Morphological Diagnosis Research Articles

First report of adult †Burmecaelidae with description of a new species from mid-Cretaceous Burmese amber (Orthoptera: Caelifera)

An adult male of †Burmecaelinus armis Uchida, Husemann and Kotthoff, 2023, and a newly identified genus and species †Moban zhengzheminigen. et sp. nov., are reported based on two well preserved adult specimens from mid-Cretaceous Burmese amber. †M. zhengzheminigen. et sp. nov. can be distinguished by following characters: body with irregular small dark spots; pronotum is in uniform width, with dispersed shallow dents and two distinct transverse sulci, posterior angle is protruding forward; posterior thoracic process is shark-tooth shaped; pronotal disc without four longitudinal carinae; tip of apical spurs on metatibia not curved. The morphological diagnosis of the family †Burmecaelidae was emended, and the posterior thoracic process of adult †Burmecaelidae species is possibly specialized scutellum. We proposed a hypothesis that this extinct family was a sister group of Tridactyloidea and species of †Burmecaelidae lived in humid environment near water and had affinity for wet and semi-aquatic habitats.

Association of the SHOX2 and RASSF1A methylation levels with the pathological evolution of early-stage lung adenocarcinoma

Background The methylation of SHOX2 and RASSF1A shows promise as a potential biomarker for the early screening of lung cancer, offering a solution to remedy the limitations of morphological diagnosis. The aim of this study is to diagnose lung adenocarcinoma by measuring the methylation levels of SHOX2 and RASSF1A, and provide an accurate pathological diagnosis to predict the invasiveness of lung cancer prior to surgery.Material and methods The methylation levels of SHOX2 and RASSF1A were quantified using a LungMe® test kit through methylation-specific PCR (MS-PCR). The diagnostic efficacy of SHOX2 and RASSF1A and the cutoff values were validated using ROC curve analysis. The hazardous factors influencing the invasiveness of lung adenocarcinoma were calculated using multiple regression.Results: The cutoff values of SHOX2 and RASSF1A were 8.3 and 12.0, respectively. The sensitivities of LungMe® in IA, MIA and AIS patients were 71.3% (122/171), 41.7% (15/36), and 16.1% (5/31) under the specificity of 94.1% (32/34) for benign lesions. Additionally, the methylation level of SHOX2, RASSF1A and LungMe® correlated with the high invasiveness of clinicopathological features, such as age, gender, tumor size, TNM stage, pathological type, pleural invasion and STAS. The tumor size, age, CTR values and LungMe® methylation levels were identified as independent hazardous factors influencing the invasiveness of lung adenocarcinoma.Conclusion: SHOX2 and RASSF1A combined methylation can be used as an early detection indicator of lung adenocarcinoma. SHOX2 and RASSF1A combined (LungMe®) methylation is significantly correlated to age, gender, tumor size, TNM stage, pathological type, pleural invasion and STAS. The SHOX2 and RASSF1A methylation levels, tumor size and CTR values could predict the invasiveness of the tumor prior to surgery, thereby providing guidance for the surgical procedure.

Acute megakaryoblastic leukemia (AML7) about a case

Acute myeloid megakaryoblastic leukemia (AML7) is a rare and severe form of acute myeloid leukemia. Its diagnosis is based essentially on cytometric and cytogenetic data, given the complexity of morphological diagnosis. Myelofibrosis and osteolytic lesions may be a particular feature of AML7. Treatment with chemotherapy is considered, but the outcome is often unfavorable. The gold standard of treatment is bone marrow transplantation. Our article reports the case of an infant diagnosed with acute megakaryoblastic leukemia initially revealed by a bone marrow failure syndrome and aggravated by a cerebro-orbital extension with osteolytic lesions of the orbital cavity, treated with chemotherapy with a good clinical-biological evolution.

Utility of SHOX2 and RASSF1A gene methylation detection on the residual cytology material from endobronchial ultrasound-guided transbronchial needle aspiration.

This study aims to assess the effectiveness of Short Stature Homeobox 2 (SHOX2) and RAS Association Domain Family 1 Isoform A (RASSF1A) gene methylation detection in residual liquid-based cytology (LBC) materials from Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) and investigate the diagnostic accuracy of a comprehensive diagnostic approach. Between June 2022 and May 2023, a total of 110 cases that underwent EBUS-TBNA were enrolled in the study. SHOX2 and RASSF1A genes methylation detection using the residual cytological material, LBC, and cell block (CB) were conducted for each EBUS-TBNA case. The sensitivity and specificity of cytology, CB histopathology, SHOX2, and RASSF1A methylation in diagnosing EBUS-TBNA samples were determined based on follow-up data. Among the 72 cases confirmed as pulmonary carcinomas, the methylation test yielded positive results in 24 adenocarcinoma cases, 10 squamous cell carcinoma cases, and 14 small cell carcinoma cases. The sensitivity of the comprehensive diagnosis (combining LBC, CB, and methylation detection) in distinguishing metastatic pulmonary epithelial malignancies in mediastinal and hilar lymph nodes or masses from benign lesions was higher (97.22%, 70/72) than that of morphological diagnosis alone (LBC and CB) (88.89%, 64/72; P < 0.05). SHOX2 and RASSF1A methylation detection demonstrates a high sensitivity and negative predictive value in the identification of pulmonary epithelial malignancies and holds promise as a valuable ancillary approach to enhance morphological diagnosis of EBUS-TBNA.

A rare case of classic Kaposi’s sarcoma with a lesion of the oral mucosa

Kaposi’s sarcoma is a systemic tumor multifocal disease of vascular genesis. In the classic Kaposi’s sarcoma, lesions are most often localized on the skin of the lower extremities, lesions of the mucous membranes are extremely rare. The article presents a rare clinical case of the classic Kaposi’s sarcoma in a 56 years old man with lesions of the oral mucosa. This clinical case is of particular interest due to the difficulties of differential diagnosis of Kaposi’s sarcoma and lichen planus when mucous membranes are involved in the pathological process. The presented case emphasizes the importance of a histological examination of the biopsy in differential diagnosis of Kaposi’s sarcoma. In case when the rash is widespread and the mucous membranes are involved, it is recommended to collect the material from the skin, because the histological picture will be more characteristic. It is important to pay attention to the duration of the elements’ existence, as morphological diagnosis in the early stages of Kaposi’s sarcoma can imitate the pattern of chronic dermatosis.

PAPILLARY FIBROELASTOMA: AN UNUSUAL CAUSE OF TRANSIENT ISCHEMIC ATTACK

Abstract Papillary fibroelastomas (PFEs) are small, avascular benign tumors. Despite that, PFEs could lead to important clinical consequences such as transient ischemic attack and myocardial infarction. A 65–year–old female patient was admitted to our ER presenting a transient ischemic attack characterized by retrograde amnesia lasting about an hour. She had a history of systemic scleroderma and left breast cancer treated with local radiotherapy. In our hospital she underwent a neurological examination and a head CT which were negative for ongoing acute pathologies. An electrocardiogram was performed which showed sinus rhythm at 65 bpm. A transthoracic echocardiogram was also performed revealing a floating mass arising from left ventricular outflow tract between aortic and mitral valves. The transesophageal echocardiogram confirmed a solitary lesion approximately 2 centimeters long localized between A2 and A3 mitral valve scallops. The patient was therefore referred for surgery. During surgery the mass was found to arise from anterior mitral annulus and was resected. The histopathological examination of the mass confirmed the morphologic diagnosis of papillary fibroelastoma. Histologically PFEs are made up of a single layer of endocardial cells covering a matrix of collagen. The main risk factors for the development of PFEs are iatrogenic causes, such as radiotherapy, and autoimmune diseases such as systemic scleroderma. In 54% of cases PFEs are asymptomatic at the time of diagnosis. Since over 95% of PFEs present on the left side of the heart, systemic embolism is the most frequent presentation typically as transient ischemic attacks. Initial evaluation is accomplished with echocardiography. PFEs appear as echo–dense and pedunculated masses. Cardiac computed tomography and magnetic resonance imaging are second line modalities in PFEs evaluation. Definitive diagnosis of PFE requires pathological confirmation. Surgical resection remains the treatment of choice for all symptomatic patients. For symptomatic patients who are not surgical candidate, long term antiplatelets or anticoagulation therapy should be initiated. Asymptomatic patients should have surgical resection if the size of the tumor is &amp;gt; 1 cm. PFEs are associated with significant morbidity and mortality. Echocardiography remains the most utilized diagnostic modality. Surgical treatment should always be considered. Antithrombotic therapy should be considered in non–surgical candidates.

Validation and redescription of Acanthamoeba terricola Pussard, 1964 (Amoebozoa: Acanthamoebidae)

Acanthamoeba castellanii (Douglas, 1930) Page, 1967 is the type species of a widespread genus of free-living amoebae, potentially pathogenic for humans and animals. The Neff strain is one of the most widely used in biological research, serving as a model for both A. castellanii and the whole genus in general. The Neff strain, isolated in California, closely resembles another strain found in France and originally described as a separate species, Acanthamoeba terricola Pussard, 1964, but both were successively synonymized with A. castellanii. Molecular sequence analysis has largely replaced morphological diagnosis for species identification in Acanthamoeba, and rDNA phylogenies show that the Neff strain forms a distinct lineage from that of the type strain of A. castellanii. In this study, we compared the type strain of A. terricola with the Neff strain and A. castellanii, and analysed the available molecular data including new sequences obtained from A. terricola. Here we provide molecular evidence to validate the species A. terricola. The Neff strain is therefore transferred to A. terricola and should no longer be considered as belonging to A. castellanii.

Inflammatory myofibroblastic tumor of the stomach. Literature review and case study

We have presented a very interesting theoretical, practical and methodological clinical observation of a rare disease, extremely difficult for clinical and morphological diagnosis. A 35-year-old patient with gastric bleeding underwent emergency surgical treatment for a myofibroblastic tumor of the stomach, morphologically difficult to differentiate from gastrointestinal stromal tumors.

Adrenocortical cancer: principles of morphological diagnostics for the endocrinologist

Adrenocortical cancer (ACС) is a rare malignant endocrine neoplasm from adrenocortical cells. Despite the orphan character of the disease, the increase of incidentalomas in modern clinical practice requires endocrinologist's awareness of the principles of diagnostics and tactics of patient management. This disease is characterized by highly variable biological behavior. This peculiarity of ACC necessitates a personalized approach for each clinical case, which should be ensured not only by interdisciplinary interaction between oncologists, surgeons and endocrinologists, but also by analysis of the pathomorphological features of each tumor. The present article highlights the current views on the morphological diagnosis of ACC, obtained as a result of research in the last decade, which should be taken into account by the endocrinologist.

Lymphomas with massive splenomegaly – a case series

Hairy cell leukaemia (HCL) is an uncommon chronic B-cell lymphoma. Classical HCL and its variant are separate entities. Splenic marginal zone lymphoma (SMZL) is rare accounting for &lt;2%of lymphoid neoplasms2. A 62-year-old woman presented with constitutional symptoms and mild splenomegaly was having pancytopenia, monocytopenia and hairy cells in the peripheral blood. Bone marrow aspiration was a dry tap while trephine biopsy revealed diffuse lymphoid cell infiltration with characteristic fried egg appearance and fibrosis. Morphological and immunophenotypic diagnosis was HCL. She was successfully treated with IV-cladribine and G-CSF for chemotherapy induced severe neutropenia. She achieved complete remission in 6 months. A 56-year-old woman presented with abdominal distension and lower limb swelling was having marked splenomegaly, absolute lymphocytosis, mild neutropenia and anaemia. Blood film revealed lymphocytes showing moderate cytoplasm and cytoplasmic projections. With bone marrow biopsy and flow cytometry, splenic B-cell lymphoma/leukaemia with prominent nucleoli was diagnosed and was treated with rituximab monotherapy. A 76-year-old woman presented with progressive abdominal fullness, unintentional weight loss and early satiety was having splenomegaly, bicytopenia and absolute lymphocytosis consisting predominantly of small mature lymphocytes and occasional lymphocytes with polar villi. Morphological and immunopheno-typical results confirmed SMZL. She was treated with rituximab monotherapy.

The vicuna (Vicugna vicugna) as a natural host of Dictyocaulus filaria in Peru

Lungworm infection, or verminous pneumonia, is a parasitic disease that causes serious problems in small and large ruminants. Despite the fact that nematodes of the genus Dictyocaulus in cattle and sheep are the main cause of this disease, there are few studies on the natural infections of South American camelids. For this reason, this study aims to report the natural infection by Dictyocaulus filaria in vicunas (Vicugna vicugna) for the first time. During a shearing season (chaku) in Cuzco, Peru, two accidentally killed adult vicunas were submitted to the IVITA-Marangani research center in Cuzco for their respective necropsies. The tracheas of both vicunas had numerous nematodes, as seen during the necropsy. The nematodes were collected in 70% ethanol and were morphologically identified as D. filaria. Likewise, the DNA of six nematodes was extracted, and the ITS2 region and the 28S rRNA gene were amplified and sequenced. The nucleotide sequences of both genetic markers were up to 100% identical with previously reported D. filaria DNA sequences found in the goat yearlings from Turkey, sheep from Iran, Turkey, and India, and the argali from Uzbekistan, which confirmed the morphological diagnosis. This finding represents the first molecular confirmation of a natural D. filaria infection in a South American camelid. It will be necessary to carry out future studies to know the current situation of verminous pneumonia in domestic and wild South American camelids and to know the negative effects of the disease on them.

Two new species of grass flies (Diptera, Chloropidae) from Sweden

This study implements an integrative taxonomy approach to describe two new species of Swedish grass flies Aphanotrigonum palpalis sp. nov. and Tricimba atipica sp. nov. Morphological and molecular diagnoses plus illustration of key morphological features are included, and amended keys to the Fennoscandian species of both genera are given.

Taxonomic review of Palearctic Eurypogon Motschulsky (Coleoptera: Artematopodidae), with a redescription of the only European species and descriptions of three new species from China

Eurypogon Motschulsky, 1860 is a small genus in the beetle family Artematopodidae distributed in the Holarctic region. Here, we review the Palearctic members of this genus, with main emphasis on the dark-colored species. We redescribe E. cribratus (Hampe, 1867) from Italy and describe three new species from China: E. pubescens sp. nov. from Shaanxi province, E. ruzickai sp. nov. from Yunnan province, and E. turnai sp. nov. from Hubei province. This brings the total number of Eurypogon species to 16. Additionally, we provide morphological diagnoses and photographs of selected characters for all previously described East Palearctic species as well as an updated identification key for the species of mainland China. We discuss the variability of main diagnostic characters, including the shape of pronotum, the surface and punctation of elytra, and the shape of male genitalia.

EENet: Application of convolutional neural network‐based deep learning methods in bone tumor pathological diagnosis

AbstractBone tumors are one of the most common diseases in bone and soft tissue tumors, and accurate classification is crucial for developing effective treatment strategies. However, traditional pathological morphology diagnosis is subjective and uncertain, requiring highly specialized knowledge and experience. Therefore, how to efficiently and accurately classify bone tumor types based on pathological images is an urgent problem to be solved. In this study, a lightweight convolutional neural network (CNN) model called Efficient and Enhance Network (EENet) was proposed for the automatic recognition of bone tumor pathological images. The model introduced efficient channel attention (ECA) blocks to improve the efficiency of feature extraction and reduce computational complexity. A comprehensive dataset of bone pathological images, including five types of bone lesion tissues and normal bone tissue, was compiled for the research. Due to the low incidence of bone tumors and the difficulty in obtaining a large amount of data, the transfer learning method was chosen to overcome the problem of limited data volume. The experimental results from the fivefold cross‐validation demonstrate that the proposed model achieves 99.06% accuracy, 99.08% precision, 99.19% recall, 99.81% specificity, and 99.03% F1‐score in the bone tumor classification task, highlighting its potential as a clinical diagnostic tool.

Low level of the dental health as an indicator of malignant of the oral mucosa

Introduction. The manifestation of oncological alertness during dispensary observation by a dentist is very important. The most accessible options for preventing malignancy of the oral mucosa are sanitation, regular professional oral hygiene, as well as educational work among doctors and the population. However, despite the visual accessibility of tissues and organs of the oral cavity, there is an annual increase in malignant neoplasms in this area. In this case, most patients are diagnosed with a tumor process of the last stage. malignant neoplasms of the head and neck organs require special attention due to high risk of disability even at an early stage. Aim. To evaluate a correlation between malignancy of the oral mucosa and the burdened dental status of patients. Materials and methods. A controlled study was conducted which included 142 patients with cancer of the oral mucosa without sequential or parallel inclusion of patients in groups. Dental status was assessed at help-seeking stage or during clinical examination, as planned, by evaluation of main dental indices. The morphological diagnosis was established using histological verification. Results. The majority of patients with oral tumors had hard dental plaque (81.7 % of cases). The condition of the soft tissues, in addition to presence of the mucous membrane lesion, was characterized by bleeding (69 % of cases). moderate periodontal pathology was detected (19 % of cases). patients with the cavity tumors had an acute traumatic edge of hard tissues (70 % of cases), extensive caries (26 % of cases) and the presence of removable dentures (82 % of cases). Conclusion. The values of parameters evaluated in patients in the study with squamous cell carcinoma of the oral mucosa show its relation to aggravation of general somatic status. All patients in the study required dental treatment and training in oral hygiene care.

A new species of the genus Amolops (Amphibia: Ranidae) and the first national record of Amolops vitreus from China

Abstract The torrent frogs of the genus Amolops represent a great anuran diversification in southern China and Southeast Asia. Previous studies have shown that, the diversity of this genus still remains underestimated. During herpetological surveys from 2021 to 2022, several Amolops specimens were collected from the international border regions of southwestern Yunnan Province, China. Herein, we utilized molecular phylogenetic and morphological data to identify these specimens. Our findings indicate the presence of a separate and previously unknown lineage in the A. viridimaculatus group, which we formally describe as a new species. Furthermore, the specimen from Xishuangbanna National Nature Reserve clustered with A. vitreus from the paratype, supporting the morphological diagnosis. Therefore, we describe a new species and a new species record for China. Our study contributes to the species richness of the genus Amolops as well as the diversity of amphibians in China. Notably, our discovery brings the total number of Amolops species to 85 and the total number of torrent frog species known to occur in China to 53. In addition, our study further confirmed that Yunnan and Indochina Peninsula have similar faunal composition, implying that more studies are needed to achieve a complete understanding of the species diversity and distribution pattern.

Hybrid Deep Learning Approach for Hydraulic Fracture Morphology Diagnosis in Coalbed Methane Wells

Hybrid Deep Learning Approach for Hydraulic Fracture Morphology Diagnosis in Coalbed Methane Wells

The Difficulties and Ease of Diagnosing Anaplastic Large Cell Lymphomas on Cytology.

Anaplastic large cell lymphoma (ALCL), a unique non-Hodgkin lymphoma (NHL), is a CD30-positive neoplasm of T-cell lineage. Its distinctive yet variable cytomorphology makes diagnosing fine needle aspiration cytology (FNAC) challenging. This study was undertaken to study the cytomorphology and the utility of immunocytochemical (ICC) stains on cytology in ALCL and to discuss their morphological differential diagnosis. The present study was conducted in the Department of Pathology of a tertiary care center. A retrospective review was done from January 2017 to July 2022, and all histopathologically and immunohistochemically (IHC) diagnosed cases of ALCL were taken and correlated with the cytological diagnosis. Twenty-one cases of histopathology examination and IHC-proven cases of ALCL were retrieved from the departmental archives and reviewed. The ages ranged from 3 to 80 years (median age 28 years). Commonly noted cytomorphologic features included singly dispersed large pleomorphic cells, hallmark cells, and Reed-Sternberg-like cells. CD15, CD30, epithelial membrane antigen, and anaplastic lymphoma kinase-1 were some of the ICC stains used in this study. All 21 cases had cytology correlation. Fourteen cases had concordant cyto-histological correlation. Seven cases of histopathologically proven ALCL were reported as Hodgkin lymphoma (HL) in three, ALCL/anaplastic diffuse large B-cell lymphoma, HL/ALCL, poorly differentiated carcinoma, and NHL in one case each on cytology. ALCL has a reasonably distinct cytomorphologic appearance and ICC staining pattern, and a careful interpretation of both helps arrive at a reliable FNAC diagnosis.

Novel scoring system provides high separation of diploidy and triploidy to aid partial hydatidiform mole diagnosis: an adaption of HER2 D-DISH for ploidy analysis

AimsDiagnosis of hydatidiform mole or molar pregnancy based on morphology alone can be challenging, particularly in early gestation, necessitating the use of ancillary techniques for accurate diagnosis. We sought to...

Preparation of the endometrium in the programs of auxiliary reproductive technologies for sterility in women

Background. The most important stage in the treatment of infertility is the introduction into clinical practice of the methods of in vitro fertilization (IVF), which made it possible to implement the function of childbirth in almost all forms of female infertility. The introduction of endoscopic technologies made it possible to significantly expand diagnostic possibilities and clarify the nature of intrauterine pathology when using assisted reproductive technologies. Purpose – of the research should be to increase the effectiveness of the treatment of female infertility when using assisted reproductive technologies and hysteroscopy by creating conditions in the endometrium for embryo implantation. Materials and Methods. A study was conducted in 42 patients with infertility aged 32 to 38 years. In all women, the morphological state of the endometrium was determined after diagnostic hysteroscopy. The patients were divided into 2 clinical groups. Group 1 included 28 women who were in a state of preparation for IVF after hysteroscopy with changes characteristic of endometrial pathology, which were found during ultrasound. The second group included 14 patients in whom, according to ultrasound, no structural changes of the endometrium were noted. These patients had a failed IVF attempt. In the next cycle, the women underwent a diagnostic hysteroscopy due to the lack of pregnancy after the first IVF attempt. Results. Group 1 patients (n = 28) with endometrial changes before IVF showed that the causes of pathology were: endometrial hyperplasia (53.6%); chronic endometritis (21.4%), endometriosis (25%). Therefore, before stimulation of superovulation, a hysteroscopy was performed to confirm the morphological diagnosis. In patients of the 2nd group (n = 14) after hysteroscopy and histological examination, pathological changes of the endometrium were found in all patients. Chronic endometritis occurred in 5 cases (35.7%), micropolyposis of the endometrium – in 6 (42.9%), endometriosis – 3 (21.4%). Clinical pregnancy occurred in 17 patients (60.7%) in the first group, in 9 (64.2%) in the second group. Conclusions. Hysteroscopy with morphological examination of the endometrium remains the main method of diagnosing intrauterine pathology. Diagnosis of infertility by hysteroscopy plays a very important role in the normalization of reproductive function during in vitro fertilization (IVF). After an unsuccessful IVF attempt, in the absence of pathological changes in the endometrium, a diagnostic hysteroscopy should be performed to rule out endometrial pathology.