Differential diagnosis of calcified nodules from a medieval Székely woman in Transylvania

Calcified uterine leiomyoma from an 18th-century nunnery in North Italy

OBJECTIVE

To develop a differential diagnosis of a mass retrieved alongside skeletal remains in the crypt of the church of Santissima Annunziata of Valenza (Province of Alessandria, Northern Italy).

MATERIAL

A calcified mass measuring 40 × 39 mm and 17.62 × 16.3817.62 × 16.38 mm.

METHOD

The analysis utilized macroscopic assessment and histologic examination (including histochemical and immunohistochemical analyses).

RESULTS

Morphological traits include an irregular and spongy external surface. Holes of different sizes lead toward the inner part of the object. A section of the mass shows an "intertwined bundle" pattern, confirmed by microscopic examination.

CONCLUSIONS

Differential diagnosis determined the mass to be consistent with calcified leiomyoma.

SIGNIFICANCE

Identifying uterine leiomyoma adds to the paucity of paleopathological literature on the condition and to calcified tumors more broadly. It also allows for an important discussion of women's gynecological health in the past and potentially among nulliparous women.

LIMITATIONS

Neither histochemical staining nor immunohistochemical analysis demonstrated the certain muscular nature of the specimens due to the rehydration and decalcification processes, for which there are no gold standards.

SUGGESTIONS FOR FURTHER RESEARCH

Calcified masses are common in the clinical literature but remain rare in paleopathological literature. Careful excavation and improved recognition of apparently calcified masses are necessary to improve recognition, diagnosis, and interpretation.

Differential diagnosis of a calcified object from the South Tombs Cemetery at Amarna, Egypt

OBJECTIVE

This paper provides a brief history of the publication of calcified biological objects and presents one that was present in the grave associated with a mature adult female buried in the South Tombs Cemetery at Amarna, Egypt (c. 1353-1332BCE).

METHODS

Macroscopic examination revealed an ovoid object constructed of concentric layers of a coarse sand-like material oriented around a dense core that lacked evidence of parasites. Microscopic examination revealed the object is composed of densely, yet haphazardly packed, elongated octahedron shaped crystals with no evidence of cellular structures. Basic chemical analysis eliminated calcium carbonate as a constituent material.

RESULTS

Based on comparison with previously published examples from the archaeological and clinical literature and careful differential diagnosis, it is suggested this object is a bladder stone.

SIGNIFICANCE

A brief discussion of the implications of bladder stones on individual health and broader epidemiological constraints to illustrate the depth such discoveries can bring to our understanding of ancient lived experience concludes the work.

LIMITATIONS

The burial of Ind. 286 was disturbed. The identification of a bladder stone presumes the stone would have been found within the pelvic cavity, which cannot be confirmed. Other graves in the vicinity of this grave were also disturbed. It is unlikely, but still possible, that the stone originated from another grave and was relocated to this grave after disturbance. Full chemical analysis was not possible.

SUGGESTIONS FOR FUTURE RESEARCH

Radiographic and chemical analysis would provide more information to strengthen the certainty of the differential diagnosis.

Surviving (but not thriving) after cranial vault trauma: A case study from Transylvania

OBJECTIVE

To link an antemortem cranial injury on the left parietal bone with potential neurocognitive consequences.

MATERIALS

The skeleton of a male individual from a Székely archaeological site in Transylvania was examined. The skeleton was radiocarbon dated to Cal AD 1450 and AD 1640 and presented a well-healed antemortem penetrating cranial injury on the left parietal bone.

METHODS

Macroscopic and radiographic analyses were conducted and the cranium was also archived digitally with a Faro FreeStyle3D scanner. In addition, well-known literature from neuroscience was synthesized in order to better understand the likely neurological consequences of the injury.

RESULTS

The literature suggests that tasks of attention and working memory, sensory processing, language processing, and vision are affected when the parietal lobe of the brain is injured.

CONCLUSIONS

Burial 195 did not likely return to a 'normal' life after he survived the cranial injury.

SIGNIFICANCE

This study demonstrates that bioarcheological interpretations involving antemortem cranial injuries can be enhanced by collaboration with neuroscientists. Bioarcheological interpretations are improved when the consequences of soft tissue injuries are understood.

LIMITATIONS

This study was limited by a lack of historical documents relevant to the region, time period, and specific case study. In addition, interpretations are cautionary because brain functioning cannot be assessed in vivo in the absence of life.

SUGGESTIONS FOR FURTHER RESEARCH

Bioarcheologists who study antemortem cranial injuries should continue to collaborate with neuroscientists.

Differential diagnosis of a calcified cyst found in an 18th century female burial site at St. Nicholas Church cemetery (Libkovice, Czechia)

During archaeological excavations in burial sites, sometimes stoned organic objects are found, in addition to human remains. Those objects might be of a different origin, depending on various factors influencing members of a community (i.e. diseases, trauma), which provides information about their living conditions. The St. Nicholas Church archaeological site (Libkovice, Czechia) in the 18^th century horizon of the cemetery, yielded a maturus-senilis female skeleton with a stone object in the left iliac fossa. This object was an oviform cyst-like rough structure, measuring 54 mm in length, 35 mm in maximum diameter and 0.2–0.7 mm shell thickness. Within the object there were small fetal bones (long bones, i.e. femur and two tibias, two scapulas, three ribs, vertebrae and other tiny bone fragments). Methods utilized to analyze the outer and inner surface morphology of the cyst and its inside, included: X-ray, CT imaging, SEM, histological staining and EDS. The EDS analysis revealed the presence of primarily oxygen, calcium and phosphorus in bone samples, and oxygen and silicon, in stone shell. Based on the length of the femur (20.2 mm) and tibia (16 mm) shafts, the fetal age was determined as being in the 15–18 week of pregnancy. The differential diagnosis was conducted, including for the three most probable cases: fetiform teratoma (FT), fetus-in-fetu (FIF) and lithopedion. The possibility of fetiform teratoma was discounted due to the presence of an anatomically correct spine, long bones and the proportions of the find. Although the low calcium content in the shell (2.3% atom mass), the lack of skull bones and the better developed lower limbs indicate fetus-in-fetu rather than lithopedion, the analyses results are unable to conclusively identify the object under one of these two categories since there are insufficient such cases in excavation material with which to draw comparison.