249 / 366
where special examinations of no importance for underlying death or for
clinicians would result in delay of the final reports, as some neuropatho-
logical examinations. The same department also did not send preliminary
autopsy reports, in contrast to the practise followed by all other
departments.
Conclusion:
Short turnaround times may be achieved by changing the way
of reporting autopsy answers. The primary goal must be to ensure useful
feedback to the clinicians before they forget or give up complaining.
PS-18-010
Case of politarteritis nodosa undiagnosed during life
A. Sapargaliyeva
*
, B. Sultanova
*
Kazakh National Medical Univer, Pathology, Almaty, Kazakhstan
Objective:
Systemic poliarteritis nodosa is a rare condition and diagnosis
is often based on clinical manifestations. In absence of treatment, system-
ic poliarteritis nodosa is characterized by poor prognosis since the condi-
tion develops rapidly and is often fatal.
Method:
Case of systemic poliarteritis nodosa which was not diagnosed
during life was retrospectively analysed.
Results:
The clinical manifestations of systemic poliarteritis
nodosa appeared for very first time in a female patient (72 years
old) after viral respiratory infection, and included dizziness, fa-
tigue, and joint pain. Over the period of 5 months she was re-
peatedly admitted by different hospitals with diagnosis of
‘
en-
cephalopathy
’
,
‘
erosive gastritis
’
,
‘
acute myocardial infarction
’
.
In 10 days after latest discharge she was admitted to the hospital
with massive gastrointestinal haemorrhage. In 6 days after latest
admission the patient died. Despite obvious clinical manifestations
of a systemic disease (including, fever, weight loss, encephalopa-
thy), the final diagnosis was made only after a histological exam-
ination. Morphological manifestations of the disease included le-
sions of small and medium vessels in kidneys, gastrointestinal
tract, myocardium, and lungs. Morphological changes were
characterised by segmental fibrinoid necrosis or circumferential
fibrinoid necrosis.
Conclusion:
The patient was present with systemic poliarteritis nodosa,
which became a cause of renal insufficiency and bowel infarction. The
disease was characterised by gradual progression within the period of
5 months. Within this time period, the patient received symptomatic treat-
ment in different hospitals, however, the correct diagnosis was never
made, and therefore, administration of hormone therapy was impossible.
PS-18-011
Hidatidosis: A case report
R. Esteves
*
, A. da Costa Ferreira, M. H. Oliveira, A. Catarino
*
Hospital Beatriz Ângelo, Dept. of Pathology, Loures, Portugal
Objective:
We present an autopsy case of Hidatidosis seen in our depart-
ment. Hydatidosis is a zoonotic disease caused by the Echinococcus
parasite. Its different forms are a public health problem, which in
Europe has its greatest expression in the Mediterranean basin. In
Portugal it is a notifiable disease (2016
n
= 2).
Method:
Autopsy, cytology and histology
Results:
Forty-one year-old man with a history of pulmonary and peri-
cardial hydatid cyst surgically treated at age 21. He has an ICD. Two
months earlier begins to suffer from haemoptysis and, in spite of the
empirical antibiotic treatment, his condition gradually worsens. Chest
CT scan and bronchofibroscopy were inconclusive. He goes into the
emergency room in cardiorespiratory arrest, following massive
haemoptysis refractory to resuscitation attempts. The autopsy revealed a
bilateral multicystic pulmonary hydatid cyst with a fistula to a pulmonary
artery branch and the presence of hydatids in the right ventricular cavity.
Conclusion:
In high-prevalence countries, hydatidosis is an entity which
clinicians should take into account in their differential diagnoses and
which can be fatal if undiagnosed.
PS-18-012
A fatal case of idiopathic mesenteric venous thrombosis
S. Komina
*
, L. Spasevska, G. Petrusevska, A. Petlickovski, A.
Nikolovski, V. Janevska
*
Medical Faculty, Institute of Pathology, Skopje, F.Y. Republic of
Macedonia
Objective:
Idiopathic mesenteric vein thrombosis (MVT) is a rare type of
intestinal ischemia associated with significant mortality and morbidity
because of its diagnosis delay.
Method:
A 32-year-old female patient was admitted to the Emergency
Department complaining of right-lower abdominal pain. After physical
examination and routine laboratory was done, laparascopy for suspected
appendicitis was performed. The patient
’
s condition was deteriorating and
was transferred to Intensive Care Unit. CT-scan revealed a
hypoattenuating venous filling defect with superior mesenteric vein en-
largement. She was scheduled for second-look operation where small
intestinal infarcted segment was resected. Unfortunately, the patient died
3 days after hospitalisation.
Results:
Autopsy revealed superior mesentery vein thrombosis associated
with small bowel infarction, fibrinopurulent peritonitis and disseminated
intravascular coagulation. Analysis of genetic status for known pro-
thrombotic mutations has revealed compound heterozygosity for 677C>T
and 1298A>C in MTHFR gene and heterozygosity for Factor V R2 mu-
tation. The assumed reduced MTHFR enzyme activity, combined with the
genetic constitution, abdominal trauma and infection has lead to precipita-
tion of thrombophilic disorders.
Conclusion:
A screening of primary coagulation abnormalities must be
carried out in all patients with MVT because they represent the most
frequent cause of venous thrombosis. It would be rational to offer genetic
testing for thrombophilia to at-risk family members before exposure to
recognized risk factors.
PS-19-001
Role of cell block and immunocytochemistry in cytological diagnosis:
A new dimension to diagnosis of cancer
S. Jain
*
, R. Sharma, H. Sarin, M. Guleria
*
Medanta- the Medicity, Haryana, India
Objective:
To analyze the role of cell block and immunochemistry(ICC)
in fine needle aspiration cytology(FNAC) and malignant fluid cytology
Method:
Retrospective descriptive analytical study done from January
2014 to February 2017 analyzing 8950 cases of FNAC and 8290 fluids.
Cell blocks were prepared in 1920 cases. Immunocytochemistry(ICC)
was done wherever required.
Results:
Cell blocks with ICC helped in categorization of tumours in 224
FNAC samples. Commonest site was lymph node (
n
= 102,45.5 %) with
diagnosis of metastasic carcinoma(
n
= 45,44.1 %),metastatic
melanoma(
n
= 03,2.9 %),B-cell(
n
= 36,35.3 %)and T-cell
lymphomas(
n
= 18,8.17.6 %). Pancreatobiliary lesions(
n
= 60,27 %)-
comprised high grade neuroendocrine tumours (
n
= 28,46.7 %),poorly
differentiated adenocarcinomas(
n
= 18,30 %),solid pseudopapillary neo-
p l a s m s (
n
= 0 8 , 1 3 . 3 % ) , l ymp h om a s (
n
= 0 3 , 5 % ) , -
metastasis(
n
= 02,3.3 %%)and pancreatoblastoma (
n
= 01,1.7 %).Soft
Wednesday, 6 September 2017, 09:30
–
10:30, Hall 3
PS-19 Cytopathology
Virchows Arch
(
2017
)
471
(
Suppl 1
):
S1
–
S352
S235