Coarctation of the abdominal aorta in elderly patients. Case report and review of the literature

Coarctation of the abdominal aorta as a congenital disease is infrequent, the diagnosis mostly being made at an early age because of renovascular hypertension. Patients who reach the age of 40 more often tend to have the problems located distally to the renal arteries. A 66-year-old female is described, who developed an aortic occlusion, renovascular hypertension and uremia. She was cured with a bifurcation graft and a patch angioplasty of a stenotic renal artery and nephrectomy of the contralateral kidney with an occluded artery without refilling. A literature survey is made of patients older than 40 years.     

先天性腹壁缺损36例尸体解剖和组织学观察

目的：探讨腹壁缺损的病理形态学变化,方法：对36例腹壁缺损进行尸体解剖,按照Hartwig方法分型,并对24例不同组织和胎盘进行组织学观察。结果：36例腹壁缺损多伴有其它畸形,包括肢体,颜面,神经管,泌尿生殖及消化和心血管系统,腹壁缺损皮肤－膜移行区为复层扁平上皮逐渐向意志层上皮过渡,间质由丰富胶原纤维变为疏松的结缔组织,证实了羊膜外胚层过渡带的存在。5例肾脏和1例脑组织中发策钙化病灶,胎盘表现绒毛发育不同步,绒毛间质水肿或纤维化,有血管增生,血栓形成等变化。部分病例提示有绒毛炎,13例孕母曾有TORCH感染,11例胎儿脏器TORCH PCR－DNA扩增检测阳性,结论：在胚胎腹壁形成期,如果受到某些致畸因素的干扰,除发生腹壁缺损外,还将出现多种复杂畸形,腹壁缺损的致畸因素不能除外TORCH如巨细胞病毒等感染的可能。     

The autopsy lexicon: suggested headings for the autopsy report

CONTEXT: Although standard autopsy texts and other publications discuss the general content of autopsy reports, and some provide examples of autopsy report formats, no publication to date has recommended specific headings for autopsy report organization. The College of American Pathologists Autopsy Committee decided it would be helpful to provide suggestions for autopsy report headings to foster more standardized autopsy reporting, to facilitate review of reports by third parties, and to facilitate searches of electronically stored autopsy reports. OBJECTIVES: To create a model document (named the Autopsy Lexicon), which defines standard categories of information that are useful to include in autopsy reports; to offer specific wording for the headings of various sections of the report; and to explain the rationale for including the various items of information and headings. PARTICIPANTS AND METHODS: The members of the Autopsy Committee of the College of American Pathologists prepared the document by reviewing various examples of autopsy report formats, identifying specific categories of information usually contained in such reports, and developing wording for various sections of the autopsy report that would contain specific information. A draft was submitted to 45 members (including 12 forensic pathologists) of the College of American Pathologists for review, comment, and reality testing. Reviewers included pathologists from both community and academic settings. Comments of reviewers were incorporated to the extent possible. RESULTS: The Autopsy Lexicon was prepared and is a model document for autopsy pathologists who wish to define an autopsy template of headings for consistent organization of autopsy reports. CONCLUSIONS: The Autopsy Lexicon is available to foster more uniform reporting of autopsy information, which may facilitate review of autopsy reports and retrieval of information from electronically stored autopsy reports.     

Erdheim-Chester disease. Case report with autopsy findings

Erdheim-Chester disease is a rare pathologic entity characterized by symmetrical radiodensities in the metaphyseal and the diaphyseal portions of the long bones. Fibrosis, osteoblastic cortical bone deposition, and fibroxanthomatous granulomas with lipid-laden macrophages and multinucleated giant cells, which have a particular tropism for connective and adipose tissues, are the pathologic hallmarks. To our knowledge, 27 cases have been reported in the literature since the entity was first described in 1930. Protean clinical features range from a focal and asymptomatic process to a multisystemic infiltrative disease. We describe the clinical course of a new case and review the extensive pathologic findings at autopsy, including those demonstrated by light and electron microscopy and cytochemical and immunocytochemical studies.     

Familial CHARGE syndrome: clinical report with autopsy findings

We report on a patient with CHARGE syndrome, as manifested by a coloboma of the optic nerve head, congenital heart defect (ASD, VSD, and parachute mitral valve), choanal atresia, severe growth retardation, genital hypoplasia, abnormal ears, cleft lip and palate, and pectus carinatum. His chromosomes were normal. He died at 19 months. His mother was short and had hearing impairment, choanal atresia, and a coloboma. We suggest that this represents evidence for dominant transmission of this disorder in this family. Other familial cases from the literature are reviewed.     

New method of abdominal wall incision in autopsy]

The incision of the anterior abdominal wall proposed by the author is begun (after dissection of thoracic tissues on the median line) from processus xyphoideus sterni and led toward left regio iliacae (on the straight line or first on the left regio hypogastricae to its middle, then on liniae pararectalis) approximately till the middle of ligamentum Pouparti. Then from the lower end of this incision a transversal incision of superpubica is made at an angle, about 4--6 cm above simphysis ossium pubis, in adults 15--20 cm long. This incision provides a wide access to the organs of the small pelvis, demonstration of their changes on the spot, goes aside from median wounds or scars, and permits to penetrate from the transversal incision along the subcutaneous cellular tissue to the organs and tissues of regio subpubica.     

A family of Gardner's syndrome with report of an autopsy case

A family with Gardner's syndrome including one autopsy case is reported. A 22 year-old man had multiple polyposis of the colon and the small intestine, epidermal cysts, soft part tumor of the abdominal skin and osteomas in the calvarium and rib, and died of a carcinoma in the transverse colon and embolism of the brain. Histologically, all polyps were diagnosed as adenomatous polyp. The greater their diameter, the higher the tendency of atypism was observed. However, the polyps around the cancer were few, small, and with low atypism, and we could not obtain evidence showing direct transformation of adenomatous polyps into carcinoma. His two elder brothers had multiple polyposis of the colon, epidermal cysts and osteomas in the calvarium or mandibular bone, but are still alive.     

Di-George's syndrome with multiple infections (an autopsy report)

Di-George's syndrome is a rare condition of congenital immunodeficiency. An infant presented as hypocalcemic tetany with multiple infections. Autopsy confirmed the hypoplasia of thymus and thyroid associated with other anomalies. A brief of the relevant literature is presented.     

血栓性血小板减少性紫癜:一例尸检分析

死者女,48岁.因右下腹疼痛6 d,全身多处淤点、淤斑,多次发生晕厥、全身抽搐,意识不清1 d于2005年1月21日入当地医院,入院后行阑尾切除术.术后1 h出现阴道流血,较平时月经量多1倍以上.     

Cardiac botryomycosis: an autopsy report

Visceral botryomycosis is rare, and documented sites are lung, brain, kidney, liver and prostate. This report describes a rare autopsy case of disseminated visceral botryomycosis, with bulky, grape-like botryomycotic vegetations in the heart, and similar abscesses in the lungs and bone marrow. This is the first such report in the literature to the best of our knowledge.     

Pure non-gestational choriocarcinoma of ovary a case report with autopsy findings

Primary choriocarcinoma of the ovary (PCO) is rare. This can be gestational (GCO) or non-gestational (NGCO) in origin. It is difficult to differentiate between CGO and NGCO. Non-gestational choriocarcinoma carries a bad prognosis than GCO. We present a case of NGCO who had pulmonary metastasis.     

Jarcho-Levin syndrome--a report of an autopsy case with cytogenetic analysis.

Jarcho-Levin syndrome (JLS) is a condition manifested by malformations of vertebral bodes and related ribs. There are two major subtypes spondylocostal dysostosis and spondylothoracic dysostosis, with different survival rates, associated malformations, and inheritance patterns. We have experienced an autopsy case of a premature female fetus with multiple congenital anomalies. She was 30 weeks of gestational age, born as the second baby of twins and expired shortly after birth. A post-mortem examination revealed multiple abnormalities including cervicothoracic hemivertebrae, a diminished number of right-sided ribs, and pulmonary hypoplasia with left diaphragmatic hernia. In addition, there were anomalous rotation of the foregut, unfused pancreas and anomalous drainage of the superior vena cava. Chromosomal analysis showed 46, XX, del(4)(q ter).     

Giant cell tumor of the lung: An autopsy case report with immunohistochemical observations

Tumors resembling giant cell tumor (GCT) of bone are well known to occur in other organs and many cases have been reported to date. While GCT occurring as primary lesions in the lung are extremely rare, the authors experienced such a tumor at an autopsy of a 77 year old woman and subsequently performed histological and immunohistochemical examinations. The clinical and morphologic characteristics of this case are documented, and the literature concerning this type of tumor is reviewed. The present tumor of the lung was histologically characterized by proliferation of benign-looking osteoclast-like giant cells in association with slightly atypical mononuclear cells. The tumor cells were immunohistochemically positive for histlocytic markers but negative for epithelial markers. This case appears to be the first reported benign giant cell tumor of the lung in which histiocytic differentiation of mononuclear cells was suggested by immunohistochemistry.