ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 manner. Immunosuppressed patients have a highest risk of multi colonic segment affection. PS-07-056 Crypt epithelial apoptosis: sounds like IBD is on the horizon... H. Berber*, A.T. Bol, E. Dicle Serbes, S. Kurt, Z. Kuloglu, A. Kansu, M. Toruner, B. Savas, A. Ensari *Ankara University Medical School, Pathology Department, Turkey Background & objectives: In inflammatory bowel disease(IBD), inflammatory crypt damage leads to shedding of epithelium, man- ifesting as increased crypt epithelial apoptosis which is usually overlooked. Here, we focused on crypt epithelial apoptosis and other histopathologic features of colitis in paediatric and adult IBD. Methods: Initial diagnostic biopsies containing at least five differ- ent sites taken from adult(n=38) and paediatric(n=29) IBD cases were evaluated retrospectively. Histopathologic features of coli- tis, cryptitis in terms of extent and location (basal/midzonal/full- thickness), crypt abscesses (neutrophilic, mixed, apoptotic) and crypt epithelial apoptosis graded as (0:none,1:scattered, 2:count- able, 3:uncountable) were evaluated in each biopsy. Statistical analysis was performed using Chi-square test and Spearman’s rank correlation. Results: There were 29 paediatric cases(PC) comprising 20(69%) ulcerative colitis (UC), 9(31%) Crohn’s disease (CD) while there were 26 (68.4%) UC, 12 (31.6%) CD in 38 adults. Apop- tosis (97%) was the most frequent feature present throughout the colon in all cases in both UC and CD followed by cryptitis (93%) and crypt abscesses (60%) the majority of which were apoptotic or mixed. Apoptosis was significantly more common and more severe in UC compared to CD in left colon (p=0.017). There was positive correlation between grade of apoptosis and full-thick- ness cryptitis for left colon in PC (r=0.538,p=0.014), for right colon in adults (r=0.447,p=0.042) and for right colon in all cases (r=0.410,p=0,004). Conclusion: Crypt epithelial apoptosis seems to be more common in UC compared to CD and is correlated with the extent of cryptitis in all age groups. These findings suggest that inflammatory damage to the crypt epithelium leads to apoptotic cell death in the active phase of the disease, since no correlation was found between the features of chronicity and apoptosis in our cohort. We believe that apoptosis may be an early sign of IBD, particularly when drugs are ruled out. PS-08 | Poster Session Gynaecological Pathology PS-08-001 Heat artifact simulating serous tubal intraepithelial carcinoma: systemic histological analysis of prophylactic fallopian tube resection specimens M. Fukunaga*, N. Fukunaga *Shin-Yurigaoka General Hospital, Japan Background & objectives: Prophylactic fallopian tube resection has been prevailing. Among pathological changes in tubular speci- mens, serous tubal intraepithelial carcinoma (STIC) is most impor- tant for patient management, and heat artifacts simulating STIC should be acknowledged in order to avoid misdiagnosis. Methods: One thousand consecutive cases of prophylactic fallopian tube resection by laparoscopic excision using an electronic knife our hospital between 2015-2020 were examined, and the characteristic morphology and incidence of heat artifacts were analysed. Two blocks of the distal fallopian tube were prepared for examination in each case. The cases were benign uterine and ovarian disorders. Results: Heat artifacts were observed in 530 of 1000 cases (53%). Marked changes were found in 118 cases (11.8%), moderate changes in 102(10.2%) and minor changes in 250 cases (25%). Eight cases were initially diagnosed as STIC. No patient had STIC. Histological findings of heat artifacts included cellular pseudo- stratification, a pronounced papillary arrangement and detachment of the epithelium from the connective tissue, mainly in the fim- bria. Cytological changes included marked nuclear elongation and smudging, eosinophilic cytoplasm and obliteration of cell bound- aries and lack of mitotic figures in the epithelial lining. These findings mimicked STIC. Immunostaining of p53, WT1 and Ki67 performed on 33 representative cases did not indicate STIC. Conclusion: Heat artifacts from electronic knife usage are not uncommon. The marked papillary pattern of the epithelium was the principal histological characteristic leading to confusion with STIC, likely resulting from the structural characteristics of the tubal fimbria. Heat applied to tissue can produce nuclear elon- gation, hyperchromatism, smudging of nuclei, eosinophilic cyto- plasm, and obliteration of cell boundaries. Awareness of this poten- tial source of diagnostic error leads to its complete avoidance. PS-08-002 Intravenous leiomyomatosis of the uterus: a clinicopathological analysis of nine cases F. Sassi*, F. Khanchel, R. Jouini, I. Helal, R. Hedhli, E. Ben Bra- him, S. Sassi, A. Chadli Debbiche *Department of Pathology, Charles Nicolle Hospital Tunis, Tunisia Background & objectives: Intravenous leiomyomatosis (IVL) is a rare and benign smooth muscle neoplasm. It grows intravenously in the uterus and may invades cardiovascular and pulmonary system. The purpose of this study was to analyse clinicopathological data of 9 cases of IVL. Methods: We retrospectively reviewed 9 patients treated for IVL and diagnosed at Pathology Department from 2008 to 2020. All patients underwent surgical treatment. Results: Mean age of patients was 41.8 years (22-49 years). The 9 patients presented with no specific symptoms including menorrhagia (n=4), uterine mass (n=2), hypogastralgia (n=2) and dysuria (n=1). The diagnosis was made on myomectomy (n=5) and hysterectomy specimens (n=4). The diagnosis of IVL was suspected macroscopically in 4 cases by the presence of peripheral digitiform tabs or peripheral buds appearing to be endovascular. No intravenous leiomyomas were detected. Microscopically, all the cases showed a proliferation of benign smooth muscle within the vessels. Rare mitoses were noticed. Three patients were lost to follow-up. Six patients who were followed up are still alive and experienced no recurrence after a follow-up of 60months. Conclusion: IVL can be easily misdiagnosed as symptoms are not suggestive clinically and it can mimic uterine leiomyoma. Radiologists should make an early detection of IVL when there is venous blood flow signals in fissure-like echoe. Hysterectomy is the treatment and myomectomy could be considered when there is fertility needs. Pathologists should perform careful sampling insisting in the surrounding uterine smooth muscle. IVL is yet a benign disease but is considered malignant due to its recurrency. Long-term follow-ups are crucial. PS-08-004 Immunohistochemical expression of neuroendocrine markers in a large cohort of primary ovarian tumours S106