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Aim. To conduct a retrospective analysis and evaluate the morphological methods for HPV-related intraepithelial lesions detection in women of reproductive age. Materials and methods. The data of cytological diagnosis, as well as the results of histological reports were analyzed for the period from 2018 to 2019. A comparative analysis was performed in 415 patients with HPV-related intraepithelial lesions, who applied to the scientific and polyclinic department of the Kulakov National Research Medical Center at the age of 19 to 45 years. Morphological examination was carried out by specialists of the 1st pathology department of the Center. Results. According to the results of a comparative analysis of cytological and histological conclusions, 3 groups were formed: 1 the group of coincidence (agree) of cytological and histological conclusions; 2 group of minor discrepancies (minor under/ over) between cytological and histological finding; 3 group of major discrepancies (major under/ over) between cytological and histological findings. Cytological and histological compliance was achieved in 194 (46.74%) patients. The total number of minor nonconformities was 192 (46%) cases. The total number of significant discrepancies between cytological and histological findings was 29 (6.9%) patients: 20 (4.8%) cases were found in the group NILM, hr. cervicitis HSIL and 9 (2.1%) cases in the group HSIL hr. cervicitis according to the results of histological examination. Conclusion. Cervical screening reduces the risk of breast cancer due to cytological examination of the cervix, but histological examination is crucial in making a correct diagnosis, since its result determines the choice of treatment method. The comparative analysis showed that in all groups there were cases of hypo- and hyperdiagnostics during cytological examination although the major discrepancies which can change treatment algorithm, were found only in 6.8% cases.

BACKGROUND: The association of Helicobacter pylori-negative gastritis with lymphoid follicles (LFs) in children is still unclear. Therefore, we aimed to investigate the natural history and significance of H. pylori-negative gastritis with LFs in children. METHODS: We identified children with histologically proven H. pylori-negative gastritis with LFs between June 2014 and January 2017. The children were invited for a follow-up examination. The clinical, endoscopic, and histological findings of the index esophagogastroduodenoscopy (EGD) were revised and compared to the follow-up findings. RESULTS: A total of 754 children underwent EGD. Among the 48 children diagnosed with H. pylori-negative gastritis, 17 (35.41%) had gastric LFs. Eight agreed to participate in the study. The mean follow-up was 25.58 ± 4.52 (range, 20.53-35.73) months. Three children still had histologic findings of chronic gastritis with LFs. Four children had resolution of the gastritis but still had LFs, and 1 patient had resolution of both the gastritis and LFs. CONCLUSION: LFs were still present in children with H. pylori-negative gastritis after a mean follow-up of 2 years, and in some children, despite resolution of the gastritis. Therefore, this histological finding might be a non-pathological feature in children and does not need any contribution or follow-up.

Eccrine squamous syringometaplasia (ESS) is a histological term describing a mature squamous metaplasia of the eccrine ducts. Eccrine squamous syringometaplasia is not an infrequent histological finding and may be associated with chemotherapy or with a variety of non-specific conditions including infections, neoplastic conditions, and inflammatory skin diseases. We report a 75-year-old man who developed ESS within lesions of leukemia cutis (LC). The patient had an inaugural diagnosis of acute myeloid leukemia (AML) and he was not on chemotherapy when the biopsy was performed.

Primary cardiac tumors are rare in pediatrics age group. Germ cell tumor although relatively common in mediastenum, but intracardiac mature teratoma with PDA are extremely rare histological finding reported in our department of pathology in 9 days old full term neonate.

Background: Cutaneous reactions, mostly on injection site after mRNA-based COVID-19 vaccines, have been reported but not with detailed histopathological characterization.Objectives: Characterization and classification of these reactions in a clinical and pathological point of view.Methods: Monocentric case series of 11 patients with cutaneous manifestations, clinically and histologically characterized after COVID-19 vaccination.Results: From January to June 2021, we recorded 11 cutaneous reactions to mRNA COVID-19 vaccines from BNT162b2 (n = 8) and mRNA-1273 (n = 3). Generalized reactions showing erythematous rash or purpura were the most common clinical presentation, and drug-reaction-like pattern was the most common histological finding.Conclusions: A proper clinicopathological classification will be helpful in the early diagnosis and management of the cutaneous reactions to mRNA COVID-19 vaccines.

In this case report of bilateral fibroadenomas of the breast in a 17-year-old male, we add to the relatively small number of reported cases. Initially assumed to be Highly Active Antiretroviral Treatment (HAART)-associated gynecomastia, our patient with congenital HIV, had normal hormone levels and was otherwise of normal secondary sexual development, except for an uncomplicated undescended testis. The conjunction of clinical finding, imaging and histological finding confirmed a fibroadenoma with gynecomastia. Only a small number of bilateral fibroadenomas in male have been reported in the literature. The finding of co-occurring gynecomastia strengthens the argument for gynecomastia as a necessary prerequisite for the development of fibroadenoma in male due to the quasi inexistent glandular tissue in a normal male breast (the so called sequential theory). The finding suggest that despite the scarcity of fibroadenoma in male, this condition can still be found in the spectrum of male breast pathologies.

Endocervical microglandular hyperplasia (MGH) is a reactive type of glandular lesion that may be confused with endocervical adenocarcinoma from the macroscopic and the colposcopic findings, as well as from a histological. Differential diagnosis is very important. Here, we report a case of a 21 years-old women with a challenging differential diagnosis in the colposcopy and a MGH as histological finding.

• The aim of this case report was to evaluate the treatment of vulvar lymphangioma applying photodynamic therapy (PDT). Patient aged 61 years, complained of vulvar region burning, local pain, which caused intense discomfort for over 5 years. She had developed vulvar edema, papules and vesicles that drained clear exudate, in which histological finding confirmed the vulvar lymphangioma. A red diode laser (Photon Lase III, DMC, Brazil) was applied locally after a 2% methylene blue aqueous solution (MB) in the vulvar target area. It was used a 660 nm wavelength light source, irradiance- 100 mW/cm2, radiant energy-20 J/cm2, exposer time-40 s, applied weekly at 10 points onto vulvar area in a total of 5 sessions. A clinical improvement post PDT was observed as well as a better quality of life. Post 3 years follow up no recurrence was observed. The clinical response followed MB- mediated PDT suggested a non-invasive, secure and low-cost treatment.

Background: In the cholesteatoma surgery ossicles can be replaced to reconstruct middle ear function. It is important that these ossicles are free of squamous epithelium, to prevent residual disease. This study focuses on the histological findings of the malleus and incus harvested during cholesteatoma surgery. Materials and Methods: Eighty middle ears ossicles were examined in vivo and histologically to consider the relationship of cholesteatoma to ossicles, grade of bone destruction and invasion of cholesteatoma to deeper layers of bone. Results: Serious ossicular destruction was observed more frequently in incus compared to malleus (p = 0.0065). Difference of ossicles destruction between children and adults was not significant (p = 0.3032). Deep invasion of cholesteatoma into the vascular spaces or inner core of the bone was not observed. Conclusions: Autograft ossicles from cholesteatomatous ears should not necessarily be rejected for reconstruction of the ossicular chain. Regarding the histological finding, the authors suggest mechanical cleaning of the ossicle surface to eliminate residual disease.

Subacute thyroiditis (SAT) is a self-limiting inflammatory condition of the thyroid gland in which multinucleated giant cells constitute a key histological finding. SAT is generally a clinical diagnosis and consequently its histological features are rarely encountered by pathologist. Herein, we present a case that exemplifies the characteristic clinical and pathological features of this entity. In addition, we compare SAT to other thyroid disorders characterized by the presence of multinucleated giant cells.

La calcinose scrotale est une maladie rare, benigne, de pathogenie incertaine caracterisee par de nombreux nodules indolores, durs du scrotum en absence de tout trouble metabolique systemique. Nous rapportons le cas d’un patient âge de 57 ans qui presente une calcinose scrotale de decouverte histologique fortuite associee a un eczema chronique et une hernie inguinale gauche. Nous discutons apres une revue de la litterature, les aspects pathogeniques, cliniques, therapeutiques et anatomopathologiques de cette pathologie mal comprise. Mots Cles: Calcinose; scrotum; kyste epidermique; reaction granulomateuse English Title: Bringing Histopathology in the Diagnosis of Scrotal Calcinosis: About a Case English Abstract Scrotal calcinosis is a rare, benign condition of uncertain pathogenesis characterized by multiple painless, hard lumps in the scrotum, without any systemic metabolic disorder. We report on the case of a patient aged 57 years who presented with scrotal calcinosis as an incidental histological finding associated with chronic eczema and a left inguinal hernia. We discuss, after reviewing the literature, the pathogenic, clinical, therapeutic, and pathologic aspects of this poorly understood condition. Keywords: Calcinosis; scrotum; epidermal cyst granulomatous reaction

Hepatic steatosis is a common histological finding in obese patients. Even mild steatosis is associated with delayed hepatic regeneration and poor outcomes following liver resection or transplantation. We sought to identify and target molecular pathways that mediate this dysfunction. Lean mice and mice made obese through feeding of a high-fat, hypercaloric diet underwent 70 or 80% hepatectomy. After 70% resection, obese mice demonstrated 100% survival but experienced increased liver injury, reduced energy stores, reduced mitoses, increased necroapoptosis, and delayed recovery of liver mass. Increasing liver resection to 80% was associated with mortality of 40% in lean and 80% in obese mice ( P < 0.05). Gene expression profiling showed decreased epidermal growth factor receptor (EGFR) in fatty liver. Meta-analysis of expression studies in mice, rats, and patients also demonstrated reduction of EGFR in fatty liver. In mice, both EGFR and phosphorylated EGFR decreased with increasing percent body fat. Hydrodynamic transfection of EGFR plasmids in mice corrected fatty liver regeneration, reducing liver injury, increasing proliferation, and improving survival after 80% resection. Loss of EGFR expression is rate limiting for liver regeneration in obesity. Therapies directed at increasing EGFR in steatosis might promote liver regeneration and survival following hepatic resection or transplantation.

Objectives: We aimed to determine the value and accuracy of ultrasound guided fine needle aspiration biopsy (FNAB) in diagnosis of parotid masses. Material and Methods: Data from patients who were operated for parotid masses at our clinic and performed preoperative ultrasound guided FNAB were analyzed retrospectively between 2003-2009. Fine-needle aspiration biopsy as a diagnostic test specificity, sensitivity values were calculated. Results: Thirty-eight of the patients (58%) were male and 28 (42%) were female with a mean age of 48 (18-81). FNAB was benign at 54 patients and malign at 12 patients. We did not have any nondiagnostic values. Fifty-five of the 66 patients (83%) were reported as benign and 11 of the patients (17%) were reported as malign at postoperatif postoperative pathological examination. The sensitivity, specificity, positive predictive and negative predictive rates were 64% , 91%, 58%, 93%. Conclusion: Ultrasound guided FNAB is a reliable method of preoperatively assessing parotid masses.

Background/aim The vast majority of colorectal carcinomas (CRCs) evolve from mucosa not associated to lymphoid tissues aggregates via the adenoma-carcinoma sequence or via the serrated pathway. Rarely CRCs evolve from gut mucosa associated to lymphoid tissue (GALT). Materials and methods Based on the presence of a circumscribed elevation in the colorectal mucosa, GALT carcinomas are also referred to as dome carcinomas (DC). Descriptions of the surface mucosa covering 21 GALT-CRCs appearing in pathological reports were reviewed. Results Three of the 21 GALT-CRCs fulfilled the criteria of dome carcinoma. Of the remaining 18 GALT-CRCs, nine were described as polypoid lesions, five as plaque-like lesions, two as sessile elevated lesions or mass, one as ulcerated and one as histological finding. Hence, only 14.3% (n=3) of the 21 GALT-CRCs displayed a dome configuration, whereas the majority, 85.7% (n=18), exhibited structures other than dome shapes at gross or at histologic examination. Conclusion It becomes apparent that by using "dome" in addressing carcinomas in the colorectal mucosa, many cases of GALT carcinomas might be overlooked. Another drawback of using the "dome" nomenclature is that dome-like outlines may be detected in small metastatic tumors in the submucosa or in small colorectal carcinomas not arising from GALT mucosa. Instead, by using "GALT carcinoma", that is the histologic diagnosis in addressing these neoplasias, all cases of GALT-CRCs will be included.

The present study aimed to determine the prevalence of Kamino bodies in Reed nevus, since most studies to date show conflicting data on this issue. This was a retrospective observational study, in which the histopathology of 19 Reed nevus lesions were reviewed. The slides were stained by hematoxylin and eosin and periodic acid-Schiff, with a special focus placed on the identification of Kamino bodies. Some clinical data were also collected. The median patient age was 12 years (range of 2 to 58). The women to men ratio was 5:4. Lesions were located on different parts of the body. Kamino bodies were found in eleven lesions (57.89%). five showed pigmented Kamino bodies (26.31%), four non-pigmented Kamino bodies (21,05%), and 2 (10.52%) had both. Kamino bodies, pigmented or not, are a common histological finding in Reed nevus and may well represent a good marker to differentiate these from malignant melanomas.

PURPOSE OF REVIEW: The histological finding of pleural inflammation (pleuritis/fibrosis) is frequently found in pleural biopsies taken at thoracoscopy. This is a nonspecific finding, representing a common endpoint of many pleural conditions. Additional features, such as malignant cells, caseating granulomas and evidence of vasculitis, are required to make an aetiological histological diagnosis; in the absence of these features, the term 'nonspecific pleuritis/fibrosis' (NSP) is used. The cause of NSP is obscure and presents a particular dilemma: whether this apparently benign result represents a 'false-negative' sampling error in malignancy. RECENT FINDINGS: In a recent longitudinal follow-up study of 142 patients undergoing thoracoscopy, NSP was found in 31%. Of these, a likely cause for the NSP was found in 38% and malignancy occurred in 12%. These data were consistent with previous studies. SUMMARY: NSP is a histological diagnosis made in approximately 30-40% of patients with an undiagnosed exudative pleural effusion. The majority of cases adopt a benign course, although 8-12% may be subsequently found to have malignancy, particularly mesothelioma. In 25-91% no cause for the NSP is found; these patients are considered to have 'idiopathic pleuritis'. Prolonged follow-up, with occasionally further (usually more invasive) biopsies, is essential to rule out malignancy. © 2011 Lippincott Williams and Wilkins, Inc.

Objectives: A persistent problem in generating a functional myocardial patch is maintaining contractions in a thicker construct. Thus far, we have successfully created contracting constructs with a defined directionality by seeding neonatal rat cardiomyocytes (CMs) on decellularised porcine small-intestinal submucosa (SIS). Here, we report our efforts in generating a thicker contracting construct by combining CM cell sheets with CM-seeded SIS. Methods: Porcine SIS was decellularised, opened along the longitudinal axis, fixed in a metal frame (45 mm � 25 mm) and seeded onto the submucosal side with neonatal rat CMs at a density of 1.8 � 10 5 cells cm � 2 . CM sheets were prepared using temperatureresponsive dishes by seeding CMs at a density of 4.0 � 10 5 cells cm � 2 . Three days after CM seeding, one- or three-layered CMs sheet(s) were stacked onto seeded SIS. Construct contraction was observed for an additional 10 days followed by histological analysis. Results: Stacked CM sheets contracted spontaneously and synchronously with seeded SIS after adherence. A large portion of analysed constructs showed a defined contraction direction, parallel to the longitudinal axis (seeded SIS: 83%, seeded SIS + 1 sheet: 70%, seeded SIS + 3 layered sheets: 71%). This finding was in agreement to the histological finding of aligned CMs parallel to the longitudinal axis. The thickness of seeded SIS with and without three-layered sheets was approximately 800 mm and 500 mm, respectively. Conclusions: By combining layered CM sheets with CM-seeded SIS, a three-dimensional myocardial patch with contraction in a defined direction was successfully generated. This may represent an intermediate step to a multiple layered, vascularised contractile myocardial graft. # 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Galli-Galli disease is a rare genodermatosis currently regarded as an acantholytic variant of Dowling-Degos disease. The 2 diseases have the same clinical features: reticular hyperpigmented macules in the great skin folds, erythematous scaly papules and plaques, comedo-like lesions, and pitted perioral scars, and the only differentiating characteristic is the histological finding of acantholysis, usually without dyskeratosis. We describe the case of a patient with hyperpigmented papules in the skin folds as the only sign of Galli-Galli disease, and we present a review of the literature.

Fox-Fordyce disease is a rare skin condition characterized by the presence of multiple pruritic follicular papules in areas rich in apocrine glands, such as the axillae, mammary areolae, or genital regions. There is a high degree of variability in the histological findings seen in Fox-Fordyce disease. In addition to those described as typical of this entity, such as dilation of the infundibulum and hyperkeratosis and spongiosis of the infundibular epithelium, many other histological changes can be observed. We report the case of a 21-year-old woman with Fox-Fordyce disease and highlight the importance of perifollicular xanthomatosis as a key histological finding in the diagnosis of the disease.

Fox-Fordyce disease is a rare skin condition characterized by the presence of multiple pruritic follicular papules in areas rich in apocrine glands, such as the axillae, mammary areolae, or genital regions. There is a high degree of variability in the histological findings seen in Fox-Fordyce disease. In addition to those described as typical of this entity, such as dilation of the infundibulum and hyperkeratosis and spongiosis of the infundibular epithelium, many other histological changes can be observed. We report the case of a 21-year-old woman with Fox-Fordyce disease and highlight the importance of perifollicular xanthomatosis as a key histological finding in the diagnosis of the disease.

The present study was carried out to examine the bone healing effect of a magnet as the feasibility test for clinical application. The surgical technique of tibia puncture was performed with male Sprague Dawley rats for investigating radiological and histological findings. The treated group was attached the magnet, and control group was attached the placebo magnet for 4, 6, and 8 weeks respectively. The rats were taken a radiograph for examining radiological findings on 2-weekly interval for 8 weeks. Also, the rats were partly euthanized for investigating histological findings on 2-weekly interval from 4 week to 8 week. In the magnet treated rats, the healing process of bone trauma was positively stimulated to compare with control rats.

Multinucleated keratinocytes (also known as multinucleated epidermal giant cells) are a frequently overlooked histological finding in noninfectious inflammatory dermatoses. They are sometimes found in conditions characterized by chronic rubbing and pruritus, such as lichen simplex chronicus or prurigo nodularis, and may be a helpful clue in making the clinical diagnosis. This finding must be differentiated from other conditions characterized by multinucleated keratinocytes on histopathology, specifically herpes simplex, varicella zoster, or measles viral infections. The authors present a case series of 2 patients with unique clinical noninfectious diagnoses but similar histopathologic findings on biopsy. The histopathologic findings on both cases demonstrated multinucleated keratinocytes, which were related to manipulation of the epidermis.

A 54-year-old lady presented with a mass in the left atrium causing an acute mitral valve pseudo-stenosis. The tumour mass was assumed to be a myxoma. The patient was scheduled for tumour mass extirpation to clear the obstruction of the mitral orifice. Histological finding from the acquired specimen showed a leiomyosarcoma, as a rare primary malignant cardiac tumour.

São descritos os aspectos epidemiológicos, clínicos e patológicos de um surto de intoxicação por Pteridium arachnoideum e Pteridium caudatum em bovinos no Estado de Mato Grosso. A distribuição dessas plantas no Estado, a intensidade de invasão de pastagens e alguns fatores associados à invasão das pastagens por Pteridium spp. são também descritos. Pteridium spp. foi observada em 83 propriedades de nove municípios de Mato Grosso e deste total, amostras de 22 propriedades foram coletadas para identificação taxonômica. Em 22 propriedades identifica-se P. arachnoideum e em duas dessas havia também P. caudatum. O desmatamento e a realização de queimadas parecem estar relacionados com a invasão de Pteridium spp. nas pastagens. Na propriedade em que ocorreu a doença, 306 bovinos foram introduzidos em uma pastagem formada por Brachiaria brizantha intensamente invadida por P. arachnoideum e P. caudatum e desses 22 bovinos adoeceram e morreram. Os principais sinais clínicos foram febre alta, apatia, fadiga, fraqueza e decúbito. Na necropsia havia graus variáveis de hemorragias em vários órgãos e cavidades e infartos ocasionais. Microscopicamente, a alteração mais importante consistiu em aplasia severa da medula óssea vermelha. Os achados epidemiológicos, clínicos e patológicos associados à identoificação taxonômica da planta fundamentam o diagnóstico de intoxicação aguda por P. arachnoideum e P. caudatum em bovinos. O crescente desmatamento e a frequente utilização de queimadas em Mato Grosso podem contribuir para que esta doença venha a ser uma importante fonte de prejuízos para a pecuária do Estado.

Melasma is a symmetrical hypermelanosis of the exposed skin characterized by brown macules on the sun-exposed areas of the skin. The present study was carried out on 43 patients to analyze the correlation between histopathological features with clinical and Wood′s light examination. The study showed a clinical and histopathological discordance of 16.2%. Solar elastosis (55.8%) was the single most common histological finding apart from increased melanin concentration, epidermal flattening and dermal lymphomononuclear inflammation.

© 2015 The Authors. doi: 10.2340/00015555-1908 Journal Compilation © 2015 Acta Dermato-Venereologica. ISSN 0001-5555 Porokeratosis (PK) is a disorder of clonal hyperproliferation of keratinocytes. It has several clinical manifestations characterised by variably sized papules or plaques with a fine peripheral keratotic rim and central atrophy accompanied by a histological finding of cornoid lamella (1). Cutaneous lesions vary in their appearance and distribution. Disseminated superficial actinic porokeratosis (DSAP) is characterised by numerous papules and plaques distributed over sun-exposed sites. Coexistence of disseminated superficial and disseminated warty PK is very rare (2). A recent review on DSAP found no published controlled trials evaluating its treatment (3). The knowledge base for treatment is derived exclusively from case reports. To our knowledge, none of the published cases of disseminated superficial and warty PK describe the results of systemic treatment with acitretin.

We reported a case of a 74-year-old male with pseudoglandular squamous cell carcinoma on the scrotum. An erythematous lesion was first noticed about ten years before visiting our clinic. During the enlargement of the erythematous lesion, several bean-sized nodules also occurred. A biopsied specimen from the nodular lesion showed many tubular lamina lined with several layer of epitheliums, histologically diagnosed as pseudoglandular squamous cell carcinoma. Histological finding of another specimen from the slightly erythematous hyperkeratotic lesion was compatible with Bowen's disease. For treatments, the whole skin of scrotum was excised surgically and a combined chemothrapy with carboplatin and fluorouracil was employed. Histological finding of Bowen's carcinoma was co-existed adjacent to that of pseudoglandular squamous cell carcinoma in the excised specimens. These findings suggest that the lesion of Bowen's disease may develop in the patterns of pseudoglandular squamous cell carcinoma and Bowen's carcinoma.

An osseous metaplasia is a phenomenon which has been described in a wide variety of tissue types with respect to both neoplastic and non-neoplastic conditions. However, an osseous metaplasia is exceedingly rare in colonic polyps. We are herein representing a case of osseous metaplasia in a juvenile rectal polyp in a six year old boy, with review of the literature on the suggested mechanisms of its aetiology.

For sonographic assessment of the endometrium in postmenopausal women, measurement of the maximum thickness is used in many cases as the sole criterion. The cut-off values stated in the literature, however, vary considerably. This prospective study examined 200 female patients in order to ascertain the value of echomorphology in addition to endometrial biometry. Up to an overall endometrial thickness of 3 mm, we observed only histologies without any pathological findings, whereas from an endometrial thickness of 10 mm upwards, only polyps, hyperplasias and carcinomas were found. In more than a third of our patients, the endometrial thickness was between 3 and 10 mm where the structure of the endometrium could reflect the possible histological finding: homogeneity, low echo and a sonographically depictable central echo between symmetrical endometrial leaves were an indication for absence of pathological findings, whereas heterogeneity and high echogenicity were pointers for pathological changes. In contrast to the sole measurement of endometrial thickness in the postmenopause, the combined metric and morphological parameters improve not only the predictability of pathological findings but, above all, the selectivity of the vaginosonographic assessment of the endometrium in postmenopausal women.

An experimental model of haemosiderosis, using the chicken, was developed to examine the distribution of iron in the liver following an injection of iron dextran and to allow calibration of image analysis readings. Image analysis was used as a tool to quantify the stainable iron present in hepatic tissue obtained from wild and captive birds presented for necropsy. A retrospective study of 180 necropsy cases, representing 40 different species of bird, is described. Statistical evaluation of the amount and distribution of stainable iron in the liver tissue of birds from different taxonomic orders indicated that the concentration of iron measured in liver tissue was significantly different in different species of bird. The results of the study showed that hepatic haemosiderosis is a common histological finding in most avian species examined. Although not necessarily associated with overt liver disease, it is often associated with concurrent malignant and infectious diseases. The presence of excess stainable iron in the liver is probably a reflection of an altered iron metabolism associated with increased turnover of tissue iron. This alteration may occur following starvation or trauma.

Aiming at improving the diagnostic accuracy not to overlook irreversible cholecystitis such as gangrenous cholecystitis, 21 cases operated on for acute cholecystitis at the hospital in a recent 6-year period were studied for each histological finding of the excised specimens in terms of diagnostic accuracy.The results were: In judging the degree of inflammation in acute cholecystitis leukocytes counts at the first visit, characteristics of the gallbladder wall by ultrasonography and serial-ultrasonography, swelling of the gallbladder by serial-ultrasonography, and observation of debris changes were useful. Such a case, in which gallbladder swelling increases, debris in the gallbladder does not disappear, and irregular gallbladder wall is observed, is strongly indicated to be of gangrenous cholecystitis.

A 62-year-old female patient suffered from numbness and resting pain in the right ring and little fingers for 3 years. We confirmed cubital tunnel syndrome with electrodiagnostic study and performed the operation. We found seven firm consistent nodules, compressing the overlying the ulnar nerve, proximal to the medial epicondyle in the operation field. Histological finding showed synovial chondromatosis. We report a rare case of a patient with cubital tunnel syndrome caused by synovial chondromatosis.

症例は52歳,男性で,肝機能異常精査を目的として入院した.検査成績は,ALP,γ-GTP, LAPが高値を示したが,T. Bilは正常であった.IgG, IgMは高値を示し,抗ミトコンドリア抗体が陽性であった.肝組織所見では,慢性非化膿性破壊性胆管炎の像を呈しており,Sheuer 1期PBCと診断した.退院後患者は黄疸,掻痒感などの症状が出現することなく外来通院していたが,3年6ヵ月後に急性胆嚢炎を併発し胆嚢摘出術を受けた.手術時の肉眼所見で肝表面は粗大結節状を呈していた.同時に施行された肝生検組織所見では,門脈域は線維性に結合し偽小葉の形成も認め,小葉間胆管は瘢痕化し消失しており,Sheure 3期ないし4期のPBCと診断した.本例は無症候性PBCの予後と組織学的推移を論じる上で貴重な症例であると考えられた.

In cases of schistosomiasis, the appendix is commonly infested. It is not known if this is a predisposing factor for appendicitis, or a mere coincidental histological finding.A total of 56 patients (51 males and 5 females) underwent appendectomy for schistosomal appendicitis over a 10-year period at Dammam Central Hospital. The histological slides of 41 of the patients (73.2%) were retrospectively studied.The highest incidence of schistosomal appendicitis was recorded in the 21-40-year age group. Ova were seen in the submucosal layers of all the excised appendices. The most common tissue responses were submucosal fibrosis (92.7%) and eosinophilia (87.8%), followed by the presence of suppurative inflammation (80.5%). Granulomatous reaction was evident in only 13 cases (31.7%). A striking feature was atrophy of submucosal lymphoid follicles in 70.7% of the cases. Hyperplasia of lymphoid follicles and serosal granulomas were rare (2.4%). Similar tissue responses were histologically seen in four normal appendices examined.Appendiceal infestation may predispose to appendicitis in the majority of affected cases, but in others, it may well be a mere coincidental histological finding. However, preoperative knowledge bears no clinical significance and does not alter management.

Melkersson-Rosenthal syndrome (MRS) classically shows a triad of orofacial swelling, fissured tongue and facial palsy, more commonly the oligosymptomatic form. The orofacial swelling is characterised by swollen reddish-brown non-pruritic lips and facial oedema. In one-third to one half of patients, fissured tongue is seen, which also aids in diagnosis. The histological finding of MRS includes non-caseating, sarcoidal granulomas, but their absence does not exclude the diagnosis. All these findings together form a basis for a cautious search for confrontational reasons for the symptom complex of MRS.

Characteristically pathognomonic findings are only those that can be evidently measurable at quiescent phases. Adamandiades-Behcet syndrome (or Behcet's disease) is a rare idiopathic multisystem disease of

20 Peliosis hepatis is a rare condition characterized by dilatation of hepatic sinusoids and blood-filled spaces in the liver mainly observed in subjects exposed to toxic substances or estrogens, which is frequently asymptomatic. Non-cirrhotic idiopathic portal hypertension (NCIPH) is also a vascular disease of the liver rarely observed in European countries, which is usually diagnosed only when the hemorrhagic complications of portal hypertension occur. We report a case of NCIPH in a young Caucasian male who was diagnosed with liver peliosis, showing ultrasonographic and endoscopic signs of portal hypertension four years after. A second biopsy was diagnostic for NCIPH. Even if the pathogenesis remains obscure, peliosis hepatis can be considered as an early sign of vascular disease of the liver, which may progress to more definite conditions.

A 50-year-old Japanese female of acral lentiginous melanoma in situ involved into deeper eccrine duct epithelium on the right middle finger was described. Histopathologically, increased number of atypical melanocytes were proliferated involving both lower epidermis and deeper portion, 643μm from epidermal basal layer, of eccrine sweat duct epithelium, which is a rare histological finding in usual ALM. It is well known and interesting that malignant melanoma in situ, especially ALM in situ often proliferate involving into superficial portion of eccrine duct epithelium, however, our case was exceptional.We supposed that ALM in situ cells could proliferate with affinity to eccrine duct epitherlium. Taken together, we need careful treatment and follow-up for ALM in situ with proliferation into the deeper portion of eccrine duct as our case.

The article presents an unique case of trans-sexual person (FtM) with histological finding of pre-invasive cervical carcinoma after performed hysterectomy.