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关键词： autopsy   forensic   medicolegal  

摘要： The system of death investigation in England and Wales is complex, resulting in a distinction between ‘non-forensic’ and ‘forensic’ medicolegal autopsies. This article reviews the medicolegal investigation of sudden death and the actions of the police at the scene, and features in the history, external examination and internal examination that ‘non-forensic’ pathologists should be attune to in their everyday practice. © 2021

关键词： 妇产科病-病理学  

ISBN: (纸本)9787030610935

摘要： 本书为妇产科病理学专著, 在第一版的基础上进行修订, 共有38个章节, 彩色图片约1500张。作者以近年妇产科病理学的最新理论为基础, 强调先进性与实用性, 对女性生殖道疾病进行了系统的阐述, 还涉及如何避免病理诊断的陷阱, 正确面对签发病理报告时遇到的问题, 应该淘汰的术语和理论以及很多疾病的临床处理原则。可以说, 这本书的整体水平达到同期国外类似妇科病理专著的水平, 远远超过国内同类图书, 是一部对于我国妇科病理学以及妇产科临床都具有重要价值的图书。

关键词： CAG repeat   Huntington disease   Aggregates   Chaperon   Neurodegeneration   Gene-targeting  

摘要： Selective neuronal accumulation of misfolded proteins is a key step toward neurodegeneration in a wide range of neurodegenerative diseases, including Huntington's (HD) diseases. Our recent studies suggest that Hsp70-binding protein 1 (HspBP1), an Hsp70/CHIP inhibitor that reduces protein folding, is highly expressed in neuronal cells and accounts for the accumulation of the HD protein huntingtin (HTT) in neuronal cells. To further determine the role of HspBP1 in regulation of mutant protein accumulation, we investigated whether increasing expression of HspBP1 in glial cells can also induce the accumulation of endogenous mutant HTT in glial cells and yield non-cell-autonomous toxic effects. We performed stereotaxic injection of AAV to selectively express HspBP1 in astrocytes in the brains of HD140Q knock-in (KI) mice that express mutant HTT ubiquitously but do not display obvious neurodegeneration. However, HspBP1 expression in HD140Q astrocytes led to the increased accumulation of endogenous mutant HTT and robust neuronal loss in the striatum of HD140Q KI mice. In transgenic HD mice that selectively express mutant HTT in astrocytes, increased accumulation of mutant HTT in astrocytes via HspBP1 expression did not elicit neurodegeneration but could exacerbate neurological symptoms. Consistently, suppressing the expression of endogenous HspBp1 in the striatum of HD140Q KI mice via CRISPR/Cas9 led to a significant reduction of mutant HTT accumulation. Our findings suggest that although endogenous mutant HTT in astrocytes can exacerbate neurological symptoms, it mediates neurodegeneration only when mutant HTT is also accumulated in neuronal cells.

关键词： Prostate cancer   Targeted biopsy   MRI   PSMA PET   CT   Upgrading  

摘要： Purpose Prostate-specific membrane antigen (PSMA) positron emission tomography (PSMA-PET) is an ideal tool for staging and restaging of prostate cancer (PCa). This study was designed to investigate the prognostic role of preoperative Ga-68-PSMA-11 PET/CT in predicting pathological upgrading from multiparametric magnetic resonance imaging-targeted biopsy (mpMRI-TB) to final radical prostatectomy (RP) specimens in patients with localized PCa. Methods A total of 67 biopsy-confirmed localized PCa patients with mpMRI and Ga-68-PSMA-11 PET/CT prior to RP were included. Clinical and imaging characteristics derived from mpMRI and PET/CT were compared in patients with or without pathological upgrading. Predictors for pathological upgrading were evaluated by using univariate and multivariable analyses. A prediction model was developed based on the identified parameters and validated using internal validation. Results Pathological upgrading from mpMRI-TB to final RP specimens occurred in 38.8% (26/67) of the patients. Multivariable logistic regression analysis showed SUVmax (OR: 1.223, 95% CI 1.068-1.399, p = 0.003);highest tumor grade at mpMRI-TB, ISUP grade group (ISUP GG) 1 vs. 4 (OR: 0.11, 95% CI 0.000-0.452, p = 0.018) and ISUP GG 2 vs. 4 (OR: 0.16, 95% CI 0.001-0.252, p = 0.003);and multifocality on PET/CT (OR: 9.821, 95% CI 1.438-67.085, p = 0.02) were independent risk factors for pathological upgrading. Our developed prediction model based on the identified parameter showed good calibration at internal validation (mean absolute error = 0.033). Conclusion Ga-68-PSMA-11 PET/CT was found to be an ideal biomarker for the prediction of pathological upgrading from mpMRI-TB to RP, especially for patients with lower tumor grade at mpMRI-TB.

关键词： Melanoma   Diagnosis   Histopathology   Pathology   Plastic Surgery   Report  

摘要： Conventional histopathology is the primary means of melanoma diagnosis. Both architectural and cytologic features aid in discrimination of melanocytic nevi from melanoma. Communication between the clinician and pathologist regarding the history, examination, differential diagnosis, prior biopsy findings, method of sampling, and specimen orientation is critical to an accurate diagnosis. A melanoma pathology report includes multiple prognostic indicators to guide surgical and medical management. In challenging cases, immunohistochemistry and molecular diagnostics may be of benefit.

关键词： abdominoperineal resection   anorectal melanoma   histopathology   mucosal melanoma  

摘要： Aim The aim of our study was to scrutinize diagnostic and treatment factors that may contribute to the low survival rate from anorectal melanoma while adding 17 more cases to the global research database. Method We carried out a retrospective analysis of 17 cases of anorectal melanoma treated at a single institution from 2000 to 2020. Data on patient age, sex, complaints, treatment and survival as well as tumour size, resection margins, histological and immunohistochemical features were assessed. Results The median age of patients was 72 +/- 12.49 (45-92) years. Most of the patients were women (n = 11, 64.71%). Three (17.65%) patients underwent no radical treatment. Of eight patients treated initially with radical surgery (either total mesorectal excision or abdominoperineal resection), six (75%) were found to have positive lymph nodes. Mean survival was 20 +/- 23.46 (1-84) months. The average diameter of the resected tumours was 5.43 +/- 3.02 cm (1.3-10 cm). Most tumours had epithelioid or spindle cell morphology and were positive for one or more melanocytic markers (S100, HMB-45 or MITF). More than half of the tumours contained no or very little melanin pigment. None of the tumours had significant lymphocytic infiltration. Three tumours showed positivity for keratins (PANCK or CAM5.2) and one tumour showed positivity for C-KIT stain. Conclusion An aggressive surgical approach may have an effect on survival in most early stages while more advanced disease benefits from a more conservative approach. Attention to sentinel lymph nodes and further systemic research into therapy is required. For now, treatment and diagnostic modalities seem to be inconsistent, requiring further investigation to elucidate common points.

关键词： fat grafting   nanofat   scar treatment   scars  

摘要： Background Scars are the unfortunate outcome of most injuries and some diseases. Its psychological impact on patients can deeply affect their quality of life. Aim The aim of this study was to evaluate the efficacy of autologous nanofat injection in improving the aesthetic outcome of scars, combined with histopathological correlation of the response. Patients and methods Thirty patients with scars of different etiologies undergone one session of nanofat injection and evaluation was done 6 months after the session. Efficacy of treatment was assessed clinically using Vancouver scar scale by two independent blinded dermatologists and histopathologically using image analysis system. Results The age of enrolled patients ranged from 18 to 40 years old. There was a statistically significant improvement on the total Vancouver scar scale regarding the height and pliability of the scars. Pathological evaluation showed an increase in epidermal thickness, increased number and density of collagen and elastic fibers along with neovascularization. Conclusion Evidenced by clinical and pathological improvement, autologous nanofat injection is an effective strategy for treating scars of different etiologies.

关键词： desmoplastic melanoma   immunohistochemistry   melanocyte   nevus   perineurioma   perineuriomatous  

摘要： Background: Perineuriomatous nevi are rare and diagnostically problematic. We report a series of eight perineuriomatous nevi to highlight the diagnostic features. Methods: Cases were retrospectively reviewed and characterized. Results: Median age was 42.5 years (range 25-64), with equal sex distribution. Lesions occurred on the arm (n = 4), trunk (n = 2), and head/neck (n = 2). Median size was 7.5 mm (range 5-12 mm). Clinical differential diagnoses included atypical nevus (3), blue nevus (1), neurofibroma (1), and dermatofibroma (1). Lesions were circumscribed, dome-shaped (5/8), and biphasic (8/8) with nested epithelioid cells and wavy spindled cells arranged in whorled fascicles in a myxocollagenous stroma. When present, junctional growth was lentiginous (4/8). No cases displayed pleomorphism or mitotic figures. The perineuriomatous component stained positively for epithelial membrane antigen (8/8 focal to diffuse) and CD34 (4/5 focal to diffuse). SOX10 and S100 protein stained all nevoid cells and in some cases a subset of intermingled spindled cells in perineuriomatous areas, where other melanocytic markers were negative. p16 protein expression was uniformly retained (3/3), and p53 negative (0/2). Nevoid cells in most lesions were positive for BRAFV600E (5/7). Ki67 was mildly elevated (similar to 5%) in 3/3 cases. Conclusions: Recognizing the histopathologic and immunophenotypic features in these unusual nevi helps avoid overdiagnosis.

关键词： Rectal cancer   Lateral lymph node   Lateral lymph node dissection   Extramural vascular invasion   Magnetic resonance imaging  

摘要： Purpose Multidisciplinary treatment for locally advanced rectal cancer requires an accurate assessment of the risk of metastasis to the lateral lymph nodes (LNs). We herein aimed to stratify the risk of pathological metastasis to lateral LNs based on the preoperatively detected malignant features. Methods All patients with rectal cancer who underwent surgery from January 2016 to July 2020 were identified. We recorded the TNM factors;perirectal and lateral LN sizes;and MRI findings, including mesorectal fascia involvement, extramural vascular invasion (EMVI), tumor site, and tumor distance from the anal verge. Results 101 patients underwent rectal resection with lateral lymph node dissection, of whom 16 (15.8%) exhibited pathological metastases to the lateral LNs. Univariate analyses demonstrated that lateral LN metastasis was significantly correlated with mrEMVI positivity (p = 0.0023) and a baseline lateral LN short-axis length of >= 5 mm (p < 0.0001). These significant associations were confirmed by a multivariate analysis (p = 0.0254 and 0.0027, respectively). The lateral LN metastasis rate was as high as 44% in cases bearing both risk factors, compared to 0% in cases lacking both risk factors. Conclusion The results elucidated in this study may contribute to risk stratification, which can be used when determining the indications for lateral lymph node dissection.