ECP 2023 Abstracts

S123 Virchows Archiv (2023) 483 (Suppl 1):S1–S391 13 number of bland stromal cells with clear cytoplasm, proliferating vessels and inflammatory cells. Immunohistochemical analysis were CK7 and TTF1 positive in epithelial component and CD10 in stroma. Conclusion: Placental Transmogrification of the lung (PTL) is a rare benign pulmonary lesion whose morphological pattern mimic placen- tal villus, with approximately 40 cases described in the literature. Its incidentally observation in hamartomas or bullectomy specimens may cause problems for pathologists and clinicians unfamiliar with this lesion. Although immunostaining could be helpful, its morphology awareness will allow an accurate diagnosis and will avoid confusion. PS-20-016 Proposal of a grading system for squamous cell carcinoma of the lung – the prognostic importance of tumour budding, single cell invasion and nuclear diameter N. Zombori-Tóth*, F. Hegedűs, S. Almási, A. Sejben, L. Tiszlavicz, J. Furák, G. Cserni, T. Zombori *Csongrad-Csanád County Hospital of Chest Diseases, Hungary Background & objectives: The prognostic factors of lung squamous cell carcinoma (LSCC) are less investigated. Therefore we aimed to evaluate the prognostic impact on overall survival (OS) and recur- rence-free survival (RFS) of morphologic features and grading systems among patients with resected LSCC. Methods: Patients who underwent surgical resection at the Depart- ment of Surgery, University of Szeged between 2010 and 2016 were included. Follow-up data were collected from medical charts. Mor- phological characteristics were recorded from histological revision of slides. Kaplan-Meier analysis, log-rank test, and Cox proportional- hazards model were utilized. Results: Altogether 220 patients were included. In univariate analysis, higher degree of tumour budding, infiltrative tumour border, larger nuclear diameter, presence of single cell invasion and spread through air spaces (STAS) were associated with adverse prognosis. The previ- ously introduced grading schemes failed to separate three clusters of patients. Therefore, based on our results, we proposed an easily appli- cable grading scheme focusing on tumour budding, nuclear diameter and single cell invasion. In multivariate analysis, the proposed grading system (HR-OS: 3.41, 95%CI:1.89-6.17; HR-RFS: 2.49, 95%CI: 1.66- 3.74), infiltrative border (HR-OS: 3.08, 95%CI:1.46-6.50; HR-RFS: 2.04, 95%CI: 1.15-3.6) and STAS (HR-OS: 3.36, 95%CI:1.59-7.16; HR-RFS: 3.19, 95%CI:1.82-5.58) were independent prognosticators. Conclusion: We validated the prognostic impact of tumour budding, single cell invasion, nuclear diameter, and STAS in LSCC. We recom- mend a grading system combining tumour budding, single cell inva- sion and nuclear diameter for proper prognostic stratification of LSCC patients. Further research is required for the validation of this grading scheme and to gather more data about its reproducibility. PS-20-017 The more extensive the spread through air spaces (STAS), the worse the prognosis is – semi-quantitative evaluation of STAS in pulmonary adenocarcinomas N. Zombori-Tóth*, D. Paróczai, J. Lantos, S. Almási, A. Sejben, L. Tiszlavicz, G. Cserni, J. Furák, T. Zombori *Csongrad-Csanád County Hospital of Chest Diseases, Hungary Background & objectives: The extent of STAS is less investigated among patients with lung adenocarcinoma who underwent sublobar resection. We aimed to evaluate the extent of STAS semi-quantitatively, to assess its prognostic impact on overall survival (OS) and recurrence- free survival (RFS). Methods: The number of tumour cell clusters and single tumour cells within air spaces were recorded in three different most prominent areas (200x field of view). The extent of STAS was categorized into three groups and the presence of free tumour clusters (FTC) was recorded. Results: Altogether 61 patients were included. Recurrence was more frequent with higher architectural grade (p=0.027), presence of lym- phovascular invasion (p=0.027) and presence of STAS of any extent (p=0.007). In multivariate analysis, presence of FTC (HR: 5.909; 95%CI: 1.72-20.25; p=0.005) and more pronounced STAS (HR: 3.9; 95%CI: 1.54-9.87; p=0.004) had impact on OS and RFS, respectively. Concerning reproducibility, excellent agreement was found among STAS parameters (ICC range: 0.92-0.94). Conclusion: More extensive STAS is an unfavourable prognostic factor in adenocarcinomas treated with sublobar resection. As the semiquan- titative evaluation of extent of STAS is reproducible, we recommend to include it in histopathology reports. PS-21 | Poster Session Autopsy Pathology PS-21-001 Attitudes of clinicians toward autopsy in a tertiary hospital A.C. Ablaza*, A.B. Asanion *Baguio General Hospital and Medical Center, Philippines Background & objectives: Hospital autopsies have been decreasing despite their great benefit to healthcare and legal systems. Considered as the most critical factor contributing to this decline is the clinician’s attitude. We aim to determine the association between clinicians’ atti- tude and their demographics. Methods: The attitude was evaluated through a self-administered sur- vey which consisted of 22 validated questions. Attitudes were inter- preted as either positive or negative. Demographic profile with empha- sis on the respective clinical department, total years of clinical practice, and number of autopsies observed were studied. Statistical analysis was performed using IBM SPSS version 20. Results: There were 385 respondents (68 internal medicine, 50 surgery, 50 paediatrics, 35 radiology, 32 obstetrics-gynaecology, 31 anaesthesi- ology, 28 family medicine, 23 otorhinolaryngology, 18 neuroscience, 18 orthopaedics, 18 psychiatry, 14 ophthalmology) with 174 males (45.2%), 211 females (54.8%), and majority belonged to the 25-34 year age group (42.2%). Most had short-term clinical experience (44.8% <5 years, 8.1% >20 years). Overall autopsy exposure was low (52.1% none, 2% >20 autopsies). Majority expressed positive attitude, great- est in orthopaedics (76.0%), those with <5 year clinical experience (64.5%), and those with >20 autopsies (65.5%). There was significant association between attitude and 8 of 12 departments, 1-20 year clinical practice, and 1-20 year autopsy experience (p<0.05). Conclusion: Factors that influence the clinicians’ attitudes toward autopsy can be addressed to promote positive attitudes and thereby increased hospital autopsy rates. Knowledge and experience in autopsy can be enhanced by correcting any misinformation and spreading awareness that one can request it without additional financial burden to the patients’ family. We recommend to improve the collabora- tion between pathologists and clinicians regarding autopsy request, informed consent, and issues of interest, as well as the communication of autopsy findings in a timely manner. PS-21-002 Systemic fungal infection in patients with haematological malig- nancies, a retrospective autopsy study W. Cao* *Rhode Island Hospital, USA Background & objectives: Invasive fungal infection (IFI) is one of the causes of death in immunocompromised patients. In this study, we