This review addresses morphological changes in coronary arteries following stenting, which result from damage to the vascular wall. These changes include 1) formation of a thrombus in the site of intimal injury; 2) inflammation; 3) proliferation and migration of smooth muscle cells; 4) formation of extracellular matrix. Each of these pathological processes has specific morpho-biological features. The review shows the role of von Willebrand factor in development of early thrombosis after intimal injury, which provokes activation of the inflammatory response followed by proliferation of smooth muscle cell that synthetize the extracellular matrix. These cellular and intercellular changes are based on overexpression of TGF-β1 protein, which facilitates modulation of various types of smooth muscle cells, including contractile and secretory ones. Issues of fine regulation of cellular and intercellular interactions by apoptosis, activation of mTOR signaling molecules, and microRNA are still understudied. Dynamic changes in drug-coated stents during development of neoatherosclerosis and late thrombosis remain not elucidated. Current reports show that initial mechanisms triggering pathological regenerative and hyperplastic processes that result in coronary restenosis in the area of implanted stents may form early (first hours or days) after stenting. Most studies were performed on experimental rather than on autopsy material, which does not allow fully unbiased interpretation of obtained data. Studying dynamics of morphological and molecular changes in coronary arteries after stenting, including on autopsy material, will allow one to express an opinion on the risk of postoperative thrombosis and restenosis.

No abstract

Background. Tumours of peripheral nervous system are represented by benign and malignant neoplasms with different clinical and biological traits. Malignant peripheral nerve sheath tumours of paraspinal localisation with the involvement of nerve structures are extremely rare and may occur isolated or comorbid with congenital neurofibromatosis. Current literature contains a few bioptic and selected autopsy clinical reports. Herewith, we present an own sectional observation of a rare malignant peripheral nerve sheath tumour with multiple metastasis supplemented with morphological and immunohistochemical descriptions.Clinical Case Description. An autopsy was performed on a 30-yo man’s cadaver. A tumour infiltrate was observed along Th5—Th9 of the spinal column intimately associated with thoracic vertebral bodies. Metastases were detected in the right lung, myocardium, peripancreatic and perirenal adipose tissue. Histological tumour examination revealed heterogeneous solid and rosette-like structures. Tumour immunophenotype: vimentin+, pancytokeratin-, CD45-, S-100+, NSE+, GFAP-, proliferative activity index (Ki-67 = 75-80%). This profile is descriptive of peripheral nerve sheath malignancy of high grade with multiple organic metastases.Conclusion. The sectional observation presented illustrates the difficulty to in vivo diagnose rare peripheral nerve sheath malignancies due to their infiltrative growth into spinal bone marrow and metastasis to organs (lungs, myocardium, peripancreatic and perirenal adipose tissue).

Pathological anatomy of pulmonary vascular lesions plays a key role in understanding the patho-genesis and morphogenesis of COVID-19. This review focuses on morphological features of pulmonary vascular injury in COVID-19. The virus is known to be capable of causing not only cytopathic cell damage of various organs and tissues (type II pneumocytes, cardiomyocytes, neurons, epithelial cells of the gas-trointestinal tract) but also endotheliotropic damage that aggravates the development and course of acute alveolar damage to the lungs. We studied the literature on microscopic changes in the vessel walls in lung tissue for 2020–2022. This review discusses the issues of local or systemic vascular lesions, morphologi-cal changes in the vessels over time, the likelihood of the development of microangiopathy, vasculitis, and endotheliitis in COVID-19 patients. Particular attention is paid to possible mechanisms of endotheliopathy in COVID-19 patients and its role in the microthrombi genesis. We speculate that in the future, postmor-tem lung examination in COVID-19 patients using histological, histochemical, and immunohistochemical methods will clarify the features of alterative and inflammatory changes and reparative processes in the blood vessel walls, as well as neoangiogenesis at different stages of the disease. Keywords: pathological anatomy, COVID-19, lungs, endotheliopathy, endotheliitis, microthrombus formation

Выполнено морфологическое исследование нестабильных атеросклеротических бляшек (АБ) коронарных артерий сердца. На секционном материале были изучены 20 коронарных артерий у 12 мужчин и 8 женщин в возрасте 67±5 лет с макроскопическим и микроскопическим описанием. Показано, что наиболее часто при атеросклерозе поражаются устье левой коронарной артерии, передняя межжелудочковая ветвь левой коронарной артерии с развитием стеноза, вторичных изменений (кальциноза, кровоизлияния в бляшку). Полученные морфологические данные позволили выделить пять вариантов нестабильных АБ коронарных артерий сердца: 1) с преобладанием пенистых клеток (макрофагов); 2) с внутристеночным кровоизлиянием в бляшку; 3) с дистрофическими изменениями и кальцинозом бляшки; 4) с признаками неоангиогенеза в бляшке; 5) с хроническим воспалением в бляшке. Основными морфологическими ориентирами, позволившими выделить данные варианты нестабильной АБ, были: площадь атеромы, площадь фиброзной покрышки, площадь кальциноза, площадь кровоизлияний, количество пенистых клеток (макрофагов), количество лимфоцитов, количество сосудов. Наши данные дополняют ранее выполненные работы, посвященные строению АБ различных артерий, и помогают по-новому взглянуть на их структурные особенности. Представленное морфологическое исследование особенностей строения нестабильных АБ коронарных артерий сердца дополняет представление о возможных морфотипах, в которых важную роль, по-видимому, играют пенистые клетки (макрофаги). Изучение клеточномежклеточных взаимоотношений в АБ коронарных артерий в морфогенезе ее нестабильности позволит уточнить механизмы прогрессирования и регрессирования атеросклероза, что имеет большое практическое значение при прогнозировании течения ИБС. Ключевые слова: атеросклероз, коронарные артерии сердца, нестабильная бляшка, морфология, пенистые клетки, воспаление, неоангиогенез.