The article presents the main principles of clinical and pathological analysis at the present stage, unification of approaches to which is a necessary condition for obtaining reliable information on the causes of death in the Russian Federation. As a result of this analysis, the cause and mechanism of death, the features of tanatogenesis, the defects in the provision of medical care and their causes should be established, the information about which should be included in the clinicopathoanatomical epicrisis. It is also advisable to determine the preventability in each case of death, assigning it to the groups of preventable causes A, B, C and calculating the index of preventability of lethal outcomes. The final judgment on the existing defects in the provision of medical care, their causes, predictability or the unavoidability of death should be collegial and be adopted at the meetings of the subcommittee of the medical commission for the study of deaths, the treatment and control commission and the clinico-pathoanatomical conference.

Clinical and pathological epicrisis is an important component of the Documents "Protocol of Post Mortem Autopsy” and "Protocol of Post Mortem Autopsy of Fetus, Stillbirth or Newborn", reflecting the opinion of the prosector on the nature of diseases, their etiological, pathogenetic, clinical and morphological features, thanatogenesis, the cause of death of the patient. However, at present there is no unified approach to its design. The article proposes the rules for compiling a clinical and pathological epicrisis at the present stage, a list of questions to be answered by a pathologist on the basis of clinical and pathological comparisons.

In 2015, there was suggested the new international morphological classification of endometrial polyps which is based on the specific histological structure. The retrospective analysis of correlation between the histological variants of polyps in the biopsy and surgical material of Chelyabinsk regional pathologicoanatomic buro including the period from October 2014 to October 2017 was made in the aspect of age. The characteristics of correlation among the polyp’s histovariants according to the age were revealed. Endometrial polyps are registered more often in the postmenopausal period (44,2%). The atrophic variant predominated over the other variants (46,5%). The functional polyps more often occurred in the late reproductive period (45,4%) and the atrophic polyps - in the post-menopause (78,5%). Our received data can have importance in the patient management and prognosis of disease.

The review presents literature data on portal hypertension associated angiogenesis assay in experimental studies. The information was collected from the PubMed database, the Google Scholar retrieval system, and the reference lists from relevant publications for 1981 - 2017 using the keywords: “portal hypertension,” “jCT,” “angiogenesis,” “immunohistochemistry,” “intravital microscopy,” “microspheres.” Analysis of the literature showed that intra- and extrahepatic angiogenesis assays, such as micro-computed tomography in vivo and ex vivo, intravital microscopy, and computer image processing allow us to establish its important role in portal hypertension pathogenesis. The development of anti-angiogenic therapy, which would be focused on newly formed vessels, may be a perspective direction in the treatment of portal hypertension and its complications

The observation of anaplastic thyroid cancer in a patient of 60 years old with an established diagnosis of carcinosarcoma of the uterus. Abnormal formation in the thyroid gland was found accidentally during a control examination by the method of combined positron emission and computed tomography (PET / CT) and had no clinical manifestations. The diagnosis is established at pathohistological examination of an operating material - the resected left share of a thyroid gland. The data of literature about the features of diagnosis of anaplastic thyroid cancer.

This work is aimed to identify changes in levels of apoptosis and cell proliferation markers in pulmonary tumour tissues in workers following occupational radiation exposure. We analyzed immune and morphological specific characteristics of apoptosis system using autopsy samples of 40 pulmonary adenocarcinomas including 22 samples from Mayak PA radiation workers. Levels of apoptosis regulating proteins were shown to differ considerably in pulmonary adenocarcinoma foci of plutonium workers internally exposed to alpha-particles compared to those in occupationally unexposed individuals.

The article presents materials characterizing the place of hamart in the new classification of tumors and tumor-like liver processes. A detailed morphological description, histogenesis of individual species of hamartom is described.

We took 540 prostate biopsy samples from 90 patients and divided them the into six groups: the 1st group consisted of 15 patients with prostate carcinoma of a I Grade; the 2 nd group - 15 patients with prostate carcinoma of a II Grade; the 3 rd group - 15 patients with carcinoma of a III Grade; 4 th group - 15 patients with prostate carcinoma of a IV Grade; 5 th - 15 patients with prostate carcinoma of a V Grade; 6 th - 15 patients with atypical small acinar proliferation. We used morphological assay and statistical methods to provide comparative analysis of the groups. The highest mitotic activity of epithelial cells was found in patients with adenocarcinoma of a V Grade [Me = 15% (9-31)]. The lowest level of mitotic activity was identified in patients with atypical small acinar proliferation [Me = 3% (1-6)] and II Grade [Ме = 3% (1-6)]. The lowest expression of caspase-3 was detected in patients with atypical small acinar proliferation [Ме =9% (2-18] and with carcinoma of a I Grade [Ме=11% (2-18)]. The smallest expression of caspase-3 marker was identified in patients with adenocarcinoma of a V Grade [Me = 3% (1-12)].

The study was aimed to evaluate histopathological tumor response of omental metastases in BRCA1-associated and sporadic ovarian tumors after platinum-based neoadjuvant chemotherapy (NACT). We selected patients with histologically confirmed ovarian high-grade serous carcinoma who were treated with NACT followed by optimal debulking. Forty patients (14 BRCA1-associated cancers and 26 sporadic cases) meeting the criteria mentioned above were enrolled in the pathological examination. Clinical data (platinum-free interval, PFI) were collected through database review. Good regress [score 3] was observed in 4 out of 16 (25%) BRCA1-associated carcinomas and in one of 24 (4%) sporadic cancers (p = 0.14, Fisher's exact test). PFI was associated with the degree of response (minimal regress - median PFI 3.62 months, moderate regress - median 8.17 months, good regress - 21.28 months, p = 0.026, Kruskal-Wallis test). The omental response score predicted platinum-free interval in BRCA1-associated tumors (score 2+3 vs. 1; median PFI, 18.6 vs. 2.9 months; p = 0.04, Mann-Whitney U test). Histopathological tumor response of omental metastasis in BRCA1-associated and sporadic ovarian tumors after platinum-based neoadjuvant chemotherapy predicts PFI.

A comparative morphological, morphometric and immunohistochemical study of cervical biopsy specimens with dysplastic changes (cervical intraepithelial neoplasia - LSIL, HSIL) in women of two age groups: 1 group - patients of reproductive age; 2 group - women postreproductive (perimenopausal and menopausal) age. It was shown that a positive immunohistochemical staining for the presence of HPV was found in patients of reproductive age. It was revealed that in the patients of both groups the index of labeling p16 reached the maximum value at HSIL, regardless of the negative or positive reaction with HPV. The number of positively stained cells for ER and PR was higher in young women with LSIL and HSIL in comparison with the older age group, but their number decreased with the increase in the degree of dysplasia in both groups. It was noted that the highest index of protein labeling of p53 was found in women of the 2 age group with HSIL. There is no clear relationship between the expression of the p53 protein and the positive HPV coloration. The highest marking index of Ki67 is noted in women of reproductive age at all degrees of SIL.

The aim of the study is to evaluate the expression of TTF-1, EGF, Mesotelial cell, P504S in papillary carcinoma of the thyroid gland in children. Material and methods. Samples of 30 thyroid glands of children aged 10-17 that have been deleted after surgical treatment. Analysis of expression of TTF-1, EGF, Mesotelial cell, P504S was performed by immunohistochemical method on serial sections. Results. The expression of TTF-1, EGF was observed in papillary carcinoma and more severe in morphologically normal thyroid. In all studied samples of carcinomas detected the weak expression of Mesotelial cell. P504S-positive cells was determined in the tissue of papillary cancer (in follicular and papillary). Conclusions. The frequency of coexpression Mesotelial cell and P504S in papillary thyroid cancer enables the use of these markers as additional for the differential diagnosis of papillary cancer.

We took 540 prostate biopsy samples from 90 patients with atypical small acinar proliferation and prostate carcinoma. We divided the into six groups: the 1st group consisted of 15 patients with prostate carcinoma of a I Grade group; the 2 nd group - 15 patients with prostate carcinoma of a II Grade group; the 3 rd group - 15 patients with carcinoma of a III Grade group ; 4 th group - 15 patients with prostate carcinoma of a IV Grade group; 5 th - 15 patients with prostate carcinoma of a V Grade group; 6 th - 15 patients with atypical small acinar proliferation. We used morphological assay and statistical methods to provide comparative analysis of the groups. The lowest acid mucin expression level was observed in patients with atypical small acinar proliferation, whereas the highest level was observed in patients with prostate carcinoma of a I Grade group. The highest epithelium marker AE1/AE3 expression level was observed in patients with carcinoma of a II Grade group (3 scores); the lowest was observed in patients with carcinoma of a V Grade group (1 score). D2-40 marker expression level analysis revealed, that the total bulk density of limphatical vessels was the highest in atypical small acinar proliferation than in prostate carcinoma.

In order to study the individual links of the pathogenesis of kidney cancer using innovative morphofunctional methods of investigation, 84 patients were examined. The groups formed differed in age and in the nature of the prevalence of the tumor process. The results of the complex approach of the study showed that in renal carcinoma in peripheral blood a change in the ratio of the morphological forms of erythrocytes is noted. It was determined that the level of some biomarkers in a kidney cancer is higher with a more pronounced metastatic lesion, and the concentration is different when comparing age groups. In addition, the work presents a histological picture of kidney cancer, obtained by atomic-force and raster microscopy.

Introduction. According to the 2010 WHO classification, the precursors of colorectal cancer are conventional adenomas (tubular -AT, tubulo-villous - ATV and villous) and serrated lesions (hyperplastic polyps - HP, sessile serrated adenomas/polyps - SSA/P, traditional serrated adenomas - TSA). The evaluation of Ki67 expression is one of the components of the malignant potential of premalignant lesions of the colon and rectum. Materials and methods. Immunohistochemical expression of Ki67 was assessed in 28 HP, 30 SSA/P, 15 TSA, 30 AT, 28 ATV. In all cases the average percentage and location of colored nuclei were estimated. Results. Ki67 expression in HP and SSA/P was predominantly registered in the lower crypt regions, the Ki67-index in HP was 63%, in the non-dilated crypts of SSA/P - 66,2% (p>0,05). In the dilated crypts of SSA/P the Ki67-index was 35,8%, that is significantly lower than in the HP and the non-dilated crypts of SSA/P (p<0,05). In AT, ATV and TSA, the expression of Ki67 is noted predominantly in the upper crypt regions and is 59,3%, 64,2% and 63%, respectively (p>0,05). In the ectopic crypts of TSA the Ki67-index is 29,9% and is not significantly different from the basal regions in ATV. Conclusion. The predominance of Ki67-positive cells in the upper half of the crypts supports the "descending" model of cancer development in AT, ATV and TSA; the predominance of Ki67-positive cells in the lower half of the crypts in HP and SSA/P may be indicative of the "ascending" model of carcinogenesis. Based on the predominant localization of Ki67-positive cells and the index of proliferative activity, it is possible to divide the premalignant lesions of the colon and rectum into two groups: serrated lesions (HP + SSA/P) and conventional adenomas (AT + ATV + TSA).

Analysis was performed of obstetric and gynecologic history of 262 primary breast cancer patients referred for surgery to regional oncological center in January - December 2013 year. All patients were divided into 6 groups according to cancer molecular-biological subtype: 1) triple negative with basal phenotype, 2) triple negative without basal phenotype, 3) luminal B Her2neu+( positive), 4) luminal А, 5) luminal B Her2neu- negative, 6) non luminal Her2neu+. Results. Patients with more aggressive and prognostically worse triple negative and luminal B Her2neu positive subtypes of cancer had more abortions and miscarriages. Proportion of women with 3 and more pregnancies in group of triple negative cancer was higher compared with luminal. Amount of deliveries was also higher for patients with triple negative cancer compared to those with favourable luminal subtypes.

The analysis of morphological diagnostic of adrenals tumors during 2013-2016 is provided. There were 20 men and 50 women. Average age of men 62,7, women - 51,7. Tumors of adrenal cortex met in 31 cases, a medullar - in 39 cases. The histological and the immunohistochemical research were conducted. Malignant tumors consists of 23 observations. For their assessment used the following criteria - a polymorphism of cells, an invasion of the capsule, vessels and perineural space, existence of the focus of a necrosis, size of a mitotic index, and also an index of proliferative activity (Ki67). Grade- stading of tumors was carried out.

The morphological characteristics of intrapulmonary lymph nodes (IPLN) are presented in patients with primary lung cancer according to resection data. Clinical, radiological and pathological comparison was performed and it was shown that in most cases, a differential diagnosis was made between the primary tumor process and metastatic lung injury. Macroscopically on the resected material, increased IPLN with pronounced dust and atrophy were detected. In a number of cases, IPLN was identified as a random finding in the morphological study of surgical material. An observation was made in which a segmental resection of the lung was performed in connection with an erroneous diagnosis of metastasis in patients with anthracoconiosis IPLN.

In the article there have been estimated the resources of cell block method by having conducted an immunocytochemical research for further morphologic diagnostics of tumorous pleura lesions studied on the material of pleural fluid. During the research pleural fluid of patients with unilateral tumorous pleura lesions was studied with cell block method. Cell blocks were studied with immunocytochemical method and there were verified metastases of lung adenocarcinoma in pleura and mesothelioma. The results of the research have proved diagnostic significance of cell block method that improves quality of morphologic diagnostics of tumours of various localizations and provides conducting a valuable immunocytochemical research without using methods of “explosive” fixation that is especially valued when it is impossible to get histological material.

The reproducibility of the Modified Vienna classification of gastrointestinal neoplasia on the gastric mucosal biopsies was evaluated by using the kappa statistic. The work of a group of pathologists-experts was organized in the remote access mode with a demonstration of 26 cases (98 microphotographs) and an evaluation of the diagnostic category of gastric intraepithelial neoplasia/dysplasia. Different levels of agreement between the opinions of the participating experts have been established in depending on the diagnostic difficulty level. The kappa level ranged from 0.2 (poor agreement) to 0.66 (good agreement) and was depending from the chosen method of correction of the result. , This circumstance contributed to the formation of opinion that the diagnoses indefinite neoplasia/dysplasia-low and high grade neoplasia/dysplasia were the most difficult decisions. Possible reasons which reduce the level of consistency of pathologists are discussed.

Purpose: to reveal the peculiarities of the duodenogastric reflux (DGR) impact on acidity and morphological features of the gastric mucosa in patients with "primary" reflux gastritis, as well as in cases of reflux gastritis in combination with H. pylori. Methods: 66 patients with chronic reflux gastritis were examined, 15 people formed a control group. All patients had gastric endoscopy with determination of the gastric acidity and concentration of bile acids. Biopsy material for histological examination was obtained from 55 patients, in 12 cases of suspected intestinal metaplasia additional histochemical (PAS and alcian blue) and immunohistochemical (cytokeratin 20, Villin, carcinoembriogenic antigen, MUC2, CD45) assays were performed. Results: the level of acidity in patients with DGR was higher (pH = 3.55 ± 2.3) compared to the control group (pH = 6.85 ± 1.34). Cases of DGR differed from the control group regarding the mononuclear infiltration (p=0,001), foveolar hyperplasia (p=0,001) in both antral and fundic parts of the stomach, mucosal edema (p=0,022) and atrophy (p=0,02) at the level of the antrum, and intestinal metaplasia (p=0,022) at the level of the body. In the presence of H. pylori infection, in addition to the abovementioned signs, infiltration by cells of acute inflammation (p = 0.005) was detected, which indicates an increase in the damaging effect of H. pylori infection in DGR. Conclusion: DGR may lead to "oxidation" of gastric contents. The effect of DGR leads to intestinal metaplasia of the body and atrophy of the antral part of stomach, chronic inflammation and foveolar hyperplasia. The presence of H. pylori boosts the morphological changes in the gastric mucosa caused by DGR.

The aim of the study was to evaluate the expression of p16ink4a protein in the histological preparations of the uterine mucosa by the method of immunohistochemistry in women with benign endometrial diseases (chronic endometrium, endometrial hyperplasia). Materials and methods. 60 people were observed, which were divided into 3 groups: I group consisted of 20 women with histological examination of endometrium diagnosed with hyperplasia associated with chronic endometritis, group II (comparison group) - 20 patients with chronic endometritis, group III (group control) - 20 women with normal endometrium. In our material, in all women, endometrial hyperplasia is combined with a chronic low-activity endometritis. At the same time, 90% of these women register p16 ink4a protein expression more often as a diffuse form. In patients with chronic endometritis, p16 ink4a is detected in 85% of the observations, but only as a single expression. In women with normal uterine mucosa, in most cases (85%), expression of p16 ink4a is not observed. The foregoing indicates the need to examine patients who have endometrial hyperplasia in combination with chronic endometritis, for the presence of papillomavirus infection to optimize therapy.

Background. Distribution of tuberculosis (TB) in prison population (PP) is nearly 100 times higher, than among the civilian population according to WHO data. Aim: to estimate TB at ex-prisoners. Material and methods. 1045 protocols of autopsies of persons with a pulmonary tuberculosis (2000-2010 yrs.) are analysed. The analysis was carried out with use of nonparametric methods of statistics. The comorbid status was described by the Charlson's comorbidity index. Results. In the group of exprisoners larger distribution of chronic forms of the TB was revealed. Conversely, the group of honest citizens was characterized with the augmentation of a part of the acute progressing forms. As a comorbid diseases alcohol abuse and drug addiction prevailed. Conclusions. Tuberculosis of the ex-prisoners patients had not any age features. Longer course of TB, prevalence of chronic forms are, in our opinion, a positive effect of the increased attention in the relation infection with tuberculosis and well-timed treatment in this group of persons. The prevalence of acute progressing forms among died honest citizens demonstrates overdue diagnostics and the tardive beginning of specific therapy of TB in a cohort of law-abiding citizens of the Russian Federation.

The article presents the observation of a generalized hemangiomatosis in the puerpera of 28 years. The patient entered the maternity hospital at the gestational age of 39-40 weeks with the clinic of antenatal fetal death, premature detachment of the normally located placenta. In an emergency, she was laparotomy, a Caesarean section. During the subsequent period of the patient's stay in the hospital four operations were performed. In the course of the operations, the uterus and tubes were extirpated for 12 days, splenectomy for 32 hospital stings. Each surgical intervention was accompanied by a significant blood loss (1800 ml, 1500 ml). Despite the resuscitation measures carried out in full, the death of the child was due to the progression of the DIC syndrome. As a result of an autopsy study, the diagnosis "General Disease” was diagnosed with O99.8 generalized hemangiomatosis with uterine and splenic lesions, thrombosis of abnormal vessels of various prescriptions during pregnancy 39-40 weeks. From the standpoint of the doctrine of preventable mortality, this lethal outcome should be considered unacceptable, and clinical diagnosis of generalized hemangiomatosis is difficult due to the absence of cutaneous manifestations of the disease.

The results of a morphological study of 1049 needle biopsies of the prostate are presented. The study showed that prostate cancer is detected in 1 of 39 men aged 40-59 years, in 1 out of 14 - at the age of 60-69 years, in 1 of 7 - older than 70 years. Adenocarcinoma accounts for 95% of all malignant tumors of the prostate. In most cases, the tumor is diagnosed as acinar adenocarcinoma. Benign hyperplasia and dysplasia occurred in the 6th decade of life, chronic prostatitis in 6 and 7 decades, in 4 cases, tuberculosis lesions were detected, noninformative material was presented in 1 case (0,095%).

In order to create wet gross specimens of the eye by experimentally modeling the aim fixation in solutions and isolating individual structures for the subsequent study of the similarities and differences in the structure of the human and bovine eyeball and its muscular apparatus, and also for the use of wet gross specimens of cadaveric eyes in the simulation training of ophthalmic surgeons, enucleated eyeballs in different solutions. In total, 12 eyeballs fixed in four working solutions were studied, followed by an evaluation of external morphometric parameters. The most optimal way of fixing cadaveric enucleated eyes is to create wet gross specimens was fixation in a hypertonic solution of white salt for 7 days. Wet gross specimens of the eyes of cattle are applicable to the study of the general anatomical structure of the human organ of vision and the development of basic surgical skills, such as carrying out incisions and suturing

Resume. The aim of the study was to study the structural organization of the liver and the ultrastructure of Kupffer cells in neonatal mice of two opposing lines of CBA and C57BI/6, who underwent chronic intrauterine hypoxia (CIUH). Materials and methods. One-day mice of the lines CBA and C57B1/6 were divided into four groups, 10 animals each: animals 1 (CBA) and 2 (C57B1/6) groups - mice bearing CIUH; animals 3rd (CBA) and 4th (C57B1/6) groups - mice of control groups. The effect of CIUH led to significant destructive changes in the liver parenchyma of one-day mice of both lines (CBA and C57Bl/6), more pronounced in C57B1/6 mice. The processes of reparative regeneration of liver parenchyma in C57Bl/6 mice transplanted with CIUH were less than in CBA mice and control mice and did not correspond to the scale of destructive changes in the liver parenchyma. In the Kupffer cells in C57Bl/6 mice transferred CIUH, a decrease in the protein-synthetic and energy functions of the Kupffer cells was detected, which was manifested by a decrease in the indicators characterizing the endoplasmic retikuluum, mitochondria, and demonstrates the state of desadaptation of the Kupfer cells. In the CBA mice that underwent CIUH, the Kupffer cells energy function was increased in relation to that in the control animals and characterizes the Kupfer cells compensation state in CIUH conditions.

The purpose of this work was the presentation of morphological data of the structure of the skin of a Syrian hamster, actively used as an experimental animal to create a model of a burn wound. According to our studies, it is revealed that, with the similarity of the structure of the skin of a Syrian hamster to human skin, the distinctive feature is the absence of sweat glands. In connection with this, the Syrian golden hamster can be used as an experimental animal in the analysis of the processes of skin regeneration in the burn wound with subsequent extrapolation of data to humans.

The work was performed on 120 white non-linear rats. The cerebral cortex ischemia (CCI) was induced by diathermocoagulation of the pial vessels in the sensomotor zone of the cerebral cortex. Erythropoietin (EPO) was used intraperitoneally at a total dose of 15,000 IU/ kg, laser radiation (LR) - once to the area of the ischemic focus (970 nm, 2 min). The number of small blood vessels was counted and an expression of the vascular endothelial growth factor (VEGF) was determined in the ischemic focus. In case of CCI the expression of VEGF increases and the number of small blood vessels decreases in the ischemic focus on days 3, 7, 14, and 30. The use of EPO in CCI increases the number of small blood vessels, LR increases an expression of VEGF and the number of small blood vessels on the 3, 7, 14, 30 days of the experiment; the quantity of blood vessels is higher after exposure of LR as compared with the use of EPO. The maximal expression of VEGF and the number of small blood vessels in CCI are revealed after the combined use of EPO and LR.

We investigated the features of reparative process in the resected liver after laser irradiation of the zones of red bone marrow localization In rat experiment, the wedge-shaped resection of a liver lobe was performed. Infrared laser was applied for 5 days after the operation. The hystological analysis of liver specimens demonstrated the increase in hepatocyte proliferation with the increase in the ki-67 index and the nuclear-cytoplasmic ratio, the increase in binuclear hepatocytes number, the increase in the expression level of VEGF and Hsp 70 in the laser treatment group that is the evidence of successful recovery process and neoangiogenesis. The activation of hepatic tissue regeneration after laser irradiation of bone marrow localization zones may be the basis for the development of methods for treatment of liver disease patients.

The experiment was carried out in 25 laboratory rats. After modeling of normotrophic cutaneous scars, the procedure of laser dermabrasion with 50 Watt carbon dioxide laser was performed in superpulse mode with impulse-pause ratio of 0,5:100 ms and 500 pm spot diameter. Morphological, immunohistochemical and morphometric examination of skin histological sections were performed. A single exposure to CO2 laser radiation in this mode resulted in the early formation of mainly type III collagen and then type I collagen in ratios approaching to the intact skin.