Metastatic Hepatocellular Carcinoma Represents an Important but Rare Pitfall in the Diagnostic Evaluation of ER Negative Ovarian Malignancy: A Case Report.

Metastatic hepatocellular carcinoma (HCC) to the ovary is a rare and challenging histopathological diagnosis in the absence of the relevant clinical history. The differential diagnoses of a hepatoid tumor in the ovary are extensive, and correct diagnosis requires well-considered clinical-pathologic correlation. Familiarity with the diverse architectural patterns and immunophenotype of HCC is essential; however, even in the setting of known hepatic disease, a well-developed pseudoglandular pattern may be a convincing morphologic mimic of a primary surface epithelial ovarian malignancy. We describe a diagnostically challenging case of a 50-year-old woman with metastatic HCC exhibiting a prominent pseudoglandular pattern mimicking primary endometrioid adenocarcinoma, and an approach to overcome this important pitfall.

Placental histopathology and correlated clinical outcomes in kidney transplant recipients.

Pregnancies after kidney transplantation are high-risk. Whilst previous studies have explored pregnancy outcomes, there are no existing data on the placental histopathology findings of kidney transplant recipients and how these correlate with clinical outcomes. From 1976 to 2020, 62 pregnancies to 37 transplant recipients were identified in a South Australian clinical unit. The medical records were evaluated to identify if placental tissue had been sent for histopathology. The histology was reviewed contemporaneously, blinded to outcomes, following the Amsterdam consensus. The findings were correlated with the clinical data. Placental tissue was referred for histopathological examination in 20 pregnancies to 15 women. A high rate of adverse perinatal outcomes was noted, with fetal growth restriction (FGR; n=6), pre-eclampsia (n=8), worsening renal function with >10% increase in serum creatinine from preconception (n=9), pre-term birth (n=15), and antenatal hypertension (n=12). Maternal vascular malperfusion was seen in 14/20 pregnancies, including in all cases with pre-eclampsia, and was commonly observed with FGR (5/6 cases), decline in kidney function (8/9), antenatal hypertension (7/12) and preterm birth (12/15). In this high-risk population, increased obstetric ultrasound scans with uterine and umbilical Doppler should be considered to monitor and manage maternal uteroplacental vascular perfusion. We recommend all placental tissue from transplant recipients be referred for histopathological examination.

Climate and season: the effects on ophthalmic diseases.

Seasonal changes and climate have a significant impact on human health. Diseases influenced by temperature and climate conditions are likely to undergo dynamic pattern shifts with consequent impact on human health. A number of infectious and non-infectious ophthalmic diseases are influenced by temperature and seasonality. Awareness of this is important from public and global health perspective in addition to resource allocation strategies. We examine the evidence for a seasonal pattern to ophthalmic diseases and assess the possible impact of climate change.