ABSTRACT
Background@#Coronavirus disease 2019 (COVID-19) has emerged as a pandemic for more than 2 years. Autopsy examination is an invaluable tool to understand the pathogenesis of emerging infections and their consequent mortalities. The aim of the current study was to present the lung and heart pathological findings of COVID-19–positive autopsies performed in Jordan. @*Methods@#The study involved medicolegal cases, where the cause of death was unclear and autopsy examination was mandated by law. We included the clinical and pathologic findings of routine gross and microscopic examination of cases that were positive for COVID-19 at time of death. Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed through molecular detection by real-time polymerase chain reaction, serologic testing for IgM and electron microscope examination of lung samples. @*Results@#Seventeen autopsies were included, with male predominance (76.5%), Jordanians (70.6%), and 50 years as the mean age at time of death. Nine out of 16 cases (56.3%) had co-morbidities, with one case lacking such data. Histologic examination of lung tissue revealed diffuse alveolar damage in 13/17 cases (76.5%), and pulmonary microthrombi in 8/17 cases (47.1%). Microscopic cardiac findings were scarcely detected. Two patients died as a direct result of acute cardiac disease with limited pulmonary findings. @*Conclusions@#The detection of SARS-CoV-2 in postmortem examination can be an incidental or contributory finding which highlights the value of autopsy examination to determine the exact cause of death in controversial cases.
ABSTRACT
Epstein-Barr virus associated smooth muscle tumors [EBV-SMT] are rare neoplasms that can occur in various anatomical locations. They mainly affect immunocompromised patients, and their clinical presentation is variable depending on size and organ involvement. They can pose diagnostic challenges, therefore if they are not considered in the differential diagnosis, they can be definitely misdiagnosed. Synchronous and multifocal involvement has been reported. Although malignant behavior maybe rarely seen; most behave in a benign fashion with favorable clinical outcome. We herein report an unusual case of synchronous EBV-SMT that occurred in the lung and liver in a 44-year-old female patient 7 years after renal transplantation. Both lesions were histologically examined revealing benign appearing spindle cell neoplasm that was positive on immunohistochemical staining for smooth muscle actin, desmin, and caldesmon with strong nuclear staining for EBV RNA by in situ hybridization. A brief pertinent literature review and discussion of EBV-SMT pathogenesis is offered
ABSTRACT
Fatal abdominal sarcomatosis is a rare complication secondary to gastrointestinal stromal tumor [GIST] arising from the small intestine. Here, we describe a 49-year-old man who presented with massive ascites and multiple mesenteric solid masses. Autopsy showed large necrotic mass [19x14x8.0 cm] surrounding the terminal ileum with multiple smaller nodules on the omentum and mesentery. Histological examination revealed highly cellular, predominantly bland, spindle cells with low mitotic activity. Gastrointestinal stromal tumor was confirmed by strong positive staining for c-KIT [CD 117]. Our case is an example of fatal intra- abdominal sarcomatosis of GIST where the histological features were essentially bland