Ceskoslovenská Patologie

Histopathological pattern of progressive pulmonary fibrosis could be seen in many different fibrotic lung interstitial diseases. Exact diagnosis is crucial for precise therapy, moreover, different diseases have different prognosis. The most important disorders in this group are idiopatic pulmonary fibrosis and fibrotic hypersensitivity pneumonitis, and their separation is crucial because of totally different treatment of the patients. The aim of this review is to sum up the most important characteristics of usual interstitial pneumonia, histopathological pattern of idiopatic pulmonary fibrosis, and fibrotic hypersensitivity pneumonitis and provide a practical work-up for precise diagnostics of these diseases in the frame of effectively cooperating multidisciplinary team...

Cystic trophoblastic tumor (CTT) is a rare non-aggressive germinative neoplasm from the group of non-choriocarcinomatous trophoblastic tumors, which is presented by cystic spaces lined with mononuclear degenerative-looking trophoblastic cells. CTT has been most often described as a residual disease in dissected retroperitoneal lymph nodes of patients with metastatic germ cell testicular tumours after chemotherapy. There were published only sporadic cases of primary testicular mixed germ cell tumour with CTT component...

The 5th edition of WHO classification of the urinary tract tumors is only mildly edited version of the previous WHO classification (from year 2016). The most prominent changes are represented by modifications in the structure and concept of chapters and there are minor alterations in the nomenclature of some entities. Histological characteristics are still the gold standard for classification of urothelial tract neoplasms.

The fifth edition of the WHO classification of prostate tumors provides new insight into prostate cancer pathogenesis supported by molecular data. It discards the terms low-grade PIN and high-grade PIN. The new entity „Treatment-related neuroendocrine prostatic carcinoma“ is introduced. The importance of the diagnosis of intraductal carcinoma is highlighted. The terminology of prostatic basocellular carcinoma is upgraded. Some cancer subtypes are being relocated to different chapters based on new findings...

Compared to the WHO classification of the male genital tumors in 2016, minimal changes were introduced in the current WHO 2022. Classification of germ cell tumors remains the same as in the previous edition, dividing germ cell tumors into those derived from germ cell neoplasia in situ (GCNIS) and those independent of GCNIS. The group of GCNIS derived germ cell tumors is essentially unchanged. Most remarkable change was made to the chapter teratoma with somatic malignancy. Primitive neuroectodermal tumor (PNET), a particular type of somatic malignancy arising in the setting of teratoma, is currently termed embryonic-type neuroectodermal tumor (ENET)...

Similarly to testicular tumors, key changes on penile and scrotal neoplasia were incorporated into WHO classification 2016. Therein, penile squamous cell carcinomas were divided into two groups based on the pathogenesis, namely HPV-associated and HPV-independent. This remains unchanged in WHO classification 2022. For those carcinomas where HPV status can not be determined, a category of squamous cell carcinoma NOS was added. Variants of squamous cell carcinoma, namely basaloid, papillary-basaloid, warty, warty-basaloid, clear cell and lymphoepithelioma-like carcinomas are not recognized as distinctive variants of HPV-associated group anymore...

The 5th edition of WHO classification of adult renal tumors introduced a couple of changes in existing, well established entities, as well as some new distinct renal tumors. Papillary renal cell carcinoma (RCC) is no longer divided into type 1 and type 2. Type 1 is now called “classic” variant and type 2 doesn´t exist anymore. There were long discussion about problematic type 2. According to WHO 2022 the correct name is papillary RCC (and subtype/variant should be mentioned in the description)...

Mucormycosis is a fungal disease caused by fibrous saprophytic fungi called mucorales. The most important genera include Lichtheimia, Mucor and Rhizopus. For a weakened person they are pathogenic. The disease progression is serious, with high mortality. The clinical picture is varied, depending on the organ affected. We distinguish several main forms: rhino-cerebellar, pulmonary, cutaneous, disseminated, gastrointestinal and other rare forms. Our case concerns a less common gastrointestinal form that affected a patient after a lung transplant and was accompanied by perforation of a fungal ulcer of the gastric wall with bleeding and hemorrhagic shock...

Giant cell fibroblastoma is a rare locally aggressive tumor of subcutaneous mesenchymal tissue, occurring mostly on the trunk in young individuals with maximal incidence in the first decade of life. Local recurrences of giant cell fibroblastoma are common if marginally excised, however, distant metastases do not occur. Giant cell fibroblastoma was labelled as a juvenile variant of dermatofibrosarcoma protuberans (DFSP) due to quite frequent combination of both lesions, morphological similarities, identical immunoprofile, and shared gene fusion t(17;22) COL1A1-PDGFB...

Tumors of the central nervous system (CNS) include primary tumors - itraaxial, growing from brain and spinal cord cells (neuroepithelial tumors) or extraaxial, growing from surrounding structures (brain and spinal cord, nerve sheaths, vascular structures, lymphatic tissue, germ cells, malformations, pituitary glands). Much more often they are located in the intracranial space a solitary or multiple metastatic spread of malignancy originating from another organ (eg lung, breast, malignant melanoma, Grawitzs tumor)...

The current progress and increasing knowledge about the genetic causes of cancer opens up new possibilities for its treatment. However, it is necessary to combine the results obtained using classical pathological methods with sensitive, multiplex molecular pathological methods. The method that meets the required criteria is MLPA based on multiplex PCR reaction. This method detects both changes in gene copy number and DNA methylation and, last but not least, point mutations. The MLPA reaction is applicable to even highly fragmented DNA...

The new WHO classification of CNS tumors is largely based on molecular diagnostic. Without molecular methods some entities can no longer be diagnosed. We are trying to show a rational approach to the CNS tumors diagnostics, which is based on conventional molecular methods such as RT-PCR, Sanger sequencing, MLPA, extended by the next generation sequencing (NGS) and methylation SNP array.

The aim of the presented communication is to clearly inform the general professional public about the newly approved modifications in this classification, including the newly approved types of tumours. A significant change is the new grading system for these tumours, including the innovative involvement of tumour profiling at the molecular level in the system for determining the degree of tumour differentiation and the application of the principle of integrated diagnostics, i. e. the synthesis of available histopathological and molecular findings in CNS tumors...

A group of 279 adult autopsy patients (66 obese with BMI 30, versus 213 nonobese with BMI < 30) was retrospectively studied for the relation between body weight and coronary artery atherosclerosis. In the obese group, there was slightly higher grade of coronary narrowing than in the nonobese (2.31/2.5 versus 2.12/2). With increasing BMI in the obese, there was a statistically significant trend for milder coronary atherosclerosis, with least involvement in the extremely obese (BMI > 50). It seems that increased body weight by itself has little impact on coronary atherosclerosis, and extreme obesity may even by protective from it...

We present a case report of a 51-year-old patient who underwent totalization of thyroidectomy - resection of the right thyroid lobe for growth progression of the largest nodule from which a fine needle aspiration biopsy (FNAB) was performed and was cytologically suspected of malignancy. Nodule was a graywhite colored tumor with a solid structure, histologically with an unusual morphology and immunoprofile, called cribriform morular thyroid carcinoma (CMTC). Usually, the tumor behaves indolently with a good prognosis...

Gastrointestinal (GIT) diseases represent an important part of pediatric health disorders. The recent years have brought not only significant improvement of digestive endoscopy technologies and a new equipment suitable for pediatric age but also progress in management of diagnostic approach and treatment of the pediatric GIT diseases. In contrast to adult patients, endoscopic examination in pediatrics is in most cases performed for diagnostic, not therapeutical purposes. The histological assessment of biopsy specimens taken during endoscopy therefore forms an integral part of the endoscopic examination and in most cases the diagnosis cannot be concluded without their evaluation...

Duodenum is currently the most popular site to obtain samples of intestinal mucosa for recognition of a disorder leading to malabsorption. Although there are significant overlaps between histological findings described in various non-neoplastic diseases of the duodenum, recognition of one of the six basic morphologic patterns, namely coeliac disease-like pattern, active chronic duodenitis, acute GvHD-like pattern, enteritis with predominant eosinophilic infiltration, enteritis with predominant infiltration by macrophages, and non-inflammatory enteropathy, usually allows diagnostic separation, especially if subtle histological details, clinical setting and serological investigation are taken into account...

Histological investigation of non-neoplastic endoscopic biopsies of gastric mucosa is one of the most common tasks most pathologists have to face on daily basis. Although the most common clinical question is still being whether Helicobacter organisms are found, pathologists have to bear in mind the whole spectrum of causes and associated morphological patterns of gastritides and gastropathies, governed by characteristic combinations of various types of inflammatory infiltrate, alterative and reactive changes of epithelial component, vascular response, and variability of stromal composition...

Uterus transplantation is a new experimental treatment method of absolute uterine factor infertility which affects 3-5% of infertile women. Absolute uterine factor infertility includes infertile women with agenesis or severe malformation of the uterus, several acquired uterine diseases causing infertility, and patients of fertile age after hysterectomy because of various causes. Uterus transplantation is considered a new method of assisted reproduction which allows women with absolute uterine factor infertility to have own biological offspring...

Penile paraffinoma or sclerosing lipogranuloma is a disease occurring uncommonly in Czechia; a pathologist meets this only rarely. Microscopically, we deal with chronic fibroproductive inflammation localised usually in subcutaneous tissue of the penis. It is caused by previous voluntary injection of liquid paraffin / mineral oil for the purpose of penis circumference augmentation, usually performed by a non-healthcare person or by the patient himself. Human tissues do not have enzymes that can break down synthetic lipids...