Histological Verification Research Articles

Evaluating systemic immune-inflammation indices as predictive markers for endometriosis diagnosis: A retrospective observational study.

Endometriosis is a chronic inflammatory disease for which there is currently no accurate screening test to identify or predict the probability of the disease in individuals. This can often lead to delays in diagnosis. Several systemic immune-inflammation indices are currently used as predictive or supportive markers for several inflammation-associated diseases. In this study, we investigated whether these immune-inflammation indices, such as systemic immune inflammation index (SII), systemic inflammation response index (SIRI), neutrophil-to-lymphocyte ratio (NLR), and pan-immune inflammation value (PIV) could serve as predictive or supplementary markers for diagnosing endometriosis. A total of 434 women with confirmed endometriosis and 517 controls were included in this study. Data on peripheral blood tests, including total counts of white cells, neutrophils, monocytes, lymphocytes, and platelets, were collected, and systemic immune-inflammation indices were calculated. SII, SIRI, NLR, and PIV values were significantly higher in women diagnosed with endometriosis compared to controls. Using the cut-off values of 538 for SII, 0.814 for SIRI, 2.03 for NLR, and 210 for PIV, we achieved 76 % sensitivity and 70 % specificity. When the four indices were combined, the area under the ROC curve (AUC) was 0.796 (95 % CI: 0.766, 0.827), with 76 % sensitivity and 70 % specificity. In conclusion, while ultrasonography or MRI remains the gold standard for visualizing the lesions in diagnosing endometriosis, followed by laparoscopy and histologic verification, routine peripheral blood tests in combination with clinical symptoms, could provide additional clinical diagnostic value for endometriosis as a non-invasive and cost-effective test.

ИНТЕРСТИЦИАЛЬНО-КЛЕТОЧНАЯ ОПУХОЛЬ СЕМЕННИКА У КОБЕЛЯ: КЛИНИЧЕСКИЙ СЛУЧАЙ

The aim of the study is to describe the clinical and morphological features of the manifestation, diagno-sis, and postoperative histological verification of a feminizing tumor that developed from Leydig cells in the cryptorchid testis of a 3-year-old Labrador dog named Biscuit. During the clinical andrological examination of the male, symmetrical bilateral alopecia of the sides of the abdomen, hypertrophy of the milk packets and their nipples were noted. During the examination of the scrotum, one testis was not found, while ex-amining the prepuce and penis, it was also noted that the penis was visually reduced in size, and the pre-puce hangs from the abdominal wall. Ultrasound of the scrotum: the left testicle is not visualized, the right one is located in the scrotum, measuring 26 x 12 mm. Ultrasound of the abdominal cavity and small pel-vis: liver, spleen, kidneys and bladder without pathological features. The left testicle is located in the ab-dominal cavity, enlarged, 31 x 27 mm in size, its structure is heterogeneous, diffuse hypoechoic for-mations without clear contours are visualized. The prostate gland is enlarged, oval, 74 x 51 mm in size, its structure is heterogeneous, multiple anechoic structures are visualized with an uneven contour up to 21 x 15 mm in size. Thus, according to the results of ultrasound, the dog was diagnosed with a neoplasm in the left cryptorchid testis and prostatic hypertrophy with multiple cysts. Intraoperative visual examination of the abdominal cavity confirmed the preoperative diagnosis. There were no technical difficulties during the resection of a cryptorchid testis affected by a tumor and a testicle localized in the scrotum. The postopera-tive period passed without complications. Approximately 2.5 months later. after resection of the tumor (to-tal bilateral orchiepididymitectomy), the signs of sex inversion disappeared in the male and the coat was fully restored. The results of the pathohistological examination of the postoperative material showed that instead of the expected sertolioma, the pathognomonic signs of which are estrogenic alopecia and gyne-comastia, the dog was diagnosed with leidigoma. The presented clinical case demonstrates that endocrine alopecia and gynecomastia are not only a classic manifestation of sertolioma, but in some cases, signs of sex inversion can also be associated with Leydig tumor.

Lateral pterygoid muscle enthesis reconstruction in alloplastic total temporomandibular joint replacement: An animal experiment with histological verification.

In current alloplastic total temporomandibular joint replacements (TMJRs) typically the lateral pterygoid muscle (LPM) insertion is sacrificed, affecting joint function. This study assesses a novel additively manufactured TMJR (CADskills BV, Gent, Belgium) designed to enable LPM reinsertion through a scaffold feature on the implant. Thirteen TMJRs were implanted in Swifter crossbreed sheep, with follow-up CT scans after 288 days to evaluate LPM reintegration. Five specimens showed a close approximation between the LPM enthesis and the scaffold. Histological analysis with Masson-Goldner staining and microscopy revealed close bony enthesis alignment with the scaffold, although true bony ingrowth was not observed. One specimen could not be fully evaluated due to preparation issues, limiting conclusions on osseointegration. Random samples from the ramal scaffold showed good integration with the native mandible, with osteogenic activity noted, but no bony ingrowth from the reattached enthesis into the bone grafted titanium scaffold. Despite this, all samples displayed a continuous fibrotic attachment, suggesting functional restoration of the LPM. Findings indicate that while the TMJR design supports fibrotic attachment, further optimization of reattachment techniques, scaffold properties, and post-operative care may improve osseointegration and functional outcomes in future human TMJRs.

Cerebral blood flow and histological analysis for the accurate differentiation of infiltrating tumor and vasogenic edema in glioblastoma.

Glioblastoma is characterized by neovascularization and diffuse infiltration into the adjacent tissue. T2*-based dynamic susceptibility contrast (DSC) MR perfusion images provide useful measurements of the biomarkers associated with tumor perfusion. This study aimed to distinguish infiltrating tumors from vasogenic edema in glioblastomas using DSC-MR perfusion images. Data were retrospectively collected from 48 patients with primary IDH-wild-type glioblastoma and 24 patients with meningiomas (Edemas-M). First, we attempted histological verification of cell density, Ki-67 index, and microvessel areas to distinguish between non-contrast-enhancing tumors (NETs) and edema (Edemas) which were obtained from stereotactically fused T2-weighted and perfusion images. This was performed for evaluating enhancing tumors (ETs), NETs, and Edemas. Second, we also performed radiological verification to distinguish NETs from Edemas. Two neurosurgeons manually assigned the regions of interests (ROIs) to ETs, NETs, and Edemas. The DSC-MR perfusion imaging-derived parameters calculated for each ROI included the cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT). Cell density and microvessel area were significantly higher in NETs than those in Edemas (p<0.01 and p<0.05, respectively). Regarding radiological analysis, the mean CBF ratio for Edemas was significantly lower than that for NETs (p<0.01). The mean MTT ratio for Edemas was significantly higher than that for NETs. The receiver operating characteristic (ROC) analysis showed that CBF (area under the curve [AUC] = 0.890) could effectively distinguish between NETs and Edemas. The ROC analysis also showed that MTT (AUC = 0.946) could effectively distinguish between NETs and Edemas. DSC-MR perfusion images may prove useful in differentiating NETs from Edemas in non-contrast T2 hyperintensity regions of glioblastoma.

Inhibition of prefrontal glutamatergic neuron activity during the recovery period following chronic stress disrupts fear memory in male rats: potential role of the infralimbic cortex.

Chronic stress typically leads to deficits in fear extinction. However, when a delay occurs from the end of chronic stress and the start of fear conditioning (a "recovery"), rats show improved context-cue discrimination, compared to recently stressed rats or nonstressed rats. The infralimbic cortex (IL) is important for fear extinction and undergoes neuronal remodeling after chronic stress ends, which could drive improved context-cue discrimination. Here, glutamatergic IL neurons of Sprague-Dawley male rats were targeted for inhibition using inhibitory designer receptors exclusively activated by designer drugs (DREADDs) and daily injections of clozapine N-oxide (CNO) during a 21-day recovery period from chronic stress. Histological verification confirmed DREADDs in the IL with some spread to nearby medial prefrontal cortex (PFC) regions. CNO administration was then discontinued before fear conditioning started and behavioral testing thereafter so that behavioral assessments occurred without neuronal inhibition. Fear conditioning involved presenting male rats with three tone-foot shock pairings on 1 day, which was followed by 2 days of 15 tone-alone extinction sessions. Daily and repeated inhibition of mainly IL neurons during the 21-day recovery period did not disrupt fear learning or fear extinction in all groups (controls, stressed rats without a recovery, and stressed rats with a recovery). However, chronically stressed rats given a recovery and with DREADD activation showed impaired spontaneous recovery, indicating a failure to form a tone-foot shock association. The findings show that daily inhibition of mainly IL neurons prior to fear conditioning and extinction depends upon the changes that occur during the recovery period following the end of chronic stress.

THE VALUE OF FUSION BIOPSY IN THE DIAGNOSIS OF LOCALIZED TUMORS: A COMPARATIVE ANALYSIS OF MR-GUIDED PROSTATE BIOPSY METHODS

Abstract. Prostate cancer (PC) is one of the most common oncological diseases in men. Standard prostate biopsy with subsequent histological verification is currently an integral part of the diagnosis of PC, however, the number of false-negative results and cases of underestimation of the degree of tumor aggressiveness remains excessively high. Advances in the field of multiparametric magnetic resonance imaging (mMRI) have led to improved detection of prostate tumors. This review summarizes the main technical aspects of fusion biopsy. The most well-founded classification of fusion biopsy is described, which allows comparing the results of MR-guided biopsy methods with standard methods of prostate biopsy. Attention is focused on the frequency of complications after fusion biopsy, which will significantly improve the outcome of treatment of oncological patients.

CRISPR-Cas9 screening identified novel subtypes of cutaneous melanoma based on essential cancer genes.

Our primary objective was to identify genes critical for cutaneous melanoma (CM) and related typing, based on essential genes, to generate novel insights for clinical management and immunotherapy of patients with CM. We analyzed RNA sequencing (RNA-seq) data from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx), and sequencing data of 29 CM cell line from Cancer Cell Line Encyclopedia (CCLE) databases. Combined with DepMap database, 406 CM essential cancer genes were finally obtained. Based on the expression of essential genes in cancer, the patients included in TCGA and Gene Expression Omnibus (GEO) databases were divided into three different molecular subtypes (C1, C2, and C3) by the NMF algorithm. Data analysis from TCGA and GEO datasets revealed that subtype C3 had the poorest prognosis, while subtype C1 exhibited the best prognosis. Combined with the CIBERSORT, ESTIMATE and ssGSEA algorithm, patients with different molecular subtypes can be divided into two immune subtypes (hot and cold). We found that subtype C1 was characterized by hot tumors, in contrast to subtypes C2 and C3, which were characterized by cold tumors. Then, we used univariate Cox regression, LASSO, and multifactor Cox regression analysis to select risk genes and constructed a prognostic model based on eight genes: RABIF, CDCA8, FOXM1, SPRR2E, AIP, CAP1, CTSW, and IFITM3. All patients were divided into two risk subtypes (high and low ) according to the median of risk scores. We found that most hot tumor subtypes were found in the low-risk subtypes and most patients with this subtype survived for longer. Ultimately, we selected RABIF, which exhibits the highest risk coefficient, for histological and cytological verification. The results showed that RABIF was overexpressed in melanoma. Inhibition of RABIF expression could suppress the proliferation and invasion of melanoma cells and promote the apoptosis of melanoma cells. In conclusion, we used CRISPR-Cas9 screening to verify the association between molecular subtypes (C1, C2, and C3), immune subtypes (hot and cold), and risk subtypes (high and low) in patients with CM, particularly in distinguishing survival and prognosis. These findings can be used to guide clinical management and immunotherapy of patients with CM.

Long-term outcome of photodynamic therapy with hexyl aminolevulinate, 5-aminolevulinic acid nanoemulsion and methyl aminolevulinate for low-risk Basal Cell Carcinomas

BackgroundNon-surgical treatments are cost-effective options for low-risk basal cell carcinomas (BCCs) i.e. superficial or small nodular BCCs located outside the high-risk locations. Hexyl aminolevulinate (HAL) and 5-aminolevulinic acid nanoemulsion (BF-200 ALA) with enhanced penetration depth enables the use of lower concentrations compared to methylaminolevulinate (MAL) in photodynamic therapy (PDT). We have previously reported comparable short-term efficacies for MAL 16%, BF-200 ALA 7.8% and HAL 2% in PDT of low-risk BCC, and here we report the long-term results. ObjectivesThe goal of this trial was to compare long-term outcomes of HAL and BF-200 ALA, compared to MAL in PDT of low-risk BCCs. MethodsNinety-eight histologically verified low-risk BCCs on the trunk or extremities were included and randomized into three arms to receive PDT in two sessions with MAL, BF-200 ALA or HAL. A blinded dermatologist assessed the response, cosmetic outcome, and obtained biopsies for histological verification at three months, one year and five years. Histologically verified non-responsive lesions were excised. Patients’ satisfaction with the treatment was also queried. ResultsAccording to intention-to-treat (ITT) analyses, the cumulative response rate at one year was 90.6% for MAL, 81.3% for BF-200 ALA, and 75.8% for HAL, and correspondingly at five years 71.9%, 54.6% and 60.6%. There were no statistically significant differences between interventions and comparator. The overall cumulative response rate for PDT was 82.5% at one year and 62.2% at five, and 48.6% of the treatment failures were recorded at five years. The recurrent lesions were excised as second line treatment. No aggressive subtypes were reported, with only superficial or nodular growth in the final histopathological report. There were no significant differences in cosmetic outcome or patient satisfaction. ConclusionsThis trial shows that HAL has potential for dermatological PDT. However, the long-term efficacy of PDT in the treatment of low-risk BCCs remains rather low.

&amp;#1052;odern methods of diagnosis of endometrial carcinoma

The main methods of histological diagnosis of endometrial carcinoma are dilatation and curettage, fractional curettage, and diagnostic hysteroscopy with endometrial biopsy. This retrospective study aims to compare the preoperative histological results obtained by different diagnostic methods with the postoperative ones in patients with endometrial carcinoma and determine the most accurate and safest method for diagnosing the disease. From 06.2020 to 09.2023, a retrospective study was conducted on 80 patients with histologically proven carcinoma of the endometrium, treated at University Hospital Saint Marina-Pleven. The mean age of the patients was 58.04 &amp;plusmn; 10.46, ranging from 28 to 78. The comparative analysis of the discrepancies of the histological verification methods in the evaluation of the preoperative and postoperative histological result showed that a statistically significantly higher percentage of discrepancies (19.5%) had the dilatation and curettage compared to the zero discrepancy of the hysteroscopy (0.0%). The relative proportion of discrepancies of the fractional curettage is 14.3%. The cytological result was negative for tumor cells in 97.5% and positive in 2.5%. In all patients with a positive cytological result for tumor cells, the method of histological verification was dilatation and curettage. Performing diagnostic hysteroscopy and observing safety principles such as creating low intrauterine pressure and short operative time is a safe and reliable method for diagnosing endometrial carcinoma.

DSOG Guideline Bulletin: Diagnostic approach for patients with endometriosis

The aim of this guideline was to update an existing guideline from 2012. An update was evident due to the scientific progress and political focus on endometriosis in recent years. Based on recent evidence, we aimed to provide clinical recommendations for training and use of ultrasound, magnetic resonance imaging (MRI), computed tomography, and diagnostic scoring systems, as well as diagnostic considerations when evaluating patients suspected for endometriosis. Current literature was searched for consensus and discrepancies. A total of eight research questions were formulated to review different aspects, when diagnosing endometriosis. The level of evidence was graded according to the Oxford Centre for Evidence-based Medicine Levels of Evidence and up- or downgraded depending on the study quality. According to the current literature, no diagnostic imaging tool can replace histologic verification of endometriosis except ultrasound when diagnosing lesions in the abdominal wall. Skills for diagnosing endometriosis in the posterior compartment with transvaginal ultrasound (TVUS) can be achieved within 50-60 scans. TVUS seems equivalent to MRI when endometriosis is suspected in the vagina, the sacrouterine ligaments, the rectovaginal fascia, and the rectosigmoid. Additionally, ultrasound has a high sensitivity for diagnosing endometriotic lesions in the abdominal wall, while MRI seems superior for deep infiltrating endometriosis (DIE) in the bladder, the ureter, the lumbosacral plexus, lungs and oral segment of the colon starting from the rectosigmoid. No biomarkers are currently recommended for diagnosing endometriosis. When considering bowel involvement, 60-96% of DIE in the colon is localized in the rectum with decreasing rates in the oral segments with a prevalence of affected appendix of 2.6-4.1%. Measuring the distance from the anocutaneus transition to the nodule is feasible with TVUS. The most promising grading systems for endometriosis are the EFI, #ENZIAN and AAGL scoring systems. The level of evidence across studies ranged from 1b to 5.

Abstract 4120929: Silent Myocardial Infarctions in Women with Ischemic Sudden Cardiac Death

Background: Sudden cardiac death (SCD) is a significant mode of death in both sexes, with most cases attributed to coronary artery disease (CAD). In women, ischemic SCD seems to occur more often without previously diagnosed CAD, but the prevalence and characteristics of silent myocardial infarctions (SMI) in women are not known. Aim: This study aimed to investigate the prevalence and characteristics of women with silent myocardial infarction (SMI) and ischemic SCD. Methods: The Fingesture study consists of 5,869 autopsy-verified SCD cases (21.1% women) in Northern Finland 1998-2017. In this study, we investigated women with ischemic SCD without previous CAD diagnosis (N=660). SMI was defined as a myocardial infarction (MI) scar at autopsy in the absence of CAD history in medical records. As a control group, we used women with ischemic SCD without MI scar and previous CAD diagnosis. Coronary artery stenosis, myocardial fibrosis, and MI scars were evaluated through macroscopic assessment during autopsy, with further histological verification for myocardial fibrosis and MI scars. Results: Among 660 ischemic SCD subjects without prior CAD diagnosis, 220 (33.3%) had SMI. Women with SMI were older compared to those without SMI (73.4 vs. 71.4 years in subjects without SMI, p=0.03), and SMIs became more prevalent with advancing age (+4.4% per decade, p&lt;0.01). Women with SMI had higher heart weight (411 vs. 386 g in subjects without SMI, p&lt;0.01) and a higher prevalence of left ventricular hypertrophy (LVH) (73.6% vs. 64.5% in subjects without SMI, p=0.02). The average body mass index was 27.1 kg/m 2 in subjects with SMI and 27.6 kg/m 2 in subjects without SMI (p=0.34). Subjects with SMI were more likely to have severe coronary artery stenosis with &gt;90% occlusion (37.3% vs. 22.5% in subjects without SMI, p&lt;0.01). Severe (15.0% vs. 3.0% in subjects without SMI, p&lt;0.01) and moderate (69.1% vs. 39.4% in subjects without SMI, p&lt;0.01) degrees of myocardial fibrosis were more prominent among subjects with SMI. Conclusions: One-third of ischemic SCD cases without prior CAD diagnosis in women had findings of SMI at autopsy. Women with SMI were slightly older and exhibited more severe coronary disease, LVH and myocardial fibrosis at autopsy. These findings underscore the importance of earlier diagnosis and treatment of CAD in SCD prevention in women.

CNSC-33. GROUP3 MEDULLOBLASTOMA WITH BONE MARROW AND ABDOMINAL CAVITY METASTASIS:A CASE REPORT

Abstract Medulloblastoma is an infratentorial primitive neuro-ectodermal tumour, which is commonly occurring in childhood. It often spreads through the cerebrospinal fluid pathways with a very low rate of systemic metastases. Extra-central nervous system metastases have a poor prognosis in medulloblastoma. Here, we reported a case of Group3 medulloblastoma with bone marrow and abdominal cavity metastasis. A 10-year-old girl complained of headache, dizziness, vomiting and nausea. Magnetic resonance imaging(MRI) of the brain showed a large mass in the fourth ventricle and obstructive hydrocephalus. The surgery was performed to remove the mass and ventriculoabdominnal shunt was performed for obstructive hydrocephalus. Histological verification was proven classic medulloblastoma and next-generation sequencing confirmed molecular group of Gruop3 with MYC amplication. Radiotherapy was subsequently performed one month after the surgery. During the radiotherapy, brain MRI showed metastasis on the surface of the brain, which confer a poor prognosis. After the radiotherapy According to the therapeutic schedule, She would accept chemotherapy one month after the radiotherapy. But She suffered severe bone marrow suppression manifested as anaemia and thrombocytopenia, which can not be improved by medication and blood transfusion. A bone marrow aspiration was subsequently performed, and bone marrow smear showed large numbers of tumor cells at high magnification and was lack of normal hematopoietic cells. The girl was deteriorating rapidly with jaundice, ascites, hepatosplenomegaly and pancreatitis after the bone marrow aspiration. We found a lot of tumor cells in the bleeding tendency ascites and finally confirmed bone marrow and abdominal cavity metastasis concurrently. Eventually, She died less than a month after the metastasis and the overall survival was only 6 months. This typical case demonstrated severe bone marrow suppression of unknown origin should caused alarm and be performed bone marrow aspiration as soon as possible. The prognosis of medulloblastoma with extra-central nervous system metastases is poor and people may die in months.

Intraoperative Germinoma Staining: A Technical Note.

As the main treatment modality of central neural system germinomas is radiotherapy and/or chemotherapy, the exact initial diagnosis of the disease is crucial. Depending on the different national protocols, histologic verification can be obligatory in some instances. This is a serious challenge, taking into account the usual location and nonspecific macroscopic appearance of these lesions. Here, we propose a safe and effective method of intraoperative tumor enhancement that can increase the confidence of the surgeon during the intervention.

Neuronal activity in the ventral tegmental area during goal-directed navigation recorded by low-curvature microelectrode arrays

Navigating toward destinations with rewards is a common behavior among animals. The ventral tegmental area (VTA) has been shown to be responsible for reward coding and reward cue learning, and its response to other variables, such as kinematics, has also been increasingly studied. These findings suggest a potential relationship between animal navigation behavior and VTA activity. However, the deep location and small volume of the VTA pose significant challenges to the precision of electrode implantation, increasing the uncertainty of measurement results during animal navigation and thus limiting research on the role of the VTA in goal-directed navigation. To address this gap, we innovatively designed and fabricated low-curvature microelectrode arrays (MEAs) via a novel backside dry etching technique to release residual stress. Histological verification confirmed that low-curvature MEAs indeed improved electrode implantation precision. These low-curvature MEAs were subsequently implanted into the VTA of the rats to observe their electrophysiological activity in a freely chosen modified T-maze. The results of the behavioral experiments revealed that the rats could quickly learn the reward probability corresponding to the left and right paths and that VTA neurons were deeply involved in goal-directed navigation. Compared with those in no-reward trials, VTA neurons in reward trials presented a significantly greater firing rate and larger local field potential (LFP) amplitude during the reward-consuming period. Notably, we discovered place fields mapped by VTA neurons, which disappeared or were reconstructed with changes in the path–outcome relationship. These results provide new insights into the VTA and its role in goal-directed navigation. Our designed and fabricated low-curvature microelectrode arrays can serve as a new device for precise deep brain implantation in the future.

Experience in treating patients with autoimmune pancreatitis

Objective — to establish the main diagnostic signs of autoimmune pancreatitis and aspects of patient treatment. Materials and methods. The study analyzed the results of examination and treatment of 17 patients with autoimmune pancreatitis (AIP) from 2010 to 2022. Among the total number of patients with AIP, there were 11 men (65%) and 6 women (35%). The average age of the patients was 52.4 years. Among all patients with AIP, focal involvement of the pancreas was found in 3 (18%) patients, with a predominant involvement of the head of the pancreas. Segmental form of AIP was diagnosed in 6 (35%) patients, while diffuse form was found in 8 (47%) patients. Type 1 AIP was identified in 13 (76%) patients, and type 2 AIP in 4 (24%) patients. For all patients suspected of AIP, the HISORt criteria were assessed: instrumental visualization, serological and histological verification, determination of the volume of pancreatic involvement, and response to steroid therapy. Results. Recurrence of AIP was observed in 8 (47.0%) patients with type 1 AIP and 1 (5.8%) patient with type 2 AIP. AIP recurred in patients with proximal bile duct involvement, diffuse pancreatic involvement, persistently elevated IgG4 levels after steroid induction, delayed radiological remission, and damage to more than two organs. Increased serum levels of IgG, IgG4, apnd eosinophilia indicated a recurrence of IgG4‑RD. A repeat induction of steroids was performed in patients with recurrent AIP, which proved to be very effective, resulting in high remission rates, specifically in 7 (70%) patients with type 1 AIP and in 1 (100%) patient with type 2 AIP. Among all AIP patients that were operated on, 3 (40%) underwent Roux‑en‑Y hepaticojejunostomies, 1 (20%) pancreaticoduodenectomy, and 1 (20%) a Frey procedure. Conclusions. The low incidence of AIP necessitates the use of a clear diagnostic algorithm, and the peculiarities of the disease’s course require compliance with all the principles of conservative treatment and surgical interventions in case of surgical complications.

Primary Diffuse Large B-Cell Lymphoma of the Adrenal Glands: a Rare Cause of Paraneoplastic Neuropathy

The article presents a detailed analysis of clinical observation of primary diffuse large B-cell lymphoma of the adrenal glands, a rare disease affecting less than 1% of patients with non-Hodgkin’s lymphomas. It describes the case of a 46-year-old man hospitalized with progressive limb paralysis, later diagnosed as paraneoplastic polyradiculoneuropathy associated with bilateral adrenal lymphoma. The diagnostic challenges of this pathology, including ambiguous imaging results and the need for histological verification to confirm the diagnosis are discussed. Special attention is paid to the uniqueness of clinical manifestations and the importance of early symptom recognition to improve prognostic outcomes in highly aggressive forms of the disease. The necessity of multidisciplinary approach in managing such patients with the participation of oncologists, endocrinologists, and neurologists to optimize diagnostic and therapeutic processes is also emphasized.

A comparison of 2D and 3D with the use of HDlive mode imaging in the diagnosis of endometrial polyps in infertility

Objective: to compare 2D ultrasound and 3D with HDlive mode ultrasound in the diagnosis of endometrial polyps in infertility.Material and methods. The retrospective cohort study included 116 women aged 29 to 43 years (mean age 36.9 ± 3.78) with infertility who were observed at the Nova Clinic Center for Reproduction and Genetics from January 2021 to June 2024. 2D and 3D ultrasounds were performed in all patients. The final conclusion on the presence or absence of pathology was based on the results of the 3D study with HDlive mode. The histological verification of polyps was carried out after hysteroscopy.Results. Hysteroscopy revealed no signs of pathology in 5 (4.3%) patients; moreover, the results of 2D imaging were also negative, and the results of 3D imaging were positive. In other 111 cases (95.7%), the diagnosis of a polyp was confirmed on hysteroscopy. Among them, no signs of pathology were found on 2D ultrasound in 19 (16.4%) patients. According to the obtained results, the use of 3D imaging with HDlive mode leads to overdiagnosis and false positive results with a chance of 4.5%. On the contrary, 2D imaging leads to underdiagnosis and false negative results with a chance of 19.6%, which is statistically significantly higher than the chance of a false positive result using the 3D method (p = 0.008). Thus, the chance of a false result using the 2D mode is 4.4 [1.57; 12.09] times higher than using the 3D mode.Conclusions. The study demonstrated a higher accuracy of the 3D ultrasound compared to 2D ultrasound in diagnosing endometrial polyps.

Two rare localizations of chondrosarcoma: cervical and thoracic spine

Chondrosarcoma is a primary malignant bone tumor, with spinal involvement being rare. Diagnosing this condition can be challenging and typically requires histological verification. Chondrosarcoma has the potential to invade locally and spread systemically. We report the case of 32 year-old women presenting with back pain and weight loss. Magnetic resonance imaging of the spine showed a bone growth at the low cervical spine which extends to the upper dorsal spine. Histological examination showed low-grade chondrosarcoma. Given the tumor proximity to the spinal cord, an incomplete surgical excision was performed followed by radiotherapy sessions. Clinical course was marked by partial regression of the tumor process with a stability of the radiological image of the tumor after a three years follow-up. Our case is original because of the bifocality of the chondrosarcoma in two adjacent segments of the spine.

A novel methodology for mapping interstitial fluid dynamics in murine brain tumors using DCE-MRI

We present a comprehensive methodology for measuring heterogeneous interstitial fluid flow in murine brain tumors using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) coupled with the computational tool, Lymph4D. This four-part protocol encompasses glioma cell preparation, tumor inoculation, MRI imaging protocol, and histological verification using Evans Blue. While conventional DCE-MRI analysis primarily focuses on vascular perfusion, our methods reveal untapped potential to extract crucial information about interstitial fluid dynamics, including directions, velocities, and diffusion coefficients. This methodology extends beyond glioma research, with applicability to conditions routinely imaged with DCE-MRI, thereby offering a versatile tool for investigating interstitial fluid dynamics across a wide range of diseases and conditions. Our methodology holds promise for accelerating discoveries and advancements in biomedical research, ultimately enhancing diagnostic and therapeutic strategies for a wide range of diseases and conditions.

Third ventricle teratoma with malignant transformation

Intracranial germ cell tumors(GCTs) are rare and heterogeneous group of primary brain tumors, mainly affecting pediatric population and young adults. The current understanding of the etiology of intracranial GCTs and their optimal management strategies remain controversial. Treatment plans differ depending on the subtype GCT and may vary among physicians and institutions. Central nervous system non-germinomatous germ cell tumor (NGGCT) usually requires surgical resection with histological verification, chemotherapy, and radiation. The extent of surgical resection is an important prognostic factor alongside the etiology and genetics of NGGCT. This article presents a rare clinical case of a rapidly growing teratoma located in the posterior part of third ventricle of a 17-year-old male presenting with symptoms of intracranial hypertension. Surgical total resection was preceded by endoscopic third ventriculostomy. Immunohistochemistry revealed the presence of embryonal carcinoma and immature teratoma cells turning the tumor into mixed type NGGCT with unfavorable prognosis. Despite the complete resection of the tumor and the timely initiation of adjuvant therapy, a rapid progression of the disease with subsequent unfavorable outcome was observed 3.6 months after the surgical treatment.