[Clinicopathological analysis of sudden cardiac death cases by autopsy].

OBJECTIVE: To explore the major correlation factors and cardiac pathological changes of sudden cardiac death (SCD). METHODS: The clinical and pathological profiles of 119 SCD cases at Wuxi People's Hospital Affiliated to Nanjing Medical University from January 1985 to March 2012 were retrospectively analyzed. And the parameters of gender, age, causes of death and pathological changes of SCD were included. RESULTS: Among them, the primary etiologies were coronary atherosclerotic heart disease (n = 53, 44.5%), hypertensive heart disease (n = 9, 7.6%), myocarditis (n = 13, 10.9%), acute pulmonary embolism (n = 8, 6.7%) and myocardiopathy(n = 3, 2.5%). The heart weights of male and female cases were (407 ± 126) and (349 ± 101) g respectively. Among 53 cases of coronary heart disease, there were 28 cases (52.8%) of grade IV coronary artery atherosclerotic stenosis and 17 were involved with multiple branches. The differences of coronary artery stenosis were insignificant between gender and age (P > 0.05). Acute myocardial infarction occurred in 18 cases and 15 of them were complicated with old myocardial infarction (OMI) while there were 27 cases of simple OMI. Twenty cases (16.8%) without obvious cardiac organic pathological changes were classified as juvenile sudden unexplained death. CONCLUSIONS: Sudden and dangerous SCD frequently occurs in elders. Multiple severe coronary atherosclerotic stenosis is an important pathological hallmark of SCD.

Interdigitating dendritic cell tumor of the lymph node in the right submaxillary region: a case report and review of the literature.

Interdigitating dendritic cell tumor/sarcoma is an extremely rare neoplasm that mainly occurs in the lymph node, with only 51 cases reported in the literature to date. The authors report the case of a 41-year-old woman who presented with a 4-month history of a gradually enlarging painless mobile lymphadenopathy in the right submaxillary region. The lymph node mass was completely resected and was treated with 1 cycle of CHOP chemotherapy. After 10 months, she was alive with no evidence of disease. Because interdigitating dendritic cell sarcomas are rare and can show morphologic and immunohistochemical heterogeneity, correct diagnosis requires a high index of suspicion and complete pathological study.

Giant-cell anaplastic carcinoma with osteoclastic giant cells of the chest cavity: a distinctive form of thymic carcinoma?

Here, the authors describe a case of giant-cell anaplastic carcinoma with osteoclastic giant cells of the chest cavity-which could be a distinctive form of thymic carcinoma-which expressed CD5 and CD45. To the authors' knowledge, there has been no previous report on this subject. A 62-year-old woman presented with continuous pain in the left back associated with coughing and shortness of breath for more than 2 months prior to referral to the hospital. Palliative resection of a mediastinal tumor was performed. During the operation, it was found that the mass occupied most of the chest invading the chest wall, aorta, vena cava, and lung tissue. The patient soon died from diabetic complications in spite of anti-infection treatment. The tumor was composed of large areas of necrosis and anaplastic neoplastic giant cells with high mitotic activity, and osteoclast-like cells; there was marked inflammatory cell infiltration. The anaplastic neoplastic giant cells were immunoreactive for CKpan, CD5, CD45, VIM, and p53. Approximately 50% to 60% of the tumor cells showed immunoreactivity for Ki-67. In situ hybridization for Epstein-Barr virus-encoded RNA was negative for tumor cells and nonneoplastic osteoclastic giant cells. Because this tumor is very rare, extensive clinical, radiological, and morphological examinations as well as immunohistochemical studies are essential to make the diagnosis.

[Pathologic and immunohistochemical study on lethal primary brain stem injury].

OBJECTIVE: To study the histopathologic changes of primary brain stem injury and to investigate their significance in the diagnosis of primary brain stem injury. METHODS: Sixty-five autopsy cases died of primary brain stem injury and other diseases were enrolled into this study. The cases were subdivided into brain stem injury group (n = 25) and control group (including 20 cases died of cardiovascular disease and 20 cases died of non-cardiovascular diseases). The brain stem tissue sections were stained with hematoxylin-eosin and silver impregnation techniques. Immunohisto chemical study for glial fibrillary acidic protein, neurofilament, amyloid-beta and myelin basic protein was carried out. The widest cross diameters of 10 axons highlighted by immunostaining were measured in each low power field (x 100) through light miscroscopy in all the cases studied. RESULTS: In comparing with that of the control group, there were differences in the degree of contusion lesion, reactive astrocytosis, edema and pathologic changes of neuronal cells present in the brain stem injury group and was statistically significant (P < 0.05). The axons locating in the brain stem injury group showed a distinctive histology by the appearance of significantly larger diameters (P < 0.05). CONCLUSIONS: Primary brain stem injury demonstrates certain distinctive histopathologic changes and measurement of axonal diameters provides an additional quantitative index useful in autopsy diagnosis.