ECP 2023 Abstracts

S334 Virchows Archiv (2023) 483 (Suppl 1):S1–S391 13 1:50,000 cases. The purpose of the work is to demonstrate a multi-stage approach to making a pathoanatomical diagnosis. Methods: We have studied a sectional case of pathoanatomical autopsy of an 8-month-old child with a chromosomal abnormality, which included the stage of autopsy with an assessment of organometric and morphometric parameters, microscopic and histochemical studies of organs with additional staining of the PAS reaction. Results: Pathologically, the child revealed: agenesis of the corpus callosum, internal non-occlusive hydrocephalus; perimembranous ventricular septal defect (1cm); bilateral ureterohydronephrosis and cryptorchidism; bilateral aplasia of the patella (confirmed x-ray); clinodactyly 2 fingers; deformed phalanx and nail plate of 2 fingers of the right foot; synostosis of the spinous processes C2-C3. Stigmas of dysembryogenesis: sunken nose bridge, snub nose, symmetrical orbital hypertelorism, short palpebral fissures, thick lips, gothic palate, short and wide folded neck, dysplastic large low-lying auricles, transverse palm furrow. On the part of the pancreas, hypoplasia of the islets of Langerhans (2-3 in each lobule) was revealed, the number of PAS- positive cells was reduced. Conclusion: in the biochemical analysis of cadaveric blood, the con- tent of glycohemoglobin was 5.9%; determination of glucose - the result is negative, acetone at a concentration of 30.5 mg / ml.The mos 47, XY, +8 karyotype was cytogenetically identified. The complica- tions of the disease include: oedema and swelling of the substance of the brain, pronounced metabolic disorders in the form of uncorrectable hyperglycemia, decompensated metabolic acidosis and multiple organ failure. A post-mortem comprehensive approach is needed to clarify this pathology. E-PS-19-021 Comprehensive assessment of thanatogenetically significant changes in the heart in miscarriages at a period of 15-21 weeks of gestation V. Mironov*, E. Ignatyeva, S. Lezhenina, E. Guryanova, E. Shamitova *Chuvash State University by I.N.Ulianov, Russia Background & objectives: We analysed the dynamics of macrometric parameters and pathomorphological changes in the vegetative ganglia of the heart, contractile and conductive myocardium of foetuses at 15-22 weeks of gestation under the influence of various intrauterine factors. Methods: The protocols of autopsies of miscarriages with a single method of morphometric analysis of the 121 hearts were retrospec- tively studied at 15-22 weeks of gestation. First the perimeters of large vessels and outlets, foetal circulatory communications, the mass and volume ofthe heart with separate weighing ofits chambers, the ven- tricular index were measured. Microscopy of preparations stained with hematoxylin-eosin was performed. Results: The main causative factors leading to intrauterine foetal death are identified: congenital malformations, intrauterine infection and intrauterine foetal hypoxia. In 50% of cases, intrauterine growth retar- dation was detected. Weight and hemodynamically significant macro- metric parameters of the heart directly depend on the gestational age of the foetus (CI=98%, p<0.01). The calculation of the volume of the heart in the foetus is more informative than its size, and in combina- tion with its assessment and the mass of the heart, it serves as strong evidence in ascertaining thanatogenetically significant manifestations of heart failure in the foetus. Conclusion: Thus, the dynamics of macrometric parameters and patho- morphological changes in the autonomic ganglia, contractile and con- ductive cardiomyocytes in miscarriages with a gestation period of 15 to 22 weeks are directly dependent on the gestational age and do not have specificity to the nature of the impact of antenatal factors (intrauterine hypoxia, intrauterine infection and congenital developmental anoma- lies). The noted macrometric indicators make it necessary to revise the existing standards for autopsy studies in foetuses. E-PS-19-022 Total anomalous pulmonary venous return: two unusual perinatal autopsy cases of a rare diagnosis C. Mora*, J. Vaz Silva, A. Costa Braga *Serviço de Anatomia Patológica, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal Background & objectives: Total anomalous pulmonary venous return (TAPVR) accounts for 2% of congenital cardiac anomalies, where pul- monary veins communicate into systemic venous circulation rather than left atrium. Prenatal diagnosis is often missed, with a high mortal- ity in the first year of life. Methods: We describe two unusual presentations of this entity, with a brief literature review. A 19 day-old term newborn (case 1), presented with cyanosis and severe pulmonary hypertension, and a 3 day-old term newborn (case 2), with a diagnosis of an obstructive TAPVR, whom a stent was placed after birth. After multiple episodes of hemodynamic instability, both newborns deceased. Results: Regarding the autopsies, in case 1, the pulmonary veins converged into a common descending vertical vein, anterior to the abdominal aorta, which crossed the diaphragm, and drained into the portal vein - infracardiac TAPVR- associated with interatrial defect (ostium secundum type) and a patent ductus arteriosus. Case 2 showed a retroatrial common confluence with a stent, communicating with the innominate vein - obstructive supracardiac TAPVR. The case 1 also had syndactyly of the 5th/6th fingers of the right foot. No facial dysmorphic features were identified. Histopathological examination showed hypoxic-ischemic alterations in both cases and a bronchopneu- monia and osmotic tubulopathy in case 2. Conclusion: Performing an autopsy with meticulous inspection of car- diac vascular connections, pulmonary and systemic circulations, allows more discoveries and a better understanding of TAPVR, resulting in earlier diagnosis and surgical intervention. Despite the improvement of the overall prognosis, our cases had conditions associated with poor outcome which contributed to their demise. We highlight the impor- tance of acknowledgment of this rare entity, as clinical recognition is challenging, and it can be mistaken for respiratory diseases or sudden infant death. E-PS-19-023 Diffuse multifocal chorangiomatosis: a rare case of placental pathology O. Pedro*, G. Miranda, M. Honavar, R. Machado-Neves, T. Amaro *Unidade Local de Saúde de Matosinhos - HPH, Portugal Background & objectives: To report a case of diffuse multifocal cho- rangiomatosis, presented in a 27-year-old woman with a history of Type 1 Diabetes and autoimmune thyroiditis presented with a 32+4 weeks gestation and foetal growth restriction with umbilical cord flow abnormalities. Methods: Six days after the admittance, a caesarean section was performed due to late decelerations in foetal cardiotocography. The delivery was uneventful, with a live female newborn weighing 1350g and Apgar scores of 6/9/9. The newborn was admitted to the neonatal intensive care unit, and both the mother and newborn’s hospitalizations were uneventful. Results: Gross decription: The placenta weighed 237.9 grams with brownish and partially translucent membranes, with marginal insertion. The umbilical cord measured 180 mm in length, with paracentral inser- tion and hyper-spiralization. The parenchyma showed several compact nodular areas, whitish, yellowish, and reddish, dispersed and occupying 40% to 50% of the placental parenchyma. Microscopy: There where several nodules of variable size, scattered throughout the placental parenchyma with proliferation of small capillaries with a circumferential layer of pericytes, and occasional