Cyst Wall Research Articles

Clinical, genomic, and histopathologic diversity in cerebral cavernous malformations

Cerebral cavernous malformations (CCMs) are hemorrhagic vascular disorders with varied clinical and radiological presentations, occurring sporadically due to MAP3K3 or PIK3CA mutations or through inherited germline mutations of CCM genes. This study aimed to clarify the clinical, genetic, and pathological features of CCMs using a multicenter cohort across three Chinese centers. We analyzed 290 surgical specimens from symptomatic CCM patients, utilizing whole-exome sequencing, droplet digital PCR, and targeted panel sequencing, alongside immunohistology to examine genotypic and phenotypic differences. Among 290 cases, 201 had somatic MAP3K3, PIK3CA, or germline CCM mutations, each associated with distinct clinical parameters: hemorrhage risk (P < 0.001), lesion size (P = 0.019), non-hemorrhagic epilepsy (P < 0.001), Zabramski classifications (P < 0.001), developmental venous anomaly presence (P < 0.001), and MRI-detected edema (P < 0.001). PIK3CA mutations showed a higher hemorrhage risk than MAP3K3 and combined MAP3K3 & PIK3CA mutations (P < 0.001). Within PIK3CA mutations, the p.H1047R variant correlated with higher bleeding risk than p.E545K (P = 0.007). For non-hemorrhagic epilepsy, patients with single MAP3K3 mutations or combined MAP3K3 & PIK3CA mutations were at greater risk than those with PIK3CA mutations alone. Histopathologically, lesions with PIK3CA mutations displayed cyst walls, pS6-positive dilated capillaries, and fresh blood cells, while MAP3K3 and double mutation lesions exhibited classic CCM pathology with SMA-positive and KLF4-positive vessels, collagen, and calcification. PIK3CA lesions had fewer KLF4-positive cells than double mutations lesions (P < 0.001), and EndMT (SMA-positive) cells compared to double mutation lesions (P < 0.05) and MAP3K3 mutations (P < 0.001), with more pS6 compared to MAP3K3 mutations (P < 0.05). This study underscores the diverse clinical, genomic, and histopathological characteristics in CCMs, suggesting potential predictive markers based on mutation subtypes and MRI features.

Surgical management options for childhood intracranial arachnoid cysts: a comparative study

BackgroundThe symptomatic and incidentally discovered childhood intracranial arachnoid cysts may make it challenging to define the best management option, which may be surgical or observational. The best surgical option is still in debate, either regarding the type or the indication of surgery. This study aims to evaluate cysto-peritoneal shunts, endoscopic fenestration, and our technique of microsurgical partial excision of the cyst wall with maintenance of subarachnoid patency as surgical treatment options for childhood intracranial arachnoid cysts.ResultsThis retrospective study was performed to compare three surgical options for treatment of childhood intracranial arachnoid cysts during the period from January 2015 to October 2022, with a follow-up of at least one year. These options included a cysto-peritoneal shunt, endoscopic fenestration, and microsurgical patency of the subarachnoid space without basal fenestration. Clinical improvement rating and operative complications showed insignificant differences between the three surgical options; however, total disappearance of the arachnoid cysts was significantly associated with the microsurgical option (p = 0.0312).ConclusionSurgical management of childhood arachnoid cysts either by cysto-peritoneal shunt, endoscopic fenestration, or microsurgical techniques was efficient according to the accessibility of the cysts, and the microsurgical patency of the subarachnoid space had the most significant effect on the disappearance of the cysts.

Toxoplasma chitinase-like protein orchestrates cyst wall glycosylation to facilitate effector export and cyst turnover

Toxoplasma bradyzoites reside in tissue cysts that undergo cycles of expansion, rupture, and release to foster chronic infection. The glycosylated cyst wall acts as a protective barrier, although the processes responsible for formation, remodeling, and turnover are not understood. Herein, we identify a noncanonical chitinase-like enzyme TgCLP1 that localizes to micronemes and is targeted to the cyst wall after secretion. Genetic deletion of TgCLP1 resulted in a thickened cyst wall that decreased cyst turnover, blocked the export of virulence effectors into host cells, and resulted in failure to persist during chronic infection. Genetic complementation with a series of mutants revealed that the GH19 glycosidase domain was crucial for regulating glycosylation of several glycoproteins in the cyst wall. Overall, our findings reveal that TgCLP1 is a multifunctional survival factor that modifies glycoproteins within the cyst wall to modulate export of virulence effectors and regulate turnover of tissue cysts.

Intra-infundibular Epidermoid Cysts- A Distinct and Rare Entity.

Epidermoid cyst (EC) located completely within the pituitary infundibulum is a rare entity with only seven reported cases. In this study, we have described our experience with resection of intra-infundibular epidermoid cysts (IECs) and reviewed the existing literature highlighting its distinguishing features and operative nuances. Three consecutive cases of IEC operated at our institute was retrospectively studied. PubMed and EMBASE databases were searched, and seven case reports of IEC were found. Relevant clinical, radiological, operative data of ten cases were analyzed. The median age at diagnosis was 53.5 years and six cases were males. Preoperatively, although the average tumor size was only 1.62 cm3, 80% of patients had visual disturbance, and 78% of patients had deficiency in pituitary hormones. Five patients had preoperative diabetes insipidus. Mild diffusion restriction was noted in four out of five cases that mentioned it. The most common differential diagnosis considered was Rathke's cleft cyst and craniopharyngioma. Adhesion of the cyst wall to the stalk and/or the hypothalamus was a common occurrence resulting in residual wall being left behind in 50% cases. Expanded endoscopic endonasal approach was utilized in nine cases and one case underwent fronto-temporal craniotomy with resection via pretemporal approach. Postoperative chemical meningitis was demonstrated in two cases and sterile abscess was noted in another case. IECs are rare tumors that are often misdiagnosed preoperatively. They have different postoperative morbidity profiles compared to other cystic lesions in the infundibulum. This makes it important to recognize this distinct entity.

A Novel Method for Hemorrhage Control During Laparoscopic Distal Pancreatectomy with Splenic Vessel Preservation: Triple Occlusion.

Laparoscopic distal pancreatectomy (LDP) has the advantages of reduced blood loss, shorter hospital stays, and a better postoperative quality of life compared with open distal pancreatectomy (ODP).1 Meanwhile, spleen-preserving laparoscopic distal pancreatectomy is the preferred technique for low-grade malignant and benign tumors located in pancreatic body and tail, since it preserves the immune function of the spleen. The splenic-vessel-preserving (SVP) Kimura technique and splenic vessel resection Warshaw technique are the two primary procedures. Although the Kimura procedure and the Warshaw procedure were comparable in most postoperative outcomes, the former was superior to the latter in reducing the risk of gastric varices and splenic infarction.2,3 However, in cases of large tumors in the distal pancreas or those with tight adhesions of the tumor to the splenic vessels, laparoscopic Kimura procedure is technically challenging because of the higher risk of intraoperative hemorrhage.4 Herein, we present an effective surgical approach to laparoscopic SVP that minimizes the chances of vascular injury and maximizes the chances of a successful splenic preservation-triple occlusion strategy. A 46-year-old woman was admitted to our department owing to vague pain in the upper abdomen lasting for 6 months. Enhanced computed tomography (CT) scan revealed a 3.9 ✕ 4.3 cm cystic tumor in the distal pancreas, which has a smooth cystic wall without wall nodules; despite poor demarcation of the tumor from the splenic vein, tumor markers were all within normal limits (CA19-9, 5.78 U/ml; CEA, 1.14 ng/ml), so a benign tumor was considered. We present the triple-occlusion strategy during laparoscopic Kimura operation. This approach, as demonstrated in the video, includes triple occlusion of the proximal splenic artery, proximal splenic vein, and splenic pedicle; In addition, we use cold scissors to carefully dissect the tumor from the splenic vein, which minimizes the possibility of splenic vein injury and tumor rupture caused by thermal damage of ultrasonic scalpel, thus improving the safety of the surgery and the chances of spleen preservation. The operation lasted for 136 min with 10ml of estimated blood loss. Multiple sites of the cystic wall were sampled (including the margins of the splenic vein), and intraoperative freezing was conducted to consider mucinous tumors, with no cancer cells detected. The amylase in the drainage fluid on postoperative day (POD) 3 was 1410 U/l, and the drainage tube was removed on POD 4. The patient showed an uneventful recovery and was discharged on POD 5. Finally, mucinous cystadenoma with mild atypical hyperplasia was diagnosed by pathological examination. The laparoscopic triple-occlusion strategy may be helpful for selected patients with tumors located at the distal pancreas, especially for those with large tumor or tumors with tight adhesion to splenic vessels.

Laparoscopic peritoneal mucinous cystadenoma debulking: A case report.

Peritoneal mucinous cystadenoma is rare in the clinic, lacks specific clinical manifestations, tumor markers, and imaging features, and is easily misdiagnosed and missed. Clinical practitioners should maintain a high level of vigilance. Here, we report a case of laparoscopic peritoneal mucinous cystadenoma stripping to improve our understanding of the disease. A 34-year-old woman was admitted to our hospital with a history of epigastric pain over the past year that had worsened over the previous 4 months. The patient had no history of trauma or surgery. A computed tomography scan of the whole abdomen, as well as hepatobiliary and pancreatic scans and magnetic resonance cholangiopancreatography examinations, showed a low-density mass of approximately 5.8 × 4.8 cm between the right lobe of the liver and the right kidney. The lesion showed no significant enhancement on the enhanced scan, and analysis of tumor markers was normal. The preoperative diagnosis was cholelithiasis with cholecystitis and hepatic cysts. It was proposed to perform "laparoscopic cholecystectomy + hepatic cyst decapitation and decompression" under general anesthesia; however, intraoperative exploration revealed that the abdominal cyst had originated from the right side of the peritoneum and was located between the liver and kidney. The surgical procedure was thus changed to "laparoscopic abdominal cyst removal + cholecystectomy." The patient recovered well and was discharged on the fourth postoperative day. Postoperative pathological examination (abdominal cyst) showed mostly serous cells partially covered with high columnar mucus cells, which was consistent with mucinous cystadenoma. The postoperative diagnosis was peritoneal mucinous cystadenoma and cholecystolithiasis with cholecystitis. Clinical diagnosis of mucinous cystadenoma of the abdominal wall is difficult. The possibility of the disease should be considered when a cystic space is found in the abdominal cavity. Diagnosis depends on postoperative pathological examination, and surgery is the preferred treatment option. During the operation, attention should be paid to avoid rupture of the cyst wall and overflow of cyst fluid, and to avoid blind fenestration and drainage or puncture and aspiration sclerotherapy when the diagnosis is unclear.

Sarcocystis Cymruensis in the Brown Rat (Rattus Norvegicus) from an Urban District in Kuwait: Detailed Morphologic and Molecular Characterization.

The objective of the study was to establish the prevalence of Sarcocystis (Apicomplexa, Sarcocystidae) in brown rats from Jleeb Al-Shuyoukh, Kuwait, and to describe detected parasites using morphological and DNA analysis methods. Ninety-eight brown rats (Rattus norvegicus) were examined for Sarcocystis spp. Obtained sarcocysts were investigated using light microscopy and electron microscopy. The detected Sarcocystis species was characterised at nuclear 18S and 28S ribosomal RNA (rRNA), internal transcribed spacers 1 and 2, (ITS1 and ITS2), mitochondrial cytochrome c oxidase subunit I (cox1) and cytochrome b (cytb), and apicoplast RNA polymerase beta subunit (rpoB). Sarcocysts were found in thigh muscles of 13.3% of the animals examined, while no oocysts/sporocysts were detected in faecal samples. Under a light microscope, sarcocysts were spindle-shaped, 850-3152 × 73-125μm (1781 ± 763 × 99 ± 15μm) in size and had thin (up to 0.9μm) and apparently smooth cyst wall. By transmission electron microscopy, sarcocyst wall was 0.7-1.1μm in thickness with numerous osmiophilic bleb-like protrusions. Based on DNA sequencing the sarcocysts examined were identified as S. cymruensis. Notably, ITS2 and rpoB sequences of S. cymruensis were obtained for the first time. No intraspecific variation was detected comparing 28S rRNA, ITS1, cox1 and cytb sequences of S. cymruensis isolated from Kuwait, Grenada and China. According to phylogenetic analysis, S. cymruensis was most closely related to S. muris, S. myodes and S. ratti using rodents as their intermediate hosts and cats as their identified or predatory mammals as their presumed definitive hosts. We present the first report of S. cymruensis in Kuwait and in Persian Gulf area. The study shed light on the usefulness of different genetic loci for the characterization of Sarcocystis spp. from rodents.

Global Warming and Equatorial Atlantic Paleoceanographic Changes During Early Eocene Carbon Cycle Perturbation V

AbstractA series of transient global warming events (“hyperthermals”) in the early Eocene is marked by massive environmental and carbon cycle change. Among these events, the impacts of the Paleocene Eocene Thermal Maximum (∼56 Ma), Eocene Thermal Maximum 2 (∼54 Ma) and Eocene Thermal Maximum 3 (∼53 Ma) are relatively well documented. However, much less is known about the many subsequent hyperthermals that apparently occurred on orbital eccentricity maxima until at least the end of the Early Eocene Climatic Optimum (EECO; ∼53–49 Ma). Ocean Drilling Program (ODP) Site 959 (Equatorial Atlantic Ocean), we report a large negative carbon isotope excursion (CIE) in both organic and carbonate substrates that we correlate to the “V” event sensu Lauretano et al. (2016), https://doi.org/10.1127/nos/2016/0077 (or C22nH1 sensu Sexton et al. (2011), https://doi.org/10.1038/nature09826) at ∼49.7 Ma, following combined bio‐ and chemostratigraphic constraints. Through TEX86 paleothermometry, we reconstruct a sea surface temperature rise of 1.3–2.0°C associated with this CIE, which, combined with evidence for warming from the deep sea, implies that this event indeed represents a transient global‐scale warming episode like the earlier hyperthermals. Organic walled dinoflagellate cyst assemblages indicate a productive paleoceanographic background setting, likely through regional upwelling, which alternated with episodes of stratification. Warming reconstructed across V at Site 959 is relatively similar to the higher‐latitude‐derived deep ocean reconstructions. However, the presence of upwelling and its variable intensity across the event compromises the use of the reconstructed warming as an estimate for the complete tropical band.

Protective humoral immunity induced by virus-like particles expressing Toxoplasma gondii CST1 or MIC8.

Protective efficacy assessment of toxoplasmosis vaccines, at least at the preclinical level, frequently involves lethal dose challenge infection. Nonetheless, their efficacies remain largely unexplored against low infection doses which better reflects how humans become infected in the real world. In this study, we compared the immunity elicited in mice that were heterologously immunized with recombinant baculovirus and virus-like particles expressing either the cyst wall protein (CST1) or microneme protein 8 (MIC8) of Toxoplasma gondii (T. gondii). We also investigated how these vaccines fared against both light and heavy infection intensities of T. gondii ME49. Interestingly, under light infection intensity, vaccines expressing CST1 induced significantly higher mucosal antibody responses than MIC8. Germinal center B (GC B) cell responses were elicited to a greater extent following immunization with either antigen, regardless of the infection dose. Similarly, both antigens suppressed IFN-γ production in the brains upon heavy infection. The overall vaccine-induced protection was also similar for the two vaccine antigens under heavy infection. However, in lightly infected mice, CST1 conferred improved GC B cell induction and further inhibited IFN-γ and cyst burden than those elicited by MIC8, thereby contributing to better protection. These findings indicated that light infection could be used to identify optimal vaccine candidates, thus highlighting the impact of infection intensity in vaccine efficacy evaluations.

Ultrasound B-Scan for Posterior Segment and Extraocular Evaluation in Ocular Cysticercosis.

Cysticercosis, caused by Taenia solium larvae, can affect various ocular and extraocular structures, leading to significant morbidity. Ultrasound B-scan imaging plays a pivotal role in diagnosing and classifying cysticercosis lesions.The aim of the study was to describe the ultrasound B-scan characteristics of ocular and extraocular cysticercosis, proposing a classification system based on anatomical localization to enhance understanding and management. A retrospective study of consecutive cases with intraocular or extraocular cysticercosis was conducted from January 1993 to December 2023 in Mumbai, India. B-scan ultrasound was performed by an experienced imaging specialist. Descriptive statistics were used to summarize demographic characteristics and the proportion of cysticercosis in each anatomical location. Cysticercosis lesions were classified based on anatomical location observed during imaging. Amongst the 56 eyes evaluated, intraocular posterior segment involvement (n=25) and extraocular involvement (n=31) were observed. Extraocular cysticercosis predominantly affected the medial rectus muscle (40%), followed by the inferior rectus (28%), lateral rectus (20%), and superior rectus muscles (12%). Orbital cysts were localized in the posterior extraconal (50%), anterior extraconal (34.33%), and intraconal (16.67%) regions. Intra-vitreous cysticercosis (n=9) exhibited thin-walled cysts with minimal inflammation, progressing to thickened cyst walls in the late stages. Sub-hyaloid cysticercosis (n=8) showed initial thin vitreous detachment, progressing to thickened vitreous adhesions. Sub-retinal cysticercosis (n=9) without retinal detachment indicated early disease, while cases with detachment suggested disease progression. The proposed anatomical classification system based on B-scan ultrasound features provides a structured approach to categorizing cysticercosis lesions, enhancing understanding and management in ophthalmic practice.

Ectopic lacrimal gland combined with cyst in the nasal conjunctiva

A 43-year-old female presented with a tumor in the nasal bulbar conjunctiva of the left eye that had been present for 3 years. A yellowish tumor measuring approximately 7 × 5 mm was observed. It was solidly elevated, bumpy, well-defined, and exhibited angiogenesis. Below the tumor, there was a translucent, thin-walled cyst. Both lesions were removed by microscopic surgical excision. Pathological diagnosis: The hyperplastic lacrimal gland of the conjunctiva exhibited focal duct papillary hyperplasia. The cyst wall consisted of a bilayer columnar epithelial cells. The features of the conjunctival ectopic lacrimal gland differed from those of the normal lacrimal gland. Furthermore, the ectopic lacrimal contained an excretory duct that formed a cyst. The combination of an ectopic lacrimal gland and a lacrimal ductal cyst in the nasal conjunctiva is rare. Pathological diagnosis is necessary to confirm the diagnosis.

The DETECTION project part 1: An international Delphi survey about diagnostics and treatment of anterior mediastinal cystic lesions.

Differentiating benign anterior mediastinal cysts from malignancies is challenging in clinical practice. International guidelines on optimal diagnostics and treatment for anterior mediastinal cystic lesions are lacking. The first part of the DETECTION project focuses on possible heterogeneity in diagnostics and treatment of anterior mediastinal cystic lesions among international thoracic medical experts. A Delphi-survey was created by 14 multidisciplinary panel members, affiliated with three Dutch tertiary referral hospitals for thymic tumours. The survey contained 55 questions and was reviewed by international experts of the International Thymic Malignancy Interest Group (ITMIG) and Réseau tumeurs THYMiques et Cancer (RYTHMIC). The survey was launched online for members of the ITMIG and RYTHMIC from May 26th, 2023 till July 18th, 2023. The survey was completed by 21 thoracic surgeons, 15 radiologists, 15 medical oncologists, 11 pathologists, 9 pulmonologists, and 4 radiation oncologists from 24 countries. Heterogeneity was observed in performed diagnostic radiological imaging, laboratory tests, indications for surgery and follow-up of anterior mediastinal cysts. Cystic wall thickness of anterior mediastinal cysts was reported as clinical relevant in decision making more frequently by thoracic surgeons (76.2%) than pulmonologists (44.4%) and medical oncologists (15.4%) (p=0.015). The survey outcomes showed heterogeneity in the diagnostics and indication for resection of anterior mediastinal cysts among thoracic medical experts. A large variation in radiological imaging, laboratory tests, surgery, pathological analyses, and follow-up of anterior mediastinal cysts was observed. The development of evidence-based clinical practice guidelines may guide clinicians.

Immunohistochemical Study of Expression of Cyclynd1 Expression in Invasive and Non-invasive Odontogenic Cysts

Introduction: A radicular cyst is an inflammatory cyst arising from the remnants of epithelial malassez, while the Dentigerus cyst is linked to the impacted crown. The odontogenic Keratocyst is a developmental cyst that exhibits suggesting invasive behavior and a propensity to adjacent tissues, potentially due to the proliferation of the epithelial lining or the enzymatic composition of the cyst wall. CyclynD1 is a protein in the Rb pathway that regulates the shift from G1 to S phase. This protein can enable the cell to bypass cell cycle checkpoints and is crucial in lesion development. Considering the varied outcomes and limited research on the expression of the aforementioned marker in odontogenic cysts ، the aim of this study was to compare odontogenic keratocysts (OKC) with two types of non-invasive inflammatory and growth-developmental cysts. Methods: Following a review of the patient records from the Pathology Department of Dental School of Yazd for all jaw cysts، 15 blocks from each of the three cyst types with adequate tissue were chosen for immunohistochemical staining using the Cyclin D1 marker. The stained cell count under a light microscope at x400 magnification was performed and the findings were analyzed using SPSS16 software utilizing Mann-Whitney and Kruskal-Wallis tests. Results: There was no statistically significant difference observed among the three cysts regarding epithelial coverage (p = 0.226) and connective tissue (P = 0.578). Conclusion: Based on the findings of this study، the high expression of this marker in odontogenic Keratocyst may signify its involvement in the pathogenesis and progression of this cyst in contrast to other cysts.

Cerebellar pilocytic astrocytoma: predictors of recurrence based on MRI morphology—a single-centre experience

PurposeWe aimed to present our surgical experience and the impact of a solid or cystic morphology of cerebellar pilocytic astrocytoma (cPA) on surgery and the risk for a re-resection.MethodsWe retrospectively analyzed all children operated at our institution between 2009 and 2023 for cPA. Tumours were categorized into 4 groups: (i) cystic PA without cyst wall enhancement, (ii) cystic PA with cyst wall enhancement, (iii) solid tumour, (iv) and solid tumour with central necrosis.ResultsForty-two children with a median age at surgery of 7.1 years (range 0.7–14 years; male to female ratio 1.5) were identified. The median follow-up time was 3.1 years (0.6–14 years). Twenty-eight patients (66.6%) presented with cystic PA (20 without and 8 with cyst wall enhancement), 9 patients (21.4%) exhibited a solid tumour with central necrosis and 5 (11.9%) had a solid tumour without central necrosis. Gross total resection could be achieved in 31 patients (73.8%), near total resection in 6 (14.3%), and subtotal resection in 5 (11.9%). Progression occurred in 11 cases with 9 patients having a 2nd resection after a mean time of 3.4 years. The highest risk for a 2nd resection was seen in the group of solid tumours with a necrotic centre (odds ratio = 2.3), progression of enhancing cyst wall remnants was seen in one out of two patients with remnants needing reoperation.ConclusionSurgery in cerebellar PA should aim for gross total resection of the solid-enhancing tumour.

Morphological and molecular characterization of a Sarcocystisbovifelis-like sarcocyst in American beef

BackgroundParasites in the apicomplexan genus Sarcocystis infect cattle worldwide. Assessing the economic importance of each such parasite species requires proper diagnosis. Sarcocystiscruzi, a thin-walled species, infects virtually all cattle. The prevalence of the other thin-walled parasite, Sarcocystisheydorni, remains less well established. The remaining six species all have thick (> 3 µm) cyst walls (Sarcocystishirsuta,S.hominis,S.bovifelis,S.bovini,S.sigmoideus, and S.rommeli). Thick-walled sarcocysts often induce inflammation in striated muscles (causing bovine eosinophilic myositis), leading to condemnation of carcasses at slaughter. One of these, S.hirsuta, can be seen macroscopically and lead to condemnation of beef. Two Sarcocystis species, S.hominis and S.heydorni, are zoonotic. Although S.hominis has been reported as prevalent in Europe, the occurrence of thick-walled species in the US remains poorly known. Here, for the first time to our knowldge, we characterize a thick-walled Sarcocystis species from a sample of beef from a local grocery store in Maryland. By morphological and genetic criteria, it closely, but not perfectly, resembles parasites previously ascribed to S.bovifelis.MethodsBeef samples were examined for Sarcocystis infection, using acid-pepsin digestion to search for bradyzoites, microscopically by compression between a glass slide and coverslip, by histology of paraffin embedded sections stained with hematoxylin and eosin, and by transmission electron microscopy (TEM). Molecular characterization was attempted employing genetic markers: 18S rRNA, 28S rRNA, cox1, ITS1, gapdh1, ron3, and rpoB.ResultsMolecular evaluation revealed 100% identity with S.bovifelis-like sarcocysts from naturally infected cattle from Germany and Argentina; although the condition of the frozen material precludes complete characterization by TEM, we noted morphological features which differed from the S.bovifelis originally described from experimentally infected cattle from Germany.ConclusionsA novel Sarcocystis species is described from beef from the USA but not named until further evaluation.Graphical

Inflammation of adenohypophysis is commonly associated with headache in surgically managed Rathke's cleft cysts.

Rathke's cleft cysts (RCC) are present in up to 20% of autopsy studies but only a minority necessitate surgical treatment. Inflammation of RCC is thought to be significant in three processes: the development of classical symptoms, a predisposition to rupture or apoplexy, and increasing the rate of RCC recurrence. We aim to characterize clinical presentation, histological and radiological findings in patients with surgically managed RCC. We conducted a retrospective case series of 31 RCC, which had undergone surgical management between April 2016 and April 2024. Histopathology and radiology were independently reviewed by neuropathologist and neuroradiologist, and case notes were reviewed for clinical and biochemical data. Median age was 43 years (IQR 32-63); 77% were female. 23/31 demonstrated inflammation of RCC cyst epithelium (n = 13), cyst wall (n = 20) or anterior pituitary (adenohypophysitis) (n = 12). 8 cases were not inflamed. Preoperative features included pituitary dysfunction (70%), headache (65%), visual disturbance (26%) and polyuria/polydipsia (7%). Six patients presented with features of apoplexy. Headache was more prevalent (92%) in patients with adenohypophysitis vs. those without (47%), p = 0.020, and present in all 11 cases where inflammation in the adenohypophysis was chronic. Pituitary dysfunction was not associated with inflammation overall (76% vs. 70% p = ns), nor specifically within the adenohypophysis (75 vs. 63% p = 0.69). Histological inflammation was associated with radiological loss of posterior bright spot (70% vs. 14% p = 0.024). Headache but not pituitary dysfunction was associated with adenohypophyseal inflammation. A trend of increasing headache prevalence was seen with increasing degree of inflammatory infiltrate within RCC.

Case of Epidermoid Cyst in Parotid Gland in a 23-Year-Old Female Patient Initially Diagnosed as Parotid Tumor: A Rare Case Report

Epidermoid cyst is a tumor-like lesion that is generally benign, containing slow-growing keratin and lined by epithelial cells such as epidermis located in the dermis or subcutaneous, where this cyst is very rare in the parotid gland. The incidence of epidermoid cysts in the parotid gland is unclear due to limited reports. Although this lesion is benign, an accurate diagnosis is very important early, so that better management can be carried out. In this case report, a 23-year-old female patient was reported with a lump on the back of the right cheek since 3 years ago. The lump was initially small and slowly enlarged to a fairly large size of about 3 x 4 cm. The lump was the same color as the skin, the punctum was not visible, it was soft to the touch, partially fixed and there was no palpable fluctuation. Ultrasonography examination showed a hypoechoic shadow with a clear boundary in the right parotid area, so that the initial diagnosis was as a right parotid tumor. Initially the plan was for superficial parotidectomy, but switched to parotid cyst excision after the incision in the parotid area showed that the cyst was visible. The removed cyst was examined histopathologically and showed cyst wall tissue with a surface covered with squamous epithelium, the lumen containing a keratin mass, thus confirming that the lesion was an epidermoid cyst. Epidermoid cysts in the parotid gland can be misdiagnosed as parotid tumors due to their similar clinical and radiological manifestations. Accurate identification of clinical and pathological features is essential to differentiate them. Slow growth and ambiguous radiological appearance can lead to misdiagnosis. Complete excision of the parotid cyst is the primary treatment of choice for epidermoid cysts.

A Rare Complication After Renal Cyst Aspiration: Distal Catheter Fragment Remaining Within the Cyst Wall and Laparoscopic Treatment

A Rare Complication After Renal Cyst Aspiration: Distal Catheter Fragment Remaining Within the Cyst Wall and Laparoscopic Treatment

A putative new Besnoitia species in the southern black-eared opossum Didelphis aurita

Besnoitia spp. are cyst-forming coccidian parasites with a broad host range, infecting various wild and domestic animal species. Northamerican opossums (Didelphis virginiana) are severely affected by the infection with B. darlingi. This study presents a case of infection with Besnoitia in a road-killed female southern black-eared opossum (Didelphis aurita) in Misiones, Argentina. Many 0.5 to 1 mm cysts were observed in several muscles and visceral organs and were microscopically identified in skeletal muscles, tongue, and heart. Histological analysis disclosed multiple spherical cysts with a myriad of bradyzoites like-cells and a well-defined cyst wall. A small number of degenerate and ruptured cysts, surrounded by mild to moderate inflammation were observed. Genomic DNA from an individual cyst and muscle was extracted and ITS1 marker and 18S rRNA gene fragments from sarcocystid protozoa were successfully amplified by PCR and sequenced. The 18S sequence exhibited 100% identity with sequences of B. darlingi and B. oryctofelisi. Comparison of the complete ITS1 sequence (259 bp) revealed an identity of 99.2% with B. oryctofelisi and 97.7% with B. darlingi. This result together with the phylogeny positioning, suggest that the Besnoitia sp. in the present case differ from B. darlingi, being closely related with B. oryctofelisi.

Assessment of the cyst wall and surface microbiota in dormant embryos of the Antarctic calanoid copepod, Boeckella poppei.

Embryos of zooplankton from inland waters and estuaries can remain viable for years in an extreme state of metabolic suppression. How these embryos resist microbial attack with limited metabolic capacity for immune defence or repair is unknown. As a first step in evaluating resistance to microbial attack in dormant zooplankton, surface colonization of the Antarctic freshwater copepod, Boeckella poppei, was evaluated. Scanning electron micrographs demonstrate the outer two layers of a five-layered cyst wall in B. poppei fragment and create a complex environment for microbial colonization. By contrast, the third layer remains undamaged during years of embryo storage in native sediment. The absence of damage to the third layer indicates that it is resistant to degradation by microbial enzymes. Scanning electron microscopy and microbiome analysis using the 16S ribosomal subunit gene and internal transcribed spacer (ITS) region demonstrate the presence of a diverse microbial community on the embryo surface. Coverage of the embryos with microbial life varies from a sparse population with individual microbes to complete coverage by a thick biofilm. Extracellular polymeric substance binds debris and provides a structural element for the microbial community. Frequent observation of bacterial fission indicates that the biofilm is viable in stored sediments.