Histological features of gastric cardia in adults: an autopsy study.

BACKGROUND AND AIMS: The existence, histology and origin of gastric cardiac mucosa are controversial. The aim of the present study was to determine the existence, histological characteristics and length of cardiac mucosa and to correlate these features with the patients' age and the presence of inflammation in the gastric cardia and/or esophagus. METHODS; The cardiac mucosa within the whole esophagogastric junction was histologically analyzed in 38 consecutive autopsy specimens and measured in 24 cases. RESULTS: The cardiac mucosa was identified in all specimens from all cases, with a mean length of 6.7 mm, range 0.927-19.5 mm. In the majority of cases, the length of cardiac mucosa was less than 10 mm (87.5%) and greater than 5 mm (71%). Cardiac mucosa was composed of a combination of pure mucous glands and mucous glands with parietal cells in 74% of cases, and only of mucous glands with parietal cells in 26% of cases. Carditis was recorded in 23.7% cases and reflux esophagitis in 15.8%. The length of cardiac mucosa was not significantly different between cases with and without carditis (p>0.05), between those with and without esophagitis (p>0.05), and between age groups older and younger than 60 years (p>0.05). CONCLUSION: In the adult population, a short histological segment of gastric cardia was consistently present as a normal histological structure. The type, length and circumferential presence of cardiac mucosa were not significantly associated with carditis, esophagitis or age.

Medicolegal aspects of post-traumatic gastroduodenal ulcers: a retrospective study.

Retrospective examination of 5-year autopsy material showed the presence of posttraumatic gastroduodenal ulcers (PGDU) in 17.7% of decedents deemed to be at risk. They were more common in males (77%) and in patients aged over 50. In the majority of cases (76%) the survival period was < 12 days; in 16.5% it was < 48 h. PGDU developed most commonly in victims of polytrauma and isolated craniocerebral injury, with ISS values > or = 16; patients with spinal cord injuries were at greatest risk. Most frequently affected was the stomach, exhibiting numerous, usually superficial lesions, while solitary acute and exacerbated chronic peptic ulcers were more common in the duodenum. Complications of PGDU developed in 40% of cases, mostly in the form of hemorrhage; in 20% of cases PGDU have contributed to death. Medicolegal aspects of PGDU are, most frequently, concerned with the causal relationship between trauma, PGDU, and fatal outcome, as well as the potential for allegations of medical negligence.

[Autosomal recessive polycystic kidney disease: case report].

INTRODUCTION: Autosomal recessive polycystic kidney disease is the most common heritable cystic renal disease occurring in infancy and childhood. The clinical spectrum of signs and symptoms of this disease is widely variable ranging from perinatal death to a milder progressive form, which cannot be diagnosed until adolescence. CASE OUTLINE: A female neonate born in the 35th/36th week of gestation. The findings of all standard medical examinations of the neonate done by the mother were within normal limits. A few days before delivery physicians at a regional medical centre revealed enlarged kidneys and oligohydramnios. The delivery was performed by caesarean section. The vital functions of the newborn were in critical condition so that she was referred to the University Children's Hospital in Belgrade. Soon after admission, despite all undertaken measures, the infant died. Autopsy was done at the Institute of Pathology of the Belgrade Clinical Centre. All findings were typical for autosomal recessive polycystic kidney disease. The kidneys were hugely enlarged, with cystically dilated collecting ducts that almost completely replaced the renal parenchyma. The lungs were mildly hypoplastic. The liver showed dilated portal spaces, with multiple irregularly branching bile ducts. The cause of death was respiratory distress and renal failure. CONCLUSION: In all cases of congenital anomalies of the kidney with lethal ending it is necessary to perform autopsy and aimed genetic investigation.

Primary non-hodgkin lymphoma of urinary bladder with nine years later renal involvement and absence of systemic lymphoma: a case report.

AIMS: Primary bladder non-Hodgkin lymphoma (PBNHL) is very rare, especially as extranodal B-small lymphocytic lymphoma (B-SLL). Also, late isolated renal manifestation of PBNHL is extremely unusual. We report a very rare type of extranodal B-SLL of bladder wall with extremely unusual late isolated renal involvement, clinically manifested by nephrotic syndrome and incipient renal failure. A CASE REPORT: A 56-year-old woman was presented with a solitary tumor of bladder wall, with history of dysuria and night sweating. A transvaginal needle biopsy of the tumor was performed, and diagnosis of primary extranodal B-SLL was made in the absence of bone marrow, lymph node, or blood involvement. She was treated with chemotherapy until the achievement of complete remission. Nine years later, she developed nephrotic syndrome. The renal biopsy revealed parenchymal lymphoma's involvement associated with glomerular lesion. Immunohistochemical analysis confirmed the same imunophenotype of lymphoma cells like in bladder wall nine years ago. Restaging procedure showed no evidence of disease elsewhere. CONCLUSION: To our knowledge, it is the first case of association of very rare primary bladder B-SLL with late isolated renal involvement.