Characteristic Microscopic Features Research Articles

Uterine Angioleiomyoma: Clinical and Histopathologic Differentiation of an Underrecognized Mimicker of Uterine Leiomyoma.

Angioleiomyoma is an uncommon benign neoplasm of mesenchymal origin that arises from perivascular smooth muscle cells. This soft tissue neoplasm usually occurs in the dermal or subcutaneous tissues of the extremities, head and neck, or trunk with fewer than 40 reported angioleiomyomas arising in the uterine corpus. Herein we report a uterine angioleiomyoma in a 44-year-old G5P4 Hispanic woman with a longstanding history of recurrent abdominal pain, pelvic organ prolapse, abnormal uterine bleeding, anemia, and hypertension. The patient underwent surgical treatment with total laparoscopic hysterectomy with bilateral salpingectomy and a uterosacral ligament suspension. Uterine angioleiomyoma was diagnosed post-operatively based on gross and microscopic features. The location of the uterine angioleiomyoma within the myometrium corresponded with contrast enhancement apparent on preoperative imaging. This and other uterine angioleiomyomas have characteristic imaging, macroscopic, and microscopic features which distinguish it from leiomyoma. Enhancing awareness of this underrecognized entity will facilitate precise diagnosis and thereby enable improved understanding of the clinicopathological characteristics of uterine angioleiomyoma.

АНАЛИЗ ПОКАЗАТЕЛЕЙ ПОДЛИННОСТИ ЛИСТЬЕВ КУБЫШКИ ЖЕЛТОЙ (NUPHAR LUTEA L.) И ОЦЕНКА ПЕРСПЕКТИВ ИСПОЛЬЗОВАНИЯ ДАННОГО ВИДА СЫРЬЯ

In the article the author presents the results of studying the morphological and anatomical features in the raw material of the above-water leaves of Nuphar lutea using macroscopic and microscopic analyses, as well as the qualitative composition of the extract of the leaves of Nuphar lutea. The rhizomes of Nuphar lutea were selected as a pharmacopoeial raw material for comparison to confirm a similar component composition. The studies were conducted in accordance with the requirements of the general pharmacopoeia articles. The characteristic macroscopic and microscopic features of the leaves of Nuphar lutea were revealed, the qualitative composition was similar to the rhizomes of this plant. To assess the presence of certain groups of alkaloids, a method unusual for pharmacognostic analysis was proposed – microcrystalline analysis. When evaluating the prospects for use, it was revealed that the leaves of Nuphar lutea can potentially become a more environmentally friendly substitute for the pharmacopoeial raw materials of the rhizomes of Nuphar lutea, and also have a number of distinctive pharmacological properties

Human Papillomavirus-Associated Oral Epithelial Dysplasia: Report of 5 Illustrative Cases from Latin America.

Human papillomavirus-associated oral epithelial dysplasia (HPV-OED) is a distinct oral epithelial disorder characterized by viral cytopathic changes caused by transcriptionally active high-risk HPV. The aim of the present study was to report 5 additional cases from Latin America. Clinical data from five patients with HPV-OED were obtained from the archives of three oral pathology services from Brazil and Chile. All cases were submitted to morphological, p16 expression and in situ hybridization (ISH) for HPV analyses. Four patients were male and one patient was female, with a mean age of 55.4 years. Four patients were HIV seropositive and two were smokers. Three cases affected the buccal mucosa and commissure, one of which had an additional plaque in the soft palate, and one case each occurred on the floor of mouth and lower labial mucosa. Most cases presented as well-demarcated white plaques with a verrucous surface. One case presented multiple lesions ranging from normal to white-colored slightly elevated plaques with a cobblestone surface. Peripheral mucosal pigmentation was observed in two cases. All five cases presented with the characteristic microscopic features of HPV-OED, including severe dysplasia with numerous karyorrhectic and apoptotic cells, full-thickness "block positivity" for p16 and high Ki-67 index (> 90%) sharply demarcated from the adjacent non-dysplastic epithelium. Wide-spectrum DNA ISH-HPV was positive in 4 cases. All patients were treated with conservative surgical excision with no signs of recurrence after a mean of 39-month follow-up. This represents the first series of HPV-OED from Latin America; most cases presented as well-demarcated papillary white plaques affecting the buccal mucosa and commissure of HIV-positive middle-aged men, two of them exhibiting peripheral pigmentation caused by reactive melanocytes. The typical microscopic findings of HPV-OED were observed in all cases, which also showed strong p16 positivity in a continuous band through the full thickness of the epithelium and high Ki67.

Microscopic feature of lymph node anthracosilicosis adherent with pulmonary artery: a case report

BackgroundAlthough thoracic surgeons occasionally encounter dense adhesions of interlobar lymph node anthracosilicosis with the pulmonary artery, adhesiolysis may be challenging. Besides, characteristic microscopic features of the adherent lesion remain limited.Case presentationDuring a thoracoscopic right upper lobectomy of a patient with stage IA3 primary lung adenocarcinoma, several interlobar lymph nodes adhered to the posterior ascending branch of the pulmonary artery to the right upper lobe were noted. After an unplanned conversion to a thoracotomy to avoid massive bleeding, the pulmonary artery branch was safely isolated. Microscopic examination revealed lymph node anthracosilicosis proximal to the peripheral pulmonary artery wall, with granulomatous inflammation. The adventitial stroma of the pulmonary artery developed into dense and borderless fibrous tissue with dust-laden macrophages.ConclusionsOur pathological findings on lymph node anthracosilicosis provide substantial evidence that adhesions between lymph nodes and the pulmonary artery walls may develop into dense and borderless fibrous tissue. This finding would remind thoracic surgeons that adhesiolysis could cause injury to the pulmonary artery.

PHARMACOGNOSTIC STUDY OF COSMOS BIPINNATUS CAV. (FAM. ASTERACEАE), CULTURED IN THE WESTERN CAUCASIAN REGION

The purpose of the work: to reveal the study of the morpho-anatomical composition and composition of biologically active groups – compounds, carboxylic acids and trace elements of the aerial part of various species of Cosmos bipinnatus Cav.: ‘Purity’, ‘Rosea’ and ‘Dazzler’.
 Materials and methods. The object of the study is the cultivation of three species of space plants in Europe, collected in the flowering phase at the beginning of 2020. Micropreparations were obtained using a Biomed-2 microscope (eyepiece 16x, objective 4x, 10x) in accordance with the procedures of the State Pharmacopoeia of the Russian Federation, XVI edition (SP XVI). Carbohydrate complexes are isolated from dried raw materials by the method of N.K. Kochetkov and M. Sinner. Quantify the content of each assessment gravimetrically. The monosaccharide composition is established after acid hydrolysis by paper chromatography. Identification of acid consumption is carried out using thin layer chromatography. The elemental and amino acid composition is examined by capillary electrophoresis.
 Results and discussion. Certain characteristic microscopic features of Cosmos bipinnatus Cav., Aster varieties ‘Rosea’, ‘Dazzler’, ‘Purity’ for various morphological parts of plants (leaves, flowers, inflorescence involucre, stem), revealing the identified signs of the alleged medicinal source as a source of biologically active connections. A comparative analysis of the composition of carbohydrates, carboxylic acids and carbohydrates of shoots (leaves and stems) showed that water-soluble polysaccharides are arabinose fructose, rhamnose and galactose, pectin monosaccharides are galacturonic acid, glucose and arabinose detection, and hemicelluloses A and B are xylose, glucose and galactose. In all known varieties, succinic acid is noted. A high content of proline and essential amino acids: leucine, methionine, valine, threonine, as well as the ability of all the studied sources to collect potassium, magnesium, iron and boron ions were noted.
 Conclusion. It has been established that the unusual colors of the flowers are predominantly the color of the stems. The anatomical features of different species are practically the same. It was revealed that the ‘Purity’ variety surpasses the objects in terms of the content of water-soluble polysaccharides, cellulose-hemi A and B, other essential amino acids, aliphatic amino acids, iron and boron. Variety ‘Dazzler’ is the richest in pectin doses and potassium ions. ‘Rosea’ variety contains the maximum amount of high content of amino acids.

Basaloid Squamous Cell Carcinoma of Cervix – A Rare Case Report

Basaloid squamous carcinoma of the uterine cervix is a rare tumor type characterized by an ulcerated, infiltrating growth pattern; nests or cords of small basaloid cells; prominent peripheral palisading of cells in the tumor cell nests; and the absence of significant stromal reaction. The characteristic microscopic features are nests, lobules, trabeculae and groups of round to oval basaloid tumor cells. These tumor cells are small with high nuclear cytoplasmic ratio and shows peripheral palisading. There may be areas of comedo type necrosis and areas showing typical squamous cell carcinoma differentiation.

Can Orthodontic Treatment Stimulate Formation of Odontogenic Keratocyst?: A Case Report

Odontogenic keratocyst (OKC) has always been a subject of interest for researchers and clinicians, owing to its unique pathogenesis, aggressive clinical behavior and association with syndromes. Majority of OKCs occur in the mandibular posterior region, and sporadic type of cysts have a predilection to occur in males and in patients of older age groups. The present article reports a case of sporadic OKC presenting in a relatively unusual manner, occurring in the maxillary anterior region of a young female patient. Unlike other reported cases that found OKC prior to commencement of orthodontic treatment, herein it had possibly occurred as a complication of the orthodontic treatment. The article also depicts characteristic microscopic features of OKC such as uniform parakeratinized lining with multiple infoldings, basal palisading, areas of interface separation between the lining and capsule. Disrupted lining with severe inflammatory cell infiltrate in the capsule was indicative of secondary infection

Microscopic Studies and Preliminary Pharmacognostical Evaluation of Leaves and Roots of Ophiorrhiza eriantha Wight

Death and suffering caused by cancer have been a major concern throughout the history of mankind. Extensive research has been undertaken in the plant kingdom to find out an effective drug for the treatment of various cancer diseases. Drugs derived from plants and microorganism plays a major role in the chemotherapy of cancer. Monoterpene indole alkaloid camptothecin (CPT) is a potent anticancer agent first isolated and reported from extracts of the Chinese tree Camptotheca acuminata (Nyssaceae). Thereafter camptothecin was isolated from plants of different families mainly Ophiorrhiza mungos and Nothapodytes nimmoniana. The genus Ophiorrhiza is a potent natural source of camptothecin. The presence of fortyseven species and nine varieties of Ophiorrhiza was reported in the Indian subcontinent. Ophiorrhiza eriantha Wight is an erect subshrub species, its anticancer potential and detailed phytochemical analysis are yet to be studied. Our aim is to evaluate the pharmacognostic parameters of leaves and roots of Ophiorrhiza eriantha Wight. Our objective is to identify characteristic microscopic features of leaves and roots of the plant and to study the quantitative microscopy, ash value, loss on drying, phytochemical screening, fluorescence analysis, and powder analysis of leaf and roots of Ophiorrhiza eriantha Wight. The thickness of the midrib, lamina, leaf margin, and epidermal trichome is measured. It showed the presence of paracytic stomata. Non-glandular epidermal trichomes are common in leaf powder. Ophiorrhiza eriantha Wight is a promising anticancer plant; this is a pioneer work to explore the anatomical features of Ophiorrhiza eriantha Wight. Keywords: ,, , , And

Study of Morphological Features of Sea Buckthorn Leaves by Luminescent and Stereomicroscopy Methods

Introduction. Sea buckthorn – Hippophaё rhamnoides is a perennial shrub, the fruits of which are a source of carotenoids and are harvested on an industrial scale to obtain a number of drugs. Recently, not only fruits, but also other parts of the plant, such as buds, leaves, shoots and bark, are of increasing interest. It is known that sea buckthorn leaves are rich in compounds such as tannins, polyunsaturated fatty acids and vitamins (C and E). The rich composition of biologically active substances with a sufficient content of components allows us to consider leaves as a new type of medicinal plant material for the further development of various preparations based on them. In addition, the leaves are an annually renewable raw material and it is possible to harvest them on an industrial scale, since this valuable medicinal plant is cultivated everywhere in Russia. Data on the microscopic characteristics of the fruits of sea buckthorn are described in detail in the scientific literature, which cannot be said about the leaves. The scientific literature also does not describe the features of the luminescence of the tissues of the leaves of the sea buckthorn.Aim. The aim of this work was to study the possibility of using the luminescent and stereomicroscopic methods of analysis to determine the main morphological features of the leaves of the sea buckthorn.Materials and methods. Dried whole leaves of a plant of the genus Hippophaës collected in the Voronezh region were used as the object of the study. The study of microdiagnostic signs was carried out according to the State Pharmacopoeia of the XIV RF GPA.1.5.3.0003.15 «Technique of microscopic and microchemical examination of medicinal plants and herbal medicinal products». A stereomicroscopic study was carried out using a Biomed 2 microscope. The luminescence of the tissues of the sea buckthorn leaves was investigated using a luminescent microscope of the Miсromed 3 LUM brand.Results and discussion. Stereomicroscopic analysis of sea buckthorn leaves was carried out. High-resolution volumetric images were obtained in a short period of time. It was found that the characteristic microscopic features of the leaves are the presence of a large number of corymbose hairs along the upper and corymbose-stellate along the lower surfaces, including the vein and petiole (from colorless to white, yellow and dark brown). Single simple stellate hairs are rare. When removing the layer of hairs, the spongy structure of the epidermis of the leaf is visible. The carried out luminescent analysis made it possible to reveal the features of the luminescence of the tissues of the leaves of the sea buckthorn. Diagnostic luminescent features include: the most pronounced yellow glow is observed for the cells of the base of the corymbose hair; the plates that make up the corymbose hairs do not have bright fluorescence; stellate hairs do not have a glow; pronounced yellow-green fluorescence is characteristic of the leaf vein.Conclusion. For the first time, stereomicroscopic and luminescent analyzes of sea buckthorn leaves were carried out and the main morphological features of this type of medicinal plant material and their biometric characteristics were established. The carried out luminescent analysis made it possible to reveal the features of the luminescence of the tissues of the leaves of the sea buckthorn.

Primary solitary fibrous tumor of the thyroid gland: A review starting from a case report.

Primary solitary fibrous tumor (SFT) of the thyroid gland is a rare mesenchymal tumor with fibroblastic differentiation, ramified, thin-walled, enlarged (staghorn) vessels and specific NAB2-STAT6 gene fusion, which is more commonly found in pleura and peritoneum. This neoplasm can be located in a variety of anatomical sites outside pleura and peritoneum including bone, visceral organs and soft tissues, head and neck examples representing only 10-15% of the extra-pleural and extra-peritoneal tumors. Diagnosing this entity can be difficult, especially in thyroid gland, mainly because of the rarity of this neoplasm, but presence of characteristic microscopic features together with positivity for STAT6 and CD34 can confirm the diagnosis and exclude other differential diagnosis. Information about the diagnosis and treatment options of thyroid SFTs is limited but almost all primary thyroid SFTs have a good prognosis and indolent clinical course. Clinical surveillance is still necessary because some SFTs can be aggressive. Raising awareness regarding extra-pleural and extra-peritoneal location of this tumor in endocrine organs can help to better manage these patients. We report the case of a 34-year-old female with primary SFT of the thyroid gland. Additionally, we review the literature for the main clinical, paraclinical and pathological features of this neoplasm.

A rare ovarian hilus cell tumour accompanying bilateral serous cystadenomas: report of a case

BackgroundHilus cell tumours is considered an uncommon branch of androgen producing neoplasms that accounts for < 5% of all ovarian tumours. They are mostly benign and have characteristic gross and microscopic features. Here we present the first case of a hilus cell tumour in association with bilateral serous cystadenomas.Case presentationA 65-year-old lady with no symptoms of virilization, presented with postmenopausal dysfunctional uterine bleeding and radiological investigations revealing bilateral ovarian cysts that required a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Gross and microscopic evaluation confirmed the diagnosis of hilus cell tumour associated with bilateral serous cystadenomas.ConclusionsThis was the first case of hilus cell tumour in association with bilateral serous cystadenomas of the ovaries. Although, majority of hilus cell tumours that have been reported in the literature were benign, further studies are required to determine the behavior of the disease.

Characteristic Light and Electron Microscopic Features of Adelina melolonthae, a Coccidian Pathogen of the European Cockchafer, Melolontha melolontha (Coleoptera/Scarabaeidae).

The aim of this study was to investigate and document the characteristic electron microscopic features of the oocyst of Adelina melolonthae, a coccidian pathogen of the European cockchafer, Melolontha melolontha (Coleoptera: Scarabaeidae). Larvae of M. melolontha were collected at Ordu, Turkey. Each larva was dissected in insect Ringer solution. Adeleid oocysts from the tissue that is suspected to Contain coccidian infections were examined under a light microscope (Zeiss), a scanning electron microscope (FEI Quanta 200) and transmission electron Microscope (Philips EM 208). Spherical to ellipsoidal oocysts measure ca. 24-44.5µm (mean 35.6µm) in diameter (n = 50) and include up to twelve sporocysts. The oocyst wall has double layers; the outer layer measured 400-500nm in thickness and the inner one 10-25nm. Sporocysts including two sporozoites are rounded ca. 11-12.5µm (mean 11.7µm) in diameter. The sporocyst wall consisted of only one 70-80-nm-thick layer. The sporozoites are ellipsoidal and measured 9-11µm length and 3-4µm in width. Sporocysts include residual bodies. In the present paper, the morphology and ultrastructure of the oocyst of A. melolonthae is documented for the first time and compared with other Adelina and coccidian species infecting insects. The results in this study confirm his identification and justify the classification as a separate species A. melolonthae, which differs from other Adelina species.

TUMORS AND TUMOR-LIKE LESIONS OF THE SALIVARY GLANDS: MORPHOLOGICAL CHARACTERISTICS OF THE SURGICAL MATERIAL

The aim is to give a morphological characteristic of tumors and tumor-like lesions of the salivary glands in the course of a comprehensive analysis of the surgical material. Materials and methods: The study used surgical material from 67 patients with various pathologies of the salivary glands. The patients were treated at Kyiv City Clinical Hospital No. 12 (Ukraine, Kiev) from 2014 to 2018. The resulting material was fixed in a 10% solution of neutral formalin (pH 7.4) for 24-48 hours, carried out according to the generally accepted technique and embedded in paraffin. Serial sections 2 μm thick were made from paraffin blocks and stained with hematoxylin and eosin. Microspecimens were studied, using Olympus BX-41 microscope (Japan). Results: A comprehensive morphological study of the surgical material of patients with salivary gland pathology undergoing treatment at Kyiv City Clinical Hospital No. 12 (Ukraine, Kiev) for the period from 2014 to 2018 revealed benign tumors and tumor-like lesions of these glands. Pleomorphic adenomas and adenolymphomas represented benign tumors of the salivary glands, while cysts represented tumor-like lesions. Different ratios of parenchymal and stromal components characterized pleomorphic adenomas of the salivary glands. On this basis, we identified three tumor variants (mesenchymal (15 cases, 50.0 %); mixed or classic (10 cases, 33.3 %); epithelial (5 cases, 16.7 %)). A characteristic microscopic feature of salivary gland adenolymphomas was a pronounced predominance of the parenchyma over the stroma. A well-defined wall, represented by connective tissue fibers and epithelial lining, characterized the cysts of the salivary glands. The connective tissue capsule separating the tumor tissue from the intact tissue of the salivary gland was clearly pronounced in adenolymphomas, and in pleomorphic adenomas it could be clearly expressed, intact, with tumor invasion or absent. In mesenchymal and mixed variants of pleomorphic adenomas, in comparison with the epithelial variant, there was a frequent tumor invasion of the capsule, thinning of the capsule or its absence. Conclusions: Morphological examination of the surgical material allows us to diagnose tumors (pleomorphic adenomas and adenolymphomas) and non-tumor lesions (cysts) of the salivary glands. This, of course, is of great therapeutic, diagnostic and prognostic value. Among the identified pathology of the salivary glands, pleomorphic adenomas cause certain difficulties in morphological diagnosis due to their structural diversity and heterogeneity, sometimes requiring morphometric, immunohistochemical or genetic research.

Clinical, morphologic, and genomic findings in ROS1 fusion Spitz neoplasms.

The presence of a characteristic chimeric fusion as the initiating genomic event is one defining feature of Spitz neoplasms. Characterization of specific subtypes of Spitz neoplasms allows for better recognition facilitating diagnosis. Data on clinical outcomes of the specific tumor types may help in predicting behavior. In this study we present the largest series to date on ROS1 fusion Spitz neoplasms. We present the clinical, morphologic and genomic features of 17 cases. We compared the morphologic features of these 17 cases to a cohort of 99 other non-ROS1 Spitz neoplasms to assess for features that may have high specificity for ROS1 fusions. These tumors consisted of 10 Spitz nevi and 7 Spitz tumors. None of the cases met criteria for a diagnosis of Spitz melanoma. Morphologically, the ROS1 fusion tumors of this series were characterized by a plaque-like or nodular silhouette, often densely cellular intraepidermal melanocyte proliferation, frequent pagetosis, tendency towards spindle cell cytomorphology, low grade nuclear atypia and floating nests with occasional transepidermal elimination. However, there was a significant range in microscopic appearances, including two cases with morphologic features of a desmoplastic Spitz nevus. Different binding partners to ROS1 were identified with PWWP2A and TPM3 being the most common. No case had a recurrence or metastasis. Our findings document that most ROS1 fusion Spitz neoplasms have some typical characteristic microscopic features, while a small proportion will have features overlapping with other genomic subtypes of Spitz neoplasms. Preliminary evidence suggests that they tend to be indolent or low grade neoplasms.

Neurosarcoidosis (Brain)

This review focuses on neurosarcoidosis with pathological alterations in the brain. Patients with neurosarcoidosis develop several symptoms such as cranial nerve palsies, headache, consciousness disturbance, and seizures. It may be difficult to reach a definite diagnosis and carry out differential diagnosis. Sarcoidosis is characterized by noncaseating granuloma that may be seen at the dura, leptomeninges, brain (including the cranial nerves), spinal cord, and peripheral nerves. Epithelioid histocytes and multinucleated giant cells, including Langhans cells, are characteristic microscopic features. In some instances, an asteroid body and a Schaumann body may be seen. In particular, infectious diseases including tuberculosis and mycosis must be ruled out. Therefore, the pathologic diagnosis of brain lesions is the gold standard for diagnosing neurosarcoidosis. In addition to prednisolone therapy, infliximab, a monoclonal antibody against tumor necrosis factor-α, has received much attention for treating neurosarcoidosis.

Odontogenic keratocyst: Analysis of recurrence by AgNOR, p53 and MDM2 profiling.

Background:Odontogenic keratocyst (OKC) is a clinical entity with characteristic microscopic features, high growth potential and propensity to recur. Aggressive behavior and higher tendency for recurrence have been attributed to greater proliferative activity of epithelial lining. The incidence of recurrence in various reported series ranges from 2.5% to 62%.Objectives:The objective of the study was to investigate the clinical behavior of OKC by evaluating p53, MDM2 expression, AgNOR staining and to ascertain if the expression of these markers correlate with the clinical outcome and tendency for recurrence.Materials and Methods:All recurrent and nonrecurrent OKCs from the archives were included, and sections were subjected to AgNOR staining, p53 and MDM2 immunohistochemical staining.Results and Conclusion:There was a significant difference in the staining pattern of MDM2 and AgNOR in the recurrent group as compared to the nonrecurrent group. The higher expression of these markers in recurrent lesions may be important in order to consider additional surgical interventions to improve prognosis.

The microscopical investigation of diagnostic diseases of Thymus х Citriodorus var. «Silver Queen» herbs

The actual problem of modern pharmacy is the study of promising essential oil plant species with pronounced antimicrobial and anti-inflamattory activity for their further introduction in medical practice. Species of one of the most famous Thymus L. genus are characterized by a great diversity and distribution in the world flora. The genus has about 400 species, of which up to 50 are identified in the modern flora of Ukraine. They are widespread in countries of Europe, Minor Asia, Middle Asia, North Africa, and the Mediterranean basin. Phytochemical studies the species of the Thymus L. genus were established the accumulation of various biologically active substances: essential oils, flavonoids, hydroxycinnamic acids, polysaccharides, tannins, fatty oils, vitamins, triterpene saponins, amino acids, bitterness, gums, inorganic elements. Essential oils and herbal extracts are part of phytopreparations with pronounced antimicrobial, anti-inflammatory and antioxidant activity. Ornamental varieties of this species are successfully cultivated in Western Europe and Ukraine: «Silver Queen», «Doone Vally», «Golden Duarf», «Bertram Anderson».&#x0D; Lemon thyme (Thymus x citriodorus Pers. Schreb. var. «Silver Queen») is promising for cultivation and introduction into medical practice. The plant has the necessary raw materials and a promising composition of biologically active compounds. The aim of the work is to install the characteristic microscopic diagnostic features of lemon thyme herb (Thymus x citriodorus Pers. Schreb. var. «Silver Queen»), harvested in Ukraine. We carried out a morphological, anatomical and microscopic study of fresh and dried herbal raw materials. The results of the research were obtained with a «Micromed XS-3320» microscope with a digital camera (5 mpix) in combination with a computer and «Biolam» with an FN-6 photo nozzle for direct and reflected light. When conducting morphological, anatomical and microscopic study of herbal raw materials of lemon thyme, common and distinctive features were established. Morphological, anatomical and microscopic studies of lemon thyme herbal raw materials were conducted and common and distinctive features were established. The established distinctive diagnostic features of lemon thyme can be used to identify herbal raw materials and are included in the draft article of the state pharmacopoeia of Ukraine «Herba Thymus x citriodorus Pers. Schreb. var. «Silver Queen».

1660 Malakoplakia of the Rectum Masquerading as a Tumor: A Case Report

INTRODUCTION: Malakoplakia is a rare inflammatory disorder that occurs in the clinical setting of persistent infections, immunosuppression and tumors. The most common sites of involvement are the urinary, gastrointestinal and respiratory tracts, skin, brain and lymph nodes where they can mimic malignancies. CASE DESCRIPTION/METHODS: A 60-year-old woman with myasthenia gravis and stage IV metastatic thymoma (status-post resection and chemo-radiation) presented with persistent weight loss, bloating, nausea, tenesmus and hematochezia. Her recent history included treatment-resistant Giardia lambia infection for one year as well as recently diagnosed Norovirus and Enteroaggregative Escherichia coli, diagnosed by stool pathogen PCR testing. On colonoscopy, the rectum contained a 7 cm region of polypoid, non-circumferential, non-obstructing nodules (Figure 1) which were highly suspicious for tumor. Microscopically, biopsies revealed rectal lamina propria infiltration by epithelioid cells with small central nuclei, eosinophilic cytoplasm (Figure 2) and lamellated cytoplasmic calcifications (Figure 3). The cells expressed cytoplasmic CD68 (Figure 2) and Von Kossa stain highlighted the calcifications, consistent with Michaelis-Gutmann bodies (Figure 3). Immunostain for pancytokeratin and Ziehl-Neelsen and Gomori's methenamine silver stains were negative. The final diagnosis was malakoplakia. A re-biopsy of the lesion showed positivity for Cytomegalovirus (CMV) immunostain and high levels of CMV viremia (1010IU/mL), for which she was treated with Gancyclovir. DISCUSSION: Malakoplakia is a rare gastrointestinal disorder without specific symptoms, endoscopic features or gross findings and tends to masquerade as a tumor. As illustrated herein, it is often an unexpected diagnosis that depends on pathological recognition of characteristic microscopic features. The correct diagnosis is critical to avoid inappropriate radical treatment. Various micro-organisms have been implicated in its development including bacteria, most commonly E. coli, viruses, fungi and even protozoa such as Taeniaspecies and it is characterized by defective bactericidal activity of the macrophages. Pathologists should be aware that malakoplakia can coexist with malignancy and tuberculosis, therefore, thorough sampling of mass lesions and appropriate adjunctive stains are advisable. Risk factors in our case included an immunocompromised state, multiple concurrent infections, and advanced malignancy, although no malignancy was identified in the biopsies.

Quality control standardization of the leaves and root of Landolphia owariensis (Apocynaceae)

The leaves and roots of Landolphia owariensis have received much attention for their incredible ethnomedicinal uses and are widely commercialized as aphrodisiac, anti-infective and anti-inflammatory agents in West Africa. A systematic evaluation of the leaves and roots was carried out in order to set standards for its identification and quality control. The organoleptic, macro-morphology and micromorphology of whole and powdered leaves and roots were carried out. Physicochemical, phytochemical, fluorescence analysis and preliminary HR-LC/MS analysis were also performed.From organoleptic and macromorphological studies, the leaf was identified to be ovate in shape with an acuminate apex, symmetrical base, entire margin and reticulate venation. Characteristic microscopic features of the leaf lamina, petiole and midrib include the presence of hypostomatic anomocytic stomata, wavy walled epidermal cells, a concentric vascular bundle displaying xylem and phloem cells, unicellular clothing trichomes and secretory cells. Prismatic calcium oxalate crystals, broken stomata, stone cells, pitted vessels, fibers, cork cells and unicellular clothing trichomes are found in the leaf and root powder. Various solvent soluble extractives, ash content, moisture content, pH and fluorescence characteristics were determined. Tannins, saponins, triterpenes and alkaloids were the major phytoconstituents identified. The essential diagnostic attributes of L. owariensis established in this study are useful for the authentication and quality control of the plant.

Long-term follow-up in children with progressive familial intrahepatic cholestasis type 2 after partial external biliary diversion with focus on histopathological features.

Progressive familial intrahepatic cholestasis (PFIC) comprises agroup of rare cholestatic liver disorders of childhood that could lead to liver cirrhosis. Nowadays, the partial biliary diversion procedure is still atherapeutic option in non-cirrhotic children with PFIC1 or PFIC2 after an ineffective ursodeoxycholic acid (UDCA) therapy. However, the relevant disadvantage of the partial external biliary diversion (PEBD) is that adolescent patients could not accept apermanent stoma. In some of them, despite of good clinical and biochemical results of this procedure, the ileal exclusion (IE) procedure had to be performed many years after PEBD. Our aims were to find the most characteristic early microscopic features of the disease as well as to compare changes in the liver biopsy specimens at the time of diagnosis and long-time (more than 10 years) after asurgical procedure. We examined retrospectively 8 liver biopsies from 4 PFIC2 patients comparing the results from the first biopsies done at the time of PFIC diagnosis and the second ones, done many years after PEBD. The characteristic lobular rosette formations of hepatocytes were found in all patients at the time of diagnosis. Cholestasis was observed in each patient, but only in two of them, centrally located bile plugs were found. The majority of hepatocytes showed degenerative changes from mild to severe degree. In the follow-up biopsies, cholestasis completely disappeared in 3 patients and decreased significantly in 1 other patient. Based on Batts and Ludwig fibrosis scoring system, the liver fibrosis had resolved in two out of three patients. The formation of lobular rosettes with centrally located bile plugs and degenerative changes of hepatocytes seem to be the most characteristic microscopic features in early liver biopsies in PFIC2 patients. Partial external biliary diversion significantly improved the clinical, anthropological, biochemical as well histological outcome of the patients.