We have posted updates of the following topics:
Autopsy & forensics > General > Postmortem chemistryby Ilaria Tarozzi, M.D., Lorenzo Gitto, M.D.
Topic summary: Postmortem chemistry is a critical ancillary procedure for the forensic pathologist. Biochemical analytes provide useful information in deaths when autopsy findings are nonspecific or no apparent cause of death is identified. Vitreous humor is less subject to putrefaction than blood and not subject to diffusion of microbes or xenobiotics from the central body cavities. Cardiac blood is useful for qualitative / screening analyses; peripheral blood is the matrix of choice for quantitative analysis. Urine is used for qualitative screening; gives information on recent drug use but not on acute toxicity. Many different types of drugs and toxins can be incorporated into hair, which can be used for testing in suspected chronic exposure.
Fallopian tubes & broad ligament > Broad ligament miscellaneous tumors > STK11 adnexal tumor
by Shaima N. Elgenaid, M.D., Lewis A. Hassell, M.D.
Topic summary: Aggressive tumor that arises in paratubal / paraovarian soft tissues, has variable morphology and immunohistochemistry and harbors pathognomonic alterations in STK11. Associated with Peutz-Jeghers syndrome in ~50% of cases. Age: wide range from middle age to elderly. Clinical features: abdominal / pelvic pain or mass, abdominal distension, urinary tract symptoms, abnormal uterine bleeding. Can be incidental finding; metastatic tumor at presentation (50%).Recurrences at 3 – 79 months after initial diagnosis, most commonly in the omentum, abdominal wall, peritoneum and pelvis; metastasis: most commonly to omentum and uterine serosa. Treatment: surgery with or without chemotherapy or radiation.
Heart & vascular pathology > Inflammatory disease > Giant cell arteritis
by Maryam Ashfaq, M.D., M.B.B.S., Aliya N. Husain, M.D.
Topic summary: Giant cell arteritis (GCA) is a systemic inflammatory disorder characterized by granuloma formation in medium and large sized arteries, occurring most frequently in adults; very frequently coexists with polymyalgia rheumatica. Commonly presents in older patients above age 50, mostly women, with new onset headache; most common in Scandinavian countries. Diagnosis: temporal artery biopsy is gold standard. Factors associated with decreased risk of permanent blindness: fever, rheumatic symptoms; factors associated with increased risk of permanent blindness: age, history of transient ischemic visual symptoms, jaw claudication. Corticosteroids are the mainstay of treatment, especially to prevent blindness.
Kidney tumor > Benign / borderline adult tumors > Hemangioblastoma
by Lin Cheng, M.D., Ph.D., Maria Tretiakova, M.D., Ph.D.
Topic summary: Very rare, benign tumor in kidney, with fewer than 20 cases reported in English literature; renal counterpart of the central nervous system (CNS) hemangioblastoma. Lipoblast-like epithelioid cells with abundant cytoplasmic microvacuoles; complex network of thin walled vessels in arborizing or pericytomatous patterns. Also known as capillary hemangioblastoma. M = F (in contrast to CNS hemangioblastoma, which is male predominant); sporadic, not associated with von Hippel-Lindau (VHL) disease (different from CNS hemangioblastoma, which is associated with VHL in 25% of cases). Mostly asymptomatic; occasionally hematuria or abdominal pain. Benign tumor, no distant metastasis; persistent disease after incomplete resection.
Mandible & maxilla > Cysts of the jaw > Radicular (periapical) cyst
by Kelly Magliocca, D.D.S., M.P.H.
Topic summary: Inflammatory type odontogenic cyst associated with the root of a nonviable (necrotic) tooth; lined by nonkeratinized stratified squamous epithelium, derived from rests of Malassez. Most common jaw cyst, accounts for ~60% of all odontogenic cysts. Located in the maxilla or mandible. Inflammation (usually associated with dental caries extending into the dental pulp or trauma) stimulates cells in the rests of Malassez; epithelial cells proliferate to form a cystic cavity. May be asymptomatic and incidentally discovered; symptoms of pain and drainage if secondarily infected. Treatment varies with age of patient, access to care and state or prognosis of the tooth. Overall prognosis is excellent once lesion is treated; recurrence rate is low.
Featured Image
Contributed by: Aliya N. Husain, M.D.
Diagnosis: Giant cell arteritis
Giant cell arteritis involving the temporal artery. Note the thickened wall with compressed lumen and adventitial inflammation (low magnification).
Blog | PathologyOutlines.com 