A biological stone from a medieval cemetery in Poland

Calcified uterine leiomyoma from an 18th-century nunnery in North Italy

OBJECTIVE

To develop a differential diagnosis of a mass retrieved alongside skeletal remains in the crypt of the church of Santissima Annunziata of Valenza (Province of Alessandria, Northern Italy).

MATERIAL

A calcified mass measuring 40 × 39 mm and 17.62 × 16.3817.62 × 16.38 mm.

METHOD

The analysis utilized macroscopic assessment and histologic examination (including histochemical and immunohistochemical analyses).

RESULTS

Morphological traits include an irregular and spongy external surface. Holes of different sizes lead toward the inner part of the object. A section of the mass shows an "intertwined bundle" pattern, confirmed by microscopic examination.

CONCLUSIONS

Differential diagnosis determined the mass to be consistent with calcified leiomyoma.

SIGNIFICANCE

Identifying uterine leiomyoma adds to the paucity of paleopathological literature on the condition and to calcified tumors more broadly. It also allows for an important discussion of women's gynecological health in the past and potentially among nulliparous women.

LIMITATIONS

Neither histochemical staining nor immunohistochemical analysis demonstrated the certain muscular nature of the specimens due to the rehydration and decalcification processes, for which there are no gold standards.

SUGGESTIONS FOR FURTHER RESEARCH

Calcified masses are common in the clinical literature but remain rare in paleopathological literature. Careful excavation and improved recognition of apparently calcified masses are necessary to improve recognition, diagnosis, and interpretation.

Differential diagnosis of a calcified object from the South Tombs Cemetery at Amarna, Egypt

OBJECTIVE

This paper provides a brief history of the publication of calcified biological objects and presents one that was present in the grave associated with a mature adult female buried in the South Tombs Cemetery at Amarna, Egypt (c. 1353-1332BCE).

METHODS

Macroscopic examination revealed an ovoid object constructed of concentric layers of a coarse sand-like material oriented around a dense core that lacked evidence of parasites. Microscopic examination revealed the object is composed of densely, yet haphazardly packed, elongated octahedron shaped crystals with no evidence of cellular structures. Basic chemical analysis eliminated calcium carbonate as a constituent material.

RESULTS

Based on comparison with previously published examples from the archaeological and clinical literature and careful differential diagnosis, it is suggested this object is a bladder stone.

SIGNIFICANCE

A brief discussion of the implications of bladder stones on individual health and broader epidemiological constraints to illustrate the depth such discoveries can bring to our understanding of ancient lived experience concludes the work.

LIMITATIONS

The burial of Ind. 286 was disturbed. The identification of a bladder stone presumes the stone would have been found within the pelvic cavity, which cannot be confirmed. Other graves in the vicinity of this grave were also disturbed. It is unlikely, but still possible, that the stone originated from another grave and was relocated to this grave after disturbance. Full chemical analysis was not possible.

SUGGESTIONS FOR FUTURE RESEARCH

Radiographic and chemical analysis would provide more information to strengthen the certainty of the differential diagnosis.

Differential diagnosis of a calcified cyst found in an 18th century female burial site at St. Nicholas Church cemetery (Libkovice, Czechia)

During archaeological excavations in burial sites, sometimes stoned organic objects are found, in addition to human remains. Those objects might be of a different origin, depending on various factors influencing members of a community (i.e. diseases, trauma), which provides information about their living conditions. The St. Nicholas Church archaeological site (Libkovice, Czechia) in the 18^th century horizon of the cemetery, yielded a maturus-senilis female skeleton with a stone object in the left iliac fossa. This object was an oviform cyst-like rough structure, measuring 54 mm in length, 35 mm in maximum diameter and 0.2–0.7 mm shell thickness. Within the object there were small fetal bones (long bones, i.e. femur and two tibias, two scapulas, three ribs, vertebrae and other tiny bone fragments). Methods utilized to analyze the outer and inner surface morphology of the cyst and its inside, included: X-ray, CT imaging, SEM, histological staining and EDS. The EDS analysis revealed the presence of primarily oxygen, calcium and phosphorus in bone samples, and oxygen and silicon, in stone shell. Based on the length of the femur (20.2 mm) and tibia (16 mm) shafts, the fetal age was determined as being in the 15–18 week of pregnancy. The differential diagnosis was conducted, including for the three most probable cases: fetiform teratoma (FT), fetus-in-fetu (FIF) and lithopedion. The possibility of fetiform teratoma was discounted due to the presence of an anatomically correct spine, long bones and the proportions of the find. Although the low calcium content in the shell (2.3% atom mass), the lack of skull bones and the better developed lower limbs indicate fetus-in-fetu rather than lithopedion, the analyses results are unable to conclusively identify the object under one of these two categories since there are insufficient such cases in excavation material with which to draw comparison.

Identifying sialoliths through SEM technology

OBJECTIVE

To define SEM characteristics that may aid identification of sialoliths.

MATERIALS

Two sialoliths from modern patients affected by sialadenitis.

METHODS

Samples were coated with silver and subjected to scanning electron microscopy using an energy-dispersive X-ray spectroscopy detector. Samples were then sectioned to permit study of the internal structure.

RESULTS

Sialoliths show an external smooth surface with no distinctive features. Internal structures consist of a distinctive aggregate of coarse granules of different sizes surrounded by a lamellar coat. Elemental composition consists of carbon, phosphate, calcium and oxygen, with traces of magnesium. The proportion of these elements differs between the core and the surface.

CONCLUSION

Although elemental composition is not specific, SEM analyses of sialoliths greatly differ from those of sesamoid bones, gallstones and nephroliths. Therefore, SEM analysis constitutes a useful tool for the precise identification of small calcified structures recovered during archaeological excavations.

SIGNIFICANCE

Precise identification of calcified structures may provide information about nutritional and/or pathological aspects of past individuals.

LIMITATIONS

Sialoliths are less common than other types of calcifications, and only two cases were analyzed in this study.

FUTURE PROSPECTS

SEM technology should be applied to identify the etiology of all minute calcified remains recovered during archaeological excavations of burial sites.

Differential diagnosis of calcified nodules from a medieval Székely woman in Transylvania

OBJECTIVE

To differentially diagnose two calcified objects found with the well-preserved and nearly complete skeletal remains excavated in June 2012 by the Haáz Rezső Múzeum in Odorheiu Secuiesc, Romania.

MATERIAL

Two objects measuring 25.55 × 18.23 mm and 17.62 × 16.38 mm found with the skeletal remains of a probable female approximately 25-35 years old at the time of death.

METHODS

Analysis utilized X-ray, SEM, EDS, CT scanning, and gross morphology to assess pathological conditions with calcification as a common sign.

RESULTS

Multiple analyses of the objects revealed two roughened ovoid nodes with internal hollows and openings. Elemental analysis indicated an organic origin, likely representing calcified soft tissue.

CONCLUSIONS

Differential diagnosis determined the calcified nodules to be consistent with calcified tumors, and most consistent with a calcified leiomyoma with cystic degeneration, potentially uterine.

SIGNIFICANCE

The identification of the calcified nodules as most consistent with calcified uterine leiomyomas adds to the paucity of paleopathological literature on calcified leiomyomas and calcified tumors more broadly. It also allows for an important discussion of the health of women in medieval Transylvania.

LIMITATIONS

Interpretation would be aided if a more precise origination within the body was known. Careful excavation and improved recognition of organic objects is necessary for a more definite diagnosis.

SUGGESTIONS FOR FURTHER RESEARCH

Soft tissue calcifications are a common process in a wide variety of diseases and can arise in all areas of the body. Pathological calcifications are relatively common in modern contexts, but remain rare in paleopathological literature.

Novel Substrates as Sources of Ancient DNA: Prospects and Hurdles

Following the discovery in the late 1980s that hard tissues such as bones and teeth preserve genetic information, the field of ancient DNA analysis has typically concentrated upon these substrates. The onset of high-throughput sequencing, combined with optimized DNA recovery methods, has enabled the analysis of a myriad of ancient species and specimens worldwide, dating back to the Middle Pleistocene. Despite the growing sophistication of analytical techniques, the genetic analysis of substrates other than bone and dentine remain comparatively "novel". Here, we review analyses of other biological substrates which offer great potential for elucidating phylogenetic relationships, paleoenvironments, and microbial ecosystems including (1) archaeological artifacts and ecofacts; (2) calcified and/or mineralized biological deposits; and (3) biological and cultural archives. We conclude that there is a pressing need for more refined models of DNA preservation and bespoke tools for DNA extraction and analysis to authenticate and maximize the utility of the data obtained. With such tools in place the potential for neglected or underexploited substrates to provide a unique insight into phylogenetics, microbial evolution and evolutionary processes will be realized.

A giant urinary bladder stone in the mummy of Lebanese Maronite Patriarch Joseph Tyan (1760-1820) and its environmental and nutritional implications

INTRODUCTION

Historical sources and anthropological investigations, with the indispensable support of radiology, bring to light pathological evidence of the past.

CASE PRESENTATION

The purpose of this article is to present the radiological investigation conducted on the mummy of the Maronite Joseph Tyan (1760-1820), a famous patriarch who guided the Lebanese Maronite community during a critical period of its history. The natural mummy of the Patriarch was temporarily removed from its burial site to certify the degree of preservation. Conventional radiography was necessary to determine the state of the internal organs and any physical abnormalities, and to clarify the degree of conservation of the mummy.

DISCUSSION

Radiological analysis uncovered an exceptional case of a large urinary bladder stone. This pathological evidence confirms historical documentary sources that in the last years of his life the Patriarch suffered from abdominal pain and urinary problems. We can suppose that the environment and diet of the Maronite community, limited by restricted agricultural resources, was the possible cause of the urinary bladder stone, as today the epidemiology of these diseases demonstrates links with mainly cereal diets in rural areas.