BACKGROUND Primary malignant pericardial mesothelioma(PMPM)is an extremely rare malignant tumor,and it is difficult to diagnose definitively before death.We present a case in which PMPM was diagnosed at autopsy.We con...BACKGROUND Primary malignant pericardial mesothelioma(PMPM)is an extremely rare malignant tumor,and it is difficult to diagnose definitively before death.We present a case in which PMPM was diagnosed at autopsy.We consider this case to be highly suggestive and report it here.CASE SUMMARY A 78-year-old male presented with transient loss of consciousness and falls.The transient loss of consciousness was considered to result from complications of diastolic dysfunction due to pericardial disease,fever with dehydration,and paroxysmal atrial fibrillation.Ultrasound cardiography(UCG)and computed tomography showed cardiac enlargement and high-density pericardial effusion.We considered pericardial disease to be the main pathogenesis of this case.Cardiac magnetic resonance imaging and gadolinium contrast-enhanced T1-weighted images showed thick staining inside and outside the pericardium.Pericardial biopsy was considered to establish a definitive diagnosis,but the patient and his family refused further treatment and examinations,and the patient was followed conservatively.We noticed a thickening of the pericardium and massive changes in the pericardium on UCG over time.We performed an autopsy 60 h after the patient died of pneumonia.Giemsa staining of the autopsy tissue showed an epithelial-like arrangement in the pericardial tumor,and immunostaining showed positive and negative factors for the diagnosis of PMPM.Based on these findings,the final diagnosis of PMPM was made.CONCLUSION PMPM has a poor prognosis,and early diagnosis and treatment are important.The temporal echocardiographic findings may provide a clue for the diagnosis of PMPM.展开更多
The Asian water monitor(Varanussalvator)or kabaragoya isthe predominant large animalscavenger of human remainsin Sri Lanka;however,its significance is rarely discussed in the forensic literature.This is the case of a ...The Asian water monitor(Varanussalvator)or kabaragoya isthe predominant large animalscavenger of human remainsin Sri Lanka;however,its significance is rarely discussed in the forensic literature.This is the case of a 54‑year‑old male with a history of dementia,depression,and wandering behavior whose body was found,partially submerged in a river,2 days after he was reported missing.There were several linear wounds with regular margins over his arms and face which raised the suspicion of homicidal sharp weapon trauma.The injuries were seen in clusters and did not involve harder structures such as tendons,ligaments,or bones.There were no signs of inflammation or bleeding.They were attributed to kabaragoya claw marks,which are postmortem artifacts that mimic incised wounds.However,there were no areas of tissue loss to indicate that the animal had begun feeding on the corpse.This case discusses the problems faced by medicolegal investigators when encountering this phenomenon which is relatively underreported in the forensic literature.展开更多
在法医学检案中,经常要对尸体上的损伤进行检验以确定生前伤或死后伤,并要鉴定损伤时间.损伤超过8小时者一般用常规组织学方法可以解决,但损伤后经过时间较短,单用组织学方法不能解决,如利用酶活性反应方法和利用在组织内细胞内进行特...在法医学检案中,经常要对尸体上的损伤进行检验以确定生前伤或死后伤,并要鉴定损伤时间.损伤超过8小时者一般用常规组织学方法可以解决,但损伤后经过时间较短,单用组织学方法不能解决,如利用酶活性反应方法和利用在组织内细胞内进行特异、灵敏、稳定的抗原抗体反应,可以较准确鉴定损伤时间.Perper J. A. Raek Allio、Tanaka、Fatteh等报导用组织化学方法鉴定损伤时间,祝家镇、刘世仓教授近年来也有报道,但用免疫组化学方法来鉴定损伤后早期时间,就作者所知,国内、外未见报道,而FN在创伤愈合过程中的作用国内外已有报道.展开更多
文摘BACKGROUND Primary malignant pericardial mesothelioma(PMPM)is an extremely rare malignant tumor,and it is difficult to diagnose definitively before death.We present a case in which PMPM was diagnosed at autopsy.We consider this case to be highly suggestive and report it here.CASE SUMMARY A 78-year-old male presented with transient loss of consciousness and falls.The transient loss of consciousness was considered to result from complications of diastolic dysfunction due to pericardial disease,fever with dehydration,and paroxysmal atrial fibrillation.Ultrasound cardiography(UCG)and computed tomography showed cardiac enlargement and high-density pericardial effusion.We considered pericardial disease to be the main pathogenesis of this case.Cardiac magnetic resonance imaging and gadolinium contrast-enhanced T1-weighted images showed thick staining inside and outside the pericardium.Pericardial biopsy was considered to establish a definitive diagnosis,but the patient and his family refused further treatment and examinations,and the patient was followed conservatively.We noticed a thickening of the pericardium and massive changes in the pericardium on UCG over time.We performed an autopsy 60 h after the patient died of pneumonia.Giemsa staining of the autopsy tissue showed an epithelial-like arrangement in the pericardial tumor,and immunostaining showed positive and negative factors for the diagnosis of PMPM.Based on these findings,the final diagnosis of PMPM was made.CONCLUSION PMPM has a poor prognosis,and early diagnosis and treatment are important.The temporal echocardiographic findings may provide a clue for the diagnosis of PMPM.
文摘The Asian water monitor(Varanussalvator)or kabaragoya isthe predominant large animalscavenger of human remainsin Sri Lanka;however,its significance is rarely discussed in the forensic literature.This is the case of a 54‑year‑old male with a history of dementia,depression,and wandering behavior whose body was found,partially submerged in a river,2 days after he was reported missing.There were several linear wounds with regular margins over his arms and face which raised the suspicion of homicidal sharp weapon trauma.The injuries were seen in clusters and did not involve harder structures such as tendons,ligaments,or bones.There were no signs of inflammation or bleeding.They were attributed to kabaragoya claw marks,which are postmortem artifacts that mimic incised wounds.However,there were no areas of tissue loss to indicate that the animal had begun feeding on the corpse.This case discusses the problems faced by medicolegal investigators when encountering this phenomenon which is relatively underreported in the forensic literature.
文摘在法医学检案中,经常要对尸体上的损伤进行检验以确定生前伤或死后伤,并要鉴定损伤时间.损伤超过8小时者一般用常规组织学方法可以解决,但损伤后经过时间较短,单用组织学方法不能解决,如利用酶活性反应方法和利用在组织内细胞内进行特异、灵敏、稳定的抗原抗体反应,可以较准确鉴定损伤时间.Perper J. A. Raek Allio、Tanaka、Fatteh等报导用组织化学方法鉴定损伤时间,祝家镇、刘世仓教授近年来也有报道,但用免疫组化学方法来鉴定损伤后早期时间,就作者所知,国内、外未见报道,而FN在创伤愈合过程中的作用国内外已有报道.
