[About the first publication of I.M. Sechenov. (To the 195th anniversary of his birth)]. / O pervoi publikatsii I.M. Sechenova. (K 195-letiyu so dnya rozhdeniya).

Ivan Mikhailovich Sechenov is a Russian physiologist, a natural scientist, and the creator of the Russian physiological school. The classic work «Reflexes of the Brain¼, published in 1863, became revolutionary in its own way for medicine and society, since the reflex nature of conscious and unconscious activity was proved. Along with numerous well-known scientific works, there is an early student publication in the Moscow Medical Journal published by A. I. Polunin. It describes the medical history of a patient with a tumor who was unsuccessfully treated for a long time in accordance with the humoral theory of pathology. This publication makes it possible to understand why I. M. Sechenov became disillusioned with practical medicine, but found his vocation in the study of physiology. The article is devoted to the 195th anniversary of the birth of I. M. Sechenov.

[IgG4-associated sclerosing cholangitis mimicking cholangiocellular carcinoma]. / IgG4-assotsiirovannyi skleroziruyushchii kholangit, protekayushchii pod maskoi kholangiotsellyulyarnoi kartsinomy.

The paper presents an update on the epidemiology, main clinical manifestations, and diagnostic methods in IgG4-associated sclerosing cholangitis. It highlights the importance of morphological and immunohistochemical studies in the diagnosis of the disease. It describes a case of diagnosing IgG4-associated sclerosing cholangitis when examining the surgical material from a patient with suspected cholangiocellular carcinoma of the hepatic hilus.

[Value of liver biopsy in the diagnosis of hereditary hemochromatosis]. / Znachenie biopsii pecheni v diagnostike nasledstvennogo gemokhromatoza.

The paper gives an update on the pathogenesis and main clinical manifestations of primary (hereditary) hemochromatosis and its diagnostic methods. It emphasizes the importance of genetic research in the diagnosis of the disease. Its clinical manifestations are associated with iron deposition in organs, such as the liver, pancreas, joints, skin, and heart. The paper points out the importance of liver biopsy using Perls' reaction for the diagnosis of liver damage with the development of fibrosis, cirrhosis, and cancer as the main cause of death in patients with hereditary hemochromatosis and presents the results of examining liver biopsy specimens in patients with hemochromatosis.

[Microscopic polyarteritis in a patient with hypertension]. / Mikroskopicheskii poliarterit u bol'nogo gipertonicheskoi bolezn'iu.

A case of microscopic polyarteritis in a male aged 45 years having hypertension for 22 years is reported. There were clinical manifestations (hemorrhages, subfebrile temperature, arthralgias and others) and damages in many organs: productive-necrotic alveolitis, capillaritis of various organs, morphological features of hypertension, atherosclerosis, subendocardial myocardial infarction. The leading clinical feature was rapid progression of renal and pulmonary-heart failure.

[Classification and coding of clinical-anatomical forms of tuberculosis]. / Klassifikatsiia i kodirovanie kliniko-anatomicheskikh form tuberkuleza.

Principal forms of tuberculosis are morphologically characterized as well as their complications. The comparison with ICD-10 is made.

[Tuberculosis: socio-medical aspects]. / Tuberkulez: mediko-sotsial'nye aspekty.

Tuberculosis is an ubiquitous infection. The epidemiological situation is now critical. 2.5 million people die every year in the world due to different types of tuberculosis. In Russia, tuberculosis morbidity and mortality are also on the increase. Clinical manifestations of the disease became grave while the treatment less efficient. The key element in tuberculosis pathogenesis is interaction between bacteria, T-lymphocytes and macrophages with cytokines participation this resulting in elimination of the bacteria and formation of hypersensitivity. One of the main control mechanisms may be macrophage apoptosis in the center of the granulomas following with caseous necrosis. Methods of molecular biology open new perspectives in diagnosis, understanding of pathogenesis and tuberculosis treatment.

[A case of systemic lupus erythematosus in a 13-year-old girl]. / Nabliudenie sistemnoi krasnoi volchanki u devochki 13 let.

A case of systemic lupus erythematosus with a typical clinical picture and morphology in a 13-year-old girl is reported. Duration of the disease was 4 years. Arteriitis, pneumonitis, sclerosis and lymphomacrophagal infiltration of portal hepatic tracts, mesangioproliferative glomerulonephritis were observed. Glucocorticoid therapy was followed by improvement of the patient's condition, but the patient stopped taking the hormones. This may contribute to exiturs letalis.

[Angiosarcoma of the testicular tunica]. / Angiosarkoma obolochek iaichka.

One autopsy case of angiosarcoma of the testis tunica in a male of 60 is described. Histologically, the tumour corresponded to malignant haemangioendothelioma while electron microscopically areas having the structure of malignant haemangiopericytoma were also found.

[Early stomach cancer: its morphology, histo- and morphogenesis]. / Rannii rak zheludka: morfologiia, gisto- i morfogenez.

Macroscopic, histologic and ultrastructural features of an early stomach carcinoma are presented on the basis of literature and the authors' data. Ultrastructural and immunohistochemical data confirm the concept of a common histogenesis of different histologic types of stomach carcinoma, i.e. from reserve cells. Carcinoma, most likely, develops from reserve cells of the foveolate epithelium and metaplastic epithelium of intestinal type (foci of incomplete intestinal metaplasia with sulfomucine secretion). The data are accumulating on the precancerous nature of severe epithelial dysplasia. The development of an early carcinoma from preexisting dysplasia was observed in patients after long follow-up with repeated gastric biopsies.

[Relation between epithelial dysplasia and early cancer of the stomach]. / Sootnoshenie displazii épiteliia i rannego raka zheludka.

Mild to severe dysplasia ranked first among precancerous lesions in gastric adenoma and stomach stump gastritis. Repeated gastric biopsy of adenomas revealed enhancement of dysplasia proceeding to papillary adenocarcinoma. Epithelial dysplasia invariably occurred in areas adjacent to early carcinoma. A relationship was established between the pattern of dysplasia and histologic type of cancer. As dysplasia advanced, the ultrastructural signs of cell atypia became more pronounced. The electron microscopic features of severe dysplasia were similar to those of carcinoma.

[Morphometric and electron microscopic characterization of immunocompetent cells in dysplasia and early cancer of the stomach]. / Morfometricheskaia i élektronno-mikroskopicheskaia kharakteristika immunokompetentnykh kletok pri displazii i rannem rake zheludka.

Histologic, electron-microscopic and morphologic methods were employed to study the cells of the infiltrate and lymphocytes in dysplasia and early cancer of the stomach. Less numerous plasma cells and more numerous lymphocytes and macrophages were observed in the infiltrate in severe dysplasia and cancer than in mild and moderate dysplasia, no dysplasia. With growing severity of the dysplasia, cooperative activity of immunocompetent cells is on the increase, the proportion of intermediate and large lymphocytes appeared elevated. Adenocarcinoma versus severe dysplasia demonstrated reduced lymphocytic magnitude with predominance of small lymphocytes. Contrary to dysplasia, there was a macrophage cytotoxic effect observed also for large granular lymphocytes in all histologic variants of cancer, in line with stromal presentation of myofibroblasts. This can provide additional criteria by ultrastructure in differential diagnosis between severe dysplasia and initial cancer.

[Visceral manifestations of glycosphingolipidosis (Fabry's disease)]. / Vistseral'nye proiavleniia glikosfingolipidoza (bolezni Fabri).

Fabry's disease is glycolipid sphingolipidosis which belongs to the group of lipid storage diseases and has as its underlying cause congenital deficiency of alpha-galactosidase. The pathologic anatomy of visceral lesions is described at the macroscopic, light-optical, and electron-microscopic levels in a 50-year-old male with striking systemic manifestations of Fabry's disease. In addition to lesions typical for glycolipid sphingolipidosis, atherosclerosis involving primarily heart arteries (which is not characteristic for this disease) was found in the patient. This case demonstrates that although cutaneous lesions underlie the traditional designation of Fabry's disease as angiokeratoma corporis diffusum, skin involvement is only one of its external signs.

[Clinico-morphological characteristics of thymomegaly]. / Kliniko-morfologicheskaia kharakteristika timomegalii.

48 autopsy cases of thymomegaly in children up to 14 years and in adults from 18 to 55 years are studied. The patients died either from the acute or chronic infectious diseases resistant to the therapy or suddenly during or several hours after the diagnostic manipulations, small surgical interventions. Analysis of clinical data and morphological immunohistochemical and ultrastructural studies of the thymus and organs of the immune and endocrine system showed the thymomegaly in the majority of cases to be a local manifestation of the endocrine-immune deficiency syndrome. Primary (congenital) and secondary (acquired) thymomegaly are to be distinguished. A primary thymomegaly occurs in children and adults having congenital pluriglandular endocrinopathy with hypocortisism as well as an adrenal hypo- or aplasia with an antigenic stimulation. A secondary thymomegaly occurs in children of the first year of life and reflects the first phase of the thymic response in the activation of the immune T-system predominantly prolonged due to the immature state of the hypothalamico-hypophyseal-adrenal system. In the adults secondary thymomegaly occurs in cases of the acquired endocrinopathy with hypocortisism.

[Malignant carcinoid of the duodenum with polymorphism of the neuroendocrine granules]. / Zlokachestvennyi kartsinoid dvenadtsatiperstnoi kishki s polimorfizmom neiroéndokrinnykh granul.

In a man of 67, malignant multihormonal carcinoid of the duodenum 1 or 2 cm in size with deep penetration into the intestinal wall and multiple metastases into the lymph nodes became a cause of a secondary biliary liver cirrhosis and fatal intestinal haemorrhage. There was a difference between the cell population of a primary tumour in which D-cells dominated and EC-cells were also present and metastasis where a higher level of serotonin and its analogs was detected and where EC-cells dominated and ECL-cells were found as well. This observation confirms the opinion that the malignancy of carcinoid is determined by the degree of its invasiveness. Polymorphism of secretory granules in the cells of the same tumour supports the concept of the unique precursor of APUD-cells.

[Association of small peripheral lung cancer and early stomach cancer]. / Sochetanie malen'kogo perifericheskogo raka legkogo i rannego raka zheludka.

A combination of peripheral lung oat-cell carcinoma and early gastric highly differentiated adenocarcinoma in a man of 52 with long-term chronic peptic ulcer existing for 20 years is described. Electron microscopic and histochemical examinations of pulmonary carcinoma revealed neurosecretory granules and keratohyalin in the tumor cells. The gastric tumor on the ultrastructural level had cells differentiating in the direction of the glandular and intestinal epithelium. The presence of two independent malignant tumors in the patient was proven by the use of several morphological methods (cytologic, histologic, histochemical and electron microscopic).