[Update on collaborative autopsy-based research in German pathology, neuropathology, and forensic medicine]

BACKGROUND

Autopsies are a valuable tool for understanding disease, including COVID-19.

MATERIALS AND METHODS

The German Registry of COVID-19 Autopsies (DeRegCOVID), established in April 2020, serves as the electronic backbone of the National Autopsy Network (NATON), launched in early 2022 following DEFEAT PANDEMIcs.

RESULTS

The NATON consortium's interconnected, collaborative autopsy research is enabled by an unprecedented collaboration of 138 individuals at more than 35 German university and non-university autopsy centers through which pathology, neuropathology, and forensic medicine autopsy data including data on biomaterials are collected in DeRegCOVID and tissue-based research and methods development are conducted. More than 145 publications have now emerged from participating autopsy centers, highlighting various basic science and clinical aspects of COVID-19, such as thromboembolic events, organ tropism, SARS-CoV‑2 detection methods, and infectivity of SARS-CoV-2 at autopsy.

CONCLUSIONS

Participating centers have demonstrated the high value of autopsy and autopsy-derived data and biomaterials to modern medicine. The planned long-term continuation and further development of the registry and network, as well as the open and participatory design, will allow the involvement of all interested partners.

[Dacryolith in a lacrimal duct]

A 31-year-old woman presented with a prominent, yellowish conjunctival mass in the left temporal canthus that had persisted for 3 months despite previous puncture. Repeat incision and curettage produced an 8 mm long concretion. A histopathological examination revealed a dacryolith in the lacrimal duct. This pathology is very rare in this location but has to be considered as a differential diagnosis when patients present with prominence and discomfort in the area of the temporal canthus. The treatment of choice is resection of the dacryolith and irrigation of the lacrimal ducts with penicillin.

Epididymal leiomyoma: a benign intrascrotal tumour

Physicians will be rarely confronted with epididymal tumours. These represent only 5% of intrascrotal tumours and are mostly (75%) benign. We report the case of a 50-year-old white male who was presented with a 5-year history of a slow-growing, left scrotal mass, noted through self-examination. Ultrasound study of the scrotum identified a well-circumscribed paratesticular mass. On inguinal surgical exploration, a solid, encapsulated, grey-white mass at the tail of the left epididymis was identified and excised, with intra-operative pathological consultation showing no signs of malignancy. The diagnosis of an epididymal leiomyoma was determined through subsequent immune-histopathological analysis. Diagnostic steps preceding operative exploration of a paratesticular, epididymal tumour are briefly analysed and physicians are encouraged to avoid a radical approach, without prior pathological consultation. Epididymal leiomyomas are benign tumours that can be cured through simple, organ-preserving surgical excision.

Galectin-3 and Cyclin D3 Immunohistochemistry and Tumor Dimensions Are Useful in Distinguishing Follicular Oncocytic Carcinomas from Oncocytic Adenomas of the Thyroid

Aims. Oncocytic (Hurthle) follicular cell tumors (OTs) of the thyroid are both adenomas (OAs) and follicular carcinomas (OCs). The routine diagnosis of these tumors can be problematic even after an accurate sampling and histological examination. Beside preoperative evaluation due to the tumor's dimension several studies have been performed to find markers able to distinguish malignant from benign follicular tumors in the thyroid, with Galectin-3 being one of the most effective. Recently, some authors suggested cyclin D3 as adjunct to the diagnosis of the oncocytic lesions of the thyroid. Methods and Results. In this paper we assess the role of Galectin-3 and cyclin D3 in a well-selected group of follicular oncocytic tumors (14 OCs and 26 OAs). The diameter of each lesion was also evaluated. The combination of Galectin-3 and cyclin D3 has a good specificity (81%) and sensitivity (100%). Moreover, the maximum diameter (in cm) of OCs is greater than OAs (4.1 versus 2.3). Conclusions. We believe that the use of Galectin-3 and cyclin D3 in OTs of the thyroid can be a helpful panel in daily practice when histology is doubtful.

Disseminated Superficial Porokeratosis with Dermal Amyloid Deposits

Only 6 cases with an association of disseminated superficial porokeratosis with dermal amyloid deposits are reported in the literature. We present the case of a 76-year-old woman who presented with a disseminated superficial porokeratosis. Histological examination revealed amyloid deposits in the upper dermis, which were typed with routine HE stains, Congo red stains and anticytokeratin antibodies (AE1-AE3 and CK5). Positive staining with Congo red and, moreover, with CK5 (a cytokeratin strongly represented in the basal cell layer of the epidermis) indicates an epidermal origin of this protein.

A Case of Ketron-Goodman Disease

Pagetoid reticulosis (PR) is a rare form of cutaneous T-cell lymphoma [Mod Pathol 2000;13:502-510]. Two variants of the disease are described: the localized type Woringer-Kolopp disease (WKD) and the disseminated type Ketron-Goodman disease (KGD). KGD may have disseminated lesions, high rate of recurrence and a guarded prognosis [Mod Pathol 2000;13:502-510]. In patients with KGD, therefore, long-term observation is necessary. Disappearance of cutaneous lesions does not mean resolution of the disease [J Am Acad Dermatol 2002;47:183-186]. Herein we report the case of an 84-year-old man with erythematous patches of the trunk and the upper and lower extremities in whom the diagnosis of KGD was made. We describe this case for the rarity of this pathology and for the good response to therapy (IFN).