[Breast granular cell tumor]. / Zernisto-kletochnaya opukhol' molochnoi zhelezy.

The report of the biopsy diagnosis of the granular cell tumor with rare localization in the breast is given. Currently, the tumor is considered a neoplasm of neuroectodermal origin. Differential diagnostic criteria for the tumor are positive expression in cytoplasm of protein S-100, absence of expression of epithelial antigens, histiocytic antigens, oncoproteins, estrogens and progesterone receptors, PAS-positive reaction of intracellular granules. With ultrasound examination and mammography, a tumor always initially assessed as cancer or calcification.

[Varicose veins of the esophagus as a manifestation of left-sided portal hypertension]. / Varikoznoe rasshirenie ven pishchevoda kak proyavlenie levostoronnei portal'noi gipertenzii.

An autopsy of pancreatic cancer in a woman who died from acute posthemorrhagic anemia due to repeated bleeding from esophageal varices is presented. The mechanism of development of esophageal varices associated with the so-called left-sided portal hypertension, caused by compression of the splenic vein by the tumor and the opening of porto-caval anastomoses, is considered. A brief review discusses other possible causes of left-sided portal hypertension syndrome and its consequences.

[Three-chambered heart: the unusual clinical course of a fatal birth defect at 58 years old]. / Trekhkamernoe serdtse: neobychnoe klinicheskoe techenie vrozhdennogo poroka s letal'nym iskhodom v 58 let.

The paper describes an autopsy case of congenital heart disease as a single ventricle with transposition of the great vessels in a woman who survived to the age of 58 years. Due to hemoconcentration that has compensated for chronic hypoxia, the woman received low-molecular-weight heparin, which was complicated by severe heparin-induced thrombocytopenia resulting in death from cerebral hemorrhage. The author is inclined to explain the unusual clinical course of the disease by the fact that despite the mixing of arterial and venous bloods, transposition of the great arteries in the patient must have been accompanied by the flow of the bulk of arterial blood into the aorta and venous blood into the pulmonary trunk.

[Artificial illness as a result of non-medical use of anabolic androgenic steroids: A case report and a review of literature]. / Posledstviya nemeditsinskogo ispol'zovaniya anabolicheskikh steroidov.

A 42-year-old female body builder who had used anabolic androgenic steroids (AASs) for 18 years to build up muscle mass died from liver rupture. The cause of the latter was multiple abscesses caused by Actinomyces, which developed in the presence of immunodeficiency. The postmortem changes in different organs were due to hormonal imbalance. The paper gives the data available in the literature pertaining to the analysis of the effects of AASs taken in supraphysiological doses on the body and their non-medical application.

[An observation of HELLP syndrome with fatal outcome].

The paper describes the morphopathological changes found at autopsy of a 42-year-old pregnant woman whose death was due to HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelets) that is rarely encountered in autopsy practice and that is a type of preeclampsia. It considers the morphogenesis of these changes in the light of the pathophysiological mechanisms underlying the syndrome.

[Renal urothelial carcinoma mainly composed of signet-ring cells].

Autopsy study of an 80-year-old man has identified his renal tumor metastasizing to the heart, lung, and liver as urothelial car- cinoma; at the same time some cells in the main tumor and all cells in the metastases had a signet-ring phenotype, but neither mucicarcimine nor alcian blue stained the cell cytoplasm. The paper provides the histological and immunohistochemical pattern of the tumor and emphasizes its exclusive rarity. Attention is drawn to the possibility of signet-ring cell transformation in the cells of different tumors, including nonepithelial ones.

[AL amyloidosis originally considered as systemic vasculitis].

The paper describes a sectional case of the rare unusual manifestation of AL amyloidosis in a 58-year-old woman with multiple small myocardial scars, a lung decay focus, and extensive gastric mucosal necrosis that has led to fatal hemorrhage, which was assessed as the pattern of systemic vasculitis before immunological examination. The pathogenesis of this form of AL amyloidosis is considered as a manifestation of malignant transformation of B lymphocytes.

[Iatrogenes of manipulator character in abdominal surgery].

The authors analyzed the data of 281 cases of iatrogenes of manipulator character in abdominal surgery in order to investigate the circumstances and character of origin. There were 187 cases of operative confirmation and 84 cases of unintentional intraoperative retained foreign bodies. It was detected, that primary planned intervention of higher category of complexity should be related to the high risk group of the development of the operative confirmation. Retained foreign bodies with soft fabric base were diagnosed in early postoperative period as the result of the beginning of postoperative complications. The retained foreign bodies with tough backer material as a rule didn't cause the complications in early postoperative period. They were diagnosed in long-term postoperative period in majority of cases.

[The inexpediency of using the term "iatrogenicity" in expert and legal practices].

Various contradictory definitions of "iatrogenicity" are considered. Bearing in mind the absence of the universally recognized interpretation of this concept, the authors believe it nappropriate to use the term "iatrogenic" in expert and juridical practice.

[About eligibility of certificates of death from hepatic insufficiency].

Death from hepatic insufficiency is casuistic and occurs only in rare cases of fulminant viral hepatitis B, poisoning with some hepatotrophic compounds, and reaction to certain pharmaceutical products. Hepatic insufficiency is frequently indicated as the immediate cause of death of the subjects suffering liver cirrhosis and some other diseases in postmortem conclusions of forensic medical expertise and autopsy protocols. This mistake ensues from the incorrect interpretation of the results of laboratory analysis of the affected hepatocytes as manifestations of compromised liver function. The true cause of death to be stated in death certificates should be deduced based on different characteristics.

[Breast silicone granulomas].

With the lapse of time, silicone leakage from breast implants leads to the formation of giant cells granulomas and fibrous capsule with calcification caused painful sensation. The morphogenesis of tissue changes around implants, which has been persistence up to 12 years, are described.

[Cellular pathology and revolution of scientific medicine (on the occasion of the 190th anniversary of Rudolf Virchow's Birth)].

Rudolf Virchow destroyed the old humoral pathology, created the doctrine of cell physiology and pathology, which has not lost its importance to date, described a great many pathological processes in detail, and put into practice appropriate terminology and classification. Up until the present pathology appreciably remains Virchow's cellular pathology despite modern science advances, inevitable changes and clarities of our ideas about the structure and function of organs and tissues. Virchow's cellular pathology has radically altered the view on the essence of painful processes, by opening a new epoch in the history of medicine and medical science.

[Lethal poisoning with the death-cap mushrooms].

We have analysed morphological manifestations in five cases of lethal poisoning with the Death Cap toxin and compared the relevant clinical and laboratory findings with those in 15 survived subjects. It was shown based on the results of autopsy that poisoning was associated with hepatopathy, extensive hepatic necrosis, and nephropathy. Elevated blood bilirubin levels in conjunction with lowered prothrombin and fibrin concentrations appear to be the main causative factors responsible for the unfavourable prognosis of this intoxication.

[Experience in teaching microscopic diagnosis to beginning pathologists].

The following methods of microscopic diagnosis training are proposed: the analysis of microscopic slides using the microscope equipped with video camera visualizing images on the screen of telemonitor with a group of 2-4 physicians; situation tasks using histological slides from legal postmortems; discussion with trainees of their conclusions on current biopsies obtained by these trainees; situational tasks on the sets of biopsies of last years.

[Contribution of the pathology chair of the Military Medical Academy to the development of military pathological anatomy]. / Rol' kafedry patologicheskoi anatomii Voenno-meditsinskoi akademii v razvitii voennoi patologicheskoi anatomii.

In 1930-1940 the pathology chair of the Military Medical Academy participated in organization of military pathological anatomy service. The activity of the chair staff goes in two directions: management of pathology service activity in the army both at peace and war time and research in combat pathology.

[Liver changes in people of conscription age--"carriers" of hepatitis B and C viruses]. / Izmeneniia pecheni u lits prizyvnogo vozrasta--"nositleli" virusov gepatita B i C.

89 liver needle biopsies from young persons--HBV and HCV carriers--were studied histologically, immunohistochemically, morphometrically and electron microscopically. Groups with compensatory-adaptive and degenerative liver lesions, those with mild manifestations of a chronic virus infection, and those with chronic hepatitis of minimal and weak activity were identified. Latent chronic hepatitis is found in 68.5% of HBV and HCV carriers. Morphological picture of HCV infection is more pronounced as compared to that of HBV infection. The role of eosinophils in the development of hepatitis B and C forms lacking clinical symptoms is demonstrated.