Zoonotic parasite infection from a funerary context: A Late Antique child case from Cantabrian Spain.

OBJECTIVE: To evaluate the presence of Dicrocoelium sp. in a child from a Late Antique funerary context from Cantabrian Spain and discuss whether the infection is true infection or pseudoparasitosis. MATERIALS: Four skeletons, including one from a 5-7 year old child, have been analysed from the archaeological site of El Conventón, dated between the sixth and seventh centuries AD. METHODS: The paleoparasitological study was conducted through the analysis of soil samples from different parts of the skeleton and funerary context using the rehydration, homogenization, and micro-sieving method, and visualized through brightfield microscopy. RESULTS: A soil sample from the pelvic region tested positive for Dicrocoelium sp. (possibly D. dendriticum). CONCLUSIONS: The child was infected with Dicrocoelium dendriticum, which based on archaeological and historical contexts may be related to hygiene or dietary behaviour. SIGNIFICANCE: We present one of the few cases of the identification of a Dicrocoelidae parasite directly associated with a human skeleton that provides historical knowledge of a zoonotic disease. LIMITATIONS: The diagnosis of a zoonosis through the identification of ancient parasites is complex. In addition, Dicrocoelium sp. in association with skeletal human remains is rare due to the potential low prevalence of this parasite. SUGGESTIONS FOR FURTHER RESEARCH: Highlight the importance of paleoparasitological analysis to link parasitic infection diseases with socioeconomic issues by using funerary contexts with skeletal remains.

Incidental diffuse esophageal intramural pseudodiverticulosis. A rare autopsy finding / Pseudodiverticulosis intramural difusa esofágica incidental. Un raro hallazgo de autopsia

Esophageal intramural pseudodiverticulosis (EIPD) is a rare condition of uncertain etiopathogenesis which usually presents with either intermittent or progressive dysphagia. A review of the literature revealed very few studies of its histopathology. We report the case of a 70-year-old diabetic man who died after a road traffic accident. The patient had no history of dysphagia. The entity was discovered incidentally during the medico-legal autopsy. The esophagus showed numerous dilated pseudodiverticula confined to the submucosa and lined by both stratified squamous and cuboidal epithelium. EIPD can remain stable and asymptomatic. This case demonstrates the importance of a thorough investigation during a forensic autopsy (AU)

La pseudodiverticulosis intramural esofágica (PDIE) es un raro proceso de etiopatogénesis incierta que generalmente se manifiesta con disfagia intermitente o progresiva. Una revisión de la literatura ha revelado muy pocos casos publicados mostrando el aspecto histológico de esta condición. Presentamos el caso de un varón de 70 años de edad, diabético, que falleció tras un accidente de tráfico. El paciente no tenía historia de disfagia. La entidad fue descubierta incidentalmente al practicar la autopsia médico-legal. El esófago mostraba numerosos pseudodivertículos confinados a la submucosa y tapizados por epitelio estratificado escamoso y cuboideo. La PDIE puede permanecer estable y asintomática. Este caso demuestra la importancia de una exhaustiva investigación en la autopsia forense (AU)

Aortitis activa aislada (idiopática) en aneurismas de aorta ascendente: una vasculitis escasamente reconocida / Isolated (idiopathic) active aortitis in ascending aortic aneurysms: An underrecognized vasculitis

La aortitis aislada (o idiopática) es un proceso raro caracterizado por inflamación con presencia de células gigantes o de tipo linfoplasmocitario de la aorta. Esta entidad es una causa infrecuente de aneurisma de la aorta ascendente. La forma aislada de la aortitis se manifiesta generalmente como un aneurisma de la aorta ascendente y se descubre comúnmente de modo incidental durante el estudio patológico de la muestra de aorta tras la cirugía torácica. Presentamos dos casos de aortitis con células gigantes, activa, descubiertos tras el estudio anatomopatológico del tejido aneurismático aórtico extirpado quirúrgicamente. Las pacientes eran dos mujeres de 63 y 62 años respectivamente sin historia reumatológica. Ambas eran hipertensas y una de ellas era una gran fumadora. La aortitis de células gigantes se observó en el 2% de los pacientes operados por aneurisma de la aorta ascendente. La aortitis con células gigantes sin historia previamente establecida de arteritis (temporal) de células gigantes es difícil de identificar. Los casos que muestran aortitis con células gigantes solamente en el estudio histopatológico generalmente no son una manifestación de arteritis (temporal) de células gigantes. Puesto que la aortitis descubierta incidentalmente suele ser una lesión focal que ya ha sido extirpada, se recomienda un tratamiento conservador con evaluación periódica cuidadosa en este grupo de pacientes. Todas las muestras de pared aórtica deberían ser evaluadas por el patólogo(AU)

Isolated (idiopathic) aortitis is a rare process characterized by giant cells or lymphoplasmacytic inflammation of the aorta and is an uncommon cause of ascending aortic aneurismal disease. Isolated aortitis usually manifests as an aneurysm of the ascending aorta and it is often an incidental finding during the histopathological study of the aortic wall after thoracic surgery. We present two cases of isolated active aortitis discovered on microscopy of surgically excised aneurismal tissue. The patients were 63- and 62-year-old females, both hypertensive, one a heavy smoker but neither of whom had a history of rheumatic disease. Isolated aortitis occurred in 2% of surgical interventions for ascending aneurysms. Isolated aortitis with giant cells in the absence of previously established giant cell (temporal) arteritis is difficult to identify. Cases showing aortitis with giant cells only in the histopathologic study are usually not a manifestation of giant cell (temporal) arteritis. Since incidentally discovered aortitis may represent a focal lesion that has been surgically removed, a conservative approach to the management of these patients, which should include careful periodical evaluation, is recommended. All surgical aortic samples should be submitted for histopathological examination(AU)