ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 tumour cells showed variable morphology and the differentials included primaries in: lung, pancreas, colorectum, stomach, prostate, cervix, added to multiple myeloma, which has been clinically suspicioned in one case. The immunoexpression of tumour cells corroborated with gross findings and routine histology features certified the diagnoses, with primaries in lung, colon, pancreas, cervix, and prostate, associated with splenic metastases, along with lymph nodes, liver, lung, meninges, and/or brain secondaries. Although the primary tumour remained unknown in one case, the morphology and immunohistochemical pattern certified the diagnosis of poorly differentiated carcinoma, excluding the multiple myeloma suspicion. Conclusion: Our cases certify that the most common sources of splenic metastases are lung, colon, along with pancreas, and reproductive tract, in cases of multivisceral cancers, while other primaries, such as breast carcinomas and malignant melanoma are reported in literature. Immunohistochemistry is useful to distinguish primaries from secondaries in cases with multiple disseminations, including spleen. However, the primaries are difficult to establish in occult poorly differentiated carcinomas/ cancer from unknown primary site, without any gross feature favouring a certain primary location. PS-18-004 Lung COVID-19 infection – morphological spectrum and mor- tality-related risk factors C. Amalinei*, L.A. Riscanu, D. Bulgaru Iliescu, A. Grigoras *"Grigore T. Popa" University of Medicine and Pharmacy Iasi and Institute of Legal Medicine Iasi, Romania Background & objectives: The lung microscopic features of SARS- CoV-2 infection include diffuse alveolar damage (DAD), atypical pneu- monia, microthrombi, its unfavourable evolution being correlated to multiple risk factors. The aim of our study is the presentation of the pathological spectrum registered in our files. Methods: The reports from autopsies performed in the last two years in our Department have been reviewed, selecting 343 cases of lung COVID-19 disease, with cases age range between 5 to 99 years old (81.34% males vs. 18.66% females). The cases have been investigated by routine paraffin-embedding sections, followed by hematoxylin and eosin staining, along with histochemical stains in selected cases. Results: Grossly, pulmonary changes were variable, from pulmonary oedema to lung consolidation, haemorrhagic areas, and pulmonary thrombosis or microthrombi. The microscopic exam showed severe capillary congestion ± hyaline membranes, alveolar haemorrhage corresponding to exudative DAD, reactive pneumocytes changes and syncytial cells, microthrombosis, interstitial and intra-alveolar fibroblastic proliferation. Foci of pneumonia, as superimposed secondary infection, have been observed (37.02% of cases). In a decreased order of frequency, different chronic comorbidities have been registered: ischemic coronary disease, benign nephroangiosclerosis, liver steatosis ± chronic hepatitis/ cirrhosis, diabetes mellitus, chronic pyelonephritis, and emphysema, along with rare diseases, such as lung tuberculosis, gastric carcinoma, Down syndrome, liver hydatid cyst, atherosclerotic aortic dissection, stroke, and traumatic injuries. Conclusion: Pathologists have an important role in the diagnosis and management of COVID-19 infections, with a magnitude of 506 million confirmed cases, resulting in over 6.2 million deaths worldwide, in April 2022. This study provides an overview of the post-mortem lung lesional spectrum in patients with COVID-19 lesions and the risk factors that may contribute to their fatal out- come. Our findings can also provide valuable data for COVID-19 disease management perspectives, according to the assessment of categories of patients’ risk factors. PS-18-005 Morphological peculiarities of liver in patients died of Corona- virus disease: a series of autopsy reports T. Bocharova, V. Gargin*, A. Bondarenko, V. Sakal *Kharkiv National Medical University, Ukraine Background & objectives: Coronavirus infection (COVID-19) caused by SARS-CoV-2 remains a global pandemic problem today. In respect that Coronavirus disease frequently accompanied with a high ami- notransferase rate in some patients, the detection of the pathological effect of coronavirus on liver becomes especially relevant. Methods: We described 25 liver section from patients who died of disease related to COVID-19 at the Kharkiv Regional Clinical Infectious Diseases Hospital. Coronavirus disease was detected with PCR isolation of SARS-CoV-2 RNA from nasopharyngeal lavage. All liver sections were taken from representative appearing areas, formalin fixed, paraffin embedded, stained with Hematoxy- lin and Eosin and analysed under light microscopy. Results: In our study 72 % of patients had elevated serum levels of aminotransferases. We identify local disorder of hepatic lobules with huge amounts of apoptotic hepatocytes and areas of necrosis in the central part of hepatic lobules. The majority of portal tracts showed a mixed inflammatory infiltrate consisted of lymphocytes, macrophages and plasma cells. The central veins and centrilobular sinusoids were full-blooded with lymphocytic infiltration in the endothelium. Sings of macrovesicular fatty degeneration with accumulation a huge amount of lipids were detected in the hepatocytes. Eosinophilic inclusions in the cytoplasm and nuclear pyknosis of the cholangiocytes were found in the interlobular bile ducts as a sing of apoptosis. Conclusion: Detected changes in the liver of patients with COVID-19 are regarded as an acute reactive interstitial hepa- titis on the diffuse steatosis background with severe bile ducts damage. Histological changes in sinusoidal and central veins endothelial cells may be related with a direct cytopathic viral influence. The mechanism of liver injury from SARS-CoV-2 which includes both inflammatory response and a direct cyto- toxic damage requires further study. PS-18-006 Paraneoplastic syndromes associated with cancers of unknown primary Á. Jakab*, I. Kocsmár, A. Kiss, Z. Schaff, R. Istók, G. Lotz, É. Kocsmár *Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, Hungary Background & objectives: Cancers of unknown primary (CUP) are metastatic tumours without an identified primary lesion. Paraneoplastic syndromes (PNs) occur independently of the physical presence of the tumour. In our study, we aimed to assess the characteristics of PNs in patients with CUP. Methods: We examined 12837 autopsy cases between 1993 and 2019 in the electronic register of the II. Pathology Department of Semmelweis University, Budapest. Out of 3691 cancer cases we found 135 CUPs, The PNs of this cohort were compared to the clinicopathological features of the tumours. For further S155