ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 largely consistent with the projection of the impact. In the second group of animals, the damage area was located in the region of the disturbed coronary blood flow. In the third group of animals, the damage sites were diffused in the myocardium of both ventricles and ventricular septum. Conclusion: The approach helps to identify areas of myocardial damage regardless of their nature (traumatic, ischemic-hypoxic, secondary-metabolic). Since the proposed model for identifying sites of myocardial injury is universal, it can be successfully used to identify candidate zones for morphological examination, including for immunohistochemical studies to assess severity, localization and ratio of tissue autophagy and apoptosis reactions in altered myocardium. The model allows the selection of heart tissue fragments for examination in the alteration zone and adjacent areas of intact myocardium. E-PS-04 | E-Posters Cytopathology E-PS-04-002 Strongyloides stercoralis: a rare case diagnosed with oesopha- geal swab sample A.H. Aydin*, B. Bayazit Gözüküçük, N. Turhan *Ankara City Hospital, Turkey Background & objectives: Strongyloides stercoralis (S.s.) is an intes- tinal nematode which might involve different systems. Although the infection caused by S.s. is usually asymptomatic, in immunocompro- mised host it could be severe and fatal. We presented a case that diag- nosed with oesophageal swab sample. Methods: A 70 year old man with pneumoconiosis, applied to hospital with oral intake disorder. Endoscopic examination was performed. Because of diffuse ulcers on oesophagus only one swab sample could be obtained. On this sample larvae and soils were observed. It was reported to clinic that may correspond to S. stercoralis, then another esophagogastroduodenoscopy was performed. Many biopsies were conducted on. Results: This samples exhibited chronic inflammation and distor- tions of gland architecture. In crypt lumens, eggs as aggregations with basophilic granular appearance and typical larva structure with sharply ended tails were seen. Concurrent fresh sampling from gastric and oesophageal fluid studied by spreading between slides was examined with biopsies. The biopsy and swab samples were evaluated as compatible with S. s. Conclusion: Infected individuals with S.s. are usually asymptomatic. However, it may cause a hyperinfection syndrome in immunocompromised hosts. Furthermore, this scenario may be severe and has a high mortality risk. It can be prevented by detecting infection in asymptomatic individuals. Particularly in risk groups that have history of travel endemic zones or begin using immunosuppressive agents can be scanned. E-PS-04-003 Metastatic malignant mixed germ cell tumour of the epigas- trium as a primary incidental finding: a rare case presentation N. Katsoulas, D. Goutas, A. Sykaras*, I. Zyli, I.S. Papanikolaou, E. Politi *Department of Pathology, Evangelismos General Hospital, Ath- ens, Greece Background & objectives: Germ cell tumours (GCTs) constitute a rare and diverse group of neoplastic entities. They affect mainly young people and arise from primordial germ cells. We present a rare case of metastatic malignant GCT to the epigastrium, diagnosed by EUS- FNA cytology. Methods: A 57-year-old male, with a history of weight loss and abdominal pain, presents with a 16-cm lymph node block in the epigastric region, accompanied by enlarged mediastinal and peri- pancreatic lymph nodes, and a 2-cm mass in the body of pancreas, as detected on CT scans. His laboratory tests were normal, except for elevated LDH levels. Results: With the clinical impression of lymphoma, an EUS- FNA of the mass was performed. FNA smears revealed highly atypical pleomorphic cells, lying singly or in loose clusters in a haemorrhagic and necrotic background with many lymphocytes. Immunocytochemical evaluation showed strong and diffuse positivity of malignant cells for SALL-4, PLAP, OCT-4, a-FP, focal positivity for AE1/AE3 and CK7, and Ki67 index > 80%. The final diagnosis of a metastatic malignant germ cell tumour was rendered. Since there was no known history of testicular tumour, a thorough evaluation of the gonads was advised, for identification of the primary lesion. Conclusion: GCTs are an uncommon group of heterogeneous tumours including both benign and malignant neoplasms. They are categorized into germinomatous and non-germinomatous types, affecting mainly the gonads of young patients. The uncommon mixed GCTs are constituted of two or more types of malignant primitive or germ cell components, accounting for approximately 8% of all malignant GCTs. E-PS-04-004 Pancreatic metastasis of multiple myeloma diagnosed by EUS- FNA: report of a rare case I. Zyli, A. Sykaras*, N. Katsoulas, D. Goutas, I.S. Papanikolaou, E. Politi *Department of Pathology, Evangelismos General Hospital, Ath- ens, Greece Background & objectives: Multiple myeloma (MM) metastases to pancreas, as a secondary extramedullary disease (EMD), is a rare occurrence with less than 300 cases reported in the literature, and only 2,3% in autopsies. Methods: A 68-year-old female, with a past history of MM 5 years ago, presented to our hospital with obstructive jaundice. Abdominal contrasted CT scan detected a non-homogenous mass in the head of the pancreas (2,5 cm), fat stranding, peripancre- atic fluid collection and swelling of the regional lymph nodes (<1cm). Results: An ultrasound-guided fine needle aspiration (EUS-FNA) of the pancreatic mass revealed infiltration by a population of monotonous neoplastic plasma cells with characteristic eccentri- cally placed nuclei and abundant cytoplasm, mainly arranged in compact nests. Immunocytochemistry was performed taking into consideration patient’s history. The neoplastic cells were positive for CD138, MUM-1, CD79a and kappa light chain and negative for CD3, CD20 and lambda light chain. Morphology and immunocy- tochemistry profile lead to a diagnosis consistent with metastasis of MM to the pancreas. Conclusion: Pancreatic metastasis from MM are rare but despite their rarity they should be considered in the differential diagnosis of obstructive jaundice and primary pancreatic neoplasms. There- fore, a detailed medical history in combination with immunocyto- chemical findings are paramount for the diagnosis. Extramedullary involvement is one of the indicators of poor prognosis. There is no consensus in treatment options and their efficacy. S204