Node Enlargement Research Articles

Idiopathic multicentric Castleman disease in children: a single-center retrospective analysis

ObjectiveTo investigate the clinical features, pathological phenotype, treatment and prognosis of idiopathic multicenter Castleman disease (iMCD)in children.MethodsFrom January 2017 to September 2023, basic information, laboratory tests, treatment and prognosis of children diagnosed with iMCD who attended Beijing Children's Hospital of Capital Medical University were collected.ResultsA total of 9 children were enrolled, with a median age of onset of median 11 (2–15) years, 6 males and 3 female. 3 cases were pathologically typed as plasma cell type, 1 case was mixed type, and the remaining 5 cases were hyaline vascular type. 9 children received different regimens of chemotherapy. The median follow-up time was 26 (13, 58) months, with no deaths, 7/9 cases showing improvement, 1/9 cases showing stable condition, and 1/9 cases showing active condition.ConclusionChildren with multicentric CD often have systemic symptoms, lymph node enlargement and related compression symptoms are the most common manifestations, followed by fever, malaise and other systemic symptoms. Anti-IL-6-based therapy combined with hormones lenalidomide and other medications have a specific therapeutic effect on multicentric CD.

Multicentric Castleman's Disease presenting with bilateral panuveitis.

To report a rare case of Multicentric Castleman's Disease presenting with bilateral panuveitis. Case report. A 65-years-old caucasian man presented with progressive blurred vision in both eyes for two weeks, along with weight loss, polyarthralgias and reduced muscle strength persisting for about a year. Examination revealed bilateral panuveitis after intraocular lymphoma being initially considered. CT scans showed multiple lymph node enlargements suggestive of lymphoproliferative disorder. Excisional biopsy of an axillary lymph node confirmed the diagnosis of plasmacytic type Castleman's disease. Treatment was started with topical dexamethasone and tropicamide for anterior chamber inflammation, followed by oral prednisolone. After definitive diagnosis, treatment with siltuximab was initiated, which led to significant improvement in panuveitis and systemic symptoms. The patient became off corticosteroids and continued on siltuximab with stable visual acuity and low-grade vitritis. To the best of our knowledge we described the first case in which the diagnosis of Multicentric Castleman's Disease was established through the investigation of bilateral panuveitis, which was successfully managed with corticosteroids and siltuximab.

Nomogram for pre-procedural prediction of lymph node metastasis in patients with submucosal early gastric cancer.

The treatment of early gastric cancer (EGC) is contingent upon the status of lymph node metastasis (LNM). Accurate preoperative prediction of LNM is critical for reducing unnecessary surgeries. This study seeks to evaluate the risk factors for LNM in submucosal EGC and develop a predictive model to optimize therapeutic decision-making. A retrospective analysis was performed on clinical data from 389 patients with T1b-stage EGC who underwent radical gastrectomy. Univariate and multivariate analyses were conducted to identify independent risk factors, followed by the development of a nomogram to predict LNM. The model's efficacy was validated through receiver operating characteristic curves, calibration curves, and decision curve analysis. Of the 389 patients, 77 had LNM. Logistic regression analysis identified gender, CA199 levels, tumor location, degree of differentiation, presence of ulcers, and lymph node enlargement on CT as independent risk factors for LNM. A nomogram was constructed to assess the risk of LNM, demonstrating strong predictive accuracy with an area under the curve of 0.82 in the training set and 0.74 in the validation set, along with good sensitivity and positive predictive value. This study presents a reliable preoperative nomogram to estimate the likelihood of LNM in submucosal EGC, providing valuable guidance for determining the most effective treatment strategies for patients.

Emphysema or fibrosis progression in patients with combined pulmonary fibrosis and emphysema.

Patients with combined pulmonary fibrosis and emphysema (CPFE) may experience emphysema or fibrosis progression on chest computed tomography (CT). This study aimed to investigate the relationship and prognosis in CPFE patients with emphysema or fibrosis progression. A total of 188 CPFE patients were included in our retrospective cohort study. The clinical presentations, radiographic features, and laboratory findings of the patients were reviewed. Among CPFE patients, 28.1% exhibited emphysema progression and 43.3% showed fibrosis progression. Different higher tumour markers were observed in the emphysema or fibrosis progression groups. Smoking, definite usual interstitial pneumonia (UIP), and total extent of emphysema were risk factors for emphysema progression. Age, definite UIP, and mediastinal lymph node enlargement were risk factors for fibrosis progression. Patients with fibrosis progression had worse prognoses than patients without fibrosis progression (HR 2.159; 95%CI, 1.243-3.749; P = 0.006). However, the prognosis was similar between patients with and without emphysema progression (HR 0.839; 95%CI, 0.429-1.641; P = 0.608). There was no significant interaction between emphysema and fibrosis progression (p>0.05). In CPFE patients, emphysema and fibrosis progression had different higher tumour markers, risk factors, and prognosis effects. There was no significant interaction between emphysema and fibrosis progression. Fibrosis progression had a deleterious effect on prognosis, whereas emphysema progression did not affect prognosis. Therefore, the primary objective of CPFE treatment should be to halt or even reverse the progression of fibrosis. CPFE may be primarily a fibrotic disease, with emphysema being an incidental complication.

THE ROLE OF Β2-MICROGLOBULIN IN ASSESSING THE PROGRESSION OF B-CELL CHRONIC LYMPHOCYTIC LEUKEMIA

Introduction. The primary assessment of β2-microglobulin holds significant value in monitoring the dynamics of oncohematological processes, which can serve as a crucial marker for evaluating the baseline condition of patients with B-cell chronic lymphocytic leukemia. Aim: to analyze the levels of β2-microglobulin in patients experiencing progression of B-cell chronic lymphocytic leukemia. Materials and methods. Twenty six patients with progressive B-cell chronic lymphocytic leukemia (CLL) were examined, comprising 12 males (46%) and 14 females (54%). These patients were designated as Group I. The control group (Group II) included 20 healthy individuals aged 23–43 years, consisting of 11 females (55%) and 9 males (45%). In Group I, disease staging was assessed using the Rai-Binet classification: stage II (B) was observed in 18 patients (69.2%), stage III (C) in 4 patients (15.4%), and stage IV (C) in 4 patients (15.4%). Among patients with progressive CLL, hyperplastic syndrome was evaluated, including lymph node enlargement (≥3 cm in diameter) and hepato- or splenomegaly (liver or spleen extending ≥5 cm below the costal margin). General and biochemical blood analyses were conducted, along with measurements of β2-microglobulin levels. Statistical methods were applied to process and analyze the data. Results. In patients with progression of B-cell chronic lymphocytic leukemia (CLL), hematological analysis revealed anemia (hemoglobin <100 g/L) in 6 patients (23.1%) and thrombocytopenia in 8 patients (30.7%). Leukocytosis with leukocyte levels >100 G/L was observed in 4 patients (15.4%) in Group I. Notably, an inverse correlation was identified between β2-microglobulin levels and hemoglobin levels (r = -0.52; p = 0.02). Biochemical analysis showed a reduction in total serum protein to grade 1 according to CTCAE in 2 patients (7.7%), elevated serum creatinine levels, reaching grade 1 according to CTCAE, were observed in 4 patients (15.4%) in Group I. An inverse correlation was found between β2-microglobulin levels and total serum protein levels (r = -0.44; p = 0.02). A direct correlation was also identified between β2-microglobulin levels and serum creatinine levels (r = 0.65; p = 0.04). In 9 (34.7%) patients of group I, the concentration of β2-microglobulin in blood serum exceeded the level of 5 mg/l. It is important that all 100% (9/9) of patients in this category were found to have hyperplastic syndrome. In addition, 33.3% (3/9) of patients had a combination of lymphadenopathy, splenomegaly, and hepatomegaly (liver +5 cm below the edge of the costal arch), 55.6% (5/9) had a combination of two factors, in 11, 1% (1/9) hyperplastic syndrome was characterized by an increase in the size of peripheral lymph nodes by more than 3 cm. The average level of β2-microglobulin was 6.24 mg/l in patients with progression of B-cell chronic lymphocytic leukemia of group I, of which 9 patients had a level of β2-microglobulin greater than 5 mg/l. Conclusion. The level of β2-microglobulin corresponds to the severity of progression of B-cell chronic lymphocytic leukemia and correlates with the level of anemia, hypoproteinemia, hypercreatinemia, and the severity of hyperplastic syndrome.

Solitary pulmonary metastasis at presentation in a dog with anal sac adenocarcinoma without nodal metastasis

AbstractA 10‐year‐old, male, neutered labrador retriever was diagnosed with a left‐sided anal sac adenocarcinoma. At diagnosis, staging with an abdominal computed tomography revealed no intraabdominal lymph node enlargement. Thoracic radiographs revealed a soft tissue pulmonary nodule with cytology consistent with a carcinoma. The dog underwent a left anal sacculectomy, and re‐presented 24 days later for a lung lobectomy in which histopathology represented primary anal sac adenocarcinoma metastasis. Forty‐nine days after initial presentation, the dog was referred for a right distal radial lytic lesion in which cytology was concerning for osteosarcoma. After 132 days of initial presentation, an abdominal ultrasound revealed normal‐sized iliosacral lymph nodes. The dog was humanely euthanased 446 days after initial diagnosis. This case report describes a dog who had a solitary metastatic pulmonary nodule from apocrine gland anal sac adenocarcinoma at the time of presentation with no nodal metastasis identified, which is atypical compared to previous reports.

Radical prostatectomy outcomes of prostate cancer cases: Insights from a leading surgeon's experience in Azerbaijan.

Prostate cancer is a significant health concern worldwide and ranks as the 4th most frequent cancer among men in Azerbaijan. While robot-assisted laparoscopic radical prostatectomy is the preferred surgical technique in many countries, open retropubic radical prostatectomy (ORP) remains the primary treatment option in Azerbaijan due to limited access to robotic surgical systems. This study aims to analyze the outcomes of ORP in patients with local and locally advanced prostate cancer. We retrospectively evaluated 95 men who underwent extraperitoneal retropubic ORP for prostate cancer at our center between May 2020 and December 2023. Comprehensive data on patient demographics, preoperative parameters, surgical details, and postoperative outcomes were collected. Statistical analyses were conducted using IBM SPSS 27.0 software. The mean age of the patients was 65.9 years. The median preoperative PSA level was 14.8 ng/mL, and lymph node enlargement was identified in 29.5% of patients. A rectal injury occurred in one patient (1.1%) as the only intraoperative complication. The mean intraoperative blood loss was 330 mL, and the median hospital stay was 6 days. A positive surgical margin was observed in 38.9% of cases. Diabetes mellitus and higher intraoperative blood loss were associated with prolonged hospital stays (≥ 7 days). Erectile dysfunction was reported in 52.6% of patients 6 months postoperatively, while urinary incontinence was observed in 2.2%. ORP outcomes in Azerbaijan are comparable to those reported for laparoscopic and robot-assisted techniques in terms of perioperative and oncological results. Despite the absence of advanced surgical technology, ORP remains an effective treatment option for prostate cancer when performed by experienced surgeons.

Desmoplastic Small Round Cell Tumor: a study of CT, MRI, PET/CT multimodal imaging features and their correlations with pathology

PurposeExploring the computed tomography (CT), magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography (FDG-PET)/CT Multimodal Imaging Characteristics of Desmoplastic Small Round Cell Tumor (DSRCT) to enhance the diagnostic proficiency of this condition.MethodsA retrospective analysis was performed on clinical data and multimodal imaging manifestations (CT, MRI, FDG-PET/CT) of eight cases of DSRCT. These findings were systematically compared with pathological results to succinctly summarize imaging features and elucidate their associations with both clinical and pathological characteristics.ResultsAll eight cases within this cohort exhibited abdominal-pelvic masses, comprising six solitary masses and two instances of multiple nodules, except for one case located in the left kidney, the remaining cases lacked a clear organ source. On plain images, seven cases exhibited patchy areas of low density within the masses, four cases showed calcification within the masses. Post-contrast imaging displayed mild-to-moderate, uneven enhancement. Larger masses displayed patchy areas without significant enhancement at the center. In the four MRI examinations, T1-weighted images exhibited uneven, low signal intensity, while T2-weighted images demonstrated uneven high signal intensity. Imaging unveiled four cases of liver metastasis, four cases of ascites, seven cases of lymph node metastasis, three cases of diffuse peritoneal thickening, and one case involving left ureter invasion with obstruction. In the FDG-PET/CT examinations of seven cases, multiple abnormal FDG accumulations were observed in the abdominal cavity, retroperitoneum, pelvis, and liver. One postoperative case revealed a new metastatic focus near the colonic hepatic region. The range of maximum standardized uptake values (SUVmax) for all lesions are 6.62–11.15.ConclusionsDSRCT is commonly seen in young men, and the imaging results are mostly multiple lesions with no clear organ source. Other common findings include intratumoral calcification, liver metastasis, ascites, peritoneal metastasis, and retroperitoneal lymph node enlargement. The combined use of CT, MRI and FDG-PET/CT can improve the diagnostic accuracy and treatment evaluation of DSRCT. However, it is imperative to underscore that the definitive diagnosis remains contingent upon pathological examination.

Molecular genetic characterization of porcine reproductive and respiratory syndrome virus outbreak in Assam, India and neighbouring regions.

Porcine reproductive and respiratory syndrome (PRRS) is a significant swine disease with no effective vaccine due to high viral mutation rates. This study investigates a natural PRRS outbreak through molecular, pathological, and serological analyses. Nineteen affected pigs were clinically examined, and 10 underwent post-mortem examination. PRRS virus (PRRSV) presence was confirmed in all tissue samples by RT-PCR targeting open reading frame (ORF) 5 and ORF7 genes. Clinical signs, especially in boars and sows, included fever, appetite loss, movement reluctance, erythematous skin patches, vomiting, and abortions in sows. Post-mortem findings highlighted lung consolidation, severe lymph node enlargement, interstitial pneumonia with mononuclear cells, macrophage accumulation and necrotic cells in alveolar spaces. Multifocal myocarditis, lymphoid follicular degeneration, and follicular necrosis were observed in the tonsil, spleen, and lymph nodes. PRRSV-specific antibodies were detected in 32.75% of serum samples, confirming the outbreak. Phylogenetic analysis of the PRRSV-ORF5 and ORF7 genes revealed a close genetic relationship between the outbreak samples from Assam and recent outbreaks in Idukki, Kerala, India (2018), and neighbouring country China, indicating the circulation of Genotype 2 virus in Assam. However, the sequences showed some differences from the isolates of Mizoram, India. In conclusion, this study provides molecular and pathological evidence of a PRRSV outbreak, confirms the presence of PRRSV-specific antibodies and viral RNA, and shed light on the virus's genetic characteristics in India.

Sarcoidosis: Pathogenesis, Diagnosis, and Clinical Management

Introduction: Sarcoidosis is a multisystem inflammatory disease of unknown etiology. It is more common in women and in people suffering from obesity. A characteristic feature is the formation of non-sarcomatous granulomas, which could occure important organs. It could also present as an asymptomatic form, and its diagnosis may be made incidentally on a routine chest X-ray. Aim of the study: The aim of this study was to review the literature describing the disease sarcoidosis-its course, clinical forms, diagnosis and treatment. Methods and materials: : We reviewed the literature available in the PubMed database, using the key words: "sarcoidosis"; "granulomatosis’’; “cardiac sarcoidosis”; “neurosarcoidosis”; "pulmonary sarcoidosis''. Results: The most common form of sarcoidosis is pulmonary, with enlargement of hilar lymph nodes and parenchymal lesions. The disease could manifest itself in the form of skin lesions-specifically and non-specifically, ocular lesions, where nay most often appears as uveitis, usually bilateral, and could also involve the heart. Patients with neurosarcoidosis usually have involvement of the pituitary, hypothalamus, meninges and cranial nerves. Conclusion: The diagnosis of sarcoidosis is difficult because its symptoms are often nonspecific. Diagnosis is based on exclusion of other diseases and is confirmed through imaging, histopathological, and immunological tests. In most cases, the prognosis of sarcoidosis is positive, and the disease may resolve spontaneously or under treatment. Treatment of sarcoidosis depends on the severity of the disease and the involvement of specific organs, the most common treatment is glucocorticoids.

Fine Needle Aspiration Cytological Diagnosis of Primary Breast Large-Cell Neuroendocrine Carcinoma/Squamous Cell Carcinoma.

Primary breast large-cell neuroendocrine carcinoma (LCNEC)/squamous cell carcinoma (SCC), also referred to as mixed neuroendocrine/non-neuroendocrine neoplasms of the breast (Br-MiNENs), represents an exceedingly rare malignancy. We report the first case of primary breast LCNEC/SCC diagnosed via ultrasound-guided fine-needle aspiration (FNA) biopsy of the left supraclavicular and left internal mammary lymph nodes. The patient, a 40-year-old female, underwent a lumpectomy followed by breast-conserving surgery and was diagnosed with primary breast LCNEC. Notably, within merely four months following the breast-conserving surgery, PET-CT revealed lymph node enlargement, prompting the performance of FNA. FNA cytology of metastatic lymph nodes revealed two distinct tumor components, allowing for clear differentiation between LCNEC and SCC in the smear. The diagnosis was further corroborated by immunocytochemical (ICC) staining of the cell blocks. Subsequently, histopathological re-examination of the breast mass revealed occult SCC components comprising less than 1% of the tumor cells. Additionally, the case exhibited triple-negative breast cancer, with PIK3CA, TP53, RB1, and BCL2L11 mutations identified through next-generation sequencing (NGS). Br-MiNEN is exceedingly rare, and its cytological diagnosis poses significant challenges. It is recommended that a detailed and objective description of each tumor component and its proportion be provided. This report provides the first detailed description of the FNA cytology of LCNEC/SCC, thereby enhancing cytopathologists' comprehension of this tumor. Auxiliary studies, including ICC staining and molecular biology assays, are crucial for accurate diagnosis, therapy, and prognosis.

Isolation and Identification of Lumpy Skin Disease Virus.

Lumpy skin disease virus (LSDV), a member of the capripoxvirus genus, induces lumpy skin disease (LSD) in cattle and buffalo populations. The initial documentation of LSD dates back to 1929 in Zambia, with subsequent rapid dissemination within the cattle community in Africa and Asia. Described as the "smallpox" equivalent in cattle, LSD manifests through clinical features such as fever, extensive cutaneous nodules, body wasting, lymph node enlargement, and skin edema. Isolation of LSDV constitutes an important step in evaluating virulence and implementing disease control measures. Skin samples obtained from afflicted cattle serve as the primary source for LSDV isolation due to its tropism for epidermal cells. Other tissues, including blood, lung, spleen, and saliva samples, are also employed for viral isolation. This chapter presents protocols for the convenient isolation of LSDV, relying on the plaque formation phenotype and utilizing MDBK cells. Emphasis is placed on stringent quality control methodologies to identify isolated viruses through multiple techniques, facilitating further investigations such as the in vitro growth of isolated LSDV.

Centrilobular nodules are predictive chest CT findings related to adult T-cell leukemia/lymphoma development in human T-lymphotropic virus type I carriers

AIMTo evaluate predictive chest CT findings associated with the development of adult T-cell leukemia/lymphoma (ATLL) in human T-lymphotropic virus type I (HTLV-1) carriers. MATERIALS AND METHODSThis retrospective study examined 171 adult T-cell leukemia/lymphoma and 158 HTLV-1 carriers who were treated from November 2004 to April 2021. The radiological features of 888 chest CT scans in total were retrospectively assessed by two chest radiologists who were unaware of the underlying diagnoses, and compared between the groups. RESULTSIn patients with aggressive type ATLL (acute type and lymphoma type), lymph node enlargement was the most frequently observed abnormality (65.2%), followed by ground-glass opacity (33.3%) and pleural effusion (30.4%). In patients with indolent type (chronic type and smoldering type), lymph node enlargement and bronchiectasis were the most frequently observed abnormalities (5.6% and 5.6%, respectively). In each type, centrilobular nodules were observed in none and in one patient, respectively. In the 158 HTLV-1 carriers, centrilobular nodules (n=62; 39.2%) were the most frequently observed abnormality. Centrilobular nodules were significantly frequently observed in HTLV-1 carriers compared with ATLL patients. No HTLV-1 carrier with centrilobular nodules on CT developed ATLL during the duration of care. A comparative analysis between CT scans performed before ATLL development in ATLL patients and those of HTLV-1 carriers showed that no centrilobular nodules were observed on the pre-ATLL CT scans, and a statistically significant difference in centrilobular nodules was found between these two groups. CONCLUSIONThe presence of centrilobular nodules may be an indicative CT finding in HTLV-1 carriers who are less likely to develop ATLL.

Abnormal Breast Temperature and Cortical Enlargement of the Axillary Lymph Nodes Through the Thermography.

Breast thermography may be used for the early detection of breast diseases in women younger than 50 years. Performed breast thermography on a woman in her 20s, revealing an average temperature difference of about 1°C. Ultrasound imaging further identified a simple cyst and enlarged, vascularized lymph nodes in both axillae.

Prediction model construction of cervical central lymph node metastasis in papillary thyroid carcinoma combined with Hashimoto's thyroiditis utilizing conventional ultrasound and elastography.

When papillary thyroid carcinoma (PTC) is accompanied by Hashimoto's thyroiditis (HT), it is often challenging for preoperative ultrasound to distinguish between central lymph node enlargement caused by PTC metastasis and inflammatory reaction due to HT. However, central lymph node metastasis (CLNM) is closely associated with the risk of PTC recurrence after surgery. In this study, we developed a model to predict in patients with PTC combined with HT, based on conventional ultrasound characteristics and shear wave elastography (SWE) quantitative parameters of the primary lesion. We aimed to evaluate its predictive value to provide a useful reference for clinical decisions regarding central lymph node dissection. This retrospective study included ultrasound data for 181 PTC patients with concurrent HT (totaling 215 nodules), confirmed by surgical pathology at our hospital and routinely undergoing central neck lymph node dissection. All enrolled PTC patients were randomly divided into training and test groups at a 7:3 ratio. Then, patients in each group were further segregated into two distinct cohorts: the CLNM group and the non-CLNM group as per the gold standard of pathology assessment. Subsequent statistical analysis of conventional ultrasound characteristics pertaining to primary foci alongside quantitative parameters derived from SWE, facilitated the identification of independent risk factors associated with CLNM. Then, a nomogram model was constructed, and its predictive value was evaluated. The test group was used for internal validation. Univariate analysis results in the training group indicated that nodule size, multiplicity, location, capsular invasion, and Emax were significantly associated with CLNM (all P<0.05). Multivariate analysis further identified nodule size, multiplicity, location, capsular invasion, and Emax as independent risk factors for CLNM (all P<0.05). Based on the multivariate analysis results, a nomogram model was developed to predict the occurrence of CLNM in PTC patients with HT. Receiver operating characteristic (ROC) curve analysis showed high predictive accuracy for CLNM, with an area under the ROC curve (AUC) of 0.837 in the training group and 0.882 in the test group. Calibration curves demonstrated good fit, closely aligning with the diagonal, indicating strong consistency in predicting CLNM. The nomogram model, based on primary lesion ultrasound characteristics and SWE quantitative parameters in PTC patients with HT, may aid clinicians in preoperatively predicting the likelihood of CLNM in PTC patients.

Clinical and chest CT manifestations of Talaromycosis marneffei: a retrospective study comparing anti-IFN-γ autoantibodies-positive and HIV-positive cases

BackgroundTo explore the clinical and chest CT features of Talaromycosis marneffei (TSM), and to compare the differences between anti‑IFN‑γ autoantibodies‑positive and HIV-positive cases.MethodsClinical data and chest CT images of 54 HIV-negative patients with Talaromyces marneffei (TM) infection and positive anti-interferon-γ (anti-IFN-γ) autoantibody were retrospectively analyzed. Ninety-three HIV-positive patients with TM infection during the same period were included as controls. Differences between groups were compared by the two-sample t-test and the Mann-Whitney U test, respectively.ResultsThe time from symptom onset to diagnosis of TSM with positive anti-IFN-γ autoantibodies was significantly longer than that of controls (P < 0.001). BALF/sputum and lymph nodes were the better specimens for detecting TM in the anti-IFN-γ autoantibody-positive group, while TM were more often isolated or detected in blood samples in the other group. Patients with TM infection tended to present with cough, expectoration, and fever. Compared with controls, anti-IFN-γ antibody-positive patients with TM infection had a higher incidence of shortness of breath, skin lesions, joint pain, and high CD4/CD8 ratio (P < 0.05). There were only 1 and 6 cases with negative lung involvements in CT scans in anti-IFN-γ autoantibody-positive patients and HIV-positive patients with TM infection, respectively. In the remaining patients, chest CT manifestations were diverse, mainly presenting as fibrous cord‑like lesions, lymph node enlargement, and sporadic nodules. The incidences of patchy consolidation, air bronchogram, pleural effusion and pleural thickening were higher in anti-IFN-γ autoantibody-positive patients with TM infection than those of controls (P < 0.05).ConclusionsAnti-IFN-γ antibody positive patients with TM infection showed a longer diagnostic interval. clinical specimens from which TM was isolated or detected were different between the two groups. The clinical and imaging manifestations of patients with TM infection are characteristic.

Serous endometrial carcinoma metastatic to the sigmoid colon masquerading as a primary colon cancer detected by bowel obstruction

BackgroundThe majority of colorectal malignancies are primary tumors. Secondary tumors are rare, and colorectal metastasis from endometrial carcinoma is exceptionally uncommon. We report a case of serous endometrial carcinoma that metastasized to the sigmoid colon, initially presenting as a primary colon carcinoma due to bowel obstruction.Case presentationA 79-year-old woman presented with abdominal distention and constipation. Five years earlier, she had undergone an open total hysterectomy with bilateral salpingo-oophorectomy for endometrial serous carcinoma. A colonoscopy revealed stenosis encircling the entire sigmoid colon. Abdominal computed tomography demonstrated irregular wall thickening in the sigmoid colon with enhanced regional lymph node enlargement and upstream bowel dilatation. Peritoneal dissemination in the pelvis was also noted. To relieve the obstruction, two self-expanding metal stents were inserted. Subsequently, due to the presumed diagnosis of sigmoid colon carcinoma with peritoneal dissemination, an open left hemicolectomy with resection of the peritoneal dissemination was performed. Histopathological examination identified the colon tumor and peritoneal dissemination as metastatic serous endometrial carcinoma. Immunohistochemical studies showed the tumor cells were negative for CK7, CK20, and CDX2. No chemotherapy was administered, and 6 months post-operation, no recurrence was observed.ConclusionsMetastasis of endometrial carcinoma to the colon is extremely rare. Diagnosing a colon tumor as a metastasis from endometrial carcinoma is challenging during preoperative examinations. Therefore, in patients with a history of endometrial carcinoma, the possibility that the primary site might be the uterus should be considered.

18F]‐NOTA‐FAPI‐04 PET/CT downgraded the staging of a breast cancer patient and changed their treatment management

AbstractA 47‐year‐old woman underwent [18F]‐FDG and [18F]‐NOTA‐FAPI‐04 PET/CT to assess the staging of suspected axillary lymph node enlargement following breast‐conserving surgery. The imaging with these two PET agents revealed starkly contrasting results. Significant [18F]‐FDG uptake in the right axillary fossa, intrathoracic muscles, and clavicle lymph nodes led nuclear medicine physicians to suspect metastasis. However, no uptake of [18F]‐NOTA‐FAPI‐04 was observed. Subsequently, the patient underwent an ultrasound‐guided biopsy of the enlarged axillary lymph nodes, which pathologically confirmed the diagnosis as inflammation. After a multidisciplinary discussion, the patient received radiotherapy for the right breast and 2.15Gy/F×28F for the tumor bed. She was discharged following the completion of her radiotherapy. Accurate diagnosis and staging are pivotal in selecting the optimal clinical treatment for breast cancer patients. Notably, [18F]‐NOTA‐FAPI‐04 PET/CT downgraded this patient's staging, significantly influencing the treatment strategy.

A Case Report of Disseminated Nocardiosis

Objective: To summarize the clinical characteristics and treatment plan for a case of disseminated nocardiosis. Methods: The study summarized the clinical characteristics and treatment plan for a case of disseminated nocardiosis. Results: The primary symptoms of the patient included high fever and multiple enlarged lymph nodes. Chest computed tomography revealed a shadow of nodules in the upper lobe of the left lung, multiple nodules, and pleural effusion in both lungs. Additionally, bilateral blood cultures indicated the presence of Nocardia terpenica. The final diagnosis was disseminated Nocardia sp. infection. Upon admission, anti-infective treatment was initiated with sulfamethoxazole and linezolid. Conclusion: In patients with normal immune function, disseminated nocardiosis may present as high fever with lymph node enlargement, necessitating differentiation from lymphoma. This study reports on the diagnosis and treatment plan of a case of disseminated nocardiosis to enhance understanding and clinical management of this disease.

A rapid and simple clonality assay for bovine leukemia virus-infected cells by amplified fragment length polymorphism (AFLP) analysis.

Enzootic bovine leukosis (EBL) is routinely diagnosed based on external manifestations at the farm, such as the presence of tumors and/or general lymph node enlargement. However, due to the nonspecific clinical manifestations of EBL, over half of EBL cases are unrecognized at the farm, with most cases being diagnosed during postmortem inspection at the slaughterhouse. Early detection and monitoring of clonal expansion are necessary for managing EBL and reducing economic losses. In this study, we developed BLV-AFLP that represents a significant advancement in the diagnosis of EBL in cattle. This method can rapidly assess the clonal proliferation of BLV-infected cells, crucial for distinguishing between asymptomatic and EBL cattle. Additionally, tracking clonal dynamics offers insights into the disease's progression, potentially providing strategies for avoiding economic losses. Overall, as BLV-AFLP is a simple and rapid test for detecting EBL, it is feasible and efficient for routine veterinary practice.