Biopsy Procedures Research Articles

Costs of a structured early detection program for advanced liver fibrosis and cirrhosis: insights on the "plus" of Check-up 35.

The implementation of an early detection program for liver cirrhosis in a general population has been discussed for some time. Recently, the effectiveness of a structured screening procedure, called SEAL (Structured Early detection of Asymptomatic Liver cirrhosis), using liver function tests (AST and ALT) and APRI to early detect advanced fibrosis and cirrhosis in participants of the German "Check-up 35" was investigated. This study identifies the expected diagnostic costs of SEAL in routine care and their drivers and reports on prevailing CLD etiologies in this check-up population. The analysis is based on theoretical unit costs, as well as on the empirical billing and diagnostic data of SEAL participants. Screening costs are mainly driven by liver biopsies, which are performed in a final step in some patients. Depending on the assumed biopsy rates and the diagnostic procedure, the average diagnostic costs are between EUR 5.99 and 13.74 per Check-up 35 participant and between EUR 1,577.06 and 3,620.52 per patient diagnosed with fibrosis/cirrhosis (F3/F4). The prevailing underlying etiology in 60% of cases is non-alcoholic fatty liver disease. A liver screening following the SEAL algorithm could be performed at moderate costs. Screening costs in routine care depend on actual biopsy rates and procedures, attendance rates at liver specialists, and the prevalence of fibrosis in the Check-up 35 population. The test for viral hepatitis newly introduced to Check-up 35 as once-in-a-lifetime part of Check-up 35 is no alternative to SEAL.

The diagnostic accuracy of 332 incisional biopsies in patients with malignant tumors in the musculoskeletal system

BackgroundIt is known that specimen collection followed by histopathological workup is the core of evidence-based medical therapy of musculoskeletal tumors. There exist many controversies about how a biopsy should be performed. While some centers recommend minimal invasive biopsy procedures, mostly the core needle biopsy (CNB), others prefer the incisional biopsy.Purpose of the studyThis study aimed to determine the accuracy of incisional biopsy for malignant tumors in the musculoskeletal system. Moreover, advantages and disadvantages to other biopsy methods are discussed.MethodsThis retrospective, single-center study about 844 incisional biopsies (benign and malignant) analysis the diagnostic accuracy of 332 malignant tumors, concerning the final histopathological result. In addition, surgical complications are analyzed to find the best way to plan and treat patients timely and correct. Secondary endpoints are the patients age, the pure operation time, as well as the type of tumor, and the subsequent therapy.ResultsIn summary, incisional biopsy corresponded a sensitivity of 100% for malignancy in 844 incisional biopsies and a specificity of 97.6% in 332 malignant tumors, but it features greater operative expense (incision/suture 23.5 min) and the risk of general anesthesia.ConclusionThe method of biopsy should be tailored to the individual patient and the experience of the center performing the procedure.

The Advantage of Using an Optical See-Through Head-Mounted Display in Ultrasonography-Guided Needle Biopsy Procedures: A Prospective Randomized Study.

An optical see-through head-mounted display (OST-HMD) can potentially improve the safety and accuracy of ultrasonography (US)-guided fine-needle aspiration. We aimed to evaluate the usefulness of an OST-HMD in US-guided needle-puncture procedures. We conducted a prospective randomized controlled study in which we compared the accuracy and safety of the US-guided needle puncture procedure and the stress on the practitioner when using OST-HMD versus standard US display (SUD). Inexperienced medical students were enrolled and randomly divided into two groups. A breast phantom was used to evaluate the required time and accuracy of the US-guided needle puncture. Practitioner stress was quantified using a visual analog scale (VAS). When the procedure was performed for the first time, the time required to reach the target lesion at a shallow depth was significantly shorter in the OST-HMD group (39.8 ± 39.9 s) than in the SUD group (71.0 ± 81.0 s) (p = 0.01). Using the OST-HMD significantly reduced the unintentional puncture of a non-target lesion (p = 0.01). Furthermore, the stress felt by the practitioners when capturing the image of the target lesion (p < 0.001), inserting and advancing the needle more deeply (p < 0.001), and puncturing the target lesion (p < 0.001) was significantly reduced in the OST-HMD group compared with that in the SUD group. Use of OST-HMD may improve the accuracy and safety of US-guided needle puncture procedures and may reduce practitioner stress during the procedure.

Diagnosis of Cholangiocarcinoma.

Cholangiocarcinoma (CCA), a tumor of the bile duct epithelium, is increasing in incidence. CCA remains a highly fatal malignancy because early diagnosis is difficult. Based on its anatomical location, CCA can be categorized into the following three groups: perihilar, intrahepatic, and extrahepatic. Patients with CCA complain of asymptomatic jaundice, weight loss, and right upper quadrant abdominal discomfort. Imaging modalities, including transabdominal ultrasound, computed tomography, and magnetic resonance imaging, play an important role in detecting tumors as well as guiding biopsy procedures and staging workups in CCA. Characteristically, extrahepatic CCA shows abrupt changes in ductal diameter with upstream ductal dilation. Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) are recommended as the next step in the evaluation of extrahepatic CCA. Tissue is obtained through EUS-FNA or ERCP (biopsy, brush cytology), and therapeutic intervention (such as stent insertion) is performed with ERCP. Moreover, several serum tumor markers (carbohydrate antigen 19-9 and carcinoembryonic antigen) can be useful in diagnosing CCA in some patients.

Nationwide outcomes of newborns with rectosigmoid versus long-segment Hirschsprung disease

PurposeHirschsprung Disease (HD) is a common congenital intestinal disorder. While aganglionosis most commonly affects the rectosigmoid colon (rectosigmoid HD), outcomes for patients in which aganglionosis extends to more proximal segments (long-segment HD) remain understudied. This study sought to compare postoperative outcomes among newborns with rectosigmoid and long-segment HD. MethodsThe Nationwide Readmission Database was queried from 2016 to 2018 for newborns with HD. Newborns were stratified into those with rectosigmoid or long-segment HD. Those who received no rectal biopsy or pull-through procedure during their newborn hospitalization were excluded. A propensity score-matched analysis (PSMA) of newborns with either type of HD was constructed utilizing 17 covariates including demographics, comorbidities, and congenital-perinatal conditions. ResultsThere were 1280 newborns identified with HD (82% rectosigmoid HD, 18% long-segment HD). Patients with rectosigmoid HD had higher rates of laparoscopic resections (35% vs. 12%) and less frequently received a concomitant ostomy (14% vs. 84%), both p < 0.001. Patients with long-segment HD were more likely to have a delayed diagnosis (12% vs. 5%) and require multiple bowel operations (19% vs. 4%), both p < 0.001. They experienced higher rates of complications, including small bowel obstructions (10% vs. 1%), infections (45% vs. 20%), and Hirschsprung-associated enterocolitis (11% vs. 5%), all p < 0.001. After PSMA, newborns with long-segment HD were found to have a longer length of stay and higher hospitalization costs. ConclusionNewborns with long-segment HD experience significant delays in diagnosis, surgery, and complications compared to those with rectosigmoid HD. This information should be utilized to improve healthcare delivery for this patient population. Type of StudyRetrospective comparative study. Level of EvidenceIII.

The Effect of Relaxation and Respiratory Exercise on Anxiety in Thyroid Biopsy Patients

Objectives: It is known that high stress levels increase the risk of complications in invasive procedures. The aim of this study is to investigate the effect of the relaxation and respiratory exercise on the anxiety state specific to the thyroid biopsy procedure in patients. Methods: 100 randomly selected thyroid biopsy patients from 200 patients watched the Relaxation and Respiratory Exercise video (group 1) and did the instructions, and the rest 100 patients were control group (group 2) who did not watch it. The State-Trait Anxiety Inventory state scale (STAI-I) and trait anxiety scale (STAI-II) were administered to all patients before the procedure. Group 1 watched the video just before the biopsy procedure. After the biopsy procedure, all the 200 patients rested for 15 minutes, and the STAI- I scale was filled again. Results: When the STAI-II and pre-biopsy STAI-I questionnaire results of the patients were compared between two groups; study group (Group 1): Patients who were selected to watch the video, control group (Group 2): Patients who were not watching the video), no statistically significant difference was found (p&gt;0,005). When the anxiety levels in the first STAI-I performed before the biopsy and the STAI-I tests performed after the procedure were compared, a statistically significant decrease was found in the anxiety levels of the SG (p&lt;0,001). Anxiety levels of female patients were statistically significantly higher than male patients. Conclusions: Although thyroid biopsy is a minimally invasive procedure, it may cause anxiety in patients. Watching the video before the procedure resulted in a decrease in the anxiety levels of the patients.

TRENDS IN PROSTATE CANCER DIAGNOSIS DURING THE COVID-19 PANDEMIC: SINGLE-INSTITUTION EXPERIENCE.

The aim of this study was to compare the number of biopsy and surgical procedures on prostate, as well as the number of newly diagnosed, histologically confirmed cases of prostate cancer during the COVID-19 pandemic at Zagreb University Hospital Center (UHC). We retrospectively collected and processed a total of 1344 histopathologic findings of the prostate at the Zagreb UHC. Our results show that during the COVID-19 pandemic, there was a statistically significant decrease in the absolute number of biopsy and surgical procedures on prostate at Zagreb UHC, and so was the number of newly diagnosed, histologically confirmed cases of prostate cancer. During the observed time of the pandemic (March 19, 2020 to December 31, 2020), there was a 37.5% decrease in the absolute number of newly diagnosed prostate cancer cases compared to the same period of the previous year (March 19, 2019 to December 31, 2019). To our knowledge, this is the first study of this kind that is based on the number of prostate cancer diagnoses in Croatia. By observing the early period of the pandemic, our results provide important guidelines for monitoring and understanding the long-term consequences of the pandemic on the prostate cancer morbidity and mortality.

Accelerated mineralization kinetics in children with osteogenesis imperfecta type 1.

Not much is known about the time course of mineralization in newly formed bone from healthy individuals nor in patients with bone disease. To investigate the early phase of mineral accumulation in human bone, we measured the mean mineralization content between double fluorescence labels (CaYoung) with quantitative backscattered electron imaging (qBEI) in human transiliac biopsy samples. Fluorescent labels for histomorphometric evaluation were administered over two 2-day periods separated by a 10-day-free interval, 4–5 days before biopsy procedure. We compared n = 19 children with osteogenesis imperfecta type I (OI, 6 girls/13 boys, age-range 2.2–14.1 years) with both a reference group of n = 38 healthy children (REF, 24 girls/14 boys, age-range 1.5–20.9 years) and an age-matched subgroup ( n = 17) of the latter (CON, 5 girls/12 boys, age-range 2.0–14.7 years). We observed significantly higher levels of CaYoung in OI type I compared to CON and REF in both cortical bone (Ct.CaYoung, +8.3 % and +7.0 %, respectively) and cancellous bone (Cn.CaYoung, +6.5 % and +4.9 %, all p < 0.001). When comparing cortical and cancellous compartments intra-individually, we found a significantly higher Cn.CaYoung than Ct.CaYoung in REF (2.3 ± 2.9 %, p < 0.001), but not in the OI group (0.6 ± 1.6 %, not significant). In the REF group, n = 7 samples also contained double labels in primary woven bone (which is deposited at the external cortex during growth/lateral drift of the iliac crest). This primary woven bone in REF had a higher CaYoung than secondary osteonal bone (4.9 ± 2.7 %). Our findings suggest that bone in OI has an accelerated mineral accumulation compared to healthy bone. This is reflecting the overall increased bone mineralization in OI as reported previously, and indicates that the higher levels of mineralization than those seen in healthy individuals are already achieved in OI type I early after onset of mineralization. • We measured mineralization kinetics by the combination of qBEI and CLSM imaging. • The mineral content of bone between the double labels (CaYoung) was analyzed. • CaYoung was increased in young patients with OI compared to healthy children. • In healthy children but not in OI, CaYoung was higher in spongiosa than in cortex.

Protocol for Treatment of Oral Verrucous Carcinoma - A Systematic Review and Meta-Analysis.

The objective of this study is to provide a structured protocol for the treatment of verrucous carcinoma (VC) based on size, bone invasion, recurrence and whether neck dissection is necessary or not. In addition, the study evaluates the probability of a wrong histopathological diagnosis. A search was conducted in the Cochrane Library, PubMed and Google from January 1962 to October 2022 by using MeSH terms and keywords. Studies reporting treatment modalities for VC and different histopathological diagnoses after excision of the lesion were selected except case reports and review articles. Thirteen articles were selected. Six hundred and thirty cases of VC were treated by surgery, surgery + neck dissection, radiotherapy, chemotherapy and combination therapy. Statistical analysis revealed surgical treatment as a preferred option. Despite being enlarged, the lymph node was negative for metastasis. So, in OVC cases neck dissection adds only unnecessary morbidity to patients. Radiotherapy or chemotherapy can be used to downstage the disease. 23.3% of cases reported wrong histopathology diagnosis. Patients treated for squamous cell carcinoma (SCC) will only experience unnecessary morbidity unless the correct diagnosis is made between VC and hybrid VC. Irrespective of size VC does not metastasise until there are no foci of SCC. Surgical excision of T1- and T2-sized lesions can be performed under local anaesthetic as a biopsy procedure. T3 or T4 lesion can be resected with a safe margin. If it comes as hybrid VC or VC with close margin (0.5 cm, <0.5 cm), neck dissection and further margin should be excised as a second procedure respectively.

Skin cancer recognition using SVM image processing technique

According to some estimates, skin cancer is the leading cause of death for people in the modern period. Although it can happen anywhere on the body, the majority of the time, this sort of cancer targets particular body regions that are more prone to being exposed to light. Skin cells proliferate in an erratic or patchy manner as a symptom. The majority of skin cancers can be treated if they are discovered early. Therefore, a patient’s life can be saved by promptly and precisely diagnosing skin cancer. Modern technology has made it feasible to detect skin cancer in its earliest stages. Skin cancer can be diagnosed systematically using the biopsy procedure (1). Skin cells are removed and supplied as a sample, following which they are evaluated in several laboratories. It’s an extremely unpleasant and time-consuming process. For primitive detection of skin cancer disease, we proposed a skin cancer detection system based on support vector machine (SVM). It is more helpful to patients. Various methods of image processing and the supervised learning algorithm called SVM are used in the identification process. In particular, epiluminescence microscopy is utilized using an image and several preprocessing techniques which are used in the reduction of sound artifacts and improve the quality of images. Segmentation is done by using certain thresholding techniques like Otsu. The gray level co-occurrence matrix technique must be used to remove certain image features. These characteristics are fed into the classifier as input. The supervised learning model called SVM is used to distinguish data sets. It determines whether a picture is cancerous or not.

Meta-analysis and systematic review of mediastinal cryobiopsy versus endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of intrathoracic adenopathy.

Endobronchial ultrasound (EBUS)-guided mediastinal/hilar cryobiopsy (MedCryoBx) is a relatively new modality, being combined with EBUS-transbronchial needle aspiration (TBNA) to improve yield in the diagnosis of intrathoracic adenopathy. This meta-analysis aims to investigate the diagnostic yield of MedCryoBx versus EBUS-TBNA for intrathoracic adenopathy. We conducted a systematic search using Google Scholar, Embase, and PubMed/MEDLINE for studies about a diagnosis of intrathoracic adenopathy using MedCryoBx and EBUS-TBNA. Two authors separately reviewed studies for inherent bias using the Quality Assessment Data Abstraction and Synthesis-2 (QUADAS-2) tool. Inverse Variance weighting for random effects methodology was used for meta-analysis. Pooled diagnostic yields overall and for subgroups were estimated. Complications of MedCryoBx were reviewed. Ten studies with 844 patients undergoing either biopsy procedure were in the final analysis. A total of 554 patients underwent MedCryoBx and 704 patients EBUS-TBNA. Meta-analysis showed a pooled diagnostic yield of 91% (504 of 554) for MedCryoBx and 81% (567 of 704) for EBUS-TBNA, with odds ratio (OR) of 2.5 [95% confidence interval (CI): 1.6 to 3.91; P<0.001], with I2 of 20%. Subgroup analysis for benign conditions showed increased diagnostic yield with OR of 7.95 (91% MedCryoBx versus 58% EBUS-TBNA, P<0.001) with an I2 of 25%. Subgroup analysis for lymphoma showed a statistically significant increase in pooled diagnostic yield with OR of 11.48 (87% MedCryoBx versus 29% EBUS-TBNA, P=0.001). Mild bleeding (36.5%) without any intervention was the most common complication. Bleeding requiring intervention (0.7%) was noted in patients. Pneumothorax (0.4%) and pneumomediastinum (0.4%) were less common in this analysis. MedCryoBx is a very promising tool for the diagnosis of intrathoracic adenopathy. It has improved diagnostic yield over EBUS-TBNA in benign and possibly lymphoproliferative diseases, but less so in lung cancer. The complication rates with MedCryoBx are comparable to EBUS-TBNA.

Evaluation of Raman spectroscopy combined with the gated recurrent unit serum detection method in early screening of gastrointestinal cancer.

Gastric and colorectal cancers are significant causes of human mortality. Conventionally, the diagnosis of gastrointestinal tumors has been accomplished through image-based techniques, including endoscopic and biopsy procedures coupled with tissue staining. Most of these methods are invasive. In contrast, Raman spectroscopy has the advantages of being non-invasive and label-free and requiring no additional reagents, making it a potential tool for the detection of serum components. In this study, we collected Raman spectra of serum samples from patients with gastric cancer (n = 93) and colorectal cancer (n = 92) and from healthy individuals (n = 100). Analysis of Raman peak areas revealed that cancer patients had significantly higher peak areas at around 2923 cm-1 compared to normal individuals, which corresponded to the presence of lipids and proteins. We successfully achieved the early screening of gastrointestinal tumors using the improved gated recurrent unit (GRU) algorithm and traditional machine learning methods. The accuracy of identifying digestive tract tumors using different recognition models exceeds 84.72%, with support vector machine (SVM) and GRU achieving 100% accuracy. The use of GRU further demonstrated its ability to differentiate subtypes of gastric and colorectal cancers based on the degree of differentiation and stage, with a recognition accuracy exceeding 95%, which is challenging using traditional machine learning methods. Furthermore, our study revealed that principal component analysis (PCA) dimensionality reduction has a limited impact on the recognition results obtained using different recognition models.

Review of the Developing Landscape of Prostate Biopsy and Its Roles in Prostate Cancer Diagnosis and Treatment.

Prostate cancer remains a significant global health challenge. Traditionally anchored by the Gleason score/Grade Group (GS/GG), the landscape of prostate cancer diagnosis is undergoing transformative steps, particularly in the domain of biopsy procedures. GS/GG continues to be pivotal in malignancy grading, but recent technological strides have augmented the diagnostic relevance of biopsies. Integral to this progression is the adoption of advanced imaging techniques, especially magnetic resonance imaging, which has refined biopsy accuracy and efficiency. A deep understanding of prostate cancer pathology reveals a cribriform pattern and intraductal carcinoma of the prostate as independent forms of malignancy, suggesting a potentially aggressive disease course. Furthermore, the distinct behaviour of ductal adenocarcinoma and small cell carcinoma of the prostate, compared with acinar adenocarcinoma, necessitates their accurate differentiation during biopsy. The genomic era ushers in a renewed emphasis on tissue samples obtained from prostate biopsies, especially as mutations in genes, such as BRCA1/2, and paves the way for precision medicine. This review encapsulates the evolving dynamics of prostate biopsy, from technological advancements to the profound implications on prostate cancer management and therapy.

Systematic review and meta-analysis of low-dose CT-driven biopsy for pulmonary nodules.

The diagnosis of pulmonary nodules (PNs) has traditionally relied on computed tomography (CT)-guided biopsy. To reduce radiation exposure, low-dose CT-guided PN biopsy has been employed. This meta-analysis aimed at evaluating the efficacy and safety of low-dose CT-guided biopsy in the diagnosis of PNs. PubMed, Web of Science, and Wanfang were searched for relevant articles until June 2023. Comparing low-dose CT to normal-dose CT, we considered factors such as diagnostic yield, diagnostic accuracy, biopsy process time, dose-length product (DLP) value, the frequency of pneumothorax and pulmonary bleeding, and the frequency with which complications necessitated the placement of a chest tube. This meta-analysis included data from a total of 6 investigations. There was a total of 459 patients who had a CT-guided PN biopsy performed at a low dosage, and 384 patients who had a normal-dose CT-guided PN biopsy. There were no statistically significant differences between the low-dose CT and normal-dose CT groups in terms of diagnostic accuracy (p = 0.08), diagnostic yield (p = 0.55), biopsy procedure duration (p = 0.30), pneumothorax (p = 0.61), pulmonary hemorrhage (p = 0.29), or complications requiring a chest tube (p = 0.48). Low-dose CT patients obtained a DLP that was 91% lower than those in the standard-dose CT group (p = 0.01). According to Egger's test, there is a significant possibility of publication bias in DLP (p = 0.034). The diagnostic and safety results of low-dose CT-driven PN biopsy are equivalent to those of the standard one, although patients are much less exposed to radiation.

Retracted: Nanocarbon Tracer and Areola Injection Site Are Superior in the Sentinel Lymph Node Biopsy Procedure for Breast Cancer.

[This retracts the article DOI: 10.1155/2022/4066179.].

The influence of the operator's experience on the outcomes of fusion prostate biopsy.

Magnetic resonance imgaing (MRI) targeted biopsy is the gold standard for prostate cancer (PCa) diagnosis. In this study, we examined the association between the operator's experience and the improvement in the precision of the MRI prostate biopsy procedure and the detection of PCa. We included consecutive patients who underwent prostate fusion biopsy. Data on biopsy duration, prostate-specific antigen (PSA) value, lesion size, number of samples taken, number of cores involved, and International Society of Urological Pathology (ISUP) grade were subjected to statistical analysis, with the study group divided into three consecutive time periods (tertiles). There were statistically significant differences in biopsy duration between tertiles (p <0.001). The greatest difference in the involved/taken cores ratio occurred between the first and third tertile (p = 0.002). The difference between the first and second tertile was insignificant (p = 0.4), while the difference between the second and third tertile was statistically significant (p = 0.004). The differences between tertiles in Prostate Imaging and Reporting Data System v2.1 were also significant (p = 0.003). The PSA value (p = 0.036) was statistically significant, unlike prostate volume (p = 0.16), digital rectal examination (DRE) (p = 0.7), and ISUP grade (p = 0.7). There was no statistical difference between tested tertiles in the number of detected PCa ISUP ≥2 (Z = 0.191; p = 0.8). The abilities and precision of the operator increase with the increase in the number of procedures performed. The biopsy duration is shortened, and the detection of PCa during the procedure seems to improve with the operator's experience.

Circulating tumor cells in cancer-risk populations as a cancer interception tool.

Cancer interception (CI) is a new approach to cancer prevention and treatment in a cancer-risk population that aims to detect and treat pre-tumoral stages. It has several potential advantages over traditional cancer diagnosis and monitoring methods because it is non-invasive, making it less painful and risky than conventional biopsy procedures. The circulating tumor cells (CTCs), liquid biopsy family members, are essential for the CI approach; then, the liquid biopsy (LB) is used as a CI tool. LB can be performed frequently because of its easy sampling and early pathological stages, which allow repeated non-invasive monitoring of cancer progression and response to treatment. CTCs have been found in the bloodstream of several types of cancer patients, including in early-stage cancer and premalignant lesions, suggesting a tumor development role in cancer's early stages. This chapter will present foundational scientific studies addressing CI and the clinical impact of CTC screening in a population at risk for cancer.

Cancer-associated stroke in a patient with testicular cancer - case report

Introduction. Cerebral venous thrombosis is a rare cerebrovascular disease that affects about 5 in 1 million people each year and accounts for 0.5% of all strokes. There is significant overlap of many risk factors for cerebral venous thrombosis and venous thromboembolism: cancer, obesity, genetic thrombophilia, trauma, infection, and prior neurosurgery. Testicular cancer is a malignant tumor found in testicular cells and it is generally called testicular germ cell tumor. This case report puts emphasis on the importance of recognizing cerebral venous thrombosis as one of the cancer-associated symptoms that can help set the appropriate diagnosis, which, however, is not very common for this type of disease. Case report. A 58-year-old patient has been examined many times due to recurrent strokes. Lumbar puncture, computed tomography scan, magnetic resonance imaging, magnetic resonance angiography, magnetic resonance venography, immunoserology and electroencephalography have been performed. Apart from the vascular changes in the brain blood vessels, the cause of the stroke was not clear. Further?more, the patient was examined by a hematologist and an urologist. Laboratory testing showed increased levels of alpha fetoprotein and beta-human chorionic gonadotropin, however, no tumor was found in the suspected testis. Eventually, the patient underwent retroperitoneal lymph mass percutaneous core biopsy procedure and was diagnosed with non-seminoma germ cell tumor - Yolk sac tumor. Conclusion. Patients with cerebral venous thrombosis require multidisciplinary approach for the appropriate diagnosis.

Clinico-cytomorphological Spectrum of Calcinosis Cutis.

The deposition of calcium in the skin is known as calcinosis cutis. It can affect any part of the body and can mimic soft tissue or bony lesions clinically. To describe the clinical and cytomorphologic features of calcinosis cutis on fine needle aspiration cytology smears. A total of 17 cases reported as calcinosis cutis on fine needle aspiration cytology were reviewed for the available clinical and cytological details. The cohort included both adult and pediatric patients. Clinically, the lesions appeared as painless swellings of variable sizes. The common sites affected were the scrotum, iliac region, scalp, pinna, neck, axilla, elbow, arm, thigh, and gluteal region. Aspirate was chalky white, paste-like in all the cases. The cytologic evaluation revealed amorphous crystalline deposits of calcium along with histiocytes, lymphocytes, and multinucleated giant cells. Calcinosis cutis has a wide spectrum of clinical presentations. Fine needle aspiration cytology is a minimally invasive approach for diagnosing calcinosis cutis, thus eliminating the need for more extensive biopsy procedures.

A multimodal imaging-guided software for access to primate brains

BackgroundImaging-guided access to the brain has become a routine procedure for various research and clinical applications, including drug administration, neurophysiological recording, and sampling tissue. Therefore, open-source software is required to handle such datasets in these specific applications. New methodsHere, we proposed an open-source tool utilizing different imaging modalities for automating the steps to access the brain. This tool provides means for easily calculating the coordination of the area of interest concerning a specific point of entry. The source and documentation are available at this link. ResultsWe have used this software for three different applications: electrophysiological recording, drug infusion in the nonhuman primate brain, and guided biopsy procedure in the human brain. We performed a neural recording of two monkeys' prefrontal cortex and inferior temporal cortex using this software in submillimeter resolution. We also applied our procedure for infusion in the putamen and caudate nuclei in both hemispheres of another group of rhesus monkeys with histological proof in one animal. More so, we validated this software in the human subjects that underwent biopsy surgery with the commercial software used in human biopsy surgery. Comparison with existing methodsOur software uses different imaging modalities by co-registering them. This will provide structural details of the skull and brain tissue. We can calculate each brain region’s coordination at the point of entry by re-slicing the images. Atlas-based image segmentation were implemented in our software. Three mentioned applications of our software in neuroscience will be further discussed in this paper. ConclusionIn our procedure, working with different imaging modalities provides a precise estimation of the specific region in the brain related to the location of implants or stereotaxic frames. There is no limitation to using metal implants in this procedure.