Background Sudden cardiac death (SCD) is defined as natural unexpected death occurring within <1 hour in witnessed cases and within <24 hours of last being seen alive in unwitnessed cases. To assess the cause of death, many guidelines have been produced1 and all toxicological investigation is essential. The term ‘sudden adult death syndrome’ (SADS) means an SCD where the heart is morphologically normal. It is well-known that many drugs increase the risk of ventricular arrhythmia.2 This is the first study to assess the incidence of drug abuse and the characteristics of those with a normal ..read more

Background Specimens with incorrect patient information are both a critical safety error and difficult to identify. Estimates of sample mislabelling rely on subjective identification of mislabelling, with the possibility that not all mislabelled samples are being caught. Methods We determined the blood type of two or more complete blood count specimens with the same patient label and assessed for discrepancies. We additionally determined the rate of identified sample mislabelling for the study period. Results We found a rate of 3.17 per 1000 discrepancies over the study period. These discrepan ..read more

Aims This study presents the findings of a global survey of pathologists’ views of online conferences and digital pathology. Methods An online anonymous survey consisting of 11 questions focusing on pathologists’ perceptions of virtual conferences and digital slides was distributed to practising pathologists and trainees across the globe using the authors’ social media accounts and professional society connections. Participants were asked to rank their preference for various aspects of pathology meetings on a 5-point Likert scale. Results There were 562 respondents from 79 countries. Several a ..read more

Aims Identification of recurrent genetic alterations in JAK2, MPL and CALR remains crucial in the diagnosis of Philadelphia-negative myeloproliferative neoplasms (MPNs). Current laboratory testing algorithms may entail batching and/or sequential testing, involving multiple testing modalities and sometimes send-out testing that increase the technical and economic demands on laboratories while delaying patient diagnoses. To address this gap, an assay based on PCR and high-resolution melting (HRM) analysis was developed for simultaneous evaluation of JAK2 exons 12–14, MPL exon 10 and CALR exon 9 ..read more

Aims The identification of haemophagocytosis in bone marrow (BM) is recurrently identified in patients with severe COVID-19. These initial COVID-19 autopsy studies have afforded valuable insight into the pathophysiology of this disease; however, only a limited number of case series have focused on lymphoid or haematopoietic tissues. Methods BM and lymph node (LN) specimens were obtained from adult autopsies performed between 1 April 2020 and 1 June 2020, for which the decedent had tested positive for SARS-CoV-2. Tissue sections (H&E, CD3, CD20, CD21, CD138, CD163, MUM1, kappa/lambda light ..read more

Aims The purpose of this study is to evaluate the accuracy and validity of the determination of cause of death (COD) and manner of death (MOD) at the completion of the forensic autopsy prosection. Methods We analysed 952 autopsy cases conducted from 2019 to 2020 and compared every patient’s COD, other significant contributing factors to death (OSC), and MOD after prosection to their COD, OSC and MOD after completion of the final autopsy report. Results We found that 83% of cases (790 patients) did not have an unexpected change and 17% of cases (162 patients) exhibited a true change in their fi ..read more

Aims Currently, the clinicopathological characteristics of gastric cancer (GC) with oncogenic NTRK alterations are not well known. Although NTRK fusion has been identified as prevalent in DNA mismatch repair protein deficient (dMMR) colorectal cancer (CRC), the relationship between NTRK alterations and dMMR protein expression in GC has not been previously explored. Methods Our study comprised 51 cases of EBV(Epstein-barr virus)-associated gastric carcinomas, 94 cases of dMMR GC, 90 cases of gastric adenocarcinoma with hepatoid or enteroblastic differentiation (GAHED) and 256 cases of conventio ..read more

In this issue of the Journal of Clinical Pathology, Pu and colleagues from the Nanjing University Medical School, China, report that NTRK gene alterations were enriched in gastric carcinoma with hepatoid or enteroblastic differentiation but not, as in the colon, dMMR-type gastric carcinomas.1 The study analysed 51 cases of EBV (Epstein-Barr virus)-associated gastric carcinomas, 94 cases of dMMR gastric carcinomas, 90 cases of gastric adenocarcinoma with hepatoid or enteroblastic differentiation and 256 cases of conventional gastric carcinomas. All four tumours with NTRK gene alterations were i ..read more

The porphyrias are rare disorders of haem biosynthesis. Diagnosis requires demonstrating increased porphyrins or porphyrin precursors in blood, urine and faeces. Patients may only be investigated once, and therefore, understanding the preanalytical factors affecting the reliability of results is crucial. Guidance for sample handling exists, but published evidence regarding the stability of porphyrins and their precursors is limited. The aim of this study was to evaluate the effect of light exposure and different storage temperatures on analyte stability for measurement of urinary aminolaevulin ..read more

Aims We aimed to evaluate the performances of the Idylla GeneFusion Assay (IGFA) designed to detect, in a single, rapid and fully automated assay, ALK, ROS1, RET, NTRK1, NTRK2 and NTRK3 gene fusions and MET exon 14 skipping in cancer samples. Methods Based on a set of tumours enriched in cases with gene fusions, we applied the IGFA to tumour areas of various sizes and tumour cell contents. IGFA results were compared with those obtained with other methods (immunohistochemistry, fluorescent in situ hybridisation, DNA and RNA next-generation sequencing). Results We selected 68 tumours: 49 cases w ..read more