TO THE EDITOR

The current issue of Autopsy and Case Reports (2013;3(1):5-14) has an interesting report by Cavalcante et al. purporting to describe an additional case of “hepatoid carcinoma.” Unfortunately, the case description does not fully satisfy the criteria for that diagnosis

Hereditary hemochromatosis

Hereditary hemochromatosis (HH) is the most commonly identified autosomal recessive genetic disorder in the white population, characterized by increased intestinal iron absorption and secondary abnormal accumulation in parenchymal organs, not infrequently accompanied by functional impairment. This entity is associated with mutations of the HFE gene (located on the short arm of chromosome 6 at location 6p22.2; closely linked to the HLA-A3 locus), which encodes the HFE protein, a membrane protein thought to regulate iron absorption by affecting the interaction between transferrin receptor and transferrin

Asbestos-related pleural disease

The image shows asbestos plaques on the right parietal pleura of a 58-year-old former shipyard worker who died of acute suppurative bronchitis. He also had cor pulmonale and congestive heart failure. Histologically, pulmonary interstitial fibrosis with asbestos bodies was demonstrated. The pleural plaques consist predominantly of dense collagen. This photograph was taken after removal of the lung with the camera held in the lower right thorax, at approximately the level of the diaphragm, looking up toward the apex of the chest cavity

Focal nodular hyperplasia of the liver

A benign, non-neoplastic, reactive growth of the liver, focal nodular hyperplasia (FNH) of the liver was first clearly described by Edmondson in the 1950’s, although there are various prior reports that likely represent the same lesion. A variety of synonyms have been applied including focal cirrhosis, pedunculated adenoma, solitary hyperplastic nodule, mixed adenoma, hamartoma and hamartomatous cholangeiohepatoma

Clostridium difficile infection

Clostridium difficile infection (CDI) is a significant and increasing medical problem, surpassing methicillin-resistant Staphylococcus aureus as the most common hospital-onset or facility-associated infection, and a key element in the challenging battle against hospital-acquired infections. This Gram-positive, anaerobic, spore-forming colonizes the intestinal tract after antibiotics have altered the normal intestinal flora

Crohn disease

Aretaeus of Cappadocia (1st century CE) describeda young man with chronic and recurring abdominaldistress possibly representing the first recorded instanceof Crohn disease (CD).1-3 More evidence that this diseasewas extant for many years comes from the descriptionof the 10th century English king, Alfred “the great,”who suffered for many years from what was a typicalenteritis but also had anal fistula and/or abscess

Carcinoid heart disease

The images are of the tricuspid valve and the pulmonic valve from the autopsy of a patient with mid-gut neuroendocrine carcinoma, carcinoid pattern, extensively metastatic to the liver. The patient had typical “carcinoid syndrome,” including clinical evidence of tricuspid and pulmonic stenosis and insufficiency. The tricuspid valve (left) shows slight retraction and distortion by the overlying endothelial deposition of plaque composed of acid mucopolysaccharide-rich matrix with varying amounts of smooth muscle cells and collagen fibers. The plaque material causes partial coalescence of chordae tendinae with effacement of the usual delicate strands. The pulmonic valve (right) shows more marked distortion with shrinkage and obliteration of cusps and coalescence at the commissures. Beneath the plaque the valves are intact

Ureteric carcinoma

Ureteric neoplasms are rare tumors. The annual incidence (during the period 1995-2005) was 0,95-1,15/100.000 person-year. They are almost always urothelial tumors, especially papillary transitional cell carcinoma, as in the image above, and are less common than tumors of the renal pelvis and 10 times less common than urinary bladder tumors. In a large series of 1249 cases of urothelial neoplasms of the upper urinary tract (pelvis and ureter) (upper urinary tract tumors; UUTT) 34% of the cases involved the ureter, and in 8% the neoplasia was found in both sites concomitantly. Concomitance with bladder tumors is also observed, either synchronously or methachronously. When metachronous; bladder tumors precede UUTT in 10,2% of cases, and when synchronous in 49%

Renal papillary necrosis

In 1877, Dr. Nikolaus Friedreich (1825-\ud 1882; student of Virchow who became Professor\ud of Pathology at Heidelberg and who also described\ud Friedreich’s ataxia) first described renal papillary\ud necrosis (RPN) in patients with prostatic hypertrophy\ud and secondary hydronephrosis. Thereafter in 1937,\ud Froboese and Günther emphasized the association\ud of this entity with diabetes mellitus. These authors\ud also observed renal papillary necrosis in cases of\ud urinary tract obstruction even in the absence of\ud diabetes mellitus