the results of pathological anatomy report fetal death to decart bad fetal maternal perfusion. From this case, the different forms of presentation that a retained abortion may present are rescued.

Patient diagnosed with Crohn's disease (CD) underwent urgent surgery for intestinal obstruction. Intraoperatively, an ileal stenosis causing the obstruction was observed. The pathological anatomy revealed a small bowel adenocarcinoma on Crohn's disease. Although the association of carcinoma and CD is very rare, we consider important to have a high level of suspicion in order to achieve early management of these patients and to improve the poor prognosis of this disease.

Professor V.G. Shlopov – an outstanding representative of domestic pathological anatomy (to the 80th birthday)

Le pancreas ectopique (ou aberrant ou heterotopie pancreatique) se definit par la presence de tissu pancreatique en situation anormale, sans rapport anatomique avec la glande principale. Son incidence est estimee entre 0,5% et 14% sur les series autopsiques, mais est probablement sous-estimee du fait de son caractere le plus souvent asymptomatique. Les localisations habituelles sont representees par le duodenum (30-35%), l´estomac (30%) et le jejunum (15%). Sa localisation hepatique est exceptionnelle. Nous en rapportons un nouveau cas de decouverte fortuite. Il s´agit d´une patiente âgee de 54 ans, hypertendue, operee deux ans auparavant pour un adenocarcinome du sigmoide classe pT3N1b (A). L´evolution etait marquee par l´installation de multiples nodules d´allure secondaire predominant au niveau du lobe hepatique droit (B), d´ou l´instauration d´une chimiotherapie neo-adjuvante (4 cures FOLFOX-ERBITUX). La patiente a beneficie d´une lobectomie droite. L´examen histologique des differents prelevements effectues a confirme la presence d´une localisation secondaire hepatique d´un adenocarcinome moyennement differencie d´origine colorectale avec des limites d´exereses saines. Le foie alentour etait le siege d´une steatose macrovacuolaire non systematisee estimee a 20%. Il s´y associait un foyer d´heterotopie pancreatique englobant des acini et des canaux excreteurs organises en lobule (C, D). Les suites operatoires immediates etaient simples, cependant, l´evolution a ete marquee par la recidive tumorale au niveau du foie gauche.

O corpo adiposo da bochecha é uma massa tubular de gordura localizado no espaço bucal, entre os músculos masseter e o bucinador, auxiliando nos processos de sucção e mastigação, além de desempenhar uma função protetora de algumas estruturas da face. Devido à sua rica vascularização, tamanho semelhante em todos os indivíduos, fácil acesso e pequena taxa de complicações, é usado para vários fins terapêuticos. Neste artigo é relatado um caso clínico no qual o corpo adiposo de bichat é utilizado em uma reconstrução orbitária para dar volume ao conteúdo orbitário.Descritores: Tecido Adiposo; Corpo Adiposo; Cirurgia Bucal.ReferênciasShoja MM, Tubbs RS, Loukas M, Shokouhi G, Ardalan MR. Marie-François Xavier Bichat (1771-1802) and his contributions to the foundations of pathological anatomy and modern medicine. Ann Anat.2008;190(5):413-20Alonso-González R, Peñarrocha-Diago M, Peñarrocha-Oltra D, Aloy-Prósper A, Camacho-Alonso F, Peñarrocha-Diago M. Closure of oroantral communications with Bichat´s buccal fat pad. Level of patient satisfaction. J Clin Exp Dent. 2015;7(1):e28-33.Peñarrocha-Oltra D, Alonso-González R, Pellicer-Chover H, Aloy-Prósper A, Peñarrocha-Diago M. Closure of oroantral communication with buccal fat pad after removing bilateral failed zygomatic implants: A case report and 6-month follow-up. J Clin Exp Dent. 2015;7(1):e159-62.Baumann A, Ewers R. Application of the buccal fat pad in oral reconstruction. J Oral Maxillofac Surg. 2000;58(4):389-92.Zhang HM, Yan YP, Qi KM, Wang JQ, Liu ZF. Anatomical structure of the buccal fat pad and its clinical adaptations. Plast Reconstr Surg. 2002; 109(7):2519-20.Stuzin JM, Wagstrom L, Kawamoto HK, Baker TJ, Wolfe SA. The anatomy and clinical application of the buccal fat pad. Plast Reconstr Surg. 1990;85(1):29-37.Pessa JE, Rohrich RJ. Discussion: aging changes of the midfacial fat compartments: a computed tomographic study. Plast Reconstr Surg. 2012; 129(1):274-75.Xu J, Yu Y. A modified surgical method of lower-face recontouring. Aesth Plast Surg. 2013; 37(2):216-21.Martin-Granizo R, Naval L, Costas A, Goizueta C, Rodriguez F, Monje F et al. Use of buccal fat pad to repair intraoral defects: review of 30 cases. Br J Oral Maxillofac Surg. 1997;35(2):81-4.Carbonell A, Salavert A, Planas J. Resection of the Buccal Fat Pad in the Treatment of Hypertrophy of the Masseter Muscle. Aesthetic Plast Surg. 1991;15(3):219-22Meyer E, Liebenberg SJ, Fagan JJ. Buccal fat pad-a simple underutilised flap. S Afr J Surg. 2012; 50(2): 47-9.Berrone M, Florindi FU, Carbone V, Aldiano C, Pentenero M. Stage 3 medication-related osteonecrosis of the posterior maxilla: surgical treatment using a pedicled buccal fat pad flap: case reports. J Oral Maxillofac Surg. 2015; 73(11): 2082-86.

For Rokitansky, pathological anatomy was not only a descriptive but also an explanatory science. Since the changes in the solidis (morphological conditions) did not always adequately explain the cause of death, Rokitansky considered that the answers to his research questions were to be found in a combination of solidar pathology and humoral pathology. Many reviewers claim that Rokitansky had fallen back into the "old" humoral pathology. However, Rokitansky's approach to humoral pathology also included the analysis of blood, blood plasma, blood serum, secretions, excretions, lymph and exudates in pathological anatomy. In his research, Rokitansky referred to "the oxidation of protein to fiber", "illnesses of the protein" and "illnesses of the fibrin". Rokitansky postulated that the progression of a disease was determined by the different forms of protein and fibrin in the blood. From his point of view, diseased blood components (dyscrasias) influence the tissue in its cellular and intercellular dimensions. He sought to generate awareness of this interaction in his Krasenlehre, which was criticised by Rudolf Virchow. Only in the past thirty years has research confirmed the visionary dimension of Rokitansky's humoral pathology.

The editorial published in this same journal entitled "Sombras del tratamiento actual del hepatocarcinoma en España: una verdad incómoda" has awakened the need to review the available scientific literature on the precise diagnosis of hepatocarcinoma based on a clinical case. A 58-year-old male patient has a radiological finding in the left hepatic lobe of a new lesion of 3.5 cm in size. Nuclear magnetic resonance imaging and computerized axial tomography confirmed the typical radiological behavior of hepatocarcinoma. However, the definitive pathological anatomy (A-P) after surgery was compatible with intrahepatic cholangiocarcinoma. The main national and international clinical guides offer the use of imaging tests for diagnosis, especially in high-risk patients. However, diagnostic biopsy is not included as mandatory in the hepatocarcinoma diagnostic process, although it may be recommended in some cases. The interest of the clinical case we present establishes the relevance of reaching a histological diagnosis of certainty, since imaging tests can objectify findings that are confusing with other tumor histologies, with future therapeutic and prognostic implications.

Introducción: La estructura histológica de los ligamentos, incluyendo el LCA, está compuesta por colágeno y elastina envueltos en una matriz de agua y proteoglicanos. El colágeno es el componente principal de los tendones y ligamentos, representa el 65 – 75% de su peso en seco. El objetivo del presente estudio es realizar una evaluación histopatológica de los fragmentos de LCA rotos tomados en el momento del acto quirúrgico por artroscopía. Material y métodos: Estudio prospectivo observacional sobre 50 casos con rotura de LCA. Se tomaron muestras de LCA en procedimiento artroscópico y se evaluó la histopatología del ligamento. Resultados: Se mencionan los resultados en base a resultados de anatomía patológica y evolución post operatoria. Conclusión: No se evidenciaron cambios degenerativos en la histopatología que justifiquen la rotura ligamentaria. Palabras claves: ligamento cruzado anterior, LCA, Histopatología, anatomía patológica. Nivel de evidencia: IV serie de casos. Abstract Introduction: Histological structure of ligaments, including the anterior cruciate ligament, is composed of collagen and elastin wrapped in a matrix of water and proteoglycans. Collagen is the main component of tendons and ligaments, accounting for 65-75% of its dry weight. The aim of the present study is to perform a histopathological evaluation of the ruptured anterior cruciate ligament fragments taken at the time of surgical procedure by arthroscopy. Methods: A prospective observational study of 50 cases with anterior cruciate ligament rupture. Anterior cruciate ligament samples were taken in an arthroscopic procedure and histopathology of the ligament was evaluated. Results: Pathology results and post-operative evolution are mentioned. Conclusion: Degenerative changes were observed in the histopathology exam; it cannot be demonstrated if these changes are previous or posterior to ligament rupture.

The typical treatment of ameloblastoma is by surgery. The result of the procedure nevertheless does not always lead to complete healing of the sickness but to a recurrence during the post-operative period. It has been reported by a number of authors that the recurrence of the condition is influenced by a number of factors such as the kind of surgical intervention, the histological variant of the ameloblastoma and the incomplete removal of the tumor. The purpose of this research is to study the incidence of recurrence of ameloblastoma after surgery, taking into consideration type of surgery and size of the tumor. A study of 76 cases of ameloblastoma with different histological structures was undertaken in the laboratory of pathological anatomy of Central Research Institute of Dental and Maxillofacial Surgery. Data such as the recurrence of the disease and tumors size was collected, registered and analysed. The size of the tumors was expressed in conventional units. The analysis showed that basal cell and plexiform variants of ameloblastoma are often relate to cases with aggressive clinical courses. The tendency to the recurrence of the disease was also observed in the follicular and acanthomatous variants. According to the results of this study, cases of peripheral variants of ameloblastoma have the best prognosis.

Introduccion: Las enfermedades acatoliticas son un grupo heterogeneo de enfermedades que presentan como caracteristica central histopatologica la acantolisis. Generalmente presentan un curso de evolucion cronica y recidivante, con variadas manifestaciones clinicas. Objetivo: caracterizar los pacientes con diagnostico de enfermedad acantolitica, bajo 5 criterios clinicos y realizar una revision de la literatura. Metodos: Se realizo una revision de la base de datos del Servicio Anatomia Patologica del Hospital Clinico San Borja Arriaran (HCSBA) entre los anos 2007 y 2017 y se complementaron con los antecedentes clinicos extraidos de las fichas clinicas. Resultados: Se obtuvo un total de 13 casos. el 53,8% correspondieron a enfermedad de Darier, 20,6% a enfermedad de Hailey-Hailey y un 20,6% a enfermedad de Grover, obteniendo un promedio de edad al momento del diagnostico de 22,5 anos, 44,3 anos y 47,6 anos respectivamente. Los antecedentes familiares estuvieron presentes en el 53,8% del total de pacientes, ninguno de ellos presentaba estudio genetico. El 61,5% de la muestra correspondio a pacientes de sexo femenino y el promedio de anos de evolucion previo al diagnostico fue de 7,4 anos para Darier, 8,6 para Hailey-Hailey y para Grover. El 100% de los pacientes con enfermedad de Darier y Grover estaban con terapia sistemica y el 66,6% de enfermedad de Hailey-Hailey con terapia topica, todos con adecuada respuesta clinica. Discusion y conclusiones: las enfermedades acantoliticas corresponden a genodermatosis poco frecuente cuyo diagnostico y tratamiento constituyen un desafio para el dermatologo. Summary Introduction: Acantholytic diseases are a heterogeneous group of diseases that present acantholysis as a histopathological central characteristic. They usually present a course of chronic and recurrent evolution, with varied clinical manifestations. Objective: to characterize the patients diagnosed with acantholytic disease, with 5 clinical criteria and to carry out a review of the literature. Methods: A review of the database of the Pathological Anatomy Service of the San Borja Arriaran Clinical Hospital (HCSBA) between 2007 and 2017 was carried out and complemented with the clinical records extracted from the clinical files. Results: A total of 13 cases were obtained. 53.8% corresponded to Darier's disease, 20.6% to Hailey-Hailey's disease and 20.6% to Grover's disease, obtaining an average age at diagnosis of 22.5 years, 44.3 years and 47.6 years respectively. Family history was present in 53.8% of the total patients, none of them had a genetic study. 61.5% of the sample corresponded to female patients and the average of years of evolution prior to diagnosis was 7.4 years for Darier, 8.6 for Hailey-Hailey and for Grover; 100% of the patients with Darier and Grover's disease were on systemic therapy and 66.6% of Hailey-Hailey's disease with topical therapy, all with adequate clinical response. Discussion and conclusions : acantholytic diseases correspond to rare genodermatosis whose diagnosis and treatment constitute a challenge for the dermatologist.

The science-based Viennese School of Medicine arose from the collaboration between pathological anatomy and clinical medicine. The recognition of the clinical–pathological correlation enabled the Bohemian pathological anatomist Carl Rokitansky to describe the course of a disease and make a diagnosis. Rokitansky’s systematic classification and explanation of diseases, documented in the Manual of Pathological Anatomy, was published in several languages and thus led to medical specialisation in Vienna and beyond the borders of Austria. It also contributed to the Medical Faculty of the University of Vienna becoming an interdisciplinary centre of expertise that attracted students from all over the world. Rokitansky’s methodology was influenced by his early studies of the humanities in Prague. This article describes the impact of Rokitansky’s handbook using new sources from the Rokitansky family archive, focusing in particular on its international reception and the relationships that were formed as a result. The model of Viennese Medicine was transferred to universities abroad and implemented in new medical schools in Japan, Iran, Mexico, Greece and the USA that developed it further. Rokitansky’s international network contributed greatly to this transfer of knowledge as shown by newly-discovered source material from the Rokitansky family archive.

Le Fœtus in Fœtu (FIF) est une anomalie congénitale extrêmement rare définie comme une masse contenant un axe vertébral associé souvent à d'autres organes ou à des membres autour de cet axe. Nous rapportons l'observation d'un fœtus de sexe féminin âgé de 4 mois qui se présentait pour une masse rétropéritonéale mesurant 7x6x4cm évoquant un tératome à la tomodensitométrie. La masse était réséquée. L'examen macroscopique montrait une masse d'aspect fétiforme recouverte par un tissu cutané et se prolongeant par des ébauches de membres supérieurs et inférieurs (A). A la coupe, elle était centrée par plusieurs fragments ostéocartilagineux disposés d'une façon linéaire rappelant un axe vertébral (B). L'examen histologique objectivait la présence du tissu glial autour d'un ventricule cérébral en plus des tissus cutané, musculaire et osseux. Le diagnostic d'un FIF était retenu. Le FIF a été rapporté essentiellement au niveau du rétropéritoine suivi par les localisations sacro-coccygienne, intra-abdominale, crânienne, buccale, médiastinale, pulmonaire, rénale et scrotale. Le diagnostic est établi en anténatal dans 15% des cas. L'étiopathogénie du FIF inclut la théorie de grossesse monochoriale biamniotique monozygote par laquelle un aberrant jumeau asymétrique s'intériorise dans l'autre jumeau et la théorie d'implantation défectueuse d'un embryon dans le mésenchyme de son jumeau au lieu de la paroi utérine. Le diagnostic différentiel se pose avec le tératome, le pseudokyste méconial et la grossesse ectopique.

Resumen Partiendo de la hipótesis de que el laboratorio jugó un papel importante en la autonomía disciplinar de la pediatría, este artículo estudia la influencia del viaje científico en la apropiación de nuevas metodologías por parte de los pediatras y puericultores españoles del primer tercio del siglo XX. Para ello, se analizan las pensiones concedidas a tal efecto por la Junta para Ampliación de Estudios e Investigaciones Científicas. Se describe la geografía científica creada por el programa y se profundiza en el papel de los mentores – especialmente de Gustavo Pittaluga (1876-1956) – en este proceso. Además de un estudio prosopográfico del grupo, se presentan tres casos que demuestran la importancia del programa en el encuentro de la pediatría con la bacteriología, la anatomía patológica y la bioquímica. Abstract Starting from the hypothesis that laboratories played an important role in pediatrics becoming an autonomous discipline, this article studies the influence of scientific travel on the appropriation of new methodologies by Spanish pediatricians and child-care experts in the first third of the twentieth century. To do so, it analyzes the travel awards granted by the Junta para Ampliación de Estudios e Investigaciones Científicas. It describes the scientific geography created by the program and takes an in-depth look at the role of mentors – especially Gustavo Pittaluga (1876-1956) – in this process. In addition to a prosopographical study of the group, it presents three cases that demonstrate the importance of the program in bringing pediatrics into contact with bacteriology, pathological anatomy and biochemistry.

Giovanni Morgagni remains an eminent figure in the field of pathological anatomy. Born in Forli, Italy, he excelled as a child. He entered medical school at the age of 16 years old in Bologna. By the age of 31 he held the chair position at the University of Padua. During his tenure, he discovered many anatomical and pathological findings, with the most widely known discovery being the Morgagni Hernia. Morgagni first described this eponymic hernia in an adult stonecutter during an autopsy. In addition to his many discoveries, his most esteemed written contribution to the field of medicine came in the form of a five-volume book titled De Sedibus et Causis Morborum per Anatomen Indagatis, in which he correlated cadaveric anatomy and symptomatology revealed upon autopsy. He remained on faculty at the University of Padua for over five decades until his death in 1771.

The article presents data on the main stages of formation and development of the pathological anatomy department of Kazan (Imperial) University from department approval under the auspice of Professor A.V. Petrov in December, 1965 to its reorganization by merging of two departments - Pathological Anatomy and Pathological Physiology in June, 2014. Data on the department heads for the 150-year history are summarized, the main directions of scientific research conducted under the department heads supervision are described. Particular consideration is given to the Kazan scientists-pathologists achievements and contribution in fundamental and practical pathological anatomy, related subjects, clinical practice, social sciences, students’ education and doctors of various specialties training. Joint General Pathology department faculty new challenges are identified, namely transition plan generation, educational process radical restructuring in order to optimize it according to modern requirements for the higher and postgraduate education system. Initiated and conducted measures in connection with the department reorganization in the framework of new General Pathology discipline allowing to preserve the pathological anatomy structural and organizational integrity as a basic science, which is also of great practical importance, are presented.

Objective: To provide information about a safe and easy technique to remove live nematode in the anterior chamber. Case Presentation: A 21-year old male presented with a sudden-onset of pain in right eye for 5 days. The complaint was accompanied with irritation and photophobia. On examination, visual acuity was 6/6,5 with his best corrected, with circumcorneal congestion. We performed slit-lamp examination on the AC and witnessed a thin, white motile object with wriggling movement, that was swimming live in AC. The worm was removed surgically from AC by using forceps and adding lidocain with nacl 0,9% intracorneal to stop its movement. The worm was sent to pathological anatomy department to be examined microscopically. Conclusion: A method of using lidocaine as a chemoparalysis substance has been proven effective to facilitate an easy removal of the worm so as to prevent major harm to the ocular structure.

Actinomycosis is a chronic, opportunistic infection caused by Actinomyces species, such as Actinomyces bacillus. Actinomycosis in long bones is very rare. To the best of our knowledge, isolated primary actinomycosis of the humerus is rarely reported in literature. We present a rare case of a refractory primary actinomycosis of the humerus. A 66-year-old man with no history of concomitant conditions was admitted to our hospital with a history of a tumour on the distal third of the left arm as a result of a closed trauma without fracture 20 years before. Pathological anatomy samples showed the presence of Actinomyces. Cultures were subjected to a prolonged incubation of 21 days under aerobic and anaerobic conditions and were always negative. He underwent several surgical procedures and received long-term antibiotic therapy with poor outcome. Primary actinomycosis in long bones is uncommon. Diagnosis may be challenging: considering the small number of case studies reported in the literature, symptoms are not specific, and the organism is difficult to isolate. Antibiotic treatment may not be sufficient to improve the clinical condition, and surgical alternatives should be considered

The authors describe the stages of development and characteristic features of the activity of the Department of Pathology Anatomy of Bukovina State Medical university. The main problems and tasks pathological and anatomical service in Bukovina since 1945 - year of foundation of the department at Chernivtsi medical institute. Contains materials on the beginning of teaching pathological anatomy, consistent activity heads of the department and their contribution to the educational and scientific work on pathological anatomy. In addition, it is shown gradual formation of a qualitative training base scientists and doctors on pathological anatomy, which work in many regions of Ukraine and for its outside. The indicated subjects, directions activities of the department - educational, teaching and scientific work.

The aim of the study was to present the results of necropsies carried out in the years 2000–2014 in the Department of Pathological Anatomy, Faculty of Veterinary Medicine, University of Life Sciences in Lublin. The material used for the analysis consisted of expert opinions prepared on the basis of a decision by a judicial body to admit an expert opinion as evidence. An increase was observed in the demand for the services of veterinary forensic experts, beginning in 2006 and persisting through 2014. The response to the growing popularity of veterinary forensic examinations should be systematization of knowledge and exchange of experience, which would enable the further development of this interdisciplinary science.

2015 marks the 120th anniversary of the birth of Nikolay Fedorovich Poryvaev - the outstanding Russian physician-pathologist and scientist. After graduation from the Penza boys gymnasium Nikolay Fedorovich entered the Medical Faculty of Kharkov University, graduating in 1923. He first worked as a therapist in the Mokshan village of Penza region. Then he moved to Penza, where he continued to work as a therapist in the provincial hospital (currently SBIH «Penza Regional Clinical Hospital named after N.N. Burdenko»). From 1929 to 1936 he was in charge of the provincial hospital prosectorium. He became interested in scientific and pedagogical activity, which he began to be engaged in further by moving to the Department of Pathological Anatomy of Kazan State Medical Institute. In 1950 N.F. Poryvaev defended his PhD thesis on «Pathology». For a time, from 1955 to 1959 and from 1966 to 1968 he headed the department. The article presents a brief biography of the associate professor N.F. Poryvaev, his activities in Penza and Kazan are described. Nikolay Fedorovich was World War II veteran, he was awarded the Order of the Red Star and three medals for his services to the country. In the literature devoted to the history of medicine of Penza and Kazan, there are only fragmentary information about associate professor N.F. Poryvayev. This work is presented to fill this gap.

Breast lesions may, during their development, provide sonography signs can be difficult to view or are not very specific. They are called “subtle images”. Proximal (ductal) lesions are differentiated from distal (ductal-lobular) lesions. Proximal lesions are mainly inflammatory or infectious, altering the duct walls that evolve into ectasia and then fibrosis with possible acute episodes of plasmocyte mastitis or bacterial mastitis. The fibrovascular stalks of the papilloma accounts for the Doppler flow. Certain secretory forms of intra-ductal carcinoma may distend the structure of the milk ducts. The sonography of lesions of the ductal-lobular units are related to the degree of fibrosis, the atrophy or cell proliferation, and the disorganisation of the architecture. The extent of the fibrosis, or the cell density of certain tumours may modify the tissue hardness in elastography.

Aim To evaluate the feasibility of magnetic resonance imaging (MRI) for the transformation of preserved organs and their disease entities into digital formats for medical education and creation of a virtual museum. Materials and methods MRI of selected 114 pathology specimen jars representing different organs and their diseases was performed using a 3 T MRI machine with two or more MRI sequences including three-dimensional (3D) T1-weighted (T1W), 3D-T2W, 3D-FLAIR (fluid attenuated inversion recovery), fat–water separation (DIXON), and gradient-recalled echo (GRE) sequences. Qualitative assessment of MRI for depiction of disease and internal anatomy was performed. Volume rendering was performed on commercially available workstations. The digital images, 3D models, and photographs of specimens were archived into a workstation serving as a virtual pathology museum. Results MRI was successfully performed on all specimens. The 3D-T1W and 3D-T2W sequences demonstrated the best contrast between normal and pathological tissues. The digital material is a useful aid for understanding disease by giving insights into internal structural changes not apparent on visual inspection alone. Volume rendering produced vivid 3D models with better contrast between normal tissue and diseased tissue compared to real specimens or their photographs in some cases. The digital library provides good illustration material for radiological–pathological correlation by enhancing pathological anatomy and information on nature and signal characteristics of tissues. In some specimens, the MRI appearance may be different from corresponding organ and disease in vivo due to dead tissue and changes induced by prolonged contact with preservative fluid. Conclusions MRI of pathology specimens is feasible and provides excellent images for education and creating a virtual pathology museum that can serve as permanent record of digital material for self-directed learning, improving teaching aids, and radiological–pathological correlation.

This paper presents a complete overview of the scientific, professional and social activity of a great Polish pathologist, Witold Nowicki (1878-1941), from mainly Polish-written, original sources with a major impact on mostly his own publications. The biographical commemoration of this eminent professor is not only due to the fact that he provided a profound microscopic characterization of pneumatosis cystoides in 1909 and 1924. Nowicki greatly influenced the development of anatomical pathology in Poland, having authored over 82 publications, with special reference to tuberculosis, lung cancer, sarcomatous carcinomas, scleroma and others. However, the first of all his merits for the readership of Polish pathologists was his textbook titled Anatomical Pathology, which was a basic pathology manual in pre-war Poland. Witold Nowicki - as the head of the academic pathological anatomy department and former dean of the medical faculty - was shot with other professors by Nazi Germans in the Wuleckie hills in Lvov during World War Two. Professor Nowicki was described as being "small in size but great in spirit" by one of his associates, and remains an outstanding example of a meticulous pathologist, a patient tutor and a great social activist to follow.

The objective of the present study was to analyze the results of research reported in the theses for the degree in "forensic medicine" defended in different dissertation committees during the 5 year period (from 2010 till 2014) and to summarize and compartmentalize the main research areas in which the authors carried out their study and thereby make the data obtained more readily available for the wide circles of readers. A total of 55 theses for the scientific degree in "forensic medicine" (14.03.05) were defended during the period from 2010 till 2014 including 18 (32.7%) ones for the degree in two disciplines, the second being either "pathological anatomy" (n=6) or "stomatology" (n=4). Despite the great variety of the problems resolved in the studies conducted during the five year period, the subject matter of most research was on the whole consistent with the main lines of activities of the institutions with which the degree-seeking workers were affiliated. The same refers to the choice of the tutors and scientific advisers. the authors emphasize the necessity of centralized planning of research in compliance with the list of priority investigations having practical significance and coordination of cooperative studies carried out based on the state bureau of forensic medical expertise (SBFME) and departments of forensic medical expertise of medical universities.Цель исследования - проанализировать результаты диссертационных исследований, выполненных соискателями по двум научным специальностям (включая специальность 'Судебная медицина'), защищенных в различных диссертационных советах за 5-летний период (2010-2014 гг.), обобщить и структурировать основные научные направления, над которыми работали соискатели, сделав их более доступными для широкого круга читателей. За период с 2010 по 2014 г. по научной специальности 'Судебная медицина' (14.03.05) было защищено 55 диссертаций, из них по двум специальностям - 18 (32,7%) работ, среди которых в качестве второй специальности преобладали 'Патологическая анатомия' (6) и 'Стоматология' (4). Несмотря на широкий спектр решенных научных задач, в указанный пятилетний период выбор тематики научных исследований происходил в соответствии с профилем учреждений, на базе которых выполнялись диссертационные исследования, и предпочтений научных руководителей (консультантов). Показаны необходимость централизованного планирования научных исследований в соответствии с перечнем приоритетных направлений, характеризующихся высокой практической значимостью, а также обсуждение и координация совместных научных исследований, выполняемых в ГСМЭУ страны и на кафедрах медицинских вузов.

The most significant cardiovascular anatomoclinical observations from Morgagni's masterpiece De sedibus et causis morborum per anatomen indagatis (1761) are herein reported, divided into the current taxonomy according to cardiac structure: (a) aorta and pulmonary artery, (b) pericardium, (c) coronary arteries, (d) myocardium, (e) endocardium, (f) congenital heart defects, and (g) heart rhythm disorders. Morgagni's interpretations in cardiovascular pathology were strictly related with the most advanced theories of his time, such as those of blood circulation and iatromechanics; nevertheless, he remained close to the empirical description of clinical and pathological anatomy phenomena with their individual specificity. Through a systematic review of the literature, he compared the data from his own observations and experiments with those from physicians he considered reliable by applying the method of literature review which is still valid nowadays.

Purpose To study the diagnostic value of static elastography of the breast (score, histogram, quantitative ratio) in masses classed as BI-RADS 4 and BI-RADS 5 on sonography using the findings from pathological anatomy analyses on the masses as a reference. Materials and methods A prospective study using a representative sample into 68 masses seen on sonography and their elastography results. For each mass, we determined the elastography colourimetry score (UENO et al. classification, scores 1–3 = benign and 4–5 = malignant). We studied quantitative elastography parameters based on the Z2/Z1 (fat/lesion) ratio and a histogram showing the pattern of mass stiffness distribution. The results were compared with histology findings (68 lesions assessed, 22 benign lesions and 46 malignant lesions). Results Elastography was consistent with histology (sensitivity: 73.9%, specificity: 86.4%, PPV: 91.9%, NPV: 61.3%). There were twelve false negatives and three false positives. With the Z2/Z1 ratio, we set a cut-off point of 3.05 for 99.0% specificity. Conclusion Elastography is a reliable technique that is able to assist radiologists in their diagnostic approach to breast pathology.

The identification of HER2 alterations in advanced gastric carcinomas is of critical importance in daily clinical practice as such neoplasms require specific treatment with trastuzumab. For these reasons, pathologists and oncologists with expertise in gastric carcinomas and HER2 testing from both organisations (SEAP and SEOM) have endeavoured to discuss and agree on national guidelines for HER2 testing in gastric carcinomas. These guidelines are based on the experience of those who participated in the discussions and also on experience published internationally. These agreed guidelines give the minimum requirements that a pathological anatomy laboratory must fulfil in order to guarantee adequate HER2 testing in daily practice. Any laboratories which do not meet the minimum standards set out in the guidelines must make every effort to achieve compliance.

In 1888, the Austrian neuroanatomist Heinrich Obersteiner, founder of Vienna's Neurological Institute, published his "Introduction to the Study of the Structure of the Central Nervous Organs in Health and Disease", a fundamental textbook in which he summarised the state-of-the-art knowledge available then on the normal and pathological anatomy of the human nervous system, incorporating many of his original research findings. The book became "the Bible for generations of budding neurologists" worldwide and was crucial for the eventual development of neurology as an independent medical discipline. In his early career as a neuroanatomist, Sigmund Freud wrote a review of Obersteiner's book for the Wiener Medizinische Wochenschrift. That review was not included in the "Standard Edition of the Complete Psychological Works". The present article provides an English translation of Freud's review and further discusses its historical context, especially regarding the influence of Theodor Meynert on his two illustrious students, Freud and Obersteiner.

The "Tissue" concept emerged apparently in the medical literature at about the French revolution, during the second half of the 18(th) century. It was found in the texts written by the physicians of Bearn and Montpellier, the Bordeu-s and also by the famous physician, Felix Vicq d'Azyr, the last attending physician of the queen Marie-Antoinette, "Bordeu et al. (1775) et Pouliquen (2009)". It was elaborated into a coherent doctrine somewhat later by Xavier Bichat, considered as the founder of modern pathological anatomy, Bichat. With the advent of histochemistry, from the beginning of the 20(th) century, several of the principal macromolecular components of connective tissues, collagens, elastin, "acid mucopolysaccharides" (later glycosaminoglycans and proteoglycans) and finally structural glycoproteins were characterized. These constituents of connective tissues were then designated as components of the extracellular matrix (ECM), closely associated to the cellular components of these tissues by adhesive (structural) glycoproteins as fibronectin, several others and cell receptors, "recognising" ECM-components as integrins, the elastin-receptor and others. This molecular arrangement fastens cells to the ECM-components they synthesize and mediates the exchange of informations between the cells to the ECM (inside-out) and also from the ECM-components to the cells (outside-in). This macromolecular arrangement is specific for each tissue as a result of the differentiation of their cellular components. It is also the basis and condition of the fulfillment of the specific functions of differentiated tissues. This is a short description of the passage of the "tissue" concept from its vague origin towards its precise identification at the cellular and molecular level up to the recognition of its functional importance and its establishment as an autonomous science. This can be considered as a new example of the importance of metaphors for the progress of science, Keller (1995).

Luigi Sacco (1769–1863) was the main protagonist of early vaccination campaign in Italy. He found a native source of vaccine lymph: with that, he personally vaccinated more than 500,000 people and furnished all Italy and some Middle East countries too. Starting from the pictures of his books, Sacco proposed to create wax models of “real” and “spurious” smallpox pustules in human, cow, sheep and horse; just to permit, not only to doctors, but also to all other health operators, the identification of the right pustules from where to extract active lymph for vaccination. In the Museum of Pathological Anatomy of the Padua University Medical School, we have four anatomical waxes which corresponded exactly to the explicative pictures in 1809 Sacco’s treatise on Vaccine. We have found the same models also at the University of Milan, Pavia and Bologna—the main cities of “Cisalpine Republic”, the state of North Italy formed at the epoch of Sacco following the Napoleon conquest. The history of the diffusion of these models presented in this text will be a starting point to develop wider questions. In particular, this history could be useful to improve our understanding of the birth of scientific and experimental medicine through XIX and XX Century.

La equinococosis es una infección parasitaria provocada por Echinococcus granulosus, que, en su estado quístico, forma al denominado quiste hidatídico. Presenta morbilidad importante, con posibles secuelas relacionadas con la ubicación, y altos costos debido al tratamiento quirúrgico y farmacológico prolongado. El hígado y el pulmón son las ubicaciones anatómicas más usuales, mucho más raras son el riñón, bazo, cerebro y corazón, este último representa el 0,5 % a 2 % del total de casos. El Perú es un país endémico de esta antropozoonosis y principalmente registra casos procedentes de la sierra central (95 %). Se presenta el caso de una niña de diez años, con diagnóstico de esta entidad, clasificación ecográfica CE 1, grupo clínico 1 (confirmado por anatomía patológica) con posterior tratamiento quirúrgico y farmacológico específico (albendazol). La paciente se recuperó satisfactoriamente de la cirugía practicada, y fue dada de alta a los 16 días, sin complicaciones.

Carl Rokitansky was one of the foremost experts and pioneers in pathological anatomy of the 19th century. Virchow and Rokitansky paved the way for the modern specialty of pathology, as we know it today. Whilst Virchow was the doyen of histopathology, Rokitansky's merit was his excellent gross pathology establishing thereby a nosological classification of disease. For this achievement, Virchow called Rokitansky the Lineè of pathology. In spite of his importance little is reported on Rokitansky. If the cause of death is mentioned, it is always stated incorrectly. This error may be due to a misleading certificate of death, which was issued without autopsy. This essay aims to describe Rokitansky's illnesses, particularly in his last months, and to deduce from available evidence the most probable cause of his death - with short explanations for non-medical readers. Briefly, Rokitansky suffered from arteriosclerosis leading to stenocardial attacks (angina pectoris). Rokitansky tried to relieve himself from pain by using chloroform. His personal description of the symptoms in his autobiography and the circumstances of his death clearly indicate a heart attack as the cause of death.