Adult ; Colon, Transverse ; pathology ; Hernia, Diaphragmatic ; pathology ; Humans ; Male ; Respiratory Insufficiency ; pathology ; Spleen ; pathology ; Stomach ; pathology

Scrub typhus, an acute febrile infectious disease caused by R. tsutsugamushi, has been reported from various parts of the far east and pacific rim of Asia including Korea. It is well known that all human pathogenic rickettsia share an affinity to endothelial cells of the small blood vessels and evoke vascular inflammation variably associated with a rash, microthrombi, and hemorrhage. We infected the ICR mice by inoculating sublethal doses of R. tsutsugamushi R19 strain intraperitoneally and observed the pathologic changes by time sequence. The histopathologic features of experimentally induced scrub typhus in the mice were generally nonspecific interstitial inflammations characterized by interstitial pneumonitis, periportal inflammation, multifocal hepatic necrosis, interstitial nephritis, sinusoidal engorgement, and lymphohistiocytic cell infiltration in lymph nodes and spleen. Contrary to the general features of other rickettsial diseases, the pathologic process of scrub typhus experimentally induced by R. tsutsugamushi R19 strain mainly involved the interstitial connective tissue but not the blood vessels.
Animals ; Liver/pathology ; Lung/pathology ; Male ; Mice ; Mice, Inbred ICR ; Scrub Typhus/*pathology ; Spleen/pathology

To determining the postmortem interval (PMI) through quantitative analysis of the DNA degradation of cell nucleus in human brain and spleen by using image analysis technique (IAT). The brain and spleen tissues from 32 cadavers with known PMI were collected, subjected to cell smear every 1 h within the first 5-36 h after death, stained by Feulgen-Van's staining, Three indices reflecting DNA in brain cells (astrocytes) and splenic lymphocytes, including integral optical density (IOD), average optical density (AOD), average gray (AG) were measured by employing the mage analysis instrument. The results showed that IOD and AOD declined and AG increased with the prolongation of dead time within 5-36 h. A correlation between the PMI and gray parameters (IOD, AOD and AG) was identified and the corresponding regression equation was obtained. The parameters (IOD, AOD and AG) were proved to be effective quantitative indicators for accurate estimation of PMI within 5-36 h after death.
Cell Nucleus/*pathology ; DNA Degradation, Necrotic ; Forensic Pathology ; Liver/*pathology ; Postmortem Changes ; Spleen/*pathology ; Time Factors

Splenic hamartomas are rare benign tumors, which are usually small in size and asymptomatic and which are discovered incidentally at surgery or autopsy. The authors report on a case of splenic hamar toma in a 35-year-old man with intermittent left upper quardrant pain, who underwent an elective splenc tomy. Final pathology confirmed diagnosis of a hamartoma of the red pulp in the spleen. The patient's symptoms were resolved after the splenectomy. A splenic hamartoma should be kept in mind in the differential diagnosis of splenic tumors. The authors suggest that a splenectomy is indicated in cases where malignancy cannot be excluded and in cases of associated clinical symptoms or hematologic disorders.
Adult ; Autopsy ; Diagnosis ; Diagnosis, Differential ; Hamartoma* ; Humans ; Pathology ; Spleen* ; Splenectomy

Adult ; Female ; Humans ; Sclerosis ; pathology ; physiopathology ; Spleen ; pathology ; Splenic Neoplasms ; pathology

Animals ; Echinococcosis, Hepatic ; pathology ; surgery ; Humans ; Male ; Organ Sparing Treatments ; methods ; Spleen ; pathology

OBJECTIVESeven cases of autopsy from SARS patients are studied to investigate the pathogenesis and the pathologic changes of the major organs.

METHODSDetailed gross and microscopic examination of the autopsy specimen is performed, including lung, heart, liver, kidney, spleen and lymph nodes.

RESULTSAll of the lungs are markedly enlarged and consolidated. Microscopically, pulmonary edema is a prominent finding, especially at the early stage of the disease (5 days after the onset). The alveolar spaces are filled with fibrinous exudates and lined with hyaline membrane. In 5 cases that undergo over 3 weeks of the course, the main pattern is organization of intra-alveolar deposit, along with fibroblastic proliferation in the alveolar septa, which leads to obliteration of alveolar space and pulmonary fibrosis. All of the lungs show bronchopneumonia, scattered hemorrhage, and proliferation of alveolar epithelial cells with desquamation. Microthrombi are seen in 6 cases. Fungal infection is noted in 2 cases. One of them is disseminative, involving bilateral lungs, heart, and kidney; the other one is diagnosed in hilar lymph nodes. In immune system, hilar and abdominal lymph nodes are usually congested and hemorrhagic, with depletion of lymphocytes, and accompanied with subcapsular sinus histiocytosis. One of the cases shows enlargement of abdominal lymph nodes, which have reduced number of germinal centers. Spleen exhibits atrophy of white pulps, and even lost of white pulps in some areas. The red pulp is markedly congested and hemorrhagic. In 5 cases, cardiomegale is prominent. Thrombosis (2 cases), focal myocarditis (1 case), and fungal myocarditis (1 case) are observed. In addition, liver shows massive necrosis (1 case) and nodular cirrhosis (1 case).

CONCLUSIONSLung is the major organ affected by SARS, demonstrated as diffuse alveolar damage. It is postulated that viral infection induces severe damage of alveolar epithelial and capillary endothelial cells, leads to pulmonary edema, intra-alveolar fibrin deposit, and hyaline membrane formation. Consequently, intra-alveolar organization and alveolar septal fibrosis causes loss of alveolar spaces, eventually, pulmonary fibrosis and atelectasis. The immune system is often affected, and presented as depletion of lymphoid tissue in lymph nodes and spleen. Secondary infection is a common complication, which should be paid close attention in the management of SARS patients.

Adrenal Glands ; pathology ; Adult ; Autopsy ; Bone Marrow ; pathology ; Female ; Humans ; Kidney ; pathology ; Liver ; pathology ; Lung ; pathology ; Male ; Middle Aged ; Myocardium ; pathology ; Severe Acute Respiratory Syndrome ; pathology ; Spleen ; pathology

OBJECTIVETo study the pathological characteristics of severe acute respiratory syndrome (SARS) and its relationship to clinical manifestation.

METHODSTissue specimens from 3 autopsy cases of diagnosed SARS were studied under microscopy and the clinical data were reviewed.

RESULTSThe typical pathological changes of lungs were diffuse hemorrhage on surface. A mixture features of serous, fibrinous and hemorrhagic inflammation were seen in most pulmonary alveoli with engorgement of capillary and there were microthrombosis in some capillary. Pulmonary alveoli became thick with interstitial mononuclear inflammatory infiltration, diffused alveoli damage, desquamation of pneumocytes and hyaline-membrane formation. Fibrinoid materials and erythrocytes could be found in alveolar spaces. There were thrombo-embolisms in some bronchial artery. Meanwhile, haemorrhagic necrosis was showed in lymph nodes and spleen with attenuation of lymphocytes. Other atypical pathological changes, such as hydropic degeneration, fatty degeneration, interstitial cell proliferation and some lesions observed in liver, heart, kidney, pancreas may have existed before the hospitalization.

CONCLUSIONSevere damages of pulmonary and immunological system damage are responsible for clinical features of SARS and may lead to death of patients.

Aged ; Female ; Humans ; Lung ; pathology ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Severe Acute Respiratory Syndrome ; pathology ; Spleen ; pathology

OBJECTIVETo study the pathological characteristics of severe acute respiratory syndrome (SARS) and its relationship to clinical manifestation.

METHODSTissue specimens from 3 autopsies of probable SARS cases were studied by microscope, and the clinical data was reviewed.

RESULTSThe typical pathological changes of lungs were diffuse hemorrhaging on the surface. A combination of serous, fibrinous and hemorrhagic inflammation was seen in most of the pulmonary alveoli with the engorgement of capillaries and detection of micro-thrombosis in some of these capillaries. Pulmonary alveoli thickened with interstitial mononuclear inflammatory infiltrates, suffered diffuse alveolar damage, experienced desquamation of pneumocytes and had hyaline-membrane formation, fibrinoid materials, and erythrocytes in alveolar spaces. There were thromboembolisms in some bronchial arteries. Furthermore, hemorrhagic necrosis was also evident in lymph nodes and spleen with the attenuation of lymphocytes. Other atypical pathological changes, such as hydropic degeneration, fatty degeneration, interstitial cell proliferation and lesions having existed before hospitalization were observed in the liver, heart, kidney and pancreas.

CONCLUSIONSevere damage to the pulmonary and immunological systems is responsible for the clinical features of SARS and may lead to the death of patients.

Aged ; Humans ; Lung ; pathology ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Severe Acute Respiratory Syndrome ; pathology ; Spleen ; pathology

OBJECTIVETo investigate the value of acoustic radiation force impulse (ARFI) in evaluating the stage of hepatic fibrosis and early stage cirrhosis.

METHODSSixty-six patients with viral hepatitis underwent liver biopsy and 33 normal subjects (S0) were selected to accept ARFI,the shear wave velocity of hepatic segments s5, s6, s7, s8 and size of liver were measured. The results of liver and spleen size and portal vein's diameter were also measured.

RESULTSThe 66 patients were divided into 3 groups: S1, S2-S3, S4. ARFI for 66 patients and 33 normal subjects showed good image quality. There were statistically significant differences between S4 group and S0 group, S1 group, S2-S3 group for the shear wave velocity of hepatic segments s5, s6, s7, s8 (P < 0.05). Between S2-S3 group and SO group S1 group, the shear wave velocity of hepatic segments s5, s6, s7, s8 also have statistically significant differences (P < 0.05), other parameters showed no significant difference (P > 0.05). Spleen size and the portal vein's diameter of S4 group were larger than those in other groups (P < 0.05).

CONCLUSIONSThe invasive acoustic radiation force impulse could evaluate the stage of hepatic fibrosis and early stage cirrhosis in patients suffering from viral hepatitis. The measurement was feasible. It was suitable for clinical use.

Acoustics ; Adult ; Female ; Humans ; Liver ; pathology ; Liver Cirrhosis ; pathology ; Male ; Middle Aged ; Portal Vein ; pathology ; Spleen ; pathology