Common Pathological Finding Research Articles

General features of patients with Pulmonary Langerhans Cell Histiocytosis followed in our instution.

Pulmonary Langerhans Cell Histiocytosis (PLCH) is a rare disease affecting young smokers. It is more common between the ages of 20-40 and equals the male/female ratio. Lung biopsy is the most useful methods for diagnosis. The first treatment is to quit smoking. Corticosteroids or chemotherapeutic agents can be used in severe progressive cases despite of quiting smoking. The patients with PLCH followed in our clinic were assessed with general clinical features in the light of the literature. We retrospectively evaluated patients with PLCH in our clinic between January 1999 and June 2017. The female and male distribution of the 21 patients was 11/10. The average age was 35.04 ± 11.78 years. All patients were active smokers at the time of admission. The most common symptom was dyspnea. The most common finding in the pulmonary function tests was obstructive ventilatory defect. The DLCO value of the 70% patient in the carbonmonooxid diffusion test was below 80%. The most common pathologic findings detected in high-resolution chest tomography (HRCT) were cystic lesions involving bilateral upper and middle areas. There were 3 (14%) patients with pneumothorax at the time of admission and 6 (28.5%) patients with pneumothorax history before. The most common diagnostic method was open lung biopsy. All the patients quit cigarette after the diagnosis. There were 6 patients using steroid therapy, 1 patient receiving steroid and bosentan therapy, and 1 patient made pleurectomy due to recurrent pneumothorax. Lung transplantation was done to patient who received combined bosentan treatment with steroids. PLCH is a rare disease and should be considered in young, smokers with spontaneous pneumothorax and cystic lung disease in the differential diagnosis. As more diffusions are affected in patients, respiratory functions for follow-up should be evaluated with diffusion tests. It is essential to quit smoking in therapy.

Pitfalls in the Imaging Interpretation of Intracranial Hemorrhage

Intracranial hemorrhage (ICH) is one of the most common pathologic findings in the emergent computed tomography (CT) imaging. ICH presents as hyperattenuation in parenchymal, subarachnoid, subdural, or epidural location. However, the initial interpretation of areas of hyperattenuation can be challenging as other pathologic or nonpathologic processes (eg, calcifications, vascular malformations, highly cellular tumors, iodinated contrast, or beam-hardening artifacts) can have similar appearance. ICH can also present as isoattenuation on CT, being difficult to distinguish from the brain parenchyma. Dual-energy CT can separate hemorrhage from other causes of hyperattenuation. Albeit, this type of technology has limited availability. Pitfalls on magnetic resonance imaging (MRI) are possible but less common. The characterization of hemorrhage on conventional MR sequences, and particularly on gradient recall echo or susceptibility-weighted imaging is improved. Thus, MRI is considered a problem-solving technique. Radiologists have a prominent role in the interpretation of the initial head CT, recognizing potential pitfalls or alternative diagnosis and if necessary recommending additional work-up. Key imaging findings and technical considerations in common and uncommon pitfalls of ICH are reviewed here.

METASTASIS AND LOCAL INVASION PATTERN OF BLADDER CANCER IN HASAN SADIKIN HOSPITAL

Objective: The aim of this study is to provide database about local invasion and metastasis pattern, as well as the disease characteristics of bladder cancer in Hasan Sadikin Hospital, Bandung. Material & Methods: Between January 2011 and December 2016 there were 321 cases of bladder cancer recorded in our hospital. Of all cases, 106 patients included in this study, with evident of local invasion or distant metastasis either radiologically (contrast abdominal pelvic CT scan) or pathologically. Results: The study group consist of 106 patients (86 men [81.7%], 20 women [28.3%]); with mean age of 56.78 ± 13.19 (4-76) years old. Histopathology findings of transitional cell carcinoma (TCC) consist of 82 (77.3%) patients and the atypical histology features group of 24 (22.7%) patients. Local invasion was found in 99 patients of 321 (30.8%), with the most common organ invasion to the prostate in male (n=38 [35.8%]). Lymph node metastasis were found in 47 patients (44.3%), with the most common nodal metastasis to obturator lymph nodes (n=21 [19.8%]). Distant metastasis was found in 24 patients (22.6%) with the most common site for distant metastasis was the liver (n=12 [11.3%]). In TCC group, 12 patients (63.1%) had a distant organ metastasis with nodal metastasis, whereas in atypical group, majority of the patients with distant organ metastasis (n=5 [83.3%]) had no lymph node involvement. Moreover, in transitional cell group, not all patient (n=17 [73.1%]) had local invasion of the tumor, while all patients with distant organ metastasis in atypical group (n=6 [100%]) had abdominal or pelvic wall invasion (cT4b). Conclusion: TCC is the most common pathology findings and with Prostate is the most common site for local tumor invasion. Obturator lymph nodes is the most common nodal metastasis and liver is the most common site for distant metastasis in bladder cancer.

Predictors and outcome surgery for posterior cortex epilepsies

ObjectiveThe aim of this study is to identify the prognostic role of MRI and EEG in posterior cortex epilepsies (PCES) and to characterize their clinical features. Patient and MethodsWe retrospectively studied 54 consecutive patients (18 females, 36 males) from April 2011 to November 2015, who had undergone PCES surgery. Electro-clinical, pathological and surgical data were evaluated. Of the patients, 18 (33.3%) patients underwent a cortical resection (corticectomy), 10 (18.5%) lobectomy, 6 (11.1%) multilobar resection, 20 (30.1%) disconnection. ResultsThe postoperative follow-up duration was ≥1 year in all patients (12–44 months, mean = 25). Thirty-two patients (59.3%) became seizure free (ILAE 1) and 40 (74.1%) had a good (ILAE 1, 2, 3) outcome. The most common pathological finding was focal cortical dysplasia (in 34 patients). Univariate analysis showed that regional scalp interictal epilepsy discharges (IEDs) (P = 0.031), Regional EEG onset (P = 0.027), a MRI lesion (P = 0.001) and the number of seizures that were recorded by the epilepsy monitor unit (P = 0.016) were significantly associated with freedom from seizures. Multivariate analysis confirmed that MRI positive was statistically significant (HR = 4.284, CI = 1.198–15.315). ConclusionsSurgical treatment is effective for PCES, and MRI and EEG analyses are important in presurgical evaluation of PCES.

Heat shock protein family A member 6 combined with clinical characteristics for the differential diagnosis of intestinal Behçet's disease.

To investigate the role of heat shock protein family A member 6 (HSPA6) expression alone and in combination with clinical characteristics in distinguishing intestinal Behçet's disease (BD) from Crohn's disease (CD) with ileocolonic involvement. Patients diagnosed with either intestinal BD or CD were enrolled. Their clinical characteristics, disease activity, laboratory test results including hypersensitive C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR), endoscopic, pathological and radiological features were retrospectively analyzed. Enzyme-linked immunosorbent assay was applied to measure serum HSPA6 levels. Among intestinal BD patients, abdominal pain and diarrhea were the leading gastrointestinal symptoms. Submucosal lymphocyte infiltration was the most common pathological finding. Computed tomography enterography features involved number of segments of less than 4 and bowel wall thickening. Independent factors were round/ellipsoid intestinal ulcer (P < 0.001), number of ulcers ≤5 (P = 0.050), elevated ulcer margin (P = 0.019), absence of aphthous ulcer (P = 0.005), bowel wall thickening >13 mm (P < 0.001) and serum HSPA6 level >3.725 ng/mL (P = 0.008) for the differential diagnosis between intestinal BD and CD. Serum HSPA6 expression was significantly elevated in intestinal BD (0.72 ± 0.39 ng/mL) compared with CD (0.50 ± 0.24 ng/mL, P = 0.000) and healthy controls (0.38 ± 0.37 ng/mL, P = 0.000). HSPA6 in combination with clinical, radiological and pathological characteristics is useful in distinguishing intestinal BD from CD with ileocolonic involvement.

F12. Detecting MRI brain undiagnosed findings – The role of multidisciplinary epilepsy conference

Introduction Every year, more than 1300 patients undergo resections for treatment of medically refractory epilepsy. Outcome studies repeatedly showed that success of epilepsy surgery is partially dependent on finding a lesion on MRI. Frequently, lesions are subtle and missed on initial review. A dedicated epilepsy surgery conference with comprehensive clinical presentation can guide physicians to target a focus for missed subtle lesions. Methods Retrospective data was collected as part of a Quality Improvement (QI) project. We reviewed the last 369 patients presented at the multidisciplinary epilepsy patient management conference (MEPMC) at the University of Pittsburgh Medical Center from January 2013 to November 2017 with available MRI scans. Patients with initial non-lesional MRIs, per radiology reports, who were found to have brain lesions on further MRI review during the conference were the primary focus. These cases were further analyzed based on the pathology of the lesion and surgical outcome. Results Of the 369 patients presented at the conference, 120 patients (32.5%) were deemed non-lesional based on their initial MRI radiology report. Further review revealed that 39 of these 120 patients (32.5% representing 11% of total cohort) had lesions, out of which there were 17 cases of hippocampal sclerosis, 18 cases of malformations of cortical development (7 focal cortical dysplasia (FCD), 3 tumors, 6 abnormal neuronal migration with heterotopia and 2 polymicrogyria-schizencephaly), 3 hypothalamic hamartoma and one region of encephalomalacia. A total of 24 patients (70.58%) had an epilepsy protocol MRI. Out of these 39 patients, 27 (69.23%) had temporal lobe epilepsy and 12 patients had extratemporal (frontal or parietal lobe) epilepsy. 27 patients underwent surgery. Pathology data was collected on all patients with non-laser ablation surgery (23 patients). Hippocampal sclerosis (11 patients, 47.82%) was the most common pathological finding, followed by cortical dysplasia (4), tumors (1 ganglioglioma, 1 DNET and 1 pleomorphic xanthoastrocytoma), polymicrogyria (2) and gliosis (3 patients). At 1 year assessment 15/21 patients had ENGEL I outcome (71.4%). The remaining patients were classified as ENGEL II (5 patients) and III (1 patient). At 2 year assessment 11/15 patients had ENGEL I outcome (73.3%) while 3 patients were classified as ENGEL III and 1 as ENGEL IV. Conclusion Subtle lesions are occasionally missed during MRI examination. This is likely due to multiple factors such as human error and technological inadequacy. The incidence of missed lesions was not significantly different between types of epilepsy (temporal vs extratemporal) or pathologies, after considering expected prevalence of these entities in a major epilepsy center. In addition, this study highlights the importance of a thorough review of all imaging studies during multidisciplinary epilepsy surgery conference in improving outcome.

Monogenic Causes of Proteinuria in Children.

Glomerular disease is a common cause for proteinuria and chronic kidney disease leading to end-stage renal disease requiring dialysis or kidney transplantation in children. Nephrotic syndrome in children is diagnosed by the presence of a triad of proteinuria, hypoalbuminemia, and edema. Minimal change disease is the most common histopathological finding in children and adolescents with nephrotic syndrome. Focal segmental sclerosis is also found in children and is the most common pathological finding in patients with monogenic causes of nephrotic syndrome. Current classification system for nephrotic syndrome is based on response to steroid therapy as a majority of patients develop steroid sensitive nephrotic syndrome regardless of histopathological diagnosis or the presence of genetic mutations. Recent studies investigating the genetics of nephrotic syndrome have shed light on the pathophysiology and mechanisms of proteinuria in nephrotic syndrome. Gene mutations have been identified in several subcellular compartments of the glomerular podocyte and play a critical role in mitochondrial function, actin cytoskeleton dynamics, cell–matrix interactions, slit diaphragm, and podocyte integrity. A subset of genetic mutations are known to cause nephrotic syndrome that is responsive to immunosuppressive therapy but clinical data are limited with respect to renal prognosis and disease progression in a majority of patients. To date, more than 50 genes have been identified as causative factors in nephrotic syndrome in children and adults. As genetic testing becomes more prevalent and affordable, we expect rapid advances in our understanding of mechanisms of proteinuria and genetic diagnosis will help direct future therapy for individual patients.

Typical Features of Opioid-Intoxicated Corpses in Isfahan, Iran

Background: Opioid use makes the largest contribution to drug abuse mortality, while it is increasing in the world, especially in Iran. Objectives: The current study aimed at obtain the typical features of corpses under methadone maintenance treatment (MMT) and opium intoxication in Isfahan, Iran. Patients and Methods: The current cross sectional study was conducted on 742 opioid overdose deaths from March 2008 to March 2014; data on drug overdose death in forensic center affiliated to Iranian ministry of health and medical education were recorded by checklist. Results: Most of the opioid corpses were young (32.18 ± 10 years), male (76.4%), and single (58.2%). They had low income, low education and were found at home; injection was the most common way of drug abuse (47.2%). In toxicological findings, morphine was the most common drug and more than 40.7% of the corpses had the symptoms of chronic hepatitis. Pulmonary edema was the most common pathological finding. Conclusions: According to the current study findings, the low-educated and low-income young males were the most high-risk population for drug overdose death in Iran. The essential role of education and job-creation policies to prevent addiction and opium-related death was clarified.

A prospective cohort study of 122 adult patients presenting to an otolaryngologist's office with globus pharyngeus.

To investigate the epidemiology of globus pharyngeus in adult patients presenting to the otolaryngologist's office. Also, the predictors of persisting symptoms, prevalence of anxiety and the effect of clinical assessment were analysed. This was a prospective cohort study. Follow-up was carried out using a postal questionnaire. One otolaryngologists' office comprising three medical doctors. A total of 122 consecutive globus patients presenting to one otolaryngology office in a 1-year period. Globus incidence, gender and age distribution, predictors of persisting symptoms and the patient's health-related concerns. 3.8% of first-time visits were regarding globus. The mean age was 48years [range 20-88years], and a female predominance was found (ratio 1.49). Eighty-four per cent experienced anxiety, mainly due to fear of cancer. The most common pathological findings were reflux (15.6%) and post-infectious inflammation (10.6%). 21.4% of questionnaire responders reported full remission of their symptoms. Three predictors regarding symptom persistence were identified: male gender (OR 1.52), smoking (OR 3.4) and difficulties in breathing (OR 8.7). Patients with concomitant foreign body sensation were less likely to have persisting symptoms (OR 0.42). No cases of malignant disease were encountered. 94.7% was reassured by the office visit. The incidence of globus is 3.8% in the otolaryngologist's office. Female gender and concomitant foreign body sensation were predictive for presenting to the clinic even if symptom remission had occurred. Male gender, smoking and self-perceived breathing difficulties were predictive for persisting symptoms. Globus is an anxiety-causing symptom, but reassurance is provided by clinical examination by the otolaryngologist.

Intestinal neoplasia: A review of 34 cases

SummaryThe clinicopathological features of 34 horses with a histological diagnosis of intestinal neoplasia were reviewed; these included 17 horses with lymphoma, five with gastrointestinal stromal tumours (GISTs), four with adenocarcinomas, three with leiomyosarcomas, two with leiomyomas, two with squamous cell carcinomas (SCC) and one with adenocarcinoma/mesothelioma. The mean age at presentation was 19 years (range 3–36 years), and 81% of cases occurred in horses aged 15 years or older. Weight loss, acute or recurrent colic, inappetence, diarrhoea, depression and pyrexia were the most common presenting clinical signs. Hyperfibrinogenaemia, hypoalbuminaemia and leukocytosis were the most common clinical pathological findings. Transabdominal ultrasonography and exploratory laparotomy were the most useful diagnostic tests. Neoplasia was identified in all regions of the intestinal tract, with the jejunum being most frequently affected. The presence of mass lesions or thickened intestinal walls on transabdominal ultrasound, coupled with other clinical findings, were suggestive of intestinal neoplasia. Where possible, complete surgical resection offered the best prognosis, but generally the prognosis was poor to hopeless.

Possibility of the Strategic Treatment for Various Tumors using the Leukotriene Receptor Antagonist: Discussion Based on the Common Pathologic Findings that Mast Cells and Leukotrienes are Involved in the Development and Proliferation of Tumors

The leukotriene receptor antagonist is indicated with a therapeutic drug of asthma and is one of the antiallergicagents. We found that mast cells and a leukotriene receptor commonly emerged for various malignant and benigntumors and proved that the allergic reaction was strongly associated with development and proliferation of tumors.And we experimented on the effect of treatment of the leukotriene receptor antagonist for spontaneous rat tumor andconfirmed the efficacy. Our data show a wide effect of this medicine and the fewer side effects and will cause adiscussion for the chemotherapy of the current malignant tumor. This commentary briefly summarizes about currentevidence and future prospect in the oncotherapy of the leukotriene receptor antagonist.

Ginger extract has an ability to safe C57BL/6-WT mice from cerebral malaria produced by Plasmodium berghei ANKA

Sequestration of P. falciparum-parasitized red blood cells (PRBC) in vital organs, the brain in particular, is a common pathological finding of cerebral malaria (CM). Ginger (Zingiber officinale) has several pharmacological Effects; such as effects on the gastrointestinal tract, antimicrobial effects, effects on cardiovascular system, effect on blood pressure and effect on blood clotting. Therefore, this study aimed to investigate the ability of Ginger to safe C57BL/6-WT mice from cerebral malaria caused by Plasmodium berghei ANKA. Infected C57BL/6-Wild type mice with Plasmodium berghei ANKA have been used in this study. Two mice groups 6 mice in each: 1) Ginger group which treated iv with 150 mg/kg of Ginger extract and 2) Control group which injected iv with normal saline. The outcome results in this study showed a high ability of Ginger extract to safe C57BL/6-WT mice from the cerebral malaria (P-Value= 0.023.), with no antimalarial activity. In a conclusion, the Ginger extract has the ability to save 100% of the infected C57BL/6-Wild type mice during cerebral malaria time points. More studies are also required on the ginger and its constituents in reducing circulated TNF and LT-α and to reduce platelets and RBCs cytoadherence.

Mixed dementia: A review of the evidence

ABSTRACT.Mixed dementia is the coexistence of Alzheimer's disease and cerebrovascular disease (CVD) in the same demented patient. Currently, its diagnosis and treatment remains a challenge for practitioners. To provide an overview of the epidemiology, pathogenesis, natural history, diagnosis, and therapy of Mixed Vascular-Alzheimer Dementia (MVAD). The literature was reviewed for articles published between 1990-2016 by using the keywords linked to MVAD. Neuropathological studies indicate that MVAD is a very common pathological finding in the elderly with a prevalence about of 22%. The distinction between Alzheimer's dementia and vascular dementia (VD) is complex because their clinical presentation can overlap. There are international criteria for the MVAD diagnosis. The pharmacologic therapy shows modest clinical benefits that are similar among all drugs used in patients with Alzheimer's dementia and VD. The non-pharmacologic therapy includes the rigorous management of cardiovascular risk factors (especially hypertension) and the promotion of a healthy diet. The diagnosis and treatment of MVAD cannot be improved without further studies. Currently available medications provide only modest clinical benefits once a patient has developed MVAD. In subjects at risk, the antihypertensive therapy and healthy diet should be recommend for preventing or slowing the progression of MVAD.

Evaluation of three anticoagulants used for short-term storage of loggerhead sea turtle (Caretta caretta) whole blood

Anemia is a common clinical pathological finding in stranded loggerhead sea turtles (Caretta caretta) secondary to trauma and chronic debilitation. These animals may benefit from species-specific blood product administration, yet few studies have evaluated the effects of anticoagulants on loggerhead sea turtle blood storage. Sea turtles in managed collections may serve as healthy blood donors, allowing for short-term blood storage with transfer of blood products within 24 h to rehabilitation facilities. The objective of this study was to compare the packed cell volume (PCV), total solids (TS), electrolytes, glucose, and venous blood gas analytes over a 24 h storage of loggerhead sea turtle whole blood in three anticoagulants: sodium heparin, sodium citrate, and citrate-phosphate-dextrose-adenine (CPDA-1). Blood from eight loggerhead sea turtles at the Karen Beasley Sea Turtle Rescue and Rehabilitation Center (Surf City, NC) was used following routine venipuncture for health assessment. Whole blood was placed into vacutainer tubes containing sodium heparin, sodium citrate, or CPDA-1 and stored at 4–8°C (39–46°F). PCV and TS were evaluated at 0, 3, 6, 12, and 24 h. Blood gas, electrolyte, and glucose analyses using i-STAT CG8 cartridges were performed at 0 and 24 h. There were no significant differences in PCV and TS over time. At 24 hours, pink plasma was observed in 62.5% (5/8) of CPDA-1 and 12.5% (1/8) of citrate specimens. CPDA-1 and citrate specimens had a significant increase in potassium at 24 h. Both heparin and citrate specimens had a significant decrease in pH and increase in partial pressure of carbon dioxide at 24 h. Sodium values decreased over time in citrate and CPDA-1 specimens. Loggerhead sea turtle blood stored in CPDA-1, and sodium citrate had more significant blood gas and electrolyte changes over 24 h, indicating a greater degree of erythrocyte leakage or lysis. For the purposes of collection and short-term storage of loggerhead sea turtle blood, sodium heparin is preferable.

Evaluation of Three Anticoagulants Used for Short-Term Storage of Loggerhead Sea Turtle (Caretta caretta) Whole Blood

Abstract Anemia is a common clinical pathological finding in stranded loggerhead sea turtles (Caretta caretta) secondary to trauma and chronic debilitation. These animals may benefit from species-specific blood product administration, yet few studies have evaluated the effects of anticoagulants on loggerhead sea turtle blood storage. Sea turtles in managed collections may serve as healthy blood donors, allowing for short-term blood storage with transfer of blood products within 24 h to rehabilitation facilities. The objective of this study was to compare the packed cell volume (PCV), total solids (TS), electrolytes, glucose, and venous blood gas analytes over a 24 h storage of loggerhead sea turtle whole blood in three anticoagulants: sodium heparin, sodium citrate, and citrate-phosphate-dextrose-adenine (CPDA-1). Blood from eight loggerhead sea turtles at the Karen Beasley Sea Turtle Rescue and Rehabilitation Center (Surf City, NC) was used following routine venipuncture for health assessment. Whole bloo...

Research Paper: Brain CT Scan Findings in Patients Admitted to the Poisoning ICU of Baharloo Hospital, Tehran, Iran

Background: Timely and correct diagnosis of poisoning is an important part of the management of poisoned patients. This study aimed to investigate the abnormal findings of brain CT scans of patients with drug overdose poisoning. Methods: A retrospective cross-sectional study was conducted on patients with poisoning admitted to Baharloo Hospital, Tehran, Iran during 2015. Moreover, they underwent radiological assessment as a result of their decreased level of consciousness. For the purpose of the study, we examined patients’ Computerized Tomography (CT) scan reports. The collected data were analyzed with SPSS 16. Frequency and percentage frequency were calculated for qualitative variables, and mean and standard deviation were calculated for the quantitative variables. Results: Overall, 191 patients admitted with poisoning were evaluated. Of them, 119(62.3%) had normal brain CT scans and the remaining had pathologic findings. The most common pathologic findings in the brain CT scans comprised cerebral edema (24.6%) followed by infarction (5.2%). The least common pathologic finding was cerebral herniation (0.5%). This pattern was similar in both genders and in different subtypes of poisonings, with the exception of poisoning with cardio-respiratory drugs. The most common finding in the latter type of poisoning was herniation. In cases of simultaneous head trauma, the most common pathological brain CT scan findings were cerebral edema and hemorrhage. Conclusion: The radiological assessment of the brain following poisoning and decreased level of consciousness can help in the diagnostic evaluation of patients. It can be a life-saving measure, through timely detection of the type of poisoning and brain damage.

Histopathological findings of prostatic autopsy in a sample of over 50 years old men in Baghdad, Iraq

Background: Incidental carcinoma of the prostate is very important is one of the major life-threatening condition for men at all ages. The incidence was found to increase with age. The aim of this study was to evaluate prostatic autopsy samples from Iraqi men over 50 years of age.Methods: 100 autopsy samples of whole prostate were collected from the Institute of Forensic Medicine in Baghdad. All the autopsy cases over 50 years of age died from causes unrelated to prostatic disease.Results: Age ranges from 50-80 years and the mean age was 59.3 years. Benign prostatic hyperplasia was the common pathological finding (92%). Forty-eight cases of benign prostatic hyperplasia were associated with chronic non-specific prostatitis (CNP), 6 cases were associated with low grade prostatic intraepithelial neoplasia and 2 cases with infarction and 6 cases of low grade prostatic intraepithelial neoplasia. Prostatic adenocarcinoma was detected in 6% of the cases. The mean weight was 39.9gm. The mean ellipsoid volume was 34.9cm3. The mean spheroid volume was 36.1cm3. The majority of benign prostatic hyperplasia cases were found in the 6th decade.Conclusions: From the present study, we can conclude that the majority of cases were in the 6th decade, benign prostatic hyperplasia was the most common finding, the most common association with benign prostatic hyperplasia was chronic nonspecific prostatitis, a low frequency of prostatic carcinoma and it was not associated with benign prostatic hyperplasia.

Mast Cell Infiltration and Leukotriene Receptor Expression in Colorectal Adenoma: Preventive Application of Malignant Transformation Based on Common Pathological Findings

Mast Cell Infiltration and Leukotriene Receptor Expression in Colorectal Adenoma: Preventive Application of Malignant Transformation Based on Common Pathological Findings

Smoking-Related Interstitial Fibrosis: Evidence of Radiologic Regression with Advancing Age and Smoking Cessation

ABSTRACTMore data are needed regarding the radiology, co-morbidities and natural history of smoking-related interstitial fibrosis (SRIF), a common pathological finding, mainly described heretofore in association with lung cancer, where respiratory bronchiolitis (RB) usually co-exists.We prospectively acquired high resolution CT scan data (edge-enhancing lung reconstructions) to detect any radiologic interstitial lung abnormality (ILA) in individuals who ultimately underwent surgical lobectomy for lung cancer (n = 20), for radiologic/pathologic correlation. We also re-examined other smoking-related benign histologic cases: chronic obstructive pulmonary disease (COPD lung explants, n = 20), alpha 1-antitrypsin deficiency (A1AT, explanted lungs n = 20), combined pulmonary fibrosis and emphysema (CPFE, n = 8) and idiopathic pulmonary fibrosis (IPF, n = 10). Finally, we pooled our data with all peer-reviewed published data describing histologic SRIF of known ILA status.SRIF was observed in 40% of cancer lobectomies, mean (±SD) age 65.8 ± 8.7 years, none of whom had ILA. SRIF was observed in other smoking-related benign diseases (COPD 35%, A1AT 20%, CPFE 25%, and IPF 10%). 71.4% of benign SRIF cases had no RB (nearly all ex-smokers) versus 0% of cancer-associated SRIF cases (P = 1.7 × 10−3). Pooled data showed that those SRIF subjects without ILA were 15.05 years older than those with ILA (95% confidence interval 8.99 to 21.11, P = 2.5 × 10−5) and more likely to be former smokers (P = 7.2 × 10−3).SRIF is frequently found without lung cancer, and mostly without RB in former smokers. SRIF is less likely to have ILA in older subjects and with smoking cessation, which could represent RB+/−SRIF regression.

Pathologic Features of Colon Ischemia (CI) and Their Relationship to Symptom Duration: 2017 Presidential Poster Award

Introduction: CI is the most common form of intestinal ischemic injury and a common cause of acute lower GI bleeding in elderly pts. Infarction and ghost cells have been described as the pathognomonic features for CI, however, these findings are uncommon. The aim of this study was to determine common pathologic features of CI and their relationship to symptom duration. Methods: A retrospective, multi-centered chart review was performed to determine the association between pathologic features and symptom duration, defined as the time from symptom onset to time of biopsy, among pts with CI. We reviewed the charts of pts diagnosed with CI at Montefiore Medical Center (01/2005 to 07/2015), and Yale-New Haven Hospital (01/2005 to 06/2010). Inclusion criteria: (1) clinical presentation consistent with CI; (2) colonoscopic findings suggestive of CI; and (3) colonic pathology that was either pathognomonic or consistent with CI, as determined by the institutions' pathologists. Pts were excluded if their clinical presentation could be explained by an alternate underlying GI disorder. Pts were grouped based upon the time from symptom onset to pathologic specimen acquisition (e.g. <3 days, 3-5 days or >5-days) and the frequency of pathologic characteristics compared. Results: 616 pts were identified with biopsy-proven CI. The most common pathologic findings included inflammation (51.1%), ulceration (38.2%), fibrosis (26.0%), and necrosis (20.4%) (Table 1). Pathognomonic findings for CI, including ghost cells and infarction, were seen in 0.2% and 1.6% of cases, respectively. 350 of 616 pts had descriptive pathologic findings and a documented date of symptom onset. In these pts, there was a significant relationship between symptom duration and hyalinization of the lamina propria (P=0.05) and cryptitis/crypt abscesses (P=0.01). Hyalinization of the lamina propria was seen most often between 3 and 5 days, and cryptitis/crypt abscess greater than 5 days from symptom onset (Table 2).Table: Table. Characteristics of Study PopulationTable: Table. Relationship between Pathologic Findings and Symptom DurationConclusion: We report that CI is accompanied by a broad spectrum of pathologic findings. Our study suggests that traditional pathognomonic findings of CI, including infarction and ghost cells, are rare, and cannot be relied upon to exclude a diagnosis of CI. Furthermore, only hyalinization of the lamina propria and cryptitis/crypt abscesses were found to have a significant relationship to symptom duration, the former being seen at 3-5 days and the latter more than 5 days after presentation.