217 / 366
muscularis propria. Both glands were mucinous, covered with a rim of
lamina propria and did not contain structural/cellular atypia. Both cases
were diagnosed as gastritis cystica polyposa/profunda.
Conclusion:
we present two cases of gastritis cystica polyposa/profunda
with different preoperative findings, and want to remind in the differantial
diagnosis of the mass/polypoid lesions of the gastric wall.
PS-13-141
Opportunistic viral infections of upper gastrointestinal truck: Three
case reports
S. Mavropoulou
*
, Z. Tatsiou, P. Mavropoulos, I. Kotsianidis
*
Xanthi General Hospital, Dept. of Pathology, Greece
Objective:
Opportunistic infections caused by cytomegalovirus(CMV)
and her pe s simplex virus(HSV) are commonly seen in
immunocompromized and high risk patients and are responsible for severe
clinical symptoms, such as ulceration, hemorrhage and perforation.
Method:
We present the case of a 30-years-old-man, who received high
doses of corticosteroids for idiopathic thrombopenic purpura. He
complained for gastric pain and during upper GI endoscopy a gastric ulcer
and acute gastritis were found. Biopsies showed the characteristic eosin-
ophilic intranuclear and granular-purple cytoplasmic inclusions in epithe-
lial and endothelial cells, findings compatible with CMV gastritis
Results:
The other two patients, a 86-years-old-man and 82-years-old-woman,
complained for dysfagia and retrosternal pain. They both had no-clinical evi-
dence of immunosuppression, but theywere often hospitalised. Esophagoscopy
revealed white plaques, linear erosions and ulcer. Histological examination
showed acute inflammation, ulcers and typical epithelial intranuclear inclusions
and ground glass multinucleated giant cells, all suggestive of herpetic
oesophagitis. After PCR certification, antiviral therapy was given.
Conclusion:
The clinical history and the unusual endoscopic findings
may guide pathologist to careful examination of the tissue sample and
recognition of typical cells suggestive of specific viral infections, diagno-
sis crucial for patient s life. Immunohistochemistry could be used in cases
that morphology is not typical. Cultures and PCR could also be helpful.
PS-14-001
A comparison of labeling index Ki67 determined by image analysis
software and visual assessment in breast cancer
V. Kushnarev
*
, A. Kudaibergenova, A. Artemyeva
*
Cancer Research Institute, Dept. of Pathology, St. Petersburg, Russia
Objective:
The labeling index (LI) Ki67 is critical part of the pathology
practice for the diagnosis and prognosis in breast cancer. In this study we
compared the consistency between visual assessment (VA) and digital
image analysis (DIA) LI Ki67 in breast cancer in the laboratory of tumour
morphology of N.N. Petrov Cancer Research Institute.
Method:
Ki67-immunostained slides of 106 cases of breast cancer G-2-3,
mean age 64,2 randomly selected from July to September 2016 in the
pathology department. In these study two different score methods were
used: DIA and VA by two experts and one resident of 1 year indepen-
dently of each other.
Results:
The level of agreement between the DIA and VA was not sig-
nificantly different (
p
> 0.005), the intra-class correlation coefficient
(ICC) between the DIA and VA method was 0.69 CI 95 %, [0.23; 0.87]
–
DIA-VA expert 1, 0.72, CI 95 %, [0.33; 0.89]
–
DIA-VA expert 2, 0, 70,
CI 95 %, [0.30; 0.88]
–
DIA-VA resident.
Conclusion:
The values of LI Ki67 obtained by the DIA showed a strong
correlation with the expert values of the LI Ki67.
PS-14-002
Discrepancy of labeling index Ki67 in ER positive HER2 negative
breast cancer determined by image analysis software and visual
assessment
V. Kushnarev
*
, A. Kudaibergenova, A. Artemyeva
*
Cancer Research Institute, Dept. of Pathology, St. Petersburg, Russia
Objective:
We compared two different subgroups (luminal A and
luminal B) based on IHC surrogate classification by digital image
analysis (DIA) and visual assessment (VA) of labeling index (LI)
Ki67. LI Ki67 is widely used for clinical decision making in luminal
A and luminal B (St. Gallen Consensus 2015). Cut-off point widely
used in this approach is 14 %.
Method:
We selected 45 cases HER2- ER+ of breast cancer G-2-3, mean
age 58,3 in the pathology department. In this study two different score
methods were used: DIA and VA to compare consistency by intraclass
correlation coefficient (ICC) in luminal A and luminal B subgroups.
Results:
Among 45 breast cancer cases there was luminal A 46 % and
luminal B 54 % of cases according to DIA but using VA LI Ki67 luminal
A was 22 % and luminal B was 78 % respectively. Reproducibility was
poor (ICC = 0.157; 95 % CI = [
−
0.027; 0.541]) in luminal A and luminal
B was fair (ICC = 0.46; 95 % CI = [0.082; 0.722]).
Conclusion:
Using cut-off point 14 % LI Ki67 in DIA luminal A showed
two times often than in VA. LI Ki67 values distribution showed better
consistency between DIA and VA in luminal B but poor in luminal A.
PS-14-003
Medical simulation in gross examination: University experience
E. Alcaraz Mateos
*
, F. García Molina, G. Ruiz García, I. García Velasco,
J. Moya Correas, I. Navarro García, P. Pérez González, M. Sánchez
García, A. Soler Díaz, P. Victoria Campillo
*
Morales Meseguer Hospital, Dept. of Pathology, Murcia, Spain
Objective:
The importance given in recent years to the acquisition of
practical skills in medical school is mainly due to the Bologna Process
and to the Objective-Structured-Clinical-Examination (OSCE). This new
framework implies self-evaluation and a renewal of the teaching method-
ologies. For this purpose, a practical simulation for the gross examination
(GE) was carried out.
Method:
Silicone simulators of different shapes, sizes and color combi-
nations were used. The students conducted the GE study in different
clinical contexts in a guided approach, including: clinical correlation,
sample description, including weight and measurement, use of colored
dyes to evaluate surgical margins, sectioning and its inclusion in cassettes.
Finally, for the final diagnosis and understanding of macro-microscopic
correlation, digitized slides were used. The simulation was developed
with third-year medical students from the University of Murcia (2016
–
17), who were given a Likert scale questionnaire for assessment.
Results:
A total of 42 students participated in the simulation. The results
of the questionnaire showed an average score of 4.26 on a scale of 5 in the
following items: understanding tumour surgery and GE management,
assessing surgical margins, microscopic visualization and diagnosis,
and prognostic significance.
Conclusion:
- Gross examination simulation can serve as a good learning
system, in support of traditional methods. - The implementation of these
interactive teaching methodologies is well accepted by students. - The
experience presented in this study is adapted to the new requirements in
medical training, with the acquisition of clinical skills and competencies,
while at the same time transmitting a more realistic idea of the work
carried out by pathologists.
Tuesday, 5 September 2017, 09:30
–
10:30, Hall 3
PS-14 IT in Pathology
Virchows Arch
(
2017
)
471
(
Suppl 1
):
S1
–
S352
S203