ECP 2023 Abstracts

S148 Virchows Archiv (2023) 483 (Suppl 1):S1–S391 13 and pathologist. Without symptoms, aspiration often goes undetected or is misdiagnosed and may eventually cause morbidity and even mortality. Funding: FDI internalization of higher education E-PS-01-010 Massive perivillous fibrin deposition and COVID 19: a neonatal autopsy case report G. Escuer*, P. Puente López, M. Parron-Pajares, E. Martin-Boado, I. Esteban-Rodríguez, R.M. Regojo-Zapata *La Paz University Hospital, Spain Background & objectives: Massive fibrin deposition (MPFD/MFD) causes significant neonatal morbidity and mortality and has a multi- factorial aetiology. We present a neonatal autopsy case of this entity in relation to SARS-CoV-2 infection. Methods: We reviewed the clinical history and performed a radio- logical examination and a complete study of the internal organs of the newborn. Immunohistochemistry techniques C4d and SARS-CoV-2 spike antibody (1A9) Gene TeX were used for the histological evalua- tion of the placenta. We performed a literature review of this pathology in Pubmed. Results: In 2021, we performed an autopsy on a preterm newborn at week 25 who died at 45 min of life, despite resuscitation manoeu- vers, after an urgent caesarean section for risk of perinatal death in a threatened preterm labour. The mother was on HIV therapy with an undetectable load and tested positive for COVID-19 PCR in week 23. The only autopsy findings were a low weight percentile, an altered brain/liver ratio and a delayed radiological bone development. The placenta had a massive perivillous fibrin deposition with associated chronic histiocytic intervillositis. Due to the maternal medical history, spike COVID 19 immunohisto- chemistry was performed on the placenta with positive result. Conclusion: Massive fibrin deposition is a placental pathology at the second/third trimester that, although rare, has a great impact on foetal health and risk of recurrence. Although its pathophysiology is unclear, it has been associated with maternal thrombophilia, antiphospholipid syndrome, autoimmune dis- eases and a variety of infections such as cytomegalovirus, enterovirus and the newly emerging SARS-CoV-2. E-PS-01-011 Elements of COVID-19 morphogenesis after the development of viremia in the analysis of sectional cases of early death G. Gubina-Vakulik*, G. Gradil *KhNMU, Ukraine Background & objectives: The causes of death with COVID-19 were analysed and described in numerous publications. The objective was to show the paramount importance of “weakness” of the blood vessel endothelium for lethal outcome development at first days after viremia arising in COVID-19. Methods: The case histories, autopsy protocols and microprepara- tions of various organs stained with hematoxylin-eosin of 38 deceased patients with COVID-19 (Regional Clinical Infectious Diseases Hos- pital, Kharkiv) were studied, among which two patients lived from the onset of the first symptoms to death for 1-1.5 days and 7 patients who died on 5-6-7 days. Results: Patients who died within 1-1.5 days were patients with a his- tory of prolonged and severe diseases accompanied by frequent and severe damage to the endothelium of blood vessels: arterial hyperten- sion and general atherosclerosis, coronary artery disease with extensive post-infarction cardiosclerosis, type 2 diabetes. The autopsy material revealed signs of DIC followed by shock, without the formation of interstitial pneumonia. Patients who died on 5-7 days of COVID-19 had a history of the same diseases, but less long, in addition, 1 case - chemotherapy and 1 case - drug user. In them, we have observed pathologically the development of typical interstitial pneumonia with the development. Conclusion: Early deaths in COVID-19 are directly related to the rapid development of a decompensated state of the blood vessel endothe- lium due to a decrease in compensatory capabilities in the presence of endothelial-damaging background diseases. The decompensated state of the endothelium is developed very fast (shock) or in some days (interstitial pneumonia). For the pathologist, the possible effectiveness of the use of endothelium-sparing medications is obvious already at the first symptoms of COVID-19 in patients with a history of endothelial- damaging diseases. E-PS-01-012 Disseminated tuberculosis as a cause of death: an autopsy study E. Gun*, A. Bugra, S. Yalcinkaya, N. Ziyade *Basildon University Hospital, Mid and South Essex NHS Foundation Trust, Basildon, Essex, United Kingdom Background & objectives: Disseminated tuberculosis (DT) is a poten- tially fatal form of tuberculosis that occurs in 1-2% of all tuberculosis cases, as a result of the lymphohematogenous spread of Mycobacterium tuberculosis. We aimed to investigate DT cases that we encountered during forensic histopathology practice. Methods: Cases that underwent autopsies between January 2018 and July 2022 and were diagnosed with tuberculosis were reviewed. The demographical characteristics, country of origin, autopsy, histopatho- logical, and microbiological findings of the cases where DT was iden- tified as the cause of death were investigated. The histopathological prediagnosis of tuberculosis infection was confirmed microbiologically in all cases. Acid-fast staining results were graded from 1+ to 4+. Results: There were a total of 178 tuberculosis cases. Eighty-five of these cases were pulmonary tuberculosis whereas six of them were extra-pulmonary (EP) and 87 were DT. The mean age of DT cases was 35 years (15-86) with 71 males and 16 females. For DT cases, the second most commonly involved organ after the lungs was the liver, followed by the spleen, kidney, and lymph nodes. The majority of the cases had tuberculoid granulomas in multiple organs. There were six DT cases with heart involvement and two EP cases with isolated involvement of the heart. Central nervous system tuberculosis was detected in five cases and tuberculosis meningitis was detected in two. Conclusion: Tuberculosis infection continues to be a global health problem despite all treatments. According to World Health Organiza- tion data from 2021, it is the second most common infection result- ing in death worldwide. DT is a severe and potentially fatal form of tuberculosis that affects multiple organs, and its diagnosis requires a high level of suspicion. The findings from this study highlight the importance of histopathological and microbiological examinations in the postmortem period, which can aid in improving diagnostic and treatment approaches. E-PS-01-013 Conduction system hamartoma – autopsy case series E. Gun*, B. Keskin Ozturk *Basildon University Hospital, Mid and South Essex NHS Foundation Trust, Basildon, Essex, United Kingdom Background & objectives: Conduction system hamartoma is a benign hamartomatous lesion arising from Purkinje and Purkinje-like cells of the heart. It tends to occur in females under two years old. We aimed to investigate the cases that we detected during postmortem histopatho- logical examination.