Histopathological Findings In Patients Research Articles

Clinical outcomes and pathologic results following identification of appendicitis

Aims: Acute appendicitis (AA) is one of the most frequent clinical pathologies for urgent surgery in children We aimed to investigate the occurrence and distribution of pathological findings in appendectomy specimens from patients initially diagnosed with AA. Methods: The demographic information and histopathological findings of patients who underwent appendectomy at our center between 2011 and 2021 were retrospectively analyzed. Results: A total of 259 patients were included in the study. The patients were aged 38-212 months (mean 143±39), with 180 (69.5%) male patients. Based on the histopathological results, 63 (24.3%) patienst had lymphoid hyperplasia (LH), 109 (42.1%) AA, 11 (4.2%) suppurative appendicitis (SA), 46 (17.8%) phlegmonous appendicitis (PA), and 30 (11.6%) gangrenous/necrotizing appendicitis (GA). Twenty (31.7%) patients with LH and 16 patients (53.3%) with GA had an invisible appendix on ultrasound. The leucocyte count and appendix diameter were significantly lower in LH than in the other groups (for all comparisons, p<0.001). CRP level was significantly higher in the complicated groups (GA, PA,SA) than the LH and AA groups. The appendix diameter was significantly higher in the GA group than in the PA group (p=0.049). We found a positive correlation between AD and preopertaive leucocyte count, and the duration of hospitalization in days (r=0.265, p=<0.001;r=0243, p=0.001). On the other hand, there was no correlation between appendix diameter and CRP. The binary logistic regression analyses showed that high appendix diameter was a risk factor fo CA (OR:0.206, CI: 95%, 1.061-1.422, p= 0.006). Conclusion: The high rate of complicated cases (33.5%) we found in our study shows that appendicitis can still be complicated. Additionally, the conclusion has been drawn that even in serious cases such as GA, US may overlook appendicitis at a high rate. Finally new diagnostic methods should be developed for cases that do not require surgical intervention, such as LH and eosinophilic gastrointestinal pathologies (colitis).

Sleeve-gastrectomy results in improved metabolism and a massive stress response of the liver proteome in a mouse model of metabolic dysfunction-associated steatohepatitis

BackgroundBariatric surgery has been shown to improve the histopathological findings in patients with obesity and metabolic dysfunction-associated steatohepatitis, but there are also reports about non-responders or progressive disease after bariatric interventions. Therefore, it is of utmost importance to understand the pathophysiological processes in the liver after bariatric surgery. Materials and methodsIn the present study, 4 weeks old male C57/Bl6 mice were fed a Western Diet to induce metabolic dysfunction-associated steatohepatitis and sleeve-gastrectomy (SG), or sham operation in the pair-fed and ad libitum control group were performed. Mice were observed for two or eight weeks after surgery and metabolic assessment was performed throughout the experiment. Histopathology, flow cytometry and proteomic analyses were conducted to evaluate hepatic inflammation, liver metabolism and affected signaling pathways. ResultsWeight loss was higher, and metabolism significantly improved after SG. Two weeks after SG major inflammatory and regulatory disturbances in the liver were observed. The proportion of hepatic CD3+NK1.1+ cells were decreased, and proteins involved in apoptosis like Fas, Casp1 and Casp9 or in the acute phase response were upregulated in SG mice. These disturbances decreased in the long-term and we observed an increase of many proteins involved in lipid metabolism eight weeks following SG. ConclusionsThe rapid weight loss and decrease of hepatic fat after SG lead to a proinflammatory response in the liver in the early phase after surgery, which changes to a more moderate immune response in the long-term. We suggest a preoperative risk stratification and postoperative surveillance depending on the histopathological findings.

Correlation between radiological imaging and histopathological findings in patients with breast lump

Background: Breast cancer is the most common cancer among women globally and the second leading cause of cancer-related deaths, after lung cancer. Early detection via routine screening is crucial, as not all breast lumps are cancerous and benign lumps do not always progress to cancer. To improve diagnostic accuracy, a triple assessment approach is used, combining radiological imaging, pathological diagnosis, and clinical examination. Techniques such as mammography, ultrasonography, and fine needle aspiration cytology (FNAC) are key to this evaluation. This study assesses the breast imaging reporting and data system (BIRADS) scoring system’s diagnostic accuracy by comparing radiological techniques with histopathological findings. Methods: The study involved 100 patients with breast lumps, categorised into three groups based on BIRADS scores: group A (BIRADS I-III), group B (BIRADS IV), and group C (BIRADS V). Data analysis using chi-square and student’s t tests were done. Results: In our study we found that accuracy of BIRADS score: sensitivity: 88.9%, specificity: 89.5%, positive predictive value: 97.3%, negative predictive value: 65.4% and diagnostic accuracy: 81%. Conclusions: The study demonstrated a high incidence of fibroadenoma (66%), others (3%) as benign cases and invasive ductal carcinoma (31%) malignant cases. The study highlights the importance of accurate diagnosis and targeted screening, especially in high-risk groups such as postmenopausal women and those with a family history of breast cancer. The findings affirm the high sensitivity and specificity of the BIRADS system as a valuable diagnostic tool.

Histopathological lesions of the gastrointestinal tract associated with the use of polystyrene sulfonate and sevelamer: a meta-analysis.

Gastrointestinal severe adverse events such as ulceration and perforation have been reported for sodium or calcium polystyrene sulfonate and sevelamer. Howewer, their role in the pathogenesis is unclear. Chronic kidney disease is a well known risk factor, while the role of hypertension and/or diabetes is uncertain. A meta-analysis of the published literature was conducted to review the clinical features, risk factors and histopathological findings of patients who experienced gastrointestinal adverse events after administration of polystyrene sulfonate or sevelamer. The meta-analysis indicated that patients were more likely to show necrosis and/or perforation when the resin used was polystyrene sulfonate compared to sevelamer (p < 0.001). Death was more likely in patients taking polystyrene sulfonate compared to sevelamer (p < 0.001). The results show that sevelamer is more likely to lead to inflammation or ulceration in the gastrointestinal tract than polystyrene sulfonate, which is more likely to be associated with severe gastrointestinal adverse events such as necrosis and/or perforation. Polystyrene sulfonate is significantly associated with death compared to sevelamer.

Diagnostic accuracy of carotid plaque magnetic resonance imaging compared to histopathology in symptomatic carotid artery stenosis

IntroductionVulnerable plaques have been shown to predict ipsilateral cerebral ischemic events and identifying them leads to appropriate secondary stroke prevention strategies. We evaluated the diagnostic accuracy of MR carotid plaque imaging in identifying plaque vulnerability when compared with histopathological findings in patients with symptomatic carotid stenosis who underwent carotid endarterectomy (CEA). MethodsA prospective cohort of forty-five consecutive patients with moderate to severe symptomatic carotid stenosis who underwent CEA at a tertiary Indian hospital had 3 T MRI plaque imaging with multi-parametric protocol between November 2021 and December 2022. Images were analyzed by a vascular radiologist blinded to histopathological data. High-risk plaque characteristics such as lipid rich necrotic core (LRNC), intraplaque hemorrhage (IPH), thin fibrous cap and ulceration were assessed and correlated with histopathological findings as per American Heart Association (AHA) classification using Cohen’s kappa statistics to obtain diagnostic accuracies. ResultsOf the 45 patients, 38(84 %) were males. The mean age was 65 ± 7.7 years and mean duration to CEA from the most recent event was 57 days (57 ± 46 days). A significant correlation between MR plaque imaging and histopathology was noted for IPH (sensitivity-91 %, specificity-86 %, κ = 0.774, p < 0.001), LRNC (sensitivity-92.1 %, specificity-85.7 %, κ = 0.697, p < 0.001), and plaque ulceration (sensitivity-84.6 %, specificity-78.1 %, κ = 0.563, p < 0.001). MRI had an overall sensitivity and specificity of 92.3 % and 84.2 % respectively (κ = 0.77, p < 0.001) in discriminating high risk plaques. ConclusionMR plaque imaging shows a very good correlation with histopathology and can identify unstable high-risk plaques with high accuracy. This may have implication in selection of patients for carotid revascularization in symptomatic carotid stenosis.

Correlation between radiological response after locoregional treatment and histopathological findings in patients undergoing liver transplant for hepatocarcinoma

Correlation between radiological response after locoregional treatment and histopathological findings in patients undergoing liver transplant for hepatocarcinoma

Histological Findings in Antigen E Positive and Negative in Chronic Hepatitis B.

To determine the histopathological findings in patients with HBeAg-positive chronic HBV infection (immunotolerant phase in old terminology) and HBeAg-negative chronic HBV infection (inactive carrier phase in old terminology). Observational study. Place and Duration of the Study: Department of Gastroenterology, University of Health Sciences, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkiye and Diyarbakir and Mersin University School of Medicine, Diyarbakir, Turkiye, from May 2014 to August 2022. The difference between fibrosis and histological activity indices of 289 patients in the immunotolerant and inactive carrier phase who had liver biopsy was examined statistically. Additionally, the relationship of these data with age and gender was investigated. While 236 (81.7%) of the patients were in the inactive carrier phase, 53 (18.3%) patients were in the immunotolerant phase. The mean fibrosis score of patients in the immunotolerant stage was 2.0 ± 1.2, while it was 2.0 ± 1.0 in inactive carriers (p = 0.753). The number of patients with a fibrosis score of two and above was 21 (39.6%) in immunotolerant patients and 52 (22.0%) in inactive carrier patients (p = 0.004). In patients under 30 years of age, the mean fibrosis score was 1.7 ± 1.0. It was 2.0 ± 1.1 in those over 30 years of age (p = 0.016). Biochemical parameters or viral load cannot clearly reflect cellular damage in the liver. In the future, HBV DNA positivity alone may be the only criterion for the treatment. Chronic viral hepatitis B, Fibrosis, Immune tolerance phase, Inactive carrier phase.

Comparative histological and clinical differences between children and adults in IgA nephropathy

IgA nephropathy (IgAN), as an autoimmune-mediated kidney disease worldwide, is considered an important cause of end-stage renal disease in adults. The most important diagnostic method in the patients is the evaluation of the biopsy findings. To date, several studies have examined different histopathological findings in patients with IgAN with an attempt to find out the relationship between morphologic findings with outcome and disease progression. Although there have been limited reports of IgAN in children, the Oxford scoring system is currently the most widely used IgAN classification and is validated for use in children and adults. In this review, we examined the most frequently published pathological findings on IgAN with a focus on Oxford classification between adults and children and attempted to highlight the key differences. The main purpose of this study was to assess the prognosis of patients with IgAN in childhood and adulthood, with emphasis on pathological risk factors for disease progression. Our results indicated that acute glomerulonephritis in children was predominantly reported more than chronic lesions. In addition, mesangial and endocapillary lesions were more common in children than in adults. In contrast, glomerular sclerosis, tubular atrophy/interstitial fibrosis, and atherosclerotic lesions were more common in older individuals.

Evaluation of the Value of Histological Examination for the Prediction of Genetic Thoracic Proximal Aortopathies.

Background: Heritable connective tissue disorders are often accompanied by an increased risk for thoracic aortic aneurysm and dissection (TAAD). Profound knowledge of the underlying pathology may have an impact on individual treatment, systematic follow-up, and early detection by the screening of offspring. The aim of this study, based in a single high-volume tertiary center, was an analysis of the diagnostic validity of histopathologic findings in patients with TAAD due to these findings' accuracy in diagnosing heritable connective tissue disorders. Methods: Therefore, genetic testing by next-generation sequencing (NGS) was performed to evaluate the correlations. In total, 65 patients with TAAD undergoing surgical treatment before the age of 60 years or with age up to 80 years if they had offspring at the time of the procedure were included in the analysis. Results: In our cohort, no certain correlation of histological findings to the results of genetic diagnostics in patients with clinically relevant aortic pathology could be shown. Patients with histopathologic findings for heritable connective tissue disorder and a positive gene variant were 11.6 years younger than patients without mutation and without histological evidence for connective tissue disorder. Conclusions: Genetic clarification is useful to define the specific genotype of the disease of the aortic wall in the case of non-specific histological characteristics.

99mTc]Tc-HYNIC-ALUG SPECT/CT in the initial staging of 227 consecutive patients with newly diagnosed prostate cancer: a 5-year monocentric retrospective study.

The purpose of this study was to assess the effectiveness of [99mTc]Tc-HYNIC-ALUG SPECT/CT in the initial staging of patients with newly diagnosed PCa. A retrospective analysis was conducted on 227 consecutive patients who underwent [99mTc]Tc-HYNIC-ALUG SPECT/CT imaging for the primary staging of newly diagnosed PCa. The presence and location of PSMA-positive lesions were determined, and the maximum standardized uptake values (SUVmax) of the primary prostate tumor were also measured. The metastatic findings and SUVmax were stratified according to International Society of Urological Pathology (ISUP) grade, prostate-specific antigen (PSA) levels, and D'Amico classification. Furthermore, the [99mTc]Tc-HYNIC-ALUG SPECT/CT findings were compared to the histopathological findings in patients who had undergone radical prostatectomy with pelvic lymph node dissection (PLND). Of the 227 patients, 92.1% (209/227) had positive [99mTc]Tc-HYNIC-ALUG SPECT/CT findings. Advanced disease was detected in 38.8% (88/227) of the patients and was positively correlated with increasing ISUP grade and PSA levels. Lymph node metastases (both pelvic and extrapelvic), bone metastases, and visceral metastases were detected in 30.0% (68/227), 25.6% (58/227), and 3.1% (7/227) of the patients, respectively. For the 129 patients who underwent radical prostatectomy with PLND, the sensitivity of [99mTc]Tc-HYNIC-ALUG SPECT/CT in the evaluation of PCa was 90.7% (117/129). The sensitivity, specificity, accuracy, and positive and negative predictive values for detecting pelvic lymph node metastases on [99mTc]Tc-HYNIC-ALUG SPECT/CT were 23.5% (12/51), 93.6% (73/78), 65.9% (85/129), 70.6% (12/17), and 65.2% (73/112), respectively. Among the 209 patients with PSMA-avid primary prostate disease, the SUVmax of the primary prostate tumor was significantly associated with ISUP grade (p<0.0001), PSA levels (p<0.0001), D'Amico classification (p<0.0001), and advanced disease (p<0.0001). Receiver operating characteristic (ROC) analysis revealed that a PSA level >19.8 ng/ml and SUVmax of the primary prostate tumor >7.4 had a sensitivity of 71.6% and 71.6% and specificity of 76.9% and 82.6%, respectively, for detecting metastatic disease. [99mTc]Tc-HYNIC-ALUG SPECT/CT emerges as a valuable imaging tool for the initial staging of newly diagnosed PCa. The presence of advanced disease and the SUVmax of the primary prostate tumor were positively correlated with ISUP grade and PSA levels.

Histopathological Association of Non-alcoholic Fatty Liver Disease With Coronary Artery Atherosclerosis Grade

Background: The association between the severity of coronary atherosclerosis and histopathologic findings in patients with non-alcoholic fatty liver disease (NAFLD) is not entirely understood. Considering the gold standard method, this study evaluates the histopathologic association between the severity of NAFLD and the grades of coronary atherosclerosis. Methods: In this descriptive-analytical study, data from 205 cadavers who were referred to an Iranian (Tabriz) forensic medicine organization between 2015 and 2017 and underwent simultaneous liver and coronary artery biopsies were examined. Finally, 168 cases were entered based on the inclusion criteria. First, pathological slides of these cadavers were extracted from the forensic medicine archive and re-examined. Then, the selected cases’ blocks were extracted from the tissue block bank, and again, after preparing a new slide, they were stained with trichrome for accurate estimation of liver fibrosis. Results: The assessment of NAFLD histological status in the studied cases revealed that 75.6% of the cases were classified as severity I, 18.4% as severity II, and 6% as severity III. Most cases with coronary atherosclerosis were classified as American Heart Association staging (AHA), type V (19.6%), and normal (19.6%). There was no statistically significant relationship between the severity of simple steatosis, steatohepatitis, and NAFLD, with coronary atherosclerosis. In subjects with higher severity of coronary atherosclerosis, the liver fibrosis rate is also higher, but no statistically significant difference was observed. Conclusion: The present study revealed no significant histopathological association between NAFLD and coronary artery atherosclerosis grade.

Autopsy Histopathologic Lung Findings in Patients Treated With Extracorporeal Membrane Oxygenation.

Extracorporeal membrane oxygenation (ECMO) is increasingly used in the treatment of respiratory and cardiac failure, but data describing lung histopathology in ECMO recipients are limited. To examine pulmonary histopathologic findings in patients who underwent venovenous (VV) ECMO for pulmonary reasons or venoarterial (VA) ECMO for cardiac indications shortly before death, and to determine if the pulmonary changes provided insights into therapy that may prevent complications and improve outcome. We conducted a retrospective study of lung autopsies, from VV and VA ECMO recipients and patients with acute respiratory distress syndrome (ARDS) and non-ECMO treatment, between 2008 and 2020 in Silesia Center for Heart Diseases in Zabrze, Poland. Among 83 ECMO patients (42-64 years; men, 57 [68.7%]), the most common histopathologic findings were bronchopneumonia (44 [53.0%]), interstitial edema (40 [48.2%]), diffuse alveolar damage (DAD; 32 [38.6%]), hemorrhagic infarct (28 [33.7%]), and pulmonary hemorrhage (25 [30.1%]). DAD was associated with longer ECMO treatment and longer hospital stay. The use of VV ECMO was a predictor of DAD in patients with ARDS and undergoing ECMO, but it also occurred in 21 of 65 patients (32.3%) in the VA ECMO group, even though VA ECMO was used for heart failure. Although DAD was significantly more common in lung autopsies of VV ECMO patients, one-third of VA ECMO patients had histopathologic changes characteristic of ARDS. The presence of DAD in lung autopsies of patients treated with VA ECMO indicates that in these patients, protective lung ventilation should be considered.

The Analysis of the Correlations between Quantitative HBsAG Level, Virological Markers, and Histopathological Findings in Patients with Chronic Hepatitis B

Introduction: We aimedto analyze the correlations between serum HBsAg quantification (qHBsAg) level and virological properties in chronic hepatitis B (CHB) patients.&#x0D; Materials and Methods: The study was conducted with 53 CHB patients who underwent liver biopsy. Demographic characteristics of patients, biochemical parameters, serum qHBsAg levels, liver biopsy, and histopathology were assessed retrospectively.&#x0D; Results: A total of 53 patients were included in the study the mean patient age was 28,7 ± 8.1 and 34 (64.2%) were male. The mean patient qHBsAg was 631.4 ± 431.5, fibrosis score was 1,35 ± 0.87, ALT index score was 67.1 ± 53.4, and histologic activity index (HAI) score was 4,54 ± 1.55. In the statistical analysis, it was determined that there were negative correlations between the serum qHBsAg level and the HBV DNA level (r: -0,618, P&lt;0.001), fibrosis score (r: -0,273, P: 0.048), ALT (rho: -0,489, P&lt;0.001), and HAI index scores (r: -363, P: 0.008), while there was a positive correlation with the HBeAg positivity (rho: 0.445, p: 0.001).&#x0D; Conclusion: There were negative correlations between the qHBsAg level and virological (HBV DNA level), histopathological (fibrosis score, HAI index) findings, and a positive correlation with serological (HBeAg positivity) findings.

Correlation analysis of quantitative MRI measurements of thigh muscles with histopathology in patients with idiopathic inflammatory myopathy

ObjectivesTo validate the correlation between histopathological findings and quantitative magnetic resonance imaging (qMRI) fat fraction (FF) and water T2 mapping in patients with idiopathic inflammatory myopathy (IIM).MethodsThe study included 13 patients with histopathologically confirmed IIM who underwent dedicated thigh qMRI scanning within 1 month before open muscle biopsy. For the biopsied muscles, FF derived from the iterative decomposition of water and fat with echo asymmetry and least-squares estimation quantitation (IDEAL-IQ) and T2 time from T2 mapping with chemical shift selective fat saturation were measured using a machine learning software. Individual histochemical and immunohistochemical slides were evaluated using a 5-point Likert score. Inter-reader agreement and the correlation between qMRI markers and histopathological scores were analyzed.ResultsReaders showed good to perfect agreement in qMRI measurements and most histopathological scores. FF of the biopsied muscles was positively correlated with the amount of fat in histopathological slides (p = 0.031). Prolonged T2 time was associated with the degree of variation in myofiber size, inflammatory cell infiltration, and amount of connective tissues (p ≤ 0.008 for all).ConclusionsUsing the machine learning-based muscle segmentation method, a positive correlation was confirmed between qMRI biomarkers and histopathological findings of patients with IIM. This finding provides a basis for using qMRI as a non-invasive tool in the diagnostic workflow of IIM.Relevance statementBy using ML-based muscle segmentation, a correlation between qMRI biomarkers and histopathology was found in patients with IIM: qMRI is a potential non-invasive tool in this clinical setting.Key points• Quantitative magnetic resonance imaging measurements using machine learning-based muscle segmentation have good consistency and reproductivity.• Fat fraction of idiopathic inflammatory myopathy (IIM) correlated with the amount of fat at histopathology.• Prolonged T2 time was associated with muscle inflammation in IIM.Graphical

Plasma Lipids Profile in the Prediction of Non-Alcoholic Steatohepatitis in Adults: A Case-Control Study.

Patients with non-alcoholic steatohepatitis (NASH) show significantly faster progress in the stages of fibrosis compared to those with non-alcoholic fatty liver (NAFL) disease. The non-invasive diagnosis of NASH remains an unmet clinical need. Preliminary data have shown that sphingolipids, especially ceramides, fatty acids, and other lipid classes may be related to the presence of NASH and the histological activity of the disease. The aim of our study was to assess the association of certain plasma lipid classes, such as fatty acids, acylcarnitines, and ceramides, with the histopathological findings in patients with NASH. The study included three groups: patients with NASH (N = 12), NAFL (N = 10), and healthy [non non-alcoholic fatty liver disease (NAFLD)] controls (N = 15). Plasma samples were collected after 12 h of fasting, and targeted analyses for fatty acids, acylcarnitines, and ceramides were performed. Baseline clinical and demographic characteristics were collected. There was no significant difference in baseline characteristics across the three groups or between NAFL and NASH patients. Patients with NASH had increased levels of several fatty acids, including, among others, fatty acid (FA) 14:0, FA 15:0, FA 18:0, FA 18:3n3, as well as Cer(d18:1/16:0), compared to NAFL patients and healthy controls. No significant difference was found between NAFL patients and healthy controls. In conclusion, patients with NASH exhibited a distinctive plasma lipid profile that can differentiate them from NAFL patients and non-NAFLD populations. More data from larger cohorts are needed to validate these findings and examine possible implications for diagnostic and management strategies of the disease.

The relationship of serum bilirubin level with histopathological parameters in patients with nonalcoholic fatty liver disease

Objectives: Non-alcoholic fatty liver disease (NAFLD) is among the most common causes of chronic liver disease and is known as a part of metabolic syndrome (MetS), and the role of bilirubin in the pathogenesis of NAFLD is unclear. This study aimed to evaluate the relationship between bilirubin levels and histopathological findings in patients with NAFLD having no confounding factors such as morbid obesity, diabetes mellitus (DM), and hypertension.&#x0D; Methods: A retrospective analysis of clinical and laboratory data of patients with biopsy-proven NAFLD was performed. The relationship between the bilirubin levels and histopathologic findings was evaluated. &#x0D; Results: The subjects in the nonalcoholic steatohepatitis (NASH) group had greater AST (p &lt; 0.001) and ALT (p &lt; 0.001) levels than the non-NASH group. We found no difference between NASH and non-NASH groups regarding bilirubin levels. The levels of AST (p = 0.001), ALT (p = 0.011), insulin (p = 0.029), and HOMA-IR index (p = 0.027) were higher in fibrosis group comparing non-fibrosis group. However, bilirubin levels were not different comparing the fibrosis and non-fibrosis group. We couldn’t find any relation between bilirubin levels and other parameters in correlation analysis. &#x0D; Conclusion: We couldn’t find any relation between the bilirubin levels and histopathological findings of the patient with NAFLD having no confounding factors such as morbid obesity, DM, and hypertension. The difference, shown in the other studies, may be the effect of other diseases related to MetS.

Other Pathologies Were Rarely Reported after Laparoscopic Surgery for Suspected Appendicitis: A Systematic Review and Meta-Analysis

Background: Diagnostic laparoscopy is often used when a patient is suspected of having acute appendicitis. The aim of this study was to assess the rate of other pathologies found during diagnostic laparoscopy for suspected acute appendicitis. Methods: This systematic search included studies with ≥100 patients who received laparoscopy for suspected acute appendicitis and reported on the histopathologic and other intra-abdominal findings. We performed a meta-analysis estimating the rate of other pathologies, and a sensitivity analysis excluding smaller cohorts (≤500 patients). Age groups, sex, specific findings, and geographic regions were investigated. Certainty of evidence was assessed with GRADE. Results: A total of 27 studies were included covering 25,547 patients and of these 793 had an unexpected pathology. The findings were benign pathology in the appendix (34%), malignancy (30%), gynecologic pathology (5%), gastrointestinal pathology (4%), or unspecified (27%). Meta-analysis showed an overall rate of unexpected findings of 3.5% (95% CI 2.7–4.3; moderate certainty), and the sensitivity analysis showed similar results. Malignancy found in the appendix when treating suspected acute appendicitis was 1.0% (95% CI 0.8–1.3%; high certainty). Conclusion: The rate of other histopathological findings in patients with suspected acute appendicitis was low and a malignancy in appendix was found in 1% of patients.

Clinico-histopathological evaluation of tonsillectomy specimens at a tertiary care hospital

Background: Tonsillar diseases are common in paediatric and adult otolaryngological practice and often require tonsillectomy and specimens are subjected to histopathological evaluation. Chronic tonsillitis is disease with repeated attacks of acute tonsillitis/ a sub-clinical form of a resistant or poorly treated infection. Aim of study was to determine the most common histopathological findings in patients presenting with clinical features of chronic tonsillitis. Methods: The present study is an observational study carried out at the Departments of Pathology and Otorhinolaryngology at Gujarat Adani Institute of Medical Sciences and GK General Hospital, Bhuj from January 2019 to April 2022. Results: A total of 35 cases of bilateral tonsillectomy were studied in a span of 40 months. There were 17 (49%) males and 18 (51%) females. The age ranges of the patients varied from 7 to 37 years with maximum number of cases less than 20 years of age. A total of 70 specimens obtained from 35 patients were studied. The most common clinical presentation was throat pain in 29 (83%) patients. The histopathological evaluation confirmed chronic tonsillitis in 40 (57%) specimens, followed by chronic lymphoid hyperplasia/ hypertrophy in 30 (43%) specimens, 14 specimens with chronic tonsilitis showed associated actinomycetes. Conclusions: Resected tonsillectomy specimens should be routinely evaluated by histopathological examination to know the cause of enlarged tonsils.

Idiopathic granulomatous mastitis: clinical, histopathological, and radiological characteristics and management approaches.

Idiopathic Granulomatous Mastitis (IGM) is an infrequent, benign breast disease that primarily affects women during their childbearing years and can be mistaken for breast cancer. This study aimed to review the clinical, radiological, and histopathological findings of patients with IGM in addition to management and outcome. Retrospective cross-sectional study of biopsy-confirmed IGM at an academic medical center and a private hospital in Amman, Jordan. Fifty-four patients were included, with a mean age of 37.0±9.04years, mostly presenting with a breast lump (n= 52, 96.3%) and breast pain (n=45 patients, 84.9%). Approximately half of the patients (51.9%) were parous, and 50% had breastfed for an average duration of 30.37±22.38months. Most of the patients had either solitary or multiple abscesses on breast ultrasound. Histopathological analysis (n=35) showed mostly either moderate inflammation (n=16, 45.7%) or severe inflammation (n=14, 40%). Two-thirds of the patients underwent surgical interventions at the time of diagnosis, mostly incision and drainage (n=16, 29%) or surgical excision (n=7, 13%), and no mastectomies were performed. The most common medical treatment included a combination of antibiotics, corticosteroids, and methotrexate (n=21, 38.8%). After follow-up, 31 patients remained in remission, 3 experienced relapses, and 3 had a chronic course. The use of corticosteroids was significantly associated with remission (p=0.035). The presentation and demographics of IGM patients in Jordan were consistent with the existing literature. Prospective research is needed to explore different treatment options and disease outcomes.

Routine placental histopathology findings from women testing positive for SARS-CoV-2 during pregnancy: Retrospective cohort comparative study.

To assess the impact of maternal Coronavirus disease 2019 (COVID-19) infection on placental histopathological findings in an unselected population and evaluate the potential effect on the fetus, including the possibility of vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Retrospective cohort comparative study of placental histopathological findings in patients with COVID-19, compared with controls. During the COVID-19 pandemic, placentas were studied from women at University College Hospital London who reported and/or tested positive for COVID-19. Of 10 508 deliveries, 369 (3.5%) women had COVID-19 during pregnancy, with placental histopathology available for 244 women. Retrospective review of maternal and neonatal characteristics, where placental analysis had been performed. This was compared with available, previously published, histopathological findings from placentas of unselected women. Frequency of placental histopathological findings and relevant clinical outcomes. Histological abnormalities were reported in 117 of 244 (47.95%) cases, with the most common diagnosis being ascending maternal genital tract infection. There was no statistically significant difference in the frequency of most abnormalities compared with controls. There were four cases of COVID-19 placentitis (1.52%, 95% CI 0.04%-3.00%) and one possible congenital infection, with placental findings of acute maternal genital tract infection. The rate of fetal vascular malperfusion (FVM), at 4.5%, was higher compared with controls (p = 0.00044). In most cases, placentas from pregnant women infected with SARS-CoV-2 virus do not show a significantly increased frequency of pathology. Evidence for transplacental transmission of SARS-CoV-2 is lacking from this cohort. There is a need for further study into the association between FVM, infection and diabetes.