ECP 2023 Abstracts

S146 Virchows Archiv (2023) 483 (Suppl 1):S1–S391 13 injuries, which allows simple visualization, easy navigation, measure- ments, and areas of interest delimitation. By creating this section of a digital library, postgraduate students, as junior in training or residents of Pathology may have easy access to the dedicated database, with the possibility of self-training and export of their personal annotations. Due to included available software tools, the collection may be also used for testing of their progresses in histopathology learning. Conclusion: Considering that digital histopathology becomes a real- ity in many universities and Pathology labs across the world, as it allows remote work, our project creates the base of modernization of the training curricula of future specialists in Pathology, providing also an additional channel of communication between students and teachers. The use of whole-slide-based imaging techniques represents a largely accepted educational method among Medicine undergraduate and post- graduate students and teachers and opens the perspectives of a better and optimized knowledge of microscopy. This study is supported by Erasmus+, ANPCDEFP - KA220- HED - Cooperation partnerships in higher education, project 2022-1-RO01-KA220-HED-000089017. E-PS-01-003 Incidental renal angiomyolipomas – autopsy findings C. Amalinei*, A. Grigora ș , L.A. Riscanu *“Grigore T. Popa” University of Medicine and Pharmacy, Romania Background & objectives: Angiomyolipoma is a relatively rare benign mesenchymal tumour, mainly located in kidneys, but also occurring in extrarenal sites. The aim of our study is to report a miniseries of cases of incidental angiomyolipomas necroptically diagnosed, from our files. Methods: Six cases have been selected from our files, four men and two women, with age range between 53-79 years-old, in which necroptic examination has been associated to collection of tissue specimens for microscopy. Routine hematoxylin-eosin staining, along with immunohis- tochemistry, using a panel of markers (HMB45, MelanA, SMA, Desmin, S100, Vimentin, CK AE1/AE3, and CK7) have been performed. Results: The histopathological examination revealed 0.5-2cm diameter, circumscribed, non-encapsulated renal tumours, with pushing borders, containing a variable triphasic pattern of growth (mature adipose tis- sue, myoid spindle cells, and large pleomorphic epithelioid cells), with trapped renal tubules, and dysmorphic thick walled hyalinized blood vessels. A variable positive immunoexpression of HMB45, MelanA, SMA, Desmin, S100, Vimentin, along with CK AE1/A3 and CK7 negativity has been observed. The corroboration of histopathological and immunohistochemical findings led to the diagnosis of incidental angiomyolipomas, classic variant. The differentials have been clear cell renal cell carcinoma, well differentiated liposarcoma, leiomyoma, leiomyosarcoma, pleomorphic rhabdomyosarcoma, melanoma, adrenal cortical carcinoma, oncocytoma, and mixed epithelial and stromal cell tumour of the kidney. Conclusion: Angiomyolipoma, a member of the perivascular epithelioid cell (PEC) tumour family, is usually diagnosed in the second or third dec- ade of life but, due to slow growth and late symptoms, it may represent an incidental finding in autopsy, such as in our miniseries of cases. Despite their rarity, angiomyolipomas should be considered in the differential diag- nosis of other renal tumour masses. The microscopic examination associ- ated with immunohistochemistry is important in diagnosis certification. E-PS-01-004 Unusual autopsy diagnosis in an adrenal tumour C. Amalinei*, A. Grigoras, L. Lozneanu *“Grigore T. Popa” University of Medicine and Pharmacy, Romania Background & objectives: Metastatic malignancies are relatively frequent in forensic practice. The aim of our study is to report a case with an unusual apparent primary adrenal tumour with multiple metastases, in a 75-year-old man, who has been diagnosed in our department. Methods: Necroptic examination has been associated with collection of tissue specimens for microscopy. Routine hematoxylin-eosin stain- ing, along with immunohistochemistry using a panel of markers (S100, HMB-45, Melan-A, PRAME, Synaptophysin, Chromogranin A, Inhi- bin A, and Ki67) have been performed. Results: The gross examination revealed a pigmented left adrenal mass, of about 2cm diameter, adherent to pancreas, with areas of haemorrhage of 0.1-0.2 cm, leptomeningeal, intra-cerebral, and intra-cerebellar pig- mented areas, of 0.3-1cm diameter, calcified coronary atherosclerosis, ischemic myocardial fibrosis, and areas of lung condensation. Adrenal microscopy revealed an irregular distribution of large atypical epithelioid cells, with confluent growth, marked nuclear enlargement, hyperchroma- sia, irregular coarse chromatin, prominent eosinophilic nucleoli, increased mitotic activity, tumour necrosis, abundant inflammatory infiltrate, haemorrhage, and fibrin deposits. Immunohistochemistry confirmed its melanocytic origin (HMB-45, S100, Melan-A, and PRAME positivity), associated with melanocytic-positive tumour implants in myocardium, leptomeninges, brain, pancreas and retroperitoneal soft tissues. Further- more, bronchopneumonia has been microscopically diagnosed. Conclusion: Although a large adrenal tumour may suggest a pheochro- mocytoma, the variable presence of pigment and immunohistochemical positivity for melanocytic markers confirmed the onset of a metastatic malignant melanoma in left adrenal gland, myocardium, leptomenin- ges, brain, pancreas, and retroperitoneal soft tissue, in the absence of an usual cutaneous or extracutaneous location of a primary tumour. The unusual autopsy presentation of this malignant melanoma serves as a reminder that melanoma may be always included in variable tumours differential diagnosis. E-PS-01-005 Aortic invasive fungal infection – a rare case in forensic pathology C. Amalinei*, R.A. Balan, T.A. Balan, A. Grigora ș *“Grigore T. Popa” University of Medicine and Pharmacy, Romania Background & objectives: Aortic wall invasion of fungal infection is a rare condition, which may occur following cardiac surgery or in immunocompromised patients. The aim of our study is to report an aorta invasive fungal infection, necroptically diagnosed in a 34 years-old men. Methods: Autopsy examination has been associated to collection of tis- sue specimens for microscopy. Routine hematoxylin-eosin and Periodic acid Schiff staining have been performed. Results: The autopsy showed consolidation area of 70/50/40mm, located in the right lung superior lobe and an area of necrosis in the ascending aorta wall, situated at 20mm superior to the sigmoid valves, associated with an intraluminal thrombotic mass. The microscopic examination revealed the fungal hyphae and neutrophils in the alveolar spaces associated with alveolar haemorrhages in the surrounding lung areas and fungal hyphae invasion of the pulmonary blood vessels. Within the ascending aorta, a partially occlusive thrombus covering an area of necrosis located in the media of the aortic wall, associated with fungal hyphae and neutrophils has been observed. Differentials between aspergillus, candida, and mucormycota species have been considered. Conclusion: Invasive fungal infection of the aorta is a rare and aggressive complication with high mortality. Despite their rarity, fun- gal aortitis should be considered in the differential diagnosis of other infectious aortitis (tuberculous or luetic aortitis), or non-infectious aortitis, such as giant cell arteritis, Takayasu arteritis, and Ormond’s disease. These may be incidentally discovered during the necropsy, the microscopic examination being important in the certification of diagnosis.