[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.

Septische Granulomatose als seltene Differenzialdiagnose rezidivierender pulmonaler Infektionen bei Erwachsenen

Die septische Granulomatose (engl.: chronic granulomatous disease, CGD) ist bei Kindern und Jugendlichen mit häufigen Infektionen durch bestimmte Erreger differenzialdiagnostisch zu berücksichtigen.

In vorliegender Kasuistik berichten wir über eine 64-jährige Patientin mit über Jahre zunehmenden bronchopulmonalen Infektionen, teilweise durch seltene Erreger, Autoimmunphänomenen, Malignomen und im weiteren Verlauf rezidivierenden organisierenden Pneumonien (OP) mit Nachweis von Granulomen. Ursächlich wurde bei der Patientin eine septische Granulomatose, Unterform p47phox-Defizienz diagnostiziert. Ein Überleben von Patienten mit einem primären Immundefekt (PID) bis ins hohe Erwachsenenalter wird trotz wiederholter Komplikationen in Einzelfällen beobachtet, insbesondere wenn die defekte Zellstruktur eine Restaktivität aufweist. Bei rezidivierenden bronchopulmonalen Infektionen insbesondere durch bestimmte seltene Erreger und in Kombination mit organisierend-granulomatösen Lungenreaktionen sowie Autoimmunphänomenen ist auch bei älteren Erwachsenen an eine CGD zu denken. Durch eine Diagnoseverzögerung kommt es oft zu einem erheblichen Anstieg der Morbidität und Mortalität.

Hypersensitivity pneumonitis associated with the use of temozolomide

The aim of the present study was to investigate a case of hypersensitivity pneumonitis associated with the use of temozolomide in the treatment of gliosarcoma. A 54-yr-old female developed dyspnoea, cough and hypoxia after surgical resection for gliosarcoma and adjuvant radio- and chemotherapy with temozolomide. A high-resolution computed tomography scan of the thorax showed a bilateral ground-glass pattern. Bronchoscopy with bronchoalveolar lavage and lung biopsies was performed. Bronchoalveolar lavage demonstrated significant lymphocytic alveolitis and transbronchial lung biopsies revealed lymphocytic infiltration with foamy macrophages, consistent with hypersensitivity pneumonitis. There was no evidence of other causes, including infections. After withdrawing temozolomide and initiating prednisolone therapy, the patient had no further pulmonary symptoms. To the present authors' knowledge, this is the first definitively described case of temozolomide-associated hypersensitivity pneumonitis.

[Sacrococcygeal chordoma with malignant spindle cell components. Case report and review of the literature]

Malignant fibrous histiocytoma (MFH), arising in combination with a sacral chordoma in a 70-year-old men, is described. Intermediate spindle-shaped cells demonstrating keratin positivity, showed a gradual transition between the areas of conventional chordoma, and the spindle cell areas, lending credence to the theory of a multipotential neoplasm. We chose the descriptive term "chordoma with malignant spindle cell component" in the sense that high malignant sarcomatous components exists in conjunction with chordomas in the primary tumor and the local recurrence. A review of literature is undertaken chronicling the documented associations of chordoma and sarcoma, followed by a discussion of the various causes proposed to explain this phenomenon.