Benign Lesions Research Articles

Comparative Analysis of AI Models for Atypical Pigmented Facial Lesion Diagnosis.

Diagnosing atypical pigmented facial lesions (aPFLs) is a challenging topic for dermatologists. Accurate diagnosis of these lesions is crucial for effective patient management, especially in dermatology, where visual assessment plays a central role. Incorrect diagnoses can result in mismanagement, delays in appropriate interventions, and potential harm. AI, however, holds the potential to enhance diagnostic accuracy and provide reliable support to clinicians. This work aimed to evaluate and compare the effectiveness of machine learning (logistic regression of lesion features and patient metadata) and deep learning (CNN analysis of images) models in dermoscopy diagnosis and the management of aPFLs. This study involved the analysis of 1197 dermoscopic images of facial lesions excised due to suspicious and histologically confirmed malignancy, classified into seven classes (lentigo maligna-LM; lentigo maligna melanoma-LMM; atypical nevi-AN; pigmented actinic keratosis-PAK; solar lentigo-SL; seborrheic keratosis-SK; and seborrheic lichenoid keratosis-SLK). Image samples were collected through the Integrated Dermoscopy Score (iDScore) project. The statistical analysis of the dataset shows that the patients mean age was 65.5 ± 14.2, and the gender was equally distributed (580 males-48.5%; 617 females-51.5%). A total of 41.7% of the sample constituted malignant lesions (LM and LMM). Meanwhile, the benign lesions were mainly PAK (19.3%), followed by SL (22.2%), AN (10.4%), SK (4.0%), and SLK (2.3%). The lesions were mainly localised in the cheek and nose areas. A stratified analysis of the assessment provided by the enrolled dermatologists was also performed, resulting in 2445 evaluations of the 1197 images (2.1 evaluations per image on average). The physicians demonstrated higher accuracy in differentiating between malignant and benign lesions (71.2%) than in distinguishing between the seven specific diagnoses across all the images (42.9%). The logistic regression model obtained a precision of 39.1%, a sensitivity of 100%, a specificity of 33.9%, and an accuracy of 53.6% on the test set, while the CNN model showed lower sensitivity (58.2%) and higher precision (47.0%), specificity (90.8%), and accuracy (59.5%) for melanoma diagnosis. This research demonstrates how AI can enhance the diagnostic accuracy in complex dermatological cases like aPFLs by integrating AI models with clinical data and evaluating different diagnostic approaches, paving the way for more precise and scalable AI applications in dermatology, showing their critical role in improving patient management and the outcomes in dermatology.

A National Study of the Rate of Benign Pathology After Partial Nephrectomy for T1 Renal Cell Carcinoma: Should We Be Satisfied?

Objectives: To determine the rate of benign pathology in cT1 tumors following partial nephrectomy in the Netherlands, thereby evaluating the rate of overtreatment. Methods: Data were collected from a nationwide database containing histopathology of resected renal tissue from 2014 to 2022. Patients who underwent partial nephrectomy for suspected RCC staged T1a-b were extracted for analysis. Data are shown in percentages, and multivariable logistic regression was performed to determine predictive factors for benign pathology. Results: 3409 cases were analyzed, of which 403 (12%) were benign and 3006 (88%) malignant. Subtype analysis showed 2126 (62%) cases of clear-cell RCC, followed by 604 (18%) of papillary RCC and 344 (10%) oncocytomas. Mean age was 63 years among patients with malignant pathology versus 65 years for patients with benign lesions (p < 0.001). Mean tumor size was 3.2 cm for malignant pathology and 2.9 cm for benign (p < 0.001). The rates of benign and malignant pathology did not change between 2014 and 2022 (p = 0.377). Multivariable regression showed age ≥ 65 years (65–79 years [OR 1.881, p = 0.002], ≥ 80 years [OR 3.642, p < 0.001]) and tumor size (OR 0.793, p < 0.001) as predictors for benign pathology. The main limitation of this study is that we do not know the biopsy rate of our cohort. Conclusion: This study reports a low rate of 12% benign pathology after partial nephrectomy in the Netherlands. It remains debatable whether these rates are acceptable, or if renal tumor biopsies should be utilized more frequently to reduce overtreatment.

Diagnostic insights into splenic pathologies: the role of multiparametric ultrasound.

Ultrasound(US) evaluation of the spleen is mandatory in the assessment of patients with chronic liver disease, and splenomegaly can be a sign of systemic diseases. However, due to the lack of distinctive ultrasound findings in specific splenic pathologies, clinical diagnosis can be very challenging. Splenomegaly, defined by increased splenic dimensions, can indicate underlying systemic conditions and is a common manifestation of portal hypertension (PH). Ultrasound and Doppler techniques help assessing splenic involvement in PH. Splenic stiffness measurement, using elastography, offers additional diagnostic accuracy, especially when liver stiffness measurements are inconclusive. CEUS enhances the diagnostic capability for focal splenic lesions, differentiating between benign and malignant lesions by their distinct enhancement patterns, and plays also a critical role in the context of splenic traumatic pathology. Overall, CEUS significantly improves the characterization of splenic pathology, reducing the need for invasive procedures and ensuring appropriate patient management. This review article describes the normal US findings of the spleen and examines the role of multiparametric US in the evaluation of the most common splenic pathologies encountered in the daily clinical practice.

Diagnostic Efficacy of Five Different Imaging Modalities in the Assessment of Women Recalled at Breast Screening-A Systematic Review and Meta-Analysis.

There are variations in the assessment pathways for women recalled at screening, and the imaging assessment pathway with the best diagnostic outcome is poorly understood. This paper examines the efficacy of five imaging modalities for the assessment of screen-recalled breast lesions. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) strategy was employed to identify studies that assessed the efficacy of imaging modalities in the assessment of lesions recalled at screening from the following eight databases: Medline, Web of Science, Embase, Scopus, Science Direct, PubMed, CINAHL, and Global Health. Search terms included "Breast assessment" AND "Diagnostic Workup" OR "Mammography" AND "Digital Breast tomosynthesis" AND "contrast enhanced mammography and Magnetic Resonance imaging" AND "breast ultrasound". Studies that examined the performance of digital mammography (DM), digital breast tomosynthesis (DBT), handheld ultrasound (HHUS), contrast-enhanced mammography (CEM), and magnetic resonance imaging (MRI) in screen-recalled lesions were reviewed. Meta-analyses of these studies were conducted using the MetaDisc 2.0 software package. Results: Fifty-four studies met the inclusion criteria and examined between one and three imaging modalities. Pooled results of each imaging modality demonstrated that CEM has the highest sensitivity (95; 95% CI: 90-97) followed by MRI (93; 95% CI: 88-96), DBT (91; 95% CI: 87-94), HHUS (90; 95% CI: 86-93), and DM (85; 95% CI: 78-90). The DBT demonstrated the highest specificity (85; 95% CI: 75-91) followed by DM (77; 95% CI: 66-85), CEM (73; 95% CI: 63-81), MRI (69; 95% CI: 55-81), and HHUS (65; 95% CI: 46-80). Conclusions: The CEM, MRI, DBT, and HHUS demonstrate excellent performance in correctly identifying and classifying cancer lesions referred for diagnostic work-up, but HHUS, MRI, and CEM have a more limited ability to discriminate benign lesions than DBT and DM.

The incidence of benign and malignant tumors among adults with long-term physical disabilities

People with long-term physical disabilities also suffer from different types and nature of tumors as well as general population. Unfortunately, the information about the frequency of these diseases among the specified contingent is very deficient. The objectives of the study were to determine the incidence of benign and malignant neoplasia among the adults and elderly with physical disabilities and to indicate the risk factors for the appearance and development of tumors in this population. In this descriptive survey, 186 people, living in the largest home on the Balkan Peninsula for adults and elderly people with long-term physical disabilities were studied in 2021. 82.79% of the residents were over 51 years of age and almost all of them are inhabited by two residents. 42.47% of the respondents were men and 57.52% – women. Data on the demographic characteristics of the respondents, including their personal lifestyle and self-reported diagnosis of presence and/or history of a tumor formation, were collected through a semi-structured interview. The verification of the collected information about the incidence of benign and malignant lesions among adults with physical disabilities was carried out by means of the application of the second research method – content analysis based on the medical records. For processing and analysis of the collected data, it was used statistical software – IBM SPSS Statistics V21.0. The results showed a significantly high rate in the prevalence of tumor formations in the sample – 24.19%. The pre-cancerous formations have the highest incidence among residents – 42.22% with the most common variant – chronic form of cholecystitis combined with cholelithiasis (37.77%). Prostatic hyperplasia and uterine leiomyoma are the leading benign lesions in male residents – 11.11%, in female respondents – 11.11% respectively. The predominant form of cancer is breast carcinoma – 8.88%. The research found a high prevalence of tumor formations among adult patients with long-term physical disabilities. The harmful impact of a number of behavioral habits and health determinants significantly contributes to this negative tendency.

Intraoperative evaluation of tumor margins using a TROP2 near-infrared imaging probe to enable human breast-conserving surgery.

Intraoperative surgical margin assessment remains a challenge during breast-conserving surgery. Here, we report a combined strategy of immuno-positron emission tomography (PET) for preoperative detection of breast cancer and guided assessment of margins in breast-conserving surgery through second near-infrared (NIR-II) fluorescence imaging of trophoblastic cell surface antigen 2 (TROP2). We demonstrated that the intensity of PET signals in the tumors was nearly five times higher than in normal breast tissue with a zirconium-89 tracer conjugated to sacituzumab govitecan (SG) in a mouse spontaneous breast cancer model, enabling the identification of tumors. We further generated a NIR-II probe of indocyanine green conjugated to SG (ICG-SG) and developed a rapid incubation imaging method for intraoperative margin assessment in a relevant time window for the operation workflow. The ICG-SG NIR-II fluorescence image guidance was first verified to remove tumors completely and accurately in mouse breast cancer models. Moreover, the rapid incubation imaging method was applied to distinguish benign and malignant breast lesions in samples from 26 patients with breast cancer. Therefore, we have developed both nuclide and optical probes targeting TROP2 for rapid and precise identification of tumor margins during breast-conserving surgery in humans.

Early-Stage and Locally Advanced Cervical Cancer during Pregnancy: Clinical Presentation, Diagnosis and Treatment.

In this comprehensive review supported by clinical examples, the authors explore the topic of cervical cancer in pregnancy, with emphasis on potential pre-cancer progression, the possibility of coexisting preinvasive and invasive disease, and neoadjuvant chemotherapy. This manuscript addresses the challenges of managing cervical cancer in pregnant women with a pregnancy-preserving approach, including the importance of screening, the timing of surgery, and the impact of pregnancy on the course of the disease. The first case study illustrates the potential for a benign cervical lesion to transform into a malignant one during pregnancy and the possible coexistence of preinvasive lesions together with early-stage cervical cancer. It also questions the rationale behind the non-treatment of pregnant patients initially diagnosed with CIN 2/3 during pregnancy. The second presented clinical example shows the histologically confirmed response to neoadjuvant chemotherapy, resulting in a radiologically diagnosed FIGO stage IIA1 being downgraded to adenocarcinoma in situ in the histology report after surgery performed six weeks postpartum. The treatment of cervical cancer, which is becoming increasingly prevalent among pregnant women, and the necessity for an individualized diagnostic and therapeutic approach represent significant challenges for contemporary medicine. Discrepancies in therapeutic options proposed among centers within the same region lead to the conclusion that there is a need for centralization and unification of evidence-based management in referral centers with both high-level oncological and perinatal care.

A Case of Multiple Tongue Hamartomas with Cleft Palate: 7 Years of Follow-Up.

Hamartoma is a congenital benign lesion commonly found in the lungs, kidneys, colon, and other regions, but it is seldom seen in the oral cavity. Multiple hamartoma occurrences in the tongue are particularly rare. This article describes a 7-day-old female infant with multiple tongue tumors and a cleft palate, who had difficulty feeding and subsequently underwent tumor removal under general anesthesia. Nine months later, a cleft palate repair was performed. No genetic abnormalities were detected in the genetic testing. After the tumor removal, follow-ups were conducted every year to observe any recurrence of the tumors, the morphology and function of the tongue, and any systemic abnormalities. After 7 years of follow-up, there was no recurrence of the tumors, and the morphology and function of the tongue were normal, with no systemic diseases found. It is crucial to conduct multidisciplinary consultations for children diagnosed with multiple tongue hamartomas and to monitor their overall development while addressing oral lesions.

Crystal-Storing Histiocytosis of the Stomach

Abstract Introduction/Objective Crystal-storing histiocytosis (CSH) is an infrequently seen lesion comprised of eosinophilic histiocytes filled with refractile crystalline structures that most often have been characterized as IgG kappa restricted monoclonal immunoglobulins. The etiology for the mechanism of accumulation of the immunoglobulins is incompletely elucidated but numerous mechanisms have been postulated, including overproduction, faulty secretion, and impaired breakdown. Though CSH itself is a benign lesion, it has repeatedly been noted to be a harbinger of a concurrent or developing lymphoproliferative disorder. Literature review revealed a wide age range of presentations with no gender predilection and reports of this lesion occurring most commonly in the bone, kidneys, lungs, lymph nodes, and head and neck region. The gastrointestinal tract is uncommonly involved, with the stomach being the most frequently cited location. Reports of CSH in this setting have noted simultaneous infections with Helicobacter pylori and a range of associated lymphomas. Methods/Case Report We report a lesion from the stomach of a 45 year old female endoscopically described as containing patchy atrophic and nodular mucosa that was biopsied for gastric mapping in a patient with a reported history of autoimmune atrophic gastritis but without confirmatory antibodies on serology. Immunohistochemical stains highlighted a CD68 positive, smooth muscle myosin and cytokeratin negative, population of cells with cytoplasmic kappa positivity. CSH was diagnosed in a background of chronic inactive gastritis of both the antrum and fundus without evidence of H. pylori via staining or associated extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue on biopsy. Recent imaging revealed no concerning lymphadenopathy, lytic lesions, or masses. Results (if a Case Study enter NA) NA Conclusion Increasing pathologists’ awareness of this entity and its potential to be a paraneoplastic lesion is crucial, as further work-up is needed to exclude an underlying hematolymphoid neoplastic process.

Splenic Epidermoid Cyst arising within an Intrapancreatic Accessory Spleen Masquerading as a Pancreatic Mucinous Cystic Neoplasm-a diagnostic enigma

Abstract Introduction/Objective Accessory spleens are congenital embryological aberrations usually found within the splenic hilum with no clinical significance. An IntraPancreatic Accessory Spleen (IPAS) is an uncommon benign pancreatic lesion encountered clinically. A splenic epidermoid cyst arising within an IPAS is exceedingly rare and is discussed below. Methods/Case Report A 68-year-old male presented with intermittent post-prandial epigastric pain radiating to the left flank for >1.5 years. Radiological imaging identified a 5.2 cm calcified cyst in the pancreatic tail with a differential of mucinous pancreatic neoplasm/ pancreatic pseudocyst. Additionally, a 2.8cm lobulated solid hypoechoic mass was seen at the porta hepatis with a differential of enlarged lymph node/benign neoplasm. Laboratory biochemical tests were within normal limits except for mildly elevated ferritin. Fine needle aspiration biopsy was indeterminate. The patient elected to proceed with surgical resection. A laparoscopic distal pancreatectomy with splenectomy and excision of the hilar mass was performed. The hilar mass was analyzed by hematopathology and revealed a hyaline- vascular variant of Castleman disease. On gross examination of the distal pancreatic/splenectomy specimen, a well- demarcated cystic lesion with brownish fluid was noted within the pancreatic tail. Microscopic examination revealed a nonpathological pancreas separated by a fibrous capsule with a large cyst arising within an intrapancreatic accessory spleen. The cyst was lined with multilayered non-keratinized CK5/6, and p63 positive squamous epithelium with no lymphocytic infiltrates and absent hair/ dermal appendages confirming a splenic epidermoid cyst. Post-operative follow-up at 6 weeks was uneventful. Results (if a Case Study enter NA) NA Conclusion An epidermoid cyst arising within an intrapancreatic accessory spleen (ECIAS) is extremely rare thus precluding accurate preoperative diagnosis as this entity shares similar radiological imaging characteristics as other cystic lesions such as mucinous pancreatic cysts. It is important for anatomic pathologists to recognize and consider the intrapancreatic compartment as a possible location for accessory spleens. Accurate preoperative diagnosis can prevent unnecessary surveillance and/or extensive surgical resection.

A rare case report of hurthle cell adenoma mimicking malignancy

Thyroid lesions are the most common endocrine diseases, occurring in usually all age groups, though accurate diagnosis still remains a challenge, as due to oncocytic potentials of Thyroid cells leads to like indeterminate or suspicious diagnosis. Long standing benign Thyroid lesion shows atypical presentation suspicious to malignancy. Now a days with the help of WHO classification and available advanced diagnostic measures helping to confirm the diagnosis, avoiding overdiagnosis and wrong treatment. Hence this study review the importance of Histopathological study with coordination with immunohistochemistry (IHC) study, where suspicious thyroid malignant lesion finally diagnosed as benign Hurthle cell/ Oncocytic adenoma in Nodular Goitre.: 72 year old female presented huge neck swelling since one year, was reviewed in our departments of Pathology and ENT. Fine needle aspiration cytology (FNAC) features are suspicious of Malignancy, further Histopathological features were studied with co ordance of IHC study. FNAC features, which were suspicious of Malignancy were further studied with Histopathological and IHC studies diagnosed as Hurthle cell/ Oncocytic adenoma in Nodular Goitre. Histopathology remains the cornerstone for the diagnosis of thyroid oncocytic lesions and also in distinguishing between adenoma and carcinoma.

Improved diagnostic confidence using Super Resolution CEUS imaging in testicular lesions.

Ultrasound is the most used interdisciplinary non-ionizing imaging technique in clinical pathologies of the testis. The testis may be affected by a plethora of different disorders such as vasculopathies, trauma, infections and manifestations of primary and secondary malignant masses. Conventional ultrasound represents the basic imaging modality of choice to assess scrotal disorders. Contrast-enhanced ultrasound (CEUS) can provide further information to distinguish between benign and malignant testicular mass lesions. The recent introduction of Super Resolution CEUS Micro-Vascular Imaging (MVI SR) and Time of Arrival (TOA SR) parametric mapping compliments the information provided by conventional CEUS, since these two new post-processing techniques improve the visualization of microvascular structures with slow blood flow and provide high-resolution images of the peak contrast enhancement and temporal perfusion patterns. This paper gives a comprehensive overview of differential diagnoses of the testicular disorder and their corresponding sono-morphologic correlates based on representative cases of the Interdisciplinary Ultrasound Center of the University Hospital Munich.

Comparison of Frozen and Final Pathology Results in Patients Operated for Endometrial Hyperplasia

OBJECTIVE: Our study aimed to determine the frequency of endometrial cancer in patients undergoing surgery with a diagnosis of endometrial hyperplasia and to evaluate the concordance between preoperative diagnosis, frozen section examination, and final pathology results. STUDY DESIGN: The clinical findings, imaging results, and all pathology reports of patients who underwent total abdominal hysterectomy for endometrial hyperplasia (atypical or non-atypical) between January 2020 and January 2023 at our hospital were retrospectively evaluated. Demographic and clinical characteristics (age, menopausal status, parity, body mass index, presence of diabetes and hypertension) and pathology results were recorded from patient records. RESULTS: 144 patients diagnosed with endometrial hyperplasia were included in the study. The frozen section and final pathology results of all patients diagnosed with non-atypical endometrial hyperplasia were reported as benign lesions. In the atypia group, the intraoperative frozen section results of 80.7% of the patients were classified as benign lesions, while the results of 19.3% were reported as malignant pathology. A statistically significant difference was found between the benign and malignant lesion groups, which were classified based on the final pathology results, with respect to age, menopausal status, and average endometrial thickness before biopsy. CONCLUSION: In cases of endometrial hyperplasia with atypia, the possibility of cancer appearing in the final pathology results should be taken into consideration. In the preoperative evaluation of patients, characteristics such as endometrial thickness, age, and menopausal status may suggest the likelihood of encountering endometrial cancer during surgery in this patient group.

A non-invasive predictive model based on multimodality ultrasonography images to differentiate malignant from benign focal liver lesions

We have developed a non-invasive predictive nomogram model that combines image features from Sonazoid contrast-enhanced ultrasound (SCEUS) and Sound touch elastography (STE) with clinical features for accurate differentiation of malignant from benign focal liver lesions (FLLs). This study ultimately encompassed 262 patients with FLLs from the First Hospital of Shanxi Medical University, covering the period from March 2020 to April 2023, and divided them into training set (n = 183) and test set (n = 79). Logistic regression analysis was used to identify independent indicators and develop a predictive model based on image features from SCEUS, STE, and clinical features. The area under the receiver operating characteristic (AUC) curve was determined to estimate the diagnostic performance of the nomogram with CEUS LI-RADS, and STE values. The C-index, calibration curve, and decision curve analysis (DCA) were further used for validation. Multivariate and LASSO logistic regression analyses identified that age, ALT, arterial phase hyperenhancement (APHE), enhancement level in the Kupffer phase, and Emean by STE were valuable predictors to distinguish malignant from benign lesions. The nomogram achieved AUCs of 0.988 and 0.978 in the training and test sets, respectively, outperforming the CEUS LI-RADS (0.754 and 0.824) and STE (0.909 and 0.923) alone. The C-index and calibration curve demonstrated that the nomogram offers high diagnostic accuracy with predicted values consistent with actual values. DCA indicated that the nomogram could increase the net benefit for patients. The predictive nomogram innovatively combining SCEUS, STE, and clinical features can effectively improve the diagnostic performance for focal liver lesions, which may help with individualized diagnosis and treatment in clinical practice.

Keratocystoma of the Parotid Gland: A Rare Case and Review of the Literature.

Keratocystoma of the parotid gland is a rare benign salivary gland tumor. In 2022, the World Health Organization added keratocystoma to the classification of benign parotid tumors. Recently, our hospital encountered a case involving a 2-year-old child, making this the youngest patient reported to date. We excised part of the parotid gland and lesion under general anesthesia while preserving the facial nerve. There was no local recurrence during the 1-year follow-up period after surgery. Despite its rarity, it is essential to consider the possibility of keratocystoma and distinguish it from other benign neoplastic lesions of the parotid gland.

CT and MRI radiographic characteristics of seminal vesicle cysts

PurposeSeminal vesicle cysts are relatively uncommon benign lesions. Early and accurate diagnosis is crucial for guiding appropriate management strategies. The purpose of this study was to investigate the radiographic characteristics of seminal vesicle cysts in order to enhance the diagnostic proficiency of radiologists. MethodsWe conduct a comprehensive descriptive analysis of the CT and MRI findings pertaining to 15 patients with seminal vesicle cyst, complemented by a brief literature review. ResultThe mean age of 15 patients with seminal vesicle cyst was 57.53 ± 17.0 years. Among these patients, 53.33% (8/15) were incidentally detected, while 40% (6/15) presented with symptoms of abdominal or pelvic pain. One patient exhibited hematospermia. In 86.67% (13/15) of cases, the cysts were unilateral, while the remaining 13.33% (2/15) were bilateral. Radiological assessment comprised CT scans for 7 patients, MRI scans for 12 patients, and a combination of both modalities for 4 patients. Imaging characteristics revealed 11 cases of unilocular cysts and 4 cases of multilocular cysts, with the largest measuring approximately 16.0 × 9.8 cm. CT imaging distinctly demonstrated punctate or nodular calcification along the cyst wall in 3 cases. MRI, on the other hand, facilitated the visualization of cystic contents, including mucinous protein in 9 cases and hemorrhagic components in 2 cases. ConclusionThe radiographic manifestations of seminal vesicle cysts exhibit distinct characteristics, CT and MRI imaging modalities are instrumental in facilitating their accurate diagnosis.

An Immunohistochemical Study on the Role of CD83+ Dendritic Cells (DCs) in Malignant and Benign Lesions of the Human Cervix.

Background Dendritic cells (DCs) are a group of cells that mainly function as antigen-presenting cells in the human body. Proper knowledge and understanding of such cells in the human cervix would be beneficial for understanding the role of CD83+ cells in benign and malignant lesions of the cervix. Materials and methods This retrospective study was performed on cervical specimens. After processing, the CD83+ cells were counted for every 20 high-power fields. The average count per high power field (HPF) was then calculated. The CD83+ cell distributions in cervicitis, cervical dysplasia, and cervical carcinoma were then analyzed. Results A total of 30 cervical specimens were studied. Of these, 16 were cervicitis and seven were squamous cell carcinoma. Vaginal bleeding was the most common presentation in 21 patients. The mean age was 44.7 years. The mean CD83+ DCs in benign lesions was 1.75 and in malignant tissues was 12.26 per HPF (P<0.001). The area under the curve suggested a 100% sensitivity and specificity of CD83 in distinguishing benign and malignant lesions. The receiver operating characteristic (ROC) curve indicated that the probability of malignancy is higher if the number of CD83+ DCS is more than 179.50/20 HPF. Conclusions Dendritic cells play a major role in the tumoricidal activities of the host cervical tissues. Malignant cervical tissue possesses a higher concentration of CD83+ DCs than benign ones, with 100% sensitivity and specificity. This research work on CD83+ DCs in the cervix would pave the way for further research on the immune functions of the human body.

Impact of skin biopsy practices: A comprehensive nationwide study on skin cancer and melanoma biopsies.

Due to a multitude of factors, skin cancer incidence is increasing and challenges medical professionals in biopsy decision-making. While skin cancer may have a profound impact on the patient and be costly for society, there is little knowledge about the number and cost of benign skin lesions biopsied as collateral damage. This study evaluates the number and costs of skin biopsies in Denmark over 15 years, focusing on benign and malignant skin lesions and melanomas across medical settings. It aims to determine the benign to malignant ratio (BMR) and number needed to biopsy (NNB) and estimate the direct cost of benign skin lesion biopsies in the Cancer Pathway from the perspective of a public healthcare system. The study included 4,481,207 biopsy specimens from January 2007 to June 2022 from the Danish Pathology Data Bank, of which 151,988 from the Cancer Pathway were included in the primary analysis of BMR. The national reimbursement rates for biopsies were used, alongside histopathological examination costs extracted from several pathology departments, for a Monte-Carlo simulation of a simple cost and sensitivity analysis. The number of biopsies increased by 39.1% from 2007 to 2021. Overall BMR for malignancy was 4.1:1, and NNB for melanoma was 31.8, but biopsies performed on clinical suspicion of malignancy or melanoma had a BMR and NNB of 1.5:1 and 2.8, respectively. The cost of benign skin biopsies performed on suspicion of cancer or melanoma in 2021 was €6.6M, predominantly in hospitals. A healthcare system that employs filtering functions before biopsy of skin lesions can achieve some of the lowest BMR reported in the world, but with most benign skin lesion excisions due to suspicion of malignancy performed in the expensive hospital setting. Including clinical reason for biopsy in diagnostic accuracy studies using NNB is crucial.

Integrating color histogram analysis and convolutional neural networks for skin lesion classification

The color of skin lesions is a crucial diagnostic feature for identifying malignant melanoma and other skin diseases. Typical colors associated with melanocytic lesions include tan, brown, black, red, white, and blue-gray. This study introduces a novel feature: the number of colors present in lesions, which can indicate the severity of skin diseases and help distinguish melanomas from benign lesions. We propose a color histogram analysis, a traditional image processing technique, to analyze the pixels of skin lesions from three publicly available datasets: PH2, ISIC2016, and Med-Node, which include dermoscopic and non-dermoscopic images. While the PH2 dataset contains ground truth about skin lesion colors, the ISIC2016 and Med-Node datasets lack such annotations; our algorithm establishes this ground truth using the color histogram analysis based on the PH2 dataset. We then design and train a 19-layer Convolutional Neural Network (CNN) with different skip connections of residual blocks to classify lesions into three categories based on the number of colors present. The DeepDream algorithm is utilized to visualize the learned features of different layers, and multiple configurations of the proposed CNN are tested, achieving the highest weighted F1-score of 75.00 % on the test set. LIME is subsequently applied to identify the most important features influencing the model's decision-making. The findings demonstrate that the number of colors in lesions is a significant feature for describing skin conditions. The proposed CNN, particularly with three skip connections, shows strong potential for clinical application in diagnosing melanoma, supporting its use alongside traditional diagnostic methods.

The Role of Diffusion-Weighted MRI in Correlation with Contrast-Enhanced MRI and Histopathology in the Evaluation of Focal Liver Lesions.

Accurate diagnosis of focal liver lesions is of utmost importance for theinitiation ofappropriate treatment. This study aims to assess the effectiveness of diffusion-weighted imaging (DWI) in diagnosing focal liver lesions, specifically focusing on differentiating between benign and malignant lesions, distinguishing metastases from primary liver tumors, and identifying various types of both benign and malignant lesions.. The study design is that of a prospective observational study done on 28 cases withfocal liver lesions detected on ultrasound. DWI was done followed by contrast-enhanced MRI (CE-MRI). Identification of the lesion on DWI and apparent diffusion coefficient (ADC) map was madeby using the CE-MRI images as a guide. The signal intensity of the lesion on DWI is determined as either diffusion restriction or no restriction. ADC measurementswere made quantitatively over various regions of interest (ROIs) of the focal liver lesion. All the lesions were confirmed by histopathological examination (HPE) except few benign lesions like simple cysts and few hemangiomas, which were followed up by ultrasonography after six months. Our study included 28 patients with 44 focal liver lesions. Out of 28 patients in this study group (n=28), there were a total of 17 male and 11 female patients. The mean age of the sample population was 50.89±13.40 years. The lesions were more commonly seen is the age group of 41-60 years (57.14%). Out of 44 lesions(n),24 (54.5%) lesionswere benign , 20 (45.45%) were malignant. There were 17 hemangiomas (38.6%), 2 hematomas (4.5%), 2 simple cysts (4.5%), 1 hydatid cyst (2.27%), 2 hepatic adenomas (4.5%), 16 hepatocellular carcinoma (HCC) (36.36%), 3 cholangiocarcinoma (6.8%), and 1 hepatoblastoma (2.27%). DWI has 85% sensitivity and 84.7% specificity for the differentiation of benign from malignant lesions. The mean ADC value of benign lesions was 1.83x10-3mm2/s and the mean ADC of malignant liver lesions was 0.96x10-3mm2/s. In the present study, the average cut off of mean ADC to differentiate benign and malignant bone lesions is 1.3x10-3 mm2/s, with statistically significant p value of 0.001, sensitivity of 95% and specificity of 83.3%. DWI is a valuable imaging technique in the evaluation of focal liver lesions. The ability to differentiate between benign and malignant liver lesions without the need for contrast is a significant benefit, particularly in challenging cases involving uncooperative patients or when contrast administration is contraindicated.