Pathological Diagnosis Research Articles

Comparison of clinicopathological characteristics and prognosis between primary squamous cell carcinoma of the thyroid and squamous cell carcinoma combined with papillary thyroid carcinoma

BackgroundPrimary squamous cell carcinoma of the thyroid (PSCCT) has recently been reclassified as a morphologic pattern of anaplastic thyroid carcinoma (ATC). Consequently, PSCCT and squamous cell carcinoma with papillary thyroid carcinoma (SCC-PTC) were categorized as ATC. However, in terms of clinical characteristics and overall prognosis, whether PSCCT is similar to SCC-PTC has yet to be sufficiently investigated. Therefore, this study aimed to elucidate the differences and similarities between PSCCT and SCC-PTC regarding clinicopathological characteristics and prognosis.MethodsWe retrospectively reviewed the medical records of patients with squamous cell carcinoma of the thyroid in our institution from December 2009 to December 2020. In addition, the publications in CNKI, Wanfang, VIP, PubMed, Embase, Web of Science, and ProQuest databases were systematically searched to collect patient information. According to pathological diagnosis, patients were divided into the PSCCT and SCC-PTC groups, and compared their clinical characteristics, treatment, and prognosis, respectively.Results308 patients in the PSCCT group and 60 patients in the SCC-PTC group were enrolled in the study. There were significant differences in gender, age, T stage, N stage, M stage, symptoms at diagnosis, and TTF-1 expression between the two groups. Patients in the SCC-PTC group with more frequent radioactive iodine therapy, surgery, and less frequent radiotherapy than PSCCT. In addition, PSCCT and SCC-PTC also demonstrated similarities in tracheal invasion, esophageal invasion, CK5/6 expression, TG expression, P53 expression, and chemotherapy frequency. The 3-year overall survival rate of PSCCT (19.1%) was lower than that of SCC-PTC (34.6%). The prognostic factors were different between the two groups. Multivariable analysis shows that the N stage, M stage, radiotherapy, and tracheal invasion were related to the prognosis of PSCCT, while only the T stage was associated with the prognosis in SCC-PTC.ConclusionsClinicopathological characteristics and prognosis were not identical in patients with SCC-PTC and PSCCT. These findings indicated that different clinical treatment and management plans are required for patients with these two types of thyroid cancer.

Cervical Tuberculosis Mimicking Cervical Cancer in a Postmenopausal Woman: A Case Report

Cervical tuberculosis is a rare form of genital tuberculosis. A case of a 73-year-old woman who presented with cervical wall thickening on magnetic resonance imaging, suggesting an invasive malignant neoplasm, is documented. Cervical cone excision was performed for histopathological study. Microscopy showed epithelioid granulomas, without appreciable caseous necrosis, in the wall of the uterine cervix, associated with erosion of the overlying cervical mucosa. Histochemical stains for microorganisms (Ziehl–Neelsen, Grocott, and Warthin–Starry) were negative. Immunohistochemistry for Treponema pallidum revealed scarce, spiral-shaped bacilli, which raised the diagnostic possibility of secondary syphilis. The serological study for syphilis was negative, however. Polymerase chain reaction (PCR) tests for Mycobacterium tuberculosis and Treponema pallidum were performed in the formaldehyde-fixed, paraffin embedded tissue and resulted positive for Mycobacterium tuberculosis and negative for Treponema pallidum, confirming the diagnosis of cervical tuberculosis. Our objective was to report a rare case of cervical tuberculosis, discussing the advantages and limitations of complementary techniques used in the pathological diagnosis of infectious agents and highlighting diagnostic pitfalls. In conclusion, correct microbiological diagnosis requires the implementation of integrated workflows employing complementary techniques in a multidisciplinary setting to improve the accuracy of histopathological examination in infectious diseases.

Mixed neuroendocrine-non-neuroendocrine neoplasm of the colon treated with laparoscopic resection and adjuvant chemotherapy: a case report.

Mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) of the colon is rare with a poor prognosis. Since the first description of a mixed neoplasm 100years ago, the nomenclature has evolved, most recently with the 2022 World Health Organization(WHO) classification system. We describe our experience of a case of locoregionally advanced MiNEN of the descending colon treated with curative laparoscopic resection and adjuvant chemotherapy. The patient is a 72year old woman who presented with haematochezia. Initial clinical diagnosis was poorly differentiated adenocarcinoma of the descending colon, cT2N0M0, cStage I. Laparoscopic partial colectomy of the descending colon with D3 lymph node dissection and intracorporeal overlap anastomosis was performed. The pathological diagnosis however, returned mixed adenocarcinoma-neuroendocrine carcinoma (MANEC) of the descending colon, pT4aN1bM0, pStage IIIB, a subgroup of MiNEN: 70% was neuroendocrine carcinoma (NEC), whilst poorly differentiated mucinous carcinoma constituted 30% of the tumour. She completed 4 courses of irinotecan plus cisplatin (IP) adjuvant chemotherapy and is currently recurrence-free at postoperative year 2. The clinical course of MiNEN depends on the biology of the two components, both of which must be pathologically characterised. Even quantitatively discrete components should be carefully subtyped as their prognostic relevance is undetermined.

Comparative analysis of imaging and pathological features in diagnosis of endometrial carcinosarcoma based on multimodal MRI.

This case report aims to present a rare case of endometrial carcinosarcoma, a highly malignant tumor with a poor prognosis. The primary objective is to describe this unique case's clinical presentation, multimodal magnetic resonance imaging (MRI) features, typical histopathological characteristics and surgical treatment. A detailed analysis of the patient's medical history, preoperative imaging evaluation, and treatment approach was conducted. This case report includes high-resolution images and figures, showcasing MRI scans, surgical treatment, and histopathology slides related to the case. The case report outlines imaging findings of a rare case of endometrial carcinosarcoma. Multimodal imaging such as T1-weighted imaging (T1WI), T2-weighted imaging (T2WI) and multi-b-value diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) and dynamic contrast-enhanced (DCE) scanning could accurately identify the histopathological features of the case. Surgical resection is the best treatment, and preoperative imaging evaluation should be particularly important. This case report highlights endometrial carcinosarcoma's rarity and diagnostic challenges. Multimodal MRI has significant value in diagnosing endometrial carcinosarcoma. This technology not only improves the sensitivity, specificity, and accuracy of diagnosis, but also helps to more accurately evaluate the staging and grading of tumors. By comparing imaging features and pathological results, studies have found that multimodal MRI can clearly show the anatomical structure, pathological nature, and extent of the tumor, with a high degree of consistency with the pathological diagnosis. In particular, when differentiating endometrial carcinosarcoma from low-risk endometrial cancer, multimodal MRI combined with serum carbohydrate antigen 125 (CA125) and E-box binding zinc finger protein 1 (ZEB1) detection can further improve the sensitivity and specificity of differential diagnosis. In addition, research has found that the ADC value of the tumor tissue in different pathological grades is related to the multimodal MRI, which helps to better understand the biological behavior and prognosis of the tumor. In summary, multimodal MRI is an effective diagnostic tool that can provide important evidence for the precise diagnosis and treatment of endometrial carcinosarcoma.

Post-mortem diagnosis of septic arthritis by Pasteurella multocida: a case report and literature review of fatal septic arthritis.

The diagnosis of septic arthritis remains challenging in the clinical setting, often leading to a suspicion for medical liability. Our purpose is to describe an unusual case of a post-mortem diagnosis of P. multocida fatal septic arthritis, in a healthy 67-year-old woman presenting with pain in the right shoulder. Moreover, a literature review of cases of fatal septic arthritis is provided. The multidisciplinary approach consisted of a forensic autopsy and additional post-mortem analyses (microbiology, biochemical analyses, histopathology, and revision of radiological images) carried out during the prosecutor's investigation for medical liability. A systematic review of the literature was performed to collect cases of fatal septic arthritis and to understand its frequency and characteristics. No clear cause of death was determined after the autopsy, that only highlighted swelling and purulent exudation in the right glenohumeral joint. The microbiological swab performed on the shoulder tested positive for P. multocida, while histopathological and biochemical data were consistent with a sepsis. These results guided the interview with the woman's relatives, until a history of a previous contact with a stray cat emerged. The cause of death was deemed as fatal septic arthritis caused by P. multocida, occurred after cat scratches and bites and only diagnosed post-mortem. The review of the literature provided 15 articles about fatal septic arthritis, only 1 caused by P. multocida, and all with ante-mortem diagnosis. Given the nonspecific symptoms, usually including a localized pain, and the absence of a clear history, e.g. of animal contact, septic arthritis might represent an under-reported clinical and pathological diagnosis, leading to a judicial autopsy for the suspicion for medical liability. The post-mortem examination, following a multidisciplinary approach including integration of the clinical history, microbiological and histopathological analysis, could represent the only opportunity for the diagnosis of the cause of death.

Distinct prognostic impacts of age-adjusted Charlson comorbidity index and geriatric nutritional risk index in patients with intraductal papillary mucinous neoplasm.

The optimal surgical indication for intraductal papillary mucinous neoplasms (IPMN) remains highly contentious. We aimed to determine the preoperative predictive factors of malignancy and independent prognostic factors in patients with IPMN who underwent curative-intent resection. In this study, 104 patients with a pathological diagnosis of IPMN who underwent curative-intent resection were included. Multivariate regression and Cox proportional-hazards analyses were performed to identify the predictive factors for invasive intraductal papillary mucinous carcinoma (IPMC) and prognostic factors for overall survival (OS) after surgery. Among the 104 patients, 24 (23.1%) were pathologically diagnosed with invasive IPMC, and the remaining 80 had low-grade dysplasia or high-grade dysplasia. The presence of high-risk stigmata was an independent predictive risk factor for invasive IPMC. The age-adjusted Charlson comorbidity index (ACCI) (≥4/<4) and geriatric nutritional risk index (GNRI) (<99/≥99) were independent poor prognostic factors for OS (hazard ratio [HR]: 9.39; 95% confidence interval [CI]: 1.90-46.54; P = .006 and HR: 4.37; 95% CI: 1.07-17.86, P = .040, respectively). Forty patients with ACCI ≥ 4 (38.5%) had a significantly lower 5-year OS rate than those with ACCI < 4 (74.3 vs 98.2%, P < .001). Similarly, 29 patients with GNRI < 99 (27.9%) had a significantly lower 5-year OS rate than those with GNRI ≥ 99 (76.0 vs 95.1%, P < .001). These 2 factors were associated with significantly worse disease-specific survival after surgery. The ACCI and GNRI emerged as independent prognostic factors after surgery in patients with IPMN. These findings highlight the importance of patient-conditional factors as valuable indicators for predicting favorable long-term survival outcomes after surgery and for facilitating a more precise assessment of surgical eligibility in patients with IPMN.

Treatment outcomes of primary salivary gland squamous cell carcinoma: A multi-institutional retrospective study in Japan.

Primary salivary gland squamous cell carcinoma (SCC) is extremely rare, accounting for 0.3-10.4 % of all salivary gland malignancies. Due to this rarity, the clinical characteristics of primary salivary gland SCC remain unelucidated. In the present study, we conducted a multi-institutional retrospective analysis-including a large number of cases compared with that of previous studies-to reveal the prognosis, treatment outcomes, and prognostic factors of primary salivary gland SCC. The clinical course of patients with primary salivary gland SCC between January 2012 and December 2022 was retrospectively investigated. Thirteen university hospitals and cancer centers in Japan participated in this study. The diagnosis of primary salivary gland SCC was based on the following criteria: 1) pathological diagnosis of SCC and exclusion of other histological types and 2) exclusion of metastatic SCCs from other organs. Progression-free and overall survival rates were compared using Kaplan-Meier curves and log-rank tests. Treatment outcomes were assessed using univariate and multivariate analyses with Cox proportional hazards models. In total, 723 patients with salivary gland cancer were admitted to the participating institutions. Among them, 63 patients (8.7 %) were diagnosed with primary salivary gland SCC. The clinical courses of the 58 patients that received definitive treatment and had complete data were analyzed. Primary treatments included surgery in 35 patients (60.3 %), chemoradiotherapy in 16 (27.6 %), radiotherapy in 5 (8.6 %), and chemotherapy in 2 (3.4 %). Complete response and objective response rates to chemoradiotherapy were 62.5 % and 93.8 %, respectively. Five-year progression-free and overall survival rates were 30.1 % and 60.1 %, respectively. Five-year progression-free survival rates for each treatment were 37.7 % (surgery), 33.0 % (chemoradiotherapy), 0 % (radiotherapy), and 0 % (chemotherapy). Overall survival rates were 71.5 % (surgery), 39.5 % (chemoradiotherapy), 53.3 % (radiotherapy), and 0 % (chemotherapy). Multivariate analysis revealed that age ≥70 years, N classification ≥1, and surgery were independent predictors of progression-free (hazard ratios: 3.75, 2.46, and 0.33, respectively) and overall survival (hazard ratios: 3.11, 6.24, and 0.32, respectively). Adjuvant radiotherapy significantly improved progression-free and overall survival in patients with stage Ⅳ cancer or positive surgical margins. Log-rank tests revealed no significant difference between patients with or without elective neck dissection in progression-free and overall survival; however, a relatively high percentage of occult lymph node metastasis (50.0 %) was observed. Surgical resection is a favorable first-line treatment option in salivary gland SCC, and definitive chemoradiotherapy would show acceptable complete and objective response rates.

Advances in thyroid pathology in China over the past ten years: retrospect and prospect

With the development of thyroid pathology in the past decade, thyroid pathological diagnosis has entered the era of molecular pathology. As the most influential academic journal in the field of pathology in China, Chinese Journal of Pathology has published nearly one hundred articles related to thyroid diseases in the past decade. These results have made a great difference to the scientific research and clinicopathological diagnosis of thyroid diseases in China, and have also provided Chinese data for the pathological communication of thyroid diseases internationally. Pathologists should make full use of thyroid cytology and histopathology, combined with molecular testing and digital intelligence technology, to play a core guiding role in the multidisciplinary precise diagnosis and treatment of thyroid diseases.

Extracranial and nonvaginal extragonadal malignant germ cell tumors: 12 cases at a Chinese institution over the last 38years.

To provide a comprehensive understanding and propose a strategy for the management of extragonadal malignant germ cell tumors (EMGCTs) arising from extracranial and nonvaginal sites. We retrospectively reviewed the cases of 12 patients with EMGCTs arising from extracranial and nonvaginal sites treated in our center over the past 38years. Data on clinicopathological characteristics, treatment modalities, and follow-up information were analyzed. Among 209 patients diagnosed with EMGCTs, 12 women (5.7%) with EMGCTs of extracranial and nonvaginal sites were identified. These patients had tumors in the sacrococcygeal region (n = 4), abdominal cavity (n = 3), groin region (n = 2), uterus (n = 2), and mediastinum (n = 1). The median age at diagnosis was 23years. Symptoms included abnormal uterine bleeding (n = 3), abdominal discomfort (n = 3), compression symptoms (n = 3), palpable mass (n = 2), and asymptomatic (n = 1). Yolk sac tumors (YSTs) were the most common histologic type. The median level of serum alpha-fetoprotein (AFP), a sensitive tumor marker, was 8216ng/ml (2.7-74,157ng/ml). One patient started bleomycin/etoposide/cisplatin without a pathologic diagnosis based on clinical diagnosis (high AFP levels and imaging findings), and 11 patients started chemotherapy following tumor biopsy or surgical resection. During the follow-up, one patient suffered a recurrence, two patients were alive with disease, and nine patients were disease-free. Extracranial and nonvaginal EMGCTs are a heterogeneous group of tumors due to their varied onset ages, location, and clinical presentation. An all-around clinical evaluation is crucial for selecting appropriate treatment. Most patients achieve agood prognosis after surgical resection and chemotherapy. Patients with these rare diseases may benefit from individualized treatment and timely referral to experienced medical centers.

Research advances in the pathological diagnosis of melanocytic tumors with artificial intelligence

Research advances in the pathological diagnosis of melanocytic tumors with artificial intelligence

What’s new in wrist arthroscopy: A review of the literature from 2018 to 2023

Since its first description in 1979, wrist arthroscopy has gained traction in its application in the diagnosis and treatment of various intra-articular hand and wrist pathologies. Over the past five years this technology has evolved with new techniques in the management of degenerative and traumatic injuries, alongside maturation of classic descriptions with the publication of mid- and long-term outcomes. A careful review of the literature is valuable in providing a summation of the current state, limits, and potential of wrist arthroscopy to help shape the daily practice of hand surgeons.

Machine Learning Models With Hyperparameter Optimization for Voice Pathology Classification on Saarbrücken Voice Database.

Early diagnosis and referral are crucial in the treatment of voice disorders. Contemporary investigations have indicated the efficacy of voice pathology detection systems in significantly contributing to the evaluation of voice disorders, facilitating early diagnosis of such pathologies. These systems leverage machine learning methodologies, widely applied across diverse domains, and exhibit particular potential in the realm of voice pathology classification. However, machine learning models and performance metrics employed in these studies vary significantly, making it challenging to determine the optimal model for voice pathology classification. In this study, healthy and pathological voices were classified with state-of-the-art machine learning models, and the performance results of the models were compared. The voice samples employed in our research were sourced from the Saarbrücken Voice Database, a reputable German database. Feature extraction from voice signals was conducted using the Mel Frequency Cepstral Coefficients method. To assess and enhance the models' performance adequately, we employed hyperparameter optimization and implemented a 10-fold cross-validation approach. The outcomes revealed that the support vector machine model exhibited the highest accuracy, achieving 99.19% and 99.50% accuracies in the classification of male and female voice pathologies, respectively.

Immunohistochemical Study Protocol in Thyroid Pathology.

Immunohistochemical study proves valuable in the diagnosis of neoplastic pathology. Its application allows us to differentiate the origin of tumors, as seen with thyroglobulin and TTF1 in well-differentiated tumors of follicular origin and calcitonin or other neuroendocrine markers for tumors arising from C cells. At times, immunohistochemical study becomes necessary for the classification of thyroid carcinomas arising from follicular cells, although specific antibodies that would enable the exclusion of malignancy or differentiation between follicular carcinomas and papillary carcinomas have generally not been found; hence, various antibody panels are utilized. HMBE1 and galectin 3 can be beneficial in distinguishing malignancy from benignity, while CK19, galectin 3, and HMBE1 aid in identifying papillary carcinomas of follicular variant. In the differential diagnosis depending on histological morphology, various panels with automated protocols prove greatly useful.

Up-to-date pathological diagnoses of intraductal papillary mucinous neoplasms of the pancreas based on recommendations of the international evidence-based Kyoto guidelines

Up-to-date pathological diagnoses of intraductal papillary mucinous neoplasms of the pancreas based on recommendations of the international evidence-based Kyoto guidelines

Eyelid Spindle Cell Lipoma: Case Report and Review of Three Patients in Literature.

A 39-year-old woman presented a saucer-shaped mass in the left upper eyelid and underwent the extirpation at local anesthesia. Pathologically, collagen fibers, capillaries, small vessels, and CD34-positive spindle cells were dispersed among mature adipose tissues, indicative of spindle cell lipoma. Long-lasting cyst-like eyelid masses would be usually dermoid cysts, and spindle cell lipoma would be listed as a rare pathological diagnosis in differential diagnoses of cyst-like lesions in the upper and lower eyelid.

The potential role of synthetic computed tomography in spinal surgery: generation, applications, and implications for future clinical practice.

Computed tomography (CT) is widely used for the diagnosis and surgical treatment of spinal pathologies, particularly for pedicle screw placement. However, CT's limitations, notably radiation exposure, necessitate the development of alternative imaging techniques. Synthetic CT (sCT), which generates CT-like images from existing magnetic resonance imaging (MRI) scans, offers a promising alternative to reduce radiation exposure. This study examines the emerging role of sCT in spinal surgery, focusing on usability, efficiency, and potential impact on surgical outcomes. This qualitative literature review evaluated various sCT generation methods, encompassing traditional atlas-based and bulk-density models, as well as advanced convolutional neural network (CNN) architectures, including U-net, V-net, and generative adversarial network models. The review assessed sCT accuracy and clinical feasibility across different medical disciplines, particularly oncology and surgery, with potential applications in orthopedic, neurosurgical, and spinal surgery. sCT has shown significant promise across various medical disciplines. CNN-based techniques enable rapid and accurate generation of sCT from MRI scans, rendering clinical use feasible. sCT has been used to identify pathologies and monitor disease progression, suggesting that MRI alone may suffice for diagnosis and planning in the future. In spinal surgery, sCTs are particularly useful in visualizing key anatomical features like vertebral dimensions and spinal canal diameter. However, challenges persist, especially in visualizing complex structures and larger spinal regions, like the lumbar spine. Additional limitations include inaccuracies stemming from surgical implants and image variability. The application of sCT technology in spinal surgery holds great promise, improving diagnostics, planning, and treatment outcomes. Although further research is required to improve its precision, it offers a viable alternative to traditional CT in many clinical contexts, with the potential for broader application as the technology matures.

Current Status and Future Perspective of Seoul National University Hospital-Dementia Brain Bank with Concordance of Clinical and Neuropathological Diagnosis.

This paper introduces the current status of Seoul National University Hospital Dementia Brain Bank (SNUH-DBB), focusing on the concordance rate between clinical diagnoses and postmortem neuropathological diagnoses. We detail SNUH-DBB operations, including protocols for specimen handling, induced pluripotent stem cells (iPSC) and cerebral organoids establishment from postmortem dural fibroblasts, and adult neural progenitor cell cultures. We assessed clinical-neuropathological diagnostic concordance rate. Between 2015 and September 2024, 162 brain specimens were collected via brain donation and autopsy. The median donor age was 73 years (1-94) with a male-to -female ratio of 2:1. The median postmortem interval was 9.5 hours (range: 2.5-65). Common neuropathological diagnoses included pure Lewy body disease (10.6%), Lewy body disease (LBD) with other brain diseases (10.6%), pure Alzheimer's disease-neuropathological change (ADNC) (6.0%), ADNC with other brain diseases (10.7%), vascular brain injury (15.2%), and primary age-related tauopathy (7.3%). APOE genotype distribution was following: ε3/ε3: 62.3%, ε2/ε3: 9.6%, ε2/ε4: 3.4%, ε3/ε4: 24.0%, and ε4/ε4: 0.7%. Concordance rates between pathological and clinical diagnoses were: ADNC/AD at 42.4%; LBD at 59.0%; PSP at 100%; ALS at 85.7%; Huntington's disease 100%. The varying concordance rates across different diseases emphasize the need for improved diagnostic criteria and biomarkers, particularly for AD and LBD. Tissues have been distributed to over 40 national studies. SNUH-DBB provides high-quality brain tissues and cell models for neuroscience research, operating under standardized procedures and international guidelines. It supports translational research in dementia and neurodegenerative diseases, potentially advancing diagnostic and therapeutic strategies.

Breast cancer management during the COVID-19 pandemic: Report from a General Hospital Based Cancer Registry from 2019 to 2022

Purpose: This study aimed to describe breast cancer management during the COVID-19 pandemic. Methods: This research is a retrospective descriptive study using secondary data from medical records. The study included 70 patients with breast cancer at Dr. M. Djamil General Hospital from March 2019 to December 2022, who met the inclusion and exclusion criteria. The data analysis used is univariate analysis and presented in the form of a frequency distribution table so that a descriptive picture of each variable studied is obtained. Results: This study included 70 patients with mean age of 40.91 years. During the pandemic, 60.0% of the patients visited the surgical polyclinic. Half of the breast cancer patients had a secondary diagnosis such as pleural effusion (28.6%). The majority of the subjects were at stage IIIC (32.9%). More than half (51.4%) of the patients underwent a modified radical mastectomy. The most common pathological anatomy diagnosis was invasive carcinoma mammae NST (47.1%). An Immunohistochemistry examination was conducted on 24 (34.3%) subjects. Less than half of the patients received chemotherapy. The majority of the patients underwent surgery and chemotherapy 1 month after diagnosis. Mortality is seen in 8.7% of breast cancer patients. Conclusion: During the COVID-19 pandemic, the majority of breast cancer patients undergo anatomical pathology and immunohistochemistry examination through the surgical polyclinic, breast cancer patients who come to the emergency department are usually admitted with breathing problems due to pleural effusion, and surgery and chemotherapy are performed within 1 month.

Application of an Innovative Embedding and Cooling Component in the Critical Steps of Fragmented Tissue Pathological Diagnosis.

This study aimed to explore the application value of an innovative embedding and cooling component in the critical steps of fragmented tissue pathological diagnosis. Eighty small and fragmented tissue samples were collected and randomly divided into two groups. The embedding qualification rate and embedding efficiency were compared between the two groups. Seventy cases of fragmented tissue were collected, with three pieces of fragmented tissue taken from each case. The samples were randomly divided into three groups for sectioning. The wrinkle-free scores and sectioning efficiency were compared between different cooling methods. The embedding qualification rate was 90.0% in the embedding tweezer group, which was lower than 98.8% in the innovative component group (χ2 = 4.24, p < 0.05). The average embedding time per sample was 25.08 ± 4.61 s in the embedding tweezer group, which was significantly longer than the 16.69 ± 3.54 s in the innovative component group (t = 12.91, p < 0.001). The wrinkle-free section scores were 8.24 ± 0.69 in the small ice block cooling group, 8.11 ± 0.74 in the freezing platform cooling group, and 8.85 ± 0.65 in the innovative component cooling group, with the innovative component cooling group scoring significantly higher than the other two groups (q = 7.40, 8.98, p < 0.01). The innovative component cooling group had a shorter average sectioning time than the other two groups (q = 3.12, 26.75, p < 0.05, 0.01). The use of the innovative embedding and cooling component optimizes the embedding and sectioning steps in the pathological diagnosis of fragmented tissue. This method is worthy of promotion and application.

Pediatric Neurosonography: Comprehensive Review and Systematic Approach.

Neurosonography (NSG) is pivotal for rapid, point-of-care neonatal brain assessment. This review elucidates the comprehensive applications of NSG in pediatric care, emphasizing its role in early diagnosis and management of pathologies affecting the pediatric head-such as scalp lesions, misshapen calvarium, ventricular distortions, and cerebrovascular abnormalities, and its specific role in conditions like hypoxic-ischaemic encephalopathy (HIE) across different neonatal gestational ages. We explore its diagnostic advantage in critical care settings, particularly for infants with stroke risk in sickle cell disease, ECMO-related complications, screening for therapeutic hypothermia, and routine neonatal intensive care unit monitoring. This review discusses the recommendations based on the timing of brain injury (preterm and term) and describes technical considerations that enhance diagnostic accuracy. Ultimately, this article advocates for its incorporation into routine neonatal screening to improve neurodevelopmental outcomes, underscoring its importance in clinical decision-making and long-term management of pediatric brain disorders.